Tc-99m DTPA accumulation in intestinal contents of an incisional lumbar hernia.
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Adult↗
Biomedical subjects
R Prakash
Publications and source records attributed to R Prakash.
Diagnosis of renal artery branch stenosis using captopril intervention scintirenography.
A case of renovascular hypertension in a young male is presented. The patient had a small size right kidney with reduced differential function on the baseline [99mTc]-DTPA renal study. Captopril intervention scintigraphy demonstrated a dramatic reduction in renal perfusion and cortical uptake in the upper and mid-poles of the affected kidney. Time-activity curves of the [99mTc]-DTPA studies using segmental regions of interest corroborated visual findings. The presence of renal artery branch stenosis was confirmed on renal angiography.
Adolescent↗
Acute decreases in serum potassium augment blood pressure.
Potassium depletion is a risk factor for cardiovascular diseases, including hypertension, and frequently is encountered in patients with end-stage renal disease. Since the treatment of end-stage renal disease might result in K+ depletion and postdialysis hypokalemia, we investigated the relationship between acute K+ removal by hemodialysis and changes in blood pressure at the completion of treatment compared with predialysis and 1-hour postdialysis blood pressure. The effects of three different dialysate potassium concentrations ([K+]d; 1.0, 2.0, and 3.0 mmol/L) were investigated in 11 patients. Hemodialysis-induced K+ removal, serum [K+], total body K+, and blood pressure were measured. The use of 1.0, 2.0, or 3.0 mmol/L [K+]d resulted in the removal of 77.0 +/- 6.5, 54.5 +/- 7.9, and 42.5 +/- 9.9 mmol of K+ per treatment, respectively (P < 0.05, [K+]d 1.0 v [K+]d 3.0). Predialysis and postdialysis serum [K+] were 4.9 +/- 0.2 and 3.6 +/- 0.1 mEq/L for 1.0 mmol/L [K+]d, 5.1 +/- 0.3 and 3.9 +/- 0.1 mEq/L for 2.0 mmol/L [K+]d, and 5.3 +/- 0.3 and 4.2 +/- 0.2 mEq/L for 3.0 mmol/L [K+]d, respectively (P < 0.001 for each [K+]d). The baseline total body K+ corrected for gender, age, and race was 92% of predicted normal level and did not change significantly with the use of different [K+]d. Blood pressure decreased during hemodialysis as excess fluid was removed, regardless of [K+]d. Significant increases in blood pressure did occur 1 hour postdialysis compared with levels measured at the completion of treatment ("rebound hypertension") when hemodialysis was performed with 1.0 and 2.0 mmol/L, but not with 3.0 mmol/L [K+]d.(ABSTRACT TRUNCATED AT 250 WORDS)
Blood Pressure↗
Anticardiolipin antibody in patients on maintenance hemodialysis and its association with recurrent arteriovenous graft thrombosis.
To investigate the relationship between dialysis access thrombosis (arteriovenous grafts [AVG] and arteriovenous fistulas [AVF]) and the presence of elevated concentration of immunoglobulin G-anticardiolipin antibody (IgG-ACA), we conducted a cross-sectional study of all patients, in a single dialysis facility, who had a minimum of 6 months of uninterrupted hemodialysis. Episodes of thrombosis of AVGs and AVFs in the preceding 30 months were documented and each patient's IgG-ACA titer was determined. Sixteen of 74 patients with AVGs (22%) had a raised titer of IgG-ACA compared with only one of 17 patients (6%) with AVFs. In the patients with AVGs the odds ratio for patients with raised IgG-ACA titer to have experienced two or more episodes of thrombosis, compared with none or only one episode, was 3.7 (95% confidence interval, 1.2 to 11.8; P < 0.04). No events of AVF thrombosis were encountered during the same period. We conclude that in end-stage renal disease patients undergoing hemodialysis, there is a greater prevalence of elevated IgG-ACA titer in patients with AVGs than in patients with AVFs, and this in turn is associated with increased odds of having had recurrent AVG thrombosis.
Adult↗
Papillary carcinoma arising in sublingual ectopic thyroid concentrating both Tc-99m pertechnetate and I-131. Diagnosis by fine needle aspiration cytology.
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Adolescent↗
Radionuclide angiography in evaluation of cold solitary thyroid nodules. Improved diagnostic accuracy using flow and washout analysis.
Radionuclide thyroid angiography was performed in 252 patients with hypofunctioning thyroid nodules to evaluate differences in vascular flow and washout patterns in benign and malignant disease. Time activity curves of Tc-99m pertechnetate flow through the cold nodules were generated using region of interest software. Retention ratios of counts in the nodule at 2 minutes after radionuclide administration versus those at peak activity were derived. Patients subsequently underwent surgical excision and histopathologic examination. One hundred forty-four of the 204 benign nodules were avascular with absent radionuclide flow through the nodule. Fifty-six benign nodules were vascular with a prolonged radionuclide washout pattern with retention ratios ranging from 0.62-0.92. Forty-six of the 48 malignant nodules displayed increased perfusion with rapid radionuclide washout with retention ratios ranging from 0.28-0.48. Four benign nodules exhibited a similar flow and washout pattern. Radionuclide thyroid angiography with vascular flow and washout analysis appears to be a useful technique to differentiate between benign and malignant thyroid nodules with a high degree of sensitivity and specificity.
