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Biomedical subjects

S Edell

Publications and source records attributed to S Edell.

11 recordsLinked to original sources
PubMed2000

Acute thromboscintigraphy with (99m)Tc-apcitide: results of the phase 3 multicenter clinical trial comparing 99mTc-apcitide scintigraphy with contrast venography for imaging acute DVT. Multicenter Trial Investigators.

UNLABELLED: (99m)Tc-apcitide (formerly known as (99m)Tc-P280) is a radiolabeled peptide that binds with high affinity and specificity to the glycoprotein IIb/IIIa receptors expressed on the activated platelets that are involved in acute thrombosis. The purpose of the phase 3 multicenter clinical trials was to compare (99m)Tc-apcitide scintigraphy with contrast venography for imaging acute deep venous thrombosis (DVT). METHODS: A total of 280 patients were enrolled in 2 clinical trials conducted in North America and Europe. Patients were to be within 10 d of onset of signs and symptoms of acute DVT or within 10 d of surgery associated with a high risk of DVT. (99m)Tc-apcitide scintigraphy and contrast venography were to be performed within 36 h. Planar scintigraphic images were obtained at 10, 60, and 120-180 min after injection. (99m)Tc-apcitide scintigrams and contrast venograms were read with masking and also by the institutional investigators. RESULTS: Of a total of 243 patients who were evaluable, 61.7% were receiving heparin at the time of imaging. Masked reading of (99m)Tc-apcitide scintigraphy, compared with masked reading of contrast venography, had a sensitivity, specificity, and agreement of 73.4%, 67.5%, and 69.1%, respectively, which met the prospectively defined target efficacy endpoint in both trials. Institutional reading of (99m)Tc-apcitide scintigraphy, compared with institutional reading of contrast venography, had a sensitivity, specificity, and agreement of 75.5%, 72.8%, and 74.0%, respectively. However, the entire trial population included patients with a history of DVT who may have had old, nonacute venous thrombi that could confound the venography results. Therefore, data from patients having no history of DVT or pulmonary embolism and who presented within 3 d of onset of signs and symptoms (n = 63), i.e., patients for whom a venogram would be expected to be positive only if acute DVT were present, also were analyzed as a subset. In these patients, institutional reading of (99m)Tc-apcitide scintigraphy, compared with institutional reading of contrast venography, had a sensitivity, specificity, and agreement of 90.6%, 83.9%, and 87.3%, respectively. CONCLUSION: (99m)Tc-apcitide scintigraphy is a new diagnostic modality that is highly sensitive for imaging acute DVT.

Acute Disease↗
PubMed1999

Tc-99m sestamibi scintimammography in the mammographically dense breast.

PURPOSE: The mammographically dense breast or the "difficult-to-interpret mammogram" poses significant clinical and diagnostic imaging concerns. From our experience using Tc-99m sestamibi mammography in more than 650 patients, we share our experience in a pictorial manner and include suggested indications and limitations of this exciting new technique. Examples of Tc-99m sestamibi imaging in six patients with mammographically dense breasts are presented. MATERIALS AND METHODS: All patient examinations were ordered clinically for various indications. Comparison radiographic mammography and, when available, confirmatory pathologic analysis were also done. The examples were chosen from our experience with more than 650 patients at two university hospitals and one outpatient imaging center. RESULTS: Of the six examples presented, four had cancer, one had fibrosis after chemotherapy for ductal cell carcinoma, and one had no evidence of cancer. Tc-99m sestamibi imaging showed no increased uptake in the one patient with no tumor and various degrees of uptake in the other five patients. CONCLUSIONS: Six examples from our clinical experience show the usefulness of Tc-99m sestamibi imaging in patients with mammographically dense breasts. The ability to identify a malignancy or its absence supports the continued use of this procedure in these patients.

Adult↗
PubMed1981

Candidiasis in the obstructed esophagus.

Four cases of esophageal candidiasis complicating functional or mechanical obstruction are described. The causes of the obstruction included achalasia, scleroderma, and postoperative fundoplication. None of the commonly recognized conditions predisposing to esophageal candidiasis was present. The findings on barium study ranged from plaque-like filling defects to extensive nodularity and roughening of the mucosal surface, which must be distinguished from ingested debris. It is suggested that esophageal stasis of any cause can lead to candidiasis.

Adult↗
PubMed1980

Ultrasonic evaluation of popliteal cysts.

Ultrasonography was used to examine 42 patients who were complaining of popliteal and suprapatellar pain. When clinically indicated, patients also underwent phlebography, arthrography, and posterior synovectomy. In 17 patients, Baker's cysts were demonstrated by ultrasonogram. Of these 17 patients, four had confirmation of the cysts by arthrography. One patient had simultaneous deep venous thrombosis, proved by phlebography and arthrography. Five patients underwent posterior synovectomy, and the surgical specimens closely correlated with the dimensions predicted by ultrasonography. Internal echoes within the cysts correlated at surgery with either necrotic debris or organized hematoma. To our knowledge, this study is the first series where surgical correlations have been made with the ultrasonographic observations. Ultrasonography of the knee and surrounding area is a useful, painless, and relatively inexpensive method, with several advantages over arthrography.

Cysts↗
PubMed1979

Baker's cysts and true thrombophlebitis. Report of two cases and review of the literature.

We describe two patients who had knee pain and were found to have the unusual combination of a Baker's cyst and true thrombophlebitis. Since Baker's cysts can dissect along the gastrocnemius, they can cause leg pain and simulate thrombophlebitis, but they do not require anticoagulation therapy. Most of the literature implies that the two syndromes are mutually exclusive; however, our cases lend support to the fact that a dissecting popliteal cyst does not rule out the possibility of thrombophlebitis. Venography should be performed if there is any doubt as to the diagnosis.

Aged↗
PubMed1978

A comparison of the "phrygian cap" deformity with bistable and gray scale ultrasound.

Sixteen patients with a "phrygian cap" deformity of the gall bladder seen with oral cholecystography were further evaluated with both bistable and gray scale ultrasound. The bistable technique produced internal echoes that were suspicious of gall stones. When this same area was reevaluated with the more accurate gray scale technique, the folded-fundus deformity was clearly visualized.

Cholelithiasis↗
PubMed1978

Ultrasonic evaluation of renal calculi.

Nine patients with radiographic evidence of renal calculi were evaluated with gray scale renal ultrasonography. A characteristic "sonic shadow" caused by the calculus was adequately demonstrated in each case. This paper discusses the advantage of ultrasound in evaluating the presence of nonopaque and opaque renal stones.

Humans↗