The purposes of this study were to assess the presence of 99mTc-labeled white blood cells (WBC) in exercised muscle compared with nonexercised muscle over time and to determine the time course of delayed onset muscle soreness (DOMS) and eccentric torque in 10 female subjects. A pretest was followed by 300 eccentric repetitions of the right quadriceps. DOMS and eccentric torque were measured at 2, 4, 20, 24, 48, and 72 h postexercise. Eccentric torque was also tested at 0 h. Radionuclide images of both quadriceps were taken at 2, 4, 20, and 24 h postexercise. The presence of 99mTc-WBC in the exercised muscle was significantly greater (P < 0.001) than in the nonexercised muscle. Eccentric torque declined at 0 and 24 h postexercise. DOMS peaked at 24 h postexercise. The presence of 99mTc-WBC in the exercised muscle in the first 24 h suggests that acute inflammation occurs as a result of exercise-induced muscle injury. The bimodal pattern of eccentric torque supports the hypothesis that more than one mechanism is involved.

The role of radiographic and nuclear imaging in evaluation of postradiotherapy osteonecrosis of the jaw was studied. Patients who had received imaging at diagnosis and following hyperbaric oxygen therapy were studied. Radiographic changes did not correlate with the clinical status of patients. All bone scans were abnormal at the time of diagnosis of osteonecrosis, but remained abnormal following changes in the clinical status of patients. Thus, the bone scan may aid in the detection of osteonecrosis. Gallium uptake did not aid i diagnosis, but did correlate with clinical findings following treatment. Persisting positive gallium scans may indicate the need for surgery following hyperbaric oxygen therapy.

To determine if photodynamic therapy (PDT) adds anything to conventional external beam radiotherapy (XRT) in patients with obstructive endobronchial tumors, 11 patients with inoperable non‐small cell bronchogenic carcinoma obstructing a central airway were randomized into either XRT alone or PDT followed by XRT. The most proximal site of obstruction was in the trachea (2), carina (3) or a main‐stem bronchus (6). The tumors involved more than one site in all patients. The histology was squamous cell in 9 and large cell carcinoma in 2. The age. location of tumor, degree of endobronchial obstruction and karnofsky rating were similar between the two groups. The radiation dose was 3000 cGy in 10 fractions over two weeks using a parallel pair technique. The patients were reassessed 4 and 12 weeks after completion of XRT and then quarterly thereafter. Response to treatment was assessed by changes in symptom scores, quality of life scores, bronchoscopy, quantitative ventilation perfusion lung scan, spirometric measurements and arterial blood gas sampling. All patients improved symptomatically with objective evidence of regression of their tumor at 4 weeks. Four out of five patients in the XRT group who had been followed for 12 weeks or more had progression of their tumor at 12 weeks. Three of them had died 155, 256 and 261 days respectively after treatment. Only i patients in the PDT + XRT group who had been followed for 12 weeks or more relapsed at 12 weeks and subsequently died 201 days after treatment. Two patients are still in complete remission 183 days and 310 days after treatment. Our preliminary results suggest that 3000 cGy radiation therapy alone offers only transient palliation for patients with obstructive endobronchial tumor. The addition of PDT prior to XRT provides significantly better and longer lasting local control. The combined treatment may also improve survival. It is possible that a therapeutic dose–6000 cGy radiation therapy may offer better local control than 3000 cGy.

ABSTRACT:Background:This study investigated the hypothesis that the combination of regional CT brain atrophy measurements and semiquantitative SPECT regional blood flow ratios could produce a diagnostic test for Alzheimer's disease (AD) with an accuracy comparable to that achieved with the present clinical gold standard of the NINCDS-ADRDA criteria.Methods:Single proton emission computed tomography (SPECT) and CT head scans were performed on 122 subjects referred an UBC Alzheimer clinic and diagnosed as either ‘not demented’ (ND-37) or ‘possible/probable AD’ (AD-85) by the NINCDS-ADRDA criteria. Stepwise discriminant analysis (SDA) was performed on the bilateral SPECT regions of interest and compared to bilateral CT qualitative/quantitative assessment in the frontal, parietal and temporal lobes to determine which were most accurate at ND/AD distinction. Receiver operating curves (ROC) were then constructed for these variables individually and for their combined discriminant function.Results:The left temporal qualitative cortical atrophy score (CT) and left temporal perfusion ratio (SPECT) were selected in the SDA. The combined discriminant function was more specific at AD/ND distinction than either of CT or SPECT alone. The accuracy of AD/ND distinction with the combined discriminant function was below that achieved by clinical diagnosis according to the NINCDS-ADRDA criteria and was not significantly different from that achieved with SPECT or CT alone as defined by ROC curve analysis.Conclusion:The measurements of left temporal cortical atrophy and regional cerebral blood flow were most indicative of AD; however they lacked the sensitivity and specificity to recommend their use as a diagnostic test for AD.