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Biomedical subjects

S T Treves

Publications and source records attributed to S T Treves.

At least 91 records · Page 5Linked to original sources
PubMed1992

Regional cerebral perfusion in Landau-Kleffner syndrome and related childhood aphasias.

Assessment of cerebral perfusion may elucidate pathogenesis of Landau-Kleffner syndrome (LKS). We obtained 99mTc-HMPAO SPECT studies in five children with LKS and in three children with syndromes of verbal-auditory agnosia. In LKS, perfusion showed temporoparietal asymmetry (9.56% +/- 3.44%) (n = 4) or bilateral parietal abnormality (n = 1). SPECT in non-LKS patients was normal (n = 1), showed (n = 1) totihemispheral hypoperfusion accompanying structural abnormality or (n = 1) a pattern resembling but distinct from LKS. Seizures in LKS patients had never occurred (n = 1), were controlled satisfactorily (n = 2), or poorly (n = 2). Maximum EEG abnormality was left centrotemoral-occipital (n = 1), left frontocentral (n = 1), bitemporal/left central (n = 1), and left central/parasagittal (n = 1). Asymmetric temporoparietal perfusion appears characteristic of LKS, differing from findings in other childhood linguistic disturbances. This abnormality occurs across a spectrum of seizure expression, diverging from the distribution of EEG abnormalities. The SPECT abnormalities parallel PET-defined LKS metabolic abnormalities, and may indicate central pathogenetic features of the disorder.

Aphasia↗
PubMed1991

Thyroglossal duct remnants. Preoperative evaluation and management.

Midline cervical cysts arising from the thyroglossal duct are one of the most common causes of anterior neck swelling in children. The potential for confusion between the thyroglossal duct cyst and the ectopic thyroid gland is well documented and may result in serious complications. A retrospective chart analysis was therefore undertaken to determine the relative importance of clinical evaluation, thyroid function testing, and radioisotope scanning in distinguishing these two entities preoperatively. A combined study was carried out by The Children's Hospital, Boston, Mass, and Rainbow Babies Hospital, Cleveland, Ohio. The hospital records, including nuclear scans, were reviewed. A total of 229 patients were taken to the operating room between January 1, 1978, and December 31, 1987. Nuclear scanning was performed in 30% of these patients. This subgroup of patients forms the basis for our guidelines of preoperative assessment. The absolute need for a preoperative scan is reexamined.

Adolescent↗
PubMed1991

Low-back pain in adolescent athletes: detection of stress injury to the pars interarticularis with SPECT.

The authors reviewed 1 year of experience with planar and single photon emission computed tomographic (SPECT) bone scintigraphy in 162 young patients with symptoms of low-back pain possibly related to stress injury to the pars interarticularis or spondylolysis. Planar scintigraphy and SPECT revealed no abnormality in 91 patients (56%). All abnormalities detected on planar images were also detectable with SPECT. SPECT showed an abnormal focus of radiotracer uptake in the lumbar spine in 71 patients (44%). In 32 of these 71 patients, these findings were also evident with planar scintigraphy. In 39 of these 71 patients, use of SPECT. Correlation with contemporaneous radiographs was made in 72 cases (including computed tomography in 10 cases). SPECT can be used to detect stress injury not seen with planar bone imaging or radiography and is recommended in evaluation of low-back pain in young athletes.

Adolescent↗
PubMed1990

SPECT imaging of pediatric brain tumor with hexakis (methoxyisobutylisonitrile) technetium (I).

Technetium-99m-Hexamibi [Hexakis (methoxyisobutylisonitrile) technetium (i)] was developed as a myocardial perfusion agent with biologic properties similar to those of thallium-201 (201TI). As 201TI has recently been observed to be of value for the diagnosis of brain tumors when used in conjunction with single-photon emission computed tomography (SPECT) imaging technology, the possibility that the biologic similarity of the two radiopharmaceuticals extended to their affinity for tumors was tested. A 5-yr-old female patient with a brain stem astrocytoma showed marked focal uptake of 99mTc-Hexamibi at the site of tumor recurrence as defined by biopsy and prior 201TI/SPECT study. Tumor-to-normal cortex radioactivity ratios for the 99mTc-Hexamibi/SPECT study were 132:1 and the spatial resolution of the 99mTc-Hexamibi images was high. This observation suggests that 99mTc-Hexamibi merits further study as a potential agent for SPECT imaging of human brain tumors.

