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Biomedical subjects

D Groshar

Publications and source records attributed to D Groshar.

At least 55 records · Page 3Linked to original sources
PubMed1992

Does gallium uptake in the pulmonary hila predict involvement by non-Hodgkin's lymphoma?

67Ga imaging of non-Hodgkin's lymphoma is useful for evaluating the presence of viable tumour in a residual mass after treatment. However, we have frequently seen gallium uptake in the pulmonary hila without other evidence of lymphoma. To study the significance of this finding, 79 patients with intermediate grade non-Hodgkin's lymphoma were reviewed. Thirty-seven (47%) had abnormal hilar gallium uptake. Twenty-three of these could be fully evaluated, and only five (22%) had hilar lymphoma. A pattern of bilateral, symmetric hilar uptake was seen in 19 patients, but only one had evidence of lymphoma. In 15 cases, this pattern was seen only on single photon emission computed tomography (SPECT). The aetiology of this uptake remains unknown. It is not treatment related, as 12 patients had hilar gallium uptake prior to chemotherapy. Unless confirmed by other methods, hilar gallium uptake should not be attributed to lymphoma, and should not influence patient management.

Alberta↗
PubMed1992

Stress fractures associated with osteosarcoma of the lower limb.

Three patients with osteosarcoma of the femur developed abnormal radiopharmaceutical uptake in the bones of the contralateral leg. This uptake was not due to metastases. The histology in one patient, the form of the lesion and the disappearance of the abnormal uptake without treatment in the other two, indicated that the uptake was probably due to stress fractures. Changes in weight bearing and walking in the normal leg as a result of the osteosarcoma in the other leg could have been the cause of the stress fractures. It should be recognized that new abnormal uptake on bone scintigraphy in patients with osteosarcoma of the leg may not necessarily indicate metastasis. It may be caused by a stress fracture and disappears after rest.

Adult↗
PubMed1992

Radionuclide assessment of penile corporal venous leak using technetium-99m-labeled red blood cells.

In an attempt to evaluate penile corporal venous outflow, a method that utilizes intracorporal injection of Tc-RBC was developed and used in 20 patients with erectile dysfunction. Seven patients showed venous leak and 13 had normal venous outflow. Technetium-labeled RBC corporal clearance in the flaccid state and after intracorporal injection of papaverine (30 mg) and regitine (1 mg) were assessed in sequence by two separate injections of 18.5 MBq of Tc-RBC each. The time for 50% corporal clearance (T50%) was determined from the time activity curves obtained in flaccid state and after intracorporal injection of the vasoactive agent. There were no statistically significant differences in T50% measured in the flaccid state between normal venous outflow (202 +/- 139 sec) and venous leak (92 +/- 35 sec, p = 0.1). However, after intracorporal injection of papaverine and regitine a significant increase in the T50% was noted in normal venous outflow (2892 +/- 1899 sec) as compared to venous leak (213 +/- 123 sec, p less than 0.001). The results suggest that measurement of corporal clearance of Tc-RBC after intracorporal injection of papaverine may be a useful method in detecting venous leak, and could be used as a screening test in patients with erectile dysfunction.

Adult↗
PubMed1991

Effect of extracorporeal piezoelectric lithotripsy shock waves on renal function measured by Tc-99m-DMSA using SPECT.

Extracorporeal shock-wave lithotripsy has altered the therapeutic approach to urinary stone disease. Recently, a method was developed in which shock-wave generation is obtained piezoelectrically. To evaluate the effect of extracorporeal piezoelectric lithotripsy (EPL) on renal function, 20 patients were studied prior to and after EPL of renal calculi. Renal cortical function was evaluated by using a previously described and validated quantitative single photon emission computerized tomography (SPECT) method to measure individual absolute uptake of technetium-99m dimercaptosuccinic acid (Tc-99m-DMSA). Twenty kidneys were treated, and the 19 contralateral kidneys were without stone disease (1 patient had a single kidney). The absolute kidney uptake of Tc-DMSA in the normal kidneys was 21.4% +/- 6.2% before and 22.2% +/- 6.4% after EPL. For the treated kidneys the absolute update was 16.8% +/- 5.3% and 16.8% +/- 4.7% before and after, respectively. There was no statistical significant difference between pre- and post-treatment values. The absolute kidney uptake was significantly lower (p less than 0.01) in the treated than in the normal kidneys. This study indicates that the EPL procedure did not cause any damage to cortical function detectable by the DMSA uptake.

