Radionuclide Lymphoscintigraphy in the Evaluation of Lower Extremity Lymphedema – Single Hospital Experience

Objective: To find out the type of pattern of obstruction in patient with lymphedema of lower extremities by Lymphoscintigraphy to evaluate.Method: This retrospective study was carried out at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS) from January 2014 to June 2014. The study included 51 patients. Lymphoscintigraphy performed by Tc-99m nano-colloid and were interpreted by expert of Nuclear Medicine Physician.Result: Lymphoscintigraphy was done total 51patients with clinically diagnosed lymphedema (29 males and 22 females; age range 10–80 years). Seventeen patients (33.3%) revealed normal flow in both limbs, whereas only one patients (1.9%) consistent with primary lymphedema.Thirty-three patients (64.7%) consistent with secondary lymphedema, where thirty patients (58.8%) revealed unilateral partial obstruction and three patient (5.9%) had bilateral partial obstruction.Conclusion: Lymphoscintigraphy is safe and effectiveBangladesh J. Nuclear Med. 18(1): 43-46, January 2015

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Molecular Imaging of Lower Extremity Peripheral Arterial Disease: An Emerging Field in Nuclear Medicine

Frontiers in Medicine ◽

10.3389/fmed.2021.793975 ◽

2022 ◽

Vol 8 ◽

Author(s):

Mitchel R. Stacy

Keyword(s):

Nuclear Medicine ◽

Molecular Imaging ◽

Peripheral Arterial Disease ◽

Lower Extremity ◽

Lower Extremities ◽

Arterial Disease ◽

Diagnostic Tools ◽

Non Invasive ◽

Increased Risk ◽

Peripheral Arterial

Peripheral arterial disease (PAD) is an atherosclerotic disorder of non-coronary arteries that is associated with vascular stenosis and/or occlusion. PAD affecting the lower extremities is characterized by a variety of health-related consequences, including lifestyle-limiting intermittent claudication, ulceration of the limbs and/or feet, increased risk for lower extremity amputation, and increased mortality. The diagnosis of lower extremity PAD is typically established by using non-invasive tests such as the ankle-brachial index, toe-brachial index, duplex ultrasound, and/or angiography imaging studies. While these common diagnostic tools provide hemodynamic and anatomical vascular assessments, the potential for non-invasive physiological assessment of the lower extremities has more recently emerged through the use of magnetic resonance- and nuclear medicine-based approaches, which can provide insight into the functional consequences of PAD-related limb ischemia. This perspectives article specifically highlights and discusses the emerging applications of clinical nuclear medicine techniques for molecular imaging investigations in the setting of lower extremity PAD.

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Evaluation of skeletal metastatic pattern by 99m Tc- Methylene diphosphonate in prostatic carcinoma patients

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v17i2.28198 ◽

2016 ◽

Vol 17 (2) ◽

pp. 130-133

Author(s):

Nasreen Sultana ◽

Zeenat Jabin ◽

Rahima Parveen ◽

Shamim MF Begum ◽

Rokeya Begum

Keyword(s):

