Reverse redistribution pattern in 99m^{99m}Tc-MIBI myocardial perfusion imaging: A case report and review of literature

Revers redistribüsyon paterni (RRP) egzersizde bulunmazken veya hafifken istirahatte bir perfüzyon defektinin ortaya çıkması veya artması olarak tanımlanır. RRP göreceli olarak seyrektir. Yeni çalışmalar RRP'nin açık infarktüs arteriyle beslenen canlı ve nekrotik dokuların karışımı olan bölgelerde gözlendiğini düşündürmektedir. Bu derlemede $^{99m}$Tc-MIBI miyokard perfüzyon çalışmasında RRP saptanan, koroner arter hastalığı ve atriyal fibrilasyonu olan 75 yaşında bir erkek hasta bildirildi ve bu perfüzyon anormalliğinin olası fizyopatolojik mekanizmaları tartışıldı.Reverse redistribution pattern (RRP) is defined as the presence of a perfusion defect on the resting cardiac image, rather than on the exercise image. RRP is relatively uncommon. Recent reports suggest that RRP seems to represent segments with a mixture of viable and nonviable myocardial tissue that are frequently supplied by patent infarct-related arteries. We report a 75-year-old man who was detected to have reverse redistribution pattern associated with atrial fibrillation and coronary artery disease on $^{99m}$Tc-MIBI myocardial perfusion study. In this review, we report a case and discussed possible pathophysiological mechanism of the perfusion abnormality

Massive bleeding due to Meckel's diverticulum

[Cukurova Med J 2016; 41(3.000): 607-608

Effect of cerebrospinal fluid leakage on wound healing in flap surgery: Histological evaluation

The aim of this study was to find out the effect of CSF leakage on wound healing after flap surgery. Sixteen male Wistar rats were used. The superiorly based rectangular dorsal skin flap 3 x 3 cm was elevated at the interscapular region. Through this opening, paraspinal muscle dissection and three-level bilateral laminectomy were done. Finally, a dura defect with a diameter of 3-4 mm was created. In the control group, laminectomy was performed as in the study group but the dura was left intact. Persistent CSF leakage was confirmed using isotope cisternography. At the end of 2-week study period, there was no necrosis, infection, or dehiscence of the flap in either group. On necroscopy, cyst formation over the dura defect was detected in 4 animals of the study group. Another gross finding in this group was intensive vascularization of the undersurface of the flap and wound bed. With HE staining, the tissue sections from the study group revealed new vessel formation with small diameter, increase in the reactional mesenchymal tissue, granulation tissue, degeneration of the striated muscle fibers, dystrophic calcifications, fat necrosis, and coagulation necrosis (ischemic necrosis). In the control group, there was only minimal lymphocytic invasion of the subdermal plane. In this study, we have shown that CSF leakage itself has effects on wound healing in the absence of known causative factors. Copyright © 2004 S. Karger AG, Basel

Lung clearance of Tc-99m-DTPA in ankylosing spondylitis

WOS: 000265034600005PubMed: 19330176The association of ankylosing spondylitis (AS) and lung parenchyma abnormalities has been shown in previous studies by radiological and pulmonary function tests. Technetium-99m diethylene triamine pentaacetic acid Tc-99m-DTPA) dynamic lung scanning is an easy, noninvasive method to assess alveolar-capillary barrier permeability. We aimed to study the abnormalities in pulmonary clearance of Tc-99m-DTPA in patients with AS, and the presence of any correlation between this clearance and the radiological and pulmonary function tests. We studied twenty-one nonsmoker patients with AS who were compared to 21 age and sex matched healthy volunteers. All subjects underwent pulmonary function tests and pulmonary scintigraphy with Tc-99m-DTPA to evaluate pulmonary clearance. Clearance half time (T-1/2) of Tc-99m-DTPA through the lungs was calculated by placing a monoexponential fit on the 30 min activity curves. High resolution CT and pulmonary function tests were performed for each patient. Our results showed the following: Spirometric parameters of forced vital capecity (FVC) and the ratio of forced expiratory value in 1sec/FVC (FEV1%) scores were worse in patients compared to the control group (P<0.005 and P<0.05, respectively). Clearance half time was longer in AS group than in the control group (58.45 +/- 7.59 and 51.62 +/- 4.79 min, respectively; P<0.05). There was a negative correlation between T-1/2 Value and FEV1% (r=-0.876, P < 0.01), of AS patients and the control group. Additionally, there were moderate positive correlation between T-1/2 and FVC (r=0.705, P<0.001), weak positive correlation between T-1/2 and FEF2575 (r = 0.493, P<0.05), and T-1/2 and DLCO (r=0.444, P<0.05). A positive correlation was found between the duration of the disease and T-1/2 (r=0.44, P < 0.05). In conclusion, longer T-1/2 values and lower FVC values in nonsmoker AS patients may suggest not only the pulmonary involvement in AS but also the duration of the disease

A comparative study of pre-operative imaging methods in patients with primary hyperparathyroidism: Ultrasonography, Tc-99m sestamibi, single photon emission computed tomography, and magnetic resonance imaging

