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Biomedical subjects

J C Leonard

Publications and source records attributed to J C Leonard.

At least 91 records · Page 5Linked to original sources
PubMed1981

Differentiation of cholestatic jaundice in infants. Utility of diethyl-IDA.

Time-activity curves of technetium-labeled diethyl-IDA were used to evaluate 31 patients in an effort to differentiate infants with cholestatic jaundice. Results can be obtained rapidly with minimal radiation exposure and no known secondary effects. The combination of diethyl-IDA time-activity curves and gamma glutamyl transferase activity was found to discriminate biliary atresia from neonatal hepatitis. The group with neonatal hepatitis was characterized by abnormal, yet lower, gamma glutamyl transferase activities and diethyl-IDA time-activity curves which peaked within 1 minute of injection, yet decayed in a manner similar to cardiac activity. The group with biliary atresia was characterized by elevated gamma glutamyl transferase activities, hepatic peaks at 8 minutes and markedly delayed decay. In that early operative intervention is associated with increased survival in biliary atresia, prompt differentiation should improve prognosis.

Bile Ducts↗
PubMed1981

Assessment of hepatic function after hepato-porto-enterostomy for biliary atresia using Tc-diethyl-IDA.

A quantifiable biliary function index has been developed from analysis of hepatic time--activity curves. Diethyl-IDA, a technetium-labeled iminodiacetic acid was given intravenously 27 times in 11 patients with proven biliary atresia. An estimated bile bilirubin clearance index derived from the inscribed hepatic absorption and elimination curves appears to be a reliable indicator of bile bilirubin clearance. The actual bile bilirubin clearance, previously shown to be a major determinant of survival, was clinically correlated in five patients studied before and after surgery and confirms the experimental findings. The clearance index should allow objective assessment of the efficacy of surgery for biliary atresia.

Adolescent↗
PubMed1981

An evaluation of nuclear scanning in orthopaedic infections.

Making a diagnosis of osteomyelitis or septic arthritis in its early stages if often difficult but is extremely important if one is to reduce the morbidity of these diseases. Nuclear scintigraphy has been proposed as a means of making this early diagnosis with an accuracy rate in the literature that has varied from 85 to 100%. We reviewed 35 patients with osteomyelitis, septic arthritis, and cellulitis who had had nuclear scanning as a part of their initial workup. While we found a 77% accuracy rate, we found three false positives and five false negatives. In order to interpret the scintigraphic results of nuclear imaging accurately, one must be familiar with the mechanisms, both biochemical and physiological, that affect the variable uptake of the nuclear agents employed. Both "hot" and "cold" scans may have multiple causes.

Adolescent↗
PubMed1981

Thymic gallium-67 localization in pediatric patients on chemotherapy: concise communication.

Localization of Ga-67 in the thymus has been reported to occur in children. In our control group of 87 patients, 15% of children under 5 yr and 11% of children over 5 yr demonstrated thymic localization. In contrast, in our study group of seven children with acute lymphocytic leukemia or malignant lymphoma, lymphocytic diffuse, treated on a modified non-Hodgkin's lymphoma protocol, Sloan-Kettering LSA2-L2, thymic localization occurred during treatment in five of the seven. We conclude that increased thymic gallium localization in children under chemotherapy for a known malignancy may reflect increased activity of thymic medullary epithelial cells and regeneration of thymic lymphocytes during recovery form involution induced by certain chemotherapeutic agents.

Adolescent↗
PubMed1980

99m technetium sulfur colloid scanning in diagnosis of renal transplant rejection.

To evaluate the possible presence of rejection 37 99mtechnetium sulfur colloid imaging procedures were done on 17 renal transplant patients. There was good correlation between the clinical diagnosis and the results of the technetium sulfur colloid images, with no falsely positive studies in the series. An illustrative case and a review of pertinent literature confirm this technique to be an excellent method for the early detection of renal transplant rejection.

Colloids↗
PubMed1980

Gluceptate renal imaging: experience in a pediatric population.

Gluceptate renal imaging was performed to evaluate renal function and morphology in 50 pediatric patients (27 males, 23 females). Retrospective categorization revealed that 49% (27) of the studies were for functional evaluation, 27% (15) were for anatomic considerations and 23% (13) were of a miscellaneous nature. Thirty-one patients also underwent intravenous pyelograms (IVP) and in seven discordant cases gluceptate imaging provided correct information in five, compared with only one correct IVP. While both the IVP and gluceptate imaging provide clinical information concerning renal function and morphology, the ability to obtain blood flow data and to quantitate differential renal functional mass allows gluceptate imaging to define renal function more specifically than the IVP making a more meaningful diagnostic procedure for the evaluation of patients with known or suspected renal abnormalities.

