Scintigraphic appearance in Lysol-induced lung toxicity.
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Biomedical subjects
Publications and source records attributed to S Q Liao.
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OBJECTIVE: To examine the effects of estrogen therapy on cognition, mood, and cerebral blood flow in patients with AD. BACKGROUND: Some studies have suggested estrogen may be effective in the treatment of AD. However, most of these studies were not controlled adequately. METHODS: Fifty female AD patients were recruited in a randomized, double-blind, placebo-controlled 12-week trial. Each member of the estrogen-treated group received conjugated estrogen (Premarin) 1.25 mg/day. The primary outcome measures were the Cognitive Ability Screening Instrument (CASI), Clinical Dementia Rating (CDR), and Clinician Interview-Based Impression of Change (CIBIC-plus). The secondary outcome measures were Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD), Hamilton Anxiety Rating Scale (HARS), Hamilton Depression Rating Scale (HDRS), and 99mTc hexamethylpropylene amine oxime SPECT of the brain. RESULTS: No meaningful differences were found between the outcome measures (CASI, CDR, CIBIC-plus, BEHAVE-AD, HARS, HDRS, and cerebral blood flow) taken from the estrogen-treated group and those from the control group. CONCLUSION: A 1.25-mg/day dose of Premarin administered for 12 consecutive weeks does not produce a meaningful effect on cognitive performance, dementia severity, behavior, mood, and cerebral perfusion in female AD patients. Because estrogen therapy has been suspected of yielding adverse effects, and its therapeutic effectiveness is in doubt, additional evaluation of its role in AD treatment ought to be conducted.
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Accurate and reproducible quantification of tumor radioactivity by imaging requires definition of a region of interest (ROI) for the tumor. The use of a threshold for creating the tumor ROI based on tumor-to-background image contrast (image contrast) was examined. Quantification of iodine-131 in spheres in a phantom that simulated tumors in patients was investigated using planar imaging and geometric-mean and effective-point-source methods. Thresholds that provided the least quantitative error for spheres with different diameters (1-5 cm) and locations (0-11 cm deep in the body), 131I concentrations (0.037-3.2 MBq/ml), and sphere-to-background concentration ratios (1:0, 14:1 and 7:1) were investigated. The correlation between threshold and sphere image contrast was examined. The phantom study showed that an appropriate threshold value for quantification of tumor radioactivity could be determined using image contrast for a single view, provided that image contrast was >/=1.5. The error of quantification was less than 10% for spheres with high image contrast (>/=1.5) but was greater than 17% for spheres with low image contrast (<1.5). When image contrast-dependent thresholds were applied to patient studies, 131I concentrations determined by imaging were in good agreement with the concentrations determined by counting biopsy samples. Additionally, reproducibility was improved when compared with a visual boundary method. It is concluded that accurate and reproducible quantification of radioactivity in tumors is achievable using thresholds based on image contrast if image contrast is greater than or equal to 1.5. Optimal thresholds for quantification of tumor radioactivity were similar if image contrast was similar despite differing tumor diameters, locations and 131I concentrations. Under certain circumstances, the effective-point-source method was preferable to the geometric-mean method.
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Ischemia is thought to be a major component in the pathogenesis of foot problems. The authors use the Xe-133 washout method to evaluate the blood perfusion of muscle tissue in the lower legs of patients with noninsulin-dependent diabetes mellitus (NIDDM). Eighty-five male patients with NIDDM ranging in age from 51 years to 79 years (mean, 66.5 years) and 47 nondiabetic control males with a matched age ranging from 52 years to 82 years (mean, 64.5 years) were included in this study. None of the diabetics had a history or presentation of peripheral vascular disease in the lower limbs. The patients were separated into groups according to the duration of the disease and condition of blood sugar control. The Xe-133 washout method was performed in the anterior tibial muscle of all the subjects. According to a Student's t-test, the tissue perfusion were of significant difference between 1) NIDDM and normal controls (1.98 +/- 1.39 ml/100 g/minute versus 2.85 +/- 1.35 ml/100 g/minute), 2) good and poor blood sugar control (2.36 +/- 1.58 versus 1.51 +/- 0.94), and 3) long and short disease durations (1.50 +/- 0.78 versus 2.35 +/- 1.63). It is concluded that the tissue perfusion in the lower legs of patients with NIDDM is significantly decreased and related to the duration of the disease and condition of blood sugar control. This may contribute to the high incidence of foot gangrene and limb loss in patients with NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)
Tc-99m MDP bone scans were used to evaluate the heel pain (talalgia) in 38 patients with Reiter's disease, and compared with clinical examination and radiologic findings. In our work, 58% (22/38) patients presented talalgia with a total of 35 lesions. Only two lesions of clinical talalgia were missed by the bone scan. The diagnostic sensitivity was as high as 94% (33/35). However, the diagnostic sensitivity of radiography was only 69% (11/16) when the disease duration was more than one year; furthermore, it declined to 33% (4/12) when the disease duration was less than one year. Based on the bone scans, the correlation between positive scintigraphic findings and clinical talalgia was extremely good. Clinical talalgia occurred in all the 33 lesions demonstrated by bone scan. However, three lesions demonstrated by radiography were not consistent with clinical talalgia and not visualized by radioscintigraphy. Our data show that the radionuclide scan is a more sensitive indicator and has better correlation with clinical talalgia than radiography. We consider that bone scintigraphy is superior to radiography in the evaluation of heel pain in Reiter's disease.