Nuclear Medicine ◽

Retrospective Study ◽

Prostatic Carcinoma ◽

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Skeletal Metastasis ◽

Whole Body ◽

Methylene Diphosphonate ◽

Group B ◽

Age Range

Objective: The objective of this study was to find out the pattern of skeletal metastasis in-patient with prostatic carcinoma by using 99mTechnetium-Methylene diphosphonate (99mTc MDP).Methods: This retrospective study was carried out at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS) from January 2014 to December 2014. The study included 65 histologically proven prostatic carcinoma patients. They were divided into three groups according to their age. Whole body bone scintigraphy was performed with 99mTc MDP and was interpreted by expert nuclear medicine physicians as negative or positive for skeletal metastases.Results: Bone scan was done on 65 prostate cancer patients. They were divided into three groups according to their age. In this series, the lowest age of patients were 50 years and highest 85 years with a mean ± SD was 65.80 ± 10.11 years. Group A comprised of 14 subjects age ranged 50 to 59 years. Out of them 8 (57%) were positive for skeletal metastasis. Group B comprised of 25 subjects and age range from 60 to 69 years. Out of them 18(72%) were positive for skeletal metastasis. Third group C comprised of 26 subjects and age ranged from 70-80+ years of age. Out of 26 subjects 22(84%) were positive for skeletal metastasis. The most common site involved was dorsal vertebrae in which 60% secondaries were isolated. Sacroiliac joint 39% and ribs 33% were the second and third most common affected areas respectively. Other involved sites were skull, sacrum, lumbar vertebrae, ileum, mandible, femur, sternum, cervical vertebrae, iliac crest, scapula, hip joint, tibia and pelvis.Conclusion: This retrospective study focused on the pattern of skeletal metastasis in various bony sites due to prostate carcinoma, which might be helpful for the oncologist and clinician in further treatment planning.Bangladesh J. Nuclear Med. 17(2): 130-133, July 2014

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The Use of Doppler Ultrasound to Diagnose Deep Vein Thrombosis of the Lower Limbs

Journal of Biomedical Engineering and Medical Imaging ◽

10.14738/jbemi.94.9302 ◽

2021 ◽

Vol 8 (4) ◽

pp. 7-13

Author(s):

Nagla Hussein ◽

Mohamed Khalid

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Femoral Vein ◽

Lower Extremities ◽

Duplex Ultrasound ◽

Imaging Method ◽

Colour Doppler ◽

Vein Thrombosis ◽

Age Range ◽

Deep Vein

In most cases of pulmonary embolism, death occurs as a result of deep vein thrombosis (DVT) of the lower extremities. Therefore, to avoid DVT complications and sequel, DVT must be diagnosed as early as possible and this can be achieved via B-mode and colour Doppler imaging. The present paper seeks to investigate the suitability of the imaging method of ultrasound for lower extremity DVT diagnosis and to explore the outcomes of the use of this method in DVT cases. To this end, the paper undertakes a retrospective descriptive study of 50 cases of ultrasound-based diagnosis of DVT at King Khalid Hospital in the period between January 2019 and August 2020. Half of the cases were subjected to compression, colour, and duplex ultrasound, 14 cases were subjected to compression and duplex ultrasound, and 11 cases were subjected to compression and colour Doppler. The mean age across all cases was 46.2±19.9 years. The majority of cases (56%) were in the age range 22-41 years old (n=28), while 28% of cases were in the age range 42-61 years old (n=14), 6% of cases were in the age range 62-81 years old (n=3), and 10% of cases were in the age range 82-102 years old (n=5). Regarding sex, females accounted for 60% of cases, while males accounted for the rest of 40%. Furthermore, in 90% of cases (n=45), just one lower extremity was affected, whereas in 10% of cases (n=5), both lower extremities were affected. Regarding thrombus location, it was found mostly in the area above the knee, particularly the popliteal vein (34%), common femoral vein (18%), and superficial femoral vein (20%). Moreover, 2% of cases presented thrombus in the calf vein. In 26% of cases, multiple veins were affected. DVT was acute in 76% of cases (n=38) and chronic in 24% of cases (n=12). It is concluded that symptomatic and at-risk cases benefit from the use of ultrasound for DVT diagnosis. The suitability of this method stems from its lack of invasiveness and capability to assess thrombus location, magnitude, and stage.

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Cases of Lower Extremity and Perianal Burns at the Burn Center in the Southeast Anatolia of Turkey

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211049064 ◽

2021 ◽

pp. 153473462110490

Author(s):

Ebral Yiğit ◽

Yasemin Demir Yiğit

Keyword(s):

