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At least 19 recordsLinked to original sources

PubMed1981

Ruthenium-97 hepatobiliary agents for delayed studies of the biliary tract. I. ru-97 PIPIDA: concise communication.

Failure of early diagnosis of biliary atresia results in the development of cirrhosis and death. Commonly used hepatobiliary agents are not ideal for follow-up studies because of their unfavorable physical properties or short half-life. The excellent physical properties of Ru-97 should overcome these limitations. Therefore, Ru-97 PIPIDA (N,alpha-(p-isopropyl acetanilide) iminoacetic acid) is being investigated as a potential hepatobiliary agent that would allow an improved diagnosis of the disease. Ruthenium-97 PIPIDA and Tc-99m PIPIDA showed similar blood clearance rates in dogs. Ru-97 PIPIDA scintigrams in dogs showed early uptake in liver and gallbladder and slow excretion through the gastrointestinal tract. Biodistribution studies were performed in normal rats and rats with biliary obstruction. The findings suggest that Ru-97 PIPIDA should be useful for delayed studies (1-3 days) of the biliary tract.

Animals↗

PubMed1981

Hepatic imaging: a comparison of Tc-99m-sulfur colloid and PIPIDA in the detection of defects.

A prospective investigation comparing Tc-99m-PIPIDA with Tc-99m-sulfur colloid in the detection of defects of the liver was carried out in 30 volunteers. By acquiring images of 1 million counts from 5-10 minutes postinjection, high quality hepatic images could be obtained with PIPIDA. Separate interpretations by three nuclear physicians yielded similar results between paired PIPIDA and sulfur colloid studies (KAV = 0.95 +/- .09, P less than 0.001). Early multiview imaging of the liver in the course of hepatobiliary evaluation with PIPIDA may yield valuable information relative to the presence of lesions.

Humans↗

PubMed1980

Clinical comparison of 99mTc-diethyl-IDA and 99mTc-PIPIDA for evaluation of the hepatobiliary system.

Fifteen patients with a wide range of hepatobiliary function were studied with both 99mTc-diethyl-IDA and 99mTc-PIPIDA. In images obtained 5 to 60 minutes after injection, 99mTc-diethyl-IDA was clearly superior with respect to liver/background, hepatic ducts/liver, and small bowel/background ratios. The 99mTc-diethyl-IDA transit time from blood to small intestine averaged 12.2 minutes less than that of 99mTc-PIPIDA. Quantification of relative hepatocyte extraction efficiency indicated that it was 2.15 times higher for 99mTc-diethyl-IDA. Cumulative 3-hour urine collections following injection demonstrated increasing renal excretion of 99mTc-PIPIDA with rising total serum bilirubin levels in a manner quantitatively similar to that determined previously for 99mTc-diethyl-IDA. The authors conclude that 99mTc-diethyl-IDA is superior to 99mTc-PIPIDA for studies of the hepatobiliary system.

Adolescent↗

PubMed1981

PIPIDA excretory scintigraphy in the diagnosis of hepatobiliary disorders.

The diagnostic accuracy of hepatobiliary radionuclide imaging using 99mTC-labeled para-isopropyl acetanilido-iminodiacetic acid (99mTc-PIPIDA) in patients with hepatobiliary disorders was assessed in 50 patients. Thirty of the study group were jaundiced; the remaining 20 had other clinical features suggestive of some hepatobiliary disorder. The findings using PIPIDA proved to be correct in 22 (73%) of the 30 jaundiced patients and in 18 (90%) of 20 patients without jaundice. There appears to be a close relationship between the diagnostic accuracy of the test and the level of serum bilirubin. Thus, the diagnosis indicated by the PIPIDA test was correct in 30 (88%) of 34 patients in whom the serum bilirubin was less than 5 mg./dl. but only in 10 (62%) of 16 patients whose serum bilirubin exceeded 5 mg./dl. It is concluded from these observations that: 1. PIPIDA is diagnostically useful in the evaluation of hepatobiliary disorders, especially when the serum bilirubin is less than 5 mg./dl. and 2. the accuracy of this test is not absolute and the findings are not always definitive.

