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Biomedical subjects

P Lass

Publications and source records attributed to P Lass.

At least 19 recordsLinked to original sources
PubMed2006

The influence of radioisotope vehicle on breast sentinel node detection.

AIM: To assess the relationship between carrier molecule size and time elapsing between marker injection and sentinel node(s) biopsy in patients with breast cancer. MATERIAL: The study performed on 122 women, in whom the sentinel node(s) was identified according to the procedure described below. In Group I (n=72 patients), SN identification was done with radioisotope marker of 400-3000 nm molecule size (tin colloid). In Group II (n=50 patients) radioisotope marker of <100 nm molecule size (colloidal albumin) was used. METHODS: All the patients of both groups received the markers with a single-point, intradermal, periareolar injection. Four hours after the injection (Group I - surgery in the next day) or immediately before the surgery (in this same day) (Group II), stationary lymphoscintigraphy was performed. RESULTS: Mean numbers of sentinel nodes identified with the radioisotope method in Groups I and II were 1.22 and 1.48, respectively. The difference was statistically significant (p<0.01). CONCLUSIONS: There is a relationship between the radioisotope marker molecule size and the injection-to-intra-operative evaluation time. Administration of small molecule size radioisotope marker several hours prior to the planned surgery appears to be the optimum procedure in this method of SN identification in patients with breast cancer.

Breast Neoplasms↗
PubMed2005

Lung function in patients operated for chronic pleural empyema.

OBJECTIVES: To evaluate lung function after lung decortication in patients operated for chronic pleural empyema. METHODS AND MATERIALS: To determine the lung function after lung decortication in 20 men (71.4%) and 8 women (28.6%) a prospective evaluation of blood gases, spirometry, lung perfusion, ventilation, and alveolar permeability were performed 28 weeks (15-60 weeks) after the operation. RESULTS: Median lung perfusion on the affected side was 45.2% (26.1-55.3%) in 13 right and 36% (13.8-47.2%) in 15 left empyemas, and was within normal limits in 4/28 cases. The mean lung ventilation was 44.4% (21.5-54%) and 37% (18.9-50.6%) in patients affected on the right or left side, respectively. Ventilation perfusion inequality occurred in 22 patients (78.6%). Dynamic ventilation scintigraphy revealed impairment of epithelial integrity in 10 cases (35.7%). Individual analysis revealed that 15 patients (53.6%) showed a severe reduction in one of the examinations and 8 (28.6%) in more than one. CONCLUSIONS: Although the separate analysis of the different functional parameters revealed a mild reduction of lung function after decortication, in the majority of patients the impairment was more severe due to multilevel functional lung damage.

Adolescent↗
PubMed2004

[Imaging in parathyroid gland diseases with relation to surgery].

BACKGROUND: Despite the progress in the imaging techniques, the satisfactory preoperative detection of the hyperactive parathyroid glands has not been guaranteed yet. Many complementary techniques have been introduced including ultrasound imaging, CT-scanning, MRI and scintigraphy, also supported by intraoperative methods (methylene blue injections, gamma-probing, intraoperative PTH level assessment) simplifying the detection of the glands and assuring the surgeon on the adequacy of his/her treatment. DESIGN: The authors describe the methods instituted nowadays, and compare their quality parameters, applicability, indications and limitations. The critical review is accompanied by a brief presentation of own experience including 172 cases of hyperparathyroidism treated in the Department of General, Gastroenterological and Endocrinological Surgery, Medical University of Gdansk, Poland between 1996 and 2003. CONCLUSIONS: The authors conclude that radionuclid-based methods (Tc (99m)-MIBI preoperative scintigraphy and Tc (99m)-MIBI intraoperative gamma-probing) seem to be the most effective in both preoperative and intraoperative detection of hyperfunctioning parathyroids. It is also suggested that the effectiveness of the imaging is higher in primary than in secondary hyperparathyroidism. It is underlined that the effectiveness of the operative treatment is strongly determined by the experience of the operating endocrine surgeon.

Diagnosis, Differential↗
PubMed2001

Cerebral blood flow SPECT may be helpful in establishing the diagnosis of progressive supranuclear palsy and corticobasal degeneration.

