technetium-tc-99m-sulfur-colloid and Acute-Disease

The clinical consequences of lower gastrointestinal bleeding range from trivial to life-threatening. Nuclear medicine imaging techniques allow identification of those patients who are actively bleeding. The demonstration of active bleeding not only provides important prognostic information but also allows for a coordinated imaging approach using angiography and aids localization of the bleeding site. (99m)Tc-labeled erythrocytes and (99m)Tc sulfur colloid are 2 commonly used techniques to detect active bleeding. Each has its respective advantages and disadvantages, but the medical literature indicates that both tests are useful. More prolonged or delayed imaging is possible using (99m)Tc-labeled erythrocytes but care is required to prevent misinterpretation of the bleeding location because of a higher likelihood of radiotracer movement through the bowel away from the bleeding site. These forms of scintigraphy may be helpful in risk-stratifying patients and planning radiological and surgical interventions. Careful selection of patients to include those who have a high likelihood of active bleeding greatly increases the clinical utility of these tests. In addition, (99m)Tc pertechnetate imaging may be diagnostic of ectopic gastric mucosa in a Meckel's diverticulum as a potential source of bleeding. Patients also should be carefully selected for this test, based on age and exclusion of other causes of bleeding.

Topics: Acute Disease; Erythrocytes; Gastrointestinal Hemorrhage; Gastrointestinal Tract; Humans; Meckel Diverticulum; Radionuclide Imaging; Radiopharmaceuticals; Technetium; Technetium Tc 99m Sulfur Colloid

Radionuclide bleeding scintigraphy remains a simple yet powerful method of localizing sites of gastrointestinal hemorrhage and is most commonly performed today using the red blood cell technique. Radionuclide techniques for detecting bleeding remain safe, sensitive, and noninvasive. Based on several simple concepts, including the use of cine-mode imaging over the abdomen, it is possible to achieve excellent accuracy in localizing the site of bleeding. Studies often contain additional ancillary information, which is helpful for diagnosis and patient treatment.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Erythrocytes; Female; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Gastrointestinal Tract; Humans; Infant; Male; Practice Guidelines as Topic; Practice Patterns, Physicians'; Radionuclide Imaging; Radiopharmaceuticals; Technetium Compounds; Technetium Tc 99m Sulfur Colloid

Each year approximately 52 million Americans are injured, of which 11 million require hospitalization and 110,000 die. This has an associated health care cost of 3 billion dollars. Hepatobiliary injuries have always constituted a significant area of involvement. They have become more easily detectable since the advent of technetium-99m analogs of iminodiacetic acid (IDA). Biliary leakage secondary to other causes, such as inflammation, neoplasm, and iatrogenic factors are also well demonstrated in a safe, simple, and rapid manner with radionuclide imaging. The relatively low patient radiation dose that is associated with these procedures permits follow-up studies when necessary.

Topics: Acute Disease; Aged; Bile Ducts; Child, Preschool; Cholecystitis; Evaluation Studies as Topic; Female; Gallbladder; Humans; Imino Acids; Liver; Male; Middle Aged; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Time Factors; Tomography, X-Ray Computed; Ultrasonography; Wounds and Injuries

The new 99mTc biliary scintigraphy agents are highly sensitive and specific in detecting biliary tract disease and use of them is the initial procedure of choice in evaluating patients with suspected acute cholecystitis. Other clinically useful indications are evaluation of biliary kinetics; evaluation of patients with suspected traumatic bile leakage, gallbladder perforation, or postsurgical biliary tract complications; and evaluation of patients with suspected biliary obstruction. In 99mTc we have a simple radiopharmaceutical of low radiation for evaluating congenital abnormalities and neonatal jaundice. In the Orient 99mTc cholescintigraphy is extremely important in evaluating patients with suspected intrahepatic stones. The overall advantages of this technique include availability, safety, simplicity, and accuracy. In addition, it may be performed in those patients who are allergic to iodinated contrast agents.