Adolescent↗
Incidental detection of skeletal metastases on technetium-99m DTPA renal scintigraphy.
A case is presented where skeletal metastases from a prostate carcinoma were detected during 99mTc DTPA scintigraphy performed for evaluation of renal function. The lumbar vertebrae in camera field of view were intensely perfused on the arterial phase of the radionuclide flow study. Tracer pooling in these vertebrae, visualized on initial serial images, progressively faded over the 30 minute study. Widespread areas of increased radionuclide uptake, consistent with skeletal metastases, were detected on 99mTc MDP bone imaging performed two days later. Subsequent prostatic biopsy revealed a well differentiated primary adenocarcinoma.
Adenocarcinoma↗
Technetium-99m-RBC scintigraphy in liver metastasis.
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Diagnosis, Differential↗
Increased vascularity in hepatic hemangiomas. Unusual pattern on Tc-99m RBC scintigraphy.
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Adult↗
Solitary cold thyroid nodules -- a correlation of fine needle aspiration cytology with pentavalent technetium DMSA scanning and radionuclide perfusion scanning.
Twenty-five patients with solitary cold thyroid nodules (SCN) were studied by fine needle aspiration (FNA) cytology, radionuclide perfusion scanning (RPS) and pentavalent technetium dimercaptosuccinic acid (99m Tc DMSA) scanning, with an aim to distinguish neoplastic from non-neoplastic nodules. All the patients were operated upon and the nodules were subjected to histopathological examination. 13 of the 25 nodules (52%) were malignant (7 papillary carcinomas, 3 medullary thyroid carcinomas and 1 each of follicular carcinoma, insular carcinoma and clinically anaplastic thyroid tumour). The specificity of DMSA scanning and FNA cytology were 100% and that of RPS 60%. The sensitivity of RPS and DMSA scanning were 80% and 20% and that of FNA cytology (using a broad definition of test-positivity), 100%. Additionally, FNA cytology could morphologically type the majority of neoplasms.
Biopsy, Needle↗
Mucor thermophilus spec. nov. and other Mucorales from India.
Ninety-five isolates belonging to the order Mucorales were collected from the vicinity of Delhi. These were derived as pure sporulating forms from various substances viz., dung, soil and compost. In all, twenty-one different species of Absidia, Cunninghamella, Mucor and Rhizopus were identified with the help of available literature (Hesseltine and Ellis 1964, 1966, Inui et al. 1965, Schipper 1978, 1984, Baijal and Mehrotra 1980 and Schipper and Stalpers 1984). Out of these, five fungi were new to India. A new species of Mucor and Rhizopus microsporus var. pseudochinensis comb. nov. is described.
Feces↗
Evaluation of a DMSA kit for instant preparation of 99mTc(V)-DMSA for tumour and metastasis scintigraphy.
A kit has been developed to instantly prepare 99mTc(V)-DMSA. The freeze-dried kit consisting of DMSA, stannous chloride and ascorbic acid in appropriate proportions, produces quality 99mTc(V)-DMSA when mixed with 0.2 mL of 3.5% NaHCO3 solution and 2-4 mL of (99mTc)pertechnetate. The radiopharmaceutical characterized by chromatography with ITLC-SG in 0.9% saline and horizontal paper electrophoresis in 50 mM vernol buffer, pH 8.6, at a potential gradient of 15 V/cm showed a different mobility with respect to 99mTc(III)-DMSA, a known agent for kidney imaging. The new agent exhibited less plasma protein binding compared to that of 99mTc(III)-DMSA. Biodistribution of the pentavalent DMSA in mouse demonstrated greater uptake in bone and muscle and lower uptake in liver and kidney with respect to trivalent DMSA. The soft tissue tumour specificity and its suitability for tumour scintigraphy was apparent from the scintigrams of mammary carcinoma in a C3H Jax mouse and medullary carcinoma in a patient. Brain metastatic lesions were also visible in a breast carcinoma patient after administering him with the agent.
Animals↗
Physical and sexual growth pattern of affluent Indian children from 5 to 18 years of age.
