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Nuclear Medicine for Medical Students and Junior Doctors
NUCLEAR MEDICINE FOR MEDICAL STUDENTS AND JUNIOR DOCTORS Dr JOHN W FRANK M.Sc, FRCP, FRCR, FBIR PAST PRESIDENT, BRITISH NUCLEAR MEDICINE SOCIETY DEPARTMENT OF NUCLEAR MEDICINE, 1ST MEDICAL FACULTY, CHARLES UNIVERSITY, PRAGUE 2009 [1] ACKNOWLEDGEMENTS I would very much like to thank Prof Martin Šámal, Head of Department, for proposing this project, and the following colleagues for generously providing images and illustrations. Dr Sally Barrington, Dept of Nuclear Medicine, St Thomas’s Hospital, London Professor Otakar Bělohlávek, PET Centre, Na Homolce Hospital, Prague Dr Gary Cook, Dept of Nuclear Medicine, Royal Marsden Hospital, London Professor Greg Daniel, formerly at Dept of Veterinary Medicine, University of Tennessee, currently at Virginia Polytechnic Institute and State University (Virginia Tech), Past President, American College of Veterinary Radiology Dr Andrew Hilson, Dept of Nuclear Medicine, Royal Free Hospital, London, Past President, British Nuclear Medicine Society Dr Iva Kantorová, PET Centre, Na Homolce Hospital, Prague Dr Paul Kemp, Dept of Nuclear Medicine, Southampton University Hospital Dr Jozef Kubinyi, Institute of Nuclear Medicine, 1st Medical Faculty, Charles University Dr Tom Nunan, Dept of Nuclear Medicine, St Thomas’s Hospital, London Dr Kathelijne Peremans, Dept of Veterinary Medicine, University of Ghent Dr Teresa Szyszko, Dept of Nuclear Medicine, St Thomas’s Hospital, London Ms Wendy Wallis, Dept of Nuclear Medicine, Charing Cross Hospital, London Copyright notice The complete text and illustrations are copyright to the author, and this will be strictly enforced. Students, both undergraduate and postgraduate, may print one copy only for personal use. Any quotations from the text must be fully acknowledged. It is forbidden to incorporate any of the illustrations or diagrams into any other work, whether printed, electronic or for oral presentation. -
New Jersey Chapter American College of Physicians
NEW JERSEY CHAPTER AMERICAN COLLEGE OF PHYSICIANS ASSOCIATES ABSTRACT COMPETITION 2015 SUBMISSIONS 2015 Resident/Fellow Abstracts 1 1. ID CATEGORY NAME ADDITIONAL PROGRAM ABSTRACT AUTHORS 2. 295 Clinical Abed, Kareem Viren Vankawala MD Atlanticare Intrapulmonary Arteriovenous Malformation causing Recurrent Cerebral Emboli Vignette FACC; Qi Sun MD Regional Medical Ischemic strokes are mainly due to cardioembolic occlusion of small vessels, as well as large vessel thromboemboli. We describe a Center case of intrapulmonary A-V shunt as the etiology of an acute ischemic event. A 63 year old male with a past history of (Dominik supraventricular tachycardia and recurrent deep vein thrombosis; who has been non-compliant on Rivaroxaban, presents with Zampino) pleuritic chest pain and was found to have a right lower lobe pulmonary embolus. The deep vein thrombosis and pulmonary embolus were not significant enough to warrant ultrasound-enhanced thrombolysis by Ekosonic EndoWave Infusion Catheter System, and the patient was subsequently restarted on Rivaroxaban and discharged. The patient presented five days later with left arm tightness and was found to have multiple areas of punctuate infarction of both cerebellar hemispheres, more confluent within the right frontal lobe. Of note he was compliant at this time with Rivaroxaban. The patient was started on unfractionated heparin drip and subsequently admitted. On admission, his vital signs showed a blood pressure of 138/93, heart rate 65 bpm, and respiratory rate 16. Cardiopulmonary examination revealed regular rate and rhythm, without murmurs, rubs or gallops and his lungs were clear to auscultation. Neurologic examination revealed intact cranial nerves, preserved strength in all extremities, mild dysmetria in the left upper extremity and an NIH score of 1. -
Nuclear Pharmacy Quick Sample
