Joseph Jay Sanger, M.D.

Fissural Nodular Densities: Inherent Stability and Benignity and Variability in Descriptive Nomenclature
Pryluck, D; Shiau, M; Wnorowski, A; Naidich, D; Sanger, J; Rom, W
2010 MAY ;194(5):-, American journal of roentgenology
— id: 111950, year: 2010, vol: 194, page: , stat: Journal Article,

Promoting professionalism through an online professional development portfolio: successes, joys, and frustrations
Kalet, Adina L; Sanger, Joseph; Chase, Julie; Keller, Allen; Schwartz, Mark D; Fishman, Miriam L; Garfall, Alfred L; Kitay, Alison
2007 Nov;82(11):1065-1072, Academic medicine
Medical educators strive to promote the development of a sound professional identity in learners, yet it is challenging to design, implement, and sustain fair and meaningful assessments of professionalism to accomplish this goal. The authors developed and implemented a program built around a Web-based Professional Development Portfolio (PDP) to assess and document professional development in medical students at New York University School of Medicine. This program requires students to regularly document their professional development through written reflections on curricular activities spanning preclinical and clinical years. Students post reflections, along with other documents that chronicle their professional growth, to their online PDP. Students meet annually with a faculty mentor to review their portfolios, assess their professional development based on predetermined criteria, and establish goals for the coming year. In this article, the authors describe the development of the PDP and share four years of experience with its implementation. We describe the experiences and attitudes of the first students to participate in this program as reported in an annual student survey. Students' experiences of and satisfaction with the PDP was varied. The PDP has been a catalyst for honest and lively debate concerning the meaning and behavioral manifestations of professionalism. A Web-based PDP promoted self-regulation on an individual level because it facilitated narrative reflection, self-assessment, and goal setting, and it structured mentorship. Therefore, the PDP may prepare students for the self-regulation of the medical profession--a privilege and obligation under the physician's social contract with society
— id: 75401, year: 2007, vol: 82, page: 1065, stat: Journal Article,

Tc-99m LL-2 Fab' monoclonal antibody imaging in acquired immune deficiency syndrome-related lymphoma
Kramer EL; Volm M; Donahue B; Wasserheit C; Chapnick J; Sanger J; Koslow M
1997 Dec 15;80(12 Suppl):2469-2477, Cancer
BACKGROUND: Both systemic and primary central nervous system (CNS) non-Hodgkin's lymphomas (NHL) occur in people with acquired immune deficiency syndrome (AIDS). The radiographic manifestations may be similar to other neoplasms and opportunistic infections that are also found frequently in AIDS. Furthermore, these diseases may coexist with NHL in the AIDS patient. METHODS: To evaluate the use of Tc-99m Lymphoscan (the Fab' fragment of the anti-CD-22 antibody LL-2; Immunomedics, Inc., Morris Plains, NJ) in patients with suspected AIDS lymphoma, we studied 7 patients with 35 sites of suspected disease. Six had CNS lesions suspicious for parenchymal brain lymphoma. Each patient underwent planar and single photon emission computed tomography imaging at 3-5 and 18-24 hours after administration of Lymphoscan. Scintigraphic results were compared with results of conventional diagnostic modalities. RESULTS: Overall, the sensitivity of Lymphoscan was 92% and the specificity was 86%. In brain lesions, there was 100% sensitivity and 100% specificity. Lymphoscan also had 100% sensitivity for sites of lymphomatous lymphadenopathy and for liver involvement. Although less specific in extracranial sites, Lymphoscan was correctly negative in sites of coexisting adenocarcinoma and pneumonia. Two patients had both parenchymal CNS and systemic lymphoma proven by biopsy. CONCLUSIONS: Lymphoscan appears to be a sensitive and specific method for diagnosing CNS lymphoma in AIDS patients. Although slightly less specific in extracranial sites, it may be helpful in differentiating lymphoma from other etiologies in these patients at risk for multiple neoplasms and opportunistic infections
— id: 7632, year: 1997, vol: 80, page: 2469, stat: Journal Article,

Clinical SPECT imaging
Kramer, Elissa Lipcon; Sanger, Joseph J
New York : Raven Press, c1995,
— id: 502, year: 1995, vol: , page: , stat: ,

