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Biomedical subjects

P Reuland

Publications and source records attributed to P Reuland.

31 records · Page 2Linked to original sources
PubMed1991

Detection of infection in postoperative orthopedic patients with technetium-99m-labeled monoclonal antibodies against granulocytes.

A prospective study of 106 orthopedic patients was performed for the detection of infection in the early postoperative stage using 99mTc-labeled murine Mabs directed against epitopes on granulocytes. Accuracy was 81% in the hips (n = 26), 81% in the thigh (n = 21), 84% in the knee (n = 19), and 100% in the tibia (n = 27). The technique did not work well in the spine where false-negative results were observed in the three patients studied. One patient suffered transient swelling of the eyelids following injection. Optimal imaging results were obtained 2-6 hr postinjection.

Adolescent↗
PubMed1989

[Diagnosis of infection in surgery of the locomotor system with Tc-99m-HMPAO leukocyte scintigraphy].

70 patients with confirmed (23 patients) or suspected (47 patients) bacterial infection in the skeleton following diseases, injuries or operations in orthopedic surgery were investigated using Tc-99m-HMPAO leucocyte scintigraphy in order to evaluate the accuracy of this procedure. Infections could be detected correctly in 37 of 70 patients (right positives) while 28 patients had negative scans corresponding to the clinical course (right negatives). One false negative finding was observed. Five patients with clinically suspected infection had a focal uptake in the WBC-scan and were not operated subsequently. They range as false positive results, although they belong to a special group (Infection: Yes-Operation: No [IYON]-group). In the assessment of the Tc-99m-HMPAO-WBC-scan there was a senstivity of 97.1%, specificity of 82.9% and an overall accuracy of 90%. The method is suitable for detection of early and late infection as well as chronic or hematogenous osteomyelitis in the locomotor system. This means an important contribution in diagnosis of infection determining further operative or conservative treatment.

Abscess↗
PubMed1989

Gallbladder emptying in diabetic patients and control subjects assessed by real-time ultrasonography and cholescintigraphy: a methodological comparison.

Gallbladder motor function was studied in nine diabetic patients and nine control subjects matched for sex, age, and weight. None of the subjects had gallstones. Two different techniques were employed: real-time ultrasonography and cholescintigraphy using 99mTc-HIDA as imaging agent. Gallbladder volumes were determined sonographically by using three dimensions: length, lateral, and anterior-posterior diameters. Gallbladder emptying was stimulated by a standard test drink (Biloptin). Ejection fraction was computed and the results obtained by both techniques were compared. Fasting and residual gallbladder volumes after contraction were significantly larger in the diabetic patients than in the control subjects (15.9 +/- 7.6 cm3 vs. 2.3 +/- 1.3 cm3, p less than .0007; and 9.2 +/- 9.8 cm3 vs. 0.7 +/- 0.7 cm3, p less than .0007). Ejection fractions (ultrasonography/cholescintigraphy) were lower in the diabetic patients compared with the control subjects (59.9 +/- 26.6% and 63.1 +/- 23.2% vs. 73.2 +/- 23.8% and 75.3 +/- 24.8%), however, this difference was not statistically significant. Sonographically and scintigraphically determined ejection fractions were closely correlated (r = 0.90, p less than .00005).

Diabetes Mellitus, Type 1↗
PubMed1989

[Lymph scintigraphy in edema of the extremities].

The method presented here for scintigraphic measurement of lymphatic drainage can be carried out easily and entails little stress for the patient. It is very suitable for routine use in many patients. Since consistency with clinical findings is very good this is an inexpensive method for clarification of lymph drainage disturbances.

Adult↗
PubMed1989

[Comparison of the clinical value of an iterative reconstruction procedure with that of a filtered back projection in SPECT of the liver].

We have tested an iterative reconstruction procedure against the usual filtered back-projection in 14 patients with SPECT-examinations of various liver diseases. The aim of the examinations was to assess the presence of liver tumors in most cases. Further indications were Budd-Chiari syndromes and a liver malconfiguration in one case. Three of six haemangiomas and both liver metastases were better delineated with the iterative method, in one patient the haemangioma was visible only with this method. An irregular pattern after filtered back-projection led to misinterpretation as multiple metastases in another patient in whom there was no irregularity after iteration. Diagnostic improvement was not reached in the Budd-Chiari syndromes or in an atypical liver configuration, with a more homogeneous pattern after iteration however. The iterative reconstruction procedure was superior to the filtered back-projection method in the detection of small focal liver diseases.

Adult↗
PubMed1988

[Evaluating 2 simple procedures for ultrasound assessment of gastric emptying].

For evaluation of 2 simple methods gastric emptying was studied simultaneously by ultrasound and scintigraphy. In 12 patients (25-76 years-old) gastric emptying was quantified by scintigraphy after ingestion of 300 ml Tc-99m-labelled orange juice; simultaneously, the region of the gastric antrum was measured in 5-minute intervals in the aortic longitudinal section. In the following day gastric emptying was studied after ingestion of the identical volume of orange juice by planimetry of the maximal gastric area in an anatomical long-axis section in dextro-decline position. By linear regression analysis a significant correlation coefficient (r = 0.83, p less than 0.001) was obtained between the results of the sonographic antrum method and scintigraphy and between scintigraphy and the sonographic dextro-decline method (r = 0.83, p less than 0.001). These results imply that gastric emptying of fluids can be quantified by both simple sonographic methods. The sonographic dextro-decline method is less influenced by air and hence easier to perform.

