[Radionuclide study of the bone marrow using 99mTc-coren in patients with polycythemia vera]. / Radionuklidnoe issledovanie kostnogo mozga s 99mTc-korenom u bol'nykh istinnoi politsitemiei.

The results of radionuclide investigation of the bone marrow in 44 patients (of them 32 with polycythemia vera) were presented. The informative value of bone marrow scintigraphy and whole-body radiometry using 99mTc-coren was shown in the patients with polycythemia vera at advanced stages. The results obtained made it possible to specify a clinical stage and prognosis of disease, and to optimize therapy.

Phenylbutazone liver injury: a clinical-pathologic survey of 23 cases and review of the literature.

Phenylbutazone has been reported to produce several forms of hepatic injury. A clinical and histologic review of 23 well-substantiated cases in conjunction with review of 43 case reports in the literature was undertaken. Utilizing the histologic features and available clinical data, the injury was classified as moderate-marked hepatocellular injury, minor hepatocellular injury, and other injury. No sexual differences were noted. Most patients had used the drug for less than 6 weeks. Features of hypersensitivity were common. Granulomas on liver biopsy were seen mainly in association with clinical evidence of hypersensitivity nd with minor hepatocellular liver injury. The majority of deaths occurred in cases with significant hepatocellular injury or systemic vasculitis. Analysis of available data suggests that, although hypersensitivity appears to contribute to phenylbutazone-associated hepatic injury, the drug also appears to have intrinsic hepatotoxic potential. Speculation is offered regarding the relative role of these two mechanisms in the several forms of hepatic injury induced by phenylbutazone.

Clinical value of liver scans.

The contribution of technetium sulfacolloid liver scans on patient care was evaluated in 200 consecutive patients; 100 in a public (Grady) and 100 in a private (Emory University) hospital. The problem oriented record clearly described the effect of liver scan on: 1. assessment of the patient's problem(s) and 2. plans made for its diagnosis or management. For the diagnosis and treatment of 30 patients with intrinsic hepatobiliary diseases, the scan was useful in five but was misleading in four. Specific diagnosis was obtained by other methods which made the liver scan an unnecessary overutilization of a diagnostic procedure in the evaluation of patients with primary liver or biliary diseases. The scan was useful in 95 of 123 patients with extrahepatic malignancy. This was mostly due to chemotherapy protocols requiring the scans. Only 18% of positive scans had no other clinical evidence for hepatic malignancy. Definite diagnosis was not made in any of the 123 patients by liver scan. In 47 miscellaneous conditions the scan was useless in 37 (79%). In three of these the scan was misleading and impaired patient care.