12614-01_CH01-rev3.qxd 10/25/11 10:56 AM Page 1 CHAPTER 1 Radioisotopes Distribution for Not 1 12614-01_CH01-rev3.qxd 10/25/1110:56AMPage2 2 N TABLE 1-1 Radiopharmaceuticals Used in Nuclear Medicine UCLEAR Chemical Form and Typical Dosage P Distribution a b HARMACY Radionuclide Dosage Form Use (Adult ) Route Carbon C 11 Carbon monoxide Cardiac: Blood volume measurement 60–100 mCi Inhalation Carbon C 11 Flumazenil injection Brain: Benzodiazepine receptor imaging 20–30 mCi IV Q UICK Carbon C 11 Methionine injection Neoplastic disease evaluation in brain 10–20 mCi IV R Carbon C 11 forRaclopride injection Brain: Dopamine D2 receptor imaging 10–15 mCi IV EFERENCE Carbon C 11 Sodium acetate injection Cardiac: Marker of oxidative metabolism 12–40 mCi IV Carbon C 14 Urea Diagnosis of Helicobacter pylori infection 1 µCi PO Chromium Cr 51 Sodium chromate injection Labeling red blood cells (RBCs) for mea- 10–80 µCi IV suring RBC volume, survival, and splenic sequestration Cobalt Co 57 Cyanocobalamin capsules Diagnosis of pernicious anemia and 0.5 µCi PO Not defects of intestinal absorption Fluorine F 18 Fludeoxyglucose injection Glucose utilization in brain, cardiac, and 10–15 mCi IV neoplastic disease Fluorine F 18 Fluorodopa injection Dopamine neuronal decarboxylase activity 4–6 mCi IV in brain Fluorine F 18 Sodium fluoride injection Bone imaging 10 mCi IV Gallium Ga 67 Gallium citrate injection Hodgkin’s disease, lymphoma 8–10 mCi IV Acute inflammatory lesions 5 mCi IV Indium In 111 Capromab pendetide Metastatic imaging in patients with biopsy- -
Emergencies in the Treatment of Wandering Spleen Osher Cohen MD1, Arthur Baazov MD1, Inbal Samuk MD1, Michael Schwarz MD2, Dragan Kravarusic MD1 and Enrique Freud MD1
ORIGINAL ARTICLES ,0$-ǯ92/20ǯ-81(2018 Emergencies in the Treatment of Wandering Spleen Osher Cohen MD1, Arthur Baazov MD1, Inbal Samuk MD1, Michael Schwarz MD2, Dragan Kravarusic MD1 and Enrique Freud MD1 1Departments of Pediatric and Adolescent Surgery and 2Pediatric Radiology, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel and nonspecific clinical presentation [2], making diagnosis ABSTRACT: Background: Wandering spleen is a rare entity that may pose difficult and the potential for a delayed diagnosis high [3]. a surgical emergency following torsion of the splenic vessels, Torsion of the splenic vessels has been described in 64% mainly because of a delayed diagnosis. Complications after of children with wandering spleen [4,5]. The splenic veins surgery for wandering spleen may necessitate emergency are the first vessels compromised because of their lower pres- treatment. sure [6], causing splenic engorgement and capsule stretching. Objectives: To describe the clinical course and treatment for Accordingly, abdominal pain, which can be acute, recurrent, children who underwent emergency surgeries for wandering or chronic, is the most common clinical presentation [7]. spleen at a tertiary pediatric medical center over a 21 year Progression of the torsion may lead to ischemic injury to the period and to indicate the pitfalls in diagnosis and treatment spleen and ultimately splenic necrosis [1]. as reflected by our experience and in the literature. Surgery is considered the only safe treatment for wander- Methods: The database of a tertiary pediatric medical center ing spleen [8], although there are a few reports on the use of was searched retrospectively for all children who underwent conservative methods [9]. -
Wandering Spleen with Torsion Causing Pancreatic Volvulus and Associated Intrathoracic Gastric Volvulus: an Unusual Triad and Cause of Acute Abdominal Pain
JOP. J Pancreas (Online) 2015 Jan 31; 16(1):78-80. CASE REPORT Wandering Spleen with Torsion Causing Pancreatic Volvulus and Associated Intrathoracic Gastric Volvulus: An Unusual Triad and Cause of Acute Abdominal Pain Yashant Aswani, Karan Manoj Anandpara, Priya Hira Departments of Radiology Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India , ABSTRACT Context Wandering spleen is a rare medical entity in which the spleen is orphaned of its usual peritoneal attachments and thus assumes an ever wandering and hypermobile state. This laxity of attachments may even cause torsion of the splenic pedicle. Both gastric volvulus and wandering spleen share a common embryology owing to mal development of the dorsal mesentery. Gastric volvulus complicating a wandering spleen is, however, an extremely unusual association, with a few cases described in literature. Case Report We report a case of a young