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Biomedical subjects

L Rosenthall

Publications and source records attributed to L Rosenthall.

At least 19 recordsLinked to original sources
PubMed1995

A correlative study of ultrasound calcaneal and dual-energy X-ray absorptiometry bone measurements of the lumbar spine and femur in 1000 women.

The objectives of the study were firstly to determine the accuracy of ultrasound calcaneal measurements in the prediction of bone mineral density determinations with dual-energy X-ray absorptiometry (DXA) of the lumbar spine (LS), femoral neck (FN), and Ward's triangle (FW) in a mixed population of 1000 women, unsorted as to diagnosis, and secondly to determine the accuracy of the various site-specific measurements in predicting each other. Ultrasound measurements [stiffness, speed of sound (SOS) and broadband ultrasound attenuation (BUA)] were made with the Lunar Achilles device, and the bone mineral density (BMD) of the LS, FN and FW were determined with the Lunar DPX. The data were analyzed for correlation, sensitivity, specificity, and accuracy of various paired sites. The coefficients of correlation of the young adult t-scores in the total group between calcaneal stiffness and BMDs of the LS, FN, and FW varied between 0.53 and 0.60. Coefficients for LS versus FN and FW were 0.70 and 0.62, respectively. A comparison of SOS and BUA values obtained at the calcaneus with BMDs of the LS, FN and FW yielded correlation coefficients that varied from 0.54 to 0.56. The general accuracy of prediction of one site by another ranged from 64.2% to 74.4%, where normality was defined as a t-score > -2. It is concluded that no site can predict the status of another site with sufficiently high accuracy to be clinically useful. The role of ultrasound transmission in bone as a predictor of fracture risk is theoretically promising, but has yet to be proved by a long term prospective study.

Absorptiometry, Photon↗
PubMed1995

A new thrombus imaging agent. Human recombinant fibrin binding domain labeled with In-111.

The amino-terminal domain of fibronectin has a fibrin binding site and a site for covalent cross-linking to fibrin. This fibrin binding domain was isolated from human recombinant fibronectin and labeled with In-111; the final molecular weight was 12 kD. It was applied to a pilot study of 62 patients; 30 who were thought to have deep vein thrombosis and 32 controls. All 30 patients had either impedance plethysmography, duplex ultrasound, contrast venography, or various combinations of the three. Eight disagreements in the 30 patients suspected of having deep vein thrombosis were registered between fibrin binding domain imaging and the other examinations. Three of the patients with negative scan results had clots that were 1 week old or older, and this may be a limitation of the technique. In three other patients who had negative scan results, but positive alternative studies, there was a history of previous episodes of deep vein thrombosis and this could be a cause of false-positive results in the other modalities. There was one documented false-negative scan in a fresh clot. Normal scans were obtained in the lower extremities of the control patients, except in two who demonstrated uptake at the sites of insulin injections. The initial results of this feasibility study are encouraging and warrant further investigation.

Fibronectins↗
PubMed1995

Splenosis.

Explore the source record for details and available documents.

Adolescent↗
PubMed1993

Radiophosphate imaging and bone densitometry in renal osteodystrophy.

The histologic features of renal osteodystrophy vary from dialysis osteomalacia to osteitis fibrosa cystica. Commensurate with this, the number of osteoblasts and osteoclasts changes with the stage of the disease; the osteoblasts are virtually absent in dialysis osteomalacia and are numerous in osteitis fibrosa. Radiophosphate accretion in bone increases with increasing osteoblastic activity, and the bone mineral status is determined by the net difference in osteoblastic and osteoclastic activity. The application of radionuclide imaging and dual radiographic absorptiometry mineral measurements in patients with renal osteodystrophy, renal transplants, and following parathyroidectomy for secondary hyperparathyroidism is reviewed.

Bone Density↗
PubMed1992

Panostotic fibrous dysplasia. A new craniotubular dysplasia.

The authors describe the radiographic-scintigraphic features of an unusual craniotubular dysplasia characterized by diffuse osteopenia with bone expansion and a "ground glass" appearance, markedly increased skeletal turnover, myelofibrosis, hypophosphatemia, and pigmented "coast-of-Maine" patches. This syndrome, termed panostotic fibrous dysplasia, is distinct from previously reported disorders.

Adolescent↗
PubMed1992

Radionuclide investigation of osteomyelitis.

The diagnosis of osteomyelitis in the presence of fracture and orthopedic appliances and in the diabetic foot can be a formidable challenge to radionuclide imaging. Radiophosphate is highly sensitive in detecting bone disease, but of low specificity; to improve specificity it must be complemented by 67Ga or radiolabeled leukocytes. These latter agents are not without limitations, and the search for new agents and novel imaging strategies continues. The relative roles of nuclear medicine and MR imaging are coming into focus, and a diagnostic algorithm based on the shortcomings of both methods is suggested.

