Biomedical subjects
Publications and source records attributed to M J Blend.
Diffuse pulmonary uptake of sulfur colloid was seen in a 35-year-old postpartum white female with the presumptive diagnosis of fatty liver disease of pregnancy. As the disease process resolved, the pulmonary uptake of sulfur colloid disappeared. To the authors' knowledge, this scan association has not been previously reported.
A 3-year-old child with phenotypic trisomy 18 syndrome survived 26 days after a cardiopulmonary arrest, secondary to an acute viral illness. The child was deeply comatose. No barbiturates, other sedatives, or aminoglycoside antibiotics had been recently administered. The child was normothermic with adequate cardiovascular function. Brain stem function was absent, as assessed by testing of brain stem reflexes. Serial cerebral radionuclide angiograms (CRAG) documented intact cerebral blood flow while electrocerebral silence (ECS) was present on two consecutive EEG recordings within 24 hours. Preservation of intracranial circulation was confirmed by rapid rotational computed tomographic (CT) scans. Cranial CT scans also revealed communicating hydrocephalus, and bilateral basal ganglia hemorrhages. This unusual case illustrates discordance between apparent irreversible loss of cortical function as indicated by electrocerebral silence with preserved cerebral blood flow. The implications of these apparent paradoxical events will be discussed in the context of defining brain death in children.
Indium-111-labeled leukocyte scans were performed on 39 patients with suspected musculoskeletal infections to assess the usefulness of this study in detecting bone and joint infections. Results of these scans, as well as results of technetium-99m bone scans, were correlated with the patients' final diagnoses. The indium scan had an overall sensitivity of 77%, a specificity of 69%, and an accuracy of 72%. In 10 patients with a duration of symptoms of six weeks or less, the sensitivity was 100% and the specificity was 75%. In 29 patients with symptoms of greater than six weeks, the sensitivity and specificity were lower at 50% and 71% respectively. Technetium-99m bone scans were performed on 23 patients; sensitivity for infection was 100% while specificity was 60%. Our results suggest that the indium-111 leukocyte scan is a useful adjunct in the diagnosis of acute musculoskeletal infections, but may be inconclusive in chronic infections.
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Pediatric neurologists agree that the determination of brain death in children, and especially retarded children, is difficult and that the criteria used in adult brain death may not be sufficient in pediatric cases. An unusual case of sustained electrocerebral silence on electroencephalogram (EEG) in a three-year-old retarded comatosed child with preserved intracerebral perfusion documented by a series of cerebral radionuclide angiograms (CRAG) is presented. The EEG showing electrocerebral silence represents loss of cerebrum (cortex) function (Barlow 1976). This absence of cortical function is demonstrated even though intracranial circulation is shown to be intact. We believe that the correlative studies presented accurately document a discordance between apparent loss of cortical function in a child as indicated by electrocerebral silence in the face of preserved cerebral blood flow. It is suggested that when evaluating brain death in retarded children with known cerebral atrophy, special emphasis should be placed on the CRAG and that the EEG should be read with caution.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Noninvasive differentiation of benign from malignant disease has emerged as an important diagnostic challenge in this age of health-care cost containment. Most physicians today acknowledge that early and accurate detection of cancer is the key to successful treatment. Antibodies have been developed and used to detect and treat tumors. In the next few years, several radiolabeled antibodies will likely receive FDA approval for imaging colorectal, lung, and prostate carcinomas, thus expanding and improving the physician's ability to detect and follow cancer in patients. There is ample evidence in the literature that suggests that imaging with labeled antibodies is clinically useful for detecting colorectal cancer in patients with suspected recurrence, in patients with presumed isolated resectable liver metastasis, and in those at high risk of the development of recurrence. This paper reviews these studies, and also discusses some data obtained from positron emission tomography (PET) imaging in colorectal patients.