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Biomedical subjects

R S Hattner

Publications and source records attributed to R S Hattner.

At least 55 records · Page 3Linked to original sources
PubMed1985

Multinuclide digital subtraction imaging in symptomatic prosthetic joints.

One hundred eleven patients with symptomatic prosthetic joints (86 hips, 23 knees, and two shoulders) were evaluated for prosthetic loosening and infection by combined technetium-99m-MDP/gallium-67 digital subtraction imaging. Clinical correlation was based on the assessment of loosening and bacterial cultures obtained at the time of surgery in 54 patients, joint aspiration cultures obtained in 37 patients, and long-term clinical follow-up for greater than 1.5 years in an additional 15 patients. Results revealed an 80%-90% predictive value of a positive test for loosening, and a 95% predictive value of a negative test for infection. However, because of the low sensitivities and specificities observed, this approach to the evaluation of symptomatic prosthetic joints does not seem cost effective.

Adult↗
PubMed1984

Osteoid osteoma: radionuclide diagnosis.

The double-density sign, seen on radionuclide bone scans, is described for diagnosing osteoid osteomas and for localizing the nidus. Its use in differentiating the nidus of an osteoid osteoma from osteomyelitis is also described. The utility of computed tomography in localization of the nidus is also illustrated. The double-density sign was helpful in diagnosing seven cases of surgically confirmed osteoid osteoma.

Adolescent↗
PubMed1984

The effect of secretin on colonic mucin secretion rate in the dog.

A method of quantitation of mucin using chondroitin sulfate A as a standard has been modified and applied to timed mucin collections from surgically created isolated colonic fistulas in 8 dogs. 25 experiments were conducted in which the effect of secretin was tested in 5. The mucin assay is precise and showed increased colonic mucin secretin in response to secretin. This model appears suitable for pharmacologic assessment of potential drugs for augmenting colonic mucin secretin in states of impaired colonic motility.

Animals↗
PubMed1984

Correlation between gallium lung scans and fiberoptic bronchoscopy in patients with suspected Pneumocystis carinii pneumonia and the acquired immune deficiency syndrome.

We retrospectively examined the sensitivity and specificity of gallium lung scans for detecting Pneumocystis carinii pneumonia in 22 patients with known or suspected acquired immune deficiency syndrome. Correlations were made between bronchoscopic results and gallium scan findings interpreted using a simple system (normal or abnormal) and a graded score (1 to 4). All 12 patients with Pneumocystis had abnormal scans by both interpretations (sensitivity, 100%). Five of these 12 patients had normal arterial PO2 values, chest roentgenograms, or both. In the 10 patients without Pneumocystis, scans were read as abnormal in 8 using the simple system (specificity, 20%) but were abnormal in only 1 using the grading system (specificity, 90%). Five patients with Pneumocystis pneumonia had scans and bronchoscopy after treatment; neither method of interpretation correlated with the presence of organisms. We conclude: (1) gallium scanning is a sensitive initial diagnostic test in patients with suspected Pneumocystis pneumonia; (2) a graded scoring system improves specificity; (3) an abnormal gallium scan (3 or greater) in patients with suspected Pneumocystis pneumonia is an indication for biopsy, even when the PO2 and/or chest roentgenogram are normal.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Radionuclide bone scanning in neuroblastoma: skeletal metastases and primary tumor localization of 99mTc-MDP.

Of 42 radionuclide bone scans in 35 children with neuroblastoma, 21 were abnormal for the presence of skeletal metastases. Of the 21 abnormal scans, 16 were corroborated by positive bone-marrow biopsy or clinical data. The false-negative and false-positive rates for bone scanning were 4.8% and 9.5%, respectively. Calcification of the primary tumor was seen on pretreatment computed tomographic (CT) scans in 24 (89%) of 27 cases, while only 13 (48%) of 27 were detectable by plain radiographs. Uptake of technetium-99m methylene diphosphate (99mTc-MDP) by the primary tumor occurred in 20 of 27 cases, but correlation between tumor uptake and calcification was not statistically significant. All children with markedly elevated urinary vanillylmandelic acid exhibited primary tumor uptake. Survival was not affected independently by primary tumor uptake.

