Ismail Kazem

Clinical Evaluation of Lymph Node Scanning Utilizing Colloidal Gold 198

Radioactive colloidal gold 198, when injected intravenously, is localized within the reticuloendothelial system in the liver, spleen, and bone marrow. When injected in the intradermal and subcutaneous tissues, on the other hand, it flows through the lymphatic channels to the regional lymph nodes. The localization of the colloidal particles of gold 198 in the lymph nodes depends on the lymph node integrity and the patency of the lymphatic channels. The flow of the radioactive colloid through the lymphatics may be blocked by lymph nodes that are invaded or replaced by tumor. The diagnostic potential of colloidal gold 198 for the investigation of the lymphatic system has been explored by Hultborn et al. (3), Seaman et al. (8), Hahn and Carothers (2), and Sherman et al. (9, 10). The initial reports dealt not only with the distribution of the colloid in the regional lymph nodes when injected in the breast or in the calf region but also with its potential therapeutic efficacy in the treatment of lymph nodes inv...

The Parasternal Lymph-Node Scan as a Prognostic Test in Breast Carcinoma

Despite all the existing controversy, radical mastectomy is still the most acceptable approach to the ablative cure of Stage I cases of carcinoma of the breast. There is, however, experimental and clinical evidence (1–4, 7, 9) that in Stage I carcinoma of the breast an incidence occurs of between 10 and 20 per cent of parasternal lymph node metastases, regardless of the tumor location in the medial or lateral half of the breast. This incidence is almost doubled in Stage II carcinoma. With evidence of spread of the tumor to the parasternal nodes, radical mastectomy would obviously be inadequate for cure and might be contraindicated. It is suggested that parasternal lymph node metastases probably account for most of the 20 to 25 per cent failures of the radical mastectomy in curing Stage I mammary carcinoma. The need for a reliable and simple test for the status evaluation of the clinically inaccessible parasfernallymph nodes in patients with breast carcinoma cannot be overstressed. The test would not only ...

Comparative histological changes in the normal lymph node following ethiodol lymphography and colloidal gold-198 lymphscanning.

An experimental study has been performed to evaluate the possible tissue changes in the normal lymph node after lymphography and colloidal gold lymph-scanning. Eleven adult dogs were utilized, 2 of them being used as controls. The hind limbs of the remaining 9 dogs provided 18 limbs for lymphography and lymph scanning studies. Serial histological examinations of the regional lymph nodes were performed and the tissue changes are described here in detail. The results suggest that oil lymphography produces traumatic and inflammatory changes in the normal lymph node whereas the colloidal 198 Au lymph scan produces minimal changes.

Comparison brain scanning with mercury 203 and technetium 99m.

The localization by radioisotope scanning of intracranial lesions, both neo-plastic and non-neoplastic, has undergone profound change in the past seventeen years. The radiopharmaceutical originally employed was 131I-Iabeled diiodofluorescein and, subsequently, 131J-labeled human serum albumin. In 1960, Blau and Bender (1) introduced 203Hg-labeled chlormerodrin as an agent in localizing brain tumors. This material, along with improved equipment, revolutionized brain scanning. With the subsequent development of 197Hg-labelled chlormerodrin these compounds almost completely replaced radioiodinated albumin. In 1964 Harper (5) reported the development of technetium 99m and its use, as the pertechnetate ion, for brain scanning. Although 99mTc has excellent physical properties (a six-hour half-life, a nearly ideal scanning energy of 140 keV, and no associated beta emission), it came into use relatively slowly. The pertechnetate is obtained by the elution of a Molybdenum-99-Technetium-99m generator. The availabil...

A New Approach to the Evaluation of Peripheral Vascular Disease Using the Gamma Camera

A simple tracer technique for the evaluation of peripheral vascular disease is described, consisting of an intravenous bolus of 8 mCi of 99mTc pertechnetate. The arrival and distribution of activity in both calf muscles during maximum reactive hyperemia are continuously recorded, and the typical pattern of the time-activity curve obtained in normal subjects is compared with that seen in occlusive disease. This technique is clinically useful (a) as an atraumatic screening test prior to arteriography for the detection of impaired peripheral vascular circulation, (b) for selection of patients suitable for vascular surgery, (c) for postoperative evaluation of corrective surgery, and (d) for follow-up of patients.

The cardiopulmonogram: a tracer technique to evaluate intrapulmonary shunting

Abstract The cardiopulmonogram is a new technique introduced as a simple clinical test for the detection and estimation of intrapulmonary arteriovenous shunts. The technique is described and its theory is discussed. The clinical application of the technique and the results of a pilot study are published elsewhere.