Endotoxic shock and its effects on hepatobiliary scanning in dogs.Hughes, K S; Marrangoni, A G; Thompson, D R; Turbiner, E
doi: N/Apmid: 6348871
Hepatobiliary scans were obtained with Tc-99m-disofenin in 15 dogs. Of these, 5 served as controls, 5 were infused with E. coli endotoxin for 4 hours (endotoxic shock group), and 5 were bled to a mean pressure similar to that of the endotoxic shock group (hemorrhagic shock group). Scans of the controls and hemorrhagic shock group were identical. Scans of the endotoxic shock group were markedly abnormal, with a prolonged hepatic phase and little excretion of isotope into the biliary tract, a pattern characteristic of mechanical obstruction of the common bile duct. These results should alert the clinician to the potential danger of abnormal hepatobiliary scans in the septic patient.
Biopsy needle characteristics assessed in the laboratory.Andriole, J G; Haaga, J R; Adams, R B; Nunez, C
doi: N/Apmid: 6878680
Radiologists are frequently called upon to perform percutaneous biopsy. Selection of the proper needle is becoming more complex as the number of types increases and reports of better results with certain needles proliferate. The authors evaluated a wide variety of needles of different caliber, cutting tip, and bevel. Using a standard biopsy technique for in vitro specimens, the samples were analyzed quantitatively by precise weight measurement and qualitatively by cytopathological means. It was concluded that large-bore needles were superior to "skinny" needles, and small-bore needles having an acute bevel angle were superior to flat-bevel needles of similar gauge in terms of specimen size and preservation.
CT of the oropharynx, tongue base, and floor of the mouth: normal anatomy and range of variations, and applications in staging carcinoma.Muraki, A S; Mancuso, A A; Harnsberger, H R; Johnson, L P; Meads, G B
doi: N/Apmid: 6878693
CT scans of 35 patients were obtained during rapid drip infusion of contrast material to determine the range of normal variation in the structures of the oropharynx and the floor of the mouth. Superficial structures such as the tonsillar pillars and lingual and faucial tonsils vary so much in appearance that they are not useful indicators in the detection of subtle lesions; in fact, they are potential sources of "pseudomasses." Asymmetric obliteration of the parapharyngeal space is useful for the detection of subtle lesions of the upper tonsillar fossae; however, confident diagnosis in regard to the lower oropharynx depends on visualization of a mass lesion or loss of the more constant planes in the floor of the mouth and the tongue base. CT findings added unique and valuable information in eight of 12 cases of carcinoma, confirmed the clinical impression of the extent of the lesion in four cases, and were potentially misleading in one case. CT is a valuable adjunct to the detection and staging of an oropharyngeal malignancy.
Tc-99m labeled leukocytes: preparation and use in identification of abscess and tissue rejection.Farid, N A; White, S M; Heck, L L; Van Hove, E D
doi: N/Apmid: 6308712
A simple and reproducible method for the preparation and labeling of leukocytes with Tc-99m has been developed. Leukocytes were separated from blood, incubated with stannous pyrophosphate, and then with 20-30 mCi (740-1110 MBq) of 99mTcO-4. In leukocytes separated from human blood, the labeling efficiency was 81% +/- 6% (n = 4). Experiments on dogs with abscesses showed accumulation of the Tc-99m-labeled leukocytes in the infected sites, indicating the viability of the labeled leukocytes. Additional studies showed that rat lymphocytes that were labeled with Tc-99m, using the same technique, localized in heart transplant tissue that was being rejected.
Selective streptokinase infusion: clinical and laboratory correlates.Mori, K W; Bookstein, J J; Heeney, D J; Bardin, J A; Donnelly, K J; Rhodes, G A; Dilley, R B; Warmath, M A; Bernstein, E F
doi: N/Apmid: 6878683
Selective intra-arterial infusions of streptokinase (SK) were made in 50 arteries of 45 patients with a variety of acute thromboembolic conditions. The most common regimen was 5,000 units of SK/hour for 24 to 48 hours with a simultaneous heparin infusion of 250 to 500 units/hour. Significant lysis occurred in 80% of cases, with 74% of the patients benefiting clinically. Minor bleeding, usually from puncture sites, occurred in 30% of the patients. Major hemorrhages, requiring transfusion or surgery, developed in four patients (8%). No hemorrhagic strokes or fatalities were directly attributable to SK infusion. Coagulation parameters were determined before infusion, 4 and 24 hours after infusion, and every 24 hours thereafter. Significant alterations of coagulation parameters developed promptly, but were not very useful in predicting either clinical response or hemorrhage. Selective intra-arterial infusion of SK is a moderately effective and safe therapeutic technique in acute peripheral arterial thromboembolic disease. A comparison with prior reports suggests that selective low-dose infusion provides a moderate gain in benefit-risk ratio over systemic infusion.
Massive pulmonary embolism: treatment with full heparinization and topical low-dose streptokinase.Vujic, I; Young, J W; Gobien, R P; Dawson, W T; Liebscher, L; Shelley, B E
doi: N/Apmid: 6878682
Three patients with massive pulmonary embolism were treated with low-dose streptokinase (delivered topically via the pulmonary artery) and simultaneous full-dose heparin. In two patients with acute emboli, rapid but incomplete lysis was observed over 15-30 hours. In one patient with recurrent embolization over three weeks, the major embolus shrank considerably. Pulmonary artery pressure and angiographic findings improved significantly in both patients with acute emboli. In the patient with old embolus, pulmonary artery pressure did not improve despite considerable improvement in angiographic findings and arterial PO2. These data suggest that early topical administration of low-dose streptokinase plus full-dose heparin may be the treatment of choice for patients with massive pulmonary embolism, particularly those with compromised cardiopulmonary status.
Tarsal navicular stress fractures: radiographic evaluation.Pavlov, H; Torg, J S; Freiberger, R H
doi: N/Apmid: 6224230
Tarsal navicular stress fractures are a potential source of disabling foot pain in physically active individuals. The diagnosis of tarsal navicular stress fracture requires a high index of clinical and radiographic suspicion because the fracture is only rarely evident on routine radiographs or standard tomograms. The radiographic diagnosis of a tarsal navicular stress fracture may require anatomic anteroposterior tomograms or a radionuclide bone scan with plantar views. Radiographic examinations of 23 fractures in 21 patients are evaluated.