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Biomedical subjects

H W Gray

Publications and source records attributed to H W Gray.

At least 55 records · Page 3Linked to original sources
PubMed1989

Hyperinsulinism associated with primary renal cell carcinoma.

A case is reported of a patient with symptomatic hyperinsulinism associated initially with a renal cell carcinoma and then later, with secondary deposits from the same tumor. Evidence points to a strong possibility of renal tumor involvement in the production of insulin hypersecretion.

Carcinoma, Renal Cell↗
PubMed1989

99mTc-nanocolloid bone marrow scintigraphy in prostatic cancer.

Bone marrow scintigraphy was performed in 23 patients with histologically proven carcinoma of the prostate, using a new radiopharmaceutical, Technetium-99m nanocolloid. The results suggest that although bone marrow scintigraphy is less sensitive than conventional bone scintigraphy in the detection of skeletal metastases from prostatic carcinoma, the technique may have a place in the management of patients with advanced metastatic disease, especially those who are anaemic, by identifying those patients at risk from myelosuppressive therapy.

Adult↗
PubMed1988

Imaging for infection: caution required with the Charcot joint.

Scintigraphic techniques for detecting bone infection can be misleading in neuroarthropathy (Charcot joint). Three patients showed strongly positive three phase bone and 67Ga imaging despite absence of osteitis. Indium labelled white cell imaging provided the correct information on each patient. The findings have important implications for the investigation of diabetic patients with suspected bone infection.

Adult↗
PubMed1987

Unusual causes of calf swelling--2. Rhabdomyolysis mimicking deep vein thrombosis.

A 55 year old woman with pain and swelling of the leg was heparinized on the basis of a clinically diagnosed ilio-femoral deep vein thrombosis (DVT). Subsequent investigation showed her to have extensive rhabdomyolysis of the leg. Rhabdomyolysis can mimic the appearance of deep vein thrombosis and this case further illustrates the importance of venography in the assessment of the swollen leg.

Diagnosis, Differential↗
PubMed1986

Are biochemical tests of thyroid function of any value in monitoring patients receiving thyroxine replacement?

To establish their role in monitoring patients receiving thyroxine replacement biochemical tests of thyroid function were performed in 148 hypothyroid patients studied prospectively. Measurements of serum concentrations of total thyroxine, analogue free thyroxine, total triiodothyronine, analogue free triiodothyronine, and thyroid stimulating hormone, made with a sensitive immunoradiometric assay, did not, except in patients with gross abnormalities, distinguish euthyroid patients from those who were receiving inadequate or excessive replacement. These measurements are therefore of little, if any, value in monitoring patients receiving thyroxine replacement. To stop doing thyroid function tests in these cases would result in considerable savings nationally in the cost of reagents in laboratories using commercial kits.

Adolescent↗
PubMed1986

The role of 99mTc HIDA cholescintigraphy in the diagnosis of acute gallbladder disease: comparison with oral cholecystography and ultrasonography.

Fifty-four patients with suspected acute cholecystitis underwent 99mTc HIDA cholescintigraphy, ultrasonography and oral cholecystography. The correct diagnosis was reached in 49 patients by cholescintigraphy (91%) in 35 (65%) by ultrasonography and in 45 (83%) by oral cholecystography. 99mTc HIDA cholescintigraphy provides a rapid accurate diagnosis with minimal discomfort to the patient and is the investigation of choice for patients with symptoms of acute gallbladder disease, particularly if early cholecystectomy is to be considered.

Acute Disease↗
PubMed1984

Reporting of ventilation perfusion images for pulmonary embolism: accuracy and precision.

Thirty-four hospital patients with suspected pulmonary embolism (PE) had ventilation perfusion (VP) imaging after pulmonary angiography to assess the performance of highly specific criteria for diagnosis of PE and to evaluate the precision of image reporting. A diagnostic result was obtained from VP imaging in 21 of 34 patients giving a sensitivity for PE of 80% and a specificity of 100% in this subgroup. Six of 11 patients with PE had an indeterminate study which reduced the overall sensitivity of the technique for PE in the whole group. A critical analysis of image reporting by two readers gave an 85% inter-observer agreement on ranking as diagnostic or indeterminate for PE (k 0.69) and 91%-94% agreement for consensus reproducibility (k 0.82). We conclude that the degree of accuracy and precision of reporting that can be obtained using specific criteria will provide a reliable diagnosis in a significant number of patients suspected of having PE. Consensus reporting by two readers is shown to be more reliable than individual reporting.

