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H J Lundberg

Publications and source records attributed to H J Lundberg.

5 recordsLinked to original sources

Captopril-induced changes in MAG3 clearance in patients with renal arterial stenosis and the effect of renal angioplasty.

UNLABELLED: Angiotensin-converting enzyme inhibition by captopril decreases renal (131)I-o-iodohippurate sodium or iothalamate extraction in patients with renal artery stenosis (RAS). This study investigated the effect of captopril on another renal radiopharmaceutical, (99m)Tc-mercaptoacetyltriglycine (MAG3), in particular its plasma clearance. METHODS: Three groups of patients were studied. Group I contained 22 patients with hypertension but a low likelihood of RAS according to negative captopril renography results, confirmed by angiography in 5. Group II contained 22 hypertensive patients with RAS documented by angiography and positive captopril and plasma renin response. Group III contained 10 patients after successful percutaneous transluminal renal angioplasty (PTRA) with negative captopril renography results. The 60-min, single-sample technique was used for measurement of the plasma clearance of MAG3 during baseline and captopril renography. RESULTS: In 18 of 22 group I patients, clearance increased (P < 0.01) during captopril renography compared with baseline conditions, whereas in 18 of 22 group II patients, clearance decreased (P< 0.01). In group III patients, clearance was not significantly altered. The clearance decrease in group II did not correlate with the blood pressure decrease or plasma renin activity increase during captopril renography. CONCLUSION: Renal function assessed by MAG3 plasma clearance decreases in hypertensive patients with RAS but increases in patients without RAS. MAG3 clearance measurements during baseline and captopril renography can thus serve as additional diagnostic information when investigating patients with hypertension for the possibility of an RAS.

Adult↗

Radionuclide hysterosalpingography is not predictive in the diagnosis of infertility.

OBJECTIVE: To investigate whether radionuclide hysterosalpingography (radionuclide HSG), which has been suggested as a more functional approach to the diagnosis of tubal infertility than conventional patency tests, is predictive in the diagnosis of infertility. DESIGN: A retrospective analysis of data from an inquiry form containing questions about pregnancy outcome after radionuclide HSG. SETTING: University hospital-based, tertiary care infertility clinic. PATIENT(S): Two hundred sixteen women had an infertility work-up including radionuclide HSG performed between April 1986 and April 1993. Forty-one (18.9%) women were excluded from the study; 9 had moved to unknown addresses, 16 did not answer the inquiry, and 16 gave answers that were not interpretable. There were 175 (81.1%) women in the final study group. INTERVENTION(S): An inquiry form containing questions regarding pregnancy was sent to 207 women who undergone radionuclide HSG as a routine procedure in their infertility workup. MAIN OUTCOME MEASURE(S): Occurrence of pregnancy related to outcome of radionuclide HSG and its test properties calculated. RESULT(S): Bilateral or unilateral tubal transport was demonstrated by radionuclide HSG in 129 women, of whom 66 (51%) later became pregnant. Of the pregnant women, 36 (55%) had successful infertility treatment, whereas 30 (45%) reported spontaneous pregnancy. Forty-six women showed no transport at radionuclide HSG. Twenty-five (54%) of these women became pregnant, 14 (56%) with infertility treatment and 11 (44%) without infertility treatment. The predictive values of transport and no transport radionuclide HSG were 0.51 and 0.46, respectively. The sensitivity of radionuclide HSG was 0.25, and the sensitivity was 0.73. Likelihood ratios for pregnancy when radionuclide HSG showed transport and no transport were 1.03 and 0.93, respectively. CONCLUSION(S): Our data strongly indicate that a single radionuclide HSG investigation is not able to predict fertility potential.

Adult↗

Radionuclide hysterosalpingography does not distinguish between fertile women, before tubal sterilization, and infertile women.

The female genital tract is capable of active transport that can be demonstrated by serial scintigraphic imaging over time (radionuclide hysterosalpingography; RN-HSG). RN-HSG has been suggested to offer a more functional approach to tubal infertility diagnosis than conventional patency tests. However, before RN-HSG can be recommended as a routine method, its reliability in showing active transport in fertile women must be demonstrated. Therefore we compared RN-HSG in two groups: 38 fertile women before tubal sterilization and 38 women undergoing infertility work-up. Tubal transport demonstrated by RN-HSG was comparably distributed in both groups and classified as bilateral (17 versus 19), unilateral (12 versus 7) or no transport (6 versus 9). In each group three RN-HSG images were not interpretable. There was no association between patency test results and RN-HSG in the two groups. Our data suggest that RN-HSG in its present form does not seem to be a reliable method for infertility work-up. Because RN-HSG and patency tests most probably measure different properties of the genital tract, the phenomenon of active particle transportation should be studied further to enable the development of a reliable tool for the investigation of tubal function.

Adult↗

Developmental steps for radionuclide hysterosalpingography.

The active oviductal transportation capacity was studied in 73 infertile women by the use of a new deposition technique of radioactive particles into the internal cervical os. The main reason for this study was that a previous observation had shown that such a transportation capacity was lacking in 41% of the infertile patients with a normal hysterosalpingogram. The examination was performed in the immediate preovulatory phase, i.e. on days -3 to 0 before the ovulation, as measured by the basal body temperature during two preceding cycles. The deposition of 99mTc-labelled albumin particles of 0.2-1.0 micron at the internal cervical os and the interpretation of the radionuclide images are described in detail. The results show that the bilateral active tubal transportation capacity was present in 42 patients. An impaired transportation capacity was diagnosed in 22 patients. In 9 patients, the particles never reached the uterine cavity, or all activity leaked back to the vagina.

Fallopian Tubes↗

Radionuclide hysterosalpingography for measurement of human oviductal function.

A clinical method is described and claimed to evaluate the active transportation capacity of the luminal epithelium lining the human uterus and fallopian tube. After intracervical application of technetium-labelled human albumin spheres at 1-2 days before ovulation this radioactivity could be followed by gamma-camera when moved in ad ovarian direction. This method is called radionuclide hysterosalpingography (RN-HSG). The results were compared to the findings at normal hysterosalpingography (HSG). By use of this method it was possible to verify active passage in cases of tubal spasm at HSG, lack of transport in cases of normal patent oviducts at HSG as well as presence or absence of active transport through sactosalpinges with or without fimbrial passages to the abdominal cavity as seen at normal HSG. Congruent findings between HSG and RN-HSG was observed in 49%. The studied oviducts were found to be patent with normal HSG but lacked transportation capacity when studied by RN-HSG in 41%. The clinical use of this method is discussed in view of the selection of patients for different forms of in vitro fertilization and egg transfer (IVF-ET).

Adult↗