Carbon monoxide release from ultrasound-sensitive microbubbles improves endothelial cell growth.

Carbon monoxide is a gasotransmitter that may be beneficial for vascular tissue engineering and regenerative medicine strategies because it can promote endothelial cell (EC) proliferation and migration by binding to heme-containing compounds within cells. For example, CO may be beneficial for vascular cognitive impairment and dementia because many patients' disrupted blood-brain barriers do not heal naturally. However, control of the CO dose is critical, and new controlled delivery methods need to be developed.

Members of the Wnt, Fz, and Frp gene families expressed in postnatal mouse cerebral cortex.

The functions of Wingless-Int (Wnt) signaling, studied intensely in embryonic brain development, have been comparatively little investigated in the postnatal brain. We report remarkably patterned gene expression of Wnt signaling components in postnatal mouse cerebral cortex, lasting into young adulthood. Wnt genes are expressed in gene-specific regional and lamina patterns in each of the major subdivisions of the cerebral cortex: the olfactory bulb (OB), the hippocampal formation, and the neocortex.

Determination of Myocardial Viability with ECG-Gated Fluorodeoxyglucose F-18 Positron Emission Tomography.

OBJECTIVE: We hypothesize that ECG-gated positron emission tomography (PET) using Fluorodeoxyglucose F-18 (FDG) alone can determine myocardial viability by identifying dysfunctional myocardium with preserved glucose metabolism. We compared the contraction-metabolism pattern of gated FDG PET with the perfusion-metabolism pattern of conventional PET using N-13 ammonia (NH(3)) as a perfusion agent and FDG as a glucose metabolism agent in 21 consecutive patients with chronic coronary artery disease with left ventricular dysfunction (mean ejection fraction 23.6 +/- 7.

Gated stress-only 99mTc myocardial perfusion SPECT imaging accurately assesses coronary artery disease.

In today's cost containment environment it is important to consider changes to standard protocols which would reduce cost, particularly if there is no significant loss of diagnostic accuracy. The aim of the present study was to assess the usefulness of a gated stress-only Tc sestamibi protocol in comparison to conventional gated dual isotope rest-stress myocardial perfusion single photon emission computed tomography (SPECT) in the detection and localization of coronary artery disease (CAD). Sixty-five consecutive patients (65+/-10 years, 22 women) who had undergone conventional gated perfusion SPECT were chosen retrospectively.

Evaluation of left ventricular endocardial volumes and ejection fractions computed from gated perfusion SPECT with magnetic resonance imaging: comparison of two methods.

Background: Two methods of computing left ventricular volumes and ejection fraction (EF) from 8-frame gated perfusion single photon emission computed tomography (SPECT) were compared with each other and with magnetic resonance (MR) imaging.

Methods And Results: Thirty-five subjects underwent 8-frame gated dual-isotope SPECT imaging and 12- to 16-frame gated MR imaging. Endocardial boundaries on short-axis MR images were hand traced by experts blinded to any SPECT results.

Three-dimensional color-modulated display of myocardial SPECT perfusion distributions accurately assesses coronary artery disease.

Unlabelled: The objective of this study was to compare visual assessment of 3-dimensional color-modulated (to counts) surface displays with visual assessment of oblique tomographic slices of myocardial SPECT perfusion distributions in the detection and localization of coronary artery disease (CAD).

Methods: Sixty-two consecutive patients (41 men, 21 women; mean age, 61 +/- 11 y) who had undergone conventional dual-isotope perfusion SPECT were retrospectively chosen; 50 had undergone coronary arteriography previously, and 12 had less than a 5% likelihood of CAD. Four readers interpreted the 3-dimensional displays and slices in separate sessions while unaware of the findings of previous readings, the interpretations of others, and the angiographic results.

Therapeutic angiogenesis with recombinant fibroblast growth factor-2 improves stress and rest myocardial perfusion abnormalities in patients with severe symptomatic chronic coronary artery disease.

Background: We report the effects of the administration of recombinant fibroblast growth factor-2 (rFGF-2) protein on myocardial perfusion using single photon emission computed tomography imaging in humans with advanced coronary disease.

