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Biomedical subjects

L Rosenthall

Publications and source records attributed to L Rosenthall.

At least 73 records · Page 4Linked to original sources
PubMed1983

Effect of 99mTc-Sn-colloid incubation time on in vivo distribution.

The in vitro particle size of 99mTc-Sn-colloid preparation increases with the length of incubation time after reconstitution. It was found that the percentage of particles trapped (T) by a 1-micron filter as a function of time (t) could be represented by the logarithmic equation T = 5.3 + 15.7 ln t (r = 0.96). This material was applied to a crossover study involving 25 patients each of whom received preparations of the same reconstituted 99mTc-Sn-colloid that had been incubated for 15 min and (each patient received both) 5 h. It was found that there was a significant shift of radioactivity to the spleen and a significant decrease in background with the material that had been incubated longer. The 99mTc-Sn-colloid is adequate for the disclosure of space-occupying disease in the liver and spleen, but unreliable for drawing conclusions on the status of liver function based on the changes in splenic concentration.

Adult↗
PubMed1983

Immediate effects of continuous beta-irradiation to the kidneys.

Renal response to irradiation was examined over the course of 24 h in an animal preparation of continuous renal irradiation. Continuous beta-irradiation to the renal parenchyma was carried out in C57Bl6 mice by application to the surface of both kidneys of a 32P-impregnated anion exchange resin yielding an initial beta surface dose of approximately 30 cGy/min and approximately 2.3 cGy/min at a 2 mm depth. This technique proved easily reproducible and highly effective in causing immediate renal damage. In a kinetic study, the blood urea nitrogen (BUN) values of 5 week old mice exposed to continuous renal irradiation rose significantly (2 h: 21 +/- 4; 4 h: 33 +/- 4; 6 h: 42 +/- 5; 16 h: 65 +/- 8; and 24 h: 62 +/- 5 mg%) while that of sham-operated animals (provided with a nonradioactive resin) remained below 17 mg% throughout the entire observation period. When mice of various ages were exposed to continuous renal irradiation over a 16 h period, the functional changes were shown to be inversely correlated with the age of the animals (BUN at 5 week: 65 +/- 8; 8 week: 51 +/- 6; and 11 week: 20 +/- 2 mg%). Thus, our results indicate that continuous beta-irradiation to the kidneys promptly causes severe age-related renal functional deficits. This novel approach may offer an alternative to the current methods of investigation of radiation-induced renal damage.

Acute Kidney Injury↗
PubMed1983

Renal trauma.

Renal injuries are classified as minor, major, and critical/catastrophic for purposes of management. The radionuclide renal scintigram is a safe, simple, and extremely sensitive means of establishing the presence of an injury and monitoring kidney function during conservative management, which is utilized in the vast majority of cases. The information that may be obtained from radionuclide imaging is the state of overall and regional blood transit, overall and regional parenchymal function, and urinary extravasation.

Adolescent↗
PubMed1983

Difficulty of diagnosing infected hypertrophic pseudarthrosis by radionuclide imaging.

Hypertrophic pseudarthrosis was studied with Tc-99m MDP and Ga-67 citrate in 11 patients. Two of the 11 pseudarthroses were complicated by infection. A high concentration of both radiopharmaceuticals was obtained at all 11 sites and their distribution patterns were identical. It was therefore impossible to distinguish the infected from the noninfected pseudarthroses by using Ga-67.

Bacterial Infections↗
PubMed1983

Radionuclide joint imaging.

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Adult↗
PubMed1983

A crossover study comparing delayed radiohippurate images with furosemide renograms.

109 kidneys in 56 adult patients suspected of having urinary tract obstruction were studied prospectively. All patients underwent a routine 131I-hippurate series for 30 min, and to this was added a delayed image at 2 h. Later in the same day, these patients had a diuretic renogram for the first 30 min in which 40 mg of furosemide were injected simultaneously with a repeat 131I-hippurate dose. In 48 patients (85.7%) the delayed image and diuretic renogram showed mutual agreement as to the presence or absence of urinary tract obstruction, but not necessarily with the final diagnosis. Of the 8 remaining patients with 16 kidneys, there were 6 false positives and 4 false-negatives by diuretic renography, and 1 false positive and no false-negatives by nondiuretic delayed imaging. The only benefit derived from the diuretic renogram was a shortening of the examination from 2 h to 30 min.

Adult↗
PubMed1982

Predictive value of radionuclide joint scintigrams.

