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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Inflammation research 41 (1994), S. C264 
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract For imaging inflammation, white cells can be labelled with In-111 tropolonate or Tc-99m HMPAO, both of which are lipophilic complexes capable of penetrating etrating cell membranes. Mixed white cells are satisfactory for routine clinical use although in some circumstances, such as for quantitative studies, pure granulocytes are preferable. The normal distribution of labelled leukocytes includes the spleen, liver, bone marrow and lung. Although the extent of pulmonary uptake reflects labelling injury, it also reflects, with different kinetics, increased intravascular granulocyte transit time, which is encountered in several systemic inflammatory diseases. The clinical applications of labelled white cells include imaging soft tissue sepsis, imaging and quantification of inflammatory bowel disease and diagnosis of osteomyelitis. New agents for imaging inflammation are designed, in general, to target inflammationin vivo without the need for blood cell isolationin vitro. They include non-specific immunoglobulin (HIG) and monoclonal antibodies (mAbs) to granulocytes. mAbs to endothelium are also being developed but have not yet been tested in man.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    s.l. : American Chemical Society
    The @journal of physical chemistry 〈Washington, DC〉 98 (1994), S. 5541-5551 
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1619-7089
    Keywords: Cyclosporin nephrotoxicity ; Capillary permeability ; Bone marrow transplantation ; Technetium 99m diethyltriamine penta-acetic acid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Microvascular permeability to small diffusible solutes has rarely been measured at a clinical level. We have developed a simple non-invasive technique for measuring the permeability surface area (PS) product, which is suitable for clinical use. We illustrate its potential value in six subjects who underwent bone marrow transplantation for chronic myeloid leukaemia. These patients received high-dose cyclosporin A (CyA) for prevention of graft versus host disease (GVHD) and sustained an easily measurable increase in microvascular permeability to technetium 99m diethyltriamine penta-acetic acid (99mTc-DTPA). This was measured as the PS product, which increased from 1.1 (SD 0.3) to 2.2 (0.4) ml/min per 100 ml tissue between baseline and treatment with CyA for prevention of GVHD (P〈0.01). The increase broadly correlated with nephrotoxicity which was measured, from the plasma DTPA clearance, as global glomerular filtration rate (GFR). This decreased from 106 (11.1) to 49 (6.7) ml/min (P〈0.001). These abnormalities, both in PS product and GFR, were sustained for several months, after which they tended to return towards baseline levels. We conclude firstly that this technique has a potential clinical role and secondly that endothelial abnormalities due to CyA deserve further study.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 23 (1996), S. 530-533 
    ISSN: 1619-7089
    Keywords: Protein-losing enteropathy ; Imaging ; Indium-111 transferrin ; Whole-body counting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Localisation and quantification of protein loss in protein-losing enteropathy (PLE) is useful in the clinical managment of hypoalbuminaemia. Indium-111 transferrin offers the opportunity of combining localisation and quantification using a single agent. Twenty-five studies were performed in 23 patients with suspected PLE:111In-transferrin was prepared by incubating autologous cell-free plasma with111In chloride in vitro for 15 min. Protein loss was quantified by comparing whole-body counts recorded with an uncollimated gamma camera at 3 h and 5 or 6 days after injection of111In-transferrin. Gamma camera imaging performed at 3 and 24 h after injection demonstrated a site of protein loss in 15 studies. Whole-body111In excretion was abnormally elevated in 13 of these, ranging from 16% to 34% (normal 〈10%), was not assessed in one and was less than 10% in a patient with carcinoid syndrome. In the ten studies that were negative on imaging, whole-body111In excretion was normal in nine and elevated at 22% in a further patient with carcinoid syndrome. Overall, the mean whole-body111In excretion in studies with positive imaging was 21.4% (SD 6.1%) (n=14), significantly higher (P〈0.01) than in studies with negative imaging, in which it was 7.5% (SD 6.7%) (n=10). This technique should be useful for the combined approach of localising and quantifying protein loss in PLE.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 26 (1999), S. 504-510 
    ISSN: 1619-7089