Astrocytoma↗
PubMed1989

Comparison of technetium-99m MIBI and thallium-201 chloride myocardial scintigraphy in infants.

Myocardial perfusion scintigraphy was performed with both 201Tl and a new six coordinate monocationic isonitrile complex of 99mTc, [99mTc]2-methoxyisobutylisonitrile (MIBI), on 11 infants who had undergone the arterial switch procedure for transposition of the great arteries. Unlike 201Tl which can show rapid and variable rates of washout from myocardium, 73% of the initial first-pass activity of the isonitrile complex in the myocardium remains 1 hr after intravenous administration. The images obtained with [99mTc]MIBI required a shorter recording time, entailed less radiation exposure to the patient, and were qualitatively at least as good as those obtained with 201Tl. No infant had perfusion abnormalities. The potential applications of the isonitrile complexes for myocardial perfusion scintigraphy in children are discussed.

Female↗
PubMed1989

Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome.

In a prospective, randomized study of 18 infants treated with bovine surfactant (surfactant TA, Tokyo Tanabe Co, Tokyo) for severe respiratory distress syndrome, a lasting response was found in 12 infants (66%), a transient response was found in two (11%), and no response was found in four (22%) when arterial to alveolar PO2 ratios were used to define responses during the first 48 hours after treatment. In contrast, three of 23 control infants (13%) had a transient or lasting "response" to sham treatment (Pediatrics 1987;79:31-37). To determine whether maldistribution of surfactant could explain lack of response or a transient response, surfactant TA was mixed with technetium-99m sulfur colloid (approximately 300 mu Ci per infant), and eight infants with severe respiratory distress syndrome were treated six to 58 hours after birth. Scintigraphy of the lungs was performed three to 15 hours after treatment. Although a lasting response was observed in three infants, a transient one in three, and no response in two, no gross maldistribution of the radioactive label was found. Either lung received from 37% to 62% of the total radioactivity. During the past 3 years, in all infants with severe respiratory distress syndrome who were treated with surfactant (n = 29), poor or transient responses were associated with early patent ductus arteriosus and air leaks (pulmonary interstitial emphysema and pneumothoraces). Pathophysiologic conditions associated with respiratory distress syndrome are more likely to explain suboptimal responses after surfactant treatment than gross maldistribution of surfactant in the lungs.

Administration, Inhalation↗
PubMed1988

Hepatobiliary scintigraphy in arteriohepatic dysplasia (Alagille's syndrome). A report of two cases.

Hepatobiliary scintigraphy has proven to be of great utility in distinguishing biliary atresia from other causes of neonatal cholestasis. Arteriohepatic dysplasia (Alagille's syndrome) is an uncommon entity characterized by typical facial features, pulmonary artery stenosis, and a liver disorder which presents during the neonatal period as progressive jaundice. Two neonates, who were later shown to have Alagille's syndrome, underwent hepatobiliary scintigraphy to rule out biliary atresia. Findings on the hepatobiliary scans from the two patients were similar to those usually associated with biliary atresia and both finally required surgical exploration to rule out biliary atresia. The findings on hepatobiliary scans in these patients with Alagille's syndrome are discussed and compared with those associated with other forms of neonatal cholestasis.

Bile Ducts, Intrahepatic↗
PubMed1988

Bone stress lesions in ballet dancers: scintigraphic assessment.

