To improve the efficacy of extracorporeal shock wave lithotripsy (ESWL) treatment, it is desirable to identify the physical properties of urinary calculi could offer direct correlation with their fragilities during ESWL and thus could be used to guide treatment procedures for more effective stone fragmentation. Thirty stone specimens removed surgically were compressed by an axial testing system to measure the compressive strength and trace the stress-strain curve. Image analysis software SigmaScan (Jandel Co.) was used to calculate the area under the stress-strain curve, the modulus of toughness, for each stone. The values of compressive strength measured were similar to those reported by other researchers. The modulus of toughness of urinary calculi correlates with clinical representation of the stone fragility during ESWL. The modulus of toughness could be an index to evaluate the physical property of urinary calculi that could be used to guide treatment procedures for more effective stone fragmentation.

Compressive Strength↗

PubMed2002

Use of fractionated doses of iodine-131 for ablation of thyroid remnants.

BACKGROUND: Remnants of thyroid tissue are always present after surgery performed for thyroid cancer, and their ablation with I-131 is associated with decreased recurrence rates and probably increased survival. Administration of a single dose in excess of 50 mCi of I-131 requires hospitalization. In an attempt to obviate the necessity for hospitalization, the ablative dose was divided into three fractions given at weekly intervals. The purpose of this study was to assess the effectiveness of this approach. METHODS: We retrospectively analyzed the success rate of ninety-nine patients from 1995 to 1999 with thyroid carcinoma who received fractionated dose of ablation. Iodine-131 whole body scan was done 6 months after ablation to evaluate treatment efficacy. In addition, measurement of serum thyroglobulin (Tg) was obtained in 81 patients. RESULTS: "Successful ablation" has been defined as the absence of all residual thyroid uptake in the I-131 whole body scan. Ablation of thyroid remnants was successful in 71 of 99 (71.7%) patients (papillary cell type 89%; follicular cell type 53%). In 54 patients with negative I-131 whole body scan, 39 patients had undetectable serum Tg, and 11 patients were with serum Tg level below 10 ng/ml. In 27 patients with positive I-131 whole body scan, 15 patients had undetectable serum Tg. CONCLUSIONS: We suggest that the use of fractionated doses of 1-131 is a reasonable approach to ablation therapy. Tg measurement appears to be superior to I-131 whole body scan in follow-up of patients with differentiated thyroid carcinoma. However, Tg measurement can certainly not replace I-131 whole body scan. A combined application of I-131 whole body scan and Tg radioimmunoassay is thus advisable.

Adult↗

PubMedDate not supplied

A comparison study of ultrasound and Xenon-133 hepatic retention ratio in fatty liver.

BACKGROUND/AIMS: We compared ultrasound and Xenon-133 hepatic retention ratio to evaluate the accuracy of ultrasound in diagnosing fatty liver. METHODOLOGY: One hundred and forty-six patients with suspected fatty liver were included. All patients underwent an ultrasound study followed by a determination of the Xenon-133 hepatic retention. RESULTS: Using the Xenon-133 hepatic retention ratio as the diagnostic standard, the overall accuracy of ultrasound in detecting fatty liver was 57.5%, with 100% sensitivity and 6.0% specificity. CONCLUSIONS: Ultrasound can be used as a first-line screening imaging modality for fatty liver. If the result of ultrasound is equivocal, then Xenon-133 hepatic retention determination should be performed for the diagnosis and management of fatty liver.

Adult↗

PubMedDate not supplied

In-111-labeled platelet scintigraphies in patients with chronic hepatitis C.

BACKGROUND/AIMS: Chronic hepatitis C has been recognized to be associated with thrombocytopenia. The use of indium (In-111) oxine-labeled platelets has provided an important tool for classifying the mechanism of thrombocytopenia. In this study, we utilized In-111 oxine-labeled platelet scintigraphies to evaluate patients with chronic hepatitis C (with and without thrombocytopenia). METHODOLOGY: Eleven patients with chronic hepatitis C were included in this study. Six patients (3 male, 3 female) were diagnosed with thrombocytopenia (< 140 x 10(9)/L) (group A) and five patients (3 male, 2 female) had normal platelet counts (> 140 x 10(9)/L) (group B). Spleen to heart and spleen to liver ratios were calculated from 24-hour platelet scintigraphic images. RESULTS: The spleen to heart ratios in group A and group B were 5.18 +/- 2.09 and 5.17 +/- 2.17, respectively (P = 0.465). The spleen to liver ratio of group A and B were 3.08 +/- 1.60 and 2.38 +/- 0.87, respectively (P = 0.870). CONCLUSIONS: Our study revealed that patients with hepatitis C infection may have thrombocytopenia independent of hypersplenism.

