BACKGROUND: Radiotracers have become a routine technical component of the new procedure of intraoperative lymphatic mapping and selective lymphadenectomy. Because different colloids have differing physicochemical properties, their distribution and uptake may be different. For this reason, the optimal colloid to identify and localize the sentinel node remains controversial. METHODS: Nineteen consecutive patients with cutaneous malignancies underwent diagnostic lymphoscintigraphy with 99mTc-labeled human serum albumin (99mTc-HSA) and preoperative lymphoscintigraphy with 99mTc-labeled sulfur colloid (99mTc-SC). The results of intraoperative lymphatic mapping and selective lymphadenectomy were reviewed. RESULTS: Intraoperative lymphatic mapping and selective node dissection were successful in 21 of 22 lymphatic basins (18 of 19 patients). There was excellent correlation between the "hot" marker placed on the skin surface when 99mTc-HSA was used compared with the use of 99mTc-SC. In 20 of 21 lymphatic basins the sentinel node both was "hot" and was stained with isosulfan blue. CONCLUSIONS: No discernible difference between the ability to localize in the sentinel node with these two radiocolloids was identified. For logistical reasons, 99mTC-SC appears to be the colloid of choice in intraoperative lymphatic mapping.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Hemolytic anemia associated with cold agglutinin during chickenpox and a review of the literature.

PURPOSE: To describe the findings and cause of anemia and jaundice in a 2-year-old boy. PATIENT AND METHODS: This boy was admitted with a hemoglobin of 7.8 g/dL, a bilirubin of 1.8 mg/dL, and increased urobilinogen. RESULTS: On the second day after admission, hemolytic anemia associated with an anti-I cold agglutinin was diagnosed, which was transient and recovered without any treatment. CONCLUSION: This is a very rare complication of chickenpox; only five cases have been previously reported and these were all characterized by anti-Pr cold agglutinin with hemolytic anemia after the onset of chickenpox. We report the first case of hemolytic anemia associated with an anti-I cold agglutinin during the incubation period of chickenpox.

Adult↗

PubMedDate not supplied

Enzyme-linked immunosorbent assay of carbamoylphosphate synthetase I: plasma enzyme in rat experimental hepatitis and its clearance.

Carbamoylphosphate synthetase I (CPS I), a urea cycle enzyme, is located almost exclusively in the mitochondria of hepatocytes. The enzyme is unique in that it constitutes about 2-6% of total liver protein and is composed of a large subunit of 160 kD. We developed a sensitive enzyme-linked immunosorbent assay (ELISA) for measurement of the enzyme in plasma using an antibody against the rat enzyme. In galactosamine-induced rat acute hepatitis, plasma concentration of CPS I that was 1-2 micrograms/ml blood before the treatment, increased up to 125 micrograms/ml blood in 24 h after the treatment and decreased to a near control level in 72 h. Plasma concentration of ornithine carbamoyl-transferase (OCT), another urea cycle enzyme, reached a maximum in 24 h and then decreased a little more rapidly than that of CPS I. On the other hand, alanine aminotransferase activity reached a maximum in 36 h and decreased to a normal level in 96 h. In immunoblot analysis, the native CPS I polypeptide of 160 kD and its fragments of 140 and 125 kD were detected 24-48 h after the treatment. When purified rat CPS I and bovine OCT were injected intravenously into rats, the enzymes disappeared from blood roughly exponentially with apparent half-lives of about 67 and 18 min, respectively. Development of an ELISA for human CPS I and determination of the serum enzyme in various liver diseases remain to be performed.

Acute Disease↗

PubMedDate not supplied

Transient late neonatal hypocalcemia with high serum parathyroid hormone.

We report two patients with transient late neonatal hypocalcemia. Serum examination showed low calcium (Ca), high phosphorus, high parathyroid hormone (PTH), normal 25-hydroxyvitamin D and low or normal 1,25-dihydroxyvitamin D (1,25(OH)2vitD) levels. PTH infusion test revealed normal cyclic AMP production. In these patients, 1,25(OH)2vitD production by PTH, or Ca mobilization from bone and Ca absorption from intestine by PTH and 1,25(OH)2vitD might have been disturbed transiently due to developmental immaturities. This is a new type of transient late neonatal hypocalcemia with high serum PTH levels.

Calcifediol↗

PubMedDate not supplied

[Myocardial ischemia and abnormality of cardiac sympathetic nervous function in apical hypertrophic cardiomyopathy].

Exercise 201Tl myocardial scintigraphy of patients with apical hypertrophic cardiomyopathy (AH) often shows transient perfusion defect in the apex. Catecholamine may be related to the pathogenesis of AH, but this is not certain. The relationship between hypertrophy, myocardial ischemia, and cardiac sympathetic nervous function were investigated by comparing 123I-MIBG myocardial SPECT with exercise 201Tl myocardial SPECT especially at the apex which is the hypertrophic region. Seventeen patients with AH, mean age of 53 +/- 11 years old, underwent 123I-MIBG myocardial SPECT and exercise 201Tl myocardial SPECT on separate days. Decreased tracer uptake regions and the severity and extent of the defect were evaluated visually and compared. Myocardial clearance of 123I-MIBG in apical, midventricular, and basal regions was calculated from the bull's eye display. 123I-MIBG SPECT showed a decreased uptake or defect in the apex of all patients. 201Tl SPECT showed a reversible perfusion defect in the apex of 10 patients, an irreversible perfusion defect in the apex in 3, and normal perfusion in 4. Comparing decreased uptake on the exercise 201Tl myocardial image and 123I-MIBG 4-hour delayed image, the severity of the defect was: MIBG > Tl in 12 patients (71%), MIBG = Tl in 5 (29%), and the extent of the defect was: MIBG > Tl in 11 (65%), MIBG = Tl in 6 (35%). Mean clearance of 123I-MIBG in the apical and midventricular regions was significantly higher than that in the basal region (apical 46.2 +/- 7.1%, midventricular 44.4 +/- 7.8%, basal 38.7 +/- 7.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

3-Iodobenzylguanidine↗