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Biomedical subjects

I Surveyor

Publications and source records attributed to I Surveyor.

At least 19 recordsLinked to original sources

67Ga uptake at sites of heterotopic calcification: a report of three cases.

Heterotopic calcification occurs commonly in spinal cord injured patients and following joint trauma or surgery. 99Tcm-methylene diphosphonate is useful in the detection of these lesions, many of which are subclinical. Three patients are presented with heterotopic calcification, one with severe hypoxic encephalopathy and two following major trauma. Intense 67Ga uptake within areas of heterotopic calcification was noted in all three patients. Two of the patients also underwent 99Tcm-methylene diphosphonate bone scanning and showed uptake of the bone agent corresponding to the areas of 67Ga uptake. In predisposed patients, heterotopic calcification should be considered in the differential diagnosis of a focal area of 67Ga uptake.

Adult

Comparison of two yttrium-90 regimens in inflammatory and osteoarthropathies.

Two yttrium-90 (90Y) radiosynovectomy procedures were compared. One procedure, performed at the Royal Perth Rehabilitation Hospital (RPRH) required a shorter immobilisation time than that performed at the Sir Charles Gardiner Hospital (SCGH). There were no significant differences in outcome between the two procedures for the groups with inflammatory and osteoarthropathy. Thirty two patients (45 joints) with inflammatory arthropathy were treated (25 with rheumatoid arthritis, three with psoriatic arthritis, two with ankylosing spondylitis, and two with unspecified inflammatory arthropathy) and 40 patients (58 joints) with osteoarthropathy. A separate assessment of local lymph node spread in patients treated by the RPRH showed a minor spread of 90Y in one of 37 joints assessed. A marked improvement in the patient evaluation scores in the inflammatory arthropathy group at three months persisted at 12 months. Good lasting responses were more common in patients with inflammatory arthropathy with a normal joint or early radiological disease. A marked improvement in the pain and evaluation scores occurred at three months in the group with osteoarthropathy but had disappeared by six months after treatment.

Arthritis, Psoriatic

The 14C-urea breath-test for the detection of gastric Campylobacter pylori infection.

A breath-test has been developed for the detection of gastric infection with Campylobacter pylori. Urea that is labelled with carbon 14 is administered to a fasting patient and the patient's breath is sampled for radioactivity over the following 30 minutes. If C. pylori is present in the patient's stomach, urease activity causes hydrolysis of the urea and the 14C is absorbed as carbon dioxide. This carbon dioxide enters the patient's bicarbonate pool and eventually is excreted in the breath. The results are expressed as a percentage of the administered dose/mmol carbon dioxide x kg body weight. Sixty-three patients who were undergoing endoscopy were studied. The radioactivity in exhaled breath which was sampled within five minutes of 14C-urea administration was attributed to the presence of urease enzyme in mouth organisms and was discounted. The time-radioactivity curves for breath samples from five to 30 minutes after the administration of 14C-urea gave an excellent separation between subjects with negative results of the examination of gastric-biopsy samples and patients with microbiological and histological evidence of infection with C. pylori. The area under the time-radioactivity curve at between five and 30 minutes after the administration of 14C-urea in 24 patients with negative microbiological results was 6.9 +/- 4.4 area units; in 35 of 39 patients with positive microbiological results, this area was greater than 40 area units. Measured against the results of the microbiological examination of gastric-biopsy samples, the sensitivity of breath-testing was 90% and the specificity was 100%. Measured against the results of histological examination for the presence of C. pylori infection, breath-testing had a sensitivity of 94% and a specificity of 93%. A positive breath-test result also correlated well (P = 0.0001) with the serological antibody test-result. The role of non-invasive tests--enzyme-linked immunosorbent assays and 14C-urea breath-testing--in the management of gastritis and peptic ulcer disease is discussed. We consider that the 14C-urea breath-test has an important role in the noninvasive confirmation of gastric infection with C. pylori and in the follow-up of patients after treatment.

Adult

Imaging Yttrium-90 synovectomy studies.

The method of planar imaging utilizing Bremsstrahlung radiation in patients treated with intraarticular Yttrium-90 for joint synovitis is described, illustrated and discussed.

Brachytherapy

Carbon-14 urea breath test for the diagnosis of Campylobacter pylori associated gastritis.

