Does the dose of iodine-131 influence the incidence of Graves' ophthalmopathy?

Background: Radioactive iodine-131 (RAI) is an established treatment for patients with Graves' hyperthyroidism. RAI is reported to be associated with a 20-30% incidence of development or exacerbation of Graves' ophthalmopathy (GO). This study compares the progression of GO in patients who had evidence or no evidence of GO before RAI therapy.

Dynamic antral scintigraphy to characterize gastric antral motility in functional dyspepsia.

Unlabelled: We evaluated intragastric food distribution and antral motor activity in patients with functional dyspepsia.

Methods: A standard gastric emptying test and dynamic imaging of the antrum were used to characterize gastric antral motility disturbances and to correlate them with total and compartmental gastric emptying in 25 dyspeptic patients.

Results: We found a 40% prevalence of gastroparesis in functional dyspepsia.

Scintigraphic imaging of oncogenes with antisense probes: does it make sense?

Based on the specificity of the Watson-Crick base pairing formation, antisense deoxyoligonucleotides have been used to inhibit the expression of oncogenes in various cancer cells. Activation of an oncogene by means of amplification leads to an increased, detectable amount of the mRNA transcript in the cytoplasm. The aim of this study was to demonstrate that cells which are expressing a particular mRNA transcript do preferentially and specifically retain the antisense probe targeting that mRNA.

Characterization of gastric antral motility disturbances in diabetes using a scintigraphic technique.

In this study, food distribution in the stomach and gastric antral motor activity in patients with longstanding diabetes have been evaluated. With use of a standard gastric emptying test with an acquisition protocol and a refined Fourier algorithm to analyze the data, antral contractions have been characterized and gastric motility parameters were correlated to gastric retention in 20 diabetic patients with or without gastroparesis and in 10 healthy subjects. The results of this study show that, in longstanding diabetes, gastric emptying retardation is accounted for by a retention of food in the proximal stomach, which is reflected by a prolonged lag phase as well as by a reduction in antral motor activity that is determined by a decrease in the amplitude of the antral contractions.

Effect of ethyl alcohol on motor function in canine stomach.

The aim of this study was to elucidate the effects of ethanol on gastric emptying and the trituration of solid food. With the use of a noninvasive physiological imaging technique, gastric processing of a radiolabeled solid meal was evaluated in unanesthetized dogs which ingested 6-8% ethanol solutions or received intravenous alcohol before the meal. Oral alcohol (resulting in blood levels up to 174 mg/dl) decreased the amplitude of antral contractions or completely abolished them.

Quantitative distribution of radiolabeled 5-aminosalicylic acid enemas in patients with left-sided ulcerative colitis.

Rectally administered suspensions of 5-aminosalicylic acid (5-ASA) are topically effective in treating left-sided ulcerative colitis. The extent to which the contents of these enemas are distributed to inflamed mucosal linings has not previously been determined. This study was undertaken to validate a technique for labeling 5-ASA with 99mTc and to quantitate the distribution of [99mTc]5-ASA in eight patients with left-sided ulcerative colitis.

Cisapride accelerates colonic transit in constipated patients with colonic inertia.

A double-blind cross-over trial of oral cisapride 10 mg before meals and placebo was performed to determine its effects on colonic transit in patients with severe idiopathic constipation. Nine patients with less than 3 spontaneous bowel movements/wk were studied. After passing a tube to the cecum, 50 muCi of 111In-DTPA were instilled into the cecum and followed for 48 h using colonic transit scintigraphy.

The two-component stomach: effects of meal particle size on fundal and antral emptying.

Using a dual-headed gamma camera and a standardized egg test meal labeled with 99mTc-sulfur colloid, the quantitative emptying of the total, proximal and distal stomach in five normal subjects was characterized. The same egg meal was given to the volunteers in 3 different forms: homogenized, and as 2.5 mm and 5.

Scintigraphic evaluation of gastric emptying: are radiolabeled solids necessary?

