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Biomedical subjects

C E Nagle

Publications and source records attributed to C E Nagle.

At least 19 recordsLinked to original sources
PubMed1996

Differential diagnosis of a tender goiter.

Subacute thyroiditis is generally felt to have a viral etiology, and the diagnosis is usually obvious when the patient presents with a diffusely enlarged and very tender thyroid gland associated with elevated free T4 levels, elevated sedimentation rate, low radioiodine uptake and/or nonvisualization on scan and often some systemic symptoms. Subacute thyroiditis can be unilateral or focal (1,2). Corticosteroids are very effective in relieving symptoms of subacute thyroiditis, often within 24 hr (3). Three patients are presented where the initial impression was subacute thyroiditis, there was a clinical response to prednisone, but none of the patients actually had subacute thyroiditis.

Abscess↗
PubMed1992

Laparoscopic versus conventional cholecystectomy. Use of biliary scintigraphy.

Laparoscopic cholecystectomy has become a popular alternative to traditional open cholecystectomy for uncomplicated, acute cholecystitis. At some centers, laparoscopic cholecystectomy is already the more frequently performed procedure. The presence or suspicion of common bile duct (CBD) stones or obstruction may necessitate conventional surgery or additional procedures. This report describes a patient with acute cholecystitis for whom the surgical management changed based on biliary scintigraphy. The demonstration of an unsuspected CBD obstruction by biliary imaging allowed the surgeon to change the initial plan for laparoscopic cholecystectomy to conventional open surgery. Stones in the common bile duct were removed.

Acute Disease↗
PubMed1988

The determination of death and the changing role of medical imaging.

Laws and standards of medical practice with respect to the determination of death have changed dramatically as knowledge of the human body and its detailed cellular functions have increased. This article describes legal and medical advances in the determination of death emphasizing the role of modern imaging technology in this critical determination.

Brain↗
PubMed1987

Skull infarction in a patient with malignant fibrous histiocytoma.

The authors describe a case of a skull infarction initially suspected to be an isolated, remote metastasis in a patient diagnosed with soft tissue malignant fibrous histiocytoma. Osseous malignant fibrous histiocytoma has been reported to occur within a bone infarction but the presence of a benign bone infarction remote from a soft tissue malignant fibrous histiocytoma has not been reported previously. Bone infarctions and malignant fibrous histiocytomas are briefly reviewed.

Adult↗
PubMed1986

Cost-appropriateness of whole body vs limited bone imaging for suspected focal sports injuries.

Bone imaging has been recognized as a useful diagnostic tool in detecting the presence of focal musculoskeletal injury when radiographs are normal. A retrospective review of bone images in a small number of amateur athletes indicates that secondary injuries were commonly detected at sites different from the site of musculoskeletal pain being evaluated for injury. While a larger study will be necessary to confirm the data, this review suggests that it is medically justified and cost-appropriate to perform imaging of the entire skeleton as opposed to imaging limited to the anatomic site of pain and suspected injury.

Adolescent↗
PubMed1985

Bile ascites in adults. Diagnosis using hepatobiliary scintigraphy and paracentesis.

Hepatobiliary scintigraphy has been recognized as a useful diagnostic tool in detecting the presence and site of bile leaks. The authors report a case of bile ascites secondary to a postsurgical biliary leak, the scintigraphic findings in bile ascites, and the potential use of paracentesis, in combination with hepatobiliary scintigraphy, in confirming the presence of bile ascites and a bile leak.

Adult↗
PubMed1984

Abdominal and pelvic imaging as part of liver-spleen scintigraphy for the detection of mesenteric bleeding in trauma. A case report.

Liver--spleen scintigraphy in patients who have incurred blunt abdominal trauma is accepted as a useful diagnostic tool. Abdominal and pelvic imaging to detect extrahepatic or extrasplenic sites of hemorrhage should be a routine part of liver--spleen imaging in the evaluation of blunt abdominal injury. A patient with mesenteric bleeding and a normal liver and spleen detected by liver--spleen scintigraphy is reported.

Abdomen↗
PubMed1984

Is thyroid scintigraphy necessary before I-131 therapy for hyperthyroidism? Concise communication.

To assess the value of routine thyroid scintigraphy in the differential diagnosis of hyperthyroidism and as a guide to I-131 therapy, we prospectively examined 100 consecutive hyperthyroid patients referred for a 24-hr radioiodine uptake and I-131 therapy. The nuclear medicine physician recorded his preimaging diagnostic impression and therapeutic plan for each patient. After the [ 99mTc ] pertechnetate image, the patient was reassessed to determine whether the image induced any change in the diagnosis or therapeutic plan. Seventy-nine of 80 patients with diffuse goiter to palpation, had scintigrams demonstrating no discrete focal defects and were diagnosed as Graves' disease; thus the scintigram did not contribute useful information. In 17 of 20 patients with uninodular or multinodular goiters, the image was necessary to clarify the final diagnosis and therapeutic plan. Thus, selective use of thyroid scintigraphy should decrease the number of scintigrams performed before I-131 therapy for hyperthyroidism, without compromising diagnostic accuracy or therapeutic success.

Adult↗
PubMed1983

Cholescintigraphy in cholecystic cancer.

Two case reports of nonvisualization of the gallbladder by hepatobiliary scintigraphy in patients with carcinoma of the gallbladder are described. A hypothesis regarding the pathogenesis of gallbladder nonvisualization in cholecystic cancer is offered. The possible clinical utility of hepatobiliary scintigraphy in these patients is discussed.

Adenocarcinoma↗
PubMed1983

Influence of scan and pathologic criteria on the specificity of cholescintigraphy: concise communication.

The influence of scan and pathological criteria on the specificity of cholescintigraphy was assessed by a prospective study of 211 patients with suspected acute cholecystitis who underwent cholescintigraphy. Sufficient data were available in all to confirm a final diagnosis. Cholescintigraphy was performed in the standard fashion using 5 mCi of Tc-99m disofenin. Sixty patients had acute cholecystitis, 64 had chronic cholecystitis, and 87 had no demonstrable gallbladder disease. As the scan and pathological criteria for acute cholecystitis were varied from strict to liberal, the sensitivity of cholescintigraphy decreased (100% to 95.3%), the specificity increased (85.1% to 98.6%, and the predictive value increased (68.4% to 96.8%). The use of strict scan and pathological criteria for acute cholecystitis obscures the advantages that accrue from such early detection of acute cholecystitis by cholescintigraphy, and thus are to be avoided. To understand the disparate opinions voiced in the literature, an appreciation is required for the effects of changes in criteria on the specificity and predictive value of cholescintigraphy.

Acute Disease↗
PubMed1980

Use of immediate static scans in combination with radionuclide cerebral angiography as a confirmatory test in the diagnosis of brain death.

Using a portable scintillation camera in combination with a portable computer, bedside acquisition of immediate static images in combination with a dynamic radionuclide cerebral angiogram can be quickly and safely performed as a confirmatory test in the diagnosis of brain death. Confusion in the differentiation of extracerebral from intracerebral flow on the dynamic radionuclide angiogram can be accomplished by identifying the presence or absence of uptake in the cerebral sinuses. Absence of intracerebral circulation on the dynamic radionuclide cerebral angiogram in combination with the lack of uptake in cerebral sinuses confirms the lack of intracerebral flow and can be used as confirmatory evidence of a diagnosis of brain death.

Adult↗