Comparison of 99mTc-HEPIDA and 99mTc-MBrIDA from the standpoint of hepatic clearance determination - preliminary communication

BACKGROUND. In order to evaluate the functional capacity of the liver by means of clearance determination, the derivative of iminodiacetic acid (99mTc-HEPIDA) has been used in recent decades. Because of recent problems with manufacturing and delivery of 99mTc-HEPIDA, an investigation was undertaken with the aim of testing whether a more widely available 99mTc-MBrIDA could be used for clearance determination and whether hepatic clearance measured with the use of this compound provides a similarly useful test of hepatic function. MATERIAL AND METHODS. Comparative investigations were performed in 73 patients of both sexes. The state of the efficiency of liver parenchyma was determined based on seven widely used biochemical tests, i.e. levels of: bilirubin, albumin, and gamma globulin; activity of AST, ALT, GGTP, and prothrombin index. The clearances of both radiopharmaceuticals, 99mTc-HEPIDA and 99mTc-MBrIDA, were determined by means of multisample technique. The results of determination were correlated among themselves and with the results of biochemical tests. The set of results of all estimations allowed a factorial analysis to be performed to find a common factor and to compute the values of factor loadings in particular tests. RESULTS. Obvious correlation between plasma and hepatic clearances of both radiopharmaceuticals was obtained and between plasma clearance of 99mTc-MBrIDA and hepatic clearance of 99mTc-HEPIDA. Correlation coefficients of 99mTc-MBrIDA clearance and the biochemical test results attained somewhat lower values than for 99mTc-HEPIDA clearance. Similarly, values of χ2 test of independence of 99mTc-MBrIDA clearances and test results were also less close than for 99mTc-HEPIDA clearances. Factorial analysis showed that common factor loading is greatest for hepatic clearance of 99mTc-HEPIDA; the values of two loadings of 99mTc-MBrIDA clearances are very close, but somewhat lower than those for 99mTc-HEPIDA. CONCLUSIONS. From the performed investigations it is possible to conclude that 99mTc-MBrIDA clearances may be used for the evaluation of liver parenchyma performance, even if the results may not be as certain as those obtained using 99mTc-HEPIDA

Zapalenie mięśnia sercowego związane z zakażeniem Salmonella parathypi C

Myocarditis related to bacterial gastroenteritis is rare, especially in immunocompetent persons. The clinical course of the disease is characterised by non-specific, sparse symptoms, which greatly impedes diagnosis. This paper presents a case of myocarditis in a 39 year-old man with a Salmonella paratyphi C infection. Salmonella infections rarely cause myocarditis, but they should always be considered in cases where myocarditis is suspected and there is no evidence of a viral aetiology.Zapalenie mięśnia sercowego związane z bakteryjnym zapaleniem jelita występuje rzadko, zwłaszcza u osób immunokompetentnych. Przebieg kliniczny choroby charakteryzuje się niespecyficznymi, skąpymi objawami, co znacznie utrudnia diagnozę. W pracy przedstawiono przypadek zapalenia mięśnia sercowego u 39-letniego mężczyzny z zakażeniem Salmonella parathypi C. Zakażenia salmonellą są rzadką przyczyną zapalenia mięśnia sercowego, ale zawsze powinny być brane pod uwagę w przypadkach z podejrzeniem myocarditis w przypadku braku dowodów na etiologię wirusową

Zapalenie mięśnia sercowego związane z zakażeniem Salmonella parathypi C

Myocarditis related to bacterial gastroenteritis is rare, especially in immunocompetent persons. The clinical course ofthe disease is characterised by non-specific, sparse symptoms, which greatly impedes diagnosis. This paper presentsa case of myocarditis in a 39 year-old man with a Salmonella paratyphi C infection. Salmonella infections rarely causemyocarditis, but they should always be considered in cases where myocarditis is suspected and there is no evidenceof a viral aetiology.Zapalenie mięśnia sercowego związane z bakteryjnym zapaleniem jelita występuje rzadko, zwłaszcza u osób immunokompetentnych. Przebieg kliniczny choroby charakteryzuje się niespecyficznymi, skąpymi objawami, co znacznie utrudnia diagnozę. W pracy przedstawiono przypadek zapalenia mięśnia sercowego u 39-letniego mężczyzny z zakażeniem Salmonella parathypi C. Zakażenia salmonellą są rzadką przyczyną zapalenia mięśnia sercowego, ale zawsze powinny być brane pod uwagę w przypadkach z podejrzeniem myocarditis w przypadku braku dowodów na etiologię wirusową

Przeszczepienie wątroby u pacjenta z zespołem Budda-Chiariego jako czynnik poprawiający funkcję układu autonomicznego oraz obniżający ryzyko nagłego zgonu sercowego

We present the impact of liver transplantation in a patient with Budd-Chiari syndrome on improvement of autonomic system function and decreasing of sudden cardiac death (SCD). The case shows that not only implantable cardioverter defibrillator is a factor protecting patients with cirrhosis against SCD, but also liver transplantation itself.W artykule przedstawiono wpływ przeszczepienia wątroby u pacjenta z zespołem Budda-Chiariego na poprawę funkcji układu autonomicznego oraz obniżenie ryzyka zgonu z powodu nagłego zatrzymania krążenia (SCD). Przypadek ukazuje, że nie tylko wszczepienie kardiowertera-defibrylatora jest czynnikiem chroniącym pacjentów z marskością wątroby przed SCD, ale może nim być również samo przeszczepienie wątroby

Diagnostic value of optimised real-time sonoelastography in the assessment of liver fibrosis in chronic hepatitis B and C

Aim : To optimise the method of real-time elastography (RTE) in the assessment of liver fibrosis using an in-house prepared method for elastogram analysis, as well as a semiquantitative analysis based on newly introduced parameters. Material and methods : Sonoelastography was performed in 94 patients with various degrees of liver fibrosis and also in 25 healthy volunteers. As a reference method for diagnostic efficacy of sonoelastography-based parameters used for the assessment of fibrosis degree in patients with chronic B and C hepatitis, a liver biopsy was used. Patient’s elastograms were analysed using in-house prepared software, Pixel Count, calculating two semiquantitative parameters: mean stiffness fraction (MSF%) and intrinsic stiffness ratio (ISR). Results: Statistically significant differences between distributions of the above presented parameters for different degrees of liver fibrosis were revealed. Indices of diagnostic efficacy for detection of significant liver fibrosis (F ≥ 2) using MSF% amounted to: sensitivity – 76%, specificity – 87% and ISR: 81% and 87%, respectively. Sensitivity of both parameters in detection of cirrhosis (F = 4) was equal to 88% and specificity amounted to: for MSF% – 84% and ISR – 86%. Interobserver reproducibility determined for both of the above parameters was high, intraclass correlation coefficients (ICC) were 0.91 for MSF% and 0.93 for ISR. Conclusions : Real-time elastography applied in this study, using in-house prepared Pixel Count software, provided good reproducibility and diagnostic efficacy, especially specificity, in the assessment of liver fibrosis degree

Całkowity blok przedsionkowo-komorowy jako pierwszy objaw boreliozy: antybiotykoterapia zamiast wszczepienia rozrusznika serca

We present a 46-year-old male patient with complete atrio-ventricular block. A inflammatory etiology was suspected and finally lyme carditis was diagnosed. The conduction abnormalities disappeared with antibiotic treatment and a pacemaker implantation was not needed. Further follow-up of two years was uneventful