This study evaluates esophageal function in 55 healthy Chinese using a radionuclide esophageal transit test (RETT) of solid and liquid foods. A standard method modified from Klein et al. and Russell et al. was used to calculate: total mean transit time (MTT), residual fraction (RF), and retrograde index (RI) in the supine position. In Group 1, 30 cases accepted solid food RETT and in Group 2, 25 cases accepted liquid food RETT. Both groups were divided into different subgroups based on their ages: older and younger or according to their sex: male and female. The results show significant differences in MTT, RF and RI between the two groups, but no statistical differences were found in all of the parameters between the subgroups based on age or sex in both food types. In conclusion, the RETT is a simple and non-invasive method of evaluating the esophageal functions for both types of food and influences due to differences in age or sex were not significant in healthy Chinese.
The purpose of this study was to evaluate the value of bone and Ga-67 imaging in patients with malignant fibrous histiocytoma (MFH). Thirty-four patients with biopsy-proven MFH were studied. Of these patients, 15 underwent Ga-67 imaging, 26 underwent Tc-99m MDP imaging, and 7 underwent both imaging procedures. In evaluation of the primary tumors, intense Ga-67 uptake was observed in 14 of 15 patients with a diagnostic sensitivity of 93.3%. However, positive bone imaging results were observed in only 10 of 26 patients with a diagnostic sensitivity of 38.5%. Most of these were secondary to Tc-99m MDP uptake in adjacent bone invaded by the primary tumor. Only two patients, of the 18 patients without direct bone invasion, had increased radioactivity in the tumors (11.1%). In evaluation of the metastatic lesions, increased Ga-67 uptake was observed in 8 of 8 metastatic sites (100%). However, Tc-99m MDP could only detect 5 of 12 metastatic sites (41.7%), which were all diagnosed to be bone metastases. None of the extraskeletal metastasis could be detected by Tc-99m MDP imaging. Ga-67 scintigraphy appears to be a very useful tool in the evaluation of both primary and metastatic lesions of MFH and is assumed to be useful in the follow-up. However, it is emphasized that bone scintigraphy is useful only when the tumor invades the skeletal system and is of limited value in the evaluation of extraskeletal lesions.
Thirty-three patients of idiopathic Parkinson's disease (PD) and 25 volunteers were admitted to the study for comparison. Esophageal motility including esophageal mean transit time (MTT), residual fraction (RF), and retrograde index (RI) of the two groups were evaluated and calculated by the radionuclide esophageal transit test. The results show that 12% (4/33) of the cases of PD were abnormal in proximal, 15% (5/33) in middle, 0% (0/33) in distal, and 12% (4/33) in total MTT, as well as 6% (2/33) in RF, and 24% (8/33) in RI. In addition, the patients with high H-Y scale scores had a higher incidence of abnormality in proximal MTT than those with low scale (P < 0.05 by a Fisher's exact test). We consider that the radionuclide esophageal transit test has potential as an effective, simple and noninvasive screening tool to detect abnormal esophageal motility in patients suffering from Parkinson's disease.
Radionuclide gastric emptying studies of liquid phases were used to evaluate the gastric motility of healthy Chinese. A total of 53 normal volunteers were included in this study and divided into two groups. Group 1, included 20 males and 8 females (ages: 17-73) who received a meal which consisted of 500ml normal saline containing 500 uCi of Tc-99m phytate. Group 2, included 19 males and 6 females (ages: 27-73) who received a meal which consisted of 500ml 5% glucose solution (25g glucose, 100Kcal) labeled with 500 uCi Tc-99m phytate. Studies were performed with the subjects in the supine position and a gamma camera in a left anterior oblique (LAO) position, while data were collected for 30 minutes after injection of the liquid meal. The gastric emptying time was presented as the half-time (T1/2) for the food to empty from the stomach. The study results showed that the T1/2 was 20.5 +/- 7.2 min in Group 1 and 35.3 +/- 11.7 min in Group 2. We conclude that gastric emptying is slower for a liquid meal with a higher caloric content.