BACKGROUND: We present 4 cases, which illustrate the usefulness of neuroimaging studies in atypical forms of Parkinsonism. Progressive Supranuclear Palsy (PSP) and Corticobasal Degeneration (CBD) are rare neurodegenerative progressive disorders of the central nervous system of unknown cause. The clinical accuracy in this diagnosis is not very high even in centres specialising in movement disorders. Functional imaging can be helpful in diagnosing PSP and CBD. MATERIAL AND METHODS: We present the results of cerebral blood flow (CBF) SPECT scanning in 2 patients with PSP and 2 patients with CBD. This was performed using a triple-head gammacamera and 99m Tc-HMPAO. RESULTS: In PSP patients a diffuse frontal perfusion deficit was seen, eventually with striatal and occipital hypoperfusion. CT/MRI was either normal or showed a diffuse cortical-subcortical atrophy. In CBD patients left fronto-parieto-temporal cortex and a striatal hypoperfusion were shown. CT scanning was normal in one case and showed an asymmetrical temporo-parietal atrophy in second one. CONCLUSIONS: The pattern of diffuse frontal perfusions deficit in PSP and asymmetrical, contralateral to symptoms of CBD, cortico-subcortical hypoperfusion may be helpful in establishing the correct diagnosis.

Journal Article↗
PubMed2001

Does quantification of myocardial perfusion SPECT study differ while image reconstruction is carried out using iteration algorithm instead of filtered back-projection?--preliminary report.

BACKGROUND: The purpose of this study was to compare the performance of two reconstruction algorithms: conventional filtered back-projection (FBP) and an iterative algorithm--ITW--in quantitative analysis of myocardial perfusion SPECT studies. The defect size and defect severity were assessed on (99m)Tc-MIBI images reconstructed using both methods and estimation of sensitivity in the detection of perfusion deficits and myocardial viability were performed as well. METHODS AND RESULTS: The study group comprised 43 patients (38 men and 5 women) in the age of 40-73 years (mean 59 years). Heart perfusion scintigraphy was performed following an injection of 22 to 25 mCi 99mTc-MIBI for exercise and rest myocardial perfusion study. Images were reconstructed using FBP and ITW algorithms. Defect size (DS) was quantified by a threshold program and CEqual programme. Defect severity (nadir) was calculated as the ratio of minimal/maximum counts from bull?s eye polar map. Coronary arteriography was performed in all patients. RESULTS: Defect size calculated by threshold method on resting images did not differ between reconstruction methods (p=0.61 for cut-off 50% and p = 0.24 for cut-off 60%); defect severity was higher on images reconstructed with ITW (CI(0.95) = 2.4%;5.2% of maximal counts). CONCLUSIONS: Sensitivity for detection of heart perfusion defects and estimation of myocardial viability were similar on images reconstructed by both algorithms.

Journal Article↗
PubMed2001

Cerebral blood flow changes in Parkinson?s disease associated with dementia.

Dementia is one of the main non-motor symptoms of Parkinson's disease (PD) and it is diagnosed in about 30% of cases. Its aetiology remains unclear and contributing factors are controversial. Dementia may be more common in old patients with severe motor symptoms and mild cognitive impairment. Clinico-pathological studies show the association between dementia in PD and the age-related group of dementias, such as AD and VaD. A valuable aid in the assessment of dementia in PD is cerebral blood flow (CBF) brain SPECT scanning. It shows three different patterns of rCBF reduction, including frontal lobe hypoperfusion, Alzheimer-like type of hypoperfusion and multiple, vascular defects. The heterogeneity of rCBF reduction may reflect the multifactorial pathophysiology of dementia in PD. It may result from concomitant AD pathology, cerebrovascular disease, destruction of nigro-striato-frontal projection or may be a distinct disease of different aetiology.

Journal Article↗
PubMed2001

The usefulness of CBF brain SPECT in forensic medicine. A description of four cases.

BACKGROUND: The aim of this study was to show the applications of cerebral blood flow SPECT scanning in forensic medicine using four cases: two suspects and two victims of crime. MATERIAL AND METHODS: Cerebral blood flow studies were performed with the use of (99m)Tc-ECD and a triple head gammacamera. Qualitative and quantitative analysis was performed, utilising an asymmetry index for unilateral perfusion deficits and a comparison to cerebellar perfusion for assessing the regional cerebral perfusion. For assessing the normal values, a control group of 30 patients was studied. RESULTS: In these cases CBF SPECT scanning proved its usefulness in medico-legal argument and played an important role in formulating the final forensic expert's opinion. CONCLUSIONS: Radionuclide cerebral blood flow studies may play a role in forensic medicine, where this method it is mostly under-utilised at present.