Adult↗
PubMed1988

[Radiologic and scintigraphic diagnosis of primary chronic osteomyelitis in childhood].

Problems in the radiological and scintigraphic diagnosis of primary chronic osteomyelitis are discussed with reference to ten patients aged two to 13 years. Radiologically the lesions usually showed reduced bone density with surrounding sclerosis, most commonly in the distal femoral or proximal tibial metaphysis. In five children the lesions were multilocular. In four children the lesion had not healed after two years. One lesion resembling a tumour, which suffered a pathological fracture, is described. In three patients the initial bone scintigrams showed no abnormalities despite definite radiological lesions. A normal three-phase bone scintigram does not exclude osteomyelitis during childhood.

Adolescent↗
PubMed1988

[99mTc-HMPAO leukocyte scintigraphy in the diagnosis of inflammations of the skeletal system. Initial experiences].

Subsequent to orthopedic surgery 23 patients were studied by leukocyte scintiscanning using 99mTc-HMPAO to detect inflammation. 12 patients had all signs of bacterial infection. In 11 patients infection of the wound area was suspected. There was one false negative and no false positive scintigraphic finding. 2 patients with an unclear postoperative course after internal fracture fixation showed intensive uptake. Several days after the scan both patients developed severe bacterial infection. From that experience we conclude that the method may be of higher sensitivity than clinical symptoms. Further investigations are necessary for an accurate assessment of the method.

Adult↗
PubMed1988

[180 degree versus 360 degree rotation in SPECT of bone].

Opinions differ as to the advantages of the 180 degrees and the 360 degrees techniques concerning myocardial scintigraphy with 201Tl. Following our own encouraging experiences with the 180 degrees technique, we have looked for cases in bone scintigraphy where reconstructions from a semicircle could be advantageous over a full circle reconstruction. There were metastases and foci of osteomyelitis in spine, ribs and skull (especially in the skull base), to be seen better in reconstructions using images out of 180 degrees close to the object. In knee SPECT a closer radius of rotation can be chosen with single-head cameras so that, when using the 180 degrees technique, a better reproduction of the anatomical structures and pathological alterations is achieved.

Adult↗
PubMedDate not supplied

Radio-immunodetection of myosarcoma using 111indium antimyosin.

Radio-labelled antimyosin-monoclonal antibodies (AMA) have been introduced to demonstrate myocardial necrosis after cardiac infarction or in cardiac allograft transplants. As rhabdomyosarcoma (RMS) and leiomyosarcoma (LMS) are tumors of myogenic origin, thus often containing myosin, we decided to use the 111In-labelled Fab fragment of AMA (Centocor) in scintigraphic tumor detection. We examined 13 children with histologically-confirmed RMS and LMS, and five other children with other types of soft tissue sarcomas. Conventional techniques were used to determine the extent of the tumor. An uptake of the tracer was observed in all known tumor sites in seven RMS patients. As the scans were negative in three RMS patients who were in complete remission (CR) and in two other patients (fibrosarcoma and haemangiopericytoma) with a measurable tumor mass, we considered them to be "true negative". In the three remaining CR patients (1 RMS, 2 LMS) the scans were positive but weak in the primary tumor site in two cases and in a distant site (bone) in the third respectively. We considered them to be "false positive" as no tumor cells were evident in the biopsy specimen. In one case, the antimyosin uptake was presumably the result of damage to the muscles after radiation. Interestingly, in three patients with other malignancies such as rhabdoid and peripheral neuroectodermal tumors there was a noticeably strong uptake of the tracer in the primary tumors and the scans turned negative after complete remission was achieved. The diagnostic AMA scanning showed no side-effects. The reason why antimyosin antibodies permeate the membrane of the tumor cells is yet undetermined.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Treatment of neuroblastoma with [131I]metaiodobenzylguanidine: long-term results in 25 patients.

From 1984 to 1990 we have treated altogether 25 children with [131I]metaiodobenzylguanidine (131I-MIBG) for a refractory, relapsed or metastasized neuroblastoma. Three children had stage III and 22 children had stage IV of the disease; at diagnosis their ages were between 4 months and 10 years. Children with stage III disease had at diagnosis a median age of 3.0 years and at treatment 3.8 years. After first-line chemotherapy 2 children had achieved a complete remission (CR), while in 1 child the tumor did not respond (NR) to the initial treatment. At the time of 131I-MIBG treatment 2 children had relapsed and in the other one no further response was achievable. The children were treated by a 13.5 +/- 12.9 mCi/kg BW per course with a mean total dose of 280.7 +/- 243.9 mCi. One child achieved CR by 131I-MIBG alone, while in 2 cases no measurable success was observed. All 3 children were treated additionally by surgery, chemotherapy and bone marrow transplantation (BMT). Two children have died but one is alive and in CR. The 22 children with stage IV disease were treated in two different study groups. In group A, 14 children were studied for side-effects and response to 131I-MIBG. All children were pretreated with standard chemotherapy. Five were treated in relapse, 5 in progression and 3 at a refractory state of the disease; only 1 child was in complete remission when being treated with 131I-MIBG. Group A patients were treated with a mean of 2.4 courses, with 10.3 mCi/kg BW for each course.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Iodobenzylguanidine↗