Retrospective Study ◽

Lower Extremity ◽

Burn Injuries ◽

Burn Center ◽

Left Lower Extremity ◽

Training And Research ◽

Extensive Debridement ◽

Southeast Anatolia ◽

The Right ◽

Age Range

Introduction: In this study, the aim is to discuss the cases of lower extremity and perianal burns at the burn center in the southeast Anatolia of Turkey. Material and methods: A 4-year retrospective study was conducted on 775 patients who had been admitted to Gazi Yaşargil Training and Research Hospital Burn Centre with lower extremity and perianal burn injuries between January 2016 and January 2020. Results: Of the patients, 427 were male and 348 were female. Scald burns are most commonly affect the perianal and lower extremities. The right lower extremity was affected in 602 (77.7%) patients, the left lower extremity was affected in 574 (74.1%) patients and the perineum was affected in 70 (9.0%) patients. Most burn injuries occur in individuals between 0 to 4 years old, and the rate of burn injuries gradually decreases in individuals outside of this age range. No patient underwent colostomy for perianal burns. Conclusion: Early, aggressive and extensive debridement, in addition to adequate antimicrobial therapy, should be performed as the basis of treatment.

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Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0041-1728998 ◽

2021 ◽

Author(s):

Pushpinder S. Khera ◽

Pawan K. Garg ◽

Sarbesh Tiwari ◽

Narendra Bhargava ◽

Taruna Yadav ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Success ◽

Gastric Varices ◽

Early Recurrence ◽

Single Institution ◽

Vascular Plug ◽

Acute Bleeding ◽

Sclerosing Agents ◽

Age Range ◽

Refractory Hepatic Encephalopathy

Abstract Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate.

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Molecular Mechanisms Associated with ROS-Dependent Angiogenesis in Lower Extremity Artery Disease

Antioxidants ◽

10.3390/antiox10050735 ◽

2021 ◽

Vol 10 (5) ◽

pp. 735

Author(s):

Greg Hutchings ◽

Łukasz Kruszyna ◽

Mariusz J. Nawrocki ◽

Ewa Strauss ◽

Rut Bryl ◽

...

Keyword(s):

Quality Of Life ◽

Blood Vessel ◽

Lower Extremity ◽

Molecular Mechanisms ◽

Lower Extremities ◽

Tissue Response ◽

Peripheral Arteries ◽

Artery Disease ◽

Lower Extremity Artery Disease

Currently, atherosclerosis, which affects the vascular bed of all vital organs and tissues, is considered as a leading cause of death. Most commonly, atherosclerosis involves coronary and peripheral arteries, which results in acute (e.g., myocardial infarction, lower extremities ischemia) or chronic (persistent ischemia leading to severe heart failure) consequences. All of them have a marked unfavorable impact on the quality of life and are associated with increased mortality and morbidity in human populations. Lower extremity artery disease (LEAD, also defined as peripheral artery disease, PAD) refers to atherosclerotic occlusive disease of the lower extremities, where partial or complete obstruction of peripheral arteries is observed. Decreased perfusion can result in ischemic pain, non-healing wounds, and ischemic ulcers, and significantly reduce the quality of life. However, the progressive atherosclerotic changes cause stimulation of tissue response processes, like vessel wall remodeling and neovascularization. These mechanisms of adapting the vascular network to pathological conditions seem to play a key role in reducing the impact of the changes limiting the flow of blood. Neovascularization as a response to ischemia induces sprouting and expansion of the endothelium to repair and grow the vessels of the circulatory system. Neovascularization consists of three different biological processes: vasculogenesis, angiogenesis, and arteriogenesis. Both molecular and environmental factors that may affect the process of development and growth of blood vessels were analyzed. Particular attention was paid to the changes taking place during LEAD. It is important to consider the molecular mechanisms underpinning vessel growth. These mechanisms will also be examined in the context of diseases commonly affecting blood vessel function, or those treatable in part by manipulation of angiogenesis. Furthermore, it may be possible to induce the process of blood vessel development and growth to treat peripheral vascular disease and wound healing. Reactive oxygen species (ROS) play an important role in regulation of essential cellular signaling pathways such as cell differentiation, proliferation, migration and apoptosis. With regard to the repair processes taking place during diseases such as LEAD, prospective therapeutic methods have been described that could significantly improve the treatment of vessel diseases in the future. Summarizing, regenerative medicine holds the potential to transform the therapeutic methods in heart and vessel diseases treatment.