WOS: 000308045400003PubMed: 21623148Aim: This study compares the accuracy rates achieved in ultrasonography (US), 9(9m)Tc-sestamibi (MIBI), single photon emission computed tomography (SPEC), and magnetic resonance imaging (MRI) as imaging methods used in the pre-operative localization of the enlarged parathyroid glands. Subjects and methods: For the purposes of this study, US, MIBI, SPECT, and MRI were performed on 98 patients with primary hyperparathyroidism (pHPT). All patients underwent parathyroidectomy. Results: Pre-operative localization of an abnormal parathyroid gland was successfully performed in 82 of the cases scanned with US (83.7%), while the result was 66 in the cases scanned with MIBI (67.3%), 71 of the cases were successfully localized with SPECT (72.4%), while MRI revealed the diseased gland in only 60 of the total'cases (61.2%). In MIBI-positive and -negative patients there was a statistically significant difference among cases in terms of adenoma volume (1.30 +/- 1.51 vs 0.58 +/- 0.91, p < 0.05). Sensitivity, specificity and diagnostic accuracy values were 87.2%, 25.0%, and 83.0%; 70.2%, 50.0%, and 69.4%; 75.5%, 50.0%, and 74.5%; 63.8%, 50.0%, and 63.3% for US, MIBI, SPECT, and MRI, respectively. The respective values for sensitivity, specificity, and diagnostic accuracy were 94.9%, 25.0%, and 91.1% when US was combined with MIBI. Conclusions: Combining US and MIBI as imaging methods for pre-operative imaging of pHPT often produces more satisfactory results. While the accuracy of US is relatively low in the ectopic localizations, the size of the lesion can be an important factor in the accuracy achieved with MIBI. (J. Endocrinol. Invest. 35: 359-364, 2012) (c) 2012, Editrice Kurti

Comparison of Preoperative Examinations in Patients with Primary Hyperparathyroidism: US, MIBI, SPECT and MRI.

92nd Meeting and Expo of the Endocrine Society (ENDO 2010) -- JUN 19-22, 2010 -- San Diego, CAWOS: 000281989402245…Endocrine Societ

Phagocyting labeling of leukocytes with Tc-99m PLA (poly l-lactic acid) microspheres

Amaç: Bu çalışmanın amacı Tc-99m poli (l-laktik) asit (PLA) mikrokürelerini lökositleri fagositik yolla işaretleyebilmek için hazırlamak ve gerekli optimum şartları belirlemektir. Yöntem: PLA polimerlerinden (MA:52.000 D) çözücü buharlaştırma yöntemi ile PLA mikroküreleri (1-5 µm) hazırlandı. Daha sonra pH 3’te kalay klorürle Tc-99m ile işaretlendi, işaretleme verimi % 95’in ve stabilitesi ise 24 saat içinde % 70’in üzerinde bulundu. 50 ml heparinli kan gönüllü sağlıklı erişkin insanlardan alınarak oda sıcaklığında sedimantasyona bırakıldı ve lökositten zengin plazma elde edildi. 1 mL’de hazırlanan 50 mCi Tc-99m-PLA mikroküresi lökosit çökeleğine ilave edilip rotator bir mekanik sallayıcıda 37oC’de 1. saat inkubasyona bırakıldı. Tc-99m PLA ile işaretlenen lökositler santrifüj ile süspansiyondan ayrıldı, yıkandı ve trombositten fakir plazma ile süspansiyon yapıldı. Bulgular: Lökositlerin işaretlenme verimi yaklaşık % 70 bulundu. Monositlerin PLA mikrokürelerini fagosite ettiği elektron mikroskobunda gösterildi. Lökositlerin kemotaktik indeksi 2’nin üzerinde bulundu. Lökositlerin canlılığı Tripan mavisi ile değerlendirildi ve % 90’ın üzerinde bulundu. Sonuç: Tc-99m-PLA mikroküreleri ile lökosit işaretlemenin potansiyel değeri olduğu görülmektedir. Monositlerin daha belirgin işaretlenmesi nedeniyle özellikle kronik inflamasyonda kullanılabilir.Objective: The aim of this study was to prepare Tc-99m poly (l-lactic) acid (PLA) particles for phagocyting engulfment by leucocytes and determine optimization conditions. Methods: PLA microspheres (1-5 &micro;m) were prepared from PLA polymeres (MW=52.000) by solvent evaporation from methylene chloride. Then, they were labeled with Tc-99m by stannous chloride reduction at pH 3 with an efficiency of >95% and a stability of >70% at 24 hours. 50 mL heparinized blood was obtained from normal adult volunteers. The precipitate was removed and the sediment was washed with 0.9 NaCl and then centrifuged at 600 rpm for 5 minutes. 50 mCi Tc-99m-PLA particles in 1 mL was added to precipitated leukocytes and rotated in mechanical shaker in incubation at 37oC for 1 hour. Tc-99m-PLA labeled leukocytes were separated by centrifugation, washed and suspended in platelet poor plasma. Results: Leukocytes were labeled with an efficiency of about 70%. The engulfment of PLA particles by monocytes and the integrity of cell membrane afterwards were demonstrated by electron microscopy. Chemotactic index was >2. The viability of leukocytes was >90%, determined with trypan blue. Conclusion: Our results indicated the potential value of leukocyte labeling with Tc-99m PLA microspheres. This may be especially useful in demonstrating chronic infection, because of the preference of monocytes in labeling