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Pantalone KM, Misra-Hebert AD, Hobbs TM, Ji X, Kong SX, Milinovich A, Weng W, Bauman JM, Ganguly R, Burguera B, Kattan MW, Zimmerman RS. Intensification patterns and the probability of HbA 1c goal attainment in Type 2 diabetes mellitus: real-world evidence for the concept of 'intensification inertia'. Diabet Med 2020; 37:1114-1124. [PMID: 30653705 DOI: 10.1111/dme.13900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2019] [Indexed: 12/25/2022]
Abstract
AIMS To assess the effects of 'clinical' and 'intensification inertia' by evaluating the impact of different intensification interventions on the probability of HbA1c goal attainment using real-world data. METHODS Electronic health records (Cleveland Clinic, 2005-2016) were used to identify 7389 people with Type 2 diabetes mellitus and HbA1c ≥53 mmol/mol (≥7.0%), despite a stable regimen of two oral antihyperglycaemic drugs for ≥6 months. The participants were stratified by index HbA1c and analysed over a 6-month period for pharmacological intensification, and then for 12 additional months for HbA1c goal attainment (<53 mmol/mol). RESULTS The probability of HbA1c goal attainment (Kaplan-Meier analysis) in the group with index HbA1c 53-63 mmol/mol (7.0-7.9%) was highest with the addition of oral antidiabetic drugs [57.3% (95% CI 52.1, 62.0)] or glucagon-like peptide-1 receptor agonists [56.7% (95% CI 40.4, 68.6)], in the 64-74 mmol/mol (8.0-8.9%) group with the addition of oral antidiabetic drugs [31.9% (95% CI 25.1, 38.1)] or insulin [30.6% (95% CI 18.3, 41.0)], and in the ≥75 mmol/mol (≥9.0%) group with the addition of glucagon-like peptide-1 receptor agonists [53.0% (95% CI 31.8, 67.6)] or insulin [43.5% (95% CI 36.4, 49.8)]. CONCLUSIONS Numerical, but not statistically significant, differences in HbA1c goal attainment probability by type of intensification were most marked in people with the highest index HbA1c [≥75 mmol/mol (≥9.0%)]; in this group, injectable therapy showed trends toward greater glycaemic control benefits. Additional research into the phenomenon of intensification inertia is warranted.
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Affiliation(s)
- K M Pantalone
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA
| | - A D Misra-Hebert
- Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - T M Hobbs
- Chief Medical Officer, Novo Nordisk Inc., Plainsboro, NJ, USA
| | - X Ji
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - S X Kong
- Health Economics and Outcomes Research, Novo Nordisk Inc., Plainsboro, NJ, USA
| | - A Milinovich
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - W Weng
- Health Economics and Outcomes Research, Novo Nordisk Inc., Plainsboro, NJ, USA
| | - J M Bauman
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - R Ganguly
- Health Economics and Outcomes Research, Novo Nordisk Inc., Plainsboro, NJ, USA
| | - B Burguera
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - M W Kattan
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - R S Zimmerman
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA
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Abstract
OBJECTIVE To test whether cholesterol ester transfer protein (CETP) genotype (VV homozygosity for I405V) is associated with preservation of cognitive function in addition to its association with exceptional longevity. METHODS We studied Ashkenazi Jews with exceptional longevity (n = 158; age 99.2 +/- 0.3 years) for the associations of CETP VV genotype and lipoprotein phenotype, using the Mini-Mental State Examination (MMSE). To confirm the role of CETP in a younger cohort, we studied subjects from the Einstein Aging Study (EAS) for associations between CETP VV and cognitive impairment. RESULTS Subjects with MMSE > 25 were twice as likely to have the CETP VV genotype (29% vs 14%, p = 0.02), and those with the VV genotype were more likely (61% vs 30%, p = 0.02) to have MMSE > 25. Subjects with the VV genotype had lower levels of CETP (1.73 +/- 0.11 vs 2.12 +/- 0.10 mug/mL, p = 0.01), higher high-density lipoprotein (HDL) levels (p = 0.02), and larger lipoprotein particles (p = 0.03). In the EAS cohort, an approximately fivefold increase in the VV genotype (21% vs 4%, p = 0.02), higher HDL levels, and larger lipoprotein particle sizes were associated with less dementia and improved memory. CONCLUSIONS Using two independent cohorts, we implicate the longevity CETP gene as a modulator of age-related cognitive function. A specific CETP genotype is associated with lower CETP levels and a favorable lipoprotein profile. It has not been determined whether modulation of this gene prevents age-related decline or AD.