Adult↗

PubMed1983

Acute effects of nicotinic acid on hepatic transport of 99mTc-PIPIDA.

Hepatic injury has been associated with nicotinic acid treatment of schizophrenia and hypercholesterolemia. This association was implicated when the liver and biliary tract were not visualized after 99mTc-HIDA in a patient taking 3 g daily of nicotinic acid. We studied hepatic transport of 99mTc-PIPIDA both in vitro in isolated hepatocytes and in vivo in rabbits pretreated with nicotinic acid to further examine this association. Nicotinic acid increased uptake of PIPIDA by isolated hepatocytes and 7 days of nicotinic acid treatment in rabbits produced no abnormalities in hepatic uptake, gallbladder visualization, or biliary excretion of PIPIDA. We conclude that nicotinic acid does not have an inhibitory effect on uptake of biliary imaging agents and actually may be useful in enhancing hepatic imaging in patients with reduced liver function.

Animals↗

PubMed1980

Biliary excretion disorders in infants: evaluation using 99mTc PIPIDA.

A new class of hepatobiliary imaging agents has become available--the N-substituted iminodiacetic acids. After intravenous administration, these compounds are quickly extracted by the hepatocytes and rapidly excreted into the biliary tree. By using a 99mTc label, sufficient activity may be given to allow excellent gamma-camera imaging, 99mTc-labeled p-isopropylacetanilido-iminodiacetic acid (PIPIDA) has been used in the evaluation of infants with biliary excretion disorders, including two infants with neonatal hepatitis, three with intrahepatic cholestatic jaundice, and 10 with biliary atresia. Follow-up evaluation of surgically created portoenterostomies has been performed as well. In comparison with the previously available agent (131I rose bengal), the marked reduction in radiation to the liver alone should predicate the use of 99mTc PIPIDA. In addition, the speed of handling of this agent by the liver and the vastly improved imaging statistics make 99mTc PIPIDA a desirable agent for the evaluation of biliary excretion disorders in infancy.

Bile Ducts↗

PubMed1983

Effect of fasting and parenteral alimentation on PIPIDA scintigraphy.

Ten patients were prospectively studied using 99mTc-PIPIDA imaging to evaluate the effects of fasting and parenteral alimentation on gallbladder function. Three of ten patients had initial nonvisualization of the gallbladder for up to 2 hr, yet had normal visualization on repeat imaging performed after resumption of oral intake or after parenteral alimentation was discontinued. 99mTc-PIPIDA imaging should be interpreted with caution in patients fitting into either of these groups.

Adult↗

PubMed1981

Diagnosis of acute cholecystitis using hepatobiliary scan with technetium-99m PIPIDA.

Sixty patients were evaluated for acute abdominal pain using technetium-99m PIPIDA hepatobiliary imaging. The sensitivity of the test was 90.6 percent in all patients and the accuracy was 93.3 percent. In the evaluation of acutely ill patients with right upper quadrant pain, fever, nausea and vomiting, hepatobiliary imaging with PIPIDA is the preferred test for diagnosing acute cholecystitis. If the test is positive, disease of the gallbladder and probably acute cholecystitis are present. Early operation can proceed if desirable. If the test is negative and the bilirubin level is less than 5.0 mg/dl, acute cholecystitis is not present. In such cases conservative treatment is appropriate, and follow-up tests should be performed to evaluate the possibility of chronic cholecystitis. When the bilirubin level exceeds 5.0 mg/dl, the test is often indeterminate.

Abdomen, Acute↗

PubMed1982

Hepatobiliary scanning with 99mTc-PIPIDA in acute cholecystitis.

Ninety-five patients with clinically suspected acute cholecystitis underwent hepatobiliary scanning with 99mTc-PIPIDA. A positive scan (nonvisualization of the gallbladder with visualization of the common bile duct and gut) was found in 29 patients; 25 of them (86%) had surgically proven acute cholecystitis and 4 (14%) had chronic cholecystitis. Five of the 25 with acute cholecystitis had acalculous disease. A negative examination (gallbladder visualization) occurred in 63 patients; 18 (29%) had chronic cholecystitis and 45 (71%) were subsequently found to have nonbiliary disease. Three indeterminate studies (nonvisualization of both the gallbladder and gut) were obtained in patients with choledocholithiasis and chronic cholecystitis. In the evaluation of acute cholecystitis, the 99mTc-PIPIDA hepatobiliary scan was 100% sensitive and 94% specific.

