Search PubMed⌕ Search

Biomedical subjects

W J Shih

Publications and source records attributed to W J Shih.

At least 217 records · Page 12Linked to original sources
PubMed1986

Radiocolloid scintigraphy in Felty's syndrome.

The Tc-99m sulfur colloid liver-spleen scintigrams of nine patients with Felty's syndrome (a triad of rheumatoid arthritis, splenomegaly, and neutropenia) were reviewed. The characteristic scintigraphic findings include (1) moderate or severe splenomegaly, (2) the reversal of liver-to-spleen uptake ratio despite normal liver function tests, and (3) virtually no visualization of the bone marrow uptake and no pulmonary radiocolloid sequestration. In a late stage of cirrhosis of the liver, moderate-to-severe splenomegaly with the reversal of liver-to-spleen uptake ratio almost always accompanies abnormal liver function, and sometimes there may be associated pulmonary radiocolloid uptake. It was therefore concluded that in a proper clinical setting, a radiocolloid scintigraph may differentiate between Felty's syndrome and cirrhosis of the liver in a late stage.

Aged↗
PubMed1986

Opportunistic intracranial infection in AIDS detection by technetium-99m DTPA brain scintigraphy.

Radionuclide brain scintigraphy and computed tomography (CT) demonstrated cerebral lesions in two patients with acquired immunodeficiency disease syndrome (AIDS) complicated by opportunistic infection of the brain. In the detection of these cerebral lesions, [99mTc]DTPA radionuclide scintigraphy was as reliable as CT. Since malignant lymphoma involving the brain has been seen with increasing frequency in patients with AIDS, the positive brain scan alone is nonspecific and should be correlated appropriately with the clinical setting.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Technetium-99m BIDA biliary scintigraphy in the evaluation of the jaundiced patient.

Biliary scintigraphy using 99mTc p-butyl acetanilidiminodiacetic acid (BIDA) was performed as part of the diagnostic evaluation on 96 patients with jaundice (serum bilirubin greater than 2 mg/dl) to assess its value in this group of patients. The results of scintigraphy revealed no obstruction to the flow of the scintigraphic agent into the duodenum in 54 patients, delayed appearance of the agent (normal upper limit 60 min) in the duodenum indicating partial obstruction in 22 patients, and complete obstruction of the duct demonstrated by absence of agent in the duodenum in 20 patients. The findings were correlated with the final diagnosis and the overall results show accuracy of 92.7%, sensitivity of 97.3%, and specificity of 89.8%. Biliary scintigraphy was thus found to be useful in differentiating nonobstructive, partially obstructive, and completely obstructive causes of jaundice.

Adolescent↗
PubMed1985

Splenic defect on 99mTc-sulfur colloid scintigraphy but not on CT in a patient with pancreatic carcinoma.

A 99mTc-sulfur colloid (99mTc-SC) scintigraphic study of a patient with pancreatic carcinoma invading the splenic hilum demonstrated a discrete focal defect of the spleen, while computed tomography (CT) showed a normal spleen. The patient underwent splenectomy and no pathology was found in the spleen. The tumor invasion into the splenic hilum may have caused the defect shown in the 99mTC-SC study, reflecting splenic reticuloendothelial (RE) cell dysfunction, while CT might well represent anatomic structures only. This discrepant finding between functional (99mTc-SC) and anatomic (CT) imaging modalities may be explained by the fact that the impairment of the phagocytic function of the spleen apparently was not severe enough to cause structural changes detected by CT or gross and microscope examination.

Humans↗
PubMed1985

Intracranial meningioma with abnormal localization of bone-seeking radiopharmaceutical: correlation with gross and microscopic pathology.

Meningioma is one of the neoplasms in which there may be extraosseous localization of bone-seeking radiopharmaceuticals. Tumor calcification, calvarial erosion, and the formation of reactive bone have been proposed as the cause of this abnormal tracer localization. We present a patient with a frontal meningioma that was evaluated using 99mTc-methylene-diphosphonate bone scintigraphy, head computed tomography, and skull radiography; the homogeneous density seen in the radiographic studies corresponded to the area of bone-seeking-agent localization shown in the scintigram. At autopsy, bony tissue and a few psammoma bodies were found in the meningioma, and apparently accounted for the bone-tracer localization. There was no calvarial erosion and no formation of reactive bone. If skull-radiographic studies show a homogeneous, radio-opaque lesion with no reactive changes in the adjacent skull, a meningioma showing a localization of a bone-seeking radiopharmaceutical may be predicted to have bone-tissue formation with or without psammoma bodies.