Ballet dancers are athletes susceptible to ligamentous and bony injury. We reviewed retrospectively the bone scans (technetium-99m methylene diphosphonate) of 23 ballet dancers with pain in the back and/or lower extremities to determine the usefulness of scintigraphy in the detection of stress lesions of bone. The scintigraphic studies in 19 dancers identified multiple areas of stress injury in both symptomatic and asymptomatic locations. Thirteen dancers had 22 stress fractures (microfractures of trabeculae with associated bone repair) manifested by an intense focus of increased uptake of radiopharmaceutical, and 19 dancers had stress reactions (areas of accelerated remodeling and resorption of bone) demonstrated by diffusely increased uptake of radiotracer. Ten of the 13 dancers with stress fractures were symptomatic and six of the 19 dancers with stress reactions were symptomatic. The radiographs of 10 dancers with positive bone scans were normal or showed no distinction between acute and chronic injuries. Stress fractures were most prevalent in the feet, and stress reactions were most prevalent in the tibiae. The study confirmed that ballet dancers sustain significant bone stress in their legs and feet. Our results show that scintigraphy can be used to detect stress fractures and stress reactions at both symptomatic and asymptomatic sites in this population.

Adolescent↗
PubMed1987

Long-term evaluation of esophageal and pulmonary function in patients with repaired esophageal atresia and tracheoesophageal fistula.

Patients who have undergone repair of esophageal atresia and tracehoesophageal fistula as infants have been noted to have residual esophageal dysmotility and pulmonary dysfunction during their childhood years. However, limited information is available about the long-term follow-up of these patients. In this study we performed esophageal and pulmonary function studies on 12 adults who had required surgical repair of these defects in the first week of life. Most patients had symptoms of dysphagia and heartburn at time of evaluation. Pathologic gastroesophageal reflux was documented in 67% of patients and esophagitis was noted in 34%. All patients had esophageal motility abnormalities characterized by low-amplitude nonperistaltic waves throughout most of the esophagus. In addition, although most patients had no respiratory symptoms, mild restrictive lung volumes were noted in many patients. However, airflow obstruction and airway hyperreactivity were not present. These data demonstrate that clinical symptoms and abnormal esophageal manometry and pulmonary function persist well into the third and beginning of the fourth decade after repair of esophageal atresia and tracheoesophageal fistula in infancy.

Adult↗
PubMed1987

Normal hepatic and splenic size in children: scintigraphic determination.

Measurements were made on sulfur colloid scintigrams of normal pediatric livers and spleens by analyzing 131 scans from 116 patients referred for liver or spleen trauma. Studies were used only if scans were normal, there was no history of malignancy or hepatic or splenic disease either prior to of after the study. Linear correlation was made with age, weight and both age and weight. All measured parameters correlated better with weight than with age, with vertical liver dimension exhibiting the best correlation (r = 0.848). Multivariate analysis demonstrated uniformly better correlation of all measurements with both age and weight. Spleen and liver volumes were calculated assuming simple geometry, and showed excellent correlations. Graphical presentation of data will be useful in the clinical determination of hepatomegaly or splenomegaly in routine scintigraphy.

Adolescent↗
PubMed1987

Stress fractures after surgery for osteosarcoma: scintigraphic assessment.

To determine how often stress fractures occur in patients who have undergone surgery for osteosarcoma of a lower limb and to characterize such lesions, 156 bone scans obtained in 43 such patients were reviewed for bone stress. Of 43 patients who had undergone amputation or limb-preserving procedures, 42 (98%) had abnormalities on scintiscans attributable to bone stress; 31 had focal or mixed focal and diffuse lesions. Bones most commonly involved were those of the contralateral leg, pelvis, ipsilateral leg, and arms. Focal and mixed lesions seemed to be associated with increased work load on the limb involved. Findings indicated that the more active the patient, the more severe the bone stress. Because of their distribution, appearance, and intensity of tracer uptake, most stress-related lesions were readily distinguishable from bony metastases on scintiscans. Questionable lesions should be evaluated further with other imaging methods.

Adolescent↗
PubMed1987

Altered insulin distribution and metabolism in type I diabetics assessed by [123I]insulin scanning.

