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Biomedical subjects

J G Turner

Publications and source records attributed to J G Turner.

At least 19 recordsLinked to original sources
PubMed1979

Semi-quantitative interpretation of the bone scan in metabolic bone disease: definition and validation of the metabolic index.

Certain easily recognisable features are commonly seen in the bone scans of patients with metabolic bone disorders. Seven such features have been numerically graded by three independent observers in the scans of 100 patients with metabolic bone disease and of 50 control subjects. The total score for each patient is defined as the metabolic index. The mean metabolic index for each group of patients with metabolic bone disease is significantly greater than that for the control group (P less than 0.001).

Bone Diseases↗
PubMed1979

The significance of the abnormal rest thallium-201 myocardial image in coronary artery disease.

Rest Thallium-201 myocardial images were abnormal in 20 out of 40 patients with arteriographically proven coronary artery disease. The myocardial image appearances did not accurately reflect the extent of coronary artery disease present. However, in 35 of the 40 patients (88%) the presence or absence of abnormalities on the rest myocardial image correleted respectively with the presence or absence of abnormal wall motion at left ventriculography. Most rest image abnormalities could be attributed to previous myocardial infarction, but in six patients myocardial ischaemia was possibly the cause. These results suggest that though myocardial fibrosis is usually the cause of rest myocardial image abnormalities in coronary artery disease, this is not invariably so. The possible therapeutic implications are discussed.

Adult↗
PubMed1979

A clinical comparison of Tc-99m HEDP and Tc-99m MDP in the detection of bone metastases: concise communication.

We have compared bone scintigrams made with Tc-99m-tagged HEDP (1-hydroxyethylidene diphosphonate)and MDP (methylene diphosphonate), the former at 4 hr after injection, the latter at both 2 and 4 hr. In 17 patients with skeletal metastases, there was no significant difference in lesion count or scan quality between the 4-hr images. The tumor-to-bone ratio (T/B) was significantly higher with Tc-HEDP (p less than 0.02). Lesion detection rate and T/B ratios were both lower with Tc-MDP at 2 hr when compared with the 4-hr values for both Tc-HEDP (p less than 0.02, p less than 0.005) and Tc-MDP (p less than 0.02, p less than 0.01). The 4-hr Tc-MDP scan was of significantly higher quality than the 2 hr Tc-MDP scan (p less than 0.01). Although Tc-HEDP produces a higher T/B ratio at 4 hr, the present study does not suggest that either agent is superior in clinical practice.

Adult↗
PubMed1979

Can the extent of coronary artery disease be predicted from thallium-201 myocardial images?

The accuracy with which the extent of coronary artery disease can be predicted from stress thallium-201 myocardial images has been assessed in 81 patients with chest pain. Whereas the appearance of the myocardial images was both a sensitive means of detecting coronary artery disease (images abnormal in 43 of 47 patients with abnormal coronary arteriograms) and specific in excluding it (images normal in 31 of 34 patients with normal arteriograms), there was poor correlation between the extent of disease predicted from the Tl-201 images and the findings at arteriography. It is concluded that although stress Tl-201 myocardial imaging is a useful method for the noninvasive diagnosis of coronary artery disease, it cannot be relied upon to predict the number of abnormal vessels.

Adult↗
PubMed1978

Pilot's hearts.

Explore the source record for details and available documents.

Aerospace Medicine↗
PubMed1978

Subtotal thyroidectomy for thyrotoxicosis: a reassessment, including TRH responsiveness.

Thyroid function was assessed in patients treated surgically for thyrotoxicosis in Christchurch between 1965 and 1972. Seventy-eight of the 89 thyrotoxic patients were available for reassessment. Seventy-one were clinically and biochemically euthyroid. Seven patients had received radioiodine therapy for post-operative relapse and 10 patients were receiving thyroxine replacement therapy. At the time of the survey five patients were clinically thyrotoxic and two patients were hypothyroid and an additional nine patients had grossly elevated TSH levels. TRH tests performed on 31 clinically euthyroid patients with normal baseline thyroid parameters demonstrated that more than a third had excessive TSH responses consistent with reduced thyroid reserve and only one patient showed a lack of response consistent with persistent thyroid autonomy.

Adolescent↗
PubMed1978

A quantitative approach to the analysis of the normal thallium-201 myocardial image.

The visual interpretation of Thallium-201 myocardial images is made more difficult by nonhomogeneity of myocardial tracer uptake in normal studies. To increase the objectivity of the study, the variation in count density in different myocardial areas has been calculated using a computer regions of interest technique in 14 healthy, young subjects following intravenous injection of the radionuclide at rest and in 10 after injection during maximal exercise. The "normal ranges" for regional Thallium-201 uptake so obtained are presented and discussed.

Adult↗
PubMed1978

Low dose lithium-carbimazole in the treatment of thyrotoxicosis.

Fifteen patients with thyrotoxicosis were treated with low dose sustained release lithium carbonate 400 mg, combined with carbimazole 40 mg daily, and the therapeutic response was followed over a two week period. This response was compared with that obtained in a similar group of patient treated with carbimazole alone. Li-carbimazole treatment brought about a fall in the mean total serum T4 of 57.4% compared with a drop of 32.8% in patients treated with carbimazole alone. The mean serum T3 fell by 69.4% in the Li-carbimazole group compared with 47.3% in the group treated with carbimazole only. No lithium adverse effects were encountered.

