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Biomedical subjects

P Koranda

Publications and source records attributed to P Koranda.

15 recordsLinked to original sources
PubMed2006

[Sentinel lymph node detection using 99mTc-nanocolloid in endometrial cancer].

OBJECTIVE: The aim of this study was to evaluate the feasibility of pre-operative lymphoscintigraphy and radio-guided surgery in endometrial cancer patients after intramyometrial administration of labelled colloid. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology of the Palacký University Medical School and University Hospital, Olomouc, Czech Republic. PATIENTS AND METHODS: Between April 2002 and March 2005, thirty three patients with endometrial cancer received pre-operatively 50 MBq of 99mTc-nanocolloid. The radiopharmaceutical agent was administered by a 25 Gauge needle transcervically into the myometrium. Subsequently, series of static lymphoscintigrams were made 20 to 90 min after injection. Two hours after injection the surgery started. Twenty eight patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Five patients were scheduled for laparoscopically assisted vaginal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Paraaortal lymphadenectomy was performed in 11 cases. A gamma detecting probe was used to locate radioactive lymph nodes during operation. Each hot lymph node was removed separately. RESULTS: Sentinel lymph nodes (SLN) were identified in 26 (79%) of 33 patients. The mean number of sentinel nodes detected was 2.9 (range 1-10). Seventy two (15.3%) of 472 nodes obtained in total, were identified as radioactive-colloid positive. Histopathological analysis revealed five (7%) of 72 lymphonodes to be positive of metastases. Sentinel nodes in paraaortic area were identified in 11 (33%) patients. No false negative sentinel lymphonodes were observed. CONCLUSION: The preoperative lymphoscintigraphy and intraoperative gamma probe guided biopsy may be useful in identifying sentinel nodes in endometrial cancer. No false negative sentinel lymphonodes were observed if representative SLNs were diagnosed with tumor.

Adenocarcinoma↗
PubMed2001

[Prognostic significance of stress tomographic scintigraphy of myocardial perfusion in diabetic patients].

OBJECTIVE: To assess the prognostic value of SPECT in patients with diabetes (DM) and without DM. METHOD: A total of 366 patients (104 women, 262 men) were examined by T1 +/- 201 or Tc-99m-MIBI SPECT of the myocardium. DM was recorded in 149 patients, 217 patients did not suffer from DM. The SPECT findings were classified as normal and abnormal perfusion (fixed or reversible perfusion defect). A serious cardiac event was defined as sudden cardiac death or non-fatal myocardial infarction. Also angina pectoris requiring revascularization was recorded. RESULTS: During the average investigation period of 24 +/- 7 months we recorded in 147 patients with a normal load perfusion only one non-fatal myocardial infarction and the risk of a serious cardiac event was low: 0.3% per annum in the whole group. A significantly higher incidence of a severe cardiac event, 5.9% per year, was recorded in 219 patients with an abnormal finding on SPECT (10 deaths and 16 non-fatal myocardial infarctions, P < 0.01). On comparison of the frequency of serious cardiac events in groups of patients with and without DM no significant difference was found as regards normal load perfusion of the heart muscle (1.1% vs. 0%, P = NS) even in patients with an abnormal SPECT finding (5.8% vs. 6.1, P = NS). CONCLUSION: SPECT myocardial perfusion makes it possible to stratify the risk in patients with DM similarly as proved previously in non-selected groups. Similarly as in patients without DM normal perfusion in diabetic patients predicts a benign prognosis.

Coronary Circulation↗
PubMed2001

The accuracy of myocardial perfusion SPECT imaging in the evaluation of coronary artery disease in women and men.

