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At least 613 records · Page 34Linked to original sources
PubMed2000

The role of selective sentinel lymph node dissection in breast cancer.

Axillary nodal status continues to be the most statistically significant predictor of survival for patients with breast cancer. Although still providing regional control of axillary disease, axillary dissection is more important as a staging and prognostic tool. Trials are currently underway to investigate the possibility of replacing the current standard treatment of breast cancer, axillary lymph node dissection, with the less invasive lymphatic mapping and sentinel lymph node biopsy. This issue and the technical aspects of sentinel lymph node mapping for breast cancer are discussed in detail in this article.

Axilla↗
PubMed1990

Absence of pulmonary aspiration of sinus contents in patients with asthma and sinusitis.

The frequent association of asthma and paranasal sinusitis has been ascribed to a nasobronchial reflex, aspiration of sinus secretions, or enhanced beta-adrenergic blockade. We investigated possible pulmonary aspiration in a pilot study (eight patients) and follow-up study (13 patients) by means of a radionuclide technique. In the pilot study, the aim was to demonstrate aspiration as well as visibility of the radionuclide in the thorax during a period of 24 hours. The radionuclide was initially placed bronchoscopically in the bronchial tree in four patients and was still clearly visible in the same position after 24 hours in three patients. Aspiration from the nasopharynx was unequivocally demonstrated in two of four patients with depressed consciousness. The follow-up study population consisted of four patients with maxillary sinusitis only and nine patients with sinusitis and asthma. The radionuclide was placed in a maxillary sinus during therapeutic puncture. In the patients with only sinusitis as well as patients with asthma and sinusitis the radionuclide could be demonstrated in the maxillary sinus, nasopharynx, esophagus, and lower gastrointestinal tract during a 24-hour period. However, no pulmonary aspiration of radionuclide could be demonstrated in any patient. We conclude that seeding of the lower airways by mucopurulent secretions is unlikely to account for coexistent pulmonary disease. The association is probably related to generalized mucosal disease affecting both upper and lower airways.

Asthma↗
PubMed1989

Ultrasonography and scintigraphy in liver disease in developing countries. A retrospective survey.

In a study of the value of hepatic ultrasonography (US) and scintigraphy (SG) in detecting liver disease in developing countries 425 US scans and 304 SG scans of patients with focal or diffuse liver disease or normal livers were reviewed. The accuracy of both US and SG in distinguishing between normal and diseased livers was low (68% and 74%, respectively). Both techniques did better at detecting focal than diffuse liver disease; the sensitivity of US and SG in focal and diffuse disease was 88% and 92%, and 27% and 54%, respectively. The specificity of both procedures was high for both types of liver disease (91-96%). Overlap between US features of amoebic liver abscess, hepatocellular carcinoma, and metastatic carcinoma resulted in a correct final diagnosis being made in only 81% of patients with amoebic liver abscess, 29% with hepatocellular carcinoma, and 43% of patients with metastatic carcinoma who had a US scan. This study indicates that these techniques are neither accurate in detecting diffuse liver disease nor capable of determining the cause of diffuse liver disease. When diffuse parenchymal liver disease is suspected biopsy would be needed. Although the accuracy of both imaging modalities in detecting focal disease is high, overlap between the US features of the common causes of space-occupying lesions may result in an incorrect final diagnosis in some cases. In consequence, biopsy or aspiration might be required.

Biopsy↗
PubMed2000

Malignant granular cell tumor metastatic to the orbit.

OBJECTIVE: Malignant granular cell tumor is a rare type of soft tissue sarcoma. To our knowledge, ocular (eyelid) involvement has been described in only two cases. Herein, we report the clinicopathologic features of an unusual case of malignant granular cell tumor metastatic to the orbit. DESIGN: Observational case report. METHODS: Retrospective review of the medical record and the histopathologic and electron microscopic findings and review of the literature. RESULTS: A 72-year-old man with biopsy-proven granular cell tumor in the cervical region was initially seen with proptosis and motility disturbance. A magnetic resonance imaging scan showed a large intraconal mass, and biopsy of the orbital mass revealed granular cell tumor. Histopathologic examination of the primary neck tumor and the orbital mass revealed increased nuclear atypia and pleomorphism in the consecutive lesions. The morphologic impression of granular cell tumor was also supported by the immunohistochemical demonstration of S-100 protein expression and ultrastructural findings typical of granular cell tumor. Six months after the orbital involvement, systemic workup revealed multiple apparent bony and lung metastases. CONCLUSIONS: We report the first malignant granular cell tumor metastatic to the orbit and suggest the inclusion of this tumor in the differential diagnosis of metastatic orbital lesions.

Aged↗
PubMedDate not supplied

The use of scintigraphic imaging as a tool in the development of liposome formulations.

