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Biomedical subjects

L M Freeman

Publications and source records attributed to L M Freeman.

At least 19 recordsLinked to original sources
PubMed1990

Systemic to pulmonary venous shunting in superior vena cava obstruction. Unusual myocardial and thyroid visualization.

Obstruction of the superior vena cava is commonly associated with the development of several collateral venous pathways. Right-to-left systemic to pulmonary venous shunting, however, rarely has been reported. This paper describes a case in which a previously unsuspected shunt, manifested by the striking visualization of myocardial and thyroid tissue in addition to other findings, was discovered on a routine lung perfusion scan. Imaging, as well as radiologic studies are presented in the investigation of this phenomenon.

Adult↗
PubMed1990

Technetium-99m antimony sulphide colloid lymphoscintigraphy of the prostate by direct transrectal injection.

Laterality of prostatic lymphatic drainage was successfully assessed in nine patients with prostatic carcinoma after direct unilateral transrectal injections of 99Tcm-antimony sulphide colloid by Franzen needle. Pelvic lymphatic drainage was equally divided between ipsilateral, contralateral and bilateral patterns. The frequent observation of radiocolloid migration to contralateral lymph node groups in patients with prostate carcinoma, including those with primary disease localized clinically to a single lobe of the prostate, indicates the potential for contralateral pelvic lymph node metastases in this population. This finding may be important in determining the appropriate surgical staging and treatment of patients with prostate carcinoma. The clinical applicability of lymphoscintigraphy in the evaluation of metastatic spread and in lymph node biopsy planning requires further study.

Administration, Rectal↗
PubMed1990

Acute renal dysfunction during interleukin-2 treatment: suggestion of an intrinsic renal lesion.

Adoptive immunotherapy with interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cells has been effective in treating some advanced malignancies in animals and humans. One complication of this treatment is a reversible, oliguric, acute renal failure, which has been ascribed to renal hypoperfusion and resultant prerenal azotemia. We serially studied renal function in 10 patients receiving high-dose regimens of recombinant interleukin-2 (rIL-2) to attempt to delineate further the nature of the renal dysfunction caused by IL-2 treatment. Renal plasma flow was computed from iodine 131 (I-131 Hippuran; Mediphysics, Paramus, NJ) orthoiodohippurate, excretion curves, and glomerular filtration rate (GFR) was determined by creatinine clearance. Studies done prior to and on day 4 of treatment showed that GFR fell in nine of 10 patients, with a mean decrease of 43% +/- 8%, and renal plasma flow fell in five of the 10 patients with a mean decrease of 5% +/- 10%. The average pretherapy filtration fraction was calculated to be 23% +/- 1% and after 4 days of treatment, decreased to a mean value of 15 +/- 2%. The BUN to creatinine ratio also declined in all patients. These findings collectively suggest that IL-2 nephrotoxicity may result from an intrarenal defect in addition to the previously described prerenal azotemia. Additionally, radionuclide studies of renal function are a reliable and reproducible noninvasive method of assessing these changes in renal function.

Acute Kidney Injury↗
PubMed1988

Renewed role of nuclear medicine in renovascular hypertension.

The role of nuclear medicine in the differential diagnosis of renovascular hypertension has been subject to considerable disagreement. The renogram has several distinct advantages as a diagnostic test, among which are the following: it is safe, easily performed, and has a high sensitivity for the differentiation of normal renal function from abnormal renal function. The use of the captopril renogram is based on the observation that renal function appears to be maintained in renovascular hypertension through a component of the renin-angiotensin system. Captopril renography will greatly improve the efficacy of the radionuclide renogram in the differential diagnosis of renovascular hypertension.

Captopril↗
PubMed1979

Thallium-201 myocardial scintigraphy in patients with triple-vessel disease and ischemic exercise stress tests.

Thirty patients with triple-vessel coronary artery disease proven by angiography, symptomatic angina and a positive ECG stress test were evaluated with thallium-201 (201TI) scintigraphy. Twenty patients also had aortocoronary saphenous vein bypass surgery; 15 of them had repeat noninvasive evaluation. Seventy percent of these patients showed ischemia by 201TI scintigraphy, of which one-half returned to normal after surgery. Postoperative reversion of the ECG stress test together with 201TI stress/reperfusion imaging correlated well with the completeness of surgical revascularization. We could not explain the prevalence (80%) of infarcts detected by 201TI in this group, of which 76% could be anatomically correlated to epicardial scars. The positivity of infarcts by 201TI exceeded that predicted by previous history of infarction, Q waves on resting ECG or ventriculographic akinesis. These observations suggest that 201TI scintigraphy is a useful noninvasive tool in the follow-up and understanding of patients with coronary heart disease. These conclusions also support the concept that 201TI stress imaging need not have the identical connotation as the ECG stress test.

Adult↗
PubMed1979

Rapid and accurate diagnosis of acute cholecystitis with 99mTc-HIDA cholescintigraphy.

Technetium-99m dimethyl acetanilide iminodiacetic acid (HIDA) cholescintigraphy was performed on 90 patients with suspected acute cholecystitis. Visualization of the gallbladder established patency of the cystic duct and excluded the diagnosis of acute cholecystitis in 50 of 52 patients. Nonvisualization of the gallbladder with visualization of the common bile duct was diagnostic of acute cholecystitis in 38 patients, all subsequently proven at surgery. The observed accuracy of this procedure is 98% and specificity is 100%. The false negative rate is 5% and false positive rate is zero. Technetium-99m-HIDA has many advantages which make it the procedure of choice in evaluating a patient for suspected acute cholecystitis. It is a rapid, simple, safe examination which provides functional as well as anatomic information about the hepatobiliary system in individuals with a serum bilirubin level up to 8 mg/100 ml.

Acetates↗
PubMed1979

Demonstration of traumatic bile leakage with cholescintigraphy and ultrasonography.

Technetium-99m HIDA cholescintigraphy and ultrasonography are noninvasive, safe, simple procedures that can document the presence, location, and extent of a bile leak. Early detection of posttraumatic or postoperative biliary tract disruption can significantly reduce morbidity and mortality. The possibility of biliary tract disruption should be considered in any patient who has had blunt or penetrating abdominal trauma. In two cases reported, the new hepatobiliary radiotracer 99mTc dimethyliminodiacetic acid (HIDA) was quite useful in detecting such leaks. Sonography was particularly useful in detecting small intra- or perihepatic bile collections which no longer communicate with the biliary tree. An active bile leak at a surgical anastomosis may also be documented by 99mTc-HIDA cholescintigraphy and can yield information of potential prognostic importance. Serial cholescintigraphy is also useful in evaluating the response to medical or surgical treatment.

Aged↗