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Biomedical subjects

Wan-Yu Lin

Publications and source records attributed to Wan-Yu Lin.

At least 37 records · Page 2Linked to original sources
PubMed2003

Tc-99m MIBI parathyroid scintigraphy and intact parathyroid hormone levels in hyperparathyroidism.

Tc-99m MIBI has been widely used to evaluate hyperparathyroidism based on increased tracer uptake in hyperfunctioning parathyroid tissue. The functional status measurement of parathyroid glands with intact parathyroid hormone (iPTH) levels is also one of the most important diagnostic studies in this disorder. The aim of the current study was to assess the relation between MIBI imaging and iPTH levels. The authors retrospectively reviewed the records of patients with hyperparathyroidism who were referred to their department for Tc-99m MIBI scintigraphy. Sixty-five patients (24 primary and 41 secondary hyperparathyroidism) were included. The iPTH levels ranged from 66.06 to 2,836 pg/ml (normal, 10 to 55 pg/ml). Forty-two patients were MIBI positive and 23 were negative. The iPTH level in the MIBI-positive group was significantly greater than in the negative group in the primary (548 +/- 478 versus 124 +/- 45; = 0.002), secondary (1,155 +/- 692 versus 501 +/- 352; < 0.001), and overall (909 +/- 678 versus 386 +/- 341; < 0.001) groups. For the primary hyperparathyroidism group, 17 of the 24 patients were MIBI positive (71%). When iPTH levels exceeded 200 pg/ml (100%), the diagnostic sensitivity reached 100%. For the secondary hyperparathyroidism group, 25 of 41 patients (61%) were MIBI positive; 24 of 38 patients (63%) had an iPTH level greater than 200 pg/ml, 21 of 27 patients (78%) had an iPTH level greater than 500 pg/ml, and 11 of 12 patients (92%) had an iPTH value greater than 1,000 pg/ml. Tc-99m MIBI parathyroid scintigraphy showed a good correlation with iPTH level for both primary and secondary hyperparathyroidism. Visualization of hyperfunctioning parathyroid glands on Tc-99m MIBI parathyroid scintigraphy was more likely with a higher serum iPTH level in a dose-dependent manner.

Adult↗
PubMed2003

Scintigraphic findings of Mycobacterium avium complex tenosynovitis of the index finger in a patient with systemic lupus erythematosus.

The presented case is a 36-year-old woman with a history of systemic lupus erythematosus for 10 years. She had progressively painful swelling of the right index finger that later proved to be a rare case of tenosynovitis caused by Mycobacterium avium complex. Serial images of 3-phase bone scans, gallium scan, and magnetic resonance imaging demonstrate the area of involvement.

Adult↗
PubMed2003

Temporary cerebellar hypoperfusion with good outcome in cerebellitis.

The relation between clinical outcome and single photon emission tomography (SPECT) results in cerebellitis has not been studied. A 63-year-old man developed cerebellar dysfunction with left emphasis one week after onset of cough. The only abnormality on analysis of cerebrospinal fluid was elevated protein (68 mg/dl). Magnetic resonance imaging was normal on the ninth day of ataxia. SPECT showed unilateral cerebellar hypoperfusion on the 13th day, but was normal on the 20th day. His gait improved a little by discharge on the 28th day and his tandem gait was only slightly unsteady six months later. This is the first evidence that normalization of cerebellar hypoperfusion in adult patients with cerebellitis is related to good outcome. Normalization of cerebellar hypoperfusion can occur in three weeks even when ataxia remains severe.

Acute Disease↗
PubMed2002

Clinical features and gallium scan in the detection of post-surgical infection in the elderly.

