Rauf Sarper

Trace element concentrations in renal cell carcinoma.

Cadmium, zinc, copper levels and zinc‐copper, zinc‐bromine, iron‐zinc, iron‐copper and iron‐bromine ratios are measured in neoplastic and normal kidney samples from humans by the particle induced x‐ray emission analysis (PIXE) technique. It is found that cadmium which is normally present in the tubular cells of kidney is not detectable in tumor samples. It is also observed that the zinc‐copper ratios in all neoplastic kidney tissues are decreased, but this observation cannot be extended to other element ratios.

Radionuclide angiography of the liver and spleen. Noninvasive method for assessing the ratio of portal venous to total hepatic blood flow and portasystemic shunt patency.

Radioactivity verus time curves were generated for the first pass of technetium-99m pertechnetate through the left ventricle, kidneys, spleen and liver, after a 20 mCi peripheral intravenous bolus injection. The rate of change of radioactivity in these organs before recirculation is proportional to blood flow through the organ. The hepatic perfusion index, defined as the ratio of portal flow to total hepatic blood flow, was correlated with the angiographic grade of portal perfusion. The hepatic perfusion index in seven normal subjects was 66.0 +/- 3.4 percent (mean +/- standard error of the mean), and in 22 cirrhotic patients with decreasing angiographic perfusion of grades 1 to 4 the index was 54 +/- 4.6, 37 +/- 2.6, 17 +/- 4.7 and 3 +/- 1.1 percent, respectively. The correlation between the calculated perfusion index and the angiographic grade of portal flow was highly significant (p less than 0.001). The passage of radionuclide through the spleen differed before and after shunt surgery in patients with portal hypertension. The slope to height ratio, based on the downslope of the splenic curve, was significantly greater (p less than 0.01) in the shunted patients and provided a simple index for assessing shunt patency.

Comparison of the elemental composition of normal and diseased human tissues by PIXE analysis

Abstract The proton beam from a 4 MV Van de Graaff accelerator has been used in conjunction with a Si(Li) detector system to perform elemental analysis of biological samples by proton-induced X-ray emision (PIXE). Dried tissue samples from a number of different organs were analyzed; including kidney, lung, liver, colon, breast, larynx, and aorta. For each organ, two specimens were taken of the same cellular type: normal tissue and diseased tissue. Therefore, a direct comparison of the effect of the disease state on the elemental composition could easily be obtained. For the aorta sets the disease state studied compared tissue from atherosclerotic lesions to normal aorta tissue while for the other organs, a sample of cancerous tissue was compared to a healthy tissue. The present results show a marked decrease in the Cd concentration as well as for the Se and Pb, when present, for the malignant kidney tissue compared to the normal one. It is found that the Zn/Cu ratio also decreases for all malignant kidney cases. Preliminary results indicate the same trend for this ratio for the colon and liver but an increase for the breast, larynx, and lung sets. Except for Br and Cu, the aorta sets show a general increase in all elements, particularly for Ca and Sr, when the lesion tissue is compared to the normal aorta tissue.

Assessment of splanchnic blood flow in alcohol and drug abuse using radionuclide angiography

Computerized radionuclide angiography (RA) is a noninvasive, quantitative, reproducible, and cost-effective method for measuring the portal venous fraction of total hepatic blood flow (represented by the Hepatic Perfusion Index, HPI), and also can be utilized to detect hemodynamic abnormalities in the spleen. A group of 105 men (aged 20-56) were evaluated at the time of admission to the Substance Abuse Program at the Department of Veterans Affairs Medical Center. These patients were classified into three groups: (a) alcohol dependence or abuse (Group A, n = 54); (b) polysubstance abuse without alcohol (Group B, n = 9); and (c) polysubstance abuse with alcohol (Group C, n = 42). Of the respective groups, 69%, 100%, and 79% had abnormal splanchnic flow (liver and/or spleen), whereas only 43%, 78%, and 48% had abnormal liver function tests. This method may be a sensitive, noninvasive detector of early pathophysiological changes in the splanchnic organs of alcohol and drug abusers.