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Affiliation(s)
- N Barzilai
- Institute for Aging Research, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
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Peterson AC, Bauman JM, Light DE, McMann LP, Costabile RA. The prevalence of testicular microlithiasis in an asymptomatic population of men 18 to 35 years old. J Urol 2001; 166:2061-4. [PMID: 11696707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE Testicular microlithiasis is an imaging entity of the testicle thought to be a marker of testicular cancer. To our knowledge the prevalence of testicular microlithiasis in an asymptomatic population at risk for testicular cancer is unknown. We report an ultrasound screening study done to establish the prevalence of testicular microlithiasis in an asymptomatic population. MATERIALS AND METHODS Healthy men 18 to 35 years old from the annual Army Reserve Officer Training Corps training camp volunteered for study. A screening genitourinary history was obtained, and physical examination and screening scrotal ultrasound were performed. We defined testicular microlithiasis as more than 5 high intensity signals on ultrasound with each signal larger than 2 mm. We categorized testicular microlithiasis into microcalcifications that were scant-5 to 25 per side, moderate-greater than 25 per side but no areas of near confluence and too numerous to count. In all subjects with testicular microlithiasis tumor markers were also measured. RESULTS Of 1,504 evaluated men with a mean age of 22.4 years, 84 (5.6%) had testicular microlithiasis, including 45 of 1,053 white (4%), 21 of 149 black (14.1%), 6 of 71 Hispanic (8.5%), 3 of 54 Asian or Pacific Island (5.6%) men and 9 of 174 (5.2%) who claimed no race affiliation. Tumor markers were normal in all subjects with testicular microlithiasis. CONCLUSIONS Testicular microlithiasis occurs in more than 5% of healthy young men. In contrast, testicular cancer develops in 3/100,000 to 5/100,000 men or 1,000-fold less often. The relative prevalence of testicular microlithiasis with respect to testicular cancer, increased prevalence in minorities, bilateral distribution, and inverse geographic distribution of men with testicular microlithiasis and testicular cancer represent evidence against an association of the 2 conditions. This study indicates that testicular microlithiasis is a common finding in asymptomatic men that may not be related to testicular cancer.
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Affiliation(s)
- A C Peterson
- Department of Surgery, Madigan Army Medical Center, Tacoma, Washington 98431, USA
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Affiliation(s)
- D M Keadle
- Departments of Nuclear Medicine, Haemek Medical Center, Afula, Israel.
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Affiliation(s)
- D M Keadle
- Department of Nuclear Medicine, Madigan Army Medical Center, Tacoma, Washington 98431, USA.
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Wiest PW, Hartshorne MF, Inskip PD, Crooks LA, Vela BS, Telepak RJ, Williamson MR, Blumhardt R, Bauman JM, Tekkel M. Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med 1998; 17:487-496. [PMID: 9697951 DOI: 10.7863/jum.1998.17.8.487] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Detection of thyroid nodules by physical examination and high-resolution ultrasonography was compared using small groups of blinded, experienced physician examiners working with a sample of 2441 persons from Estonia, most of whom were Chernobyl nuclear reactor clean-up workers. A random subsample of 113 (5%) persons was subjected to triple control examinations with both physical examination and high-resolution ultrasonography. Positive high-resolution ultrasonographic findings were considerably more reproducible among different observers than were positive physical examination findings. Agreement between methods was poor. Nodules were found in 169 (6.9%) subjects by physical examination and in 249 (10.2%) subjects by high-resolution ultrasonography. Physical examination found only 53 (21%) of the 249 nodules found by high-resolution ultrasonography. High-resolution ultrasonography did not confirm the existence of 115 (68%) of the 169 nodules found by physical examination. Only 6.4% of nodules less than 0.5 cm in diameter, as based on high-resolution ultrasonographic results, were detected by physical examination. Physical examination detection improved with increasing nodule size but was still only 48.2% for nodules larger than 2 cm. Physical examination was relatively effective in detecting nodules in the isthmus of the thyroid gland but much less so for nodules in the upper pole of the gland. Clinical evaluation and epidemiologic studies of nodular thyroid disease stand to benefit from the greater sensitivity and specificity of ultrasonographic examinations.