Common signs of infection, such as an elevated level of C-reactive protein (CRP), raised white blood cell (WBC) count and increased temperature, may not be present in elderly patients when infection occurs. In addition, these typical signs may be normal events during the postoperative period. Therefore, early detection of post-surgical infection may be difficult in the elderly population. In this study, we evaluated the usefulness of gallium scan in the detection of infection in elderly patients after colorectal surgery and compared it with CRP, WBC count and ear temperature (ET) examinations. Thirty-three patients undergoing colorectal surgery and aged over 60 years were enrolled in the study. All patients underwent a gallium scan and CRP, WBC and ET examinations. Of the 33 patients, 18 (54.5%) were diagnosed with infection. The diagnostic sensitivity was 100% for both gallium scan and the CRP test, but only 44.4% and 61.1% for the WBC count and ET, respectively. The diagnostic specificity of the gallium scan, WBC count and ET was 80% or more, whereas that of the CRP test was only 53.3%. The diagnostic accuracy of gallium scan, CRP test, WBC count and ET was 90.9%, 78.8%, 60.6% and 72.7%, respectively. In conclusion, both WBC and ET examinations show low sensitivity in the detection of infection in the elderly population after colorectal surgery. The CRP test has good sensitivity but low specificity. Of the four diagnostic modalities, gallium scan had the highest overall diagnostic accuracy (90.9%) while the WBC test had the lowest (60.6%).

Abdominal Abscess↗
PubMed2002

Fluorine-18 FDG-PET in detecting local recurrence and distant metastases in breast cancer--Taiwanese experiences.

Fluorine-18 fluorodeonyglucose positron emission tomography (FDG-PET) was used to detect local recurrence, axillary lymph node (LN) involvement and distant metastases in patients with breast cancer. Thirty-six female patients with breast cancer s/p operation underwent FDG-PET studies. Findings were confirmed by histology following surgery and/or biopsy or negative follow-up results over a period of at least one year. In the evaluation of local recurrence, the diagnostic sensitivity, specificity, and accuracy of FDG-PET was 100, 96.8, and 97.2%, respectively. In the evaluation of axillary LN involvement, sensitivity, specificity, and accuracy was 80, 100, and 97.2%, respectively. In the evaluation of distant metastases, the diagnostic sensitivity, specificity, and accuracy was 83.3, 85.2, and 84.4%, respectively. The FDG-PET is a useful diagnostic tool in detecting local recurrence, axillary LN involvement, and distant metastasis.

Adult↗
PubMed2002

Implantation of VX2 carcinoma into the liver of rabbits: a comparison of three direct-injection methods.

The efficacy of agarose in preventing VX2 carcinoma cell leakage was evaluated and the results were compared with two traditional methods. Forty-five rabbits were divided into 3 groups: Group 1, VX2 tumor cells were injected directly into the liver and no special procedure after removal of the needle; Group 2, the puncture site was gently compressed, using an alcoholic cotton gauze, for three minutes; Group 3, 0.2 ml of heated liquid agarose was injected to seal the aperture after injection of VX2 cells. The leakage rates were 80%, 53.3% and 6.6% for group 1, group 2 and group 3, respectively. We consider agarose is a useful material in preventing the leakage in the establishment of VX2 liver tumor models.

Animals↗
PubMedDate not supplied

Worsening of left ventricular ejection fraction induced by dipyridamole on Tl-201 gated myocardial perfusion imaging predicts significant coronary artery disease.

BACKGROUND: Vasodilator stress on myocardial perfusion imaging has been found to induce ischemic stunning, which may present as transient worsening of left ventricular ejection fraction (LVEF) or regional wall motion abnormality. This study aimed to evaluate the significance of stress-induced worsening of LVEF in the diagnosis of coronary artery disease (CAD) on dipyridamole thallium 201 gated single photon emission computed tomography (SPECT). METHODS AND RESULTS: The study included 126 patients who underwent dipyridamole Tl-201 gated SPECT and coronary angiography within 3 months. Poststress and 4-hour rest images were obtained, and LVEF was calculated by use of automated software (QGS 3.0). A decrease in LVEF of 6% or greater from rest to poststress was considered significant, and this threshold was determined by the serial reproducibility assessment of Tl-201 gated SPECT. If worsening of LVEF was used as the criterion for detecting significant CAD (> or = 70% coronary stenoses in > or = 1 vessel), the sensitivity, specificity, positive predictive value, and negative predictive value were 35%, 93%, 90%, and 44%, respectively. CONCLUSION: Dipyridamole-induced worsening of LVEF, as shown by Tl-201 gated SPECT, is a valuable nonperfusion marker of significant CAD. Although the sensitivity of LVEF worsening in detecting significant CAD is only 35%, the specificity is as high as 93%.

