Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate utility of Gd-DTPA enhanced MRI (Gd-MRI) in lung cancer, Gd-MRI was performed in 69 cases. 1) Viable tumor was strongly enhanced, necrosis in the tumor, however, was not enhanced on Gd-MRI. Enhanced patterns of Gd-MRI were divided into 3 types, however there was little correlation between the enhancement patterns and histologic types. 2) In serial scan studies of 15 cases, the signal intensity of the tumor reached the peak 3 minutes to 10 minutes after Gd-DTPA administration, and after that the signal intensity decreased gradually. 3) In 23 of 27 (85%) hilar lung cancer cases, Gd-MRI could differentiate the tumor from the peripheral obstructive pneumonia or atelectasis. In 18 of these 23 cases, the peripheral lung disease showed higher intensity than the tumor. 4) In Gd-MRI of pulmonary nodules less than 3 cm in diameter, lung cancers (n = 13) were more strongly enhanced than tuberculomas (n = 5) (p less than 0.001). Based on these data, Gd-MRI was helpful for detecting tumor necrosis and tumor extension on hilar lung cancer with peripheral lung disease. Moreover Gd-MRI may become a feasible diagnostic method for pulmonary nodules.
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PMID:[Clinical studies for usefulness of Gd-DTPA enhanced MRI in lung cancer]. 131 52

Compared to leukemia, malignant lymphoma and other hematogenous tumors, multiple myeloma rarely metastasizes to the central nervous system. Intracerebral metastasis without involvement of the cranium itself is rarer. We report a case of Ig-G k-type multiple myeloma with metastasis to the left frontal lobe extending to the right basal ganglia without involvement of the cranium. A 71-year-old male complained of exertional dyspnea and lumbago. His laboratory data revealed hyperproteinemia and an abnormal increase in Ig-G (6117mg/dl) in his serum. Serum protein immunoelectrophoresis revealed an IgG k-type band, and Bence-Jones protein was detected in his urine. MMPP, VMCP, VIPP and MP chemotherapy was given, and serum IgG level decreased to a normal range. 21 months after his first admission, incontinence, disorientation, gait disturbance and apathy developed. CT-scan showed an isodense lesion with massive edema in the left frontal lobe and right basal ganglia. On MRI, a Gd-DTPA enhancing lesion was detected extending from the left frontal to the opposite frontal lobe through the splenium. No abnormal skull punched out lesions were noted. Left frontal lobectomy was performed. Histopathology revealed plasmablastic myeloma cells with clear nucleole and eccentric nucleus in the cerebrum. He was diagnosed as having intracerebral metastasis of multiple myeloma without involvement of the cranium. Unfortunately, he died of pancytopenia and pneumonia. Our case suggests the possibility of metastasis via blood into the cerebrum.
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PMID:[A case of multiple myeloma with intracerebral metastasis]. 140 49

99Tcm-diethylene triaminepenta-acetic acid (99Tcm-DTPA) lung scintigrams were investigated in 11 patients with radiation pneumonitis to assess the alteration of clearance of this small solute. Thirty minutes after the injection of 99Tcm-DTPA, all 11 patients showed abnormal accumulation. This uptake was seen in the areas with reduced 99Tcm-macroaggregated albumin activity. The curves of the lung/heart ratios obtained after 1 min after injection of 99Tcm-DTPA in areas showing abnormal accumulation were of three types. Comparison of the slope for the initial 5 min of the lung/heart curves between the abnormal accumulation sites and the contralateral non-irradiated lung revealed a significant difference. The uptake ratio (the mean counts of the last frame divided by initial peak count) was related to the degree of abnormal accumulation in the radiation pneumonitis. Moreover, study of rabbits with radiation pneumonitis revealed similar behaviour by 99Tcm-DTPA as observed clinically. This simple and rapid method may be useful in detecting and monitoring the altered regional kinetics of 99Tcm-DTPA in radiation pneumonitis.
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PMID:Altered regional clearance of 99Tcm-DTPA in radiation pneumonitis. 160 75

The changes in pulmonary epithelial permeability during and following radiation therapy were studied in 10 patients with malignant diseases of the chest; 9 patients with bronchogenic carcinoma and one with thymoma. 99mTc-DTPA aerosol was inhaled during tidal breathing with the patient in supine position, and radioactivity was measured anteriorly by a gamma camera and recorded on a computer. Half time clearance (t1/2) was calculated from exponential fitting of time activity curves by regression analysis in various regions of interest in the initial 7 min following completion of aerosol inhalation. Studies were made every two weeks. In patients who developed radiation pneumonitis, t1/2 values decreased and reached the nadir at the time of manifest pneumonitis, indicating increased pulmonary epithelial permeability. Increased pulmonary epithelial permeability was observed not only in the pneumonic regions but also in the contralateral normal lung regions. Steroid therapy reversed these changes. Increased pulmonary epithelial permeability was observed in 2 out of 5 patients who did not develop radiation pneumonitis. In summary, pulmonary epithelial permeability changes occur not only in regions of radiation pneumonitis but also in non-irradiated lung regions following radiation therapy. We consider that the judicious use of this method enables detection of changes in pulmonary epithelial permeability prior to the development of clinical manifestations of radiation pneumonitis.
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PMID:[Changes in pulmonary epithelial permeability due to thoracic irradiation]. 163 50