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Affiliation(s)
- P W Wiest
- Department of Radiology, University of New Mexico School of Medicine, Veterans Affairs Medical Center, Albuquerque, USA
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Abstract
The case of a 5-year-old girl with a lifelong history of xerostomia, poor dentition and decreased lacrimal gland secretion is presented. To our knowledge, this is the youngest reported patient with such symptoms and the first case confirmed with magnetic resonance imaging.
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Affiliation(s)
- M A Myers
- Department of Radiology, Madigan Army Medical Center, Tacoma, Wash 98431
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Kinney JB, Schofield TD, Kawabori I, Budd SE, Bauman JM. Quantitative perfusion imaging assessing acquired discrete peripheral pulmonary artery stenosis. J Nucl Med 1993; 34:1995-7. [PMID: 8229249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
We present the case an 8-yr-old boy evaluated for anastomotic stenosis of the right pulmonary artery after surgical repair of hemitruncus at 6 wk of age. Pulmonary angiography revealed only mild narrowing and a 10-mm pressure gradient across the anastomosis, but quantitative perfusion imaging demonstrated that the right lung only received 16% of pulmonary blood flow. Subsequently, balloon angioplasty of the anastomotic site was performed, resulting in complete resolution of the stenosis and gradient. Early postangioplasty perfusion imaging demonstrated increased perfusion of the right lung to 35% of total pulmonary blood flow. It is theorized that initially a chronically hyperperfused lung may develop more capacious vessels and recruit new capillaries during the years of hyperperfusion such that a "perfect" angioplasty may result in less than symmetric perfusion. The inexpensive, noninvasive quantitative perfusion study is more sensitive and accurate in evaluating acquired (postsurgical) pulmonary artery stenoses.
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Affiliation(s)
- J B Kinney
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington 98431-5000
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Bauman JM. Pseudodislocation of the glenohumeral joint diagnosed by bone scintigraphy. Clin Nucl Med 1993; 18:147-8. [PMID: 8432061 DOI: 10.1097/00003072-199302000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- J M Bauman
- Madigan Army Medical Center, Tacoma, Washington 98431-5000
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Bauman JM. Gallbladder ejection fraction: still in need of validation. Gastroenterology 1992; 102:1446-7. [PMID: 1551565 DOI: 10.1016/0016-5085(92)90812-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Bauman JM, Bergh JR, Blumhardt R, Byrd BF, Cawthon MA, Gonzales AC, Hartshorne MF, Heironimus JD, Jackson RE, Lasher JC. Rotating slanthole collimater SPECT revisited. J Nucl Med 1989; 30:1737. [PMID: 2795216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Abstract
Three hundred fifteen radioisotopic bone scans ranging from initial scan only to nine scans per patient, performed on 114 patients with adenocarcinoma of the prostate between 1979 and 1984, were reviewed. Seventeen patients had positive scans, ten on initial scan and seven at follow-up. Nine patients had bone pain at the time of the first positive scan and pain developed in two patients 6 months and 2 years later, respectively. The other six patients are still asymptomatic 1 to 4 years later. False-positive scans were found in six other patients. No patient with bone pain had a negative scan. We believe that routine bone scans for prostate cancer follow-up are not cost-effective unless the patient is symptomatic. Bone scans also are indicated for initial staging and to observe disease response to protocol treatment.
