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Biomedical subjects

A R Constable

Publications and source records attributed to A R Constable.

At least 19 recordsLinked to original sources
PubMed1981

Recognition of the superscan in prostatic bone scintigraphy.

Widespread bone metastases can occasionally give rise to a uniform distribution of 99Tcm methylene diphosphonate resulting in a superficially normal appearance on the bone scan. The scans are recognizable by the high ratio of bone to soft tissue activity, the absence of focal lesions in the axial skeleton, and there are usually no renal images. These "superscans" can occasionally be misinterpreted as normal. An index of image quantitation related to the ratio of bone to soft tissue uptake is shown to be capable of clearly distinguishing these patients from patients in other categories. The condition is thought to be more frequently associated with prostatic carcinoma than with other aetiologies.

Adult↗
PubMed1980

Successful renal transplantation in primary hyperoxaluria.

A successful live related renal transplant in a 29-year-old male patient with Type 1 primary hyperoxaluria, who remains well 32 months postoperatively, is described. The plasma oxalate and exchangeable oxalate pool before transplantation were 160 mumol/1 and 4429 mumol respectively. Since the transplant these have been greatly reduced although they remain elevated above the normal by a factor of 2. Pyridoxine therapy and the avoidance of oxalate-rich foods have been effective in maintaining these reduced levels and the 24-hr urinary oxalate excretion has also been maintained close to normal levels on this regime. After review of the previously reported transplants in patients with well documented primary hyperoxaluria and from the experience with this patient, the following guidelines for successful renal transplantation in primary hyperoxaluria are suggested: transplants should only be carried out in those who have shown a response to adequate pyrodoxine therapy; frequent haemodialysis pre-operatively and during periods of oliguria postoperatively is necessary; oxalate-rich foods should be avoided and a high fluid intake should be maintained after transplantation. If these guidelines are followed there is no contra-indicatin to live related renal transplants in primary hyperoxaluric patients.

Adult↗
PubMed1979

Plasma level and renal clearance of oxalate in normal subjects and in patients with primary hyperoxaluria or chronic renal failure or both.

1. Plasma oxalate has been measured by a radioisotopic method applicable to all concentrations of plasma oxalate and renal function, and also by an enzymatic method which was only applicable to raised concentrations of plasma oxalate. 2. Where the two methods could be applied simultaneously, the agreement between them was good. 3. Plasma oxalate was 86% ultrafiltrable at concentrations of up to 44 micromol/l. 4. Oxalate clearance and the exchangeable oxalate pool were also measured. The ratio of oxalate clearance to creatinine clearance was greater than unity in most normal subjects and patients. 5. These methods were used in normal subjects and in patients with primary hyperoxaluria and/or chronic renal failure. A raised plasma oxalate concentration was found in both conditions. Chronic renal failure is probably the most common cause of a raised plasma oxalate.

Adult↗
PubMed1979

Single sample estimates of renal clearances.

Thirty adult patients were investigated with 36 125I Hippuran and 40 51Cr EDTA single injection clearance studies. "Volumes of distribution" obtained from single samples have been correlated with the slope clearances and regression equations have been determined. From these equations it is possible to determine glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) from single plasma samples and the method is sufficiently accurate for routine application.

Adult↗
PubMed1979

Improved techniques in radionuclide imaging of prostatic lymph nodes.

Further improvements have been made in the technique of human prostatic lymphoscintigraphy, allowing better anatomical localisation of the areas of uptake of activity. A single median injection into the capsule of 99mTc labelled antimony sulphide colloid has been found to give as good imaging as 2 injections on either side of the midline. By placing markers on the umbilicus, pubic symphysis and both anterior superior iliac spines, a "pelvic grid" can be superimposed on the antero-posterior view. Further help with accurate localisation may be attained by taking 3 views; antero-posterior, postero-anterior and lateral, in 9 instances, prostatic injection was performed without any sedation or anaesthesia. The resulting scintigrams were indistinguishable in quality from those of anaesthetised patients.

Humans↗
PubMed1979

Human prostatic lymphoscintigraphy. A preliminary report.

A simple method for demonstrating prostatic lymphatic drainage by transrectal injection of 99mTc labelled antimony sulphide colloid into the prostatic capsule has been developed. This technique may be readily applied in clinical practice with obvious potential in the assessment and follow-up of patients with carcinoma of the prostate.

Humans↗
PubMed1978

Bone scanning and plasma phosphatases in carcinoma of the prostate.

Bone scanning with 99mTc-Sn-HEDP, radiographic skeletal survey and determination of plasma acid and alkaline phosphatase values were carried out in a consecutive series of 90 untreated patients with carcinoma of the prostate. 99mTc-Sn-HEDP provided satisfactory bone imaging and was convenient in use. The addition of bone scanning to radiographic survey increases the detection rate of skeletal metatases by 16%. Radiography increases the accuracy of bone scanning by identifying false positive scans due to benign disease and false negative scans when there are diffuse symmetrical bony metastases. The plasma phosphatases alone are less accurate staging tests. The acid phosphatase data support the validity of scan positive--X-ray negative findings. Bone scan abnormalities due to secondary deposits usually precede elevation of plasma alkaline phosphatase.

Acid Phosphatase↗
PubMed1978

Serial bone scanning: the assessment of treatment response in carcinoma of the prostate.

Serial bone scans and radiographic surveys were performed in 167 patients with histologically proven carcinoma of the prostate: 435 scans and surveys were performed. Nineteen of 99 patients with negative findings on diagnosis have become positive on follow-up. Forty-nine patients had positive findings on presentation; 8 have regressed on follow-up and 26 have progressed; 15 have remained unchanged. This is a sensitive method of follow-up in patients with carcinoma of prostate. Changes occurred in bone scans and skeletal surveys before any alteration in serum acid or alkaline phosphatases, symptoms of metastases or change in prostatic size in the majority of cases. The documentation of progression from MO to M1 disease presents no problems. However, problems in quantitation may arise in patients presenting with M1 disease.

Acid Phosphatase↗
PubMed1977

Radionuclide cystography in the investigation of vesicoureteric reflux in children.

50 children with urinary-tract infection and vesicoureteric reflux were investigated by direct radionuclide cystography (R.N.C.). Recent micturating cystourethrograms (M.C.U.) were used as controls. In 37 patients the results of both tests corresponded, 9 patients were M.C.U. positive only, and 4 were R.N.C. positive only. R.N.C. is associated with a considerably lower radiation dose than M.C.U.S. and intravenous urograms, it provides an accurate measurement of residual urine, and is simple to apply with equipment which is readily available. R.N.C. is a useful investigation in the diagnosis and management of reflux and a valuable complement to standard radiographic methods.

Adult↗
PubMed1977

Radionuclide cystography in the management of vesico-ureteric reflux.

Direct radionuclide cystography in 100 patients has been shown to be a useful investigation in the diagnosis and management of reflux and a valuable complement to radiographic methods; it may well have a place in the detection of reflux in the infected patient. The advantages include low radiation exposure, an accurate measurement of residual urine volumes, simplicity of technique and the use of materials and equipment that have in recent years become increasingly available for routing investigation.

Child↗