BACKGROUND: The purpose of this study is to compare sensitivity, specificity and accuracy of myocardial perfusion SPECT for the detection of coronary artery disease (CAD) in women and men. MATERIAL AND METHODS: 588 patients (455 males and 133 females, 273 after a previous myocardial infarction) underwent stress myocardial perfusion SPECT. The accuracy of myocardial perfusion SPECT was proved by coronary angiography (stenosis > 50% was considered as a CAD). RESULTS: The sensitivity of SPECT was slightly higher, but statistically not significant, in men than in women (94% versus 91%, p > 0.05). The specificity was higher in women than in men (93% versus 82%), but this difference was not statistically significant either (p > 0.05). The accuracy of SPECT was the same for both sexes (92%). In angiographically verified group of patients the selection bias was obvious--patients with CAD dominated (74%) and the fraction of patients with CAD in men's group (83%) was significantly higher than in women's group (50%), p < 0.05. CONCLUSIONS: No significant difference was revealed in the accuracy of myocardial perfusion SPECT in men and women. Our results are in accordance with the prevailing opinion in literature that discovered differences in sensitivity, specificity and diagnostic accuracy are usually not statistically significant or that they can be explained by the selection bias of patients in angiographically verified groups (significantly higher fraction of patients with CAD in men's group).

Journal Article↗
PubMed2000

Prognostic value of myocardial perfusion tomographic imaging in patients after percutaneous transluminal coronary angioplasty.

PURPOSE: The authors assessed the prognostic value of stress myocardial perfusion tomographic imaging (SPECT) in patients with recurrent angina or inconclusive results of exercise electrocardiographic tests after successful percutaneous transluminal coronary angioplasty (PTCA). MATERIALS AND METHODS: After PTCA, 70 patients (54 men, 16 women; 41 after myocardial infarction; mean age, 56 +/- 9 years) underwent TI-201 or Tc-99m sestamibi SPECT studies. SPECT patterns were divided into normal (n = 25), fixed defects (n = 15), and reversible or combined fixed plus reversible defects (n = 30). A cardiac event was defined as either cardiac death, nonfatal myocardial infarction, or unstable angina requiring further revascularization. RESULTS: During an average follow-up of 25 +/- 10 months, two patients had severe outcomes (one cardiac death and one nonfatal myocardial infarction), and revascularization was required in 13 patients. In patients with normal SPECT or fixed defects, the annual event rate was low (1.2%), with only one revascularization. In patients with reversible or combined defects, the annual event rate was significantly greater (22.4%; chi square = 17.32, P = 0.00003). CONCLUSIONS: Normal perfusion or fixed defects predict a benign prognosis in patients after successful PTCA. The presence of stress-induced reversible defects appears to be the best predictor of future cardiac events.

Angina, Unstable↗
PubMed1999

Hepatic perfusion changes in patients with cirrhosis indices of hepatic arterial blood flow.

PURPOSE: This study used radionuclide angiography to evaluate semiquantitatively the hepatic arterial blood flow changes associated with cirrhosis. METHODS: The parameters of net arterial hepatic perfusion were estimated by analysis of first-pass flow studies in 11 control participants and in 15 patients with cirrhosis (Child-Pugh classification B-C). Hepatic, renal, and splenic time-activity curves were generated, normalized per pixel, and corrected for background. The rate of hepatic arterial blood flow was compared with the reference kidney and spleen perfusion using the hepatorenal and hepatolienal perfusion indices, respectively. These indices were defined as: PI = area under hepatic curve limited by time of the renal (splenic) curve peak/area under renal (splenic) curve to its peak RESULTS: The values of both these perfusion indices are significantly greater in the patients with cirrhosis than in controls (hepatorenal perfusion index, P < 0.01; hepatolienal perfusion index, P < 0.05). The values of the hepatic perfusion index (the ratio of the arterial to the total liver blood flow), which were also calculated, were elevated in the patients with cirrhosis (P < 0.01). CONCLUSIONS: The results confirm that the net hepatic arterial blood flow is increased in patients with cirrhosis. Radionuclide angiography accompanied by calculation of arterial perfusion indices may provide semiquantitative parameters of net hepatic arterial blood flow.

Hepatic Artery↗
PubMed1998

[Restoration of digestive passage after total gastrectomy].

In a group of 20 patients the authors evaluate possibilities of reconstruction of the digestive tract after TGE from the aspect of quality of life. The evaluating criterion are subjective complaints, the necessity to restrict the volume of meals and evaluation of the gastric substitution. The authors did not find a significant difference between reconstructions using a Roux loop and bilateral interposition of a jejunal loop between the oesophagus and duodenum, while the consider the creation of a reservoir very beneficial for the patient.