Aged↗
PubMedDate not supplied

Relationship of transient ischemic dilation in dipyridamole myocardial perfusion imaging and stress-induced changes of functional parameters evaluated by Tl-201 gated SPECT.

BACKGROUND: This study assessed whether transient ischemic dilation (TID) of the left ventricle is related to ischemic stunning, manifested by stress-induced decrease of left ventricular ejection fraction (LVEF) and worsening of wall motion, by use of dipyridamole-stress and redistribution thallium 201 gated single photon emission computed tomography (SPECT). METHODS AND RESULTS: Ninety-two consecutive patients undergoing dipyridamole Tl-201 gated SPECT were included. Patients with a TID ratio in the highest quartile were defined as having TID. In patients with TID, end-diastolic volume (EDV) and end-systolic volume (ESV) were both significantly greater on dipyridamole-stress images than on redistribution images (P < .001). The degree of enlargement was much greater for ESV than EDV. In patients without TID, EDV and ESV were both decreased after stress (P < .001). Patients with TID had a lower mean LVEF on dipyridamole-stress images than on redistribution images (P < .001). Patients without TID had a higher mean LVEF on dipyridamole-stress images than on redistribution images (P < .001). Patients with TID had a significant worsening of global wall motion on dipyridamole-stress images than on redistribution images (P < .001), but patients without TID did not. CONCLUSION: TID was significantly correlated with ischemic stunning, and the enlargement of ESV was an important factor resulting in TID.

Aged↗
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

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

Boron-lipiodol: a potential new drug for the treatment of liver tumors.

BACKGROUND: Boron neutron capture therapy (BNCT) is a form of radiation therapy and has been proposed for the treatment of some malignancies with encouraging results. However, none of them has ever been applied to liver malignancy. The purpose of this study was to evaluate the potential of boron-lipiodol (B-lipiodol) for the treatment of VX2 liver tumor via BNCT. MATERIALS AND METHODS: Twelve New Zealand rabbits were randomly separated into two groups: lipiodol and boron-lipiodol groups. The rabbits were anesthetized, a midline incision was made and the left lobe of the liver was injected with 0.1 ml of VX2 tumor cells. After the tumor reached 2-3 cm in diameter, the rabbits were anesthetized and 0.5 ml of boron-lipiodol was injected into the hepatic artery via an angiocatheter. Liver function tests and renal function tests were performed before, at 12 hours, 24 hours, 48 hours and 7 days after injection of drugs in both groups. The concentration of boron in various tissues was determined on the 7th day after injection. RESULTS: Liver function was abnormal at 12 hours after injection, and then gradually returned to normal at 7 days, indicative of acute temporary hepatic damage. As for the renal function, no significant change was noted in either group. The boron level was 49.7 ppm in tumor and 6.31 ppm in the healthy liver 7 days after injection of B-lipiodol. The ratio of boron concentrations between the tumor and the normal liver tissue was 7.87. As for blood and other organs including spleen, heart and kidney, the concentration of boron was low. In the lipiodol group, the boron concentrations in tumor and various organs were low. CONCLUSION: The high concentration of boron after intra-arterial injection of B-lipiodol can be used for neutron capture therapy. B-lipiodol has potential for the treatment of liver malignancy.

Animals↗
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↗