Gd-DTPA (Gd) enhanced Magnetic Resonance (MR) early images and delayed images of 28 patients with pulmonary or mediastinal tumors were analyzed and compared with the computed tomography scans and the plain MR images. Numbers of relative signal intensity of the tumors, secondary lesions (adjacent pneumonia or collapse) and pleural effusions were calculated and graphed on time intensity curves. Gd-enhanced MR early images were more useful than other methods in delineating viable areas from necrotic areas. However, Gd-enhanced MR delayed images better delineated margins of necrotic areas than Gd-enhanced MR early images did in some cases. In distinguishing tumors from secondary lesions, Gd-enhanced MR early images were the most useful, too. We considered Gd gradually penetrated into pleural effusions after intravenous administration, just in the same way into necrotic areas. Therefore pleural effusions showed very high intensity on Gd-enhanced MR delayed images. Time intensity curves of the tumors and pleural effusions showed characteristic patterns, but those of secondary lesions showed different patterns among the individual cases. We presumed this was due to the variances of the water and fibrous components among them.
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PMID:[Clinical value of Gd-DTPA enhanced MRI of pulmonary and mediastinal tumors]. 165 71

Various non-invasive investigations were carried out in patients infected with HIV who had respiratory symptoms with and without pneumocystis pneumonia (with pneumonia, n = 13 (five smokers); without pneumonia, n = 22 (13 smokers]. These included chest radiography; lung function tests (forced expiratory volume in one second, forced vital capacity; transfer factor and coefficient for carbon monoxide); arterial blood gas tensions; arterial oxygen saturation at rest and on exercise; and lung clearance of diethylenetriaminepenta-acetic acid labelled with technetium-99m (99mTc DTPA). The effect of scan time (seven v 45 minutes from peak counts) and subtraction of background counts were examined. There were no significant differences between the two groups in lung function tests or arterial blood gas tensions at rest. The median clearance half time of inhaled 99mTc DTPA for the first seven minutes from peak counts was 7.2 minutes for patients with pneumocystis pneumonia and 22 minutes for those without. The median arterial oxygen desaturation on exercise was 5% in patients with pneumocystis pneumonia and 2% in those without. 99mTc DTPA lung clearance was better than the other non-invasive tests in discriminating pneumocystis pneumonia from other pulmonary disorders in patients positive for HIV. A short scan time of seven minutes was as sensitive and specific as the longer scan time of 45 minutes, and this allows the clearance of 99mTc DTPA to become a rapid screening test.
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PMID:Diagnostic value of lung clearance of 99mTc DTPA compared with other non-invasive investigations in Pneumocystis carinii pneumonia in AIDS. 154 24

The aim of this study was to assess the efficacy of SPECT imaging of the thorax with 99mTc-DTPA, which accumulates at sites of increased capillary permeability and expanded extracellular space, by comparing it with delayed 123I-IMP lung scintigraphy. We have previously reported that increased uptake on delayed 123I-IMP lung scintigraphy was associated with atelectasis and inflammation. Thirteen patients with lung cancer (4 with atelectasis and 3 with pleurisy), one patient with malignant lymphoma complicated by pneumonia and pleurisy, and one patient with pneumonia were studied. 99mTc-DTPA scintigraphy was performed twice, 20-160 minutes and 2-4 hours after the intravenous administration of 370 MBq of 99mTc-DTPA. 123I-IMP scintigraphy was performed 24 hours after the intravenous injection of 111 MBq of 123I-IMP. SPECT images were obtained with both types of scintigraphy. 99mTc-DTPA scintigraphy was compared with 123I-IMP scintigraphy for its ability to detect atelectasis and pneumonia. All patients showed increased accumulation corresponding to the lesions on both 123I-IMP and 99mTc-DTPA scintigraphy. 123I-IMP scintigraphy showed a defect corresponding to the tumor with increased accumulation around the tumor, whereas 99mTc-DTPA scintigraphy showed accumulation corresponding to the tumor. Ten of 11 tumors showed accumulation of an intensity equal to that of the soft tissue of the chest wall on 20-60 min 99mTc-DTPA images. The 2-4 hr images showed that 99mTc-DTPA leaked from the periphery of the tumor toward its center. All the patients with pleurisy showed increased accumulation in effusion on 2-4 hr 99mTc-DTPA scintigraphy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[SPECT images after intravenous injection of 99mTc-DTPA in lung tumors--comparison with delayed 123I-IMP lung scintigraphy]. 189 48