    Keywords: Key words: Lymph flow ; Lymph node function ; Post-mastectomy oedema ; Lymphoscintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A reliable method for measuring lymph flow in physiological units would be valuable, especially in conditions in which it is uncertain whether lymph flow is increased or decreased. The requirements of a radiopharmaceutical for such measurement include stable radionuclide labelling and rapid access to lymphatic vessels following tissue injection but no access to blood vessels. A soluble macromolecule is likely to come closest to meeting these requirements. Technetium-99m- labelled human polyclonal immunoglobulin (HIG) was therefore investigated firstly in comparison with 99mTc-labelled human serum albumin (HSA) in patients undergoing routine lymphoscintigraphy and secondly with respect to injection site in a group of volunteers with post-mastectomy oedema (PMO). Subcutaneous injection of 99mTc-HIG into the web space of a distal extremity gave images in which lymphatic vessels were more clearly defined compared with images obtained after injection of 99mTc-HSA. Lymph nodes were also more clearly defined, suggesting specific retention of HIG, possibly through Fc-mediated binding. Peripheral blood sampling showed a delayed arrival in blood of radioactivity after 99mTc-HIG compared with 99mTc-HSA, although ultimately, the blood recovery of 99mTc-HIG was significantly higher (P 〈0.05) than that of 99mTc-HSA. Clearance rates of radioactivity from the injection site were not sinificantly different, however, between the two agents. In patients with PMO, web space injection of 99mTc-HIG gave excellent images of normal lymphatic vessels, of lymph nodes and of abnormal lymph drainage such as dermal backflow in swollen arms. In contrast, neither lymphatic vessels nor lymph nodes were visualised after injection into the skin of the dorsum of the distal forearm. Although there was no difference in clearance rates from the injection sites between normal and swollen arms with either agent in PMO, clearance was significantly faster following injection into the web space (0.11% per minute for normal and swollen arms combined) than into the forearm (0.053% per minute; P〈0.05). These results suggest that (a) 99mTc-HIG is a potentially useful agent for measuring lymph flow and lymph node function; but (b) injection into the dorsum of the forearm is not a useful method of administration for these measurements; and (c) clearance rates from the injection site do not support the notion that PMO is the result of decreased lymph flow. Further studies are warranted to evaluate 99mTc-HIG as an agent for assessment of lymphatic function, especially with respect to measurement of lymph flow and possibly also for the evaluation of lymph node Fc-mediated immunocompetence.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 24 (1997), S. 488-496 
    ISSN: 1619-7089
    Keywords: Indium-111 labelled lymphocytes ; Fluorine-18 ; fluorodeoxyglucose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since lymphocytes continue to proliferate and divide in vivo, it is important to determine the fate of a radionulide following lymphocyte labelling. Using the mixed lymphocyte reaction (MLR), we induced indium-111 labelled lymphocytes from a specific in-bred rat strain (AS) to divide and then observed the subsequent111In distribution between cells and supernatant. L10 and L12.4 cells, which are allospecific CD4+ T lymphocytes from the AS rat, were stimulated in the MLR by antigen-presenting cells from the August rat, a different strain. We labelled L10 or L12.4 lymphocytes on day 0, the first day of the stimulation cycle, and continued to culture the lymphocytes in vitro. The proliferation of the cells was estimated according to their increase in number. The distribution of111In between cell and supernatant fractions and between viable and dead (but intact) cells was measured in the cell suspension each day after labelling. The metabolic activity of111In-labelled lymphocytes was compared with control cells by measuring their uptake of fluorine-18 fluorodeoxyglucose ([18F]FDG).111In-labelled lymphocytes showed a poor proliferative response compared with control cells 24–48 h after labelling but increased in number after this time. From 24 to 72 h, about 70% of111In was in the supernatant but only about 5%–10% was associated with intact dead cells. These dead cells tended to retain their111In, losing less than 30% per day, suggesting that111In in the supernatant was the result of active elimination from viable cells. Moreover, 24 h after culture, considerably more111In was associated with viable than with dead lymphocytes, although over the next few days this distribution reversed.111In-labelled lymphocytes took up more [18F]FDG than control cells at 24 h but not at 0 or 72–96 h; the maximum [18F]FDG uptake coincided with the greatest reduction in cell number. Furthermore, [18F]FDG uptake correlated with the initial111In burden in lymphocytes labelled with111In 24 h previously. The results are consistent with active elimination of111In by111In-labelled lymphocytes. The energy requirements for this are diverted away from cell division, thereby increasing the probability of cell death. As lymphocytes become111In deplete, they recover their capacity to proliferate and their risk of death decreases. These findings have important implications for111In-labelled lymphocyte scintigraphy, suggesting that cells remaining viable immediately after labelling will either subsequently die or alternatively eliminate the label.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 14 (1988), S. 555-561 
    ISSN: 1619-7089
