Leptospirose-'n bespreking van 4 gevalle

No Abstrac

A simple automated system for the routine production of 99mTc by methyl-ethyl-ketone extraction

A relatively simple, automated system for the rapid, efficient and safe routine production of 99mTcM from 99Mo03 by the methyl-ethyl-ketone (MEK) extraction technique is described. The 4 phases of the extraction process - bubbling of air, phase separation, drawing off of 99mTc in MEK, and evaporation to dryness, are controlled by an automatic timer, suction-pressure pump and solenoid switches. The eluate was found to contain neither bacterial organisms or pyrogens nor significant levels of alumina and radio-isotopic impurities. With this system it is possible to make use of locally produced 99Mo, even of low specific activity for the routine production of 99mlc in any concentration required.S. Afr. Med. J., 48, 998 (1974)

Indium·113m vir hart-, lewer- en plasentaflikkergrafie

No Abstrac

Analysis of radiation doses received by the public from 131I treatment of thyrotoxic outpatients

Radiation doses to the family and general public from 131I therapy of outpatients were assessed for comparison with the 1990 International Commission on Radiation Protection (ICRP) dose limits. Doses to family members of such patients, measured by previous workers, were converted to show that on average 5.6 ± 3.7 μSv MBq-1 is received by the spouse and 1.5 ± 0.87 μSv MBq-1 by other family members. It was deduced that the average dose to the spouse (D μSv MBq-1) when couples sleep apart for T days after administration is given by: D = 2.528 + 3.072e(-0.11T) if an effective half-life, T(eff), of 6.35 days is used. The cumulative effect of repeated treatments should be considered and in view of ALARA it is recommended that couples sleep apart for at least 14 days after each administration, even if this is below limits permitted by authorities. The dose to a pregnant colleague or family member other than the wife should be below 2 mSv if the total administered activity is not more than 600 MBq. If the wife is pregnant, couples should sleep apart for at least 30 days after administration.Articl

The role of kidney uptake of Tc-99m pertechnetate during quantitation of gastric scintigraphy

[No abstract available]Articl

The effect of rooibos tea on iron absorption

The original publication is available at http://www.samj.org.zaBibliographyA study was carried out to determine if rooibos tea (Aspalathus linearis) has a deleterious effect on iron absorption similar to that of ordinary tea (Camellia sinensis). Three groups of volunteers, each consisting of 10 healthy young men comparable with regard to iron status and body dimensions, were studied. After ingestion of 1 μCi 59Fe and 16 mg of elemental iron, group A drank rooibos tea, group B ordinary tea and group C boiled water. Iron absorption was measured 14 days later with a whole body counter. Mean iron absorption after ingestion of rooibos tea, ordinary tea, and water was 7.25%, 1.70% and 9.34% respectively. In contrast to ordinary tea (P<0.001), rooibos tea did not affect iron absorption significantly. The ascorbic acid content of rooibos tea varies between 121,8 and 154,9 μmol/l depending on the method of preparation. Rooibos tea contains small amounts of iron, magnesium, phosphorus, sodium chloride and potassium. These findings have practical nutritional and therapeutic implications.Publishers’ versio

Ventilation-perfusion imaging in evaluating regional lung function in nonpenetrating injury to the chest

The extent of chest wall and lung injury after nonpenetrating injury to the chest (NIC) determine how aggressive and invasive management modalities should be. We investigated the value of ventilation (133Xe) and perfusion (99mTc) studies as indicators of extent of lung injury in 28 patients with moderate to severe unilateral NIC. The ventilation-perfusion (V̇/Q̇) abnormalities were compared with parameters conventionally used to evaluate NIC. All studies were carried out within 24 h of NIC and repeated 24 h later. Ventilation (p < 0.001) and perfusion (p < 0.01) abnormalities were more extensive soon after NIC than suggested by chest roentgenograms. Chest x-ray film changes lagged behind V̇/Q̇ changes on admission and also after 24 h. The extent of ventilation, perfusion, and chest x-ray film abnormalities on admission were all predictors of increased morbidity. V̇/Q̇ studies may be useful to define the extent as well as the changes in regional lung function following NIC.Articl

99mTc-MIBI stress-rest myocardial perfusion scintigraphy in patients with complete left bundle branch block

Background. Patients with complete left bundle branch block (LBBB) often show a false-positive ischaemic pattern in the interventricular septum on thallium-201 (201Tl) stress-rest myocardial perfusion scintigraphy. Equivocal results have been reported with technetium-99m labelled hexakis-methoxyisobutyl isonitrile (99mTc-MIBI) in such patients. The aim of this retrospective study was to determine the effect of LBBB on the septal uptake of 99mTc-MIBI during stress-rest single photon emission computed tomography (SPECT) scintigraphy. Methods. We studied 75 consecutive patients with LBBB, referred for 99mTc-MIBI stress-rest SPECT. Studies were evaluated by visual analysis using a semi-quantitative grading technique. In all patients with abnormal septal segments, the presence or absence of ischaemic heart disease was confirmed either clinically or by means of angiographical examination. Results. Forty-three patients (57.3%) had completely normal studies. Only 15 (20%) had septal abnormalities (11 with reversible and 4 with fixed defects), while 17 patients (22.7%) had abnormal segments in areas other than the interventricular septum. Except for 1 patient lost to follow-up, ischaemic heart disease was confirmed in all the patients with septal changes. Conclusion. We conclude that 99mTc-MIBI is more specific than 201Tl for identifying ischaemic heart disease in the presence of LBBB.Articl