Adult↗
PubMed1991

Radionuclide assessment of bladder-emptying function in normal male population and in patients before and after prostatectomy.

Radionuclide assessment of the bladder-emptying function was evaluated in 82 normal individuals and in 16 patients before and after prostatectomy. The parameters evaluated were: average flow rate (AFR), peak flow rate (PFR), corrected peak flow rate (CPFR = PFR/[bladder volume] 0.5), ejection fraction (EF) of the bladder, and post-voiding residual urine (RU) volume. A good interobserver reproducibility was found in 19 measurements. Urinary flow rates, EF, and RU showed a highly significant statistical difference between normal individuals and patients before surgery: AFR, 9.2 +/- 5.1 vs. 2.9 +/- 1.5 mL/sec; PFR, 19.5 +/- 9.2 vs 7.4 +/- 3.2 mL/sec; CPFR, 1.17 +/- 0.34 vs 0.54 +/- 0.22; EF, 95.6 +/- 4.6 vs 68.2 +/- 23.2 percent; and RU, 11.8 +/- 15.8 vs 93.4 +/- 115 mL; respectively. After prostatectomy the urinary flow rates showed a highly significant improvement and did not differ from the normal individuals: AFR, 7.9 +/- 2.7 mL/sec; PFR, 19.0 +/- 6.4 mL/sec; and CPFR, 1.32 +/- 0.57. The EF after surgery (91.7 +/- 10.9%) was lower than in normal individuals, but showed a significant improvement compared with EF before surgery. The RU after surgery (27.4 +/- 48.0 mL) although lower than before surgery did not differ significantly and was greater than in the normal individuals. No relationship between age and flow was found in this study. Both average and peak flow rates were related to the bladder volume. This method involves a single, noninvasive procedure which enables determination of bladder-emptying function.

Adult↗
PubMed1991

Renal function and technetium-99m-dimercaptosuccinic acid uptake in single kidneys: the value of in vivo SPECT quantitation.

The ability to evaluate kidney function in each kidney separately by quantitative SPECT was tested in 20 patients with a single kidney and varying degrees of renal disease. Technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) uptake was compared with renal function measured by creatinine clearance and serum creatinine. There was a good correlation for both serum creatinine (r = 0.89, y = 24.6 *X -1.15, error = 5.6, p less than 0.001) and creatinine clearance (r = 0.76, y = 0.6 *X 0.84, error = 8.0, p less than 0.001). The results indicate that SPECT quantitation of 99mTc-DMSA uptake can be used as an indicator of the function of each kidney individually.

Adult↗
PubMed1990

Comparison of the acute effects of captopril and of nifedipine on left ventricular diastolic function in elderly hypertensive patients.

The acute effects of single doses of captopril (C) 12.5 mg, of nifedipine (N) 10 mg, or of their combination (C + N) on parameters of left ventricular (LV) function were assessed in 18 elderly hypertensive subjects using radionuclide ventriculography. Blood pressure (BP) was lowered by C from 177/100 to 164/92 mmHg, by N from 177/100 to 161/91 mmHg (p less than 0.02/less than 0.05 for both C and N) and by C + N from 176/100 to 151/83 mmHg (p less than 0.01/less than 0.01). Nifedipine accelerated heart rate from 74 to 85 and C + N from 74 to 82 beats/min (p less than 0.01 in both cases), whereas C left it unchanged. Left ventricular ejection fraction (EF) was not significantly affected by either drug alone or by both drugs combined. Peak ejection rate (PER) and peak filling rate (PFR) were slightly, but not significantly, enhanced by all treatments. Captopril shortened the time to peak filling rate (TPFR) by 21 msec (p less than 0.05), N by 26 msec (p less than 0.01) and their combination by 22 msec (p less than 0.05); however, when corrected for RR interval or length of diastole, TPFR was shortened only by C (p less than 0.05). Tachycardia induced by acute administration of N may have an unwanted effect on LV diastolic function, which can be partially blunted by the concomitant administration of a converting enzyme inhibitor.