female who presented with acute abdominal pain and vomiting. Radiological imaging revealed an intrathoracic gastric. Conclusionvolvulus, torsion in an ectopic spleen, and additionally demonstrated a pancreatic volvulus - an unusual triad, reported only once, causing an acute abdomen. The patient subsequently underwent an emergency surgical laparotomy with splenopexy and gastropexy Imaging is a must for definitive diagnosis of wandering spleen and the associated pathologic conditions. Besides, a prompt surgicalINTRODUCTION management circumvents inadvertent outcomes. Laboratory investigations showed the patient to be Wandering spleen, a medical enigma, is a rarity. Even though gastric volvulus and wandering spleen share a anaemic (Hb 9 gm %) with leucocytosis (16,000/cubic common embryological basis; cases of such an mm) and a predominance of polymorphonuclear cells association have rarely been described. -
Abdomen and Superficial Structures Including Introductory Pediatric and Musculoskeletal
National Education Curriculum Specialty Curricula Abdomen and Superficial Structures Including Introductory Pediatric and Musculoskeletal Abdomen and Superficial Structures Including Introductory Pediatric and Musculoskeletal Table of Contents Section I: Biliary ........................................................................................................................................................ 3 Section II: Liver ....................................................................................................................................................... 19 Section III: Pancreas ............................................................................................................................................... 35 Section IV: Renal and Lower Urinary Tract ........................................................................................................ 43 Section V: Spleen ..................................................................................................................................................... 67 Section VI: Adrenal ................................................................................................................................................. 75 Section VII: Abdominal Vasculature ..................................................................................................................... 81 Section VIII: Gastrointestinal Tract (GI) .............................................................................................................. 91 -
Weird Activity and the Wandering Spleen
Case Communications Weird Activity and the Wandering Spleen Nehama Sharon MD1, Jacob Schachter MD2, Ruth Talnir MD MBBCh MSc2, Joel First MD2, Uri Rubinstein MD2 and Ron Bilik MD3 Departments of 1Pediatric Hemato-Oncology and 2Pediatrics, Sanz Medical Center, Laniado Hospital, Netanya, Israel 3Department of Pediatric Surgery, Sheba Medical Center, Tel Hashomer, Israel Key words: wandering spleen, Doppler ultrasound, splenectomy IMAJ 2005;7:744–745 A wandering spleen is a rare form of de- in the splenic vein. There was A velopmental anomaly of the dorsal meso- a small amount of peritoneal gastrium of the spleen, leading to failure fluid around the liver and in the or incomplete attachment of the splenic pouch of Douglas. The examiner ligaments to the diaphragm, retroperi- commented on the mobility toneum and colon. Laxity of the sus- of the spleen and raised the pensory ligaments of the spleen can be possibility that it could be a congenital or acquired. These two forms wandering spleen. A computed of developmental anomalies result in the tomography-angiography scan of formation of a long vascular pedicle and the abdomen showed that the variable intraperitoneal splenic mobility stomach was grossly distended depending on the length of the vascular into the left upper quadrant pedicle. We describe here an acute tor- normally occupied by the spleen sion of a wandering spleen in a child fol- [Figure A]. The spleen was [A] Grossly distended stomach occupying the left upper quadrant normally occupied by the spleen. lowing an unusual physical activity. enlarged and located in the left lower quadrant of the abdomen, B Patient Description encroaching the pelvic inlet. -
