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Biomedical subjects

P Braunstein

Publications and source records attributed to P Braunstein.

At least 37 records · Page 2Linked to original sources
PubMed1983

Total bile duct obstruction. Prompt diagnosis by hepatobiliary imaging.

The value of hepatobiliary imaging for the early diagnosis of total bile duct obstruction is not well known. Four hundred eighteen technetium Tc 99m iprofenin (Pipida) hepatobiliary scans were reviewed, and the anatomic diagnosis was established by postmortem examination, laparotomy, endoscopic retrograde cholangiopancreatography, transhepatic cholangiography, or ultrasound. Sixty cases demonstrated the technetium Tc 99m iprofenin pattern of total bile duct obstruction. Of these, 41 had total bile duct obstruction, 14 had advanced hepatocellular disease, four had massive liver metastasis, and one had portal vein thrombosis. The test was 100% sensitive for the detection of total bile duct obstruction. When the bilirubin level was less than 10 mg/dL, the predictive value was 100%. As the bilirubin level rose to 15 and 20 mg/dL, the predictive value fell to 92% and 88%, respectively. If performed early, hepatobiliary scanning is the preferred test for suspected total bile duct obstruction.

Bilirubin↗
PubMed1983

Radionuclide enemas for localization of gastrointestinal bleeding sites.

The anatomical site of gastrointestinal bleeding may not be determined accurately with a scintigraphic bleeding scan. A case in which a radionuclide enema following a positive scintigraphic bleeding scan helped to guide the surgeon to the appropriate bleeding site, is presented. The radionuclide enema also obviates the need for barium examinations that would interfere with subsequent angiography.

Aged↗
PubMed1983

Work in progress. Gastrointestinal ulcerations: detection using a technetium-99m-labeled ulcer-avid agent.

Technetium-99m-labeled sucralfate, an ulcer-avid material, was shown in preliminary animal and human studies to be stable in vivo with good sensitivity. Eight experimentally produced discrete gastric ulcers in three rabbits were visualized using this material. Of seven human studies, four studies were true-positive and three were true-negative. It is suggested that Tc-99m-labeled sucralfate may prove to have significant clinical advantages for the evaluation of gastrointestinal ulcer disease and other diseases that are associated with loss of mucosal integrity. The method for labeling sucralfate with Tc-99m was developed by the authors.

Aluminum↗
PubMed1979

Brain scintigraphy in arteriovenous malformation.

Brain scintigraphy demonstrated an unusual image pattern which was associated with an arteriovenous malformation (AVM). A preoperative diagnosis of AVM was suspected on the radionuclide study and confirmed by contrast angiography and surgery. We review the criteria established for diagnosis of AVM by dynamic and static scintigraphy and discuss additional findings which can be helpful when noncharacteristic AVM presentations are encountered.

Adult↗
PubMed1978

Liver/pleural cavity scan for diagnosis of subphrenic abscess.

The interpretation of a combined liver/lung scan can be difficult in patients with pleural or pulmonary disease. A procedure is suggested to circumvent these difficulties by injecting 99mTc-sulfur colloid into the pleural cavity. A scan of the pleural cavity can then replace the lung scan in the conventional liver/lung scan. Two examples of liver/pleural cavity scans are shown.

Aged↗
PubMed1978

111In Desferal: a new radiopharmaceutical for abscess detection.

Desferal was labeled with 111In and its distribution was studied in normal mice, rabbits bearing turpentine-induced abscesses, and rats bearing Staphylococcus aureus-induced abscesses. The results indicate that 111In Desferal may be used in abscess detection and localization.

Abscess↗
PubMed1977

Brain death: I. Angiographic correlation with the radioisotopic bolus technique for evaluation of critical deficit of cerebral blood flow.

An innocuous intravenous portable radioisotopic test using technetium 99m pertechnetate was employed to demonstrate the deficit of cerebral blood flow associated with brain death. The results are compared to those of bilateral carotid and vertebral angiography in 20 patients. Absence of a bolus tracing from the head in the presence of a control tracing of a bolus from the femoral artery in two successive studies one hour apart reliably correlated with the clinical and electroencephalographic findings signifying cerebral death in comatose, apneic patients. Angiography indicated absence of intracranial circulation in 10 patients. Stasis filling or retrograde emptying of arterial vessels (or both) occurred in 7 patients. There was no evidence of venous filling in any of these 17 patients; all of them had either an absent head bolus or an "intermediate tracing." Results indicate that either form of tracing represents a critical decrease of cerebral blood flow. Two other patients had evidence of severely impaired abnormal posterior fossa circulation without angiographic evidence of cerebral circulation; both of these patients had an absent head bolus. An additional patient had an unusually small head bolus, and angiography revealed extravasation of radiopaque material but no evidence of intracranial circulation. We conclude that the bolus technique is a helpful adjunct in diagnosing brain death.

Adolescent↗
PubMed1977

Brain death: II. Neuropathological correlation with the radioisotopic bolus technique for evaluation of critical deficit of cerebral blood flow.

Diffuse necrosis and autolysis were found in the brains from 6 comatose, respirator-supported patients in whom the bolus technique demonstrated no cerebral blood flow during a period exceeding 20 hours prior to cardiac death. When blood flow was insufficient to produce a bolus, there was no evidence of active tissue response to necrosis. In 6 similar patients, when cerebral blood flow was detected by the bolus technique, less extensive necrosis was observed postmortem and there was active tissue response.

Apnea↗