Topics: Acute Disease; Adolescent; Adult; Aged; Biliary Tract; Child; Cholecystitis; Diagnosis, Differential; False Positive Reactions; Gallbladder; Humans; Jaundice; Kinetics; Liver; Middle Aged; Postoperative Period; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

The objective of the study was to determine if time to positive (TTP), defined as the time from the start of (99m)Tc-labeled RBC scanning to the appearance of a radionuclide blush (considered to be a positive finding for acute lower gastrointestinal bleeding [LGIB]), and lag time (LT), defined as the time from the appearance of a radionuclide blush to the start of catheter angiography (CA), affected the yield of CA for the detection of acute LGIB.. TTP and LT were retrospectively evaluated in 120 patients who had positive findings for acute LGIB on (99m)Tc-labeled RBC scanning and subsequently underwent CA for the diagnosis and localization of gastrointestinal bleeding. Two nuclear medicine fellowship-trained radiologists independently reviewed the (99m)Tc-labeled RBC scans. Two fellowship-trained interventional radiologists independently reviewed the angiograms. All data were analyzed using SAS software.. When a TTP threshold of ≤ 9 minutes was used, the sensitivity, specificity, positive predictive value, and negative predictive value for a positive CA study were 92%, 35%, 27%, and 94%, respectively. In addition, the odds of detecting bleeding on CA increased 6.1-fold with a TTP of ≤ 9 minutes relative to a TTP of > 9 minutes (p = 0.020). A significant inverse relationship was found between LT and a positive CA study (p = 0.041).. TTP and LT impact the rate of positive CA studies. A TTP threshold of ≤ 9 minutes allows the detection of almost all patients who would benefit from CA for treatment and allows a reduction in unnecessary negative CA studies. The likelihood of positive findings on CA decreases with a delay in the performance of CA.

Topics: Acute Disease; Aged; Aged, 80 and over; Angiography; Gastrointestinal Hemorrhage; Humans; Middle Aged; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Sulfur Colloid; Time Factors

A series of plain radiographs, bone scans, bone marrow scans, and MRIs is reported in a patient with Gaucher disease type I, in whom two episodes of acute bone crisis developed during a 6-year period of follow-up. Acute bone crisis and global indolent bone marrow displacement could both be assessed by bone marrow scintigraphy, whereas MRI could better clarify the corti-comedullary alteration after bone infarction. Thus, MRI and bone marrow scintigraphy could be used as complementary imaging methods in the management of patients with Gaucher disease.

Topics: Acute Disease; Adult; Biopsy; Bone and Bones; Bone Diseases; Bone Marrow; Diagnostic Imaging; Follow-Up Studies; Gaucher Disease; Humans; Infarction; Magnetic Resonance Imaging; Male; Pain; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

The scintigrams of 76 patients with gastrointestinal bleeding referred over an 8 year period have been reviewed together with their subsequent clinical course. Twenty-five patients had either 99Tcm-sulphur colloid or 99Tcm-labelled red cell scintigraphy to localize a source of active bleeding. Fourteen patients had 99Tcm-sulphur colloid scintigraphy, of which seven were false negatives, two were false positives and two were true positives. Eleven patients had 12 99Tcm-labelled red cell scintigrams, of which three were false negatives, one was a false positive and four were true positives. Fifty patients had 99Tcm-pertechnetate scintigraphy to look for ectopic gastric mucosa in Meckel's diverticula. There were 43 true negatives, two false negatives, two true positives and three false positives in this group. Our results emphasize the need for caution in interpreting nuclear medicine studies in patients with blood loss from the gastrointestinal tract.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Chronic Disease; Erythrocytes; False Negative Reactions; False Positive Reactions; Female; Gastrointestinal Hemorrhage; Humans; Infant; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Sulfur Colloid