Bone Neoplasms↗
PubMed1982

Phase image characterization of ventricular contraction in left and right bundle branch block.

The phase image is a computer-derived functional image, based on the analysis of the time versus radioactivity curve in each pixel location of the multiple gated blood pool scintigram. Within the ventricular regions of interest, the phase angle is roughly equivalent to the time of onset of counts reduction or to the time of onset of ventricular contraction and is expressed in degrees from 0 to 360 degrees. A gray scale-coded image of such a regional phase angle, the phase image, can be looked on as a map of sequential contraction. This method was applied in 33 patients without severe contraction abnormality including 16 patients with normal conduction, 9 with right bundle branch block and 8 with left bundle branch block. In patients with normal conduction the pattern of phase angle distribution, representing the pattern of ventricular contraction, was homogeneous and symmetric in both the left and right ventricles. Analysis in this normal group indicated a slight but significant difference between the mean (+/- standard deviation) phase angle of the left ventricle (8.5 +/- 11.8 degrees) and that of the right ventricle (13.6 +/0 12.9 degrees, p = 0.01). There was a slight, but nonsignificant difference between mean intrapatient left and right ventricular phase angle onset (1.9 +/- 6.5 degrees). The mean phase angle of the right ventricle in patients with right bundle branch block (27.6 +/- 14.2 degrees) and of the left ventricle in those with left bundle branch block (21.9 +/- 14.0 degrees) was delayed compared with that in patients with normal conduction (p less than 0.05 for both). The mean intrapatient difference between left and right ventricular mean phase angles in patients with normal conduction (-5.2 +/- 6.8 degrees) was significantly different from that in patients with right (-21.8 +/- 10.3 degrees, p less than 0.001) or left (21.8 +/- 6.8 degrees, p less than 0.001) bundle branch block. The mean intrapatient difference between onset of left and right ventricular phase angles was also significantly different from normal in patients with right (-10.6 +/- 7.5 degrees, p less than 0.005) or left (18.7 +/- 8.3 degrees, p = 0.01) bundle branch block. Although phase imaging is not without artifactual error, this study demonstrates that the phase image can characterize familiar conduction abnormalities. It presents the potential for application as a general noninvasive tool in the investigation of the timing and sequence of ventricular contraction in patients with normal or abnormal ventricular activation.

Adult↗
PubMed1982

An accurate means of detecting and characterizing abnormal patterns of ventricular activation by phase image analysis.

The ability of scintigraphic phase image analysis to characterize patterns of abnormal ventricular activation was investigated. The pattern of phase distribution and sequential phase changes over both right and left ventricular regions of interest were evaluated in 16 patients with normal electrical activation and wall motion and compared with those in 8 patients with an artificial pacemaker and 4 patients with sinus rhythm with the Wolff-Parkinson-White syndrome and delta waves. Normally, the site of earliest phase angle was seen at the base of the interventricular septum, with sequential change affecting the body of the septum and the cardiac apex and then spreading laterally to involve the body of both ventricles. The site of earliest phase angle was located at the apex of the right ventricle in seven patients with a right ventricular endocardial pacemaker and on the lateral left ventricular wall in one patient with a left ventricular epicardial pacemaker. In each case the site corresponded exactly to the position of the pacing electrode as seen on posteroanterior and left lateral chest X-ray films, and sequential phase changes spread from the initial focus to affect both ventricles. In each of the patients with the Wolff-Parkinson-White syndrome, the site of earliest ventricular phase angle was located, and it corresponded exactly to the site of the bypass tract as determined by endocardial mapping. In this way, four bypass pathways, two posterior left paraseptal, one left lateral and one right lateral, were correctly localized scintigraphically. On the basis of the sequence of mechanical contraction, phase image analysis provides an accurate noninvasive method of detecting abnormal foci of ventricular activation.

Adult↗
PubMed1982

The functional vascular anatomy of rib.

