Three-dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma.

Conservative surgery combined with radiation therapy for the treatment of early breast carcinoma has been shown to achieve both a high rate of local tumor control and good cosmetic results with a minimum of complications. Whether the internal mammary lymph nodes (IMNs) should be included in the treatment volume is a topic of considerable controversy. Radionuclide internal mammary node lymphoscintigraphy (IMN-LS) can locate these nodes in three dimensions.

The urologic manifestation of the tethered spinal cord.

The tethered spinal cord is an entity with potentially grave neurologic implications. Presenting urologic symptoms include incontinence, symptomatic urinary tract infections and stool soiling. These symptoms may be the first to herald a tethered cord.

The endoscopic correction of reflux by polytetrafluoroethylene injection.

Endoscopic subureteral injection of polytetrafluoroethylene (Teflon) was done in 38 patients (55 ureters) to correct vesicoureteral reflux. Followup excretory urograms and nuclear cystograms were available in 28 patients (40 ureters) 2 to 11 months after injection. Nearly 50 per cent of the patients had a neurogenic bladder.

Lymphoma: evaluation with Ga-67 SPECT.

To determine the value of gallium-67 single photon emission computed tomography (SPECT) in imaging patients with lymphoma, the authors compared Ga-67 planar images and SPECT images in 40 consecutive patients, using radiologic examinations and/or medical records to confirm the presence or absence of disease. Thirty-three patients had Hodgkin disease, and seven had non-Hodgkin lymphoma. Fifty-four examinations were performed.

Thallium-201 brain tumor imaging: a comparative study with pathologic correlation.

In patients with gliomas who were stable or improving, we noted a disparity between clinical status and computed tomography (CT) brain scan results. To elucidate this finding, 29 patients were sequentially scanned with 2.0 mCi of 201Tl (5-30 min), 20 mCi [99mTc]gluceptate (GH) (3-4 hr) and 7-10 mCi 67Ga (48-72 hr).

Intravesical transurethral bladder stimulation.

Intravesical transurethral bladder stimulation is a rehabilitative and diagnostic technique for the neurogenic bladder. The goal of therapy is threefold: to achieve the sensation of bladder filling or the urge to void, to initiate a detrusor contraction and to achieve conscious urinary control. The procedure combines the direct electrical stimulatory effect to bladder receptors, with the significant use of visual biofeedback by the patient's observation of a water manometric representation of their detrusor response.

Intravesical transurethral electrotherapy for the neurogenic bladder.

Intravesical transurethral bladder stimulation is a rehabilitative and diagnostic technique for the neurogenic bladder. The goal of therapy is 3-fold: 1) to achieve the sensation of bladder filling or the urge to void, 2) to initiate a detrusor contraction and 3) to achieve conscious urinary control. The procedure combines direct electrical stimulation of bladder receptors with visual biofeedback using patient observance of a water manometric representation of the detrusor response.

Pharmacokinetics of radiolabeled monoclonal antibody B6.2 in patients with metastatic breast cancer.

Thirteen patients with metastatic breast carcinoma were given injections of 50-1593 micrograms of 131I-monoclonal antibody (MAb) B6.2 immunoglobulin G and F(ab')2 for pharmacokinetic evaluation and radioimmunoimaging. Blood clearance of the 131I-MAb-B6.

Role of 99mTc methylene diphosphonate bone imaging in the management of lymphoma.

The role of modern techniques of 99mTc methylene diphosphonate bone imaging in the management of lymphoma patients was assessed by comparing results of 107 bone scans in 16 patients with Hodgkin's disease, and 45 patients with non-Hodgkin's lymphoma to simultaneous radiologic, clinical, and histopathologic features as well as to subsequent disease course. The sensitivity and specificity were both greater than or equal to 0.96 in both Hodgkin's disease and non-Hodgkin's lymphoma and the overall accuracy by site was 98%.

Clinical comparison of two radiocolloids for internal mammary lymphoscintigraphy.

Recent studies suggest that 99mTc-labeled radiocolloid (SC) compounded with hydrogen sulfide can be used to visualize lymph channels and nodes. Our study prospectively compared SC with 99mTc antimony sulfide (SbS) colloid, in 28 patients undergoing internal mammary lymphoscintigraphy. Images were recorded on a scintillation camera and computer at 0.