We compared bronchopulmonary distribution homogeneity of a radioaerosol before and after hospitalization in 20 patients with cystic fibrosis (CF) with pulmonary exacerbations in order to assess lung improvement. Deposition homogeneity was quantified in terms of skew (an index of distribution symmetry), derived from frequency distribution histograms generated from gamma camera images of the lungs following radioaerosol inhalation. Lower skew values indicate enhanced distribution homogeneity. Right lung skew (RLS) was significantly reduced following therapy (1.00 +/- 0.49 to 0.84 +/- 0.47), whereas skew in the left lung was unchanged (0.95 +/- 0.38 to 0.87 +/- 0.40). The reduction in RLS was significant in patients with Shwachman-Kulczycki (SK) clinical scores less than 50 (1.27 +/- 0.53 to 0.90 +/- 0.42), but not in patients with scores greater than 50 (0.81 +/- 0.38 to 0.80 +/- 0.52). These results indicate that treatment affected the right lung more than the left lung, particularly in patients with SK scores less than 50, and suggests that radioaerosol lung imaging may be valuable in identifying sites of impairment to be targeted during treatment. Statistically, skew was less sensitive an indicator of acute change than several other clinical indices that improved following hospital treatment.

Topics: Acute Disease; Adolescent; Adult; Aerosols; Child; Cystic Fibrosis; Female; Humans; Lung; Male; Radiography; Radionuclide Imaging; Respiratory Mechanics; Technetium Tc 99m Sulfur Colloid

Previous studies have suggested that mucociliary clearance (MC) is impaired in asthmatic subjects. If so, impaired clearance may be an important factor in acute exacerbation. We proposed that if MC plays a significant role in acute illness, MC should be impaired during the exacerbation but improve after recovery. To test this hypothesis, five asthmatic patients with attacks requiring hospitalization underwent measurement of MC using radiolabeled aerosol and a gamma camera. They were studied on the second or third day after admission with repeat measurements after discharge. Spirometry was performed before all studies. After an equilibrium xenon scan (133Xe), which defined lung borders and measured regional volume, radiolabeled saline particles containing technetium-labeled (99mTC) sulfur colloid were deposited and used to label airway mucus. Deposition patterns were matched by regulating particle distribution and breathing pattern. MC was then measured as percentage retention of radioactivity at 10-min intervals for 2 h. When hospitalized, 96.0 +/- 2.06% (SEM) of the initial radioactivity was retained in the lung after 2 h, indicating little clearance of mucus from the lung. In fact, no significant changes were detected when activity at 120 min was compared with measurements at 10 min (99.2 +/- 0.22%, NS). After discharge clearance was markedly enhanced. That is, retention of lung activity was significantly lower at all time intervals from 10 min onward, with only 70.9 +/- 3.86% retained at 120 min (p = 0.008). During an asthmatic attack warranting hospital admission, MC is significantly impaired, with marked improvement following recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Adult; Aerosols; Asthma; Female; Humans; Lung; Male; Mucociliary Clearance; Mucus; Radionuclide Imaging; Respiratory Function Tests; Technetium Tc 99m Sulfur Colloid; Time Factors

The uptake of radiolabelled colloid or bacteria was compared in normal rats and animals subjected to acute burn trauma. The uptake of colloid by the liver was unaffected by burn trauma, but uptake of the labelled bacteria was reduced. Spleen uptake of both colloid and bacteria was reduced by burn trauma while lung uptake was increased. These data are consistent with the hypothesis that acute burn trauma alters reticuloendothelial system phagocytic activity in the rat towards both inert particles and live bacteria.

Topics: Acute Disease; Animals; Burns; Disease Models, Animal; Escherichia coli; Female; Liver; Lung; Mononuclear Phagocyte System; Phagocytosis; Rats; Spleen; Technetium Tc 99m Sulfur Colloid

Increased hepatic activity surrounding the gallbladder fossa during Tc-99m SC liver imaging was observed. Subsequent Tc-99m IDA biliary imaging showed similar findings in the face of nonvisualization of the gallbladder--the classic "rim sign." Surgery confirmed the diagnosis of complicated acute cholecystitis. This case indicates that a rim sign may be seen with either Tc-99m SC or Tc-99m IDA imaging and may have the same diagnostic significance in both.