HUMAN SPECT STUDIES OF AMPHETAMINE-INDUCED CHANGE IN DOPAMINE ACTIVITY
SIMKOWITZ, P; BRODIE, JD; SMITH, GS; LANDSMAN, D; KRAMER, EL; SANGER, J; NOZ, M; BARTLETT, E; DEWEY, S; FRIEDHOFF, AJ
1995 MAY 1 ;37(9):598-598, Biological psychiatry
— id: 87282, year: 1995, vol: 37, page: 598, stat: Journal Article,

An integrated approach to biodistribution radiation absorbed dose estimates
Noz ME; Kramer EL; Maguire GQ Jr; McGee SA; Sanger JJ
1993 Feb;20(2):165-169, European journal of nuclear medicine
An integrated approach to existing methods of extracting biodistribution data, pharmacokinetics and radiation absorbed dose estimates from serial scintigraphic images is described. This approach employs a single computer-generated user interface to reformat planar scans into a standard file type, align conjugate (anterior and posterior) images, draw regions of interest (ROIs) over selected organs and lesions and generate count data for anterior and posterior views and calculated geometric means. Using standard correction methods, the fraction injected activity is obtained for all ROIs and total body. This methodology has been applied to the analysis of indium-III-labelled breast-cancer-directed antibodies and technetium-90m-labelled CEA-specific antibody fragments in non-small-cell lung cancer. It is anticipated that this approach will be useful for evaluating the dosimetry of other radiolabelled monoclonal antibodies, as well as other radiopharmaceuticals
— id: 8227, year: 1993, vol: 20, page: 165, stat: Journal Article,

Graphical interface for medical image processing
Noz ME; Maguire GQ Jr; Birnbaum BA; Sanger JJ; Kramer EL; Chapnick JV; Kaminer EA
1993 Feb;17(1):1-16, Journal of medical systems
We have developed a graphical interface which allows users of varying levels of computer experience and proficiency to manipulate medical image-processing data with 'point-and-click' ease. The power which had formerly been associated with protocols and shell scripts has been combined with the flexibility and 'user-friendliness' of buttons and dialog boxes
— id: 25912, year: 1993, vol: 17, page: 1, stat: Journal Article,

Graphic user interface-based nuclear medicine reporting system [see comments]
Sanger JJ
1993 Mar;34(3):515-522, Journal of nuclear medicine
A graphically based, computerized report generation program has been developed and deployed at a dozen nuclear medicine facilities. The system is based on the Macintosh graphical user interface (GUI) and has been designed to be easy to learn and use. The system allows the nuclear medicine practitioner to generate reports for any nuclear medicine or nuclear cardiology procedure without transcriptionist support, dramatically decreasing report turnaround time. The system includes a relational database engine that allows cost-effective storage and rapid retrieval of final reports and also supports facsimile transmission of reports directly to referring clinicians' offices
— id: 6509, year: 1993, vol: 34, page: 515, stat: Journal Article,

Anomalous origin of the left coronary artery. Use of thallium perfusion scans in the evaluation of successful revascularization
Fernandes J; Rutkowski M; Sanger JJ
1992 Mar;17(3):177-179, Clinical nuclear medicine
Thallium imaging was performed on a 2-month-old infant with a left coronary artery originating from the pulmonary artery. Imaging was performed before and after corrective surgery, which involved creating a new left coronary osteum from the ascending aorta. The radionuclide study documented successful revascularization postoperatively
— id: 13661, year: 1992, vol: 17, page: 177, stat: Journal Article,

Radionuclide quantitation of renal function
Sanger JJ; Kramer EL
1992 ;14(2):69-78, Urologic radiology
Quantitation of renal function may be performed with a variety of radiopharmaceuticals which reflect slightly different renal functions. Plasma sampling techniques and imaging techniques have been used to derive absolute measurements of renal function. The addition of imaging permits the determination of relative or 'split' function. Time-activity curves from renal studies provide other quantitative parameters of function reflecting arterial supply, renal cortical function, and patency of the renal collecting system. Quantitative radionuclide studies of the kidneys provide comprehensive, reproducible, and objective assessments of renal function
— id: 13763, year: 1992, vol: 14, page: 69, stat: Journal Article,