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Computed Tomography and Bronchoscopy in Endobronchial Tuberculosis

Canadian Respiratory Journal ◽

10.1155/2003/496296 ◽

2003 ◽

Vol 10 (8) ◽

pp. 445-448 ◽

Cited By ~ 11

Author(s):

Halil Yanardag ◽

Cüneyt Tetikkurt ◽

Seza Tetikkurt ◽

Sabriye Demirci ◽

Tuncer Karayel

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Therapeutic Response ◽

Histopathological Examination ◽

Computed Tomographic ◽

Before And After ◽

Endobronchial Tuberculosis ◽

Age Range

BACKGROUND: The therapeutic response to endobronchial tuberculosis is usually evaluated by bronchoscopy. Currently, there are no published studies investigating the use of computed tomography for the evaluation of therapeutic response in endobronchial tuberculosis.OBJECTIVE: A retrospective study was performed to evaluate the bronchoscopic and computed tomographic features of endobronchial tuberculosis before and after treatment. The aim of this study was to investigate the usefulness of computed tomography for the assessment of treatment.METHODS: The clinical, pathological and bronchoscopic features of endobronchial tuberculosis were evaluated in 55 patients. The age range of the patients was 21 to 52 years. Computed tomography and bronchoscopy were performed before and after treatment.RESULTS: Diagnosis of tuberculosis was confirmed by culture and histopathological examination. Bronchoscopic examination revealed 89 endobronchial lesions of various types in 55 patients. The exudative type was the most common. Follow-up bronchoscopy revealed that exudative-, ulcerative- and granular-type lesions healed completely. Computed tomography performed after treatment correlated well with the follow-up bronchoscopic findings.CONCLUSION: The results suggest that follow-up computed tomography is useful for the evaluation of therapeutic response and complications associated with endobronchial tuberculosis, and may replace bronchoscopy.

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A Study of Transcutaneous Oxygen Saturation by Pulse Oximetry in Symptomatic Ischaemic Lower Limb – A Cross Sectional Analytical Study in a Tertiary Care Hospital in Tirupathi

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/550 ◽

2021 ◽

Vol 8 (32) ◽

pp. 3018-3022

Author(s):

Sadhu Nagamuneiah ◽

Gandikota Venkata Prakash ◽

Sabitha P ◽

Jandla Bhulaxmi ◽

Dintyala Venkata S.S.Dintyala Venkata S.S. Mythri ◽

...

Keyword(s):

Lower Extremity ◽

Pulse Oximetry ◽

Analytical Study ◽

Lower Extremities ◽

Care Hospital ◽

Colour Doppler ◽

Duplex Scan ◽

Cross Sectional ◽

Transcutaneous Oxygen ◽

Arterial Insufficiency

BACKGROUND Chronic arterial insufficiency (CAI) results in stenotic-occlusive disease of vascularized arterial disorders of tissues and organs. CAI of the lower extremities represents a significant medical and socio-economic problem due to a high incidence of morbidity, invalidity and mortality. METHODS A cross sectional analytical study was conducted in a group of 100 patients, admitted at the Vascular Department of the Sri Venkateshwara Ramnaraian Ruia Government General Hospital, Tirupati during the period from September 2018 to August 2019, with evident symptoms and signs of different stages of lower extremities CAI verified by ultrasonography. In patients with lower extremity disorder of tissue arterial capillaries, SpO2 was determined by pulse oximetry. CAI of the lower extremity was determined on the basis of clinical findings and colour Doppler duplex scan echo sonography results. Using the conventional method (single-gate) and colour Doppler duplex scan (multi-gate), the presence and localization of stenosis, the segmental predominance (with multisegmental forms) and the degree of progression of stenotic-occlusive lesions were verified. RESULTS Results Using pulse oximetry, depending on the of stage of lower extremities CAI, we revealed a considerable difference in the stages of functional ischemia Mean SpO2: Fontaine I – 95.50 %, Fontaine II – 92.90; in stage critical ischemia SpO2: Fontaine III – 65.00 % and Fontaine IV – 49.87 %. In 29 patients with gangrenous foot and fingers SpO2 was immeasurable and progressive decrease in SpO2 of arterial capillaries (p<0.01 between stages). CONCLUSIONS Due to the reliability and simplicity of pulse oximetry it can be a routinely used diagnostic device for patients with early determined stage of lower extremities CAI. KEYWORDS Chronic Arterial Insufficiency, SPO2, Pulse Oximetry, Ischemia