Topics: Acute Disease; Biliary Tract; Cholecystitis; Female; Humans; Imino Acids; Liver; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

A case of acute gangrenous cholecystitis due to cystic duct obstruction by a metastasis from malignant melanoma detected by cholescintigraphy is presented.

Topics: Acute Disease; Adult; Bile Duct Neoplasms; Cholecystitis; Cholestasis, Extrahepatic; Cystic Duct; Humans; Imino Acids; Male; Melanoma; Organometallic Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid

Topics: Acute Disease; Adolescent; Adult; Bone Marrow; Female; Humans; Leukemia; Male; Prospective Studies; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

The diagnostic sensitivities of arteriography, intravenous (IV) Tc-99m sulfur colloid scintigraphy, and intra-arterial (IA) Tc-99m sulfur colloid scintigraphy were evaluated in a canine model of gastrointestinal bleeding. Fifteen dogs were studied at bleeding rates ranging from .4 to 1.0 ml/minute. All three studies were obtained in six of the 15 dogs. Intravenous scintigraphy was superior to angiography in two cases, inferior in three, and equal in one. No significant difference could be shown between these two tests at these bleeding rates. Intra-arterial scintigraphy was superior to angiography in four cases and equal in two (P = .06). It was superior to IV scintigraphy in five cases and inferior in one (P = .10). In this small preliminary study, IA scintigraphy appears to be superior to the other two modalities and may prove useful in the detection of acute bleeding at the time of negative arteriography, and in serial studies in patients receiving Pitressin.

Topics: Acute Disease; Animals; Dogs; Gastrointestinal Hemorrhage; Injections, Intra-Arterial; Injections, Intravenous; Mesenteric Arteries; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

A focal hot spot in the liver, seen on radiocolloid imaging, has been reported in several conditions. A patient with acute cholecystitis who had a hot spot in the liver on both radiocolloid and hepatobiliary scintigraphy is described. The hepatobiliary finding disappeared following cholecystectomy.

Topics: Acute Disease; Aged; Cholecystitis; Female; Humans; Imino Acids; Liver; Organometallic Compounds; Radionuclide Imaging; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid

Reports of acute splenic sequestration crises in adults with sickle cell hemoglobin C disease or sickle cell thalassemia are rare, although an enlarged and distensible spleen persists in half of these patients. Seven episodes of acute splenic sequestration crises in four adults, two with sickle C disease and two with sickle thalassemia, are described. The crises were life-threatening and recurrent in all, but there were no fatalities. One patient had mild steady-state thrombocytopenia suggesting hypersplenism. Technetium 99m/sulfur colloid scanning of the spleen during the acute splenic sequestration crises in three patients showed almost total lack of splenic uptake or decreased uptake with intrasplenic filling defects thought to be splenic infarcts or hematomas on follow-up computed tomographic scanning. The scanning abnormalities resolved following recovery from the crises. Acute splenic sequestration crises probably are common in adults with sickle C disease and sickle thalassemia but may be underdiagnosed or misdiagnosed as splenic infarctions. The hematologic and splenic findings during acute splenic sequestration crises resemble those following splenic vein ligation in animals.

Topics: Acute Disease; Adult; Anemia, Sickle Cell; Female; Hemoglobin SC Disease; Humans; Male; Pregnancy; Radionuclide Imaging; Recurrence; Spleen; Splenomegaly; Technetium Tc 99m Sulfur Colloid; Thalassemia

Massive lower gastrointestinal (GI) bleeding caused by gallbladder carcinoma eroding into the colonic wall was demonstrated accurately by Tc-99m RBCs. In addition, retrograde bleeding into the gallbladder was also identified while arteriography did not show contrast extravasation. This case supports the use of Tc-99m RBCs over Tc-99m sulfur colloid for more accurate localization of lower GI bleeding.