Scintigraphic imaging is a valuable tool that can be used during the development of liposome-based therapeutic agents. It provides the ability to non-invasively track and quantitate the distribution of liposomes in the body. This review article provides a general overview of the methods involved in producing scintigraphic images as well as methods of radiolabeling liposomes. Liposomes labeled with technetium-99m ((99m)Tc) are particularly useful for scintigraphic imaging due to the physical characteristics of (99m)Tc, which provides a high quality image. Examples of how scintigraphic imaging studies have contributed to the development of a variety of liposome-based formulations are covered in this article. These liposome formulations include long-circulating liposome-based oxygen carriers, liposome-based anti-cancer drugs, liposomes encapsulating antibiotics and anti-fungals, and liposomes targeted to lymph nodes. Studies using scintigraphic imaging for the investigation of immune responses to liposomes are also discussed. These examples demonstrate the usefulness of scintigraphic imaging for the development of novel liposome formulations.

Animals↗
PubMed1987

Hepatic blood flow determination. A comparison of 99mTc-diethyl-IDA and indocyanine green as hepatic blood flow indicators in man.

99mTc-diethyl-acetanilide-iminodiacetic acid (IDA) was compared with indocyanine green (ICG) as an indicator of hepatic blood flow (HBF). Twelve subjects (8 with cirrhosis, 2 with fatty liver, one with pancreatitis, and one with intestinal angina) were studied during hepatic vein catheterization. In 9 subjects the HBF measurements (indirect Fick-principle) were within 0.8-1.9 l/min, and no significant difference was observed between the values obtained by ICG and 99mTc-diethyl-IDA (mean 1.24 vs 1.26 l/min, P greater than 0.4). In 2 subjects with cirrhosis very high but almost identical values were found with the two indicators. In one subject ICG could not be measured in plasma because of hyperlipidaemia, but HBF was easily determined by 99mTc-diethyl-IDA. The results indicate that 99mTc-diethyl-IDA can be used as an indicator of HBF. This indicator is not superior to ICG in patients with decreased liver function, but offers advantages in that it can be used with small plasma samples and permits the determination of HBF in the presence of hyperlipidaemia.

Adult↗
PubMed2003

Comparison of three tracers for detecting sentinel lymph nodes in patients with clinical N0 lung cancer.

The goal of this pilot study was to compare three tracers for the detection of sentinel nodes in patients with lung cancer. Forty-eight patients with clinical N0 non-small cell lung cancer were enrolled. Indocyanine green (n=16) or isosulfan blue (n=18) was injected around the tumor intraoperatively, or technetium tin colloid was injected preoperatively under CT guidance (n=14). Sentinel nodes were detected in 6.3% of patients injected with indocyanine green, 50.0% of patients injected with isosulfan blue, and 64.3% of patients injected with technetium tin colloid. The detection rate achieved with indocyanine green was significantly lower than with the other two tracers. A false-negative sentinel node was seen in 1 patient using isosulfan blue. Both isosulfan blue and technetium tin colloid seem to be suitable for intraoperative sentinel node mapping in patients with lung cancer.

Adult↗
PubMedDate not supplied

[Labeling of leukocytes using stannous 99mTc-colloid in whole blood samples].

This paper presents the preparation of a radiocolloid that still makes it possible to label leukocytes using its phagocytosis capacity. Given that this function is exclusively of the white blood cells, not being exercised by other blood cells, the use of a stannous fluoride radiocolloid labeled with 99mTc (F2Sn-99mTc) was tested in order to label leukocytes in whole blood samples. Using cellular separation techniques in density gradients and acquisition of images in gamma camera of radioactivity distribution in Percol, it was observed that the white cells labeling achieved was selective and with high efficiency for leukocytes (in all cases, it was superior to 70%), optimal reproducibility, low cost and low cellular toxicity.

Humans↗
PubMed1985

Initial Tc-99m diphosphonate uptake in mineralized and demineralized bone implants in rats.

Radionuclide imaging has been suggested as a means to assess healing and viability of bone grafts and implants. This study deals with the in vivo uptake of 99mTc-MDP in the initial postoperative period in rats. Isogeneic or xenogeneic bone was implanted in subcutaneous pouches. The isogeneic grafts and implants were treated with saline or freeze-treated or demineralized. The xenogeneic implants consisted of Kiel bone or collagen sponge. One day after surgery, the accumulation of 99mTc after an intraperitoneal injection of 99mTc-MDP was seen in all grafts and implants containing bone mineral independent of prior treatment of the graft and implant. In implants composed of only the organic part of bone, no accumulation was observed. One prerequisite for accumulation of 99mTc-MDP is the presence of the inorganic phase. Thus, the interpretation of the initial postoperative scan is based on whether or not the graft or implant initially contained mineral.

Animals↗
PubMed2003

Localization of avidin in superficial bladder cancer: a potentially new approach for radionuclide therapy.

