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Ildikó Garai

Publications and source records attributed to Ildikó Garai.

9 recordsLinked to original sources

Hand perfusion with 99mTc-HSA in patients expecting to undergo coronary bypass surgery: elaboration of a new complex diagnostic protocol for the safe removal of a radial artery graft.

BACKGROUND: The Allen test is used worldwide for radial artery graft removal. The postoperative examination of our patients' hand function and circulation proved that beside the transient neurological complications chronic hand circulatory disorders may arise. AIM: To develop a non-invasive method suitable for an objective evaluation of the hand's circulation to make it possible to use radial arteries safely for the revascularization of coronary arteries. METHODS: We examined 35 patients. After selective compression of the radial and ulnar arteries of both hands, we injected 400 MBq (99m)Tc-HSA intravenously and acquired 240 images, each of 1 s. After 30 s we released the ulnar artery first, and after 120 s the radial artery, too. Then computer analysis was performed. RESULTS: The patients could be divided into two groups. In the majority of them, releasing only the ulnar artery resulted in a good circulation of the fingers. It meant that the time-activity curve rapidly reached its maximum, and the activity did not change even after releasing the radial artery. In a smaller proportion of the patients the activity of the fingers increased only slowly, and did not reach a plateau even after 30 s. Following the release of the radial artery a further increase in the activity could be observed. We assume that the latter patient group is at risk of consequent circulatory disorder of the fingers after the removal of the radial artery, whereas in the former group the artery could be removed safely. CONCLUSIONS: Hand perfusion with (99m)Tc-HSA is useful in patients selected for coronary bypass operations, so we recommend the introduction of this method as a routine examination before the removal of the radial artery in patients with an abnormal Allen test.

Adult↗

The Allen test.

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Angiography↗

High prevalence of oesophageal involvement in patients with undifferentiated connective tissue disease using radionuclide oesophageal transit scintigraphy.

AIM: To look for the frequency of oesophageal dysfunction using radionuclide oesophageal transit scintigraphy in 145 patients with undifferentiated connective tissue disease (UCTD); to seek the correlation between the clinical/laboratory data and scintigraphic alterations; and to determine predictive value of radionuclide oesophageal transit scintigraphy for evolution to established connective tissue disease (CTD). METHOD: One hundred and forty-five patients with UCTD were examined by 99mTc-DTPA oesophageal transit scintigraphy. The intraoesophageal transport of the radiopharmaceutical was followed and imaged by a gamma camera, a series of 128 x 128 images were stored and evaluated. The correlation between the scintigraphic data and clinical and laboratory parameters was analysed statistically. RESULTS: Unequivocally positive scintigraphy, indicative of motor abnormality was found in 46% of patients (66), 71% (47) of whom were totally asymptomatic. Significant correlation was found between the presence and severity of scintigraphic alterations and antinuclear antibodies, the anti-beta2GPI, IgM, IgG, the aCL antibody positivity, and the skin symptoms. Scintigraphic positivity was significantly more frequent in patients evolving to definitive CTD (P = 0.0178), and abnormal scan predisposed to transition into the definitive CTD (odds ratio, 2.292; CI, 1.610-4.525). Its cumulative positive predictive value was found to be 43% and cumulative negative predictive value 73% with regard to the development of a definitive CTD. CONCLUSION: Our results show that scintigraphic alterations together with clinical and laboratory alterations can help the clinician in the prediction of final outcome.

Adolescent↗

[Assessment of autoimmune disease activity in endocrine orbitopathy: comparison of SPECT using 99m-Tc-DTPA or 99m-Tc-depreotide and MRI scores].

INTRODUCTION: Currently there is no ideal imaging technique which could estimate the degree of inflammation in thyroid eye disease. AIM: A new, rapid and cost-effective method, using 99mTc-labelled DTPA and 4-headed SPECT, was developed which is able to diagnose inflammatory activity in patients with endocrine orbitopathy (EOP). METHODS: The MRI T2 relaxation time was used as reference. Comparative orbital SPECT with the more specific 99mTc-Neospect (depreotide) was also performed in the same patients. RESULTS: Visual evaluation of orbital SPECT frames of patients suffering from active EOP could be easily distinguished from inactive EOP patients'. Despite the supposedly different characteristics of the two tested radiopharmaceuticals, there was essentially no difference between their accumulation in the orbit and the information obtained. The MRI activity scores correlated well with 99mTc-DTPA activity uptake (AU). The mean AU value in patients with inactive EOP was 6.26 +/- 1.6 10(-6) ID/cm3, while in active EOP 10.78 +/- 0.61 10(-6) ID/cm3, significantly higher. The 99mTc-DTPA accumulation in the orbital region in active disease was similar to that of depreotide. There was a good correlation (r = 0.91, P < 0.0001) between the two methods. CONCLUSION: The authors concluded that 99mTc-DTPA orbital SPECT is a potentially useful method, which--after initial clinical and MRI staging--gives useful quantitative estimation of disease activity in endocrine orbitopathy. It may provide important visual and quantitative information during the follow up of patients.

Adult↗

[PET and SPECT scans in autistic children].

The authors have analyzed and compared the results of the 99mTc-ECD-SPECT and FDG-PET examinations, performed in alert state, of 12 children suffering from infantile (9 subjects) or atypical (3 subjects) autism. In addition to frontally increased FDG metabolism, a decreased blood flow with left-sided dominance was found bifrontally and bitemporally in the infantile form (perfusion-metabolism mismatch). The regional differences in cortical FDG uptake were not significant in atypical autism, although both the blood flow and the metabolism of the thalami were decreased. Based on the results, the authors suggest that, beyond the usually inconclusive structural (CT or MR) examinations, cerebral blood flow SPECT and metabolic FDG-PET investigations may be useful in classifying the disease.

Adolescent↗

Radiation-induced coronary artery disease in Hodgkin's disease.

PURPOSE: Secondary malignant tumours and cardiovascular complications are of great importance among the late complications after treatment for Hodgkin's disease (HD) because they may significantly reduce the patients' life expectancy. We report on coronary artery disease (CAD) after treatment for HD. METHODS AND MATERIALS: We present the case of two female patients with HD who received mediastinal irradiation after which complete remission was achieved. In 12 and 19 years after the onset of the disease, control examinations revealed ischaemic heart disease, which was confirmed by coronary arteriography and solved by stent implantation in one of the patients and bypass surgery in the other one. CONCLUSIONS: Ischaemic heart disease was due to early CAD, which was associated with mediastinal irradiation accompanied by hypothyroidism, hyperlipidaemia and, possibly, early menopause, all posing an increased risk for the cardiologic disease. Our cases may serve as a warning example to carefully plan the management (low dose, involved field irradiation) of newly diagnosed patients as well as the cardiologic follow-up of patients with HD.

Adult↗