Angiography↗
PubMed1984

Successful localisation of parathyroid adenomata by thallium-201 and technetium-99m subtraction scintigraphy: description of an improved technique.

An improved method for parathyroid scanning using thallium-201 and technetium-99m subtraction imaging is described. The technique successfully localised ten of eleven parathyroid adenomas confirmed at neck exploration. Two false-positive studies were encountered in patients with no adenoma at operation, probably due to thyroid nodules. The technique was less successful in identifying diffusely hyperplastic parathyroid glands and was negative in a single patient with recurrent, functional parathyroid carcinoma.

Adenoma↗
PubMed1984

Scintigraphic evaluation of the painful prosthetic joint: a comparison of gallium-67 citrate and indium-111 labelled leucocyte imaging.

The radiopharmaceuticals gallium-67 and indium-111 labelled leucocytes have been compared in 15 patients with a painful joint prosthesis in an attempt to identify those patients with periprosthetic infection. Gallium-67 images were abnormal in five out of six patients with periprosthetic infection and normal in seven out of nine without evidence of infection. Indium-111 leucocyte images were abnormal in three out of six patients with infection and normal in all nine patients without infection. Indium-111 labelled leucocyte imaging is technically more difficult to perform than gallium-67 imaging. This, combined with the higher sensitivity of gallium-67 imaging for infection around a prosthetic joint, leads us to conclude that gallium-67 imaging is superior to indium-111 leucocyte imaging in identifying infection as a cause of a painful prosthetic joint.

Adult↗
PubMed1984

A comparison of computed tomography, ultrasound and scintigraphy in the diagnosis of alcoholic liver disease.

In 35 alcoholics with histologically proven liver disease, computed tomography (CT), grey scale ultrasonography and liver scintigraphy were evaluated for their abilities to detect an abnormal liver and to identify the patients with cirrhosis. Abnormal studies were present on CT in 83% of patients, in 64% on ultrasound and in 94% on scintigraphy. In 10 control patients specificity was 90% by CT, 100% by ultrasound and 70% by scintigraphy. CT and ultrasound were poor in identifying the alcoholics with cirrhosis. Scintigraphy suggested cirrhosis in all but one of the patients with this diagnosis. Similar images were obtained in half of the patients with fatty change without cirrhosis but, with the exception of one patient, this appeared to be due to co-existent hepatitis. The results suggest that scintigraphy is the best of the imaging tests for screening alcoholics for cirrhosis.

Fatty Liver, Alcoholic↗
PubMed1983

The "hot patella" sign: is it of any clinical significance? Concise communication.

The presence of the "hot patella" sign was evaluated in a prospective study of 200 consecutive bone scans, and in a review of scans from 148 patients with various metabolic bone disorders and 61 patients with lung carcinoma. The incidence was found to be 31%, 26% and 31% respectively. This sign is an extremely common scan finding and may be seen in association with a wide variety of disorders. It is concluded that this sign cannot be considered to be of diagnostic value.

Adult↗
PubMed1982

Incidence and detection of occult hepatic metastases in colorectal carcinoma.

Isotope liver scan, ultrasonography, and computed tomography of the liver were performed during the postoperative period in 43 consecutive patients undergoing laparotomy for colorectal carcinoma. Obvious hepatic metastases were detected in six patients at the time of surgery. Eleven patients considered to have a disease-free liver at laparotomy developed hepatic metastases during the two-year follow-up period. These patients were considered to have had occult hepatic metastases at the time of surgery. Postoperative isotope liver scan, ultrasonography, and computed tomography detected the presence of overt metastases in four, five, and six patients respectively. Of the 11 patients with occult metastases, isotope liver scan, ultrasonography, and computed tomography detected one, three, and nine respectively. These observations suggest that 29% of patients undergoing apparently curative resection for colorectal carcinoma possess occult hepatic metastases and that computed tomography is superior to ultrasonography and isotope liver scan in detecting them.

Colonic Neoplasms↗