Biomedical subjects
Publications and source records attributed to S F Grebe.
A method of lymphoscintigraphy is described which provides additional diagnostic information, of particular value prior to surgery for the removal of cutaneous tumours. The technique demonstrates the individual physiology of the lymphatic drainage system from a particular region of the skin. However, it is not the aim of the method to diagnose possible lymph node metastases.
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Endogenous antibodies against T3 or T4 may falsify the radioimmunological determination of T3 and T4. Depending on the method of separation increased or decreased values will result. The clinical aspects are at variance with these radioimmunologically measured values. The TSH value is frequently elevated and the TRH test mostly positive. The determination of unspecific binding capacity allows the selection of suspect sera. In cases of increased binding capacity the diagnosis will be established by a precipitation reaction with human-anti-Ig-G and quantified with radio-T3 or radio-T4.
81 patients with renal abnormalities or renal disorders of different genesis and severity with and without restricted renal function were investigated by means of the classical PAH- and inulin-clearance. Furthermore a radioisotope nephrography was carried out after application of I 131-Hippuran followed by Cr 51-EDTA. In addition the activity reduction was measured above the shoulder, as well as the activity in serum samples and urine samples gained 30 min after application. A comparison of the clearance values found with those of conventional clearance resulted in poor correlation for I 131-Hippuran (r = 0.54) and no correlation for Cr51-EDTA. Of the many parameters of the radioisotope nephrogram curves only the following are able to give sufficient quantitative functional results: The parameters connected with the rise of the curve between the 48rh and 120rh s and those connected with the slope of the secant. This is also true for the values of activity measured in the urine.
Guniea pigs showed an increased uptake of 99m-Tc-04 in the inflamed joints during the first days of experimental arthritis. Tc-04 was found in the joint fluid and inflamed synovia. The uptake of Tc-04 and Tc-MDP was reduced by therapy in 13 patients with RA. Classical RA showed an increased uptake of Tc-MDP compared with probable RA. Scintigraphy offers the possibility of early diagnosis and study of progression.
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Imaging of the chest cage with gallium-67 (67Ga) citrate is relatively easier to perform and interpret than imaging of the abdomen, because normally pulmonary concentration is low after 48 hr and physiologic accumulation in bones and breast can be recognized by its distribution. Modern scintillation detectors, particularly large field cameras with multiple pulse-height analyzers, give substantially better gallium images than those available in the past. Because of the nonspecific affinity of gallium through neoplastic and inflammatory processes, its value in the differential diagnosis of pulmonary diseases is limited. However, based on the literature and our own observations in over 1100 patients with established diagnosis of a variety of pulmonary diseases, we feel that the judicious use of 67Ga in selected patients is helpful in answering specific questions. These include preoperative evaluation of hilar and mediastinal involvement in pulmonary neoplasms, differential diagnosis of pulmonary infarctions and bacterial pneumonias, evaluation of pulmonary infiltrates regarding infectious etiology, follow-up of sarcoidosis on corticosteroid treatment, assessment of inflammatory activity in interstitial fibrosis and, in selected cases, early detection of neoplastic and inflammatory diseases before radiography becomes abnormal, such as diffuse carcinomatosis and Pneumocystis carinii infection. Potential large-scale application of pulmonary gallium imaging could be found in the screening of subjects exposed occupationally to noxious dust and in long-term serial follow-up of pulmonary tuberculosis patients for treatment response and reactivation. However, it remains to be seen whether gallium imaging statistically provides essential additional information in these indications when compared to cheaper conventional techniques.
All publications dealing with tortion of the testis stress the difficulty of diagnosis and the frequency of errors. This has suggested to us the need to develop a radio-isotope testiculogram corresponding to the radioisotope nephrogram used for renal functional diagnosis. The substance for the timeactivity curve is 99mTc pertechnitate which is taken up by the tubular epithelium of the testis and epididymis. A scan at 20 minutes proved highly diagnostic and produced a small amount of radiation only. Six quantitative parameters described the shape of the curve. These have been determined for the normal and related to age and point of measurement. It is then possible to differentiate partial and total tortion from acute epididymoorchitis. It is no longer necessary to subject every patient with acute testicular disease to surgery. With partial tortion, a conservative operation with fixation of the testis can be recommended instead of semicastration.
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Gallium chest scans of 575 patients were analyzed for their clinical usefulness in conjunction with chest radiographs. The series included patients with pulmonary carcinoma, lymphoma, tuberculosis, sarcoidosis, pneumoconiosis, and interstitial fibrosis. Gallum scintigraphy does not aid in the differential diagnosis of pulmonary diseases but is helpful in determining (a) the degree of activity of a known disease process: (b) treatment response, dosage, and duration; (c) the spatial extent of the disease; and (d) the presence of unsuspected disease foci hidden radiographically in the mediastinum, behind the heart, or in pleural or parenchymal scars.
Most of the programmes for the evaluation of radio in vitro tests proceed from the anticipation that the best method should give an approximation of standard values by a curve as perfect as possible. According to our experiences this demand, however, is not decisive for a good standard curve, as in principle all standard values can be incorrect. The application of relatively simple linearising transformations and an additional curve (recovery of a normal serum) guarantees the necessary precision in the programme described. After a short description of the contents of the system, the programme for the assessment of CPBA - methods is shown, by help of which the sample changer - calculator-system determines the absolute concentration of the substance to be measured. This makes the starting point for the more complex RIA programme which methodologically takes into consideration the special problems of these tests.
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