Anastomosis, Roux-en-Y↗
PubMed1995

Optimal sampling times for OIH-clearance calculations using a two-compartment/two-sample method.

Orthoiodohippurate (OIH) clearance data obtained with the two-compartment/two-sample method of Lear which uses varying sampling time combinations, were compared with those of the reference two-compartment/multi-sample method of Sapirstein. A total of 35 studies were performed in 33 adult patients. The OIH clearance values determined by the reference method ranged from 107 to 883 ml/min/1.73 m2, with a median of 406 ml/min/1.73 m2. It was ascertained that the precision of the Lear method is partially dependent upon the sampling time combination. The most reliable results with the Lear method in this patient population were obtained by taking a first sample at approximately 8 min p.i., and a second sample at 32 min p.i. or later.

Adult↗
PubMed1993

[Experimental verification of the hepatic perfusion index for monitoring direct liver perfusion by portal blood].

The reliability of HPI measurement was studied in animal experiment. The portal vein of experimental dogs was narrowed by application of a metallic coil. The induced portal hypertension with important hepatofugal collaterals appeared to be a suitable model for the study of changes in HPI. A decrease in the index was statistically significant and corresponded to the hemodynamical efficiency of collateral circulation. The original experiment verified the reliability of HPI for an assessment of direct perfusion of the liver by portal blood.

Animals↗
PubMed1992

Absolute quantitation of gallium-67 citrate accumulation in the lungs and its importance for the evaluation of disease activity in pulmonary sarcoidosis.

Our modification of a method for the absolute quantification of gallium-67 uptake in lungs with a scintillation camera and computer is described. The uptake of 67Ga in lungs, expressed in percentage of administered radioactivity, was determined by the transmission-emission method. We proved theoretically and experimentally that a 67Ga planar source could be replaced with a 57Co planar source. The performance of lung perfusion scans allows a more accurate delineation of the regions of interest on gallium scans. The method was applied to control subjects (n = 27) and to patients (n = 114) suffering from biopsy-proven pulmonary sarcoidosis (28 with inactive and 86 with active disease). The obtained results were compared with chest X-ray findings, the percentage of lymphocytes in the bronchoalveolar fluid (BAF-ly%), and serum angiotensin-converting enzyme (SACE) values. The method seems suitable for the assessment of disease activity in sarcoidosis. It is more accurate in detecting parenchymal involvement in lung sarcoidosis than the commonly used X-ray criteria. No correlation was found between 67Ga uptake and the BAF-ly% and SACE values.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Diagnostic angioscintigraphic evaluation of malignant hepatic tumors before catheter embolization: determination of shunt, flow distribution, and reflux.

PURPOSE: The aim of this study was to evaluate quantitatively arteriovenous shunts in malignant liver tumors by injection of 99mTc macroaggregates of albumin (MAA) into the tumor-feeding artery after selective catheterization. METHODS: In 40 patients with malignant liver tumors (33 hepatocellular carcinomas and 7 metastases of colorectal cancer), a mean dose of 200 MBq 99mTC MAA was injected arterially during angiography. The embolized area and the lungs were then visualized using a gamma camera. A dedicated computer program calculated pulmonary shunt rates. RESULTS: The majority of patients (n = 30) with hepatocellular carcinoma showed small shunts varying from 0 to 15%; only 3 of these patients had shunts ranging from 18% to 37%. In patients with colorectal carcinoma metastases (n = 7) the shunt varied from 0 to 3% (2 +/- 1%), probably due to a physiological shunt in normal liver tissue in the embolized area. Importantly, the degree of shunt found bore no correlation to the tumor volume or to the pattern of vascularity on angiography. CONCLUSION: Diagnostic angioscintigraphy is a useful tool for pretherapeutic evaluation of the capacity of an individual tumor to retain particles and to measure extratumoral shunting; these are essential for therapy planning, as they can help to increase the safety and effectiveness of embolization.

Adult↗