A standard, dual-isotope meal (Tc-99m-egg sandwich and In-111 DTPA in water) was administered to 14 normal volunteers and 37 patients, who had not undergone gastric surgery, to determine if the emptying characteristics of the liquid phase alone could accurately predict delayed solid emptying. Delayed gastric emptying was defined clinically as a solid half-emptying time more than two standard deviations greater than the mean for normal volunteers. Linear regression analysis was performed on the natural logarithm of liquid fractional retention at each time interval to yield a slope and y-intercept for each subject.

Quantitative measurement of feline colonic transit.

Colonic transit scintigraphy, a method for quantitatively evaluating the movement of the fecal stream in vivo, was employed to evaluate colonic transit in the cat. Scintigraphy was performed in duplicate in five cats and repeated four times in one cat. After instillation of an 111In marker into the cecum through a surgically implanted silicone cecostomy tube, colonic movement of the instillate was quantitated for 24 h using gamma scintigraphy.

Role of opiate receptors in the regulation of colonic transit.

The effects of morphine and the opiate antagonist naloxone on human colonic transit were investigated. In a crossover, double-blind fashion, two groups of 6 normal volunteers were studied using colonic transit scintigraphy during the administration of a test drug or control. The test drugs were morphine (0.

Selenium-75-labeled sucralfate: comparison with other radiolabels and initial clinical studies.

Sucralfate was synthesized to include a 75Se label, then compared with 111In-sucralfate and 99mTc-Human serum albumin (HSA)-sucralfate in vitro and in an animal ulcer model. The 75Se label was the only one of the three that was stable in both human gastric juice and simulated intestinal fluid in vitro. In rats with gastric ulcers, ulcer:nonulcer ratios of bound radioactivity averaged 15.

Biphasic nature of gastric emptying.

The existence of a lag phase during the gastric emptying of solid foods is controversial. It has been hypothesised that among other early events, the stomach requires a period of time to process solid food to particles small enough to be handled as a liquid. At present no standardised curve fitting techniques exist for the characterisation and quantification of the lag phase or the emptying rate of solids and liquids.

Use of 111In-labeled alginate to study the pH dependence of alginic acid anti-esophageal reflux barrier.

Mixtures of alginic acid and antacid, when given orally, react with gastric acid to form a viscous barrier (raft) which floats on the surface of the gastric contents. 111In was used to label magnesium alginate in order to study the effect of gastric acidity on the extent of formation of the raft. In vitro, acid concentrations less than 0.

Effects of meal composition on gallbladder and gastric emptying in man.

Cholecystogastric scintigraphy, utilizing [99mTc]HlDA to label the gallbladder contents and [111In]DTPA to label different meals, was utilized to determine the relationships between gallbladder and gastric emptying after meals of differing composition. Gallbladder emptying was determined in response to a multicomponent meal and to monocomponent fat, carbohydrate, and protein meals and in response to isotonic and hypertonic dextrose and isotonic and hypertonic saline. Also, the gallbladder emptying responses to equivalent multicomponent solid and liquid meals were compared.

MR imaging in thyroid disorders: correlation of signal intensity with Graves disease activity.

Thirty-six patients with a variety of thyroid disorders and eight healthy subjects were studied with T1- and T2-weighted magnetic resonance (MR) imaging. Solid benign nodules, malignant tumors, and inflammatory conditions were not distinguishable by thyroidal MR signal intensity, but almost all patients with Graves disease had a moderate to marked diffuse increase in signal intensity at both settings. Quantitative evaluation showed that in these patients, the thyroid-muscle signal intensity contrast ratio was linearly related to both the serum thyroxine (T4) level and the 24-hour radioactive iodine uptake.

The effect of oral cisapride on colonic transit.

A prospective double-blind cross-over trial of oral cisapride 10 mg and placebo was performed to determine the effects of cisapride on the transit of colonic contents in normal humans. Six male volunteers were studied twice using colonic transit scintigraphy. After passing a tube to the caecum, 50 mu Ci of 111Indium diethylene triamine pentaacetic acid were instilled into the bowel lumen.