Clinical significance of solitary rib lesions in patients with extraskeletal malignancy.

A retrospective review of 2,851 bone scans done at a cancer center over a period of 4 yr revealed 41 patients having a single abnormality in a rib as their first abnormal scintigraphic finding. The scan findings in these cases were correlated with clinical, scintigraphic, and radiographic follow-up to ascertain their etiology and course. Four lesions (9.

Disseminated bilateral chorioretinitis due to Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome.

A 31-year-old white male homosexual was healthy until March 1984, when he developed Pneumocystis carinii pneumonia, which resolved with treatment. In April 1984 he developed fever, followed by hepatosplenomegaly, headaches, blurred vision, pancytopenia and pulmonary infiltrates. On June 11, intracytoplasmic yeast were noted within leukocytes on a peripheral blood smear, and amphotericin B was started.

Zygomycosis. Report of four cases with formation of chlamydoconidia in tissue.

The authors describe spheric to ovoid chlamydoconidia and mucoraceous hyphae in tissues from four patients, two with cutaneous and two with pulmonary zygomycosis. The diagnosis in each case was confirmed by immunofluorescence staining and the presence of characteristic hyphae in tissue. It is important that these conidia be recognized, because they can easily be mistaken for other fungi, nematode ova, or other microorganisms in tissue sections, thereby resulting in the potential for misdiagnosis.

Mycotic keratitis in a dog: concurrent Aspergillus sp and Curvularia sp infections.

A dog with exposure keratopathy developed secondary bilateral keratitis from which Aspergillus sp and Curvularia sp were identified. Mycotic keratitis, while rare in the dog, should be considered in the differential diagnosis of keratitis.

Management of myelomeningocele.

The care of the patient with myelomeningocele has improved over the last 15 years. Early diagnosis of urodynamic abnormalities and close monitoring of the urinary tract by ultrasonography have allowed the institution of prompt, effective therapy before upper-tract deterioration can occur. The wide acceptance of clean intermittent catheterization can in most circumstances eliminate the need for urinary diversion.

Radioiodinated B6.2 monoclonal antibody: further characterization of a potential radiopharmaceutical for the identification of breast tumors.

A monoclonal antibody (B6.2) directed against human breast carcinomas and its F(ab')2 and Fab' fragments were labeled with 125I using Iodogen. Solid phase radioimmunoassay was used to evaluate the in vitro binding of the labeled antibodies to a human breast tumor metastasis to the liver, the MCF-7 breast tumor cell line and normal liver tissue.

Pulmonary uptake of technetium 99m macroaggregated albumin: a predictor of gastrointestinal toxicity during hepatic artery perfusion.

Hepatic artery infusion of 5-fluoro-2-deoxyuridine (5-FUdR) provides high hepatic drug levels but little systemic toxicity, since, by this route of administration, the drug is detoxified by the hepatocytes. Slow infusion of technetium 99m- (99mTc) labeled macroaggregated albumin (MAA) through the hepatic artery is an aid in catheter placement, in predicting response of liver metastases to therapy, and in identifying extra-hepatic flow in the gastroduodenal or splenic arteries as an indicator of systemic toxicity. Marked pulmonary uptake of this tracer after slow radionuclide hepatic angiography was noted in four patients who showed major gastrointestinal (GI) toxicity.

Subcutaneous phaeohyphomycosis caused by Exophiala spinifera.

The second human subcutaneous infection due to Exophiala spinifera from the United States is described. Identification was based on the morphology of the fungus in tissue and the morphological features of the culture obtained from the biopsy material. Correct diagnosis and treatment with ketoconazole and 5-fluorocytosine cured the infection.

Development of fluorescent-antibody reagents for demonstration of Pseudallescheria boydii in tissues.

We prepared fluorescent-antibody reagents to detect and identify Pseudallescheria boydii in tissue. Antisera to broken mycelium and condidia (particulate antigens) and to culture filtrates (soluble antigens) of P. boydii were produced in rabbits.