Acute Disease↗

PubMed1982

PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition.

A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy.

Alcoholism↗

PubMed1981

Hepatobiliary scintigraphy with 99mTc-PIPIDA in the evaluation of neonatal jaundice.

Hepatobiliary scintigraphy with technetium 99m-labeled p-isopropylacetanilido iminodiacetic acid (99mTc-PIPIDA) was used to evaluate 22 neonates with mixed jaundice. Ten patients were proved to have biliary atresia; ten others were diagnosed as having neonatal hepatitis. In the remaining two, jaundice was secondary to prolonged hyperalimentation. Initial studies in all ten patients with biliary atresia showed no evidence of excretion of the tracer into the intestinal tract. Following three to seven days of oral administration of phenobarbital, repeat studies were performed in six of the ten patients. None showed evidence of excretion. Initial studies of the 12 patients with intrahepatic cholestasis showed definite excretion in five, questionable evidence of excretion in two, and no demonstrable excretion in five. Studies after phenobarbital therapy in five of the seven patients with questionable or no excretion on the initial studies showed definite excretion in four. Only in one patient who had poor hepatic extraction did the phenobarbital therapy not change the scintigraphic pattern. The authors conclude that hepatobiliary scintigraphy with 99mTc-PIPIDA after three to seven days of phenobarbital therapy is a highly accurate test for differentiating biliary atresia from other causes of neonatal jaundice.

Bile Ducts↗

PubMed1982

Characterization of spermatid/sperm basic chromosomal proteins in the genus Xenopus (Anura, Pipidae).

Spermatid/sperm basic chromosomal proteins from 17 species and subspecies of the genus Xenopus (Anura, Pipidae) were compared. Electrophoresis on acetic acid/urea/Triton X-100 polyacrylamide gels revealed that each Xenopus species with a diploid chromosome number of 36, 72, or 108 showed multiple, diverse spermatid/sperm-specific basic chromatin proteins with mobilities greater than the somatic histones. The numbers and mobilities of these proteins were characteristic of each Xenopus species and each subspecies of Xenopus laevis. Cytochemical tests revealed that the sperm basic nuclear proteins of these Xenopus species and subspecies were rich in arginine and lysine and contained more arginine than the nuclear proteins of somatic cells. X. tropicalis (2n = 20) and X. sp. n. (Zaire) displayed spermatid/sperm-specific basic chromatin proteins which migrated within the histone H1 region of acetic acid/urea/Triton X-100 polyacrylamide gels. Cytochemically the sperm nuclei of these species resembled those of somatic cells. These observations suggest that spermatid/sperm basic nuclear proteins can be used as molecular markers for individual species and subspecies of the genus Xenopus.

Animals↗

PubMed1985

PIPIDA scan diagnosis of traumatic rupture of the gallbladder.

Eighteen days after injury, a patient was evaluated for bilious ascites with a 99mTc-PIPIDA (paraisopropyliminodiacetic acid) scan. A ruptured gallbladder was shown, and this finding was confirmed at exploration. Radionuclide scanning offers a sensitive, non-invasive approach for delineating disruption of the biliary tract, and should be considered when such a defect is suspected.

Aged↗

PubMedDate not supplied

99mTc-PIPIDA cholescintigraphy in the diagnosis of gallbladder disease.

The efficacy of 99mTc cholescintigraphy in the diagnosis of gallbladder disease was studied in 116 patients. Sixty-one demonstrated gallbladder visualization (normal) and 55 had nonvisualization. In patients with acute abdominal pain, test sensitivity is 100%, specificity is 77%, and accuracy is 83% for the diagnosis of acute cholecystitis; no patient with gallbladder visualization had acute cholecystitis. Test sensitivity for any form of gallbladder disease is 66%, specificity is 82%, and accuracy is 71%; excluding patients with laboratory evidence of hepatobiliary disease, the predictability of acute or chronic cholecystitis increases to 100%. Cholescintigraphy demonstrated common bile duct patency in all eight post-cholecystectomy patients referred for evaluation of possible choledocholithiasis. Thus, gallbladder visualization with 99mTc-PIPIDA virtually excludes the diagnosis of acute cholecystitis, an abnormal test is a good predictor of gallbladder disease because of high specificity, and cholescintigraphy is extremely safe and simple to perform and may be used to demonstrate common bile duct patency.

