Clinical Importance of Significant Asimptomatic Bacteriuria in Newborns and Infants During Early Postnatal Period

The aim of the study was to detect newborns at risk for developing renal impairment, and to point out the importance of significant asimptomatic bacteriuria in perinatal period and early infancy. Severe urinary tract anomalies are very often accompanied only by asimptomatic bacteriuria in perinatal period. Three urinalysis ware done after delivery. 212 newborns with significant asimptomatic bacteriuria underwent ultrasound examination, and were followed up to three months. Those with normal findings and with passing bacteriuria in the first 2 months were excluded. Group of 52 newborns underwent radioisotope examination. Frequency of urinary tract anomalies in newborns was 34.6%. Increased risk for renal impairment had children with urinary tract anomalies in close family, urinary tract infection or bacteriuria, EPH gestosis and prepartal symptoms of febrile infection in mother, children with IUGR, strangulated umbilical cord, prolonged jaundice and attacks of peripheral cyanosis in perinatal period

Usporedba 18F-FDG pozitronske emisijske tomografije i kompjutorizirane tomografije u bolesnika s kolorektalnim karcinomom i limfomom: naša početna klinička iskustva

Findings obtained by fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) and computed tomography (CT) were compared in patients with malignant lymphoma and colorectal carcinoma. In 14 malignant lymphoma patients, 16 18F-FDG PET procedures were performed to assess chemotherapy and/or radiotherapy outcome (remission). One patient with clinically overt relapse of non-Hodgkin.s lymphoma underwent PET to assess disease dissemination prior to prescribing second-line chemotherapy. Two patients were submitted to PET on two occasions. PET pointed to residual disease in six of 14 patients and was inconclusive in one patient. These patients underwent computed tomography (CT), some of them before and others after PET examination. Then PET and CT findings were compared and therapeutic response, i.e. disease remission was assessed. The signs of residual disease were present in four and absent in nine patients, whereas inconclusive findings in terms of residual disease were recorded in one patient. Although our initial clinical experience was acquired in quite a small number of patients, CT modified clinical evaluation of residual disease in two patients and should be included along with PET in diagnostic work-up of these patients.Usporedili smo nalaze fluoro-18-fluorodeoksiglukoza (FDG) pozitronske emisijske tomografije (18F-FDG PET) i kompjutorizirane tomografije (CT) u bolesnika s malignim limfomom i kolorektalnim karcinom. U 14 bolesnika 18F-FDG PET je učinjen 16 puta radi procjene ishoda kemoterapije i/ili radioterapije, odnosno remisije. U jednog bolesnika s klinički jasnim recidivom ne-Hodgkinova limfoma PET je proveden radi procjene proširenosti bolesti prije ordiniranja druge linije kemoterapije. U dvoje bolesnika PET je učinjena dva puta. U šestoro od 14 bolesnika nalaz PET ukazivao je na rezidualnu bolest, dok je u jednog bolesnika bio dvojben. Stoga je u tih bolesnika učinjena i CT; u nekih bolesnika CT je izvedena prije PET, a u drugih nakon PET. Tada smo usporedili nalaze PET i CT te procijenili terapijski odgovor, tj . remisiju bolesti. Znaci rezidualne bolesti bili su prisutni u četvoro bolesnika, odsutni u devetoro bolesnika, dok je kod jednog bolesnika i dalje bilo nejasno je li rezidualna bolest prisutna ili nije. Iako se ovo naše početno kliničko iskustvo odnosi na mali broj bolesnika, CT je promijenio kliničku procjenu rezidualne bolesti u dvoje bolesnika i smatramo da bi uz PET i CT trebao biti sastavni dio dijagnostičke obrade takvih bolesnika

Usporedba 18F-FDG pozitronske emisijske tomografije i kompjutorizirane tomografije u bolesnika s kolorektalnim karcinomom i limfomom: naša početna klinička iskustva

