Humans ; Liver Function Tests ; methods ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Pentetate

OBJECTIVETo study the relationship of renal aquaporin -1, -2, -3, and -4 (AQP1-4) expression with renal parenchymal thickness and glomerular filtration rate (GFR) in children with congenital hydronephrotis.

METHODSRenal tissue samples were obtained from 10 kidneys of 10 children (age: 62.3±18.3 months) with hydronephrosis and who underwent Anderson-Hynes pyeloplasty. Renal control samples were obtained from 6 children (age: 62.7±17.1 months) undergoing nephrectomy for nephroblastoma and were confirmed histologically as normal renal tissues. Renal parenchymal thickness of the hydronephrotic kidneys was measured by ultrasound preoperatively and was verified at operation. Renal GFR was assessed using 99mTc-DTPA scintigraphy preoperatively. Western blot was used to examine the expression of AQP1-4 in the renal tissues. The correlations of renal AQP1-4 expression with the renal parenchymal thickness and GFR were assessed by Pearson correlation analysis.

RESULTSThe expression of AQP1-4 in the hydronephrotis group was markedly reduced compared to that in the control group (P<0.05). The mean renal parenchymal thickness of the hydronephrotic kidney was 4.59±2.25 mm measured by ultrasound preoperatively. The mean GFR of the obstructed kidney was significantly lower than that of the contralateral kidney in the hydronephrosis group (40±12 mL/min vs 105±20 mL/min; P<0.05). The expression of AQP1, 2, 3 and 4 was positively correlated with preoperative renal GFR and renal parenchymal thickness in the hydronephrosis group (P<0.05). Renal parenchymal thickness was positively correlated with renal GFR (P<0.05).

CONCLUSIONSThe expression of renal AQP1-4 is reduced in children with congenital hydronephrosis. The expression levels of AQP1-4 are positively correlated with renal parenchymal thickness and GFR.

Aquaporins ; analysis ; Child ; Child, Preschool ; Female ; Glomerular Filtration Rate ; Humans ; Hydronephrosis ; congenital ; metabolism ; pathology ; Kidney ; pathology ; Male ; Sulfhydryl Compounds ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Pentetate

PURPOSE: In the breast cancer patient, lymphatic mapping and sentinel lymph node biopsy are the most important procedure for axillary lymph node staging. We aimed to compare the three radiocolloids [99mTc-antimony trisulfide colloid (ASC), 99mTc-tin colloid (TC), and 99mTc-human serum albumin (HSA)] for sentinel lymph node mapping. SUBJECTS AND METHODS: Totally, 397 patients with clinically N0 stage were enrolled. 99mTc-ASC was injected in 202 out of 397 patients, 99mTc-TC was injected in 120 patients, and 99mTc-HSA was injected in the remaining 75 patients. The sentinel lymph nodes were localized by lymphoscintigraphy and selected using intraoperative gamma probe. All sentinel lymph nodes were investigated by intraoperative pathologic consultation. The axillary lymph nodes which were harvested by the lymph node dissection were also investigated. RESULTS: The patients of each group showed similar clinical characteristics. There were no significant differences (p>0.05) in the identification rate of sentinel lymph nodes (IR), false negative rate (FNR), and negative predictive value (NPV). The axillary lymphadenectomy revealed axillary lymph node metastases in those three groups (ASC-33.2%, TC-31.7%, HSA-22.7%). The IR, FNR, and NPV were not significantly different among those groups. CONCLUSION: Those three 99mTc-labeled radiocolloids showed equivalent results in sentinel lymph node mapping of breast cancer.
Breast Neoplasms* ; Breast* ; Colloids* ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Lymphoscintigraphy ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy ; Technetium ; Technetium Tc 99m Aggregated Albumin*