The adequacy of nutrient blood supply to ribs based on the intercostal-periosteal system versus the medullary nutrient artery was investigated in six dogs containing ribs of each type. Free grafts with periosteum and without periosteum were also included. Vascularity was monitored by bone scanning and tetracycline double labeling. A preliminary study with RES scanning using sulfur colloid was also preformed. The results of this study showed (1) that no demonstrable difference in blood supply exists between rib supplied by the anterior intercostal-periosteal system versus the nutrient artery (this was seen with bone scans, tetracycline double labels, and RES scans); (2) that bone scans can differentiate between vascularized rib grafts and free rib grafts for at least the first 7 days (after 7 days, some free grafts begin to take up label); and (3) that by using bone scan, no difference in the rate of revascularization is detected between free grafts with the periosteum stripped or the periosteum intact (RES scans and tetracycline labeling were not given late enough after surgery to be incorporated in either type of nonvascularized graft).

Animals↗
PubMed1982

Characterization of radiation-induced photopenic abnormalities on bone scans.

Photopenic abnormalities induced by radiation therapy are important to recognize on bone scans, since they often affect longitudinal or lateral symmetry. This phenomenon was studied in 43 patients treated through 67 ports (including the axial skeleton). Bone doses spanned 450-6,700 R (mean +/- S.D. = 3,600 +/- 1,700 R), and the interval from the midpoint of therapy to the time of the scan was 1-19 months. Photopenic defects appeared between 4 and 6 months after therapy. Of 20 patients (31 ports) studied more than 4 months after therapy, 14 (45%) had such defects. None was detected in regions receiving less than 2,000 R. The authors conclude that knowledge of a patient's radiotherapy history is an important prerequisite to interpretation of subsequent bone scans.

Bone Diseases↗
PubMed1982

Altered 67Ga citrate distribution in patients with multiple red blood cell transfusions.

Gallium-67 citrate studies from four patients who received multiple red blood cell transfusions were reviewed. Increased kidney, bladder, or bone localization was associated with decreased liver and colon activity. The findings suggest altered distribution due to competition with iron for receptor binding. Identification of inflammatory disease in two patients was possible. However, the effect of transfusions on detection of inflammatory or neoplastic diseases requires further evaluation.

Adult↗
PubMed1981

Colonic mucin secretion related to non-contractile motility in the dog.

In 8 dogs a colonic pouch with fistula was surgically created. Mucin secretion was measured by washing mucus out of the pouch and then, after a number of chemical steps, by determining the turbidity with spectrophotometry. The movement of tantalum particles insufflated into the canine rectum during periods of absence of contractions was correlated with mucus secretion in the pouch. Correlations were made after parenteral injection of secretin which increased movement of tantalum particles and production of mucin, and after injection of glucagon, which stopped movement of the particles and decreased mucin secretion in the pouch. Movement of tantalum was also observed when the particles were insufflated into the canine rectum on top of an applied layer of water-soluble jelly.

Animals↗
PubMed1980

A consideration of factors affecting the diagnostic accuracy of thallium-201 myocarial perfusion scintigraphy in detecting coronary artery disease.

Several factors influence the ability of TI-201 myocardial perfusion scintigraphy to detect coronary artery disease. Among these are the physiologic effect of the coronary lesion on relative myocardial perfusion and radionuclide distribution; technical and physiologic aspects of the scintigraphic process; and observer interpretation. The diagnostic accuracy of this scintigraphic method is related to: (1) the extent of the hypoperfused myocardium, which will depend on the severity and extent of coronary disease, the presence of collaterals, the exercise method, and the timing of thallium administration and scintigraphy; (2) the scintigraphic process, which depends on the nature of the isotope, the imaging system, and the method of image display; and (3) image interpretation, which depends on the experience of the observer as well as on the area of hypoperfused myocardium and the scintigraphic process. The diagnostic accuracy of scintigraphy for detecting coronary disease can be optimized by computer methods of image enhancement, which maximize differences in image contrast; by electrocardiographic gating; and by emission computer tomography. Other computer methods have been developed to reduce or eliminate observer intervention in interpretation and to increase the objectivity of the method.

Coronary Disease↗