Findings obtained by fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) and computed tomography (CT) were compared in patients with malignant lymphoma and colorectal carcinoma. In 14 malignant lymphoma patients, 16 18F-FDG PET procedures were performed to assess chemotherapy and/or radiotherapy outcome (remission). One patient with clinically overt relapse of non-Hodgkin.s lymphoma underwent PET to assess disease dissemination prior to prescribing second-line chemotherapy. Two patients were submitted to PET on two occasions. PET pointed to residual disease in six of 14 patients and was inconclusive in one patient. These patients underwent computed tomography (CT), some of them before and others after PET examination. Then PET and CT findings were compared and therapeutic response, i.e. disease remission was assessed. The signs of residual disease were present in four and absent in nine patients, whereas inconclusive findings in terms of residual disease were recorded in one patient. Although our initial clinical experience was acquired in quite a small number of patients, CT modified clinical evaluation of residual disease in two patients and should be included along with PET in diagnostic work-up of these patients.Usporedili smo nalaze fluoro-18-fluorodeoksiglukoza (FDG) pozitronske emisijske tomografije (18F-FDG PET) i kompjutorizirane tomografije (CT) u bolesnika s malignim limfomom i kolorektalnim karcinom. U 14 bolesnika 18F-FDG PET je učinjen 16 puta radi procjene ishoda kemoterapije i/ili radioterapije, odnosno remisije. U jednog bolesnika s klinički jasnim recidivom ne-Hodgkinova limfoma PET je proveden radi procjene proširenosti bolesti prije ordiniranja druge linije kemoterapije. U dvoje bolesnika PET je učinjena dva puta. U šestoro od 14 bolesnika nalaz PET ukazivao je na rezidualnu bolest, dok je u jednog bolesnika bio dvojben. Stoga je u tih bolesnika učinjena i CT; u nekih bolesnika CT je izvedena prije PET, a u drugih nakon PET. Tada smo usporedili nalaze PET i CT te procijenili terapijski odgovor, tj . remisiju bolesti. Znaci rezidualne bolesti bili su prisutni u četvoro bolesnika, odsutni u devetoro bolesnika, dok je kod jednog bolesnika i dalje bilo nejasno je li rezidualna bolest prisutna ili nije. Iako se ovo naše početno kliničko iskustvo odnosi na mali broj bolesnika, CT je promijenio kliničku procjenu rezidualne bolesti u dvoje bolesnika i smatramo da bi uz PET i CT trebao biti sastavni dio dijagnostičke obrade takvih bolesnika

A comparison of effective renal plasma flow and renal plasma flow in a mobile kidney before and after nephropexy

Patološka mobilnost bubrega može dovesti do funkcijskih poremećaja i tada postaje indikacija za nefropeksiju. Coj ove studije bio je ispitati radionuklidnim testovima funkcijske kapacitete bubrega prije i poslije nefropeksije i usporediti te nalaze s drugim objektivnim kliničkim i dijagnostičkim parametrima. Ispitivanjem je obuhvaćeno 86 bolesnica u kojih je učinjena nefropeksija. Dinamička scintigrafija bubrega svima je učinjena u ležećem položaju i u ortostazi, te statička scint grafija prije i poslije operacijskog zahvata. Rezultati su pokazali da nakon nefropeksije nestaje mobi nost bubrega, renalni plazmatski protok periranog bubrega ortostazi značajno raste, smanjuje se učestalost boli i uroii fekata i nestaje oscilatorna hipertenzija.Pathological renal mobility can cause a functional disorder, which is an indication for nephropexy. The aim of this study was to examine functional renal capacity before and after nephropexy applying radionuclide tests and to compare the results with objective and clinical parameters. The study included 86 patients who underwent nephropexy. Dynamic renal scintigraphy in lying and sitting position as well as static scintigraphy were performed before and after the surgical treatment. The results of those examinations confirmed a considerable post-operative rise in functional capacity of the mobile kidney in orthostatic position after nephropexy. Renal mobility disappeared as well as orthostatic pain, and UTIs and orthostatic hypertension have become less frequent

A comparison of effective renal plasma flow and renal plasma flow in a mobile kidney before and after nephropexy