The extraction rates of biogenic amines such as 5-hydroxytryptamine(5-HT) and norepinephrine(NE) in pulmonary endothelium, and the permeability of human serum albumin(HSA) to pulmonary epithelium were measured in experimental adult respiratory distress syndrome(ARDS), in order to evaluate their usefulness for the early recognition of ARDS. Sixteen mongrel dogs(body weight, 13+/-0.9 kg) were divided into 3 groups; Oleic acid 0.06 ml/kg was injected to 6 dogs(M group) and oleic acid 0.12 ml/kg to 6 dogs(S group). Four dogs were used as a control group. The extraction rates(%) of 14C-5-HT and 3H-NE, the blood concentration of (99m)Tc-HSA, hemodynamic changes and changes of arterial gas profile were measured and compared among three groups. In control group with 100% oxygen ventilation, the extraction rates of 14C-5-HT, 3H-NE and the blood concentration of 99mTc-HSA were not changed. In M group, the extraction rate(%) of 14C-5-HT was decreased from 61.5+/-3.1 to 43.8+/-5.2 in 10 minutes, and such decreased extraction rate(%) was maintained for 2 hours. The extraction rate(%) of (3)H-NE was decreased from 32.3+/-3.6 to 19.5+/-2.5 in 10 minutes. In S group, the extraction rate(%) of 14C-5-HT was decreased from 60.9+/-5.1 to 23.2+/-5.7 in the first 10 minutes, and the extraction rate(%) of H-NE was decreased from 30.1+/-4.3 to l3.1+/-1.9 in 10 min, and decreased slowly thereafter. The blood concentration of 99mTc-HSA was decreased significantly in M group and more in S group compared with control group during two-hour observation. These results suggest that measuring extraction rates of biogenic amines couid be applied for early recognition of ARDS, however, the change of blood 99mTc-HSA concentration could not be applied for early recognition of ARDS, because it has poor correlation to the progression of respiratory failure.
Adult ; Animals ; Biogenic Amines* ; Dogs* ; Endothelium ; Epithelium ; Hemodynamics ; Humans ; Oleic Acid ; Oxygen ; Permeability* ; Respiratory Insufficiency* ; Serum Albumin* ; Technetium Tc 99m Aggregated Albumin ; Ventilation

A 16-year old girl was admitted for chronic diarrhea, generalized edema, severe pain of lower extremities, and general weakness. She could not walk because of burning pain of knee and ankle. 99mTc-MDP bone scan demonstrated increased periarticular uptake in both lower extremity with focal increased activity in proximal portion of both tibias.. Abnormal abdominal activity in ascending, transverse, and descending colon is also seen. Bone densitometry showed severe osteoporosis in lower extremity. 99mTc-HSA scan showed abnormal radioactivity in small bowel, and descending colon indicating protein losing enteropathy. Endoscopic biopsy of terminal ileum showed a few dilated lymphatics in the submucosa. After steroid and supplemental therapy, the symptoms and signs of both protein losing enteropathy and RSDS much improved simultaneously. Reflex sympathetic dystrophy syndrome is a complex of symptoms characterized by severe pain, swelling, autonomic vasomotor dysfunction, and impaired mobility of affected extremities. The important causes are trauma, fracture, and inflammation. We assumed that the reflex sympathetic dystrophy syndrome of this girl was due to protein losing enteropathy. And as far as we know there has not been reported case that protein losing enteropathy assumed as a cause of reflex sympathetic dystrophy syndrome.
Adolescent ; Ankle ; Biopsy ; Burns ; Colon, Descending ; Densitometry ; Diarrhea ; Edema ; Extremities ; Female ; Humans ; Ileum ; Inflammation ; Knee ; Lower Extremity ; Osteoporosis ; Protein-Losing Enteropathies* ; Radioactivity ; Reflex Sympathetic Dystrophy* ; Reflex* ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Medronate ; Tibia

OBJECTIVETo evaluate the effectiveness of dynamic SPECT (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy on the assessment of reserve function of cirrhosis liver.

METHODSFrom January 2010 to December 2011, 55 patients with cirrhosis liver were enrolled in this study. The case numbers of male and female were 43 and 12 respectively and the age was (51 ± 9) years (ranging from 35 to 69 years). After routine biochemistry test, CT scan and (99m)Tc-GSA dynamic SPECT scan were performed in turn using a juxtaposed SPECT/CT system. Then the morphologic volume of liver parenchyma (MLV), functional liver volume (FLV) and the hepatic cell absorption rate constant (GSA-K) were calculated. The correlations between GSA-K and routine biochemistry test, Child-Pugh score, indocyanine green clearance rate (ICG-K) were analyzed. The patients were further divided into 3 groups according to whether there was occlusion or stenosis in the main branch of left portal vein (group 1, n = 5), right portal vein (group 2, n = 13) or not (group 3, n = 37) and the regional hepatic functions index of the 3 groups were compared.