ICRF-187 permits longer treatment with doxorubicin in women with breast cancer [published erratum appears in J Clin Oncol 1992 May;10(5):867]
Speyer JL; Green MD; Zeleniuch-Jacquotte A; Wernz JC; Rey M; Sanger J; Kramer E; Ferrans V; Hochster H; Meyers M; et al
1992 Jan;10(1):117-127, Journal of clinical oncology
PURPOSE: To test potential protection by ICRF-187 against cumulative doxorubicin-dose-related cardiac toxicity, we conducted a randomized clinical trial in 150 women with advanced breast cancer. PATIENTS AND METHODS: Patients received fluorouracil (5FU) 500 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 500 mg/m2 every 21 days intravenously (IV) (control regimen, 74 patients), or the same regimen preceded by ICRF-187 1,000 mg/m2 IV (experimental regimen, 76 patients). RESULTS: We previously reported that ICRF-187 in this dose and schedule provides cardiac protection and does not substantially alter the noncardiac toxicity or antitumor efficacy of the control regimen. In this updated analysis of the entire patient cohort, we provide additional support for these findings and demonstrate that patients in the ICRF-187 group received more cycles (median, 11) and higher cumulative doses (median, 500 mg/m2) of doxorubicin than patients in the control group (median, nine cycles, P less than .01; and 441 mg/m2, P less than .05). Twenty-six patients in the ICRF-187 group received doxorubicin doses of at least 700 mg/m2, and among them, 11 patients received 1,000 mg/m2 or more. Only three patients in the control group received doxorubicin doses of 700 mg/m2; the maximum dose administered to one patient in this group was 950 mg/m2. ICRF-187 cardiac protection was demonstrated by difference in incidence of clinical congestive heart failure (CHF; two patients in the ICRF-187 group v 20 in the control group; P less than .0001) and by differences in resting left ventricular ejection fraction (LVEF) determined by multigated radionuclide (MUGA) scan from baselines and that required patient removal from study (five patients in the ICRF-187 group had a decrease in LVEF to less than 0.45 or a decrease from the baseline LVEF of 0.20 or more v 32 in the control group; P less than .000001). Among the 30 patients who had an assessable endomyocardial biopsy at cumulative doxorubicin 450 mg/m2, none of 16 in the ICRF-187 group and six of 14 in the control group had a score of 2 (P less than .05). ICRF-187 cardiac protection was observed in patients with and without prior chest-wall radiation or other risk factors for developing doxorubicin cardiac toxicity. CONCLUSION: By protecting against cumulative doxorubicin-induced cardiac toxicity, ICRF-187 permits significantly greater doses of doxorubicin to be administered to patients with greater safety
— id: 13730, year: 1992, vol: 10, page: 117, stat: Journal Article,

Hepatic hemangiomas: diagnosis with fusion of MR, CT, and Tc-99m-labeled red blood cell SPECT images
Birnbaum BA; Noz ME; Chapnick J; Sanger JJ; Megibow AJ; Maguire GQ Jr; Weinreb JC; Kaminer EM; Kramer EL
1991 Nov;181(2):469-474, Radiology
A method of image analysis was developed for correlation of hemangiomas detected at computed tomography (CT) and/or magnetic resonance (MR) imaging with increased blood pool activity evident at single photon emission CT (SPECT) performed after labeling of red blood cells with technetium-99m. Image analysis was performed in 20 patients with 35 known hepatic hemangiomas. After section thickness and pixel sizes of the different studies were matched, intrinsic landmarks were chosen to identify anatomically corresponding locations. Regions of interest (ROIs) drawn on the CT and/or MR images were translated, rotated, and reprojected to match the areas of interest on the corresponding SPECT images by means of a two-dimensional polynomial-based warping algorithm. Analysis of ROIs on 30 SPECT-MR and 20 SPECT-CT pairs of registered images provided absolute confirmation that 34 suspected hemangiomas identified on SPECT images correlated exactly with lesions seen on CT and/or MR images. Accuracy of fusion was within an average of 1.5 pixels +/- 0.8 (+/- 1 standard deviation). The technique enabled diagnostic confirmation of hemangiomas as small as 1.0 cm and proved useful for evaluating lesions located adjacent to intrahepatic vessels
— id: 13849, year: 1991, vol: 181, page: 469, stat: Journal Article,

GRAPHICS APPLIED TO MEDICAL IMAGE REGISTRATION
Maguire, GQ; Noz, ME; Rusinek, H; Jaeger, J; Kramer, EL; Sanger, JJ; Smith, G
1991 Mar;11(2):20-27, IEEE computer graphics & applications
— id: 32223, year: 1991, vol: 11, page: 20, stat: Journal Article,

A prospective randomized trial of ICRF-187 for prevention of cumulative doxorubicin-induced cardiac toxicity in women with breast cancer
Speyer JL; Green MD; Sanger J; Zeleniuch-Jacquotte A; Kramer E; Rey M; Wernz JC; Blum RH; Hochester H; Meyers M; et al
1990 Sep;17(2-3):161-163, Cancer treatment reviews
— id: 15688, year: 1990, vol: 17, page: 161, stat: Journal Article,