Journal Article↗
PubMed2000

Cerebral blood flow in Sjögren's syndrome using 99Tcm-HMPAO brain SPET.

Neuropsychiatric disturbances are frequent in connective tissue diseases. Little is known about the cerebral pathophysiology of Sjögren's syndrome, including cerebral blood flow disturbances. 99Tcm-HMPAO brain SPET was performed in 21 Sjögren's syndrome patients. We also studied 77 patients with systemic lupus erythematosus and 27 healthy individuals. Our results demonstrate the high rate of alterations in cerebral blood flow in Sjögren's syndrome, both psychoneurologically symptomatic and asymptomatic. Focal interhemispherical perfusion deficits were seen in 17 of 21 patients (80.9%) with Sjögren's syndrome: 13/15 symptomatic (86.6%) and 4/6 asymptomatic (66.6%). These changes were mostly localized in the prefrontal and frontal areas, occipital lobes and occipitoparietal area, and less frequently so in the temporal, parietal and central areas. Diffuse hypoperfusion of the frontal lobes (bilateral hypofrontality) was seen in 29% of patients in the Sjögren's group. An acetazolamide stress test was performed in seven patients. There was an increase in perfusion deficits in two patients, no change in two patients, and hypoperfusion decreased in three patients compared with baseline. The results indicate that most Sjögren's syndrome patients experience alterations in cerebral blood flow that are consistent with systemic lupus erythematosus, with heterogeneous reactivity to acetazolamide-induced hypercapnia. These alterations present as focal perfusion deficits and bilateral diffuse hypoperfusion of the lobes. The mechanism of cerebral blood flow alterations is unknown, although it might be the result of diffuse cerebral vasculitis.

Acetazolamide↗
PubMed2000

Ilizarov treatment of tibial nonunions results in 16 cases.

Treatment with the Ilizarov technique was performed in 16 patients with complex tibial nonunions. Two years post treatment the functional stage and patient satisfaction were recorded. There were 4 hypertrophic, 3 atrophic and 9 infected nonunions. Eleven patients had segmental bone loss. Fifteen nonunions united, and limb length discrepancy was reduced within 1.5 cm of the contralateral leg. Average time in the frame was 182 days. Fifteen of the 16 patients were satisfied with the treatment. One patient demanded an amputation after 3 months of treatment, despite good signs of healing. There were no refractures or recurrent infections. In conclusion the Ilizarov technique for complex nonunions has a high rate of success in achieving union and eradicating infection, bone loss and malalignment. The treatment is demanding both to the surgeon and to the patient, but we strongly recommend the Ilizarov treatment for tibial nonunion, especially in cases with chronic infection and severe bone loss.

Adolescent↗
PubMed2000

Current status and future plans of Nuclear Medicine Procedure Guidelines in Central and Eastern European EANM member societies compared with those in other EANM member societies.

The main aim of the EANM Task Group on Quality Assurance and Standardisation is to develop harmonised clinical procedures that are accepted within Europe. In order to achieve an evidence-based analysis of guidelines this Task Group conducted a survey by means of a questionnaire in the 27 EANM member societies in July 1999, which investigated the current status of national guidelines in EANM member societies, specification of the cover and level of these national guidelines, and future desires for national, EANM and SNM guidelines. A reanalysis of the data of this survey was undertaken to evaluate the differences and similarities between 9 Central and Eastern European (CEE) EANM member societies and 18 non-CEE (mainly Western European) EANM member societies with regard to the aforementioned investigated topics. The results of this reanalysis show only minor differences between CEE and non-CEE EANM member societies with regard to the aforementioned topics. Both in CEE and in non-CEE EANM member societies, there is limited coverage of existing guidelines, leaving most procedures uncovered. Although the infrastructure for guideline development is present in both groups, the main explanation for this similarity is the limited advancement of the guideline development process, in both the CEE and non-CEE EANM member societies. Both groups are willing and ready for guideline development at the EANM level, with more concordant than discordant reasons for this. This allows a synchronous implementation of procedure guidelines in CEE EANM member societies.

Editorial↗