Methods And Results: A total of 59 patients with coronary disease that was not amenable to mechanical revascularization underwent intracoronary (n=45) or intravenous (n=14) administration of rFGF-2 in ascending doses. Changes in perfusion were evaluated at baseline and again at 29, 57, and 180 days after rFGF-2 administration.

Surgical management of malignant melanoma using dynamic lymphoscintigraphy and gamma probe-guided sentinel lymph node biopsy: the Emory experience.

Sentinel lymph node (SLN) biopsy is revolutionizing the surgical management of primary malignant melanoma. It allows accurate nodal staging which targets patients who may benefit from regional lymphadenectomy and systemic therapy. This is a retrospective review of patients treated at Emory University for stage I and II malignant melanoma with gamma probe-guided SLN biopsy from 1/1/94 to 6/30/98.

Management of malignant melanoma of the head and neck using dynamic lymphoscintigraphy and gamma probe-guided sentinel lymph node biopsy.

Background: The sentinel lymph node (SLN) biopsy is revolutionizing the surgical management of primary malignant melanoma. It allows accurate nodal staging, and targets patients who may benefit from regional lymphadenectomy and systemic therapy; however, its use in the management of head and neck melanoma has not been widely accepted.

Methods: A retrospective review of patients treated for clinical stages I and II malignant melanoma of the head and neck with dynamic lymphoscintigraphy and gamma probe-guided SLN biopsy.

Prognostic value of thallium-201 single-photon emission computed tomography for patients with multivessel coronary artery disease after revascularization (the Emory Angioplasty versus Surgery Trial [EAST]).

The aim of this study was to investigate the relation between reversible thallium single-photon emission computed tomography (SPECT) myocardial perfusion defects at 1-year after revascularization and quantitative indexes in Emory Angioplasty versus Surgery Trial (EAST) and outcomes 3 years after revascularization in 336 patients. EAST was a randomized controlled trial assessing cardiac outcomes for angioplasty versus bypass surgery for patients with multivessel coronary artery disease. During this prospective trial, a substudy included the evaluation of the prognostic value of reversible defects on quantitative thallium SPECT.

Left ventricular function and perfusion from gated SPECT perfusion images: an integrated method.

Unlabelled: A new technique for computing left ventricular function, including left ventricular volumes, mass and ejection fraction, has been developed. This method is a logical extension of the results of a standard perfusion quantification technique; thus, it allows integration of perfusion and functional information.

Methods: Anatomically based models of the endocardial and epicardial surfaces are generated using the myocardial samples for which perfusion values are quantified, for all frames in the cardiac cycle.

Clinical validation of three-dimensional color-modulated displays of myocardial perfusion.

Background: Two-dimensional polar maps have been validated previously with coronary arteriography for determining vascular involvement of defects from a patient's myocardial perfusion distributions with and without quantification. The purpose of this study was to validate previously developed three-dimensional color-modulated surface displays representing myocardial perfusion.

Methods And Results: The validation consisted of comparing the agreement between the three-dimensional displays and two-dimensional polar maps in localizing perfusion defects to vascular territories in 30 patients (16 men/14 women) who underwent both a 1-day rest/stress exercise 99mTc-labeled sestamibi study and coronary arteriography.

Lymphoscintigraphy, the sentinel node concept, and the intraoperative gamma probe in melanoma, breast cancer, and other potential cancers.

There is a resurgence of interest in lymphoscintigraphy because of attention to the sentinel node concept and the availability of the surgical gamma probe that can be used in the operating room to localize radiolabeled sentinel nodes. Conventional surgical management of melanoma has been altered for intermediate thickness tumors such that lymph node dissection is performed for a lymph node bed only if the sentinel node is tumor positive on histological exam after gamma probe-guided excision. This approach is cost effective, saving about 80% of these patients (sentinel node tumor negative) the cost and morbidity of unnecessary "elective lymph node dissection.

Dynamic lymphoscintigraphy to identify the sentinel and satellite nodes.