Supermicar Data Entry Instructions, 2007 363 Pp. Pdf Icon[PDF
SUPERMICAR TABLE OF CONTENTS Chapter I - Introduction to SuperMICAR ........................................... 1 A. History and Background .............................................. 1 Chapter II – The Death Certificate ..................................................... 3 Exercise 1 – Reading Death Certificate ........................... 7 Chapter III Basic Data Entry Instructions ....................................... 12 A. Creating a SuperMICAR File ....................................... 14 B. Entering and Saving Certificate Data........................... 18 C. Adding Certificates using SuperMICAR....................... 19 1. Opening a file........................................................ 19 2. Certificate.............................................................. 19 3. Sex........................................................................ 20 4. Date of Death........................................................ 20 5. Age: Number of Units ........................................... 20 6. Age: Unit............................................................... 20 7. Part I, Cause of Death .......................................... 21 8. Duration ................................................................ 22 9. Part II, Cause of Death ......................................... 22 10. Was Autopsy Performed....................................... 23 11. Were Autopsy Findings Available ......................... 23 12. Tobacco................................................................ 24 13. Pregnancy............................................................ -
2018 Southern Regional Meeting
Abstracts J Investig Med: first published as 10.1136/jim-2017-000697.1 on 1 February 2018. Downloaded from Cardiovascular club I Purpose of study Coronary artery disease (C.A.D.) is one of the highest causes of death in the world. The purpose of this 11:00 AM study is to compare Puerto Rico (P.R.), Hispanic, U.S.A. coun- try, with the U.S.A., in coronary artery disease. Thursday, February 22, 2018 Methods used Compare a population of Hispanics with the high LDL levels with normal total cholesterol and HDL in P. R. and the U.S.A. The study population was 1000 patients. 1 A POSSIBLE ROLE FOR GENETICS IN CARDIOVASCULAR The U.S.A. health statistics and P.R. Department of Health DISEASE AMONG THE ACADIANS was used for comparison. AE Tedesco*, Z Haq, KL Di Losa, MJ Ali, P Gregory. LSUHSC – New Orleans, New Orleans, Summary of results Studying the lipid profile of Puerto Rico LA population, we found that the mean value of LDL lipoprotein is high (±104 mg/dl) with similar cholesterol and HDL levels 10.1136/jim-2017-000697.1 in both societies; still the coronary disease (CAD) incidence is lower than the U.S.A. (20%–30%). Investigators from the U.P. Purpose of study It is well documented that the Louisiana Aca- R. reported the genetic admixture of this Hispanic population. ‘ ’ dians ( Cajuns ) experience a disproportionate risk for some They reported the admixture consisted of 3 genes called pro- genetic diseases due to a genetic founder effect.Furthermore, cer- tective against C.A.D. -
Neuroanatomy Dr
Neuroanatomy Dr. Maha ELBeltagy Assistant Professor of Anatomy Faculty of Medicine The University of Jordan 2018 Prof Yousry 10/15/17 A F B K G C H D I M E N J L Ventricular System, The Cerebrospinal Fluid, and the Blood Brain Barrier The lateral ventricle Interventricular foramen It is Y-shaped cavity in the cerebral hemisphere with the following parts: trigone 1) A central part (body): Extends from the interventricular foramen to the splenium of corpus callosum. 