Treatment of tyramine-induced brain edema with anion transport inhibitor L-644,711

Tyramine induces coma in phenelzine-treated dogs. Development of coma in these animals is associated with brain edema, abnormal brain scans of Tc-99m-diethylene-triamine-penta-acetic acid (Tc-99m-DTPA), and elevated levels of CSF catecholamines. We found that the intravenous administration of 6-7 mg/kg of a single dose of L-644,711 given fifteen minutes after the oral administration of tyramine to phenelzine-pretreated animals followed by an infusion of normal saline containing 6-7 mg/kg of the drug given over a period of 2 hr caused reversal of brain injury. This was accompanied by full recovery within a period of 24 hr of all the animals tested. A follow-up study revealed that 24 hr after treatment with L-644,711 CSF levels of catecholamines and brain images of Tc-99m-DTPA were indistinguishable from normal controls. Animals that received no drug died from unresolved coma within 4 to 24 hr. Animals that had recovered due to therapy with L-644,711 were given 10-14 days rest followed by a repetition of the phenelzine and tyramine treatment but denied L-644,711 therapy. These animals also died of unresolved coma within 24 hr. This preliminary study suggest that the use of L-644,711 may constitute an important advance in treatment of brain edema of a wide range of neurological disorders.

Portal venous-total hepatic flow ratio by radionuclide angiography☆

Quantitating portal perfusion of cirrhotic liver is important to surgeons preoperatively selecting shunt ‘procedures and postoperatively evaluating the results of shunting. The ideal method for measuring the portal fraction of total hepatic flow should be noninvasive, technically suitable for widespread use, and accurate in the presence of hepatocellular disease [3]. At the present, there are no methods that fulfill all these criteria. Portal perfusion has not been satisfactorily evaluated in the awake human subject because of difficulty evaluating the dual blood supply to the liver, impaired extraction capacity of diseased liver, and the anatomic inaccessibility of the portal vein. Shunt procedures are performed to control variceal hemorrhage. However, an unacceptably high incidence of disabling hepatic encephalopathy has been reported following total or nonselective shunts. Selective shunts (distal splenorenal shunts) have the lowest incidence of postoperative encephalopathy and are as effective as total shunts for preventing recurrent variceal hemorrhage. [ 93, Recently, however, several papers have questioned the efficacy of selective shunting maintaining portal perfusion in the years

Tyramine-Induced Brain Injury in Phenelzine-Treated Dogs: An Animal Model for Cerebral Edema

We have recently demonstrated that p-tyramine (p-TA) induced behavioral side-effects and precipitated coma in chronically treated dogs with the monoamine oxidase inhibitor (MAOI) phenelzine (PEH) (Faraj et al, 1983). The objective of the present investigation was to determine whether p-TA-induced neurotoxicity in PEH-treated dogs is a reflection of the development of brain edema and whether the edema is associated with increased permeability into the brain from peripheral circulation of diffusion-limited substances. We chose to examine the influence of p-TA in dogs before and after treatment with PEH on the first-pass brain image of technetium-99m-diethylenetriamine pentaacetic acid (Tc-99m-DTPA). Furthermore, kinetics of brain Tc-99m-DTPA were correlated with cerebrospinal fluid (CSF) pressure measurements and determination of CSF concentrations of catecholamines.

A Quantitative Radionuclide Imaging Technique to Study Cerebral Edema in Dogs with Impaired Monoamine Oxidase

Under normal circumstances, the brain vasculature and astrocyte cells effectively exclude most substances that are not highly lipid soluble or are not used directly in brain cellular metabolism. However, in the presence of cerebral pathology such as neoplasm, infarction, Reye’s syndrome and hydrocephalus, sufficient alterations in the blood-brain barrier occur to allow passage of diffusion-limited radioactive tracers into the region of abnormality. The most commonly employed diffusion-limited tracer for cerebral imaging is Tc-99m-DTPA (Russell et al, 1980). The tracer Tc-99m-diethylenetriamine pentaacetic acid (Tc-99m-DTPA) is a low molecular weight, negatively charged radiopharmaceutical.