sodium-pertechnetate-tc-99m and Stomach-Ulcer

Little information is available on the role of inflammation and small vessel alteration in the development and healing of peptic ulcers. We studied the spontaneous healing of experimental ulcers in the rat stomach with a novel radio-isotope technique for the monitoring of capillary damage in ulcer-related inflammation. Following ulcer induction, healing was assessed on days 1, 7 and 15 by macroscopical and histological determinations of ulcer size and lesion area, parietal cell counts in the ulcer margin and nuclear imaging of the lesion area using Nanocoll, a 99mTc-labelled colloid. The ulcers were re-epithelized after 15 days. However, Nonocoll activity was still significantly enhanced in the ulcer area, and regression of the microscopically visible lesion area, which, from day 1 on, occupied a zone considerably larger than the ulcer itself, was delayed and still incomplete at the end of the study. Compared to the intact mucosa, parietal cells were reduced in the scar tissue up to 15 days (24-40%). However, despite macroscopical and histological re-epithelization, small vessel leakage and substantial tissue alteration persisted in the ulcer scar.

Topics: Animals; Capillary Permeability; Colloids; Female; Inflammation; Radionuclide Imaging; Rats; Rats, Inbred Strains; Sodium Pertechnetate Tc 99m; Stomach Ulcer; Wound Healing

The paper is concerned with the results of clinical application of a new method of investigation of microcirculation in the gastric and duodenal wall. The method is based on the administration of a radiopharmaceutical in the submucous layer of the stomach and duodenum through the bioptic channel of a gastroscope with further recording of its rate of discharge on a gamma-chamber. A total of 48 patients with different gastroduodenal diseases were investigated. Good reproducibility of the method and good correlation of its results with clinical findings were confirmed.

Topics: Duodenal Ulcer; Duodenum; Gastritis, Atrophic; Humans; Iodine Radioisotopes; Methods; Microcirculation; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach; Stomach Ulcer

The technique of 99Tcm-labelled red cell scintigraphy as a means of detecting rebleeding was investigated in 33 patients with bleeding peptic ulcers. Scintigrams were performed twice during the 24 h period succeeding diagnostic endoscopy. There was scintigraphic evidence of rebleeding in 23 patients but this was clinically manifest in 14 patients only. Thirteen of the 14 patients with clinical rebleeding had positive scintigrams while only in one patient with clinical rebleeding was the scintigram negative (P less than 0.05). These results show that rebleeding is common and often clinically inapparent during the first 24 h following gastroscopy but that in the absence of scintigraphic rebleeding serious clinical rebleeding is unlikely to occur.

Topics: Adult; Aged; Duodenal Ulcer; Erythrocytes; Female; Humans; Male; Middle Aged; Peptic Ulcer Hemorrhage; Radionuclide Imaging; Recurrence; Sodium Pertechnetate Tc 99m; Stomach Ulcer

Topics: Female; Gastrectomy; Humans; Male; Middle Aged; Postoperative Complications; Pyloric Antrum; Radionuclide Imaging; Recurrence; Sodium Pertechnetate Tc 99m; Stomach Ulcer; Technetium

Technetium-99m pertechnetate is known to concentrate in the stomach following intravenous injection, but there is controversy on the cellular site of this uptake, with evidence for both the mucous and parietal cells being primarily responsible. Gastric uptake following intravenous pertechnetate has been studied in patients with non-ulcer dyspepsia and peptic ulcer, using a gamma camera and computer processing with regions of interest. Under identical conditions in any one patient, quantification of uptake at 20 min is reproducible to an accuracy of +/- 6%. Six patients with gastric ulcer were studied before and 3 weeks after starting treatment with carbenoxolone. There was a rise in uptake in 5 subjects with a mean percentage increase of 25%. The effect of cimetidine was studied in six patients with either gastric or duodenal ulcer. There was little change in uptake (mean 6%). These preliminary data would support the hypothesis that concentration of pertechnetate occurs primarily in the mucous cell.

Topics: Adult; Carbenoxolone; Cimetidine; Gastric Mucosa; Glycyrrhetinic Acid; Humans; Injections, Intravenous; Sodium Pertechnetate Tc 99m; Stomach; Stomach Ulcer; Technetium