Hepatic tissue in the left upper quadrant.
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Biomedical subjects
Publications and source records attributed to R P Spencer.
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Using a standard quantity of Re-186 HEDP, for therapy of osseous metastases from carcinoma of the breast, Palmedo and associates reported leukocyte and thrombocyte responses at 4 and 8 weeks. These were analyzed by dividing results into categories, based on the numeric initial values. Thrombocytes at 8 weeks exceeded pretreatment values in 10 of 18 cases. This "over-rebound" was also found in 7 of 19 leukocyte responses. The ability to predict thrombocyte-leukocyte response, in most cases, was linked to the initial hematologic values. If coupled with data on the status of bone marrow, this may allow the quantity of therapeutic radiopharmaceutical used to be increased or decreased without irreversibly compromising hematopoietic responses.
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In the course of radionuclide dynamic studies in 187 consecutive patients who had renal transplants, leakage from a ureter was identified in five cases (an incidence of less than 3%). Demonstrated patterns fell into three classes: 1) perirenal collection (n = 2), 2) peribladder activity (n = 2), and 3) downward dissection (n = 1 case). The sensitivity and specificity of the radionuclide study for detecting ureteral escape of urine after renal transplantation is unknown. However, this study suggests that both indices may be high.
A 45-year-old man, seropositive for hepatitis C, was examined because his liver was palpable well below the costal margin. A CT examination revealed multiple nodules within the liver and also several sites of ectopic tissue. The patient had a splenectomy 25 years before. A radiocolloid study showed uptake, consistent with splenosis, in the thorax, abdomen, pelvis, and possibly the left arm. The magnitude of the ectopic tissue, and its multiple locations, indicated the ability of splenic cells to grow in a variety of body sites.
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A 75-yr-old glucocorticoid-dependent asthmatic male had a bone mineral density study to assess possible osteoporosis prior to initiating therapy. A radiograph of the lumbar spine revealed an asymmetrical compression of the second lumbar vertebra, marked scoliosis, vertebral osteopenia, and a highly calcified abdominal aorta. Bone mineral density (dual X-ray absolptiometry [DXA]) revealed low bone mass in L2-L4 and a markedly abnonrnal pattern, with a linear central density representing a calcified aorta. Posterior-anterior measurements of the midlumbar region with and without the overlying aorta indicated that the calcified vessel contributed up to 33% of the measured density. This was a far higher contribution than reported in other studies. Lateral DXA measurements of the L2 vertebra and the overlying aorta were performed to validate this finding. The density of the L2 vertebra was 0.215 g/cm(2), and that of the overlying calcified aorta was 0. 210 g/cm(2). This case suggests that aortic calcifications may contribute sign)ficantly to overall lumbar bone density and, unless recognized, can inadvertently lead to misclassification of osteoporosis.
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The shorter life expectancy of human males, as compared with females, was analyzed by utilizing the assumption that the specific rate of change of disease occurrence or mortality was a function of the specific rate of change of age. Separate plots were made of log incidence versus log age, for males and females. In several disorders, the line representing males was displaced toward the origin, as compared with the females. This 'time frame shift' suggested an earlier onset of the disorder or its precursors in males ('early male initiation'). While the physiologic/genetic basis for this has to be fully determined, the earlier male 'initiation' of disorders may be a contributing factor to their shorter life expectancy.