Acute Disease↗

PubMed1979

99M Tc-PIPIDA biliary imaging in children.

A report of 99mTc-PIPIDA as a diagnostic biliary agent in children is presented. The laboratory values and radiologic examinations are included to demonstrate the clinical value of the agent in evaluating both congenital and acquired pediatric biliary tract abnormalities. The role of 99mTc biliary tract imaging in children is discussed.

Acetates↗

PubMed1982

Abnormal 99mTc-PIPIDA scans mistaken for common duct obstruction.

99mTc-PIPIDA scans were obtained in three patients with acute abdominal pain. The appearance of the scans suggested partial common duct obstruction. Two patients underwent surgery. One had acute appendicitis and the second had infarction of the distal ileum. In both cases, the gallbladder and biliary tract were normal. The third patient had been treated with morphine, which is known to increase biliary tract pressure and may cause contraction of the sphincter of Oddi. An ultrasound study of the gallbladder was normal and all symptoms resolved within 24 hours. Subsequently, three additional patients without biliary disease have been seen who had similar hepatobiliary scans. All three had received meperidine prior to the study. It is concluded that acute abdominal disease or the administration of morphine sulfate or meperidine can result in a scan pattern suggesting partial distal common duct obstruction in the absence of gallbladder or biliary tract disease.

Abdomen, Acute↗

PubMed1982

Evaluation of acute right upper quadrant pain: sonography and 99mTc-PIPIDA cholescintigraphy.

A group of 75 patients with acute right upper quadrant pain was evaluated with both sonography and cholescintigraphy. Accuracy in screening for gallbladder disease was significantly greater with sonography (96%) than with cholescintigraphy (74%). For selecting patients with acute cholecystitis from this population that included acute and chronic cholecystitis as well as nonbiliary pathology, PIPIDA was less accurate (77%) than might be expected based on previous reports primarily due to false positive nonvisualization caused by chronic cholecystitis. Of patients with nonbiliary pathology, sonography was able to detect the cause of the right upper quadrant pain in 21%. Patients with acute right upper quadrant pain should first be screened with sonography. If cholescintigraphy is subsequently used for suspected acute cholecystitis, positive results should be interpreted with caution before surgery is planned.

Acute Disease↗

PubMed2000

Ontogeny of the bizarre: an osteological description of Pipa pipa (Anura: pipidae), with an account of skeletal development in the species.

The adult osteology of the direct-developing pipid frog, Pipa pipa, is described based on cleared-and-stained and dry skeletal specimens. Observations on skeletal development are based on cleared-and-stained embryos and young removed from the backs of preserved females. Osteologically, P.pipa is distinguished from its congeners and other pipid anurans by its large size and peculiar skull, which is extremely depressed and hyperossified. Skulls of the smallest individuals are not significantly different from those of other basal anurans at a similar stage of development; comparisons are made with Bombina orientalis, Discoglossus sardus, Spea bombifrons, Rhinophrynus dorsalis, and Xenopus laevis. The general sequence of chondrification and ossification resembles that of X.laevis; however, there is evidence that the mandible forms earlier in Pipa than in Xenopus. The major allometric transformations that result in the morphologically bizarre skull of adult P.pipa commence after the embryo has resorbed its tail, an event interpreted as marking the end of metamorphic climax in this taxon. In addition, ontogenetic comparisons reveal that the sacrum forms differently in Discoglossus sardus,Silurana tropicalis, and P.pipa. The development of the sphenethmoid region of the skull is the same in P.pipa and X.laevis, and distinctly different from the development of this region of the skull in other non-pipid basal anurans and neobatrachians for which ontogenetic descriptions exist.

Animals↗