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Biomedical subjects

R Hardoff

Publications and source records attributed to R Hardoff.

At least 37 records · Page 2Linked to original sources
PubMed1995

Localized manifestations of subacute thyroiditis presenting as solitary transient cold thyroid nodules. A report of 11 patients.

Eleven patients, each with a painful solitary cold nodule of the thyroid were evaluated. All patients had subacute thyroiditis associated with neck pain and tenderness. Despite elevated sedimentation rate and increased thyroglobulin levels, nine of the patients were euthyroid, and I-131 uptake was normal in six. In all patients, thyroid scintigraphy demonstrated a solitary cold nodule that resolved regardless of anti-inflammatory therapy. Granulomatous subacute thyroiditis is characterized by decreased I-131 uptake accompanied by transient hyperthyroidism. The uncommon localized variant of this entity may present with a painful solitary nodule, normal or only moderately decreased I-131 uptake, and should be suspected even in euthyroid patients.

Adult↗
PubMed1995

Bone loss in patients with chronic renal disease: prediction with quantitative bone scintigraphy with SPECT.

PURPOSE: To determine whether quantitative bone scintigraphy (QBS) with single-energy photon emission computed tomography (SPECT) can help predict which patients with chronic renal disease will show bone mineral density (BMD) loss. MATERIALS AND METHODS: In 18 patients, the percentage of injected dose of technetium-99m methylene diphosphonate per cubic centimeter of bone was measured with QBS SPECT in the lumbar vertebrae and femoral neck. The differences in BMD over an average of 20 months were measured and compared with SPECT measurements. QBS values were also compared with serum bone turnover markers. RESULTS: There was a negative correlation (r = -.54, P < .05 for the lumbar spine and r = -.60, P < .01 for the femoral neck) between QBS values and bone loss. Positive and negative predictive values, sensitivity, and specificity of QBS for bone loss in the lumbar spine were 78%, 71%, 78%, and 71%, respectively, and in the femoral neck, 82%, 100%, 100%, and 78%, respectively. Differences between predictive values of serum bone turnover markers were not statistically significant. CONCLUSION: QBS with SPECT enabled prediction of rapid bone loss in patients with renal disease.

Absorptiometry, Photon↗
PubMed1994

[The benefit of combined therapy with captopril and nitrates in severe congestive heart failure].

We compared the acute hemodynamic effects of captopril and nitrates in 11 patients with severe congestive heart failure and grade IV cardiac disability. Pressures were measured using a Swan-Ganz catheter system; cardiac output and stroke index were measured by thermodilution, and left-ventricular (LV) volumes and ejection fraction were calculated simultaneously with the hemodynamic measurements from radionuclide ventriculography. Measurements were made in each of 4 treatment states: control, sublingual isosorbide dinitrate (ISDN; 5 and 15 mg), oral captopril (50-200 mg daily) and during combined therapy with captopril and ISDN. Captopril produced a fall in mean arterial pressure (p < 0.01) from 81 +/- 14 to 72 +/- 13 mm Hg and a rise in stroke index from 30 +/- 5 to 35 +/- 91/min/m2 (p < 0.05), while LV ejection fraction increased from 18 +/- 5 to 21 +/- 7% (p < 0.05). ISDN reduced mean arterial, pulmonary arterial, right-atrial and wedge pressure. The combination of captopril and ISDN produced a greater fall in mean arterial pressure, a further rise in ejection fraction to 22 +/- 8% (p < 0.05), a fall in systemic (p < 0.05) and pulmonary vascular resistance (p < 0.01) and a rise in cardiac (p < 0.01) and stroke work index (p < 0.01), while the beneficial effects of ISDN on right-atrial, pulmonary arterial and wedge pressure were again achieved. LV contractility, assessed from end-systolic stress-shortening relations, was essentially unaltered or decreased very slightly. The study showed that combined therapy with captopril and nitrates produced acute hemodynamic benefits superior to those achieved by treatment with captopril or nitrates alone.

Acute Disease↗
PubMed1994

Bone turnover in cortical and trabecular bone in normal women and in women with osteoporosis.