Scintigraphic scanning with [123I]insulin provides a direct and quantitative assessment of insulin uptake and disappearance at specific organ sites. Using this technique, the biodistribution and metabolism of insulin were studied in type 1 diabetic patients and normal subjects. The major organ of [123I]insulin uptake in both diabetic and normal subjects was the liver. After iv injection in normal subjects, the uptake of [123I]insulin by the liver was rapid, with peak activity at 7 min. Activity declined rapidly thereafter, consistent with rapid insulin degradation and clearance. Rapid uptake of [123I]insulin also occurred in the kidneys, although the uptake of insulin by the kidneys was about 80% of that by liver. In type 1 diabetic patients, uptake of [123I]insulin in these organ sites was lower than that in normal subjects; peak insulin uptakes in liver and kidneys were 21% and 40% lower than those in normal subjects, respectively. The kinetics of insulin clearance from the liver was comparable in diabetic and normal subjects, whereas clearance from the kidneys was decreased in diabetics. The plasma clearance of [123I]insulin was decreased in diabetic patients, as was insulin degradation, assessed by trichloroacetic acid precipitability. Thirty minutes after injection, 70.9 +/- 3.8% (+/- SEM) of [123I]insulin in the plasma of diabetics was trichloroacetic acid precipitable vs. only 53.9 +/- 4.0% in normal subjects. A positive correlation was present between the organ uptake of [123I]insulin in the liver or kidneys and insulin degradation (r = 0.74; P less than 0.001). Both decreased insulin uptake in the liver and kidneys and decreased insulin degradation were inversely correlated to the binding capacity of antiinsulin antibodies in plasma of diabetics (r = -0.87 to -0.92; P less than 0.001). In summary, type 1 diabetic patients have altered patterns of insulin biodistribution and metabolism, with decreased organ uptake and slow degradation of [123I]insulin, which correlated with the insulin antibody-binding capacity of their serum. Thus, antiinsulin antibodies, even at subclinical concentrations, may modulate the metabolic effects of insulin in the diabetic by prolonging the biological half-life of the hormone as well as by altering its distribution and uptake at specific organ sites.

Adult↗
PubMed1987

Vesicoureteral reflux in asymptomatic siblings of patients with known reflux: radionuclide cystography.

The familial nature of vesicoureteral reflux among siblings of patients with vesicoureteral reflux has been reported to be from 8% to 32%. These included both symptomatic and asymptomatic siblings. The incidence of vesicoureteral reflux in asymptomatic siblings, however, has not been studied extensively. Sixty asymptomatic siblings of patients known to have vesicoureteral reflux were studied with radionuclide voiding cystography. Their ages ranged from 2 months to 15 years (mean, 4.2 years). Vesicoureteral reflux was detected in 27 of 60 (45%) of the siblings. Vesicoureteral reflux was unilateral in 15 and bilateral in 12 of the siblings. Radionuclide cystography is more sensitive than radiographic cystography and results in a very low radiation dose to the patient. The gonadal dose with radionuclide cystography is only 1.0 to 2.0 mrads. Because of these features, radionuclide cystography is a nearly ideal technique for the diagnosis of vesicoureteral reflux in siblings of patients with known vesicoureteral reflux. All siblings (symptomatic or asymptomatic) of patients with known vesicoureteral reflux should have a screening radionuclide cystography.

Child↗
PubMed1987

Evaluation of the renal clearance of technetium-99m PAHIDA in dogs.

The renal clearance of the technetium-99m complex of para[(biscarboxylmethyl)-aminomethylcarboxyamino]hippuric acid ([99mTc]PAHIDA), has been previously studied in rodents and falls between that of [99mTc]DTPA (diethylenetriaminepentaacetic acid) and iodine-131 (131I) orthoiodohippuran (OIH). To investigate the effect of species variation, the plasma clearance of [99mTc]PAHIDA was investigated in dogs. The plasma disappearance of the renal agent approached that of [99mTc]DTPA and was significantly less than that of OIH. Despite the structural similarities of the PAHIDA ligand and aminohippurate, the [99mTc]PAHIDA complex undergoes little, if any, tubular secretion in the canine kidney.

Aminohippuric Acids↗
PubMed1987

Diffuse hepatic uptake of technetium-99m methylene diphosphonate in a patient receiving high dose methotrexate.

A child with diffuse accumulation of [99mTc]MDP in the liver on a bone scan, at the time of study the patient had a severe, but reversible, hepatic dysfunction on the basis of methotrexate toxicity. Visualization of the liver on skeletal scintigrams can be a consequence of high-dose methotrexate therapy, as there was no other explanation for this unusual finding.

Antineoplastic Combined Chemotherapy Protocols↗