Aged↗
PubMed1985

Nonvisualization of an enlarged spleen on Ga-67 scintigraphy but demonstrated by CT after splenic irradiation.

Presence of enlarged spleen using CT with absence of splenic visualization in Ga-67 citrate images in a patient with chronic myelogenous leukemia and splenomegaly after splenic irradiation was observed. Since Howell-Jolly bodies had not been identified in the peripheral circulation, the finding of splenic nonvisualization was explained by disassociated splenic functions, which are not tightly coupled, and some activities that can be suppressed by irradiation without impairing others. The Ga-67 splenic localization mechanism is probably more sensitive and liable to disruption by irradiation, and was independent of spleen size. Ga-67 scintigraphy and Tc-99m sulfur colloid liver-spleen scintigraphy are two organ function-dependent imaging procedures, while CT provides anatomic information.

Gallium Radioisotopes↗
PubMed1985

Prominent gaseous distension of bowel causing false-positive technetium-99m sulfur colloid liver scintigram.

A Tc-99m sulfur colloid liver scan carried out shortly after a prolonged upper gastrointestinal endoscopy demonstrated two concave indentations along the inferior border of the liver and increased space between the left lobe of the liver and the spleen. These abnormalities, simulating compression by an extrinsic mass, were caused by air introduced endoscopically into the gastrointestinal tract. Eight days later, a repeat radiocolloid scan was normal. There should be awareness that gaseous distension of the bowel and stomach may result in a false-positive radiocolloid liver scan. Correlation with abdominal radiographs may avert such misinterpretation.

Aged↗
PubMed1985

Thallium-201 scintigraphic visualization at rest of a dilated and hypertrophied right ventricle in a patient with sarcoidosis complicated by cor pulmonale.

Visualization, by resting TI-201 scintigraphy, of a markedly enlarged right ventricle (RV) in a 48-year-old black man with a 20-year history of pulmonary sarcoidosis is presented. The RV was three to four times larger than the left ventricle. Sarcoidosis resulted in marked distortion of the thoracic contents, as shown by the radiograph. This distortion possibly accounts for optimal scintigraphic visualization of the enlarged RV in the left lateral projection rather than in the left anterior projection. Because of the distortion, the chest radiograph could not be used to evaluate the cardiac contour; TI-201 scintigraphy demonstrated the RV enlargement.

Cardiomegaly↗
PubMed1985

Scintigraphic findings in primary amyloidosis of the heart and stomach.

The effectiveness of scintigraphic studies in the study of patients with primary systemic amyloidosis has not been reported previously. This case report describes a patient with the scintigraphic findings of thickened myocardium and delayed gastric emptying, which correlated well with the presence of amyloid deposits in these organs at autopsy. Additionally, the liver and spleen had normal scintigraphic appearances and were free of amyloid at autopsy. Radionuclide studies appear useful in assessing the anatomic and physiologic abnormalities assessed by amyloid deposition.

Aged↗
PubMed1985

Technetium-99m triethylene tetramine polystyrene resin gastric emptying studies in patients with various upper gastrointestinal diseases.

The gastric emptying study using Tc-99m triethylene tetramine polystyrene resin with or without metoclopramide hydrochloride was used in six patients with different disease entities: achalasia, gastric lymphoma, primary amyloidosis, Zollinger-Ellison syndrome, duodenal diverticulum, and short bowel syndrome. All patients had abnormally prolonged gastric emptying times. The patient with gastric lymphoma and the patient with Zollinger-Ellison syndrome had virtually no effect from metoclopramide. The patient with a duodenal diverticulum and the patient with short bowel syndrome had partial and good response to metoclopramide, respectively. Endoscopic and/or autopsy examinations in patients with achalasia, Zollinger-Ellison syndrome, primary amyloidosis, and duodenal diverticulum proved the patency of the pyloric canal. The patient with gastric lymphoma had a mass associated with marked pyloric narrowing and lymphoma cell infiltration of the gastric wall, to explain the abnormal gastric emptying. The gastric emptying study with or without metoclopramide may be used noninvasively to measure gastric function, to determine the nature of gastric outlet obstruction, and to evaluate therapy with metoclopramide.

Adult↗
PubMed1985

Photopenia of a hemithorax on technetium-99m HMDP bone scintigraphy resulting from massive pleural effusion.