Patološka mobilnost bubrega može dovesti do funkcijskih poremećaja i tada postaje indikacija za nefropeksiju. Coj ove studije bio je ispitati radionuklidnim testovima funkcijske kapacitete bubrega prije i poslije nefropeksije i usporediti te nalaze s drugim objektivnim kliničkim i dijagnostičkim parametrima. Ispitivanjem je obuhvaćeno 86 bolesnica u kojih je učinjena nefropeksija. Dinamička scintigrafija bubrega svima je učinjena u ležećem položaju i u ortostazi, te statička scint grafija prije i poslije operacijskog zahvata. Rezultati su pokazali da nakon nefropeksije nestaje mobi nost bubrega, renalni plazmatski protok periranog bubrega ortostazi značajno raste, smanjuje se učestalost boli i uroii fekata i nestaje oscilatorna hipertenzija.Pathological renal mobility can cause a functional disorder, which is an indication for nephropexy. The aim of this study was to examine functional renal capacity before and after nephropexy applying radionuclide tests and to compare the results with objective and clinical parameters. The study included 86 patients who underwent nephropexy. Dynamic renal scintigraphy in lying and sitting position as well as static scintigraphy were performed before and after the surgical treatment. The results of those examinations confirmed a considerable post-operative rise in functional capacity of the mobile kidney in orthostatic position after nephropexy. Renal mobility disappeared as well as orthostatic pain, and UTIs and orthostatic hypertension have become less frequent

Our experience in the long-term follow-up and treatment of a family with MEN 2A (2) syndrome

U 15-godišnjoj studiji članova jedne porodice s MEN 2A (2) sindromom ispitivali smo učinke ranog liječenja bolesti. U tom razdoblju praćeno je 20 članova porodice, u 9 članova je učinjena totalna tireoidektomija, u jednog obostrana adrenalektomija zbog feokromocitoma. Prosječna dob operiranih je 25,1 god. (16 -41 god.) . U 6 bolesnika dokazan je medularni karcinom štitnjače, u 3 bolesnika C-stanična hiperplazija. Samo u jedne bolesnice perzistira viša razina kalcitonina bez dokaza metastaza. Kalcitonin je mjeren nakon stimulacije pentagastrinom i alkoholom (votka) . Smatramo da je stimulacija kalcitonina alkoholom još uvijek praktična i zadovoljavajuća metoda. Niti u jedno god 20 s rodnika nije dokazana paratireoidna bolest.The effects of early treatment of the disease were studied in a 15-year study of the members of a family with MEN 2A syndrome. Twenty members of the family were followed-up during that period. Total thyreidectomy was performed in nine members and bilateral adrenalectomy due to pheochromocytoma in one. The mean age of operated persons was 25.1 years (16-41 year). Medullary thyroid was established in six patients and C-cell hyperplasia in three patients. A higher calcitonine level, without any evidence of metastases, has persisted in one female patient only. Calcitonine levels were measured after stimulation with pentagastrine and alcohol (vodka). It is our opinion that calcitonine stimulation with alcohol is still an appropriate and satisfying method. Any parathyroid disease has been established in none of twenty relatives

Our experience in the long-term follow-up and treatment of a family with MEN 2A (2) syndrome

U 15-godišnjoj studiji članova jedne porodice s MEN 2A (2) sindromom ispitivali smo učinke ranog liječenja bolesti. U tom razdoblju praćeno je 20 članova porodice, u 9 članova je učinjena totalna tireoidektomija, u jednog obostrana adrenalektomija zbog feokromocitoma. Prosječna dob operiranih je 25,1 god. (16 -41 god.) . U 6 bolesnika dokazan je medularni karcinom štitnjače, u 3 bolesnika C-stanična hiperplazija. Samo u jedne bolesnice perzistira viša razina kalcitonina bez dokaza metastaza. Kalcitonin je mjeren nakon stimulacije pentagastrinom i alkoholom (votka) . Smatramo da je stimulacija kalcitonina alkoholom još uvijek praktična i zadovoljavajuća metoda. Niti u jedno god 20 s rodnika nije dokazana paratireoidna bolest.The effects of early treatment of the disease were studied in a 15-year study of the members of a family with MEN 2A syndrome. Twenty members of the family were followed-up during that period. Total thyreidectomy was performed in nine members and bilateral adrenalectomy due to pheochromocytoma in one. The mean age of operated persons was 25.1 years (16-41 year). Medullary thyroid was established in six patients and C-cell hyperplasia in three patients. A higher calcitonine level, without any evidence of metastases, has persisted in one female patient only. Calcitonine levels were measured after stimulation with pentagastrine and alcohol (vodka). It is our opinion that calcitonine stimulation with alcohol is still an appropriate and satisfying method. Any parathyroid disease has been established in none of twenty relatives

Analysis of patients with thyroid cancer treated at the Department of nuclear medicine, radiation protection and pathophysology over the period 1968 - 1998