CT-SPECT fusion to correlate radiolabeled monoclonal antibody uptake with abdominal CT findings
Kramer EL; Noz ME; Sanger JJ; Megibow AJ; Maguire GQ
1989 Sep;172(3):861-865, Radiology
To enhance the information provided by computed tomography (CT) and single photon emission computed tomography (SPECT) performed with radiolabeled, anti-carcinoembryonic antigen monoclonal antibody (MoAb), the authors performed fusion of these types of images from eight subjects with suspected colorectal adenocarcinoma. Section thickness and pixel size of the two studies were matched, coordinates of corresponding points from each study were identified, and CT sections were translated, rotated, and reprojected to match the corresponding SPECT scans. The CT-SPECT fusion enabled identification of anatomic sites of tumor-specific MoAb accumulation in four cases, showed non-specific MoAb accumulation in two, and helped confirm information only suggested by the two studies separately in one
— id: 25913, year: 1989, vol: 172, page: 861, stat: Journal Article,

Detection of thoracic infections by nuclear medicine techniques in the acquired immunodeficiency syndrome
Kramer EL; Sanger JJ
1989 Nov;27(6):1067-1076, Radiologic clinics of North America
The challenge of the acquired immunodeficiency syndrome (AIDS) for nuclear medicine has been the early detection of related intrathoracic opportunistic infections, inflammatory conditions, and neoplasms. Gallium-67 citrate scanning has proved a sensitive test not only for Pneumocystis carinii pneumonia but for many of the other opportunistic infections and malignancies, including mycobacterial infections and lymphoma. Patterns and intensity of gallium uptake may suggest more specific diagnoses. Indium-111-labeled white blood cells may also be a valuable diagnostic tool in the AIDS patient
— id: 25915, year: 1989, vol: 27, page: 1067, stat: Journal Article,

The use of preoperative localization of adenomas of the parathyroid glands by thallium-technetium subtraction scintigraphy, high-resolution ultrasonography and computed tomography
Roses DF; Sudarsky LA; Sanger J; Raghavendra BN; Reede DL; Blum M
1989 Feb;168(2):99-106, Surgery, gynecology & obstetrics
Thirty-six patients with primary hyperparathyroidism were studied preoperatively by thallium-201 and technetium-99m pertechnetate subtraction (Tl-201/Tc-99m) scintigraphy, high-resolution real time ultrasonography and computed tomographic (CT) scanning. None of the patients had had previous surgical treatment of the parathyroid or thyroid glands. All of the patients underwent systematic bilateral exploration of the neck. All of the patients were successfully explored and 41 abnormal parathyroid glands were identified. Five patients had two adenomas. In six instances, adenomas were identified in ectopic anatomic sites. The sensitivity of correctly localizing the abnormal glands with these techniques was 49 per cent for the Tl-201/Tc-99m scintigraphy, 34 per cent for ultrasonography and 41 per cent for CT scanning. The Tl-201/Tc-99m scintigrams detected two of the six ectopically located adenomas, CT detected one, while ultrasound detected none. The five patients with multiple adenomas were not accurately identified as having multiple gland enlargement by any of these studies. Therefore, preoperative localization studies with these three techniques did not provide reliable information for initial bilateral exploration of the neck
— id: 10738, year: 1989, vol: 168, page: 99, stat: Journal Article,

Contribution of SPECT to imaging of gastrointestinal adenocarcinoma with 111In-labeled anti-CEA monoclonal antibody
Kramer EL; Sanger JJ; Walsh C; Kanamuller H; Unger MW; Halverson C
1988 Oct;151(4):697-703, American journal of roentgenology
Fourteen patients with suspected adenocarcinoma of the gastrointestinal tract received 1 mg of 111In-labeled anticarcinoembryonic antigen monoclonal antibody type ZCE025 combined with 40 mg unlabeled antibody of the same type. Planar and single-photon emission CT (SPECT) imaging studies were performed 3 days after infusion and, when possible, 7 days after infusion. Scan findings were correlated with the findings at surgery when possible. Tumor was detected by day-3 planar imaging in eight of 13 patients in whom tumor was documented histopathologically. Day-3 SPECT allowed demonstration of tumor in 11 of these 13 patients. In another patient whose scan was negative, no residual tumor was found at surgery. SPECT was particularly helpful in identifying small and midline tumors. In two cases, localization on SPECT helped identify the tumor mass on CT. Two primary tumors weighing less than 5 g could not be detected on either planar or SPECT scans. Histologically positive, normal-sized lymph nodes were not seen by planar imaging or SPECT. SPECT increased the detection rate over that achieved with planar imaging, helped to better localize scan abnormalities, and afforded more useful comparison between the monoclonal antibody study and CT
— id: 10953, year: 1988, vol: 151, page: 697, stat: Journal Article,