Accumulation of Tc-99m labeled phosphonate bone scanning agent in a pleural effusion usually shows a mild and diffuse increase in radioactivity of the involved thorax. A malignant neoplasm was thought to account for this accumulation. The photon deficiency of the hemithorax on Tc-99m HMDP bone scintigraphy was shown in a case of massive pleural effusion, which was proved by autopsy to be due to metastatic breast carcinoma in the pleura. Two factors caused these scintigraphic findings: 1) a large amount of fluid in the pleural cavity caused photon attenuation; 2) the higher body background in the noninvolved hemithorax and other areas of the body was due to renal dysfunction resulting from chronic pyelonephritis. Whether the accumulation of the radiopharmaceutical agent in the pleural effusion was malignant or benign could not readily be distinguished.

Adult↗
PubMed1985

Simultaneous demonstration of pleural effusion and ascites by technetium-99m sulfur colloid liver-spleen scintigraphy.

Scintigraphic evidence of ascites has been observed in Tc-99m sulfur colloid studies of the liver and spleen, in Tc-99m HIDA hepatobiliary scans, in Ga-67 citrate scans, and in Tc-99m phosphonate bone images. Pleural effusion has been demonstrated in Tc-99m phosphonate bone scintigraphy. The case of a 48-year-old man whose Tc-99m sulfur colloid liver-spleen scintigram simultaneously demonstrated a right pleural effusion and ascites is presented.

Ascites↗
PubMed1985

Cystic disease of the liver studied by 99Tcm DISIDA and 99Tcm sulphur colloid imaging.

Two patients with cystic disease of the liver have been studied with 99Tcm sulphur colloid and 99Tcm DISIDA scintigraphy and CT. One patient's cystic lesions are substantially enlarged as seen in 99Tcm sulphur colloid scintigrams performed at 10 year intervals. Another patient's scintigraphic studies performed at 5 year intervals demonstrated no significant progression in the size of the cysts in the liver. The 99Tcm DISIDA scintigram of each patient demonstrated no radiotracer filled-in in the cystic lesions (photon deficient areas on 99Tcm sulphur colloid scan). This finding may be used to differentiate cystic disease of the liver from hepatoma, in which usually DISIDA filled-in the defects seen on the 99Tcm sulphur colloid scintigram.

Aged↗
PubMed1985

Overestimation of splenic size and underestimation of hepatic size by radiocolloid scintigraphy in advanced cirrhosis of the liver: an autopsy correlation.

The radiocolloid liver-spleen scintigrams of seven patients with advanced cirrhosis of the liver were correlated with autopsy results. The data showed scintigraphic overestimation of splenic size and underestimation of hepatic size. The causes of underestimation of the liver size were: rotation of the liver due to ascites; photon attenuation by ascitic fluid; and/or decreased and in homogeneous distribution of radiocolloid in the diseased liver. The splenic size/weight was overestimated because of lack of the effects of ascites and the usually marked increase in splenic radioactivity. Awareness of the underestimation of the liver weight/size and overestimation of the splenic weight/size occurring on the radiocolloid liver-spleen scan of patient with advanced alcoholic cirrhosis of the liver may help avoid misinterpretation.

Aged↗
PubMed1985

Multiclinic comparative study of norfloxacin and trimethoprim-sulfamethoxazole for treatment of urinary tract infections.

Three hundred seventy patients with upper or lower urinary tract infections were entered into a multicenter, open comparative study. A total of 190 patients were treated with norfloxacin, and 180 patients were treated with trimethoprim-sulfamethoxazole. The percentage of strains susceptible to norfloxacin (99%) was significantly greater (P less than 0.001) than the percentage of strains susceptible to trimethoprim-sulfamethoxazole (90%). The percentages of patients with bacteriological outcomes of eradication were greater in the norfloxacin group (97%) than in the trimethoprim-sulfamethoxazole group (90%). The difference was significant (P less than 0.05). Seven patients (three treated with norfloxacin, four treated with trimethoprim-sulfamethoxazole) experienced early reinfection. Of 370 patients entered into the study, 20 patients experienced clinical adverse effects that were probably or definitely related to the study drug; 6 patients were in the group that received norfloxacin, and 14 were in the group that received trimethoprim-sulfamethoxazole. Study antimicrobial agents were discontinued because of clinical adverse effects in eight patients (norfloxacin, one patient; trimethoprim-sulfamethoxazole, seven patients). Three patients receiving norfloxacin and four patients receiving trimethoprim-sulfamethoxazole had laboratory adverse effects which were classified as probably or definitely drug related. None of the clinical or laboratory adverse effects was serious.

Adult↗