Reflex sympathetic dystrophy in cervical spinal cord injury patients.

Sixty consecutive patients admitted to the spinal cord injury unit at a Downey, California medical center were evaluated for hand and upper extremity pain. Patients averaged nine months postinjury and had an average age of 37 years. Seven patients (11.

Demonstration of hydrothorax by intraperitoneal injection of technetium-99m MAA in the evaluation of peritoneovenous shunt patency.

A case of hydrothorax in a patient with recurrent ascites following Le Veen peritoneovenous shunt placement is presented. Patency of the Le Veen shunt was studied by the intraperitoneal injection of Tc-99m MAA with subsequent activity seen in the right hemithorax only. A standard perfusion lung scan showed only the left lung to be perfused.

Effect of esophageal variceal sclerotherapy (EVS) on lung function. A prospective controlled study.

A prospective, controlled study to determine the short- and long-term effects of esophageal variceal sclerotherapy (EVS) on lung function was carried out on 11 patients with cirrhotic portal hypertension and variceal hemorrhage. Eleven patients with chronic liver disease undergoing diagnostic endoscopy served as controls. There was no difference in lung function tests and gas exchange in both the EVS or control groups after either procedure.

Evaluation of peritoneovenous shunt patency by intraperitoneal Tc-99m macroaggregated albumin: clinical experience.

The clinical utility of peritoneovenous shunt patency studies using intraperitoneal Tc-99m macroaggregated albumin was studied. The patency of a peritoneovenous shunt can be reliably determined using the intraperitoneal injection of Tc-99m macroaggregated albumin with the appearance of lung activity as an indicator of patency. In an evaluation of 66 cases of clinically suspected peritoneovenous shunt obstruction, using the appearance of lung activity as the sole criterion of patency, this technique was shown to have a sensitivity of 100%, specificity of 92.

Scintigraphic demonstration of splenosis.

A case of splenosis, or the autotransplantation of splenic tissue following trauma, was encountered unexpectedly on a routine liver scan performed in the workup of alcoholic liver disease. Confirmatory scintigraphic images using Tc-99m labeled, heat-damaged, autologous erythrocytes are presented with CT scans of the abdomen.

Mechanism for the abnormal liver scan in acute alcoholic liver injury.

The mechanism of liver scan abnormality was investigated in patients with acute alcoholic liver injury evaluated shortly after admission (18 patients) with repeat examination 1 month later (14 patients). Indocyanine green (ICG) and Tc99 sulfur colloid extraction ratios (ERICG and ERSC), elimination rate constants (KICG and KSC), total body clearance (TBCICG and TBCSC), and hepatic clearance of sulfur colloid (HCSC) were determined from sequential blood samples obtained at the time of hepatic vein catheterization after the intravenous injection of ICG and Tc99 sulfur colloid. Liver size and sulfur colloid redistribution expressed as a scan score (SS) and redistribution ratio (RR) were assessed from an external scan immediately after the procedure.

A new method for the measurement of intrahepatic shunts.

After transhepatic portal pressure determination, 96 patients were assessed for the presence of intrahepatic shunts by injection of microspheres (25 +/- 5 micron diameter) into the portal vein using RISA-131I as an indicator of dilution. Multiple portal vein injections in each patient allowed blood sampling from the hepatic vein (site 1) and from two inferior vena cava sampling sites (site 2, at the junction of the hepatic vein orifice with the inferior vena cava, and site 3, 2 to 3 cm closer to or within the right atrium). Intrahepatic shunting was calculated from each site: hepatic vein in 57 patients and inferior vena cava, site 2 in 43 patients and site 3 in 77 patients.

An index to measure the healing potential of ischaemic ulcers using Thallium 201.

Prediction of healing of ulcers in ischaemic limbs can preclude unnecessary treatment for ulcers that cannot heal. Non-invasive methods are of marked value as the ischaemic limb is susceptible to further ulceration from local skin penetration. Relative hyperemia of the ulcer was measured by scintillation count over the ulcer and at points 2.

201Tl perfusion study of "ischemic" ulcers of the leg: prognostic ability compared with Doppler ultrasound.

Thallium 201 perfusion analysis was compared with Doppler ultrasound as a means of determining the healing potential of an ischemic ulcer of the leg in 27 patients. The degree of hyperemia was determined by comparative point counting of the 201Tl distribution in and about the ulcer. Using established Doppler criteria and a hyperemia ratio greater than 1.

A new objective criterion for determining, noninvasively, the healing potential of an ischemic ulcer.

Peripheral vascular perfusion studies using intravenously administered thallium-201 were performed on 13 patients suffering from ischemic ulcer of the lower extremities. Scintillation camera views and point counting over the lesion and adjacent region were utilized to define qualitatively and quantitatively the relative hyperemia of the lesion. The preliminary findings demonstrate that when the relative hyperemia was equal to or greater than 1.

Detection of bacterial endocarditis with technetium-99m-labeled antistaphylococcal antibody.

The reliable diagnosis of bacterial endocarditis is an important but difficult clinical problem. The potential ability of technetium-99m-labeled antistaphylococcal antibody to detect infective endocarditis was investigated in a rabbit model. Radiolabeling of the purified antibody was effected by a mild electrolytic procedure, with full retention of immunologic activity.

Pulmonary emboli followed total hip arthroplasty: incidence study.

We compared twenty-five total hip-arthroplasty patients with twenty-five patients who underwent other operations on the lower extremity, with regard to evidence of pulmonary embolism as determined preoperatively and postoperatively from lung perfusion scans, ventilation scans, and pulmonary angiography. Blood gases and serum enzymes also were studied. The over-all incidence of pulmonary embolism was 6 per cent, despite the absence of clinical evidence of that complication.

Heterotopic ossification around the hip in spinal cord-injured patients. A long-term follow-up study.

Twenty patients with spinal cord injury complicated by ossification around the hip were followed for eighteen months or more. The bone scan, roentgenogram, level of alkaline phosphatase, and range of hip motion of each patient were analyzed. The average follow-up was forty months.

Tracer accumulation in a subdural hygroma: case report.

A surgically proven case of traumatic subdural hygroma gave a "positive" image during 111In-DTPA cisternography, This was probably secondary to a communication between the subdural and subarchnoid spaces.

Heterotopic ossification around the hip joint in spinal cord injured patients.

Thirty patients with heterotopic ossification following spinal injuries were divided into acutely-injured and post-surgical groups. Patients in the acutely injured group had symptoms of heterotopic ossification within 6 months of injury. The formation and maturation of the heterotopic bone around the affected hip(s) were studied by serial alkaline phosphatase determinations and radiographic examinations.