The role of computed tomography in evaluation of skeletal metastases
Rafii M; Firooznia H; Kramer E; Golimbu C; Sanger J
1988 Jan;12(1):19-24, Journal of computed tomography
Computed tomography was performed in 100 patients for additional evaluation of suspected skeletal metastases following radionuclide bone scanning in 86 patients and conventional radiography in all. A retrospective review of these cases revealed that the majority (78%) involved the spine and pelvis. Computed tomography contributed to the diagnosis of a malignancy by revealing a definite destructive lesion of bone in 27 patients who had an abnormal radionuclide bone scan, a normal or inconclusive radiograph, or both. It excluded a malignant lesion in 19 patients. In 38 patients, computed tomography provided additional information that contributed to such aspects of patient care as obtaining tissue diagnosis, determining the extent of lesions, and evaluating the response to treatment. False diagnoses were made in two patients. Detection by computed tomography of a skeletal lesion and histologic documentation, frequently by computed tomography-guided percutaneous needle aspiration biopsy, greatly curtailed an otherwise extensive search for the primary site. Furthermore, this information altered the treatment plan by obviating the need for radical resection or biopsy of the primary tumor and by directing the choice of an appropriate chemotherapeutic regimen
— id: 11214, year: 1988, vol: 12, page: 19, stat: Journal Article,

Aortic aneurysm dissection causing V/Q mismatch
Tiu S; Toth PJ; Banner HJ; Kramer EL; Sanger JJ
1988 Mar;13(3):190-191, Clinical nuclear medicine
A case of unilateral mismatch on a ventilation/perfusion lung scan due to aortic aneurysm dissection is presented. Pulmonary embolism should not be considered the sole cause of unilateral lung mismatch. Clinical evaluation and pulmonary angiography should be used for a definitive diagnosis
— id: 11156, year: 1988, vol: 13, page: 190, stat: Journal Article,

Stress fractures and reduced bone mineral density with prior anorexia nervosa
Baum ML; Kramer EL; Sanger JJ; Pena A
1987 Sep;28(9):1506-1507, Journal of nuclear medicine
— id: 25916, year: 1987, vol: 28, page: 1506, stat: Journal Article,

MEASUREMENT OF EJECTION FRACTION BY BIOIMPEDANCE METHOD
Capan, LM; Bernstein, DP; Patel, KP; Sanger, J; Turndorf, H
1987 Apr;15(4):402-402, Critical care medicine
— id: 31247, year: 1987, vol: 15, page: 402, stat: Journal Article,

Biventricular cavity obliteration by metastatic malignant melanoma: role of magnetic resonance imaging in the diagnosis
Gindea AJ; Steele P; Rumancik WM; Culubret M; Feiner H; Sanger JJ; Kronzon I
1987 Nov;114(5):1249-1253, American heart journal
— id: 11324, year: 1987, vol: 114, page: 1249, stat: Journal Article,

A RANDOMIZED TRIAL OF ICRF-187 TO REDUCE DOXORUBICIN (DOX) CARDIOMYOPATHY - COMPARATIVE ACUTE TOXICITIES
Green, MD; Speyer, JL; Stecy, P; Rey, M; Kramer, E; Sanger, J; Ward, C; London, C; Blum, R; Wernz, J; Rohde, J; Muggia, FM
1987 May;5(1):117-117, Investigational new drugs
— id: 31182, year: 1987, vol: 5, page: 117, stat: Journal Article,

