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Search Results: 1 - 10 of 462290 matches for " Fard Esfahani A "
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The role of scintigraphic perfusion imaging in the evaluation of patients before and after percutaneous transluminal coronary angioplasty (PTCA)
A. Fard-Esfahani,A. Mohagheghi,M. Assadi,B. Fallahi
Iranian Journal of Nuclear Medicine , 2006,
Abstract: Objectives: We studied the value of myocardial perfusion imaging (MPI) for evaluation of myocardial perfusion improvement in patients with successful percutaneous transluminal coronary angioplasty (PTCA). Methods: Sixty patients (10 females and 50 males), (Age 54.18 +/- 11.71 years) were analyzed. MPI was performed before PTCA, and then 3-6 months after the procedure. In all patients repeated coronary angiography was done at least once after PTCA. Before PTCA myocardial perfusion defects were observed in all patients. Statistical analysis of the number of segments with various degrees of perfusion (normal, transient ischemia, irreversible ischemia), before and after PTCA, was performed for three groups separately. Statistical analyses were performed using the paired T test and also ANOVA test. Results: Improvement as a decrease in the number of transiently or irreversibly ischemic segments, was observed in 13 out of 16 patients in 6-10 days, 18 out of 21 cases 1-3 months and 20 out of 23 patients 3-6 months following PTCA. The scans performed 3-6 months after PTCA as compared to 1-3 months MPI showed an increase in the number of transiently ischemic segments and a decrease of normal perfused segments, but it did not reach a statistical significance. Sensitivity and specificity of MPI using angiography as the gold standard calculated four times; before PTCA, 6-10 days,1-3 months and 3-6 months after PTCA were 80, 81; 100, 35 ; 90, 100 and 76, 100 percent, respectively. Conclusion: Our results confirm the necessity for an assessment of perfusion, both before and shortly after angioplasty, so that the longer term consequences can be followed accurately. In addition our study confirmed that MPI approximately 4 weeks after the intervention has a good correlation between stress-induced myocardial perfusion abnormalities and the presence or absence of stenosis, independent of clinical symptoms.
"New techniques in nuclear medicine for tumor detection "
"Fard Esfahani A,Eftekhari M,Vakili A,Saghari M "
Iranian Journal of Nuclear Medicine , 1999,
Abstract: Widespread studies on tumor diagnosis has led to the development of techniques with greater sensitivity and improved specificity for detection of occult and small subclinical tumors. Tumor imaging by radiolabeling of tumor-specific antibodies (Immunoscintigraphy) or tissue specific biochemical agents (Receptor imaging) and especially physiologic imaging with positron emitters (PET), have opened a new era in nuclear medicine. In this paper the latest developments in tumor imaging are reviewed.
99mTc-RBC scan in evaluation of mycotic aneurysm
"Vakili A,Eftekhari M,Fard Esfahani A,Vali R
Iranian Journal of Nuclear Medicine , 1999,
Abstract: Mycotic aneurysm is an uncommon but very important complication of subacute infectious endocarditis. It is usually asymptomatic but often causes sudden and massive bleeding with high mortality rate. 99mTc-RBC scan is a noninvasive method for detection of mycotic aneurysm throughout the body. In this report two cases with mycotic aneurysm are presented and the usefulness of 99mTc-RBC scan in diagnosis of this disease process is discussed.
"Bone scan in Erdheime Chester disease "
"Eftekhari M,Darakhshan S,Vakili A,Fard Esfahani A
Iranian Journal of Nuclear Medicine , 1999,
Abstract: In spite of very high sensitivity, bone scan is quite nonspecific in evaluation of bony lesions. In interpretation of bone scan special attention to patient’s clinical presentation and correlation with other lab and imaging modalities should be paid. In this report a patient with Erdheim Chester disease a rare and unusual form of lipidosis is presented and the pattern of 99mTc-MDP bone scan and other imaging modalities are discussed.