Cilj studije je bio izvršiti analizu oboljelih od karcinoma štitnjače u razdoblju od 1968. do 1998. godine, koji su liječeni u Centru za bolesti štitnjače Odjela za nuklearnu medicinu, zaštitu od zračenja i patofiziologiju KB Osijek. Liječenje ukupno 281 bolesnik od karcinoma štitne žlijezde. Najmlađi bolesnik imao je 7 godina, a najstariji 82 godine u momentu postavljanja dijagnoze. Srednja dob je bila 45 godina. Najviše je bilo papilamih (N=156), folikulamih (N=56), medulamih (N=28), a zatim slijede Hurthle (N=16), anaplastični (N=5) i ostali (N=5). Češće obolijevaju žene (N=226) nego muškarci (N=55), a pojava bolesti je najveća u 4, 5. i 6. desetljeću života. Tumor se javlja najčešće kao solitami čvor (N=106), te difuzna ili nodozna struma (N=132), a u 31 oboljelog kao povećani limfni čvor na vratu. Analizirana je važnost scintigrafije u postavljanju sumnje na karcinom štitnjače. Također su uspoređeni nalazi citološke punkcije sa definitivnom histološkom dijagnozom. Uspoređen je opseg operacijskoga liječenja te liječenja radiojodom. Prikazanje i mortalitet od karcinoma štitnjače kroz tridesetogodišnje razdoblje.The purpose of the study was to analyse patients treated for thyroid cancer at the Centre for thyroid diseases, Department of Nuclear Medicine, Radiation Protection and Pathophysiology, Osijek Clinical Hospital over the period 1968-1998. The total of 281 patients with thyroid cancer were treated. The youngest patient was 7 and the oldest one 82 years old at the time the diagnosis was verified. The mean age was 45. They were diagnosed as follows: papillary cancer (N=156), follicular (N=56), medullar (N=28), Hurthle (N=16), anaplastical (N=5) and other (N=5). The disease occurred more often in females (N= 226) than in males (N=55). The frequency of the disease is the highest in the 4th, 5th and 6th decades of life. The tumours mostly presented as a solitary node (N=106) and as diffuse or nodular goiter (N=132). In 31 patients, the disease appeared as an enlarged lymph node on the neck. The value of the scintigraphy in suspected thyroid cancer was analysed. Also, the results of cytological punction and final pathohistological diagnoses were compared. The extent of surgical treatment and treatment with radioiodine was compared. Mortality rate of thyroid cancer in the 30-year period was present

Left ventricular volume determination using a count- based method requiring blood sampling and rest-stress radionuclide ventriculography with Tc-99m labelled red blood cells

Istraživali smo promjene radioaktivnosti krvi u miru, tijekom opterećenja i nakon oporavka, te ispitali taj utjecaj na određivanje volumena lijeve klijetke metodom pomoću krvnog uzorka i radionuklidne ventrikulografije s Tc-99m obilježenim vlastitim eritrocitima. Radionuklidna ventrikulografija je učinjena kod 31 ispitanika: vlastiti eritrociti su obilježeni pomoću Tc-99m in vivo metodom kod 17 ispitanika (grupa I), a kod 14 osoba kombiniranom metodom in vivo/in vitro (grupa II). Volumeni lijeve klijetke su određeni metodom pomoću korigirane gustoće impulsa iz krvnih uzoraka uzetih u mirovanju, opterećenju i oporavku. Tijekom opterećenja u grupi I porasla je aktivnost krvi za 25.1 ± 6.4%, p<0.001, a u grupi II za 12.8 ± 4.5%, p<0.05 u odnosu na aktivnost krvi u mirovanju. To je imalo značajan utjecaj na određivanje srčanih volumena ukoliko se upotrijebio samo krvni uzorak uzet u miru: tijekom opterećenja volumen lijeve klijetke je značajno precijenjen u grupi I za 32.1 ± 10.3%, p<0.001, a u grupi II za 10.7 ± 6.4%, p<0.05. Nisu nađene značajne razlike aktivnosti krvi između opterećenja i nakon oporavka za bilo koju grupu. Upotreba samo jednog krvnog uzorka za određivanje referentnog volumena u miru i opterećenju u radionuklidnim studijama s Tc-99m obilježenim vlastitim eritrocitima vodi ka krivoj procjeni srčanih volumena zbog značajnog porasta radioaktivnosti krvi tijekom opterećenja i oporavka.Aim: The purpose of this study was to investigate the changes in blood activity during rest, exercise and recovery, and to assess its influence on left ventricular (LV) volume determination using the count-based method requiring blood sampling and Tc-99m labelled red blood cells. Methods: 31 patients underwent rest-stress radionuclide ventriculography: in 17 patients red blood cells were labelled using Tc-99m (Group I) in vivo, and in 14 patients (Group II) by the modified in vivo/in vitro method. LV volumes were determined by a count-based method using corrected count rate in blood samples obtained during rest, peak exercise and after recovery. Results: In Group I at stress, the blood activity increased by 25.1 ± 6.4%, p<0.001, as compared to the rest level, and in Group II by 12.8 ± 4.5%, p<0.05. This had profound effects on LV volume determinations if only one rest blood aliquot was used: during exercise, the LV volumes were significantly overestimated by 32.1 ± 10.3%, p<0.001 in Group I, and by 10.7 ± 6.4%, p<0.05 in Group II. The changes in blood activity between stress and recovery were not significantly different between the groups. Conclusion: The use of solely a single blood sample as volume aliquot in rest-stress studies, when red blood cells were labelled using Tc-99m, leads to erroneous overestimation of cardiac volumes, due to significant changes in blood radioactivity during exercise and recovery

