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Biomedical subjects

P Lass

Publications and source records attributed to P Lass.

At least 37 records · Page 2Linked to original sources
PubMed2000

Technetium-99mTc-HMPAO brain SPECT in antiphospholipid syndrome--preliminary data.

BACKGROUND: Antiphospholipid syndrome (APS) is defined as the presence of repeated episodes of arterial or venous thrombosis, recurrent spontaneous abortions and thrombocytopenia in patients with elevated antiphospholipid antibodies. An important feature of APS are cerebrovascular disorders of thrombotic origin. The aim of the study was to assess cerebral blood flow changes utilising brain SPECT HMPAO scanning. METHODS: Brain SPECT (99m)Tc-HMPAO scanning was performed in 20 patients with APS: 12 with systemic lupus erythematosus, 4 with Sneddon's syndrome, 2 with Sjögren's syndrome, 2 with primary APS. 30 healthy volunteers served as a control group. RESULTS: 19 studies were abnormal, 1 normal. Abnormalities consisted of multifocal perfusion deficits and diffuse decrease of regional blood flow. The average number of focal perfusion deficits was 4.8 +/- 1.7. In 7 patients diffuse hypoperfusion of frontal lobes was seen, in 1 patient additionally hypoperfusion of temporal and occipital lobes. There was a correlation between the number of focal perfusion deficits and cognitive impairment in this group of patients. Correlation between SPECT images and clinical data was moderate in cerebellar syndrome and paresis, weak in persistent headache and vertigo. CONCLUSIONS: Those results indicate the high utility of CBF brain SPECT scanning in antiphospholipid syndrome.

Journal Article↗
PubMed2000

Use of lung and brain perfusion imaging in the HELLP syndrome.

Patients with multi-organ disorders may present with a plethora of confusing symptoms and signs. Often early diagnosis of significant disease is essential and can be difficult with standard radiological techniques. This case report presents the use of two radioisotopic techniques to assess brain and lung perfusion in a patient with such an acute-multi-organ disorder-the HELLP syndrome.

Journal Article↗
PubMed1999

Cognitive impairment in patients with renal failure is associated with multiple-infarct dementia.

PURPOSE: Patients undergoing long-term renal replacement therapy (such as dialysis) have an increased risk for significant cognitive impairment, which may result in memory problems and subsequently missed attendance at dialysis. The aim of this study was to try to identify any abnormalities of cerebral perfusion that could explain a patient's cognitive impairment and to determine if the pattern of these abnormalities would suggest a cause. MATERIALS AND METHODS: 17 patients (13 men; mean age, 60 years; age range, 29-74 years) in end-stage renal failure or on dialysis had SPECT imaging 10 minutes after injection of 550 MBq (15 mCi) Tc-99m HMPAO. Two of the patients had a history of previous stroke. Other risk factors for stroke were noted in most of the patients (hypertension in 10 patients, smoking or former smoking in 10 patients, and cardiac atherosclerosis in 7 patients). In all patients, attenuation correction was applied and the images were reconstructed into three sets of orthogonal slices. Activity in the frontal and temporal lobes was compared by quantification against the ipsilateral and contralateral cerebellum. RESULTS: Discrete cortical defects consistent with infarcts were seen in 14 patients. The mean right and left frontal-to-cerebellar ratio was 0.837 (SD, 0.09) and 0.837 (SD, 0.08), respectively. This was not significantly different from the right and left temporal-to-cerebellar ratios of 0.843 (SD, 0.07) and 0.848 (SD, 0.07), respectively. Both were within normally accepted ranges. CONCLUSIONS: Patients in end-stage renal failure who also had cognitive impairment appear to have a high number of cortical defects consistent with infarcts (suggesting a multiple-infarct type of dementia). There was no evidence of Alzheimer-type dementia.

Adult↗
PubMed1999

Duodenogastric reflux: clinical and therapeutic aspects.

