PubMed Health⌕ Search

Biomedical subjects

S Ted Treves

Publications and source records attributed to S Ted Treves.

At least 19 recordsLinked to original sources
PubMed2004

Cardiovascular status in long-term survivors of Hodgkin's disease treated with chest radiotherapy.

PURPOSE: Cardiovascular status was assessed in 48 Hodgkin's disease (HD) survivors at a median of 14.3 years (range, 5.9 to 27.5 years) after diagnosis because they may be at increased risk for cardiovascular abnormalities. PATIENTS AND METHODS: Patients completed the Short-Form 36 quality-of-life instrument and were screened by echocardiography, exercise stress testing, and resting and 24-hour ECG. RESULTS: All patients received mediastinal irradiation (median, 40.0 Gy; range, 27.0 to 51.7 Gy) at a median age of 16.5 years (range, 6.4 to 25.0 years). Four patients received an anthracycline. Although every patient described their health as good or better, and none had symptomatic heart disease at screening, all but one had cardiac abnormalities on screening. Restrictive cardiomyopathy was suggested by reduced average left ventricular (LV) dimension (P < .001) and mass (P < .001), without increased LV wall thickness. Significant valvular defects were present in 42%; 75% had conduction defects. One survivor developed complete heart block shortly after the study visit. Autonomic dysfunction was suggested by a monotonous heart rate in 57%, persistent tachycardia in 31%, and blunted hemodynamic responses to exercise in 27%. Peak oxygen uptake (VO2max) during exercise, a predictor of mortality in heart failure, was significantly reduced (< 20 mL/kg/m2) in 30% of survivors. VO2max was correlated with increasing fatigue, increasing shortness of breath (both, r = -0.35; P =. 02), and decreasing physical component score on the SF-36 (r = 0.554; P = .00017). CONCLUSION: A variety of unsuspected, clinically significant cardiovascular abnormalities are common in long-term survivors of HD who are treated at a young age with mediastinal irradiation. We recommend serial, comprehensive cardiac screening of HD survivors who fit this profile.

Adolescent↗
PubMed2004

Patient-specific seizure onset detection.

This article presents an automated, patient-specific method for the detection of epileptic seizure onset from noninvasive electroencephalography. We adopt a patient-specific approach to exploit the consistency of an individual patient's seizure and nonseizure electroencephalograms. Our method uses a wavelet decomposition to construct a feature vector that captures the morphology and spatial distribution of an electroencephalographic epoch, and then determines whether that vector is representative of a patient's seizure or nonseizure electroencephalogram using the support vector machine classification algorithm. Our completely automated method was tested on noninvasive electroencephalograms from 36 pediatric subjects suffering from a variety of seizure types. It detected 131 of 139 seizure events within 8.0+/-3.2 seconds of electrographic onset, and declared 15 false detections in 60 hours of clinical electroencephalography. Our patient-specific method can be used to initiate delay-sensitive clinical procedures following seizure onset, for example, the injection of a functional imaging radiotracer.

Algorithms↗
PubMed2004

Young athletes with low back pain: skeletal scintigraphy of conditions other than pars interarticularis stress.

PURPOSE: Skeletal scintigraphy is an important method for showing evidence of stress injuries affecting the partes interarticulares of young athletes with low back pain. Other etiologies of low back pain may also cause uptake abnormalities in these patients. How often do the results of skeletal scintigraphy support diagnoses other than stress injuries to the partes interarticulares and what are these diagnoses? MATERIALS AND METHODS: We retrospectively reviewed the records of 209 young patients (149 females, 60 males; age range: 8-21 years, mean: 15.7 years) with low back pain and no previously treated vertebral condition who were consecutively referred from a sports medicine clinic to skeletal scintigraphy. RESULTS: Sites of high uptake supportive of diagnoses other than pars interarticularis stress were shown in 36 (17%) of the 209 patients. Other diagnoses supported by skeletal scintigraphy included stress at the articulation between a transitional vertebra and the sacrum, injuries to the vertebral body ring apophysis, sacral fracture, spinous process injury, and sacroiliac joint stress. CONCLUSION: Skeletal scintigraphy shows uptake abnormalities supportive of diagnoses other than pars interarticularis stress in a significant number of young patients with low back pain. The uptake abnormalities shown are usually stress-related in this select population.

Adolescent↗
PubMed2004

Assessment of rapid changes in renal blood flow with (191m)Ir, an ultra-short-lived radionuclide.