Topics: Acute Disease; Aged; Biliary Fistula; Colonic Diseases; Erythrocytes; Female; Gallbladder Diseases; Gallbladder Neoplasms; Gastrointestinal Hemorrhage; Humans; Intestinal Fistula; Radionuclide Imaging; Technetium; Technetium Tc 99m Sulfur Colloid

99Tcm-DTPA has been evaluated in our clinical and experimental programme for the detection of acute gastrointestinal bleeding. As an adjunct to this programme, a protocol for image subtraction has been developed. The patient remains still while sequential static images I(i) (i = 1, . . ., N) are taken. They are first normalized to equal total counts and then subtracted images are produced according to the following three methods (a) I(i + 1)-I(i) (b) I(i) - I(mask) (c) I(mask) - I(i) where i not equal to mask and I(mask) denotes a user-selected mask image. Method (a) demonstrates fresh bleeding and sequential movement of blood in the bowel. Methods (b) and (c) demonstrate overall migration of blood and accumulated bleeding depending on the choice of the mask image.

Topics: Acute Disease; Colon; Duodenal Ulcer; Erythrocytes; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Pentetic Acid; Peptic Ulcer Hemorrhage; Radionuclide Imaging; Stomach Ulcer; Subtraction Technique; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid

The mechanism of liver scan abnormality was investigated in patients with acute alcoholic liver injury evaluated shortly after admission (18 patients) with repeat examination 1 month later (14 patients). Indocyanine green (ICG) and Tc99 sulfur colloid extraction ratios (ERICG and ERSC), elimination rate constants (KICG and KSC), total body clearance (TBCICG and TBCSC), and hepatic clearance of sulfur colloid (HCSC) were determined from sequential blood samples obtained at the time of hepatic vein catheterization after the intravenous injection of ICG and Tc99 sulfur colloid. Liver size and sulfur colloid redistribution expressed as a scan score (SS) and redistribution ratio (RR) were assessed from an external scan immediately after the procedure. Improvement in hepatic tests and function was noted between the first and second study. At both the first and second study, the SS (or RR) correlated with the hepatic removal of sulfur colloid (ERSC; r = -0.59; p less than 0.001; HCSC: r = -0.56; p = 0.003) and ICG (ERICG: r = -0.85; p less than 0.001; KICG: r = -0.83; p less than 0.001). ERSC correlated with ERICG (r = 0.76; p less than 0.007) and both correlated with SS and RR consistent with intrahepatic shunting as the mechanism of decreased hepatic clearance and of sulfur colloid redistribution. However, the systemic clearance of sulfur colloid (KSC) did not correlate with redistribution (SS: r = -0.25; NS) at either study period or to ICG clearance (r = 0.23; p = NS) in the first period. The KSC/KICG ratio in both study periods correlated with serum bilirubin (r = 0.83; p less than 0.001 and r = 0.73; p less than 0.001), but was significantly higher in the first period (3.37 +/- 2.37 versus 2.00 +/- 0.75; p less than 0.01). This lack of correlation between intrahepatic shunting and systemic clearance of sulfur colloid is consistent with an increase in the nonhepatic clearance of sulfur colloid in patients with alcoholic liver injury and deep jaundice. A decrease in liver size between the first and second study correlated inversely with change in portal pressure (r = -0.67; p = 0.004) and SS (r = -0.49; p = 0.038) and directly with change in KICG (r = 0.48; p = 0.04). By virtue of these relationships, redistribution of Tc99 sulfur colloid by liver scan may have prognostic significance in patients with alcoholic liver disease.

Topics: Acute Disease; Hepatitis, Alcoholic; Humans; Indocyanine Green; Kinetics; Liver; Liver Cirrhosis, Alcoholic; Liver Diseases, Alcoholic; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

After undergoing therapeutic transcatheter embolization of the splenic artery for treatment of portal hypertension, 11 consecutive patients were evaluated with sulfur colloid scintigraphy and real-time sonography of the left upper quadrant to determine which method was better for follow-up evaluation of the spleen. Six splenic infarcts were documented by both imaging methods; sonography, however, demonstrated the characteristic wedge shape of the infarct in four of the six cases. There were no cases of splenic abscess formation. Sonography should be the primary method for evaluation of the spleen after transcatheter embolization and can help in planning treatment to avoid abscess formation.

