PubMed Health⌕ Search

Biomedical subjects

R Kloiber

Publications and source records attributed to R Kloiber.

30 records · Page 2Linked to original sources
PubMed1987

Sr-89 therapy for metastatic bone disease: scintigraphic and radiographic follow-up.

Ten patients with disseminated bone metastases, nine from prostatic and one from renal cell carcinoma, were treated with intravenous strontium-89. Half the patients experienced significant improvement in pain control and increased general well-being for an average of 14 weeks. Sequential radiophosphate bone scanning showed decreased activity in lesions present at the time of therapy, with subsequent remineralization of the metastases on radiographs. Some patients showed simultaneous reduction in alkaline and acid phosphatase levels. These objective findings prove a physiologic basis for the clinical improvement. Treatments, however, did not prevent progression at initially uninvolved sites, particularly in the extremities.

Aged↗
PubMed1986

Cholescintigraphic detection of functional obstruction of the sphincter of Oddi. Effect of papillotomy.

Unexplained abdominal pain after cholecystectomy has been attributed to sphincter of Oddi dysfunction, but no objective diagnostic criteria exist. Biliary excretion was quantitated by computer-assisted cholescintigraphy in 35 postcholecystectomy controls without symptoms, 9 patients with suspected sphincter of Oddi dysfunction (studied before and after sphincterotomy), and 18 patients with overt cholestasis from other causes (6 with extrahepatic obstruction and 12 with parenchymal liver disease). In patients with sphincter of Oddi dysfunction or with cholestasis, the time to attain maximal activity in the biliary system was significantly (p less than 0.05) longer, the percent of radiotracer excreted at 45, 60, and 90 min was less, and the emptying rate was slower compared with the controls. Cholecystokinin (0.02 U/kg X min) did not abolish biliary output, excluding a paradoxical response of the sphincter. After sphincterotomy, biliary activity peaked earlier and the percent excreted at 45 min increased but did not revert to normal. Relief of symptoms occurred in 8 of 9 patients. The one failure had normal emptying characteristics before sphincterotomy, and did not change after surgery. Another developed recurrent pain and a corresponding deterioration in biliary emptying on serial scans. Thus, functional obstruction at the sphincter of Oddi exists, is not due to any paradoxical response to cholecystokinin, and in the absence of overt cholestasis, can be detected by quantitative cholescintigraphy. Successful sphincterotomy may not completely restore biliary emptying to normal.

Adult↗
PubMed1983

Bone scintigraphy of hip joint effusions in children.

Thirty-eight children with hip pain of acute onset were studied by bone scintigraphy. Nine patients had diminished radiotracer deposition involving the entire proximal femoral ossification center. This could be related to infarction or compression of the blood supply by a tense joint effusion. Eight of these patients had joint aspiration confirming the presence of an effusion. Five patients had follow-up studies after aspiration, and femoral-head uptake reverted to normal in all but one which subsequently proved to be infarcted. A photopenic zone was seen on blood pool images in 10 patients, many of whom were also aspirated of fluid. Bone scintigraphy is useful in the diagnosis of joint effusions and can give information as to the state of perfusion of the femoral head. Follow-up studies after aspiration can differentiate infarction from reversible ischemia.

Adolescent↗
PubMed1982

Sequential use of radiophosphate and radiogallium imaging in the differential diagnosis of bone, joint and soft tissue infection: quantitative analysis.

A quantitative analysis of the results obtained by sequential 99mTc methylene diphosphonate (MDP) and 67Ga-citrate (Ga) imaging to disclose and distinguish infections in bone, synovium and adjacent soft tissue is reported. There were 129 patients with proved or probable osteomyelitis, septic arthritis and cellulitis, and 94 patients who were eventually shown to be free of sepsis, but not necessarily free of some other nonseptic affliction. Of the 159 patients referred with a presumptive clinical diagnosis of osteomyelitis 94 were eventually shown to be free of infection. The results of this group by sequential imaging were true positive 0.72, true negative 0.86 and accuracy 0.80 when low-grade Ga uptakes, which were similar in distribution to MDP, were excluded. In 26 patients with septic arthritis, the true-positive fraction for combined MDP and Ga was 0.84. The true-positive fraction for Ga in 38 patients with cellulitis was 0.79.