Lymphoscintigraphy is increasingly used to identify the first draining node (sentinel node) in patients with malignant melanoma or breast cancer. If the sentinel node is tumor free then the remainder of the nodes in that specific nodal bed are likely to be free of metastases. Localization and biopsy of the sentinel node with an intraoperative surgical probe may obviate more radical lymph node dissection.

Technetium-99m-sulfur colloid for lymphoscintigraphy: effects of preparation parameters.

Unlabelled: There has been a resurgence in the use of lymphoscintigraphy for the external detection of lymph nodes for metastatic melanoma and breast tumors. Technetium-99m-antimony trisulfide colloid was the radiopharmaceutical developed for this procedure and was found to have a narrow distribution of small particles, 0.003-0.

Early stage melanoma: lymphoscintigraphy, reproducibility of sentinel node detection, and effectiveness of the intraoperative gamma probe.

Purpose: To assess the influence of lymphoscintigraphic and intraoperative gamma probe findings on the surgical management of melanoma and to test reproducibility of lymphoscintigraphic findings.

Materials And Methods: After lymphoscintigraphic identification of the sentinel node, intraoperative gamma probe localization and sentinel lymph node excision were performed in 25 patients. To assess reproducibility, 13 patients underwent lymphoscintigraphy twice within 2-17 days.

Three-dimensional displays of left ventricular epicardial surface from standard cardiac SPECT perfusion quantification techniques.

Unlabelled: Two methods for generating left ventricular epicardial surface from SPECT perfusion tomograms are described and validated. Both methods use the locations of the maximal reconstructed count values determined from a perfusion quantification procedure as a basis for generating surfaces.

Methods: The first method fits circular contours, which are perpendicular to the long-axis, to the points obtained from perfusion quantification.

Reproducibility of thallium-201 exercise SPECT studies.

Unlabelled: A detailed analysis of intrapatient reproducibility of exercise SPECT thallium studies is presented.

Methods: Twenty patients in stable condition were re-examined with exercise-redistribution SPECT201 Tl within 3-9 days without intervening procedures. At peak stress, 3.

Laparoscopic-assisted colectomy. Initial experience.

Objective: The authors studied the results of laparoscopic colectomies performed by a surgical team on 80 consecutive patients and compared these results with standard open colectomies.

Methods: Eight consecutive laparoscopic-assisted colectomies were performed by Norfolk Surgical Group in a 14-month period and compared to 53 patients who had a conventional open colectomies. Analysis included indications for surgery, types of procedure, complications, incidence and causes for conversion, length of procedure, duration of postoperative ileus, hospital stay, operating room and total hospital charges, and examination of the pathologic specimens.

Preoperative localization of parathyroid tissue with technetium-99m sestamibi 123I subtraction scanning.

To evaluate the utility of technetium-99m (Tc-99m) sestamibi for visualization of functioning parathyroid tissue, 14 subjects underwent Tc-99m sestamibi 123I subtraction scanning as part of the preoperative evaluation for hyperparathyroidism. Informative scans were obtained in 13 subjects, including 7 patients with recurrent or persistent hyperparathyroidism, and correctly identified the location of the hyperfunctioning parathyroid tissue found at surgery. In all informative patients, hyperparathyroidism was due to adenomatous disease or hyperplasia secondary to renal failure.

Value of technetium 99m sestamibi iodine 123 imaging in reoperative parathyroid surgery.

Background: The purpose of this study was to assess the contribution of technetium 99m sestamibi iodine 123 (T/S) imaging to preoperative and intraoperative management of patients with persistent hyperparathyroidism.

Methods: During a period of 10 months, all patients being prepared for reoperative parathyroid surgery (n = 10), two patients deemed significant operative risks (one patient with severe chronic obstructive pulmonary disease and one patient with severe cervical spine ankylosing spondylitis), and two patients who had undergone prior thyroid operation were studied with T/S imaging. Six patients undergoing reoperative surgery had undergone one, three had undergone two, and one had undergone three prior procedures.