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Affiliation(s)
- D Corrie
- Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas
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Timmons JH, Hartshorne MF, Peters VJ, Cawthon MA, Bauman JM. Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review. Radiology 1988; 167:173-8. [PMID: 2831562 DOI: 10.1148/radiology.167.1.2831562] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease.
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Affiliation(s)
- J H Timmons
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, TX 78234
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Abstract
A total of 66 patients with advanced coronary artery disease (CAD) and 36 with dilated cardiomyopathies (DCM) with ejection fractions less than 20% were analyzed retrospectively to establish patterns of wall motion in each of four quadrants on standard left anterior oblique gated radionuclide ventriculograms. In both disease states the best preserved wall motion was found in the basal free wall quadrant of the left ventricle. The two terminal disease states could not be differentiated on the basis of wall motion patterns.
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Affiliation(s)
- M Boykin
- Nuclear Medicine Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234
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Lovern RE, Bosse DA, Hartshorne MF, Bauman JM, Billingsley JL, Byrd BF, Momii GD, Crooks LA. Organizing hematoma of the thigh. Multiple imaging techniques. Clin Nucl Med 1987; 12:661-4. [PMID: 3311525 DOI: 10.1097/00003072-198708000-00021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- R E Lovern
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, Texas 78234
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Abstract
Nine cases of suspected craniotomy flap osteomyelitis evaluated by combined bone and gallium scanning are presented. In six cases, the clinical data were inconclusive and evaluation by radionuclide imaging provided an accurate negative diagnosis. The other three cases considered positive by this technique were proven infected at subsequent exploration and flap removal. The use of radionuclide bone and gallium imaging should be considered in cases of possible craniotomy flap osteomyelitis.
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Bauman JM, Landry AJ, Cawthon MA, Hartshorne MF. Indium-111 labeled leukocyte uptake: false-positive results in noninfected pseudoaneurysms. Radiology 1986; 161:570. [PMID: 3763937 DOI: 10.1148/radiology.161.2.3763937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Bauman JM, Middaugh RE, Cawthon MA, Hartshorne MF, Menk EJ, Baysinger C. Radionuclide-anesthetic flow study: a new technique for the study of regional anesthesia. J Nucl Med 1986; 27:1487-9. [PMID: 3528416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A new technique to study the dynamics of in vivo distribution of regional anesthetics is described. Five hundred microcuries of technetium-99m diethylenetriaminepentaacetic acid (DTPA) added to the anesthetic in a syringe prior to injection allows both dynamic and static imaging to assess the initial distribution of the injected anesthetic. Superimposed bone scans or transmission scans help delineate anatomy. The radionuclide-anesthetic flow study is a simple, safe technique to investigate both the spread of regional anesthetics and the factors that affect it.
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Hartshorne MF, Brown JM, Cawthon MA, Bauman JM. Profound xenon-133 trapping in left main bronchus. Obstruction by necrotic tumor. Clin Nucl Med 1986; 11:525-6. [PMID: 3731659 DOI: 10.1097/00003072-198607000-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Squamous cell carcinoma of the esophagus eroded into the central airway with production of left main bronchus occlusion and aspiration pneumonia of the right lower lobe.
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Telepak RJ, Hartshorne MF, Cawthon MA, Bauman JM. Prominent confluence of the straight and transverse sinuses. A potential pitfall in the interpretation of tomographic brain scans. Clin Nucl Med 1986; 11:366-7. [PMID: 3516505 DOI: 10.1097/00003072-198605000-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Bauman JM, Hartshorne MF, Cawthon MA, Landry AJ. False-positive leukocyte imaging. A case of colon carcinoma. Clin Nucl Med 1986; 11:211-2. [PMID: 3082556 DOI: 10.1097/00003072-198603000-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
A 56-year-old man with a long history of Crohn's disease was evaluated by In-111 labeled leukocyte scanning. A "halo" of leukocyte activity was seen around the gallbladder fossa. A gangrenous gallbladder was removed at surgery.