UNLABELLED: We investigated the feasibility of using (191m)Ir (half-life, 5 s) to measure rapid dynamic alterations in differential renal blood flow. METHODS: A nonobstructive constant renal pelvic pressure model was used. The renal pelves of 6 New Zealand White rabbits were drained by use of bilateral catheters, and increased hydrostatic pressure was achieved by raising 1 catheter to 16, 25, 30, or 35 cm above the level of the renal pelvis. The contralateral kidney served as the control. (191m)Ir first-pass angiograms were obtained at baseline, after the induction of elevated pressure in the renal pelvis, and after the pressure was returned to normal. A minimum of 3 sequential angiograms were obtained at each point. RESULTS: The differential blood flow values (mean +/- SD) were 47.5% +/- 7.3% at baseline, decreased to 42.3% +/- 2.6% when the renal pelvic pressure was elevated (P = 0.001), and returned to 51.1% +/- 4.0% after the pressure was returned to normal (P = 0.0017). There was no significant difference between baseline and postcompression values (P = 0.4807). CONCLUSION: It is possible to use (191m)Ir first-pass angiography to evaluate rapid dynamic changes in differential renal blood flow in an experimental animal model.

Animals↗
PubMed2003

Stimulation with fatty meal (Lipomul) to assess gallbladder emptying in children with chronic acalculous cholecystitis.

OBJECTIVE: Chronic acalculous cholecystitis previously has been diagnosed by hepatobiliary scan stimulated with intravenous octapeptide of cholecystokinin. This compound may soon be unavailable in the United States. The goal of this study was to describe the characteristics of children with chronic acalculous cholecystitis diagnosed by hepatobiliary scintigraphy with oral Lipomul challenge, and to evaluate their clinical response to cholecystectomy. METHODS: Retrospective chart review of patients with no gall stones detected by abdominal ultrasound or computed tomography with gallbladder ejection fraction (GBEF) <35% after Lipomul challenge who subsequently underwent cholecystectomy. Fifteen patients with a mean age of 14.9 +/- 0.9 years were included. The mean duration of symptoms before evaluation was 8.2 +/- 2.5 months. RESULTS: The mean GBEF after Lipomul challenge was 16.7% +/- 2.7%. All patients had abdominal pain. Ninety percent had right upper quadrant pain and 86% had typical biliary colic. Pain was precipitated by fatty meals in 73.3%. Histopathologic analysis of the gallbladder demonstrated chronic cholecystitis in 80% of cases. The mean postoperative follow-up was 20 +/- 5 months. Six months after the surgery, nine patients (60%) were asymptomatic, five (33%) had marked improvement of symptoms, and one (6%) was unchanged. At the time of latest follow-up, symptoms had reappeared in two patients who had been asymptomatic at the 6-month visit (13%). Seven patients (46%) remained asymptomatic, five (33%) had marked improvement but continued to have some persistent symptoms, and one (6%) was unchanged. CONCLUSIONS: Chronic acalculous cholecystitis may be responsible for right upper quadrant pain in children without gallstones. A GBEF <35% at 30 minutes after Lipomul challenge may be useful in identifying patients who could benefit from cholecystectomy. Lipomul may be a good alternative to cholecystokinin for gallbladder stimulation during scintigraphy.

Abdominal Pain↗
PubMed2003

Dynamic renal scintigraphy in children with vesicoureteral reflux and suspected coexisting ureteropelvic junction obstruction.

PURPOSE: We evaluated whether findings on voiding cystourethrography suggesting ureteropelvic junction (UPJ) obstruction coexists with vesicoureteral reflux (VUR) are associated with parameters on dynamic renal scintigraphy that support significant obstruction. MATERIALS AND METHODS: We reviewed records of 44 patients referred for scintigraphy after voiding cystourethrography performed at age 1 day to 9.4 years (mean 7 months, median 1.7 months) showed VUR and findings suggestive of UPJ obstruction (blockage of contrast material at the UPJ, contrast dilution in the renal pelvis, slow renal pelvic drainage). Results were correlated with Society for Fetal Urology hydronephrosis grade and ureteral morphology. RESULTS: Halftime was in the obstructive range (20 minutes or greater) for 7 of 47 kidneys (15%). The prevalence of a post-furosemide pelvicaliceal drainage halftime in the obstructive range increased with hydronephrosis grade (0% grade 1, 17% grade 2, 50% grade 3 to 4, p = 0.002) but did not vary with ureteral morphology (p = 0.08). In 12 of 38 cases (31%) where suspected UPJ obstruction was unilateral and a contralateral kidney was present differential uptake of the affected kidney was less than 45%. The prevalence of differential uptake less than 45% was higher in patients with than without ureteral dilatation (48% vs 12%, p = 0.02) but did not vary with hydronephrosis grade (p = 0.93). CONCLUSIONS: In children with VUR and suspected coexisting UPJ obstruction dynamic renal scintigraphy may support significant obstruction when hydronephrosis is at least moderate in degree or ureteral dilatation is present but is unlikely to do so if neither is observed.

Child↗
PubMed2003

Localization of Tc-99m MDP in the rectus abdominis muscle without associated symptoms.

Skeletal tracer localization in the rectus abdominis muscle of a 17-year-old girl whose training regimen included vigorous abdominal exercise but who had no abdominal soreness is described. The case illustrates that bone tracers may localize to skeletal muscle without associated symptoms. This is consistent with bone tracer localization in skeletal muscle reflecting subtle fiber abnormalities rather than necrosis.

Adolescent↗
PubMed2003

Aneurysmal bone cyst of the sacrum: value of three-phase imaging.