BACKGROUND: Duodenogastric reflux is believed to cause damage to gastric mucosa. Most reports on this disorder concern adult patients. PATIENTS AND METHODS: 1120 children with abdominal pain were studied; endoscopic features of duodenogastric reflux were found in 92 patients. To confirm the diagnosis of duodenogastric reflux, cholescintigraphy (Tc99-HEPIDA) was performed. Children with confirmed duodenogastric reflux by scintigraphy were given a prokinetic drug (cisapride). RESULTS: Endoscopic features of duodenogastric reflux were found in 92 children; the diagnosis was confirmed by scintigraphy in 59 patients. There was no significant difference in the severity of inflammation in gastric mucosa compared with the control group, whereas significantly fewer of these patients were infected with Helicobacter pylori. There was no correlation between regions of isotope accumulation and inflammatory lesions in the stomach. The prokinetic drug (cisapride) helped eliminate or greatly reduce duodenogastric reflux in children. CONCLUSIONS: When endoscopic features of duodenogastric reflux are found the final diagnosis should be based on an examination that does not itself influence the motility of the gastrointestinal tract: cholescintigraphy seems to be a useful method. However, because the use of milk as a test meal affects the scintigraphic image, there was no correlation between the area of isotope accumulation and the localisation of inflammatory lesions in the stomach. Duodenogastric reflux seems to be less important as a cause of inflammatory lesions than other factors (such as genetic predisposition, stress, etc). Prokinetic drugs have a beneficial influence on treatment results in children with inflammatory lesions of gastric mucosa with duodenogastric reflux.

Adolescent↗
PubMed1999

[The place of radionuclide methods in diagnostic imaging of renovascular hypertension].

Numerous investigations and tests are used for diagnosis of renovascular hypertension. From many imaging techniques that are applied in radiology and nuclear medicine we selected those which give us high effectiveness in diagnosing a renal artery stenosis. Choosing from the range of radiological methods we focused on ultrasonography with the "color doppler" and "power doppler" option, renal arteriography and magnetic resonance angiography. Nuclear medicine offers us renal scintigraphy and its modification--renal scintigraphy with the administration of captopril. The high sensitivity of renal scintigraphy with the use of captopril incapables us to detect a stenosis of haemodynamic significance. This is of essential value for planning surgical revascularisation procedures.

Humans↗
PubMed1999

[Neurologic complications in Wegener's granulomatosis].

Nervous system involvement is relatively frequent in Wegener's granulomatosis (WG). It may be difficult to differentiate between the primary central nervous system involvement and complications secondary to concomitant arterial hypertension, renal insufficiency and iatrogenic effects of immunosuppressive therapy. The crucial role in the assessment of intracranial pathology may be ascribed to the diagnostic imaging techniques: magnetic resonance imaging (MRI), computed tomography (CT) and cerebral blood flow imaging utilising the single photon emission computed tomography (SPECT). SPECT may prove superior sensitivity to MRI. It may be especially useful in differentiating central nervous system involvement in WG with secondary changes of other origin.

Brain Diseases↗
PubMed1998

Cerebral blood flow assessed by brain SPECT with 99mTc-HMPAO utilising the acetazolamide test in systemic lupus erythematosus.

BACKGROUND: Cerebrovascular diseases are one of the most important complications of systemic lupus erythematosus (SLE). The diagnostic imaging of neuropsychiatric SLE complications presents many problems. This study was undertaken to investigate cerebral blood flow char s and its reactivity to hypercapnia by means of acetazolamide test in SLE patients. METHODS: Brain SPELT studies using 99mTc-HMPAO were performed in 50 patients with SLE. Acetazolamide test was performed in 35 patients 3 days after the baseline study by means of repetitive scanning 20 min after i.v. injection of 1.0 g of acetazolamide. RESULTS: Significant interhemispheric hypoperfusion areas were shown in 76.3% of all patients, 83.8% symptomatic and 63.1 % asymptomatic. Patients with antiphospholipid syndrome showed multifocal perfusion deficits. The reaction of cerebral perfusion to acetazolamide was heterogenous and showed increase, decrease, no change or mixed reaction of baseline-study-found focal hypoperfusion. Acetazolamide test revealed hypoperfusion in two patients with normal baseline study. MRI scanning revealed cerebral lesions in 41 % of patients. CONCLUSIONS: CBF asymmetries in symptomatic and asymptomatic patients with SLE are frequent. Regional CBF alterations seem to be different in patients with and without antiphospholipid syndrome. The part of the patients with SLE shows no or paradoxically inversed reaction to acetazolamide.

Journal Article↗
PubMed1997

[Modern diagnostic methods for thyroid gland diseases].