Effects Of Treatment With Radioactive Iodine On Gonadal Functions In Patients With Differentiated Thyroid Cancer
Fard Esfahani A,Eftekhari M,Aliyari Zenooz N,Saghari M
Tehran University Medical Journal , 2004,
Abstract: Background: The purpose of this study was to evaluate the effect of treatment with radioactive iodine on the function of gonads in males and females with follicular and papillary thyroid carcinoma. Materials and Methods: Consenting patients in the reproductive age were grouped according to the cumulative dose of received radioiodine and followed for at least 12 months. For all men, serum levels of FSH, LH, and testosterone were measured; some (53 cases) were also studied by semen analysis. For women, tests for serum levels of LH, FSH, estrogen, and progesterone were performed. Results: Overall, 246 patients (159 females, 87 males) were studied. In 87.4% of men, there was an increase in serum FSH level after radioiodine therapy, in 20.7% of whom the level remained high during follow-up period. The average serum level of FSH after each course of treatment was significantly higher than the level before treatment (p<0.01), and there was a meaningful correlation with the cumulative dose of received iodine (p<0.001). Reduced number of sperms was shown in 35.8% of male patients, among whom 73.7% also showed reduced motility. In 36.8% of the patients with reduced sperm number (13.2% of the total), this finding was persistent during the follow-up period. Increased level of FSH was correlated with reduced sperm counts in all doses (p
"Quantitative assessment of salivary gland function by radioisotopic scanning in a randomized trial of Pilocarpine for prevention of radiation induced Xerostomia "
"Fard Esfahani A,Modarress Mosalla MM,Haddad P,Eftekhari M
Iranian Journal of Nuclear Medicine , 2001,
Abstract: Introduction: Radioisotope scanning is the best method for objective assessment of salivary gland function. Thus, it was used in a randomized trial of concomitant pilocarpine for assessment of radiation-induced xerostomia, in addition to subjective evaluation by an approved questionnaire and objective standard xerostomia grading. Methods: Patients randomized in placebo-controlled trial of pilocarpine concurrent with irradiation for prevention of radiation-induced xerostomia were evaluated by salivary gland scintigraphy immediately before and 6 months after the end of head and neck radiotherapy. Salivary gland function was measured by ejection fraction (EF) of Technetium-99m pertechnetate. The mean values for pre and post-radiotherapy scans were calculated and compared. Also post-radiotherapy scan findings in the two groups of pilocarpine and placebo were compared using the student’s t-test. In addition, comparison was made between the scan results and the subjective findings and objective gradings. Results: Twenty patients underwent the pre-radiotherapy salivary scintigraphy, and also 20 post-radiotherapy scans were performed. Mean parotid EF was 60.85% in the pre-radiotherapy and 9.08% in the post-radiotherapy scans (P<0.01). The means for submandibular glands in the pre and post-radiotherapy scans were 41% and 11.2%, respectively (P<0.01). Also the mean EF was 14.5% in the pilocarpine group and 3.65 in the placebo group for parotid glands (P=0.07) and 18.3% and 4.1% respectively for submandibular glands (P<0.05). The salivary scans confirmed the subjective and objective xerostomia findings. Conclusion: Salivary gland scintigraphy is a valuable method for evaluation of xerostomia after head and neck radiotherapy, quantitatively demonstrating the protective effect of pilocarpine compared to placebo on salivary glands.
Incidence and Severity of Vesicoureteral Reflux in Siblings of Children with Known reflux
N Ataei,F Sayari-Fard,A Madani,ST Esfahani
Iranian Journal of Pediatrics , 2005,
Abstract: Background: The incidence of primary vesicoureteral reflux (VUR) is less than 1% in the general normal population, but it is high in siblings of children with VUR, with a reported incidence of 4.7-51%. VUR represents one of the most significant risk factors for acute pyelonephritis in children and caries long-term renal parenchymal damage. The purpose of this study was to detect the age-related incidence, and severity of reflux, in siblings of children with reflux. Methods: Out of 80 index patients with VUR, 95 siblings were evaluated with direct voiding cystography from 1994 to 2004. All siblings underwent renal ultrasonography (US) for size, shape, parenchymal echogenicity, corticomedullary differentiation, irregularity of the kidney outlining, and parenchymal reduction. Findings: Out of 95 siblings, 34 had VUR, representing an incidence of 35.8%. The mean age at study entry of the 37 boys and 58 girls was 65 months (range 3 months to 13 years). Reflux was unilateral in 22 siblings and bilateral in 12. Of the 34 refluxing siblings (46 refluxing ureters), 12 (35.3%) had history of symptomatic urinary tract infection (UTI). Of the 46 refluxing units 22 were mild, 13 moderate, and 11 were severe. Conclusion: Reflux is low in the majority of siblings. This study confirms a significant overall incidence of VUR (35.8%) in the siblings of patients with known reflux. Additionally, our review suggests that all siblings over 6 years should undergo a screening for VUR because of the high likelihood of identifying reflux in this population, even in the absence of urinary tract infection.