2) 3 horns: - Anterior horn: Lies in the frontal lobe in front of the interventricular foramen. - Posterior horn : Lies in the occipital lobe. - Inferior horn : Lies in the temporal lobe. rd It is connected to the 3 ventricle by body interventricular foramen (of Monro). Anterior Trigone (atrium): the part of the body at the horn junction of inferior and posterior horns Contains the glomus (choroid plexus tuft) calcified in adult (x-ray&CT). Interventricular foramen Relations of Body of the lateral ventricle Roof : body of the Corpus callosum Floor: body of Caudate Nucleus and body of the thalamus. Stria terminalis between thalamus and caudate. (connects between amygdala and venteral nucleus of the hypothalmus) Medial wall: Septum Pellucidum Body of the fornix (choroid fissure between fornix and thalamus (choroid plexus) Relations of lateral ventricle body Anterior horn Choroid fissure Relations of Anterior horn of the lateral ventricle Roof : genu of the Corpus callosum Floor: Head of Caudate Nucleus Medial wall: Rostrum of corpus callosum Septum Pellucidum Anterior column of the fornix Relations of Posterior horn of the lateral ventricle •Roof and lateral wall Tapetum of the corpus callosum Optic radiation lying against the tapetum in the lateral wall. -
Heterotaxy: Associated Conditions and Hospital- Based Prevalence in Newborns Angela E
May/June 2000. Vol. 2 . No. 3 Heterotaxy: Associated conditions and hospital- based prevalence in newborns Angela E. Lin, MD',~,*, Baruch S. Ticho, MD, phD3j4,Kara Houde, MA1,Marie-Noel Westgate, ME^', and Lewis B. Holmes, MD',~,~ Purpose: To provide insight into the possible etiology and prevalence of heterotaxy, we studied conditions associated with heterotaxy in a consecutive hospital population of newborns. Methods: From 1972 to March, 1999 (except February 16, 1972 to December 31, 1978), 58 cases of heterotaxy were ascertained from a cohort of 201,084 births in the ongoing Active Malformation Surveillance Program at the Brigham and Women's Hospital. This registry includes livebirths, stillbirths, and elective abortions. Prevalence among nontransfers (i.e., patients whose mothers had planned delivery at this hospital) was calculated as approximately 1per 10,000 total births (20 of 201,084). Results: We analyzed a total of 58 patients consisting of 20 (34%) nontransfers and 38 (66%) transfers. Patients were categorized by spleen status as having asplenia (7 nontransfers, 25 total), polysplenia (8, 20), right spleen (4, ll),normal left (0, I), and unknown (1, 0). Among the 20 nontransfer and 59 total heterotaxy patients, the following associated medical conditions were present: chromosome abnormality (1nontransfer, 2 total), suspected Mendelian or chromosome microdeletion disorder (1nontransfer, 6 total), and maternal insulin- dependent diabetes mellitus (1 nontransfer, 2 total). There were 6 twins (1 member each from 6 twin pairs including 1dizygous, 4 monozygous, 1conjoined; 2 were nontransfers). An associated condition occurred in 5 (25%) nontransfer and 16 (28%) total patients, or among 10 of 53 singleton births (19%). -
PG Course Syllabus – FINAL
postgraduate course Atlanta,Georgia october 23, 2014 1 2 Table of Contents MODULE 1: LIVER PRIMARY SCLEROSING CHOLANGITIS – Dennis Black MD ................................................................. 13 THE JAUNDICED INFANT ‐ Saul Karpen MD ....................................................................................... 25 ACUTE LIVER FAILURE – Estella Alonso MD ....................................................................................... 43 MODULE 2: ENDOSCOPY THE DREADED WAKE‐UP CALL (PART A) – Mercedes Martinez MD .................................................. 55 THE DREADED WAKE‐UP CALL (PART B) – Lee Bass MD .................................................................... 67 ENDOSCOPIC INTERVENTIONS FOR BILIARY TRACT DISEASE – Victor Fox MD .................................. 75 MODULE 3: GI POTPOURRI EXTRAESOPHAGEAL MANIFESTATIONS OF GER – Benjamin Gold MD .............................................. 86 EoE: PPI, EGD AND WHAT TO EAT: ALPHABET DISTRESS – Sandeep Gupta MD ............................... 105 SNEW TRICK AND TREATMENTS FOR MOTILITY DISORDERS – Carlo Di Lorenzo MD ........................ 116 DIAGNOSIS AND MANAGEMENT OF CONSTIPATION – Manu Sood MD ........................................... 130 MODULE 4: NUTRITION DIET AND THE MICROBIOME – Robert Baldassano MD .................................................................... 141 FODMAP: NAVIGATING THIS NOVEL DIET – Bruno Chumpitazi MD .................................................. 152 NUTRITION EIN TH CHILD WITH NEUROLOGICAL DISABILITIES