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EFEKTIVITAS ELEVASI EKSTREMITAS BAWAH TERHADAP PROSES PENYEMBUHAN ULKUS DIABETIK DI RUANG MELATI I RSUD DR. MOEWARDI TAHUN 2014

KOSALA : Jurnal Ilmu Kesehatan ◽

10.37831/jik.v3i1.47 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Dwi Ariani Sulistyowati

Keyword(s):

Lower Extremity ◽

Ulcer Healing ◽

Healing Process ◽

Lower Extremities ◽

Tissue Perfusion ◽

Analysis Data ◽

Control Group ◽

Control Group Design ◽

Diabetic Ulcer ◽

Equivalent Control

AbstractIntroduction: People with Diabetes Mellitus have poor circulation, especially in areas far from heart, these causing the length of time of wounds healing. One of the interventions to improve the peripheral tissue perfusion of patients with Diabetic Ulcer is lower extremity elevation.Purpose: The purpose of this research is describe the characteristics of respondents, knowing Diabetic Ulcer healing process without lower extremity elevation, knowing Diabetic Ulcer healing process with lower extremity elevation and knowing the effectiveness of Diabetic Ulcer healing without lower extremity elevation and with lower extremity elevation.Research Methods: This research is to design an quasy experiment non equivalent control group design and analysis data used Independent T TestResearch Results: Results of this research is the elevation of lower extremities more effectively to increased Ulcers Diabetic healing process. It’s evidenced by Independent T Test obtained p = 0,000Conclusion: Elevation of lower extremities more effectively to increased Diabetic Ulcer healing in patients with Diabetic Ulcer in Melati I RSUD Dr. Moewardi.Advice: Lower extremity elevation expect can be applied in patients with Diabetic Ulcer.Key Words: Lower Extremity Elevation, Diabetic Ulcer Healing Process

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Duplex doppler ultrasonography in the diagnosis of deep venous thrombosis of the lower extremities

Medicinski pregled ◽

10.2298/mpns0602011v ◽

2006 ◽

Vol 59 (1-2) ◽

pp. 11-14 ◽

Cited By ~ 2

Author(s):

Viktorija Vucaj-Cirilovic ◽

Kosta Petrovic ◽

Olivera Nikolic ◽

Viktor Till ◽

Dijana Niciforovic ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Doppler Ultrasonography ◽

Varicose Veins ◽

Color Doppler ◽

Lower Extremities ◽

Postthrombotic Syndrome ◽

Duplex Doppler ◽

Age Range

Introduction. The aim of this study was to investigate the role of duplex Doppler ultrasonography in diagnosis of deep venous thrombosis (DVT) of the lower extremities. Material and methods. During a 2-year period, 860 patients were examined by duplex Doppler sonography. Among these, 619(72%) were women and 241 (28%) men, with the age-range of 16-91; (mean 56,2) years. Siemens Versa Pro color doppler was used, with 7MHz transducers. Findings were categorized into four categories: 1. deep venous thrombosis (DVT); 2. pathology predominantly related to superficial veins without DVT; 3. pathology of superficial and deep veins; 4. normal findings. Results. 185 (21%) patients had DVT, 366 (42.5%) patients had pre?dominant pathology of superficial veins: postthrombotic syndrome, superficial thrombophlebitis and varicose veins. 128 (14.9%) patients had pathology of superficial and deep veins. Normal findings were found in 181 (21.1%) patients. Conclusions. Various vascular and nonvascular diseases may mimic deep venous thrombosis, and that is why US should be used whenever possible to avoid unnecessary anticoagulant therapy. .

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