Aged↗
PubMed1989

Preoperative prediction of results of prostatectomy by a symptom score and radionuclide uroflowmetry.

A review of preoperative and postoperative symptom scores and radionuclide uroflowmetry in patients undergoing prostatectomy for benign prostatic hyperplasia indicates that there may be certain findings that can help to predict postoperative results. A statistically significant difference was obtained comparing the postoperative results of the symptom score and radionuclide uroflowmetry with the results obtained preoperatively. The correlation between the preoperative ejection fraction and the postoperative total symptom score and irritative score showed a good correlation.

Adult↗
PubMed1989

Quantitation of renal uptake of technetium-99m DMSA using SPECT.

Quantitative single photon emission computed tomography (SPECT) methodology based on calibration with kidney phantoms has been applied for the assessment of renal uptake of [99mTc]DMSA in 25 normals; 16 patients with a single normal kidney; 30 patients with unilateral nephropathy; and 17 patients with bilateral nephropathy. An excellent correlation (r = 0.99, s.e.e. = 152) was found between SPECT measured concentration and actual concentration in kidney phantoms. Kidney uptake at 6 hr after injection in normals was 20.0% +/- 4.6% for the left and 20.8% +/- 4.4% for the right. Patients with unilateral nephropathy had a statistically significant (p less than 0.001) low uptake in the diseased kidney (7.0% +/- 4.7%), but the contralateral kidney uptake did not differ from the normal group (20.0% +/- 7.0%). The method was especially useful in patients with bilateral nephropathy. Significantly (p less than 0.001) decreased uptake was found in both kidneys (5.1% +/- 3.4% for the left and 6.7% +/- 4.2% for the right). The total kidney uptake (right and left) in this group showed to be inversely correlated (r = 0.83) with serum creatinine. The uptake of [99mTc]DMSA in single normal kidney was higher (p less than 0.001) than in a normal kidney (34.7% +/- 11.9%), however, it was lower than the total absolute uptake (RT + LT = 41.5% +/- 8.8%) in the normal group. The results indicate that SPECT is a reliable and reproducible technique to quantitate absolute kidney uptake of [99mTc]DMSA.

Adolescent↗
PubMed1988

Radionuclide assessment of bladder outlet obstruction: a noninvasive (1-step) method for measurement of voiding time, urinary flow rates and residual urine.

Radionuclide uroflowmetry was performed in 23 patients with bladder outlet obstruction and 29 controls. The parameters evaluated were voiding time, time to peak flow rate, time for 50 per cent emptying, average flow rate, peak flow rate, corrected peak flow rate [peak flow rate/(bladder volume)0.5], ejection fraction of the bladder and post-void residual urine. There was a statistically significant difference between controls and patients with bladder outflow obstruction in each parameter: voiding time 28.2 +/- 9.3 versus 49.2 +/- 26.5 seconds, time to peak flow rate 13 +/- 4.1 versus 19 +/- 12.6 seconds, time to 50 per cent emptying 5.5 +/- 2.4 versus 25.7 +/- 26.9 seconds, average flow rate 9.1 +/- 3.7 versus 4 +/- 2.3 ml. per second, peak flow rate 19.6 +/- 7.6 versus 8.8 +/- 4.1 ml. per second, corrected peak flow rate 1.22 +/- 0.32 versus 0.59 +/- 0.22, ejection fraction 95.3 +/- 3.5 versus 79.7 +/- 17.6, and residual urine 13.1 +/- 13.5 versus 74.1 +/- 135 ml., respectively. The corrected peak flow rate showed the best separation between controls and patients with obstruction. Of the controls 93 per cent had a corrected peak flow rate of 0.87 or greater compared to only 13 per cent of the patients with obstruction. This method involves a single noninvasive procedure that enables determination of voiding parameters related to urinary volume, flow and time, and it avoids the extra examination needed to determine the residual urine.