RESULTSThe value of FLV of the whole, left and right liver was (594 ± 152) ml, (244 ± 119) ml and (356 ± 171) ml, respectively. There were correlations between GSA-K and total bilirubin, prothrombintime, Child-Pugh score and ICG-K (r = -0.730--0.298, P < 0.05). The FLV and MLV ratios of involved hemiliver to uninvolved hemiliver were 0.09 ± 0.06 and 0.30 ± 0.14 in group 1, 0.57 ± 0.43 and 1.08 ± 0.63 in group 2, 0.71 ± 0.30 and 0.71 ± 0.48 in group 3. The difference in MLV-FLV ratio was signifcant between group 1 and group 3, between group 2 and group 3 (P = 0.000).

CONCLUSIONSThe dynamic SPCECT (99m)Tc-GSA scintigraphy can not only assess the whole liver function of cirrhosis liver effectively, but also evaluate the variation of regional liver function accurately.

Adult ; Aged ; Female ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Technetium Tc 99m Aggregated Albumin ; metabolism ; Technetium Tc 99m Pentetate ; metabolism ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: In the anesthetic state, various anesthetic agents may effect on hyperosmolar blood-brain barrier disruption. Therefore, the effects of intravenous anesthetics, pentobarbital, ketamine and propofol, on the mannitol induced blood brain barrier disruption (BBBD) of 21 Spague-Dawly rats were evaluated. METHODS: Intravenous anesthetics, pentobarbital (group 1), propofol (group 2) and ketamine (group 3), were administrated before right intracarotid artery infusion of mannitol in three groups. BBBD was estimated by the calculation of the ratio of radioactivity between plasma and brain tissue using 99MTC-human serum albumin and Evans blue staining in cerebral hemisphere. Also cerebral blood flow (CBF) was monitored with laser doppler flowmetry. RESULTS: Percent albuminal space of right and left cerebral hemisphere was showed 9.01 +/- 3.47%, 1.65 +/- 1.25% in group 1, 8.02 +/- 2.19%, 1.61 +/- 1.06% in group 2 and 5.63 +/- 1.79%, 1.10 +/- 0.94% in group 3 respectively. Evans blue dye staining was showed 2+~3+ in the right and 0 in the left cerebral hemisphere in all groups. Right cerebral hemisphere showed significantly more blood brain barrier disruption than left cerebral hemisphere in all groups (p<0.01). And there was no significant difference in BBBD among three groups. However, the degree of BBBD of group 3 was drop down to nearly 70-80% of group 1 and 2. The CBF of group 3 was significantly higher than that of group 1 and group 2 after intracarotid infusion of mannitol (p<0.05). CONCLUSIONS: The results suggest that pentobarbital, propofol and ketamine could be used to be anesthetics for BBBD in rats, but some caution should be paid to use ketamine in mannitol induced BBBD.
Anesthetics ; Anesthetics, Intravenous* ; Animals ; Arteries ; Blood-Brain Barrier* ; Brain ; Cerebrum ; Evans Blue ; Ketamine ; Laser-Doppler Flowmetry ; Mannitol* ; Pentobarbital ; Plasma ; Propofol ; Radioactivity ; Rats* ; Technetium Tc 99m Aggregated Albumin

Juvenile polyposis is an uncommon condition characterized by the development of multiple juvenile polyps predominantly in the colon but also in the rest of the gastrointestinal tract. Patients with juvenile polyposis commonly present with rectal bleeding, diarrhea, abdominal pain, anemia, prolapse of the polyp. We experienced a juvenile polyposis in a 7 year-old male patient with protein losing enteropathy who was diagnosed by 99MTc-human serum albumin abdominal scintigraphy, colonoscopy, and small bowel series. Proctocolectomy with ileostomy was performed and then protein losing enteropathy was resolved.
Abdominal Pain ; Anemia ; Child ; Colon ; Colonoscopy ; Diarrhea ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileostomy ; Male ; Polyps ; Prolapse ; Protein-Losing Enteropathies* ; Radionuclide Imaging ; Technetium Tc 99m Aggregated Albumin