Effects of somatostatin on gallbladder emptying.

Because approximately 80% of reported patients with somatostatinomas have gallstones, this study was performed to determine the effects of exogenous somatostatin on gallbladder emptying responses to liquid and solid meals, direct cholinergic stimulation by bethanechol, indirect cholinergic stimulation by sham feeding, and intravenously administered octapeptide of cholecystokinin. Gallbladder emptying was quantitated using 99mTc-HIDA and a gamma-camera on line to a digital computer. Somatostatin, administered at a dosage of 7 micrograms/kg X h, prevented the gallbladder emptying responses to both test meals, sham feeding, and bethanechol.

Colonic transit scintigraphy. A physiologic approach to the quantitative measurement of colonic transit in humans.

Colonic transit scintigraphy was developed to quantitatively evaluate colonic transit. Using this technique the progression of a radiolabeled marker from cecal instillation to defecation was studied in 7 normal male volunteers. An 8-ml bolus containing 50 mu Ci of indium 111-diethylene triamine pentaacetic acid was instilled into the cecum via a 2-mm tube, which was passed orally, and serial scintigrams were obtained over 48 h.

Infection in diabetic osteoarthropathy: use of indium-labeled leukocytes for diagnosis.

Indium-111 labeled leukocyte imaging was compared with three-phase skeletal scintigraphy as a means of determining whether osteomyelitis was complicating diabetic osteoarthropathy. Three-phase scintigraphy demonstrated increased activity in both infected and noninfected osteopathic bone, with a sensitivity of 75% and a specificity of 56% for osteomyelitis. Leukocyte imaging had the same sensitivity but was most helpful for excluding infection (specificity, 89%) when three-phase imaging could not.

Gallbladder emptying response to sham feeding in humans.

Cholescintigraphy, using 99mTc-HIDA, was employed to determine the gallbladder emptying response to sham feeding of a steak and potato meal, and to compare it with the emptying responses to direct cholinergic stimulation by bethanechol and to ingestion of the test meal. The maximal cumulative gallbladder emptying response to sham feeding was 44.1% + 10.

Scintigraphic techniques for the study of gastrointestinal motor function.

A variety of scintigraphic techniques has been added to the gastroenterologist's armamentarium for the evaluation of motor dysfunction of the upper gastrointestinal tract and hepatobiliary tree. These methods include: esophageal transit scintigraphy for the measurement and quantitation of aboral movement of liquids through the esophagus, and for the measurement of esophageal clearance; gastroesophageal reflux scintigraphy for the detection and quantitation of gastroesophageal reflux, gastric scintigraphy for the physiological measurement of the simultaneous rates of emptying of liquids and solids from the stomach; hepatobiliary scintigraphy for the detection of acute cholecystitis, biliary tract obstruction, bile leaks; and enterogastric reflux scintigraphy for the detection and quantitation of bile reflux from the small bowel into the stomach. Each of these methods is relatively physiologic in comparison to other modalities in that none requires intubation or other nonphysiologic maneuvers.

Cholinergic effects on gallbladder emptying in humans.

The role of cholinergic mechanisms in the control of gallbladder emptying has not been defined. In this report a scintigraphic technique using 2,6-dimethylphenylcarbamoylmethyl iminodiacetic acid labeled with technetium 99m to visualize the gallbladder and its emptying and diethylenetriamine pentaacetic acid labeled with indium 111 to visualize the stomach and its emptying was used to study 43 normal subjects and 18 patients with vagotomies. Direct cholinergic stimulation with bethanechol induced significant gallbladder emptying.

Fragment E1 labeled with I-123 in the detection of venous thrombosis.

Fragment E1, which has been shown to have specific binding affinity for thrombi in an animal model, was investigated in humans for its safety and ability to bind to venous thrombi. Human Fragment E1 was labeled with I-123 and administered intravenously to patients with proved or suspected deep vein thrombosis. The vascular distribution of radioactivity was documented by obtaining gamma camera images of the patients' legs for 30 minutes following administration of I-123-Fragment E1.