Adult↗

PubMedDate not supplied

Solid-phase radionuclide esophageal transit in progressive systemic sclerosis.

BACKGROUND/AIMS: In most patients with progressive systemic sclerosis the esophagus is affected. Reflux symptoms are most frequent whilst dysphagia also occurs. The radionuclide esophageal transit study is a sensitive screening test for esophageal dysfunction. In this study, we evaluated the esophageal motility of patients with progressive systemic sclerosis using a solid-phase radionuclide esophageal study. METHODOLOGY: Thirty-two patients with progressive systemic sclerosis and 30 normal volunteers were studied with solid-phase radionuclide esophageal study. Each subject was placed in a supine position above a gamma camera linked to a computer and was given a 4-mL bolus of solid gelatin containing 1 mCi of Tc-99m phytate. Data were acquired in the list mode. RESULTS: Twenty-nine of the 32 patients (91%) had abnormal findings from the study. CONCLUSIONS: The radionuclide esophageal transit study can be regarded as a useful tool for evaluating the esophageal function in patients with progressive systemic sclerosis and in the follow-up of treatment.

Administration, Oral↗

PubMedDate not supplied

Radionuclide colon transit study in patients with idiopathic constipation.

BACKGROUND/AIMS: Constipation is the most common digestive complaint. Radionuclide colon transit study is a useful tool for assessing the motility of the colon. In this study, we evaluate patients with idiopathic constipation using the radionuclide colon transit study. METHODOLOGY: We studied radionuclide colon transit in 23 patients with idiopathic constipation. Thirty healthy volunteers were included as a control. RESULTS: Overall, patients with idiopathic constipation usually had slow or normal colon transit. CONCLUSIONS: Our study suggested that the radionuclide colon transit study may be clinically useful in evaluating and assessing the efficacy of therapy in patients with idiopathic constipation.

Adult↗

PubMedDate not supplied

The limited use of ultrasound in the detection of abdominal abscesses in patients after colorectal surgery: compared with gallium scan and computed tomography.

BACKGROUND/AIMS: Ultrasound has been suggested to be a first-line test for the detection of intra-abdominal abscess (IAA). However, according to our experience, ultrasound seemed not so effective when applied to the patients after colorectal surgery. Computed tomography (CT) and gallium scan have also been suggested as very useful for the detection of IAA. The purpose of this study was to evaluate the efficacy of sonography and gallium scan in diagnosing intra-abdominal abscess after colorectal surgery and to compare these results with CT. METHODOLOGY: Twenty-three patients with suspected IAA after colorectal surgery at our institution were eligible for the study. A positive IAA was verifed only if pus was drained or on postmortem examination. Negative reports of abscesses were verified by adequate outpatient review following hospital discharge that indicated the clinical absence of an abscess. Within 4 days of the clinical suspicion of abscess, all patients were evaluated by three techniques: sonography, CT and gallium scan. We compared the sensitivity, specificity and accuracy of these modalities. RESULTS: Fourteen of the 23 patients (60.9%) were verified as IAA. We found the sensitivity, specificity, and accuracy of CT scan for the detection of LAA in the patients with colorectal surgery to be 92.9%, 100%, and 95.7%, respectively. The sensitivity, specificity and accuracy of gallium scan were 100%, 77.8% and 91.3%, respectively. Ultrasound had a 42.9% sensitivity, 100% specificity, and 65.2% overall accuracy for diagnosing IAA. CONCLUSIONS: Sonography plays a small role in the detection of IAA in the patients after colorectal surgery. CT and gallium scan are more helpful than sonography for the detection of IAA.

Abdominal Abscess↗