Diabetes Complications↗
PubMed1992

Computed tomographic detection of skeletal muscle calcifications in rhabdomyolysis.

The authors report a case of rhabdomyolysis with extensive calcification of the paravertebral muscles secondary to ingestion of desipramine hydrochloride, a tricyclic antidepressant. Computed tomography (CT) and isotope scanning were performed, and pathological confirmation of the condition was obtained. The extent of the calcification was probably due to the administration of supplementary calcium to correct hypocalcemia. The authors discuss the correlation between the CT and isotope scan findings.

Adult↗
PubMed1991

Porous-coated acetabular component. Quantitative assessment of normal radiophosphate uptake as a function of implant age.

A computer-assisted quantitative analysis was undertaken of normal radiophosphate bone uptake adjacent to the porous-coated acetabular component in asymptomatic patients. Implants ranged from 1.6 to 49 months of age. In 62 hips, it was found that implants newer than 12 months of age had uptakes that were significantly greater than those 12 months or older. Between 12 and 49 months, there was no correlation with age, indicating a stabilization of the remodeling process.

Acetabulum↗
PubMed1991

Nuclear medicine techniques in arthritis.

An historical review of radionuclide applications to the assessment of synovitis is presented. Contemporary radiopharmaceuticals are grouped into vascular, bone, and inflammatory markers, and their clinical utility and efficacy in disclosing peripheral synovitis and osteoarthritis are surveyed. There is focus on the debate over the usefulness of quantitative sacroiliac joint measurements for screening sacroiliitis, the significance of the negative peripheral joint scan in patients presenting with polyarthralgia, and the suitability of the joint scan to monitor the response to medical treatment objectively.

Arthritis↗
PubMed1991

Quantitative analysis of radiophosphate uptakes in asymptomatic porous-coated hip endoprostheses.

A quantitative analysis of the uptake of radiophosphate adjacent to the femoral component of a porous-coated cementless prosthesis was undertaken in asymptomatic patients in order to establish normal temporal changes. The group consisted of 55 patients with 62 arthroplasties of 1.6-49-mo duration. Ratios of the stem, stem tip, greater trochanter, lesser trochanter and calcar, and normal femur to the reference sacroiliac joint were obtained, as well as tip-to-stem, and stem-to-normal femur in unilateral arthroplasties. The ratios remained stable at 12 months and beyond, except for the tip and lesser trochanter. Tip-to-stem and tip-to-sacroiliac joint ratios decreased by 24% and 33%, respectively, between 12 and 49 mo. There was also a decrease in the relative uptakes at the lesser trochanter and calcar in the same time interval. Evidence is given that different designs of prostheses may not have the same normal temporal uptakes of radiophosphate.

Adult↗
PubMed1990

Breast tumor radioimmunodetection with a 111In-labeled monoclonal antibody (MA5) against a mucin-like antigen.

Monoclonal antibody MA5 recognizes a determinant displayed on high molecular weight antigens associated with secretory and malignant breast epithelial cells. MA5 reactivity with greater than 95% of primary and metastatic breast tumors, surface expression of the antigen, as well as its ability to localize within breast tumor xenografts prompted this initial study to determine the efficacy of MA5 to localize breast tumors by radioimmunoscanning. A total of 17 patients was monitored, each receiving 2 mg of purified MA5 labeled with 5 mCi of 111In. Some patients also received 3 or 18 mg of unlabeled carrier antibody (MA5); no serious allergic reactions were noted. Primary tumors, bone lesions, soft tissue recurrences, and lung metastases greater than 3 cm in diameter were detectable, whereas only one lesion (hilar node) less than 3 cm was localized. Significant antibody accumulation was noted in the liver and less significant uptake in the spleen and bone. The extensive fibrosis and poor vascularization of breast tumors may partly explain the limited sensitivity obtained thus far. The imaging results obtained with MA5 are compared with other antibodies which we show recognize the same antigens.

Antibodies, Monoclonal↗
PubMed1990

Benign osteopetrosis.

A case of a 3 1/2-year-old female with benign osteopetrosis is presented. There was radiographic evidence of previous fetal sclerosis of bone yielding a "bone-within-a-bone" appearance, but on radiophosphate imaging this fetal sclerosis was not hyperactive and could not be differentiated from the normal diaphysis surrounding it.

Child, Preschool↗
PubMed1990

Interobserver variability in the interpretation of contrast venography, technetium-99m red blood cell venography and impedance plethysmography for deep vein thrombosis.

