Biomedical subjects
Publications and source records attributed to J E Haines.
Teleradiology networks transmit digital radiographic images from one location to another. These networks are wide area networks. Teleradiology networks are used for diagnostic purposes and preview tasks. Wide area networks for teleradiology use public service switching. The use of fiber optics networks provide reduced costs and increased flexibility. An example is presented that compares the cost of teleradiology networks.
A woman was admitted to the hospital after blunt abdominal trauma. Initial ultrasound was equivocal but suggested a localized hepatic laceration. The patient was discharged but returned three weeks later with ascites and mild pain in the right upper abdominal quadrant. Hepatobiliary imaging identified a large bile leak originating from the porta hepatis but showed no evidence of parenchymal injury. No hepatic injury was found at surgery, but a laceration of the right hepatic duct was identified. Hepatobiliary imaging is the procedure of choice in diagnosing bile leaks from the extrahepatic biliary system.
To improve ease of use, precision, and reduce interobserver variability of the 67Ga lung index, we developed and tested a computer method that yields similar numeric values and uses previous indexing principles, except that the computer matrix unit is the fractional area assessed. Patients were referred for suspected interstitial lung disease. Fifty-three image studies were available for both manual and computer indexing. Linear regression analysis gave a correlation of 0.884. Decision matrix analysis of 58 different nonimmunosuppressed patients resulted in 93% sensitivity and 76% specificity. Receiver operating characteristic curve analysis showed that the ideal index cutoff was 50. Because there is tighter control over 67Ga uptake intensity and spatial distribution assessment, the computerized 67Ga index appears to perform better than the manual analysis.
Bilateral cervical masses were observed in two newborn, male, rhesus macaques. The clinical diagnosis was congenital goiter. Thyroid function screening tests revealed that the affected monkeys had normal triiodothyronine levels, low thyroxine values, and elevated thyroid-stimulating hormone levels. Radioactive iodine uptake and perchlorate discharge tests indicated a postorganification defect. A third, male, rhesus macaque, stillborn after a prolonged gestation, also had bilateral cervical masses. Necropsy and histopathology examinations confirmed the masses were enlarged, hyperplastic thyroid glands. Each affected infant had the same parents.
Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.
Results of initial clinical trials of brain tumor chemotherapy after osmotic blood-brain barrier disruption are promising. In general, the procedure is well tolerated. The major complication has been seizures. In this report, data are presented which indicate that the etiology of these seizures is related to the use of contrast agent (meglumine iothalamate) to monitor barrier modification. A series of 19 patients underwent a total of 85 barrier modification procedures. Documentation of barrier disruption was monitored by contrast-enhanced computed tomographic (CT) scanning, radionuclide brain scanning, or a combination of both techniques. In 56 procedures (19 patients) monitored by enhanced CT, seizures occurred a total of 10 times in eight patients. Twenty-three barrier modification procedures (in nine of these 19 patients) documented by nuclear brain scans alone, however, resulted in only one focal motor seizure in each of two patients. In eight of the 19 patients who had seizures after barrier disruption and enhanced CT scan, four subsequently had repeat procedures monitored by radionuclide scan alone. In only one of these patients was further seizure activity noted; a single focal motor seizure was observed. Clearly, the radionuclide brain scan does not have the sensitivity and spatial resolution of enhanced CT, but at present it appears safer to monitor barrier modification by this method and to follow tumor growth between barrier modifications by enhanced CT. Four illustrative cases showing methods, problems, and promising results are presented.
A male Pickwickian syndrome patient was admitted to the hospital with sudden onset of abdominal pain. Physical examination was equivocal. Due to patient's ileus and morbid obesity (weight 450 lb), neither TCT scan nor ultrasound was possible. A Tc-99m PIPIDA hepatobiliary imaging study revealed intraperitoneal leakage of radioactive bile with collection of the activity in both abdominal gutters, indicating gallbladder rupture. Prompt surgery confirmed the diagnosis.
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In a patient with right-sided stomach and malrotation of the small bowel and cecum visualized by gastrointestinal x-ray studies using barium, a right-sided spleen was demonstrated by 99mTc-sulfur colloid and 51Cr-labeled red blood cell imaging. The sulfur colloid study also demonstrated that the liver was in its usual right upper quadrant location.
A characteristic liver scintigraphic finding was observed in a 2-month-old infant with hepatic herniation through a right-sided posterolateral congenital diaphragmatic defect (Bochdalek). The liver scintigrams showed an oblique band of decreased radioactivity dividing the liver into an inferior anteromedial portion and a superior posterolateral portion. In spite of the markedly abnormal liver scintigram, other diagnostic studies, including pneumoperitoneum abdominal radiography, remained negative. The liver scintigram can provide life-saving information in the diagnosis of congenital diaphragmatic hernia, as in the present case. The distinctive liver-scan findings among the various types of common diaphragmatic hernias are also briefly reviewed.
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