The present study was conducted to study growth parameters on 12,899 boys and 9,951 girls of affluent class from 8 States of the country. In pooled data, the 50th centile height approached 30-40th centile till 6 1/2 years in boys and up to 10 years in girls, and ultimately the height growth curves for both fell between the 10-20th centile of NCHS standards. Similarly, for weight, they approached 10-20th centile of NCHS at the age of 17 yr. Comparison with other European countries showed that Indian affluents are shorter and lighter; however, they are similar to their counterparts of Asian origin. The secular trend for height in Delhi showed increase of 2.1 cm for boys, and 2.7 cm for girls per decade at 17 yr and 14 yr, respectively. In Varanasi, the corresponding trend was 1.5 and 2.1 cm at 16 yr for boys and girls, respectively. The mean ages for genital development stages G 2-5 were 11.9, 13.3, 14.6 and 15.9 yr; respectively. In girls, the breast development Stages B 2-5 had mean ages of 10.9, 12.8, 13.9 and 14.8 yr, respectively. The mean age for menarche was 12.6 yr. In 14 yr old boys, the mean height may vary between 150.3, 155.8, 161.2 and 165.2 cm and mean weight between 38.0, 42.5, 46.8 and 52.9 kg for genital stages G 2-5, respectively. Similarly, girls of 12.5 yr (close to menarcheal age of 12.6 yr) had mean height 145.3, 150.3, 152.1 and 153.8 cm and mean weight 34.7, 41.2, 45.4 and 54.4 kg for breast stages B 2-5, respectively. It is recommended that for growth assessment during adolescence these charts in relation to sexual development and age be used for comparison.
Adolescent↗
Tc-99m(V) DMSA imaging. A new approach to studying metastases from breast carcinoma.
Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.
Adult↗
Human platelet calcium measurements. Methodological considerations and comparisons with calcium mobilization in vascular smooth muscle cells.
Platelets are used as models for vascular smooth muscle cells (VSMC) in evaluating intracellular calcium ([Ca2+]i) metabolism in humans. This study was designed to determine if agonist-induced increases in [Ca2+]i in platelets occur via release from intracellular stores as previously demonstrated for VSMC. Incubation of purified platelets loaded with fura-2-AM in media containing 1.5 mmol/L Ca2+ resulted in higher basal [Ca2+]i than platelets incubated in Ca(2+)-free media. In addition, vasopressin-induced platelet [Ca2+]i transients were almost completely blocked by Ca2+ channel blockers. Thus, in contrast to VSMC, the transmembranous flux of extracellular Ca2+ is the major mechanism in vasopressin-induced increases in platelet [Ca2+]i, while mobilization of intracellular Ca2+ stores is only minimally involved.
Arginine Vasopressin↗
Follicular thyroid carcinoma masquerading as subacute thyroiditis. Diagnosis using ultrasonography and radionuclide thyroid angiography.
The rare presentation of a follicular thyroid carcinoma mimicking the clinical and radionuclide features of subacute thyroiditis is described. Granulomatous thyroiditis was initially suspected on the clinical basis of acute onset of a hard, tender right lobe thyroid enlargement with associated systemic symptoms, modest elevation of thyroid hormone levels and suppressed thyroid RAIU. Fine needle aspiration cytology specimens were unsatisfactory for characterization. Three weeks later the thyroid RAIU was normal. The thyroid enlargement persisted, now being clearly visualized as a hypofunctional nodule on scintiscan. Repeat fine needle aspiration cytology was suggestive of acinar proliferation with hyperfunction. Ultrasonography revealed a solid nodule with a peripheral sonolucent halo. Radionuclide angiography showed intense arterial flow of Tc-99m pertechnetate through the right lobe thyroid enlargement suggestive of malignant thyroid pathology. Surgical excision and histopathological examination revealed a follicular carcinoma involving the right lobe. The possibility of carcinomatous involvement should be considered in those patients where initially tender thyroid nodularity persists longer than expected for a benign inflammatory disease, careful follow-up and relevant investigations being necessary to confirm the diagnosis.
Adenocarcinoma↗
Architecture of the lower end of the human tibia.
The cancellous bone in the lower end of the human tibia is divisible into 3 broad categories, according to the density and disposition of its lamellae. Parallel fenestrated tubes of cancellous bone arise perpendicular to the inferior articular facet of the tibia and meet the shaft obliquely. They diverge from the neutral axis which inclines posterolaterally from the centre of the inferior articular facet. Horizontal lamellae course the medial malleolus, at right angle to its articular facet. The density of the cancellous bone decreases from the periphery to the neutral axis. Spicules of thin bone can be traced from the attachment of ligaments into cancellous bone lying perpendicular to the articular facets.
Humans↗
Differentiation between suppressed thyroid tissue and thyroid hemiagenesis with Tc-99m pertechnetate radionuclide angiography.
Tc-99m pertechnetate thyroid angiography was performed on 62 patients who had unilateral thyroid enlargement and no radionuclide uptake in the contralateral lobe in an attempt to differentiate suppressed thyroid tissue from thyroidal hemiagenesis. In 55 cases of toxic, autonomous functioning thyroid nodules, the suppressed contralateral lobe was unequivocally demonstrated, the flow study showing tracer coursing through this tissue in the sequential arterial images. No arterial flow was demonstrable on the rapid sequence imaging in the agenetic lobe in seven patients who had thyroidal hemiagenesis. Radionuclide thyroid angiography appears a safe, simple, and accurate one-step study for distinguishing between suppressed thyroid tissue and thyroid hemiagenesis and precludes the requirement for additional studies, such as the thyrotropin stimulation test and Tl-201 scintigraphy.
Adult↗