Contrast venography (CV) is the standard technique for diagnosing deep vein thrombosis (DVT). Newer noninvasive tests have also proven efficacious. However, there is a lack of data on the level of agreement among observers in their interpretation of the results of the various tests. After agreeing on well-defined criteria, three experienced observers assessed, blindly, the results of tests performed over a 4-month period on 117 patients who were suspected clinically of having had a first episode of DVT. The kappa statistic was used to measure the level of agreement beyond chance for CV (69 patients), red blood cell venography (RBCV) (82 patients) and impedance plethysmography (76 patients). The results of CV were assigned to normal, abnormal or inadequate categories, and those of RBCV and IPG to normal, equivocal or abnormal categories. The kappa values for CV, RBCV and IPG ranged from 0.53 to 0.56, 0.42 to 0.56 and 0.90 to 0.91 respectively. Values greater than 0.75 represented excellent agreement beyond chance and those between 0.40 and 0.75 represented fair to good agreement. Excellent kappa values were obtained for IPG because interpretation of the results of this method is entirely objective. Although the values for CV and RBCV showed good to fair agreement, there was a greater degree of observer variation, despite the well-defined criteria, indicating the subjectivity of interpretation of these test results. It is concluded that the kappa statistic can be used to measure observer variation of the results of tests for diagnosing DVT and may serve as a quality control tool for studies in which more than one person interprets the results.

Contrast Media↗
PubMed1990

Large telangiectatic focal nodular hyperplasia presenting with normal radionuclide studies: case report.

A 9 cm-lesion of telangiectatic focal nodular hyperplasia was incidentally identified in a 31-yr-old female. Despite a typical appearance by X-ray computed tomography and ultrasonography, scintigraphy with technetium-99m-(99mTc) colloid, 99mTc-diethyliminodiacetic acid, and 99mTc-labeled red cells failed to demonstrate any abnormalities. These findings are felt to reflect the relative lack of architectural disruption that histologically characterizes this particular lesion. The present report described the imaging characteristics of the telangiectatic form of focal nodular hyperplasia.

Adult↗
PubMed1989

Breast cancer imaging with mouse monoclonal antibodies.

The localization of 111In-labelled MA5 monoclonal antibody, reactive with a breast tumor associated antigen, was studied in 17 patients. MA5 was selected because 1) it reacts with greater than 95% of primary and metastatic lesions, 2) the recognized antigen is present on the cell surface in vivo and 3) MA5 gives excellent localization in human breast tumor xenografts. Each patient received 2 mg antibody labeled with 5 mCi 111In and in some cases, 3 mg or 18 mg unlabeled carrier antibody. No serious allergic reactions were noted. There was a large uptake in the liver, less significant uptake in the spleen and bone, and minimal accumulation in the bowel. Bone lesions, primary tumors, soft tissue recurrences and lung metastases larger than 3 cm diameter were imaged, while only 1 lesion smaller than 3 cm was detected. Non specific accumulation of tracer was noted at the site of a port-a-cath, in a hematoma, in fibrocystic lesions, and at sites of previous radiation treatment. Extensive fibrosis and poor vascularization characteristic of breast tumors may explain in part the limited sensitivity of the imaging.

Antibodies, Monoclonal↗
PubMed1989

Nifedipine inhibits cholecystokinin-induced gallbladder contraction.

Nifedipine is a calcium channel blocker which results in relaxation of smooth muscle. Although it has been utilized clinically to treat cardiovascular disease, and more recently spastic disorders of the esophagus and colon, its effects on gallbladder contractility have not been clearly defined. We tested the effects of nifedipine on gallbladder contraction stimulated by cholecystokinin (CCK) in a conscious guinea pig model and in healthy human volunteers. Gallbladder contraction was measured in response to repeated injections of CCK before and after intravenous nifedipine given to groups of five guinea pigs in a dose of 100, 200, or 300 micrograms. Nifedipine virtually abolished spontaneous interdigestive gallbladder contractile activity and decreased resting gallbladder tone. The mean amplitude of gallbladder contraction in response to CCK was decreased by 45, 73, and 67% (P less than 0.01), in response to the nifedipine doses of 100, 200, and 300 micrograms, respectively. The integrated gallbladder contractile response and the rate of rise of gallbladder pressure in response to CCK were also significantly decreased by nifedipine. In nine healthy human volunteers, gallbladder emptying was measured by radionuclide cholescintigraphy in response to CCK infusion; on another day the study was repeated after oral administration of 10 mg nifedipine. Ejection fraction was significantly decreased by nifedipine from 72 +/- 5 to 51 +/- 5% (P less than 0.001). These data demonstrate that nifedipine is a potent inhibitor of gallbladder contractility in guinea pigs and man. This may provide the basis for the use of nifedipine clinically in the treatment of biliary colic and also raises questions about the potential effect of long-term nifedipine use on gallstone formation and cholecystitis.

Adult↗