Peristomal pyoderma gangrenosum and inflammatory bowel disease.

Pyoderma gangrenosum (PG) is a debilitating skin disease most often associated with inflammatory bowel disease and is a reportedly rare cause of peristomal ulceration. The lesions of PG rapidly evolve from small, erythematous pustules to deep, painful, pyogenic ulcers within hours to days of onset. Although the behavior and the appearance of the lesions of peristomal PG are diagnostic, a lack of familiarity with PG often leads to misdiagnosis and inappropriate therapy.

Establishment and characterization of two Merkel cell tumor cultures.

Two Merkel cell tumor cultures (MC-MA1, MC-MA2) have been established from metastases of typical Merkel cell tumors. The mestastases in vivo were characterized by co-expression of cytokeratins 8, 18, 19, 20 and neurofilaments, presence of intermediate filament whirls, expression of synaptophysin, neuron-specific enolase, and chromogranin A, rare and weak immunostaining for plakoglobin but absence of cadherins and desmoplakins. Both cultures grow, using supplemented RPMI medium on human irradiated fibroblast feeder layers, as loosely arranged floating small aggregates.

Staff radiation doses during eight years in a nuclear medicine radiopharmacy.

It is important that staff radiation doses be kept 'as low as reasonably achievable' (ALARA). Staff working in the radiopharmacy and nursing staff responsible for injecting radionuclides are being monitored constantly in our department. We report here on the effective doses and doses to the hands received by staff at two hospitals during 8 years from January 1985 to December 1992.

Verification of a varying threshold edge detection SPECT technique for spleen volume: a comparison with computed tomography volumes.

SPECT enables quantitation of organ volume with radionuclide techniques using threshold edge detection methods. Previous phantom studies showed that a negative correlation exists between volume and threshold value. In those studies, the use of calibration curves were believed to correct for volume dependence on threshold values.

Laparoscopic cholecystectomy: comparison of university and community experience.

We compared the first year's experience in performing laparoscopic cholecystectomy in a university hospital and a community hospital to determine the impact of postgraduate surgical training on outcome. Laparoscopic cholecystectomy was attempted on 446 patients. The conversion rate to open cholecystectomy was 8.

The channel ratio method of scatter correction for radionuclide image quantitation.

The accuracy of quantitation of radionuclide distributions in human tissue with the scintillation camera is decreased by attenuation and scatter of photons. If scatter correction is applied satisfactorily, narrow beam attenuation can be applied. In this article, a scatter correction technique, the channel ratio (CR) method, is introduced.

The influence of platelet-graft interaction on platelet survival in patients with aortobifemoral Dacron grafts.

In patients with arterial grafts, platelet consumption may be due either to platelet interaction with the graft, and/or concomitant platelet consumption in the rest of the arterial tree. This hypothesis was tested by quantifying the kinetics and platelet-graft interaction of indium-111-labelled platelets with double velour Dacron grafts in 13 patients with arterial insufficiency ascribed to atherosclerosis. Mean platelet lifespan (MPLS), 149 +/- 46 hours, was significantly shorter (P = 0.

The effects of different correction techniques on absolute volume determination with SPECT using a threshold edge detection method.

Quantitation of planar radionuclide images is hampered by structures containing radioactivity which overlie or underlie the organ of interest. The introduction of single photon emission computerized tomography (SPECT) overcame this problem to a large extent and enhanced the contrast of the images. Attenuation of photons, however, degrades the resultant SPECT images and correction methods for photon absorption and scatter were subsequently proposed.

Use of a personal computer for fast acquisition of cardiovascular data over an extended period.

This paper describes data collection during open chest cardiovascular research based on an IBM compatible personal computer. Data from eight analogue data channels are collected at a rate of 500 Hz per channel for a period of more than 40 sec per run. General analysis functions include the integration of the data obtained from any channel as well as an exponential curve fitting routine.

A comparison of the clinical relevance of thallium-201 and technetium-99m-methoxyisobutyl-isonitrile for the evaluation of myocardial blood flow.

Thallium-201 is at present the radiotracer of choice for the clinical evaluation of myocardial blood flow. Although different technetium-99m-isonitrile agents have been synthesised recently, only 99mTc-methoxyisobutyl-isonitrile (99mTc-MIBI) has proved to hold promise for clinical implementation. The myocardial distribution of 201Tl and 99mTc-MIBI was compared in a group of 20 patients, who underwent both 201Tl single photon emission computed tomography and 99mTc-MIBI study as well as coronary angiography.

[A comparison of three different techniques for measuring glomerular filtration rate].

