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Radionuclide Cisternogram
A radionuclide cisternogram is a medical imaging study which involves injecting a radionuclide by lumbar puncture (spinal tap) into a patient's cerebral spinal fluid (CSF) to determine if there is abnormal CSF flow within the brain and spinal canal which can be altered by hydrocephalus, Arnold–Chiari malformation, syringomyelia, or an arachnoid cyst. It may also evaluate a suspected leak (also known as a CSF fistula) from the CSF cavity into the nasal cavity. A leak can also be confirmed by the presence of beta-2 transferrin in fluid collected from the nose before this more invasive procedure is performed. The patient may be instructed to not eat or drink, or take medications such as aspirin or other blood thinners before the procedure. Pledgets can be inserted into the nasal cavity before the procedure when a CSF leak is suspected. The patient's spinal fluid is injected with a radiopharmaceutical tracer, such as DTPA tagged with indium 111, through a lumbar puncture (spinal t ...
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Medical Imaging
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging. Measurement and recording techniques that are not primarily designed to produce images, such as electroencephalography (EEG), magnetoencephalography (MEG), electrocardiography (ECG), and others, represent other technologies that produce data susceptible to representation as a parameter graph versus time or maps that contain data about the measurement loca ...
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Aspirin
Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific inflammatory conditions which aspirin is used to treat include Kawasaki disease, pericarditis, and rheumatic fever. Aspirin is also used long-term to help prevent further heart attacks, ischaemic strokes, and blood clots in people at high risk. For pain or fever, effects typically begin within 30 minutes. Aspirin works similarly to other NSAIDs but also suppresses the normal functioning of platelets. One common adverse effect is an upset stomach. More significant side effects include stomach ulcers, stomach bleeding, and worsening asthma. Bleeding risk is greater among those who are older, drink alcohol, take other NSAIDs, or are on other blood thinners. Aspirin is not recommended in the last part of pregnancy. It is not generally recommended in children with infections because of the risk of ...
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Bed Rest
Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of a health impairment which physically prevents leaving bed. The practice is still used although a 1999 systematic review found no benefits for any of the 17 conditions studied and no proven benefit for any conditions at all, beyond that imposed by symptoms. In the United States, nearly 20% of pregnant women have some degree of restricted activity prescribed despite the growing data showing it to be dangerous, causing some experts to call its use "unethical". Medical uses Extended bed rest has been proven to be a potentially harmful treatment needing more careful evaluation. Pregnancy Women who are pregnant and are experiencing early labor, vaginal bleeding, and cervix complications have been prescribed bed rest. This practice in 2013 wa ...
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Endoscopic
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ. There are many types of endoscopies. Depending on the site in the body and type of procedure, an endoscopy may be performed by either a doctor or a surgeon. A patient may be fully conscious or anaesthetised during the procedure. Most often, the term ''endoscopy'' is used to refer to an examination of the upper part of the gastrointestinal tract, known as an esophagogastroduodenoscopy. For nonmedical use, similar instruments are called borescopes. History Adolf Kussmaul was fascinated by sword swallowers who would insert a sword down their throat without gagging. This drew inspiration to insert a camera, the next problem to solve was how to insert a source of light, as they were still relying on candles and o ...
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Gamma Counter
A gamma counter is an instrument to measure gamma radiation emitted by a radionuclide. Unlike survey meters, gamma counters are designed to measure small samples of radioactive material, typically with automated measurement and movement of multiple samples. Operation Gamma counters are usually scintillation counters. In a typical system, a number of samples are placed in sealed vials or test tubes, and moved along a track. One at a time, they move down inside a shielded detector, set to measure specific energy windows characteristic of the particular isotope. Within this shielded detector there is a scintillation crystal that surrounds the radioactive sample. Gamma rays emitted from the radioactive sample interact with the crystal, are absorbed, and light is emitted. A detector, such as a photomultiplier tube converts the visible light to an electrical signal. Depending on the half-life and concentration of the sample, measurement times may vary from 0.02 minutes to several hours ...
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Gamma Camera
A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development and nuclear medical imaging to view and analyse images of the human body or the distribution of medically injected, inhaled, or ingested radionuclides emitting gamma rays. Imaging techniques Scintigraphy ("scint") is the use of gamma cameras to capture emitted radiation from internal radioisotopes to create two-dimensional images. SPECT (single photon emission computed tomography) imaging, as used in nuclear cardiac stress testing, is performed using gamma cameras. Usually one, two or three detectors or heads, are slowly rotated around the patient's torso. Multi-headed gamma cameras can also be used for positron emission tomography (PET) scanning, provided that their hardware and software can be configured to detect "coincidences" (nea ...