Antithyroid Agents↗
PubMed1978

Clinical value of delayed thallium-201 myocardial imaging in suspected acute myocardial infarction.

Fifty patients with acute chest pain had thallium-201 myocardial imaging performed three to six days after emergency admission to hospital. The image was abnormal in 20 out of 22 patients with acute transmural myocardial infarcts but in only 1 of 5 with acute subendocardial infarcts. Indistinguishable scan abnormalities caused by old infarcts were seen in 7 patients, and caused by myocardial ischaemia in 1 patient. A single thallium-201 myocardial scan some days after the onset of symptoms appears to be of little value in the clinical assessment of patients with suspected acute myocardial infarction.

Acute Disease↗
PubMed1978

The use of whole-body retention of Tc-99m diphosphonate in the diagnosis of metabolic bone disease.

The limited role of bone scanning in the diagnosis of metabolic bone disease might be considerably improved by accurate quantification of skeletal uptake of the radiopharmaceutical. Using a standard shadow-shield whole-body monitor, we have measured whole-body retention (WBR) of Tc-99m HEDP up to 24 hr in 11 patients with renal osteodystrophy (mean WBR 88.6% at 24 hr); in ten patients with Paget's disease (mean 56.9%); in seven patients with osteomalacia (mean 40.7%); in five patients with primary hyperparathyroidism (mean 50.7%); in four patients with osteoporosis (mean 21.2%); and in 12 normals (mean 19.2%). The osteoporotic group could not be differentiated from the normal group, but the other groups were significantly different from the normal group at 24 hr (p less than 0.002), and each individual rest for the 24-hr WBR of Tc-99m HEDP in these groups lay outside our normal range. This test may, therefore, provide a sensitive means of detecting conditions with increased bone turnover. We obtained measurements of plasma activity of Tc-99m HEDP in these patients up to 24 hr, and 4-hr bone to soft-tissue ratios from bonescan images, but little additional information resulted.

Adolescent↗
PubMed1978

The role of bone scanning in osteomalacia.

The presence of eight "metabolic features" was assessed on the bone scintigrams of ten patients with osteomalacia. In all of these bone images, sufficient features were present to strongly suggest a metabolic disorder. There scintiphotos were included in a controlled blind study using 30 normal bone scans and 20 scans of metastatic disease. Nine of the ten metabolic bone images were correctly identified by two independent observers. Skeletal uptake of radiotracer, expressed as bone-to-soft tissue ratio, was significantly higher in the osteomalacic patients than in a group of 80 controls.

Adolescent↗
PubMed1977

The pituitary-thyroid axis following surgery for thyrotoxicosis: thyrotrophin-releasing hormone tests in diffuse thyroid hyperplasia and toxic uninodular goitre.

The pituitary-thyroid axis was assessed 1 month after surgery by thyrotrophin releasing hormone (TRH) testing in thirty thyrotoxic patients treated by subtotal thyroidectomy and eleven patients with toxic uninodular goitre. All toxic nodule patients gave essentially normal TRH responses and have remained clinically and biochemically euthyroid at follow-up. Only seven of the thirty subtotal thyroidectomy patients had normal TRH tests when assessed 1 month post thyroidectomy -sixteen patients showed increased response, six gave flat responses, and one showed an anomalous minimal response. Follow-up TRH tests 12 months postthyroidectomy have shown a tendency for TRH responsiveness to return towards normal, but two patients with flat TRH tests have required radioiodine for relapse and four TRH hyperresponders are currently receiving thyroxine replacement therapy.

Adult↗
PubMed1977

Thyroid vascularity--documentation of the iodide effect in thyrotoxicosis.

Thyroid vascularity was measured in 101 thyrotoxic patients by analysis of 99mTc pertechnetate thyroid flow studies obtained with a gamma camera--minicomputer system. The diffusely hyperplastic goitres tended to have higher vascularity than the toxic multinodular goitres, and many of the solitary toxic nodules had vascularity results within normal limits. Potassium iodide therapy, 60 mg b.d. for 10-14 days results in a dramatic reduction in thyroid vascularity in diffuse thyroid hyperplasia and toxic multinodular goitre but the effect on toxic nodules was marginal.

Humans↗
PubMed1976

Lithium as an adjunct to radioiodine therapy for thyrotoxicosis.

16 patients with diffuse thyroid hyperplasia were given lithium carbonate (400 mg daily) for 1 week before and 1 week after a standardised 5 mCi therapy dose of 131I. A comparable control group of 16 patients were treated with 5 mCi of 131I without lithium therapy. The % retention of the therapy dose was measured in all patients at 7 days (168-hour 131I uptake). In the lithium-treated group the 24-hour 131I uptake showed no significant change after the first week of lithium therapy. The mean 48-hour protein-bound 131I, however, fell considerably from 1-21 to 0.55%/dose/1. The mean 24-168 hour % thyroidal 131I uptake drop was significantly less in the lithium group. These results show that low-dosage lithium therapy increases the retention of a standard-therapy dose of 131I. Lithium promises to be a useful adjunct to 131I therapy in patients with a rapid thyroidal iodine turnover and particularly in young patients where the total body-radiation dose must be kept to a minimum.

Adolescent↗