Gallium imaging offers many practical advantages over indium-111-labeled leukocyte imaging, and calculating quantitative ratios in addition to performing the routine bone-gallium images allows accurate and easy evaluation of patients with suspected osteomyelitis. To add objectivity and improve the accuracy and confidence in diagnosis of osteomyelitis, quantitative comparison of abnormalities seen on bone scans and gallium scans was performed. One hundred and ten adult patients with 126 sites of suspected osteomyelitis were evaluated and categorized by gallium-to-bone ratios, gallium-to-background ratios, and spatial incongruency of gallium and bone activity. Combined evaluation using these criteria gave a 70% sensitivity and 93% specificity for the diagnosis of osteomyelitis.
Acetazolamide was tested in the extracellular alkalosis of K+ depletion, a metabolic situation which presumably elicits a general intracellular acidosis, demonstrated for both muscle and kidney. The renal effect of drug on HCO3– excretion was markedly less than normal despite elevated plasma HCO3– concentration. These experiments, together with those on metabolic and respiratory acidosis, suggest that with decreased intracellular renal pH, the role of carbonic anhydrase in renal acidification and HCO3– reabsorption is reduced.
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