Twenty-two patients with normal or "noninflammatory" 99mtechnetium-labeled polyphosphate (TPP) peripheral joint scintigrams taken between 1974 and 1976 were reevaluated clinically. Retrospective chart review revealed that all initially had persistent polyarthralgia of more than 3 months duration. At followup, a mean of 3.6 years later, none had evidence of inflammatory joint disease, although 1 patient had systemic lupus erythematosus and 2 had polymyalgia rheumatica. A noninflammatory joint scintigram as part of a thorough rheumatologic evaluation may be a useful procedure in excluding inflammatory joint disease in selected patients with chronic persistent polyarthralgia.

Adult↗
PubMed1982

Renal transplant evaluation.

Radionuclide scintigraphy of the renal transplant has assumed an important role in disclosing the complications that beset this life-prolonging procedure. Renal ischemia, whether caused by mechanical obstruction of the blood vessels or ureter or immunological rejection, can be detected by qualitative and quantitative perfusion studies using 99mTc-complexes such as pertechnetate, glucoheptonate and DTPA. Similarly, parenchymal agents such as radiohippurate and 99mTc-DTPA can be quantitated for uptake and their drainage patterns monitored to reveal possible underlying obstructive uropathy and urine extravasation. The literature is replete with mathematical strategems for quantitating perfusion and parenchymal transit of the tracers, but none are truly specific enough to be diagnostic of a given cause of renal ischemia. Serial quantitative radionuclide studies should be obtained during the first 2-3 wk after transplantation with the view of noting an improvement or deterioration of the quantitation parameters as a guage of progress. A deterioration may anticipate biochemical manifestations by 24-48 hr, but it is not specific and must be interpreted in light of the clinical circumstances or necessitate invasive procedures for a definitive diagnosis.

Graft Rejection↗
PubMed1982

A clinical comparison of MDP and DMAD.

Tc-99m labeled dimethyl-amino-diphosphonate (DMAD) was compared with methylene diphosphonate (MDP) in five healthy volunteers and 28 patients with a variety of bony afflictions. Although the normal bone uptake of DMAD is less than MDP, the lesion-to-normal bone ratio is significantly higher with DMAD. All 71 lesions detected with MDP were also seen with DMAD. However, 10 lesions were disclosed with DMAD that were not seen with MDP. These lesions tended to have low grade concentrations of the radiopharmaceutical and were detected with DMAD by virtue of the lower normal bone uptake rather than higher lesion uptake.

Adult↗
PubMed1982

Sequential use of radiophosphate and radiogallium imaging in the differential diagnosis of bone, joint and soft tissue infection: quantitative analysis.

A quantitative analysis of the results obtained by sequential 99mTc methylene diphosphonate (MDP) and 67Ga-citrate (Ga) imaging to disclose and distinguish infections in bone, synovium and adjacent soft tissue is reported. There were 129 patients with proved or probable osteomyelitis, septic arthritis and cellulitis, and 94 patients who were eventually shown to be free of sepsis, but not necessarily free of some other nonseptic affliction. Of the 159 patients referred with a presumptive clinical diagnosis of osteomyelitis 94 were eventually shown to be free of infection. The results of this group by sequential imaging were true positive 0.72, true negative 0.86 and accuracy 0.80 when low-grade Ga uptakes, which were similar in distribution to MDP, were excluded. In 26 patients with septic arthritis, the true-positive fraction for combined MDP and Ga was 0.84. The true-positive fraction for Ga in 38 patients with cellulitis was 0.79.

Arthritis, Infectious↗
PubMed1981

A crossover study comparing the effect of particle size on the distribution of radiocolloid in patients.

Two radiocolloid preparations, differing in particle size by a factor of 5 to 20, were compared in each of 15 patients. The smaller colloid, measuring less than 80 nm, showed a relative decrease in the calculated target to background ratios for the liver and spleen and an increase for the bone marrow. The increased uptake of the smaller particle in the bone marrow, as measured by the bone marrow to soft-tissue background ratio, was about 50% higher than that of the larger colloidal particles. Comparable marrow images can be obtained in a half to a third of the time with the smaller particle size for a given administered dose.

Adult↗
PubMed1981

Deforming arthritis in systemic lupus erythematosus.

Of 45 patients in the McGill Lupus Registry 6 were found to have Jaccoud's deformities. One of these 6 and 4 others had fixed flexion contractures of the elbows. Those with Jaccoud's deformities were similar to the other patients with systemic lupus erythematosus in all respects except that those with Jaccoud's syndrome had had their disease and their arthritis significantly longer. It is concluded that Jaccoud's deformities are the result of longstanding arthritis and that elbow contractures occur via a different mechanism.

Adult↗