Arthritis, Infectious↗
PubMed1981

A crossover study comparing the effect of particle size on the distribution of radiocolloid in patients.

Two radiocolloid preparations, differing in particle size by a factor of 5 to 20, were compared in each of 15 patients. The smaller colloid, measuring less than 80 nm, showed a relative decrease in the calculated target to background ratios for the liver and spleen and an increase for the bone marrow. The increased uptake of the smaller particle in the bone marrow, as measured by the bone marrow to soft-tissue background ratio, was about 50% higher than that of the larger colloidal particles. Comparable marrow images can be obtained in a half to a third of the time with the smaller particle size for a given administered dose.

Adult↗
PubMed1981

Selection of renal background for quantitative 131I-hippurate relative renal function studies.

In a series of 100 patients with a full range of normal to poor renal function it was found, using 99mTC--albumin, that the zone between the superior poles of the kidneys best approximates the vascular pool in the renal areas. It is therefore possible to perform sufficiently accurate background-corrected relative renal function studies with 131I-hippurate alone. It is most valid in monitoring renal function in follow-up examinations. Both the accumulated 1- to 2-min count and 0- to 3-min count of the estimated net 131I-hippurate renogram were compared to a standard 99mTc-albumin corrected 131I-hippurate renogram for relative renal function measurements and they correlated very well (r = 0.91). The integrated 0- to 3-min count is preferred to the integrated 1- to 2-min count as the former yields better counting statistics, particularly in renal failure.

Adult↗
PubMed1980

Prospective evaluation of sacroiliac scintigraphy in chronic inflammatory back pain.

To assess the usefulness in screening for sacroiliitis of a wide band profile cut which included the entire sacroiliac (SI) joint, 34 patients with chronic inflammatory back pain (IBP) underwent sacroiliac joint scintigraphy with 99mTc-methylene diphosphonate while receiving no antiinflammatory therapy. The sacroiliac joint to sacrum (SIJ/S) ratios in those with back pain differed significantly from the ratios of an age-matched control group. However, 12 of the 34 patients with inflammatory back pain had normal or equivocal sacroiliac radiographs and 4 of 12 had normal SIJ/S ratios. All 4 were HLA-B27 positive, had diminished lumbar movement, and required antiinflammatory medication; 2 had diminished chest expansion; 1 has developed iritis. We conclude that this technique is not a reliable screening procedure. Therapy with antiinflammatory drugs was associated with a significant decrease in the SIJ/S ratios in 19 of the 34 who were reimaged.

Adolescent↗
PubMed1979

Combined superior vena cava and pulmonary artery obstruction by an ascending aortic aneurysm.

A case report is presented on the use of intravenous radioisotope angiocardiography in the diagnosis of an atherosclerotic aneurysm of the ascending aorta in a 44-year-old man who presented with mild superior vena cava obstruction. In addition to outlining the site and extent of the aneurysm, intravenous Tc-99m-albumin radioisotope angiocardiography and blood pool imaging permitted demonstration of the site of obstruction of the cava, indicated the presence of venous collateral channels bringing about delayed filling of the right heart, and also detected obstruction of the right pulmonary artery by the aneurysm. The procedure is simple, rapid, and entirely noninvasive and permits both anatomic and hemodynamic evaluation of the abnormality.

Adult↗
PubMedDate not supplied

Osteomyelitis of the ischiopubic synchondrosis.

Infection of the ischiopubic synchondrosis (IPS) is a diagnostic dilemma. This article reviews four such cases. All patients complained of ipsilateral groin pain, were febrile, and had elevated erythrocyte sedimentation rates. Initial radiographs were interpreted as normal but later showed increasingly lucent zones at the IPS. Radionuclide bone scans demonstrated diffusely increased uptake in the vicinity of the IPS. This contrasts with the discrete pattern seen with a normal IPS. Blood cultures were positive. Satisfactory outcomes were obtained with conservative treatment. Clinical presentation, laboratory results, radiographs, and bone scans must be correlated to distinguish this syndrome from a "normal radiologic variant".

Anti-Bacterial Agents↗