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Hartshorne MF, Heggen WD, Crooks L, Cawthon MA, Bauman JM. The place of liver-spleen scanning in the workup of giant secondary cysts of the spleen. Clin Nucl Med 1986; 11:4-7. [PMID: 3943242 DOI: 10.1097/00003072-198601000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
An unusual, benign lesion of the spleen, the giant secondary cyst can be diagnosed by many imaging modalities, but the most helpful single test may be the liver-spleen scan. This study allows intelligent preoperative planning and postoperative assessment when splenic salvage is contemplated. Two cases illustrate this point.
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Abstract
SPECT done under technically unfavorable circumstances succeeded in improving cold and hot lesion detectability and clarity in a lumbar spine bone scan in a patient with a plasmacytoma of a vertebral body.
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Bauman JM, Osenbach R, Hartshorne MF, Youngblood L, Crooks L, Landry AJ, Cawthon MA. Positive indium-111 leukocyte scan in Nocardia brain abscess. J Nucl Med 1986; 27:60-2. [PMID: 3941366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We report a case of clinically unsuspected nocardia brain abscess detected by 111In-labeled autologous leukocytes. Clinical and computed tomographic findings supported the diagnosis of primary or metastatic tumor and the patient was treated with dexamethasone for 30 days prior to the leukocyte scan. Labeled leukocytes may provide a sensitive discriminator for brain abscess despite previous therapy with steroids.
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Cawthon MA, Bauman JM, Hartshorne MF. Indium-111 WBC. Splenic bed abscess. Clin Nucl Med 1985; 10:897-8. [PMID: 4075691 DOI: 10.1097/00003072-198512000-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Boykin MW, Hartshorne MF, Bauman JM, Cawthon MA. Massive retroperitoneal chondrosarcoma. Clin Nucl Med 1985; 10:899-900. [PMID: 4075692 DOI: 10.1097/00003072-198512000-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Absence of perfusion of a right lung was initially misinterpreted as pulmonary embolic disease. Pulmonary angiography revised this diagnosis to obstruction of the right pulmonary vein.
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Middaugh RE, Menk EJ, Reynolds WJ, Bauman JM, Cawthon MA, Hartshorne MF. Epidural block using large volumes of local anesthetic solution for intercostal nerve block. Anesthesiology 1985; 63:214-6. [PMID: 3896030 DOI: 10.1097/00000542-198508000-00022] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Landry A, Hartshorne MF, Bunker SR, Bauman JM, Cawthon MA, Karl RD, Howard WH. Optimal technetium-99m RBC labeling for gastrointestinal hemorrhage study. Clin Nucl Med 1985; 10:491-3. [PMID: 3875443 DOI: 10.1097/00003072-198507000-00010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Four methods of Tc-99m red blood cell labeling were tested for labeling efficiency and kinetics in normal adults. From a perspective of the gastrointestinal hemorrhage study, the in vivo method was least appropriate because of extravascular loss of pertechnetate. The modified in vitro method was disadvantageous because of long labeling intervals in a syringe fixed to the patient's forearm (45 minutes). The pure in vitro methods produced the highest labeling efficiency (95% +) and are preferred by the authors.
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Karl RD, Hartshorne MF, Cawthon MA, Bauman JM, Howard WH, Bunker SR. Dual isotope scanning with gallium-67 citrate and technetium-99m radiopharmaceuticals. Clin Nucl Med 1985; 10:507-12. [PMID: 3861284 DOI: 10.1097/00003072-198507000-00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The interpretation of Ga-67 scans is limited by the complex anatomic and physiologic distribution of Ga-67 and by the low resolution possible with this isotope. The use of a second isotope Tc-99m, tagged to an appropriate pharmaceutical allows the identification of anatomic landmarks. Computer acquisition of both the Ga-67 and Tc-99m images allows for subtraction of the Tc-99m images from the Ga-67 images and leads to precise localization of abnormal Ga-67 accumulations. Only a small percentage of the counts in the Tc-99m window are due to Ga-67 scatter and do not degrade the Tc-99m images. Cases illustrating the value of the dual-isotope technique are presented.