Urease in the human gastric mucosa is a marker for infection with Campylobacter pylori (CP), an organism suspected of causing chronic gastritis and peptic ulceration. To detect gastric urease, we examined 32 patients who were being evaluated for possible peptic ulcer disease. Fasting patients were given 10 microCi (370 kBq) of 14C-labeled urea. Breath samples were collected in hyamine at intervals between 1 and 30 min. The amount of 14C collected at these times was expressed as: body weight X (% of administered dose of 14C in sample)/(mmol of CO2 collected). The presence of C. pylori colonization was also determined by examination of multiple endoscopic gastric biopsy specimens. On average, patients who were proven to have C. pylori infection exhaled 20 times more labeled CO2 than patients who were not infected. The difference between infected patients and C. pylori negative "control" patients was highly significant at all time points between 2 and 30 min after ingestion of the radionuclide (p less than 0.0001). The noninvasive urea breath is less expensive than endoscopic biopsy of the stomach and more accurate than serology as a means of detecting Campylobacter pylori infection. Because the test detects actual viable CP organisms, it can be used to confirm eradication of the bacterium after antibacterial therapy.

Breath Tests

Early cerebral blood flow and computerized tomography in predicting ischemia after cerebral aneurysm rupture.

Cerebral blood flow (CBF) was measured during the 1st week of subarachnoid hemorrhage in 46 patients who were in a good clinical grade and had a proven ruptured intracranial aneurysm. The mean initial CBF in patients who developed cerebral ischemia was 42 ml/min-1/100 gm brain-1, which was significantly lower than in patients who did not develop cerebral ischemia (49 ml/min-1/100 gm brain-1). This reduced CBF was not secondary to raised intracranial pressure or angiographic spasm. Patients with a reduced CBF (less than 50 ml/min-1/100 gm brain-1) and diffuse subarachnoid blood on computerized tomography had a very high incidence (78%) of cerebral ischemia, despite a good clinical grade at the time of measurement. Serial CBF measurements are of value in monitoring the evolution of cerebral vasospasm.

Cerebrovascular Circulation

Demonstration of functioning heterotopic splenic autografts by scintigraphy.

The use of heterotopic splenic autografts is demonstrated as a means of preserving functioning splenic tissue in 15 patients undergoing splenectomy for trauma. In all patients, functioning splenic autografts could be shown by scintigraphy, using 99mTc-labelled erythrocytes or 99mTc-labelled sulphur colloid, performed 12 weeks after implantation.

Adult

Exercise testing and thallium-201 myocardial imaging in relation to coronary artery disease in patients with severe aortic valve disease.

Thirty-three patients with aortic valve disease, fifteen with regurgitation, eleven with stenosis and seven with mixed disease, undergoing assessment for valve replacement which included adequate coronary angiography, were studied. A symptom limited graded treadmill exercise test was undertaken with administration of 40-70 MBq of 201Tl. Myocardial imaging was started within 15 minutes and repeated after four hours using a 37 PM tube Searle gamma camera. Myocardial images were read independently by three observed. Of the 33 sets of images, 21 were -ve, 5 +ve, 2 I (Indeterminate) and 5 D (Difference of opinion). Eight of the 33 patients had significant coronary artery disease (CAD) and of these three were scored +ve (all triple vessel). Two patients without CAD were scored +ve. Eight subjects developed angina during exercise testing, of whom four had CAD, and four with CAD did no develop angina. Historically, 13 of the 33 subjects had typical angina, six having CAD; an additional eight had other significant chest pain, two having CAD. In these subjects with severe aortic valve disease, exercise testing and myocardial imaging with 201 TI was of little value in detecting CAD. All patients with CAD gave a history of significant chest pain.

Adult

Gluten enteropathy occurring in chronic hepatitis.

Steatorrhoea and subtotal villus atrophy due to gluten enteropathy was found to occur in a 27 year old female, who had histologically proven chronic active hepatitis six years ago. She had abnormal elevation of immunoglobulins IgG, IgM, and IgA, decreased level of complement C4 and a positive test for HLA-B8. The SGOT was persistently mildly elevated, but her latest liver biopsy (6 years after onset) showed only changes of chronic persistent hepatitis. She had good symptomatic and histological (jejunal biopsy) improvement with gluten-free diet.

Adult

The radioisotope spleen scan in the assessment of patients with suspected spleen trauma.

The radioisotope spleen scan was reviewed in 29 patients with suspected trauma of the spleen who had been admitted for observation to a surgical ward. At the time of the study, all patients had stable pulse rates and blood pressures. The scans of six patients showed space defects and, of these, splenic injury was subsequently proven operatively in five patients. As a detector of splenic trauma, the radionuclide scan proved to be reliable. Although the findings of radioisotope scanning are not specific for trauma, the interpretation of the scan in conjunction with other observations increases the accuracy of diagnosis.

Adolescent