Adolescent↗
PubMed1988

Radionuclide measurement of bladder emptying rate. Simultaneous comparison with urinary flow rate obtained by uroflowmetry.

Mean and peak bladder emptying rates were measured by a radionuclide method using a gamma camera and Tc-99m DTPA and were compared with average and maximum urinary flow rates obtained by a uroflowmeter in 24 simultaneous measurements. A good correlation was found between the two methods. Average urinary flow rate correlates better with mean bladder emptying rate (r = 0.96, y = 1.04X + 0.14, s.e.e. = 1.2) than maximum urinary flow rate with peak bladder emptying rate (r = 0.83, y = 0.78X + 4.5, s.e.e. = 4.2). The results suggest that the radionuclide method can be used to measure the urinary flow rate, and has the advantage of establishing the postvoid residual urine.

Adult↗
PubMed1988

Elevated CK-MB isoenzyme after exercise stress test and atrial pacing in patients with ischemic heart disease.

Using a highly sensitive monoclonal antibody kit for CK-MB, significant release of small amounts of CK-MB isoenzyme after exercise stress test was detected 4 to 6 h after induction of ischemia. This occurred in ten out of 15 patients with ischemic heart disease (66 percent) and in only one of the 18 healthy subjects (5.6 percent) serving as a control group. In five patients with coronary artery disease in whom atrial pacing was performed with simultaneous blood sampling from coronary sinus, a drastic elevation in CK-MB isoenzyme (from 2.04 +/- 2.06 ng/L to 10.88 +/- 6.9 ng/L; p less than 0.001) was detected within 10 to 30 min after induction of acute ischemia. A small but significant increase in total CK also was detected (from 21 +/- 12 IU/L to 52 +/- 14IU/L; p less than 0.01). These preliminary observations have to be further investigated in a larger group of patients before a definitive conclusion can be reached about the clinical significance of CK-MB release during exercise.

Adult↗
PubMed1987

Bone and gallium scintigraphy of an oleothorax.

Oleothorax was largely used for the treatment of pulmonary tuberculosis, before the advent of specific chemotherapy. Although the method was dis-continued more than 30 years ago, late complications do occur. We report here a case of a painful oleothorax that took up 99mTc-MDP and 67Ga-citrate.

Bone and Bones↗
PubMed1987

Comparison of a radionuclide method and catheterization for the measurement of residual volume of urine in the bladder.

Residual urine volume in the bladder was measured using a gamma camera and Tc-99m DTPA labeling of the urine and was compared to urethral catheterization in 21 male patients. The results of the radionuclide method did not differ significantly from the catheterization (P less than 0.001) and a good correlation was found between the two methods (r = 0.98). The results suggest that the simple, safe radionuclide method may be used instead of catheterization to measure residual urine volume in the bladder.

Adult↗
PubMed1987

Quantitative renal blood flow in urinary tract obstruction.

Technetium-labeled red blood cell scintigraphy using a bolus injection was used to obtain a noninvasive quantitative measurement of renal blood flow. The method used is an adaptation of the one used for calculating cerebral blood flow which involves deconvolution of the first pass of the isotope through the kidneys. The relative renal blood flow of 18 normal patients and 18 patients with unilateral urinary tract obstruction was performed. All patients with obstruction, but one, were reexamined after surgery. There was a significant difference between the normal and partially obstructed patients (p less than 0.001) and between those with partial and complete obstruction (p less than 0.01). After surgery a statistically observable improvement in the relative renal blood flow was obtained.

Adolescent↗