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Abstract
This is the first report in the nuclear medicine literature of the scintigraphic appearance of the piriformis muscle syndrome. This syndrome previously has been thought to be a purely clinical diagnosis and imaging modalities have been ignored. However, its confusing clinical presentation can lead to unnecessary surgical exploration. This case is presented to illustrate the characteristic scintigraphic pattern and suggest the role of nuclear medicine scanning in establishing the diagnosis.
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Hartshorne MF, Crooks LA, Bennett W, Ramirez H, Bunker SR, Cawthon MA, Karl RD, Bauman JM. A false-negative xenon-133 study in focal fatty infiltration of the liver. Clin Nucl Med 1985; 10:336-40. [PMID: 4040448 DOI: 10.1097/00003072-198505000-00004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A Xe-133 hepatic study was misleading when the absence of Xe-133 localization in an area of low CT numbers was considered to be negative for a diagnosis of focal fatty infiltration.
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Howard WH, Bunker SR, Karl RD, Ralston T, Hartshorne MF, Cawthon MA, Bauman JM. Unilateral renal agenesis and other causes of the solitary photopenic renal fossa. Clin Nucl Med 1985; 10:270-3. [PMID: 3888477 DOI: 10.1097/00003072-198504000-00009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The differential diagnosis of a solitary photopenic defect in the renal fossa observed at renal scintigraphy is extensive. A case of one of the most unusual causes for this finding, renal agenesis, is presented. Additional cases that illustrate the similarity in the radionuclide appearance of other pathologic entities are also presented. Correlation with clinical findings and other imaging modalities is required to accurately distinguish these conditions.
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Abstract
An unsuspected false aneurysm of the ascending aorta was discovered during a first pass, left-to-right shunt study.
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Hartshorne MF, Ramirez R, Cawthon MA, Bauman JM, Karl RD. Multiple imaging techniques. CSF shunted Arnold Chiari malformation with false-negative brain death radionuclide angiograms. Clin Nucl Med 1984; 9:650-3. [PMID: 6509837 DOI: 10.1097/00003072-198411000-00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Cawthon MA, Brown DM, Hartshorne MF, Karl RD, Bauman JM, Howard WH, Bunker SR. Biliary scintigraphy. The "hot rim" sign. Clin Nucl Med 1984; 9:619-21. [PMID: 6542471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
A new cholescintigraphic finding, the "hot rim" sign, is reported in a case of acute cholecystitis. Local inflammation in the gallbladder fossa may be the cause of this phenomenon.
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Abstract
The authors report a case of "hot spot" localization on SPECT hepatic scintigraphy secondary to IVC obstruction. The tomographic slices demonstrated the location of the focal increase in radiotracer activity as anterior, within the medial segment of the left lobe of the liver. Radionuclide angiography confirmed the extensive collateral vasculature of IVC obstruction.
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Hartshorne MF, Bauman JM, Telepak RJ, Karl RD, Cawthon MA, Howard WH, Bunker SR. Chest radionuclide angiography in the evaluation of pulmonary masses. Clin Nucl Med 1984; 9:502-5. [PMID: 6237830 DOI: 10.1097/00003072-198409000-00005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A retrospective analysis of 104 chest radionuclide angiography (CRNA) studies establishes the utility of this procedure in the evaluation of pulmonary malignancies and benign masses. Remarkable abnormalities in the perfusion of the lungs were identified in 36 (58%) of 62 cases that were not predictably normal or predictably abnormal form the clinical setting. While 60 of these 62 cases involved malignancy being evaluated for metastases, only 21 (34%) had metastases identified by radionuclide bone or liver-spleen scintigraphy. In addition to diagnosis of superior vena cava obstruction, the CRNA may have a more frequent application as an adjunct to routine scintigraphic studies directed to the identification of metastatic disease.
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Hartshorne MF, Cawthon MA, Karl RD, Bauman JM, Howard WH, Bunker SR. Ga-67 citrate in adult respiratory distress syndrome and unsuspected metastatic bronchogenic squamous cell carcinoma. Clin Nucl Med 1984; 9:163-4. [PMID: 6705418 DOI: 10.1097/00003072-198403000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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