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Diffusion
Diffusion is the net movement of anything (for example, atoms, ions, molecules, energy) generally from a region of higher concentration to a region of lower concentration. Diffusion is driven by a gradient in Gibbs free energy or chemical potential. It is possible to diffuse "uphill" from a region of lower concentration to a region of higher concentration, like in spinodal decomposition. The concept of diffusion is widely used in many fields, including physics (particle diffusion), chemistry, biology, sociology, economics, and finance (diffusion of people, ideas, and price values). The central idea of diffusion, however, is common to all of these: a substance or collection undergoing diffusion spreads out from a point or location at which there is a higher concentration of that substance or collection. A gradient is the change in the value of a quantity, for example, concentration, pressure, or temperature with the change in another variable, usually distance. A change in c ...
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Isotopes Of Indium
Indium (49In) consists of two primordial nuclides, with the most common (~ 95.7%) nuclide (115In) being measurably though weakly radioactive. Its spin-forbidden decay has a half life of 4.41×1014 years. The stable isotope 113In is only 4.3% of naturally occurring indium. Among elements with a known stable isotope, only tellurium and rhenium similarly occur with a stable isotope in lower abundance than the long-lived radioactive isotope. Other than 115In, the longest-lived radioisotope is 111In, with a half-life of 2.8047 days. All other radioisotopes have half-lives less than a day. This element also has 47 isomers, the longest-lived being 114m1In, with a half-life of 49.51 days. All other meta-states have half-lives less than a day, most less than an hour, and many measured in milliseconds or less. Indium-111 is used medically in nuclear imaging, as a radiotracer nuclide tag for gamma camera localization of protein radiopharmaceuticals, such as In-111-labeled octreotide, which ...
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DTPA
Pentetic acid or diethylenetriaminepentaacetic acid (DTPA) is an aminopolycarboxylic acid consisting of a diethylenetriamine backbone with five carboxymethyl groups. The molecule can be viewed as an expanded version of EDTA and is used similarly. It is a white solid with limited solubility in water. Coordination properties The conjugate base of DTPA has a high affinity for metal cations. Thus, the penta-anion DTPA5− is potentially an octadentate ligand assuming that each nitrogen centre and each –COO− group counts as a centre for coordination. The formation constants for its complexes are about 100 greater than those for EDTA.J. Roger Hart "Ethylenediaminetetraacetic Acid and Related Chelating Agents" in Ullmann's Encyclopedia of Industrial Chemistry, Wiley-VCH, Weinheim, 2005. As a chelating agent, DTPA wraps around a metal ion by forming up to eight bonds. Its complexes can also have an extra water molecule that coordinates the metal ion. Transition metals, however, u ...
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Beta-2 Transferrin
Beta-2 transferrin is a carbohydrate-free ( desialated) isoform of transferrin, which is almost exclusively found in the cerebrospinal fluid. It is not found in blood, mucus or tears, thus making it a specific marker of cerebrospinal fluid, applied as an assay in cases where cerebrospinal fluid leakage is suspected. Beta-2 transferrin would also be positive in patients with perilymph Perilymph is an extracellular fluid located within the inner ear. It is found within the scala tympani and scala vestibuli of the cochlea. The ionic composition of perilymph is comparable to that of plasma and cerebrospinal fluid. The major ... fluid leaks, as it is also present in inner ear perilymph. Thus, beta-2 transferrin in otorrhea would be suggestive of either a CSF leak or a perilymph leak. References {{reflist Chemical pathology Neurology Transferrins ...
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Radionuclide
A radionuclide (radioactive nuclide, radioisotope or radioactive isotope) is a nuclide that has excess nuclear energy, making it unstable. This excess energy can be used in one of three ways: emitted from the nucleus as gamma radiation; transferred to one of its electrons to release it as a conversion electron; or used to create and emit a new particle (alpha particle or beta particle) from the nucleus. During those processes, the radionuclide is said to undergo radioactive decay. These emissions are considered ionizing radiation because they are energetic enough to liberate an electron from another atom. The radioactive decay can produce a stable nuclide or will sometimes produce a new unstable radionuclide which may undergo further decay. Radioactive decay is a random process at the level of single atoms: it is impossible to predict when one particular atom will decay. However, for a collection of atoms of a single nuclide the decay rate, and thus the half-life (''t''1/2) for ...
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Fistula
A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs. Types of fistula can be described by their location. Anal fistulas connect between the anal canal and the perianal skin. Anovaginal or rectovaginal fistulas occur when a hole develops between the anus or rectum and the vagina. Colovaginal fistulas occur between the colon and the vagina. Urinary tract fistulas are abnormal openings within the urinary tract or an abnormal connection between the urinary tract and another organ such as between the bladder and the uterus in a vesicouterine fistula, between the bladder and the vagina in a vesicovaginal fistula, and between the urethra and the vagina in urethrovaginal fistula. When occurring between two parts of the intestine, it is known as an enteroenteral fistula, between the small intest ...
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