RESUMEN
OBJECTIVE: The purpose of this study was to develop a simpler method to measure severely reduced glomerular filtration rate (GFR) for patients with a GFR below 30 mL/min. METHOD: The GFR was measured in 24 patients using both the 51Cr EDTA slope-intercept method (the conventional method) and 99mTc-DTPA with our proposed simpler GFRn method. RESULTS: The correlation coefficient was 0.92 between the 2 methods, with a slope of 0.97 and an intercept of 2 mL/min. CONCLUSION: Our simplified method for measuring GFR is accurate for most patients with severely reduced GFR. Errors are acceptably small in patients with severely reduced GFR when edema or dehydration are present. If extrarenal (liver) clearance is significant, however, a urine sampling method is required for an accurate GFR measurement.
Asunto(s)
Tasa de Filtración Glomerular/fisiología , Renografía por Radioisótopo , Algoritmos , Superficie Corporal , Quelantes , Radioisótopos de Cromo/orina , Deshidratación/fisiopatología , Edema/fisiopatología , Ácido Edético , Espacio Extracelular/metabolismo , Humanos , Riñón/metabolismo , Riñón/fisiopatología , Modelos Lineales , Hígado/metabolismo , Radiofármacos/orina , Pentetato de Tecnecio Tc 99m/orinaRESUMEN
A young semi-comatose male patient was investigated using 99mTc hexamethyl-propylene amine oxime (99mTc HMPAO) brain single photon emission computed tomography (SPECT) before and after administration of the gamma-aminobutyric acid (GABA) agonist zolpidem. It was observed that 15 minutes after application of the drug the patient awoke from his semi-comatose condition and remained awake for the next 3-4 hours. When drug action subsided he returned to his semi-comatose state. Brain SPECT before drug application showed large hypo-active areas in certain parts of the brain. Brain SPECT after drug application showed a generalised cortical activation relative to the cerebellum and a marked and amplified activation of the areas that were hypo-active before drug application.
Asunto(s)
Coma Postraumatismo Craneoencefálico/diagnóstico por imagen , Coma Postraumatismo Craneoencefálico/tratamiento farmacológico , Agonistas del GABA/uso terapéutico , Piridinas/uso terapéutico , Exametazima de Tecnecio Tc 99m , Adulto , Humanos , Masculino , Receptores de GABA/efectos de los fármacos , Tomografía Computarizada de Emisión de Fotón Único , ZolpidemRESUMEN
Craniopagus twinning is a rare congenital abnormality, occurring at a frequency of 4-6 per 10 million births. A case is reported in which separation was successful for both twins. The importance of pre-operative radionuclide assessment of crucial organ function (liver, kidneys, heart, brain) and crossed circulation is stressed. The scintigraphic results were in keeping with radiographic, operative, and clinical findings. The routine use of radionuclide studies in the investigation of conjoined twins is recommended in order to delineate individual organ function, degree of fusion and measurement of cross-circulation.
