Extraosseous accumulation of Tc-99m diphosphonate.
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A pyridoxine (vitamin B6)-deficient diet in rats was used as a model of early renal lithiasis to find out if "stone-formers" could be identified from control animals by differences in the biodistribution of Tc-99m MDP. The mean renal uptake of this agent at 3 hours was about 70% higher in test animals than in controls, but there was considerable overlap between the upper limits of the normal range and lower values in "stone-formers." If these results were valid for humans, the metabolic abnormality in males with early stone-forming disease could not be identified with certainty by in vivo measurements of Tc-99m MDP renal uptake alone. However, the skeletal uptake of MDP in the "stone-forming" animals was depressed by 28 to 35%, compared with control rats. Consequently, the renal to skeletal MDP concentration ratio was invariably elevated in "stone-formers" beyond the 95 percentile normal range. Unexpectedly, 76% of the pyridoxine-deficient animals had a higher accumulation of MDP in the myocardium than the upper limit of the normal range. The pyridoxine-deficient diet induced no remarkable early changes in the biodistribution or renal clearance of I-131 Hippuran.
In a comparative study with a thyroid probe and a whole body counter (WBC) we found that whole body retention (WBR) (2 h and 24 h) may be correctly obtained using a single probe, provided that measurements are taken carefully. With the detecting geometry presented, the single probe yielded only a slightly higher WBR than the WBC (less than 3 percentage points). We conclude that the method is capable of differentiating between pathological and normal WBR values.
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The effects of EHDP (20 mg/kd/day) and APD (4.5 mg/kg/day) given for three months to patients with severe symptomatic Paget's disease have been compared in an open trial of 17 patients. Both drugs were equally effective in producing a prompt reduction in pair scores, urine hydroxyproline, and serum alkaline phosphatase levels. The remission was maintained for a variable period after stopping treatment. Both drugs were well tolerated, and a one-month course of either drug was not effective. Comparison with published responses from previous studies indicates that EHDP given at this dose as a relatively short course is more effective than a lower dose for a longer period of time; the present study does not suggest that APD has significant advantages.
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In the diagnosis of multiple myeloma (MM), the radiological skeletal survey (RSS) was proven to be most useful for the detection of bone lesions. Since 1961, a new technique radioisotopic bone scan (RIBS), for the detection of such lesions, using 85Sr and 99mTc, has been shown to be highly sensitive for the detection of skeletal metastases of epithelial tumors. We have studied 30 patients with plasma cell dyscrasia (PCD) by both methods and concluded that RSS is clearly superior to RIBS in PCD. As RIBS detected less than 50% of the lesions demonstrated by RSS there seems to be no indication for a routine RIBS in the initial work-up of patients suspected to have PCD. However, due to the fact that RIBS is useful for the detection of new bone formation it has a certain value in the localization of pathological fractures in MM, mainly in vertebral compression.
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Calcification is the most frequent cause of the failure of bioprosthetic heart valves fabricated from glutaraldehyde pretreated porcine aortic valves or bovine pericardium. Formulation and evaluation of controlled-release drug delivery system to inhibit bioprosthetic heart valve calcification is reviewed.