Topics: Abscess; Acute Disease; Diagnosis, Differential; Embolization, Therapeutic; Follow-Up Studies; Humans; Hypertension, Portal; Radionuclide Imaging; Splenic Infarction; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Topics: Acute Disease; Aged; Colloids; Erythrocytes; Female; Gastrointestinal Hemorrhage; Humans; Male; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Using combined Tc-99m sulfur colloid and In-113m chloride eluate imaging, studies from 32 patients with proven amebic liver abscess were analyzed. The results revealed good perfusion of the amebic lesion in three, poor perfusion in 11, and absent perfusion in 18. These results appear to depend on abscess size and age. Images with In-113m seem to be better than those with Tc-99m sulfur colloid in depicting amebic liver abscess during antiamebic therapy. Overall, the In-113m images provide more precise information concerning abscess size and shape.

Topics: Acute Disease; Biopsy, Needle; Humans; Indium; Liver Abscess, Amebic; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

A 43-year-old man with acute undifferentiated leukemia developed high fever and stomatitis followed by severe abdominal pain after completion of a first course of chemotherapy. A 99mTc-sulfur colloid (SC) scan showed multiple, irregular defects in an enlarged spleen. A 67Ga-citrate scan showed uniform tracer distribution except for a large defect in the upper portion of the spleen. The size of the spleen in the 67Ga-scan was much larger than in the SC scan. At surgery an abscess cavity was found between the spleen and the greater gastric curvature with multiple smaller abscesses on the splenic capsule and throughout the splenic parenchyma. A hematoma was present in the upper pole of the spleen. The disparate splenic size and seemingly discordant distribution patterns of tracer in the 99mTc- and 67Ga-scans were fully explained by histopathological study of the surgically resected spleen.

Topics: Abscess; Acute Disease; Adult; Aspergillosis; Gallium Radioisotopes; Humans; Leukemia; Male; Radionuclide Imaging; Splenic Diseases; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Acute Disease; Cholecystitis; Esophageal Diseases; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Humans; Imino Acids; Indium; Leukocytes; Meckel Diverticulum; Organotechnetium Compounds; Radioisotopes; Radionuclide Imaging; Stomach Diseases; Sulfur; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid; Technology, Radiologic

Topics: Acute Disease; Adult; Aged; Biliary Tract; Female; Hepatitis; Humans; Imino Acids; Liver; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Sulfur Colloid; Time Factors

Plasma lysozyme levels have been reported to reflect the functional status of the reticuloendothelial system (RES). We measured plasma lysozyme levels in 22 patients with acute hepatitis and 21 patients with cirrhosis and a mesocaval shunt. In 17 of these patients RES function was assessed by measuring the disappearance rate (t/2) of radio-labelled sulphur colloid. In acute hepatitis plasma lysozyme levels and colloid t/2 were significantly lower than in health controls and cirrhotics. In the acute hepatitis patients, the plasma lysozyme levels rose significantly two weeks after admission as the hepatitis improved. The colloid t/2 of the 17 patients with liver disease was significantly correlated with the plasma lysozyme level (r = +0.66, p = 0.005). These results suggest that in human liver disease, in comparison with animal experiments, plasma lysozyme is dependent on RES functional status in the sense that a more active RES will result in a lower lysozyme level.

Topics: Acute Disease; Adult; Aged; Female; Hepatitis; Humans; Liver Cirrhosis; Male; Middle Aged; Mononuclear Phagocyte System; Muramidase; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Acute gastrointestinal bleeding may be localized using noninvasive radionuclide methods. We have favored the use of technetium-99m sulfur colloid with sequential imaging because of the rapid clearance of background activity. Definition of the site of upper gastrointestinal bleeding, however, may be obscured by intense uptake of radioactivity by liver and spleen. The sensitivity of the method is such that the bleeding rates of 0.05-0.1 ml/min can be detected compared to a sensitivity of 0.5 ml/min for angiography.

Topics: Acute Disease; Gastrointestinal Hemorrhage; Humans; Methods; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid