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Biomedical subjects

A Sergent

Publications and source records attributed to A Sergent.

5 recordsLinked to original sources

Intraoperative bone scintigraphy in orthopaedic surgery.

A sterilisable radiation probe of small dimensions was designed to locate the lesions at orthopaedic surgical sites according to the procedure of intraoperative bone scintigraphy. The probe has a collimated opening 2 mm in diameter. It is connected to a portable radioactivity counter which converts the disintegration rates detected at surgical sites into an acoustic signal that increases steeply with increasing disintegration rate. The acoustic signal enables the surgeons and isotope specialists to readily monitor radioactivity in the region of interest without attention being distracted from the surgical site. Dimethylaminodiphosphonate (designated SF44) was the osteotropic radiopharmaceutical chosen for carrying out intraoperative bone scintigraphy, since the available data show that this chemical increases the pathological: normal bone uptake ratio of the lesion by 25% compared to the usual diphosphonates. Forty-seven orthopaedic interventions were carried out according to the intraoperative bone scintigraphy procedure. They showed that this procedure facilitated the rapid location of the lesion, the objective termination of the operation, less frequently the reduction in dimension of the excised areas, and rarely the simplification of the surgical technique. Practice of intraoperative bone scintigraphy requires proper training and caution.

Adolescent↗

Cortical perfusion assessment with 123I-isopropyl amphetamine (123I-IAMP) in normal pressure hydrocepha lus (NPH).

NPH can be reversible after cerebrospinal fluid (CSF) diversion. In the past no reliable criteria could be defined to predict the successful outcome of CSF shunting. Several authors demonstrated an increased cerebral blood flow after lumbar puncture in patients with NPH, indicating an underlying impairment of cerebral circulation autoregulation. 123I-AMP brain tomoscintigraphy was applied to 23 individuals with NPH before and after CSF drainage. Of these 23 patients, 10 underwent surgical shunting. The frontal and parietal hypoactive cortical pattern was present in NPH but not pathognomonic. Under stimulation of CSF pressure lowering, seven patients with improved outcome after shunting demonstrated an increase of cerebral perfusion in these areas, whereas a decrease of activity was found in three patients whose clinical status was unchanged after CSF diversion. This tomoscintigraphic test may be an interesting additional criterion for surgical admission.

Adult↗

Early and delayed SPECT using N-isopropyl p-iodoamphetamine iodine 123 in cerebral ischemia. A prognostic index for clinical recovery.

Sixteen patients with stroke, five patients with permanent regressive ischemic neurologic deficit, and three patients with transient ischemic attacks were studied by single photon emission computed tomography performed within the first hour (early scan) and four hours (delayed scan) after injection of N-isopropyl-p-iodoamphetamine-iodine-123 (IMP). These patients were classified into three groups according to their clinical improvement three months later, and results of single photon emission computed tomography were compared with computed tomographic scan results and correlated to the clinical outcome. Regional brain hypoactivity of IMP differed in some cases between early and delayed IMP scans, showing in those cases a "redistribution" activity. The amplitude of this redistribution was significantly correlated with the clinical outcome of patients with stroke, whereas the value of hypoactivity on early IMP scan did not show such a correlation. The higher the redistribution amplitude was, the better was the clinical outcome. Comparative regional brain hypoactivity of IMP on early and delayed scans could represent a prognostic index of clinical recovery inasmuch as it gives information concerning viability of ischemic brain tissue.

Adult↗

Amines for brain tomoscintigraphy.

Amines like N-isopropyl-p-123I-iodoamphetamine (IMP) and hydroxy 123I-iodobenzyl propyl diamine (HIPDM) associated with brain tomoscintigraphy have proved their worth for detecting ischaemic abnormalities. Even though the chemistry of their metabolism and their biodistribution are not fully understood, their application in the study of parenchymal impairment in stroke and reversible ischaemia yields additional information compared to the other methods of imaging like CT or MRI. The concept of a steady state in brain with a wash in/wash out model has been considered especially with IMP, to explain the evolution of the activity pattern with time when comparing early and delayed images. (This review leads to foresee the prognosis of of ischaemic diseases when redistribution is taken into account.)

Amphetamines↗