Adolescent↗
PubMed1979

Anorexia nervosa in males.

Five cases of anorexia nervosa in males aged 13--23 years are described. Four patients presented to a general medical outpatient clinic with emaciation, and the fifth was diagnosed retrospectively. Sinus bradycardia was a useful pointer to the diagnosis, which was confirmed by the finding of characteristic psychopathological features of a relentless "pursuit of thinness", along with a fear of becoming obese.

Adolescent↗
PubMed1979

Pulmonary cytomegalovirus infection: detection by Gallium 67 imaging in the transplant patient.

Cytomegalovirus (CMV) infeciton is a frequent complication during the first few months following renal transplantation. The diagnosis is sometimes difficult but may be made by viral culture, a fourfold rise in the CMV antibody titer, or by demonstration of the CMV inclusions in the affected tissue. An increased pulmonary uptake of galliulm citrate Ga 67 has been demonstrated following renal transplantation in two patients, each of whom had a fourfold rise in CMV complement fixing antibody titer, one of whom additionally had CMV inclusion bodies in a lung biopsy specimen prior to clinical or radiological demonstration of the pulmonary involvement. Gallium imaging, therefore, appears to be a valuable noninvasive test for early diagnosis of CMV pulmonary infections.

Adolescent↗
PubMed1979

Dissecting aortic aneurysms: a clinicopathological study. I. Clinical and gross pathological findings.

One hundred and seventy-one patients with dissecting aneurysm seen between 1951 and 1976 at three hospitals in Manchester were studied. There were 60 proximal dissections, 80 distal dissections, 10 abdominal dissections and in 21 the site of origin was uncertain. Pain was the major symptom in 88 per cent of patients; radiation of pain to the interscapular region was much more common in distal dissections. Systemic hypertension was present in 77 per cent, being commoner in distal dissections (83 per cent) than in proximal dissections (70 per cent). Aortic incompetence, hemiplegia and shock were all more common in proximal dissections. Post-mortem examination was performed in 125 patients. Eighty-four per cent of proximal dissections had ruptured, 74 per cent into the pericardium and five per cent into the left pleural cavity. Seventy per cent of distal dissections had ruptured, 11 per cent into the pericardium and 41 per cent into the left pleural cavity. The extent of the dissection was analysed, and it was shown that 25 per cent of distal dissections had extended proximally into the ascending aorta and arch. This implies that diagnosis of the site of origin of dissection from clinical signs and the plain chest-radiograph is inaccurate. Aortography is required for precise assessment. Since treatment often varies with the site of dissection, aortography should be performed in most patients surviving the first few hours. Attention is drawn to the frequency (10.4 per cent) of multiple aortic lesions, and to the occasional aetiological significance of giant-cell arteritis, and, possibly, hypothyroidism.

Adult↗
PubMed1979

Dissecting aortic aneurysms: a clinicopathological study. II. Histopathology of the aorta.

The aortas from 83 patients with dissecting aneurysm were studied histologically. There were two examples of giant-cell arteritis, one of non-specific arteritis and one of syphilis. Apart from these, no constant feature was found in the cases of dissection when compared with 20 controls. In particular there was no difference in the grades of cystic medial necrosis, medionecrosis and fibrosis. Focal fragmentation of elastica was present in the majority of dissections (63 per cent) but similar abnormalities were seen in most controls (85 per cent). The vasa vasorum showed no special features in dissection. Intimal fibrosis and intimal longitudinal muscle were present in both groups studied. Sixteen cases showed 'old' dissections as manifest by either granulation tissue or fibrosis. The histopathological features of the four cases diagnosed clinically as having Marfan's syndrome did not differ from controls.

Adult↗
PubMed1979

Renal cortical imaging and the detection of renal mass lesions.

Tc-99m gluceptate renal imaging was compared with the intravenous urogram in 41 patients. While the specificity of the examination was essentially the same for both techniques, the sensitivity for the detection of renal mass lesions was better with gluceptate imaging. The study suggests the desirability of a shift in emphasis from the IVU to the Tc-99m gluceptate scintigram in the early evaluation of suspected renal mass lesions, and merits further clinical evaluation.

Adolescent↗