The clearance of inulin, creatinine and radioactive tracers from the blood may be used to measure glomerular filtration rate (GFR). These techniques, however, are usually invasive and time-consuming. Although the clearance of a radioactive tracer is usually applied in nuclear medicine for the determination of GFR, it is also possible to convert the concentration of the tracer in the kidneys to absolute GFR by means of a regression equation.

Leak after vertical banded gastroplasty.

We have reported the case of a morbidly obese patient who became gravely ill during the first day after vertical banded gastroplasty. The diagnosis of a leak from the stomach was established by a Gastrografin swallow, and ten additional operations were done before the patient was discharged on the 135th postoperative day.

99mTc ethoxy methylpropyl isonitrile: a radioactive tracer for myocardial perfusion imaging.

The initial experience with a new 99mTc labelled myocardial perfusion agent, ethoxy methylpropyl isonitrile (EMI), is described in the primate as model. Rapid biliary clearance of EMI ensures low radionuclide concentration in the liver and lungs after 60 min. Adequate visualization of the myocardium is therefore possible.

Evaluation of left ventricular contractility indexes for the detection of symptomatic and silent myocardial ischemia.

This study evaluated the role of left ventricular (LV) ejection fraction and systolic blood pressure (BP) to end-systolic volume ratio to detect symptomatic and silent myocardial ischemia. The sensitivity and diagnostic accuracy of these contractility indexes were compared with angina and ST depression during exercise. Thirty consecutive patients referred for chest pain performed symptom-limited bicycle exercise and had coronary angiography within 3 months.

Daily serial evaluation of left ventricular function with equilibrium radionuclide ventriculography following thrombolysis during acute myocardial infarction.

The changes in ventricular function after reperfusion by coronary thrombolysis are important when deciding about further definitive treatment necessary to ensure long-term vessel patency. The purpose of this study was to evaluate the early changes in left ventricular function after reperfusion. Left ventricular function was serially evaluated for 10 days in a group of 18 patients receiving intracoronary thrombolytic therapy for an acute myocardial infarction.

Leaks occurring after gastric bariatric operations.

A leak from the stomach is the most serious complication that occurs after a gastric bariatric operation. The experience with 19 leaks that occurred after 791 gastric bariatric operations performed at North Carolina Memorial Hospital from 1975 to 1986 is described. The incidence of leaks was higher (8.

The effects of nisoldipine on left ventricular filling rate in patients with ischemic heart disease measured with radionuclide gated blood pool scintigraphy.

Nisoldipine is a newly developed calcium channel blocker with outstanding vasodilatory properties especially with regard to the coronary arteries. Thus it may find wide-spread application as a therapeutic agent in various ischemic heart disease syndromes. The purpose of this study was to evaluate the effect of nisoldipine on the diastolic function of the left ventricle (LV) in the clinical situation.

Absolute left ventricular volume changes after sublingual nitroglycerine and nifedipine intervention.

The haemodynamic effects of two vasodilators, sublingual nitroglycerine and nifedipine, on absolute end-diastolic volume, end-systolic volume, stroke volume (SV), heart rate, systolic blood pressure (SBP), cardiac output (CO) and corresponding cardiac indices were measured in two different groups, each consisting of 20 ischaemic heart disease patients, with gated blood pool scintigraphy. A control study was done in 5 ischaemic heart disease patients without intervention. Direct measurement of left ventricular (LV) volume was done by correcting LV activity for tissue attenuation utilising a geometric method.

Cholecystectomy in morbidly obese patients.

Indications for performing cholecystectomy simultaneously with a gastric bariatric operation remain controversial. The extremes are to always perform cholecystectomy or to perform cholecystectomy only when there are palpable stones or the gallbladder is grossly diseased. Since 1975, 136 cholecystectomies have been performed simultaneously in 724 patients who had a gastric bariatric operation.

A comparison of the acute hemodynamic effects of nifedipine and nisoldipine in patients with ischemic reduced left ventricular function.

Nisoldipine (BAY k 5552) like nifedipine, is a dihidropyridine compound with strong calcium blocking activity. The purpose of this study was to measure and compare the absolute hemodynamic effects of these two drugs before and at 30 min, 60 min and 120 min after oral intake in 20 ischemic heart disease patients with radionuclide gated cardiac scintigraphy. No significant change was seen in end diastolic volume index with either of the drugs.

Digitizing and signal averaging of left ventricular pressure signals using a dedicated radionuclide imaging system.

A method for obtaining left ventricular (LV) volume curves, synchronized with average LV pressure (LVP) curves for calculation of LV contractility, is described. Multiple gated blood pool imaging was performed to calculate average LV volume curves. Simultaneously with this acquisition, LVPs and aortic pressures were measured by indwelling catheters and recorded on an FM tape recorder.