    Keywords: DMSA, renal handling of ; Technetium-99m ; Captopril ; Renovascular hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Critical factors determining the renal handling of 99mTc-dimercaptosuccinic acid (DMSA) are protein binding in plasma and the renal 99mTc-DMSA extraction efficiency. Comparison of the count rate over soft tissue with that over the cardiac blood pool about 1 h after injection demonstrated that 99mTc-DMSA is not exclusively an intravascular label. 99mTc-DMSA was 76% protein bound in plasma as demonstrated by HPLC and gel filtration. Assuming that the 24% that is not protein bound is filtered at the glomerulus, the renal extraction efficiency of 99mTc-DMSA by glomerular filtration is about 5%. Since the total renal extraction efficiency was also found to be about 5%, the majority of the activity that becomes fixed in the renal cortex arrives there as a result of filtration followed by tubular reabsorption rather than by direct extraction from peritubular blood. However, discordant changes in DMSA and DTPA uptake induced by captopril in renovascular hypertension (RVH) suggested that a minority of uptake was by direct peritubular extraction. This kinetic model was supported by indirect measurement of protein binding and extraction efficiency based on the kinetics of 99mTc-DMSA disappearance from plasma and kinetics of uptake in the kidneys. Furthermore, differential functional studies based on 99mTc-DMSA and 99mTc-DTPA before and after captopril in patients with RVH due to unilateral renal artery stenosis confirmed filtration followed by tubular reabsorption as the predominant route for DMSA uptake by the kidney.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 17 (1990), S. 148-151 
    ISSN: 1619-7089
    Keywords: Indium 111 leucocytes ; Technetium 99m hexamethylpropylene amine oxime leucocytes ; Osteomyelitis ; Bone marrow imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The uptake of white blood cells (WBC) into normal bone marrow may lead to difficulty in detecting bone infection. Twenty-one patients in whom the WBC scan was equivocal or positive underwent a technetium 99m colloid scan to show the distribution of bone marrow. Six patients had a positive WBC scan, and in five of them a discordant colloid scan confirmed infection. However, in one the colloid scan was concordant, indicating that the WBC activity was not due to infection but the result of normal bone marrow uptake. Fifteen patients had an equivocal WBC scan. In 14, infection was excluded by a concordant scan, and 1 patient with a discordant scan was lost to follow-up. We conclude that the combination of a WBC scan and a colloid scan is an effective method to distinguish infection from normal bone marrow activity and, in particular, reduces the number of incorrect diagnoses of infection.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 18 (1991), S. 885-888 
    ISSN: 1619-7089
    Keywords: Blood flow ; Bolus volume ; Kidney ; Spleen ; Radionuclide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fractionation of cardiac output on first-pass radionuclide angiography is a recently described technique for measuring blood flow. In order to determine the influence of bolus volume, splenic blood flow (SBF) and renal blood flow (RBF) were measured from widely differing bolus volumes given in sequence over a period of a few minutes in patients undergoing routine bone scintigraphy with technetium 99m methylene diphosphonate. A bolus volume of 0.5 ml, followed by 20 ml of rapidly delivered saline “chaser”, was regarded as a “gold standard” bolus. A 50 ml bolus, but not a 20 ml bolus, resulted in a significant underestimation of both SBF and RBF. Thus, using a left ventricular region of interest to generate an arterial first-pass time-activity curve, RBF from a 50 ml bolus was 58% (SEM 4%) that given by a 0.5 ml bolus, while RBF for a 20 ml bolus was 98% (8%). Corresponding values for SBF were 52% (10%) and 102% (12%). A quality control adjustment did not correct the underestimation given by the 50 ml bolus. Bolus volumes greater than 20 ml give unreliable estimates of organ blood flow by this technique.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 18 (1991), S. 274-286 
    ISSN: 1619-7089
    Keywords: Clearance ; Glomerular filtration rate ; Renal blood flow ; Filtration fraction ; Distribution volume
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Non-invasive quantification of renal function with radionuclides is an important role of nuclear medicine. With modern commercial preparations of technetium-99m diethylene triamine penta-acetic acid (DTPA), glomerular filtration rate (GFR) can be measured accurately either from the rate of disappearance of the tracer from plasma or from its rate of uptake into the kidneys. Determination of the latter with the gamma camera allows measurement of individual kidney GFR. Renal blood flow (RBF) can be measured from plasma clearance of hippurate or from first-pass kinetics of intravenously injected tracer using the gamma camera. The filtration fraction can be obtained from separate measurement of GFR and RBF, either globally from plasma clearance studies or of each kidney from gamma camera studies. Because they are central to the understanding of plasma clearance studies, the effective distribution volumes of the various tracers used for renal function studies are also discussed in detail.
    Type of Medium: Electronic Resource
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