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Biomedical subjects

J H Shapiro

Publications and source records attributed to J H Shapiro.

At least 19 recordsLinked to original sources
PubMed1986

Inefficacy of routine laboratory analysis of CSF obtained during myelography for suspected disc disease.

The routine laboratory analysis of cerebrospinal fluid (CSF) obtained during myelography is performed in many institutions. The records of 100 consecutive patients who had myelography for suspected disc disease were reviewed retrospectively. The laboratory analysis of the CSF obtained during myelography did not benefit patient management in any instance. In one case, the CSF results adversely affected patient management. The CSF analysis did not add any information to the myelogram result. The CSF protein level did not correlate in a statistically significant way with the degree of disc protrusion seen myelographically.

Cerebrospinal Fluid↗
PubMed1985

The specific diagnosis of hepatocellular carcinoma by scintigraphy. Multiple radiotracer approach.

The accuracy of scintigraphy in diagnosing hepatocellular carcinoma (HCC) at Boston City Hospital between January 1, 1978 and September 30, 1983 is retrospectively reviewed. A combined protocol using technetium-99m sulfur colloid (TsSC), gallium (Ga), and scintiangiography (STA) was employed in order to enhance diagnostic specificity. There were 14 cases of HCC, of which 10 were proven histologically. The others were diagnosed clinically and angiographically. With one exception, all patients who had triple tracer scintigraphy showed a specific pattern of findings: (1) cold defects with TcSC; (2) Ga-avid foci, and (3) increased vascular supply from hepatic arteries. One false-positive study and one false-negative study were originally reported, although in both cases, strict adherence to the three criteria above would have avoided diagnostic error. These results indicate that triple tracer scintigraphy may be an effective diagnostic test for HCC. The relative efficacy of scintigraphy, ultrasonography, and computerized tomography in diagnosing HCC is also discussed.

Adult↗
PubMed1985

Scintiangiographic demonstration of parasitization of systemic blood supply by inflammatory lung disease.

An unusual case in which a computed tomogram demonstrated abnormal, enlarged vessels in the right lower lobe of the lung and suggested an arteriovenous malformation is presented. A scintiangiogram showed abnormal systemic supply to this area in the aortic phase. Contrast angiography demonstrated hypertrophy of the right inferior phrenic artery with abnormal systemic supply to the pleura and parenchyma of the right lower lobe, presumably on the basis of old infection.

Erythrocytes↗
PubMed1985

Comparison of overhead and cross-table lateral views for detection of knee-joint effusion.

Prompted by the failure to detect a clinically evident knee-joint effusion on the cross-table lateral view of an injured patient, a prospective study was carried out to compare the routine overhead and cross-table lateral knee views for detection of joint effusion in 18 patients with acute knee trauma. In every case, the size of the effusion as determined by the "fat-pad separation sign" was greater on the overhead view (p less than 0.001). In three patients the effusion would have been missed radiologically had the vertical-beam projection been omitted. The authors conclude that the cross-table lateral view is less sensitive than the routine overhead lateral view in the detection of knee-joint effusions because of fluid shift into the lateral recesses of the suprapatellar bursa with the patient in the supine position. This phenomenon is demonstrated by arthrography and computed tomography in one patient.

Adult↗
PubMed1984

Hepatocellular carcinoma: uptake of 99mTc-IDA in primary tumor and metastasis.

Four consecutive cases of proven hepatocellular carcinoma (HCC) showed significant avidity of 99mTc -labeled iminodiacetic acids (Tc- IDAs ) in preoperative scintigraphy. In one patient, the pulmonary metastasis showed uptake of Tc-IDA. Such scintigraphic findings were obvious only in the delayed scans, performed 2 1/2-4 hr after injection. Since Tc- IDAs and bilirubin are functional analogs physiologically, the ability of HCC to concentrate Tc- IDAs may be related to the ability of HCC neoplastic cells to form bile intracellularly. This hypothesis is supported by the fact that intracellular bile granules were found in the tumor cells of all four patients. This suggests a potential for using Tc- IDAs for the specific and preoperative diagnostic of HCC.

Adult↗
PubMed1983

Specific diagnosis of hepatoma using 99mTc-HIDA and other radionuclides.

The difficulty of clinical and radiographical diagnosis of hepatoma is discussed. A case of hepatoma is reported. Both the primary tumor and distant metastases showed strong avidity for 99mTc-HIDA, which normally is concentrated by parenchymal cells of the liver. The potential of using 99mTc-HIDA for the noninvasive investigation of patients suspected of having hepatoma is discussed. The association between tumor avidity for 99mTc-HIDA and the bile-forming ability of tumor cells is of interest.

Adult↗
PubMed1982

Radionuclide angiography for the diagnosis of thyroid cancer.

The conventional static thyroid scan is sensitive but nonspecific in detecting thyroid tumors. Radionuclide angiography is a noninvasive and simple technique that can improve the specificity of the conventional scan significantly, since it can demonstrate hypervascularity of tumors. Our case reports demonstrated hypervascularity of the primary tumor and metastatic cervical lymph nodes.

Adult↗
PubMed1982

Liver abscess: sonography in diagnosis and treatment.

Over 24 months, 22 patients with intrahepatic abscesses were diagnosed by sonography. The sonographic appearance of the abscesses was nonspecific and varied from anechoic lesions to highly echogenic solid masses. Septations, fluid-fluid interfaces, and debris were also observed. In 19 of 22 patients, the diagnosis was confirmed by needle aspiration. Subsequently, 12 patients were treated with percutaneous catheter drainage; in 10 patients this therapy obviated the need for further surgery.

Adult↗
PubMed1981

Occult gastric bleeding demonstrated by bone scan and Tc-99m-DTPA renal scan.

A patient is described who had coagulopathy and clinically intermittent gastrointestinal bleeding. The bleeding site was clearly shown on renal and bone imaging performed at a time when the patient was considered clinically to have stopped bleeding. A bleeding gastric ulcer was subsequently demonstrated by radionuclide and contrast angiography, and at surgery.

Angiography↗
PubMed1980

Diagnosis of hepatoma by scintigraphy using multiple radionuclides.

The conventional liver scan, using 99mTC-sulfur colloid, is very sensitive in detecting focal abnormalities, but it is nonspecific, since most lesions appear as "cold" defects. Liver scan can be much more specific if the right combination of the many available radiopharmaceuticals is used. This fact is exemmlified by our case report of hepatoma. All scans can be done noninvasively, with low radiation exposure to the patients.

Carcinoma, Hepatocellular↗
PubMed1979

Primary tuberculosis diagnosed by gallium scan.

We report a case of tuberculosis which, although clinically unsuspected, was diagnosed on a 67Ga scan. It is well known that 67Ga scintigraphy may be used as an adjunct to radiography for assessing extent and localization of inflammatory activity and for follow-up and progression evaluation of diffuse granulomatous diseases such as sarcoid and tuberculosis.

Adolescent↗