Left ventricular volume determination using a count- based method requiring blood sampling and rest-stress radionuclide ventriculography with Tc-99m labelled red blood cells

Istraživali smo promjene radioaktivnosti krvi u miru, tijekom opterećenja i nakon oporavka, te ispitali taj utjecaj na određivanje volumena lijeve klijetke metodom pomoću krvnog uzorka i radionuklidne ventrikulografije s Tc-99m obilježenim vlastitim eritrocitima. Radionuklidna ventrikulografija je učinjena kod 31 ispitanika: vlastiti eritrociti su obilježeni pomoću Tc-99m in vivo metodom kod 17 ispitanika (grupa I), a kod 14 osoba kombiniranom metodom in vivo/in vitro (grupa II). Volumeni lijeve klijetke su određeni metodom pomoću korigirane gustoće impulsa iz krvnih uzoraka uzetih u mirovanju, opterećenju i oporavku. Tijekom opterećenja u grupi I porasla je aktivnost krvi za 25.1 ± 6.4%, p<0.001, a u grupi II za 12.8 ± 4.5%, p<0.05 u odnosu na aktivnost krvi u mirovanju. To je imalo značajan utjecaj na određivanje srčanih volumena ukoliko se upotrijebio samo krvni uzorak uzet u miru: tijekom opterećenja volumen lijeve klijetke je značajno precijenjen u grupi I za 32.1 ± 10.3%, p<0.001, a u grupi II za 10.7 ± 6.4%, p<0.05. Nisu nađene značajne razlike aktivnosti krvi između opterećenja i nakon oporavka za bilo koju grupu. Upotreba samo jednog krvnog uzorka za određivanje referentnog volumena u miru i opterećenju u radionuklidnim studijama s Tc-99m obilježenim vlastitim eritrocitima vodi ka krivoj procjeni srčanih volumena zbog značajnog porasta radioaktivnosti krvi tijekom opterećenja i oporavka.Aim: The purpose of this study was to investigate the changes in blood activity during rest, exercise and recovery, and to assess its influence on left ventricular (LV) volume determination using the count-based method requiring blood sampling and Tc-99m labelled red blood cells. Methods: 31 patients underwent rest-stress radionuclide ventriculography: in 17 patients red blood cells were labelled using Tc-99m (Group I) in vivo, and in 14 patients (Group II) by the modified in vivo/in vitro method. LV volumes were determined by a count-based method using corrected count rate in blood samples obtained during rest, peak exercise and after recovery. Results: In Group I at stress, the blood activity increased by 25.1 ± 6.4%, p<0.001, as compared to the rest level, and in Group II by 12.8 ± 4.5%, p<0.05. This had profound effects on LV volume determinations if only one rest blood aliquot was used: during exercise, the LV volumes were significantly overestimated by 32.1 ± 10.3%, p<0.001 in Group I, and by 10.7 ± 6.4%, p<0.05 in Group II. The changes in blood activity between stress and recovery were not significantly different between the groups. Conclusion: The use of solely a single blood sample as volume aliquot in rest-stress studies, when red blood cells were labelled using Tc-99m, leads to erroneous overestimation of cardiac volumes, due to significant changes in blood radioactivity during exercise and recovery