A case of single left coronary artery is presented with the correlation between the results of thallium-201 (T1-201) myocardial single photon emission computed tomography (SPECT) and coronary angiographic findings. The chest pain in this case might be partly secondary to the myocardial ischemia, under stress, which could result from the steal phenomenon to normal perfusion myocardium due to anatomical anomaly of single left coronary artery. Our findings suggest that T1-201 myocardial SPECT could be a useful method for detecting myocardial ischemia in patients with single left coronary artery.
A 60-year-old male suffered from abdominal pain, chills and fever for two weeks. A vivid Ascaris lumbricoides in the common bile duct and intrahepatic ducts was identified in operation. Chronic cholecystitis was also noted. We discuss the findings of multiple image modalities in biliary ascariasis and review the literature.
Two patients were admitted to our hospital with a diagnosis of miliary tuberculosis (TB). Gallium-67 citrate (Ga) scans and chest X-rays were used to localize the TB lesions. One case showed normal chest X-ray with significant gallium uptake in the lung while the other showed diffuse interstitial infiltrations of both lungs in chest X-ray with negative result in gallium scan. We suggest that the combination of Ga scans and chest X-rays might be indicated to avoid the discrepancy between the two images and missing early diagnosis of miliary TB.
Tc-99m DISIDA cholescintigraphy is a highly sensitive and specific method of evaluating cystic duct obstruction in acute cholecystitis. It has also been argued that cholescintigraphy has high sensitivity in the differential diagnosis of gallstone pancreatitis due to cystic duct obstruction following gallstone migration. The purpose of this study was to evaluate the clinical availability of cholescintigraphy in acute pancreatitis. Tc-99m DISIDA cholescintigraphy performed in 18 patients with documented acute pancreatitis, including 11 gallstone and 7 nonbiliary, were reviewed. Abnormal scans were obtained in 82% (9/11) of acute gallstone pancreatitis, while only 29% (2/7) of acute nonbiliary pancreatitis had abnormal scan. These results demonstrated a significant difference with Fisher's exact test (p < 0.05). An abnormal cholescintigraphy had a sensitivity of 82%, a specificity of 71% and an accuracy of 78% in detecting gallstone pancreatitis. Ten cases of acute gallstone pancreatitis coincided with cholecystitis (2 cases of acute and chronic, and 8 cases of chronic). Both cases of acute nonbiliary pancreatitis with abnormal scan had total parenteral nutrition over 5 days. In conclusion, abnormal cholescintigraphy in acute pancreatitis indicates gallstone origin and may coincide with cholecystitis; while, a normal cholescintigraphy largely excludes such diagnoses.
The value of technetium-99m methoxyisobutylisonitrile (MIBI) single-photon emission tomography (SPET) of the chest in differentiating lung carcinomas of various histological types and benign lesions was assessed in 54 patients (47 males and 7 females aged 19-77 years) with single solid lung masses. Chest radiography had indicated that 46 of the lesions were malignant (8 small cell carcinomas, 14 epidermoid carcinomas, 18 adenocarcinomas and 6 undifferentiated large cell carcinomas) and eight, benign. Ten, volunteers who also agreed to undergo 99mTc-MIBI SPET of the chest served as a control group. The results showed that only 65% (30/46) of the lung malignancies were detected by 99mTc-MIBI SPECT, including 63% (5/8) of the small cell carcinomas, 64% (9/14) of the epidermoid carcinomas, 72% (13/18) of the adenocarcinomas and 50% (3/6) of the undifferentiated large cell carcinomas. However, 75% (6/8) of the benign lesions were also detected. The diagnostic sensitivity, specificity and accuracy in differentiating malignant and benign lesions were 65%, 57% and 70%, respectively. We conclude that 99mTc-MIBI is of limited use in the differentiation of single solid lesions in the lungs.
A Tc-99m HMPAO brain single photon emission computed tomography (SPECT) study of a patient with biopsy-proven Creutzfeldt-Jakob disease (CJD) demonstrated decreased perfusion in the right frontal and temporal areas. Brain CT findings were normal, and electroencephalographic results were nonspecific. The clinical potential of Tc-99m HMPAO brain SPECT in the evaluation of CJD is described, and its use encouraged.