UNLABELLED: This study is based on the assumption that is bone turnover, shown by the uptake of 99mTc-MDP, indicates a high rate of bone loss in patients with osteoporosis, it could potentially predict bone loss in patients at risk before significant bone loss has occurred. METHODS: Quantitative bone SPECT (QBS) using 99mTc-MDP, expressed as the %ID/cc x 10(-3), was performed in 71 women who had osteoporosis in the lumbar vertebrae, the femoral neck or both, and in 54 age-matched normal female controls. Of the women with osteoporosis, 42 had postmenopausal osteoporosis and 29 had primary hyperparathyroidism (HPT) and osteoporosis. RESULTS: QBS increased with age in the cortical bone and decreased in the trabecular bone of the normal women. Quantitative bone SPECT in the femoral neck was 3.18 +/- 1.20 and was 2.73 +/- 1.06 in the femoral shaft in 20 women with postmenopausal osteoporosis of the femoral neck. In 19 women with HPT and osteoporosis of the femoral neck, the QBS value in the femoral neck was 3.57 +/- 0.92 and in the femoral shaft 3.38 +/- 1.12. These values were also significantly higher for the femoral neck and for the femoral shaft than those of normals. Although QBS values were higher in the lumbar region in 39 women with postmenopausal osteoporosis (4.59 +/- 1.45) and in 27 women with HPT (4.30 +/- 1.52), as compared with the normal group (4.28 +/- 1.61), the difference was not statistically significant. CONCLUSION: This study shows that bone turnover is significantly higher in the cortical bone of women with osteoporosis than in normal women.

Bone Density↗
PubMed1994

Semiquantitative skull planar and SPECT bone scintigraphy in diabetic patients: differentiation of necrotizing (malignant) external otitis from severe external otitis.

UNLABELLED: Early diagnosis of necrotizing external otitis (NEO) includes the use of bone scintigraphy since clinical assessment alone cannot differentiate the necrotizing type of otitis from the severe type of external otitis in which there is no extension to the adjacent bone. Four-hour planar bone scintigraphy may reflect soft-tissue infection, and therefore may not be useful in distinguishing NEO from severe external otitis (SEO). Twenty-four-hour bone scintigraphy using planar or SPECT imaging may better reflect bone uptake and increase the accuracy of the test. METHODS: Twenty-six diabetic patients (12 diagnosed NEO; 14 SEO) and 10 nondiabetic (ND) patients were studied. Lesion-to-nonlesion (L/N) count ratios obtained from planar and SPECT imaging at 4 hr, 24 hr and 24 hr/4 hr (24/4) were assessed. RESULTS: Count ratios obtained from the 4- and 24-hr planar and SPECT images were significantly higher in the NEO patients compared to SEO patients for both planar and SPECT studies (p < 0.001, 0.005). The 24/4 count ratio was also significantly higher in the NEO patients on the planar (p < 0.01) and the SPECT studies (p < 0.001). The ND patients were not different from SEO patients on 4-hr planar, 4- and 24-hr SPECT as well as 24/4-hr planar and SPECT studies. The L/N count ratio threshold yielding the best sensitivity for detecting NEO was 1.05 for the 24/4 SPECT study. CONCLUSION: In diabetic patients, an early distinction between NEO and SEO patients can be reliably made by using L/N count ratios on 24/4 or 24-hr SPECT bone scintigraphy.

Diabetes Complications↗
PubMed1994

The yield of bone scintigraphy in cancer and non-cancer patients: its association with indication and clarity of the referral question.

The yield of bone scintigraphy was assessed in a general hospital. A random 1:2 sample of the bone studies performed within a year was evaluated. The referral forms were judged to show absent, ambiguous or clear diagnostic questions. The indications for which the study was ordered were matched with the scintigraphic diagnosis, and yield was defined as the proportion of studies with relevant findings on scintigraphy. The overall yield was 23.5%. In cancer patients the yield was 27.2% and in repeat studies 40.2%. In non-cancer patients the yield was 19.8% and when scintigraphy was performed for the evaluation of specific disease entities it was 35.7%. Relatively low-yield indications in non-cancer patients were suspected metastases 11.1%, and evaluation of X-ray abnormalities 11.5%. An association between the clarity of the diagnostic question and the scintigraphic yield was detected in non-cancer patients. When a diagnostic question was absent the yield was 12%, ambiguous 19%, and when it was clear 26%. This correlation is probably attributed to better understanding of this common procedure, and better definition of the diagnostic question in patients with diverse clinical conditions as compared to cancer patients in whom the question always relates to the presence of bone metastases.

