Seventeen patients with probable Alzheimer's disease (AD), 7 patients with frontal lobe dementia (FLD) and 19 control subjects (NOR) were examined by (99m)Tc-d,l- hexamethylpropylene amine oxime ((99m)Tc-HMPAO) SPECT. Images were standardised in the same 3D space and averaged within each group. After normalisation, the three sets of images were analysed in all cerebral lobes, hippocampus, thalamus and basal ganglia. In AD, the (99m)Tc-HMPAO uptake values were significantly reduced, as compared to NOR, in the parietal, temporal and insular lobes. In patients with FLD, the uptake was altered in all lobes with the exception of the parietal lobe. The uptake in the nucleus caudatus decreased significantly in both AD and FLD as compared to NOR. The uptake in the anterior cingulate cortex was significantly reduced in FLD. Subtraction images highlighted all significantly decreased areas. In conclusion, standardising SPECT in a common space and subtracting data from a control group improves the visual interpretation of images. In this study, the typical temporo-parietal and fronto-parietal (99m)Tc-HMPAO uptake reductions were found in AD and FLD, respectively. The uptake in the nucleus caudatus was found to decrease significantly in AD and FLD and the one in the anterior cingulate cortex was reduced in FLD.

Aged↗

PubMedDate not supplied

Gastric emptying and electrogastrography in patients on CAPD.

OBJECTIVE: To evaluate if impaired gastric emptying of digestible solids can explain the disturbed eating behavior in continuous ambulatory peritoneal dialysis (CAPD) patients, and if predialytic and dialytic (CAPD and hemodialysis) patients with impaired gastric emptying have a higher prevalence of electrogastrographic (EGG) abnormalities. DESIGN: Cross-sectional study. After ingestion of a 99mTc-labeled test meal, anterior and posterior 1-minute scintigraphic acquisitions were collected every 5 minutes during the first 50 minutes and thereafter every 10 minutes until 2 hours had elapsed. Simultaneously, cutaneous EGG recorded gastric myoelectric activity. SETTING: The Division of Nephrology and the Department of Nuclear Medicine at the same academic teaching hospital. PARTICIPANTS: Thirty outpatients participated in both the gastric emptying and the EGG studies. Dialysis patients should have been on dialysis for more than 3 months. For comparison, 160 healthy control subjects participated in the gastric emptying study. MAIN OUTCOME MEASURES: The following parameters were used to describe gastric emptying: lag phase 90%, half-emptying time (T50), gastric retention at 90 and 120 minutes (Ret 90/120) and gastric emptying rate (GER, %/min). Electrogastrographic measurements were expressed as percentages of normal slow waves [2.4-3.6 cycles/min (cpm)], bradygastria (1.5-2.4 cpm), and tachygastria (3.6-10 cpm). RESULTS: T50 was prolonged, Ret 90 and Ret 120 were higher, and GER was slower in male CAPD patients compared to male controls. No significant differences were found in postprandial EGG. CONCLUSION: Gastric emptying is impaired in male non-diabetic CAPD patients. However, abnormalities in postprandial EGG cannot explain this finding.

Adult↗

PubMedDate not supplied

Hyperostosis cranii. Radiography and scintigraphy compared.

The bone scintigrams of 52 women with radiographically proven hyperostosis cranii were examined specifically with regard to the endosteal lesions. It was confirmed that hyperostosis cranii exhibits a characteristic appearance at bone scintigraphy that is usually easy to recognize. By scoring the degree of hyperostotic changes and their scintigraphic activity according to a semiquantitative scale, an inverse relation between radiographic changes and scintigraphic activity was observed but could not be statistically proven. A tendency of more pronounced radiographic changes and a tendency of decreasing activity at bone scintigraphy with increasing age were also found. It is suggested that hyperostosis cranii starts in younger women and that the initial osseous turnover of the lesions is high. Successively, the metabolic activity decreases while the endosteal lesions increase, tending towards a stabilization of the process with increasing age.

Adult↗

PubMedDate not supplied

Quantitative single photon emission computed tomography applied to a comparison of propanetetraphosphonate and albumin colloid for liver and spleen scintigraphy.

A clinical application of a previously developed technique for absolute quantitation of organ uptake of radioactivity is presented. The method, which is based on single photon emission computed tomography involving correction for scattering and attenuation of photons, enables an accurate in vivo determination of the amount of administered activity taken up in a specific organ. The technique was applied to a comparative clinical trial between propanetetraphosphonate and albumin colloid for liver and spleen scintigraphy. The mean uptake of the liver was 73 +/- 9 per cent using propanetetraphosphonate and 63 +/- 10 per cent using albumin colloid. The corresponding figures for the spleen were 6 +/- 3 and 9 +/- 4 per cent, respectively. The activity concentration of the different lobes of the liver, bone marrow and soft tissue was also estimated. Phantom studies showed that the total uptake in the liver could be determined with an accuracy of about 6 per cent. The accuracy of the clinical examinations was estimated to about 10 per cent.

Adult↗

PubMedDate not supplied

Increase of intra-abdominal fat in patients treated with continuous ambulatory peritoneal dialysis.

OBJECTIVE: To evaluate changes in amount and distribution of body fat in patients treated with continuous ambulatory peritoneal dialysis (CAPD). DESIGN: Prospective study. Computed tomography (CT) and dual energy x-ray absorptiometry (DEXA) were used for determination of body composition at commencement of CAPD, and after a mean of 7.2 months of dialysis treatment. SETTING: CAPD unit at an academic teaching hospital. PATIENTS: The study included 19 consecutive patients who started CAPD during a 15-month time frame. Of these 19 patients, 12 (8 males) with a mean initial age of 60 years completed the study. MAIN OUTCOME MEASURES: Siemens Somatom HiQ (Erlangen, Germany) was used for CT of the abdomen and of the right thigh. Fat and muscle areas were expressed as square centimeters. The proportion of total fat mass was determined by body composition analysis using DEXA (DPX-L densitometer) (Lunar, Madison, WI, U.S.A.) and expressed as percentage of total body weight (FA%). RESULTS: Body weight changed from 67.1 to 68.4 kg (p = 0.20), and the intra-abdominal fat area increased 22.8% (p = 0.02). This increase was predominantly seen in male patients (p = 0.007). The FAT% changed from 27.8% to 30.9% (p = 0.25), without difference between sexes. CONCLUSION: The increase of intra-abdominal fat found in this study may suggest a mechanism by which the established risk for CAPD patients to develop cardiovascular morbidity and mortality may be at least partially explained.

Abdomen↗