Aneurysmal bone cyst is an uncommon nonneoplastic lesion that occurs predominantly during the first 2 decades of life. Angiographic- and tissue-phase imaging provided more striking evidence of this unexpected lesion than skeletal-phase imaging in a 13-year-old girl with pain in the right buttock and posterior thigh.

Adolescent↗
PubMed2003

Skeletal scintigraphy of young patients with low-back pain and a lumbosacral transitional vertebra.

UNLABELLED: Lumbosacral transitional vertebrae can alter the biomechanics of weight transfer at the affected spinal segment. Low-back pain may result. This study assessed what skeletal scintigraphy reveals about stress associated with a lumbosacral transitional vertebra in young patients with low-back pain. METHODS: The study population included 48 patients (30 male, 18 female; age range, 6-19 y; mean age, 15.7 y) with low-back pain and a lumbosacral transitional vertebra. Skeletal scintigraphy was correlated with plain radiographs in all, CT in 12, and MRI in 11. RESULTS: High uptake was shown at the articulation between the transverse process of a lumbosacral transitional vertebra and the sacrum in 39 (81%) of the patients. In 23 (59%) of the 39 patients with high uptake, this finding was shown only by SPECT. In 13 (81%) of the 16 for which the high uptake was shown by planar imaging, the anterior projection was more valuable than the posterior projection. In 9 (23%) of the 39 patients with high uptake at the transverse-sacral articulation, the lumbosacral transitional vertebra had not been noted in a radiographic report before skeletal scintigraphy but was identified through reevaluation or repetition of radiographs after skeletal scintigraphy. Radiographs showed sclerosis along the transverse-sacral articulation in only 8 (21%) of the 39 patients with high uptake. Findings indicating stress or motion at the joint were shown by CT in 6 (55%) of 11 and by MRI in 5 (63%) of 8 patients with high uptake at the transverse-sacral articulation who underwent these examinations. CONCLUSION: Skeletal scintigraphy often indicates stress at the transverse-sacral articulation of young patients with low-back pain and a lumbosacral transitional vertebra. Showing evidence of stress is best accomplished using SPECT. Changes are usually not radiographically evident, but there is a trend for MRI and CT to show findings that imply stress or motion at the articulation. The unique ability of skeletal scintigraphy to provide this physiologic information supports its use in these patients.

Adolescent↗
PubMed2002

Applications of nuclear medicine in pediatric oncology.

Nuclear medicine is important in the diagnosis, staging, and long-term surveillance of a number of pediatric cancers. Skeletal scintigraphy is used to evaluate primary skeletal cancers, such as osteosarcoma and Ewing sarcoma, and nonskeletal cancers such as neuroblastoma, lymphoma, medulloblastoma, rhabdomyosarcoma, and retinoblastoma. Metaiodobenzylguanidine scintigraphy is valuable in examinations of children with neuroblastoma. The therapeutic response of primary bone and brain tumors can be assessed using Tl-201 and Tc-99m MIBI scintigraphy. Imaging strategies for staging and monitoring the therapeutic response of Hodgkin's lymphoma include Ga-67 citrate scintigraphy. Pediatric oncologic applications of positron emission tomography are being investigated extensively.

Bone Neoplasms↗
PubMed2002

Ectopic ureteroceles in infants with prenatal hydronephrosis: use of renal cortical scintigraphy.

PURPOSE: This study assesses the contribution of renal cortical scintigraphy in the diagnostic evaluation of infants with ectopic ureteroceles. METHODS: The records of 20 infants (age range, 3 weeks to 4 months) who were referred for renal cortical scintigraphy after an ectopic ureterocele associated with a duplex kidney was found during follow-up of prenatal hydronephrosis were reviewed retrospectively. All infants underwent voiding cystourethrography, ultrasonography, and Tc-99m DMSA scintigraphy. RESULTS: All upper moieties showed absent or depressed Tc-99m DMSA uptake. Upper moiety functional impairment was associated with structural abnormalities shown by ultrasonography. The degree of functional impairment was reflective of ultrasonographically defined cortical thickness relative to pelvic diameter, but this relation varied. Eight of 20 (40%) lower moieties had diffusely depressed relative Tc-99m DMSA uptake. Focal defects were also present in three of these eight (38%) lower moieties. Lower moiety functional impairment was associated with higher degrees of pelvic dilatation and with vesicoureteral reflux. Ultrasonography revealed diffuse parenchymal thinning in four of the eight (50%) lower moieties with depressed uptake. Ultrasonography did not define focal parenchymal loss in any lower moiety. CONCLUSIONS: The degree to which function is impaired in the upper moieties of duplex kidneys with ureters terminating in ectopic ureteroceles is not highly predictable by ultrasonography. Lower moiety functional impairment and cortical defects are frequently present in these kidneys and often occur without ultrasonographic evidence of parenchymal damage. Use of renal cortical scintigraphy in the diagnostic evaluation of infants with ectopic ureteroceles is supported.

Female↗