Adult↗
PubMed1993

External imaging of atherosclerosis in rabbits using an 123I-labeled synthetic peptide fragment.

The oligopeptide fragment of apolipoprotein B, SP-4, has demonstrated pronounced uptake in the healing edges of balloon-injured rabbit aortic endothelium. To assess 123I-labeled SP-4 for identification of atherosclerotic plaques by gamma camera imaging, 14 Watanabe heritable hyperlipidemic (WHHL) and 5 normal rabbits were imaged 5 minutes and 12 and 24 hours after intravenous injection of 123I-SP-4. In addition, two WHHL and two normal rabbits were injected with 125I-SP-4 for autoradiography. Twelve of the 14 WHHL, but none of the normal, rabbits had visually apparent focal radioiodine accumulation in the region of the aorta. Focus-to-lung and focus-to-heart count ratios were 2.4 +/- 1.3 and 1.0 +/- 0.4, respectively. Five of the visually positive WHHL rabbits were reimaged 4 and 8 weeks later with 123I-NaI and 123I-SP-2 (an apo E peptide), respectively, as negative controls. Perceptible, but faint, aortic localization of 123I-NaI and of 123I-SP-2 was seen in only one animal each. The distributions of atherosclerotic lesions on photographs of the opened WHHL aortas and of film blackening on 125I-SP-4 autoradiograms were identical. In contrast, the two normal rabbit aortas did not exhibit plaques on photographs or film blackening on autoradiograms. Thus, in an animal model closely simulating human atherosclerotic disease, SP-4 localizes specifically in aortic atherosclerotic lesions.

Amino Acid Sequence↗
PubMed1992

Spectrum of scintigraphic appearance of liver hemangiomas.

Two hundred and twenty five liver hemangiomas in 166 patients were studied with Tc-99m labeled RBC and are the basis for this atlas. All hemangiomas showed various presentations of the perfusion blood pool mismatch, which is the basis for diagnosis. The size of the hemangiomas was the factor that determined the mixing of the Tc-99m RBC with the blood and, hence, the sequence of visualization of the lesion. Hemangiomas may appear as multiple lesions on liver scan and imitate metastases. Ninety-five hemangiomas appeared in 36 patients as multiple focal abnormalities. Hemangiomas are extremely variable in size. They may be huge (31 hemangiomas) and sometimes occupy most of the abdomen. Or they can be very small and are then detected only by SPECT (two cases). Thrombosed large hemangiomas appear as focal defects on Tc-99m RBC.

Erythrocytes↗
PubMed1992

Ga-67 lung uptake in patients with adult respiratory distress syndrome. Association with lung infection and patients' prognosis.

Nine patients with adult respiratory distress syndrome (ARDS) were studied with Ga-67 imaging in search for a site of infection. Different degrees and two patterns of Ga-67 lung uptake scoring in comparison with liver uptake were demonstrated. All patients had diffuse lung uptake, whereas five of them also showed additional focal lung activity. In only one patient was an abdominal focal uptake detected. Chest radiographs of all patients revealed diffuse and focal lung infiltrates that correlated with the Ga-67 uptake patterns. Therefore, Ga-67 imaging was unhelpful in differentiating patients with ARDS with lung infection from patients without lung infection. The intensity of Ga-67 uptake, as expressed by Ga-67 scoring, correlated with the course and outcome of ARDS. Patients exhibiting a high Ga-67 score had long periods of hospitalization and eventually died (four patients), whereas those who had low Ga-67 scores had a short disease course and survived (five patients). It is concluded that Ga-67 imaging in ARDS patients is unable to detect lung infection; however, it may be useful in the assessment of patients' prognosis.

Adult↗