The half-time of transfer of 99mTc DTPA (T50) is a useful method of assessing lung epithelial permeability, which has been shown to be altered in patients with acquired immunodeficiency syndrome (AIDS) who have Pneumocystis carinii pneumonia (PCP). The present study was designed to assess the usefulness of the T50 measurement in evaluating patients with renal transplants, breathlessness, and fever. An assessment was also made of the effect of renal failure on the T50 result. Sixty-eight non-smokers (12 normal subjects, ten patients with chronic renal failure not requiring dialysis (CRF), ten patients on haemodialysis (HD), ten patients on chronic ambulatory peritoneal dialysis (CAPD), 13 patients with functioning renal transplants (Tx), seven transplanted patients with PCP, two transplanted patients with cytomegalovirus pneumonia, and four transplanted patients with other lung infections), and 30 smokers (ten normal subjects, five CRF, five HD, five CAPD, five Tx) were studied. The lung epithelial permeability of the patients with renal failure, as judged by the whole lung T50, was not significantly different from that of the normal subjects. The T50 of transplanted smokers was significantly longer than that of the normal subjects who smoked and not significantly different from the transplanted non-smokers. Patients with PCP and CMV pneumonitis had significantly faster T50 values compared with all other patients with renal disease. This fast T50 suggests that the test may be of use in identifying patients who have an alveolitis as a cause for their fever when immunosuppressed following a renal transplant.
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PMID:Lung 99mTc DTPA transfer in renal disease and pulmonary infection. 195 58

Amiodarone pneumonitis is a serious complication that may lead to fatal lung fibrosis. In an attempt to diagnose this condition as early as possible, the technetium-99m-labelled diethylene triamine penta-acetic acid (99mTc-DTPA) aerosol washout rates of 10 non-smoking normal volunteers (group 1), 10 non-smoking patients on a long-term amiodarone regimen with dilated cardiomyopathy but no congestive heart failure (group II) and 10 patients with amiodarone pneumonitis (group III) were compared. Spirometric measurements, as percentage predicted, were higher in group I than in group III (P less than 0.05). The global mean effective half-lives of 99mTc-DTPA aerosol for both lungs together in minutes were 65 +/- 14, 55 +/- 16 and 27 +/- 4 for groups I, II and III, respectively. Group III values were significantly lower than those of groups I and II (P less than 0.05). Our results demonstrated that amiodarone pneumonitis alters the alveolar-capillary membrane permeability to hydrophilic molecules. The pulmonary clearance of 99mTc-DTPA aerosol is a useful test in the differentiation of patients on a long-term amiodarone regimen without side effects from patients with amiodarone pneumonitis. The test is rapid, easy to perform and has the potential for playing an important role in deciding which patients should discontinue therapy.
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PMID:Pulmonary clearance of technetium 99m diethylene triamine penta-acetic acid aerosol in patients with amiodarone pneumonitis. 228 6

Pneumocystis carinii pneumonia (PCP) is the most common cause of pneumonia in HIV antibody positive patients, but other pneumonias remain important, i.e. streptococcal and mycobacterial infections. A definitive diagnosis relies on obtaining samples from the lung either noninvasively (induced sputum), or invasively (bronchoalveolar lavage, transbronchial or open lung biopsy). We have used the noninvasive technique of nebulized 99mTc DTPA transfer, to assess patients with PCP (n = 30) and other lung infections (n = 20) to see whether this test will distinguish between the various infections. The presence of a biphasic, rapid transfer curve indicates severe extensive alveolar damage and is seen in PCP or legionella pneumonia. The mean transfer time (T50 +/- SEM) for patients with PCP (whether smokers or nonsmokers) was 2.1 +/- 0.2 min, and for two of the patients with legionella 3.2 min. In PCP effective treatment causes the transfer to slow (mean T50 22.7 +/- 3.3 min, n = 24) and become monoexponential. Other causes of these changes in transfer are discussed. The other pneumonias (streptococcal, mycobacterial, and staphylococcal) did not result in biphasic curves or very rapid times, their T50 values are indistinguishable from cigarette smokers. In this patient group the DTPA transfer is a useful noninvasive investigation with a very rapid, biphasic curve indicating a high probability of PCP.
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PMID:The place of lung 99mTc DTPA aerosol transfer in the investigation of lung infections in HIV positive patients. 269 35


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