Imaging of human infection with (131)I-labeled recombinant human interleukin-8.

UNLABELLED: The chemotactic cytokine interleukin-8 (IL-8) plays an important role in attraction and activation of polymorphonuclear leukocytes in infection and inflammation. A pilot study was conducted to determine if radiolabeled IL-8 would depict infection in humans. METHODS: Human recombinant IL-8 (rhIL-8) labeled with (131)I (specific activity, 0.4-0.7 MBq [11-18 microCi] (131)I/microg IL-8) was injected intravenously into 8 diabetic patients with active foot infections and evidence of osteomyelitis, 2 patients with successfully treated osteomyelitis, and 1 patient with cellulitis of the thumb. RESULTS: Focal accumulation of (131)I-rhIL-8 was seen in 8 of 8 patients with active foot infection and diffuse uptake was seen in the thumb of the 1 patient with cellulitis. In the 2 patients with successfully treated bone infection, multiphase (99m)Tc-hydroxyethylene diphosphonate bone scans were negative early, but late-phase (>3 h) uptake depicted degenerative lesions that did not image with (131)I-rhIL-8. CONCLUSION: (131)I-rhIL-8 accumulates rapidly within infected foci in osteomyelitis and cellulitis but not in successfully treated infections or degenerative joint disease.

Diagnosis of spine metastases by FDG imaging using a gamma camera in the coincidence mode.

PURPOSE: To illustrate the detection of metastatic lung cancer using a conventional dual detector gamma camera modified to operate in the coincidence mode to image the static distribution of 2-deoxy-2-[F-18]fluoro-D-glucose (FDG). METHODS: A patient with known lung cancer underwent FDG imaging to evaluate the extent of metastatic disease. Twenty-three-minute emission image acquisition at one bed position using a dual detector coincidence gamma camera was performed to evaluate the entire chest and upper abdomen. RESULTS: In addition to detecting the malignant lung nodule, mediastinal lymph node metastases and a rib metastasis, symptomatic metastases to lower thoracic and upper lumbar vertebral bodies, which were not identified on radiographs, CT, or bone scan, were shown clearly by FDG coincidence gamma camera imaging. CONCLUSION: FDG tumor imaging in the body is feasible using a dual detector gamma camera operating in coincidence mode and may find an important role in a certain subset of FDG tumor imaging.

Oncologic diagnosis with 2-[fluorine-18]fluoro-2-deoxy-D-glucose imaging: dual-head coincidence gamma camera versus positron emission tomographic scanner.

PURPOSE: To compare the performance of a dual-head single photon emission computed tomographic (SPECT) Anger camera operated in coincidence mode with that of a dedicated positron emission tomographic (PET) scanner in the imaging of cancer with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). MATERIALS AND METHODS: Thirty-one patients with known or suspected malignant neoplasms underwent imaging with both methods, and the images were read blindly. Diagnostic performance on a lesion-by-lesion basis was compared with attenuation-corrected PET as the standard of reference. RESULTS: Of a total of 109 discrete lesions depicted at PET, 60 (relative sensitivity, 55%) were identified on the coincidence-mode images. Of the nodules or masses depicted at PET, 13 (93%) of 14 lung nodules or masses, 20 (65%) of 31 mediastinal lymph nodes, five (71%) of seven lesions in the neck, five (55%) of nine axillary lymph nodes, 11 (50%) of 22 bone metastases, and six (23%) of 26 abdominal tumor deposits were correctly identified on the coincidence gamma camera images. CONCLUSION: These preliminary findings indicate FDG imaging with a modified dual-detector gamma camera operating in coincidence mode can depict many of the lesions depicted with a PET scanner, particularly in the lungs. Sensitivity for lesions detected at dedicated FDG PET was poor in the abdomen and in all locations outside the lungs for tumor deposits generally less than 1.5 cm in short-axis diameter.

A comparison between diuresis renography and the Whitaker test in 64 kidneys.

Fifty-seven patients have provided 64 dilated pelvicaliceal units for study by diuresis renography and the Whitaker test. Of 45 kidneys showing a type I or type IIIa renographic response (unobstructed), 32 were, according to Whitaker's criteria, obstructed, 8 fell into an equivocal zone and only 5 were unobstructed. Thirty-five of these kidneys--33 of which were associated with moderate or severe loin pain--were operated on for presumed obstruction with generally excellent symptomatic and renographic result. Thus the detection of a type I or type IIIa response in a dilated, painful system cannot be taken to exclude obstruction. Better correlation was obtained between renography and the Whitaker test in patients exhibiting a type IIIb or type II renographic response. Diuresis renography is a sensitive indicator of urodynamic disturbance in the upper urinary tract and an ideal means of evaluating post-operative progress. The Whitaker test provides a reliable means of selecting patients who will benefit from pyeloplasty.

An evaluation of the vitalograph pulmonary monitor.

The Vitalograph pulmonary monitor has recently been altered by the manufactures to read in litres per minute. In 200 pairs of measurements comparing the monitor to the Wright peak flow meter (PFM) the mean difference between the instrument was 0.57 litres/min and there was a strong positive correlation (r = 0.92). The mean within subject coefficient of variation was 5.8% (range 2.6% to 10.7%). There was a statistical difference (P less than 0.05) in measurements obtained with different monitors but in practical terms this difference was small. The monitor is pocket-sized and light and is therefore suitable for following changes in peak expiratory flow away from the physiology laboratory.

Facemask or mouthpiece for delivery of nebulized bronchodilator aerosols?

Two methods of administering nebulized bronchodilator solution were compared in 15 patients with chronic airflow obstruction. There was no significant difference between facemask and mouthpiece as far as breathlessness, wheezing or improvement in peak expiratory flow were concerned. Ten patients preferred facemasks, three preferred mouthpieces; two preferred mouthpieces except when severely breathless, when they preferred the facemask. It is suggested that the patients be allowed to use either mask or mouthpiece depending on their preference.

A comparison of efficiency of three types of crutches using oxygen consumption.

Because the axillary crutch can cause axillary artery thrombosis and crutch palsy, the elbow crutch is more frequently used. Canadian crutches combine features of both the axilla and elbow crutches. A previous study examined any advantages in terms of energy cost using heart rate. The present study re-evaluates the energy cost by using the measurement of oxygen consumption. The study further suggests that the Canadian crutches have advantages in terms of energy cost.