Brain uptake of iodine-131 metaiodobenzylguanidine following therapy of malignant pheochromocytoma

Intracranial metaiodobenzylguanidine (MIBG) uptake is occasionally and only faintly visualized on diagnostic studies. Recently, intense normal cerebellar uptake was described on posttherapy MIBG images. Experience at the University of Michigan with posttherapy MIBG scintigraphy of pheochromocytoma was reviewed. The patterns and correlates of intracranial uptake after therapeutic I-131 MIBG in 25 patients (61 patient treatment encounters) were evaluated by review of records and blinded consensus interpretation of diagnostic and posttherapeutic MIBG scans. Thirty-nine (64%) patient treatment encounters demonstrated at least faint (grade 1) MIBG uptake in one or more brain sites; the most common site was the cerebellum. There was a statistically significant relation between intracranial uptake and 1) size of therapeutic dose and 2) patient age, but no relation between intracranial uptake and gender, body mass index, plasma epinephrine level, plasma norepinephrine level, urine metanophrine level, or the therapy-to-imaging interval. Although the influence of age on the pattern and intensity of intracranial uptake is unexplained, the relation to therapy dose may be explained by the possible generation of MIBG metabolites that can cross the blood-brain barrier (high activity administered and the delay until imaging). Further studies are needed to define mechanisms of intracranial uptake and relation to responses and toxicity after MIBG therapy of neuroendocrine tumors.Intracranial metaiodobenzylguanidine (MIBG) uptake is occasionally and only faintly visualized on diagnostic studies. Recently, intense normal cerebellar uptake was described on posttherapy MIBG images. Experience at the University of Michigan with posttherapy MIBG scintigraphy of pheochromocytoma was reviewed. The patterns and correlates of intracranial uptake after therapeutic I-131 MIBG in 25 patients (61 patient treatment encounters) were evaluated by review of records and blinded consensus interpretation of diagnostic and posttherapeutic MIBG scans. Thirty-nine (64%) patient treatment encounters demonstrated at least faint (grade 1) MIBG uptake in one or more brain sites; the most common site was the cerebellum. There was a statistically significant relation between intracranial uptake and 1) size of therapeutic dose and 2) patient age, but no relation between intracranial uptake and gender, body mass index, plasma epinephrine level, plasma norepinephrine level, urine metanophrine level, or the therapy-to-imaging interval. Although the influence of age on the pattern and intensity of intracranial uptake is unexplained, the relation to therapy dose may be explained by the possible generation of MIBG metabolites that can cross the blood-brain barrier (high activity administered and the delay until imaging). Further studies are needed to define mechanisms of intracranial uptake and relation to responses and toxicity after MIBG therapy of neuroendocrine tumors.ArticleArticl

Single photon emission computed tomography v. planar imaging in recent myocardial infarction using technetium-99m pyrophosphate

Radionuclide imaging of the myocardium with technetium-99m-labelled pyrophosphate (PYP) is a sensitive method for the diagnosis of a recent (2-7 days old) myocardial infarct. Although the sensitivity of planar imaging with PYP is more than 95% for recent transmural infarcts, it varies between 30% and 95% in nontransmural infarcts. It has, however, been shown that single photon emission computed tomography (SPECT) considerably enhances the sensitivity of this technique in patients with proven non-transmural infarcts. In the present study SPECT is evaluated in patients with a doubtful diagnosis of a recent myocardial infarct. Ninety-nine consecutive patients, who were referred from a cardiology unit with an uncertain diagnosis of a recent myocardial infarction, were studied with routine planar and SPECT imaging with PYP. Images were obtained 3 hours after an intravenous injection of 600 MBq PYP. The images were viewed independently by 3 experienced nuclear medicine physicians in a retrospective analysis of the results. These were reported as positive, equivocal or negative for myocardial infarction. There were 30 patients with positive and 44 with negative images using both methods of imaging. Twenty-three patients with normal or equivocal images on the planar views were regarded as positive on the SPECT studies. The difference was highly significant (P < 0,001). SPECT considerably improved the sensitivity of PYP imaging in this series. It increased image quality, gave a much clearer delineation of the infarct and enhanced observer confidence during reporting. Furthermore, the method is non-invasive and inexpensive and should considerably shorten the hospital stay of many patients in whom a firm diagnosis of a recent myocardial infarction could not be made by conventional means.Articl