BACKGROUND/AIMS: Hypoxemia is often associated with liver cirrhosis without cardiopulmonary diseases. Pulmonary vascular impairments including intrapulmonary shunt have been considered as a major mechanism of hypoxemia. The aim of this study was to determine the incidence and pathophysiologic basis of hypoxemia in cirrhotic patients without respiratory symptoms. METHODS: In fourty three cirrhotic patients without heart and lung diseases, we performed the arterial blood gas analysis and calculated alveolar arterial oxygen gradient (A-aO2). According to the A-aO2, the patients were divided into hypoxemic and normoxemic groups. In each group, a Tc-99m-macroaggregated albumin (Tc-99m-MAA) scan, a contrast-enhanced echocardiography and a pulmonary function test were performed. RESULTS: Twenty-eight of 43 patients (65%) showed hypoxemia. Hypoxemic patients showed significantly more increased shunt fraction of 3.1 1.4% than normoxemic one of 2.1 1.1% in the Tc-99m-MAA scan (p<0.05). However, only two of hypoxemic patients had shunt fraction above physiologic shunt range. By contrast-enhanced echocardiography, an intrapulmonary shunt was confirmed in one patient. There was no significant correlation between the shunt fraction and the hepatic reserve based on the Child-Pugh classification in hypoxemic patients. In the results of pulmonary function test, only DLco decreased more significantly in hypoxemic group than in normoxemic group (58.4 14.2 % vs 75.3 16.5% of predicted, p<0.05). CONCLUSIONS: Hypoxemia is not infrequently observed in cirrhosis, but incidence of significant intrapulmonary shunt is low. Therefore, other mechanism such as diffusion defect may be suggested to play a role in the development of hypoxemia in cirrhotic patients without respiratory symptoms.
Anoxia ; Blood Gas Analysis ; Classification ; Diffusion ; Echocardiography ; Fibrosis ; Heart ; Humans ; Incidence ; Liver Cirrhosis* ; Liver* ; Lung Diseases ; Oxygen ; Respiratory Function Tests ; Technetium Tc 99m Aggregated Albumin

BACKGOUND: The barrier can be altered by a number of insults to the brain (e.g., hypertension, freezing, trauma, drug). But the effect of the blood brain barrier distruction immediately after the neural change is unknown. In the present study, we focused on the BBBD after cervical sympathetic chain block. METHODS: 13 male Sprague-Dawley rats were divided into 2 groups. Group 1 (N=7) was blocked with 0.5% bupivacaine on the right cervical sympathetic chain and group 2 (N=6) was blocked with 0.5% bupivacaine on the bilateral cervical sympathetic chain. All rats received 37degrees C, 25% mannitol (1.75 g/kg) via right carotid artery and then, the effect of cervical sympathetic chain block on blood-brain barrier disruption of four cerebral compartment using 99mTc-human serum albumin and Evans blue was evaluated. RESULTS: Both groups showed blood-brain barrier disruption and there was no significant difference between group 1 and group 2 in the anterior and posterior hemisphere of the right side brain. But group 2 showed significant blood-brain barrier disruption than group 1 in anterior and posterior hemisphere of the left brain (p<0.01). CONCLUSIONS: This results suggest that cervical sympathetic chain block can increase the degree of mannitol-induced blood-brain barrier disruption via neural arch or blood flow change.
Anesthetics ; Animals ; Autonomic Nerve Block* ; Blood-Brain Barrier* ; Brain ; Bupivacaine ; Carotid Arteries ; Evans Blue ; Freezing ; Humans ; Hypertension ; Male ; Mannitol* ; Rats* ; Rats, Sprague-Dawley ; Technetium Tc 99m Aggregated Albumin