OBJECTIVE: To verify whether native avidin, made radioactive through the binding with technetium-99m labeled biotin (99mTc-biotin), selectively accumulated in superficial tumor tissues following intravesical administration. METHODOLOGY: A total of fifteen patients with transitional cell bladder cancer were instilled intravesically with radiolabeled avidin. Cold biopsies were obtained from macroscopically normal and tumor tissues before transurethral resection (TUR) and the radioactivity in the samples was measured. RESULTS: Increased accumulation of radiolabeled avidin was observed in tumor tissue compared to normal bladder tissue and in some cases, remarkably high quotients of uptake (q) in tumor versus normal tissues were determined (86 and 44). The three patients instilled with a deglycosylated avidin at neutral pI, who served as a control, showed no significant uptake in either tumor or normal urothelium and no difference in relative uptake (q=1.0). CONCLUSION: This pilot study indicated that intravesical administration of radiolabeled avidin resulted in a preferential accumulation in tumor tissue compared to normal urothelium. The instillation of radiolabeled avidin warrant further investigations in order to explore the possibility to treat superficial bladder neoplasms locally by replacing 99mTc with high energy beta emitting radionuclides associated with biotin.

Aged↗
PubMed2002

Sentinel lymph node biopsy in breast cancer using technetium-99m tin colloids of different sizes.

Axillary lymph node dissection (ALND) in the treatment of breast cancer is essential for predicting the prognosis and regional control of the tumor. At the same time ALND is associated with pain, numbness and sometimes lymphedema. Sentinel lymph node biopsy (SLNB) is a potential alternative procedure to conventional ALND in clinically node-negative breast cancer. In this study, we prepared the technetium-99m-labeled tin colloids with different sizes and compared their efficacy in SLNB. From September 1998 to February 2002, 184 clinically node-negative breast cancer patients were enrolled in the study at Keio University Hospital. Sentinel lymph nodes (SLNs) were identified by both blue dye and radioisotope. We prepared small-sized technetium-99m-labeled tin colloid (particle size: 200-400 nm in diameter). Regular-sized technetium-99m-labeled tin colloid is 400-1000 nm in diameter. In 74 patients, a SLNB was performed using regular-sized tin colloid; small-sized tin colloid was used in 110 patients. Subsequently, all of the patients were immediately followed by ALND. All dissected lymph nodes were evaluated by routine histopathological examination. The clinicopathological characteristics of the two groups were comparable. The lymphoscintigram detected SLN more frequently in the small-sized colloid group than in the regular-sized colloid group (P < 0.01). Small-sized tin colloid was also superior to regular-sized tin colloid in the SLN identification rate (97.3% versus 86.5%; P = 0.01). The mean value for ex vivo counts of the hottest sentinel lymph nodes of the small-sized colloid group was significantly higher than the counts of the regular-sized colloid group (P < 0.01). There was no significant difference in the accuracy between the two groups. It was concluded that SLNB using the small-sized tin colloid was technically feasible and provided higher detection and identification rates than the regular-sized tin colloid.

Adult↗
PubMed1998

MRI lesions masked by brain development: a case of infant-onset focal epilepsy.

A 3-month-old male presented with right-side-dominant focal seizures. Focal spikes were observed on the left side of an electroencephalogram obtained at the time of onset. The immature development in the left middle temporal lobe was observed by initial magnetic resonance imaging (MRI). The hypoperfusion in the left temporal lobe observed with single-photon computed tomography was consistent with MRI findings. These MRI findings were not observed in a second MRI at 11 months of age. This observation may explain one of the causes of infant-onset focal epilepsy.

Brain↗
PubMed1996

Clinical effectiveness of 99mTc-diphosphonate scintigraphy of revascularized iliac crest flaps.

Clinical assessment of the perfusion of the musculocutaneous portion of composite iliac crest free flaps was compared to 99mTc-diphosphonate (HDP) uptake in 14 patients who underwent primary oromandibular reconstruction after ablative cancer surgery. Bone scanning was performed on average at the 9-10th postoperative day (range 4-48) 3 h after intravenous injection of 550 MBq 99mTc-HDP. Eleven patients showed complete concordance between 99mTc-HDP uptake and soft-tissue status. Two patients showed uptake and viable muscle in spite of necrotic skin. One patient had a viable musculocutaneous flap but a photopenic defect in the bone graft; 6 months later, a small corresponding part of the bone was sequestrated. In this study, bone scanning and clinical assessment of muscle perfusion were 100% accurate in predicting viability of bone grafts. Skin viability was a less reliable parameter. It is concluded that bone scanning is not indicated as a routine investigation for revascularized iliac crest flaps and that clinical assessment of muscle perfusion is a reliable monitor of the early function of such flaps.

Adult↗