The paper overviews the role of diagnostic procedures in evaluating patient with thyroid gland disease. It focuses on the diagnostics of functional disturbances and on the modern approach to the nodular goitre. The role of supersensitive, immunoenzymatic assay of TSH (sTSH) in the diagnostics of functional disturbances in underlined, particularly in subclinical course of thyroid gland diseases, or in diagnostically difficult cases. The complimentary role of tests' triangle-ultrasound, scintigraphy and fine needle biopsy in the evaluation of focal changes of the thyroid (nodular goitre) is discussed and the diagnostic algorithm of patient's qualification to surgery is proposed.

Algorithms↗
PubMed1995

Cholescintigraphy in the diagnosis of duodenogastric reflux in children, preliminary report.

The gastroduodenal reflux is considered, to be one of the important factors in the pathogenesis of gastritis and gastric ulcers. Endoscopic features suggesting bile reflux are not fully objective and may be a reason for false diagnosis of gastroduodenal reflux. The following study was established to verify the endoscopically diagnosed bile reflux by a scintigraphical test. In 30 of the 350 patients we showed bile reflux endoscopically, but 21 of them had duodenogastric reflux confirmed by cholescintigraphy. The autors maintain that cholescintigraphy seems to be a very useful method in the proper diagnosis of bile reflux.

Adolescent↗
PubMed1992

Increased cerebral blood flow in anemic patients on long-term hemodialytic treatment.

CBF was measured in 15 patients on chronic hemodialytic treatment. CBF was measured with xenon-133 inhalation using single photon emission tomography. In addition, computerized tomography (CT) and a neurological examination were done prior to hemodialysis. Mean CBF was 66.2 +/- 17.3 (SD) ml 100 g-1 min-1, which was significantly higher (t-test, p less than 0.05) than for an age-matched control group (54.7 +/- 10.2 ml 100 g-1 min-1). However, the hematocrit for the patients was considerably lower, 0.30 +/- 0.07, as compared to 0.43 +/- 0.03 in the controls. A significant negative correlation was observed between CBF and the hematocrit (y = -1.79x + 120.7, r = -0.71, p less than 0.01). Calculating CBF from this equation in the dialyzed patients using a hematocrit of 0.43 yielded a mean CBF value of 43.7 ml 100 g-1 min-1, i.e., 20% below the expected. Two patients showed a focal CBF decrease. CT showed central or cortical atrophy in five patients, and two had small hypodense lesions. The neurological examination revealed slight to moderate dementia in seven cases. Although mean CBF was found to be increased by 21% as compared to the control group, an even higher CBF level would have been expected to outweigh the decreased oxygen carrying capacity of the blood. The findings suggest a lowered metabolic demand of the brain tissue, probably due to subtle brain damage.

Adult↗
PubMed1991

Muscle coordination following rupture of the anterior cruciate ligament. Electromyographic studies of 14 patients.

In an electromyographic (EMG) study, the coordination in muscles acting on the knee joint was assessed in 14 patients with an arthroscopically verified complete rupture of the anterior cruciate ligament and in 16 controls. EMG and heel-contact signals were recorded while walking on a treadmill at walking gradients from 0 to 25 percent. There was an earlier onset of EMG bursts in the patients, especially in the lateral hamstrings and medial gastrocnemius; and the duration of EMG bursts also tended to be prolonged in the patients. Normalized root mean squares of amplitudes, which correlate with muscle tension, were higher in the gastrocnemius in the patients. EMG profiles, outlining the averaged muscle activity throughout the gait cycle, showed a displacement of peak activity in the hamstrings from the late swing phase into the stance phase, with increasing gradients in both the patients and the controls. Our study indicates that the gastrocnemius muscle contributes to functional stability in the anterior cruciate ligament deficient knee, and more attention should be paid to this muscle.

Adult↗
PubMed1990

[Femoro-popliteal bypass surgery in Denmark 1983-1987].

In a retrospective study of femoro-popliteal bypass surgery in Denmark during the period 1983 to 1987, a total of 1,532 operations were performed. Approximately 2/3 of the patients were operated upon for limb salvage, the remainder for severe disabling claudication. The perioperative lethality was below two per cent in all departments. Early occlusion rate was found to be between 21 and 11 per cent, leading to major amputation in about half of the patients.

Arteriosclerosis↗