Clinical course and treatment response in patients with Thyroid hot nodule
Fard Esfahani A,Aghayousefi HR,Eftekhari M,Fallahi B
Iranian Journal of Nuclear Medicine , 2002,
Abstract: This is a retrospective study on clinical course and treatment response of patients with thyroid hot nodule, referred to nuclear medicine department of Shariati Hospital from 1360 to 1377. From the total 58 patients with average age of 43 yr and incidence peak of 40 yr, 81% were female and 19% were male. 64% of the patients were thyrotoxic and 36% were euthyroid at presentation. Thyrotoxic symptoms and signs increased with age (P=0.04). 57% of patients received I-131 therapy without premedication. 7% received antithyroid drugs first and then underwent iodine therapy. From 36% of the patients who were euthyroid at presentation, 15.5% became thyrotoxic on follow up studies and received I-131 therapy, but 20.7% remained euthyroid without receiving any therapy. The average of first and cumulative radioiodine doses were 16.9 mci and 21.8 mci, respectively. Treatment response during 6 and 12 month follow up were 80% and 86.7%, respectively. The more administered the first dose, the better was the response (P=0.03). Men appeared to need more I-131 dosage and times of therapy as compared to women. Post radioiodine hypothyroidism incidence was 7.5% during one yr follow up. No meaningful relation was found between times of radioiodine therapy and thyroid or nodule size.
The best pattern of interpretation in dipyridamole myocardial perfusion scan for diagnosis of coronary artery disease in the territory of left anterior descending artery in patients with left bundle branch block
B. Fallahi,M. Saghari,M. Eftekhari,A. Fard-Esfahani
Iranian Journal of Nuclear Medicine , 2006,
Abstract: Objectives: Dipyridamole stress myocardial perfusion imaging (MPI) is often performed to detect coronary artery disease (CAD) in patients with preexisting left bundle branch block (LBBB). However, the accurate detection of true ischemia or infarction in these patients remains a challenge. Various interpretative methods with variable diagnostic results have been evaluated in an attempt to improve the specificity of MPI for these patients. The aim of our study was to compare the specificity of MPI using different interpretative patterns in the same series of patients. Methods: Forty two patients with LBBB referred for MPI (16 with angiographically proven CAD and 26 normal) were included in our study. Dipyridamole stress MPI was carried out for all patients and three experienced nuclear physicians interpreted the studies according to three structured patterns of interpretation. The test results in the territory of left anterior descending artery (LAD) was considered as positive, for pattern A, when a decreased perfusion was noted in the anterior, apex, septum or anteroseptal walls, irrespective to the extension of hypoperfusion and left ventricular cavity (LVC) size, for pattern B, only if perfusion defects were extending to the apex or coexisting with abnormalities in the other territories, and for pattern C, only if hypoperfusion of any extension was seen in the territory of LAD without coexisting LVC dilatation. The result of angiography as the gold standard, compared to the results of MPI with each pattern of interpretation. Results: The specificity of MPI was 16.17% for pattern A, 26.7% for pattern B and 66.7% for pattern C. The sensitivity of MPI was 100%, 66.7% and 91.7% for patterns A, B and C, respectively. Conclusion: To improve the specificity of MPI, LVC size must be particularly considered in the interpretation of scan findings in patients with LBBB. MPI result should be considered as positive for stenosis in the territory of LAD only when the perfusion defects of the septum and/or anteroseptal walls are noted in the presence of normal LVC.
The value of the Gated 99mTc-MIBI SPECT in differentiation of fixed myocardial lesions
Saghari M,Taghavi M,Fard Esfahani A,Fallahi B
Iranian Journal of Nuclear Medicine , 2003,
Abstract: Fixed myocardial defects in both stress and rest images, could be artifactual as a result of soft tissue attenuation. To increase specificity and identify the false positive results, we used gated technique to evaluate the wall motion and wall thickening as an index to differentiate real ischemic lesions from artifactual defects. 93 patients were studied. In 46 patients (48.8%) fixed perfusion defects were identified. Of these patients 10 (21.7%) had definite evidence of previous MI, 6 of whom (60%) showed abnormal gated SPECT findings. Among 36 patients without history of MI, 11 cases (30%) showed abnormal ventricular function (Probably due to silent MI) and 25 patients (70%) had normal function. The latter group was comprised of 13 females (52%) with fixed perfusion defects seen in the anterior, septal and apical segments of the myocardium. He results of the investigation indicate that using gated SPECT method with 99mTc-MIBI myocardial perfusion studies increases specificity of the fixed myocardial defects and is highly recommended.
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