Gallium-67 scans of the chest in patients with acquired immunodeficiency syndrome
Kramer EL; Sanger JJ; Garay SM; Greene JB; Tiu S; Banner H; McCauley DI
1987 Jul;28(7):1107-1114, Journal of nuclear medicine
Eighty-six [67Ga]citrate chest scans were performed in 71 adult patients with the acquired immunodeficiency syndrome. Forty-five of these patients also had Kaposi's sarcoma. Only 29 of 57 abnormal scans were correlated with abnormal chest radiographs. Chest radiographs were negative for 27 scans and unavailable for one. Several scan patterns were seen. Diffusely increased lung uptake was seen most commonly with Pneumocystis carinii pneumonia, but also other infections and noninfectious inflammatory conditions. Focal uptake corresponding to regional lymph node groups occurred most often with Mycobacterium avium-intracellulare but aslo with lymphoma. Localized intrapulmonary uptake was seen in bacterial pneumonias. Perihilar activity occurred in two cases. When chest radiographs were abnormal and 67Ga scans negative, the most common diagnosis was pulmonary Kaposi's sarcoma
— id: 25917, year: 1987, vol: 28, page: 1107, stat: Journal Article,

The impact of intradermal lymphoscintigraphy on surgical management of clinical stage I truncal malignant melanoma
Kramer EL; Sanger JJ; Golomb F; Kopf AW; Postel A
1987 May;13(5):508-515, Journal of dermatologic surgery & oncology
Lymphoscintigraphy results in 35 stage I melanoma patients were compared with primary location and surgical management. Six of 25 primaries with potentially multidirectional lymphatic drainage had drainage to one regional node group. Three of 10 with expected unidirectional drainage showed multidirectional drainage. With unidirectional drainage, decision concerning lymphadenectomy was simplified
— id: 25918, year: 1987, vol: 13, page: 508, stat: Journal Article,

Bone scan appearance of osteogenesis imperfecta in an adult
Kramer EL; Rafii M; Fazzini E; Sanger J
1986 May;11(5):331-333, Clinical nuclear medicine
An adult patient with undiagnosed osteogenesis imperfecta presented with a history of multiple fractures. Radiographs could not definitively diagnose the underlying abnormality. The radionuclide bone image suggested the presence of a skeletal dysplasia, and prompted the histopathologic review of fracture fragments. The scan appearance of osteogenesis imperfecta in the adult and possible underlying mechanisms for the radiopharmaceutical distribution are discussed
— id: 25920, year: 1986, vol: 11, page: 331, stat: Journal Article,

"Supernormal" bone image in a case of Waldenstrom macroglobulinemia
Lubat E; Kramer EL; Sanger JJ
1986 Apr;11(4):279-280, Clinical nuclear medicine
A case of Waldenstrom macroglobulinemia, a rare cause of diffusely increased skeletal uptake and relatively diminished renal uptake of bone seeking radiopharmaceutical, is presented. This pattern has been described in a variety of disorders. An important observation to be made in these cases is the skeletal distribution of the radiopharmaceutical. In diffuse bone metastases from carcinoma, which is the most common cause of these findings, the increased activity is primarily in the axial skeleton. In some of the more uncommon causes, including certain hematologic disorders, however, the increased skeletal uptake is more homogeneous in distribution, with prominent uptake in the skull and distal extremities
— id: 25921, year: 1986, vol: 11, page: 279, stat: Journal Article,

Renal uptake in liver scan
Tiu S; Klein B; Kramer EL; Sanger JJ
1986 Jan;16(1):80-81, Seminars in nuclear medicine
— id: 25922, year: 1986, vol: 16, page: 80, stat: Journal Article,

Breakdancer's pulmonary embolism
Tiu S; Srinivasan I; Banner HJ; Kramer EL; Genieser NB; Sanger JJ
1986 Jun;11(6):402-403, Clinical nuclear medicine
A case of pulmonary embolism caused by breakdancing is reported. There was no clinical suspicion of pulmonary embolism
— id: 25919, year: 1986, vol: 11, page: 402, stat: Journal Article,

Lymphedema in the replanted limb of the rat: scintigraphic evaluation
Kramer EL; McLaws R; Sanger JJ; Shaw W
1985 ;6(1):40-45, Microsurgery
The sequence of scintigraphic patterns in resolving lymphedema in the replanted hind limb of the rat is reported. Compared to simple observation of the limb, scintigraphy using 99mTc-antimony trisulfide colloid (99mTc SbSC) provides multiple qualitative parameters for assessing lymphedema, ie, diffuse uptake in the implanted limb, focal uptake at the site of surgical repair, accumulation in the popliteal node, and activity in the liver. Quantitative analysis in this model was not helpful. Scintigraphic criteria may be utilized to study the effect of alteration in the animal model described. It is hoped that this model can be used to clarify the clinical factors influencing the resolution of lymphedema
— id: 25925, year: 1985, vol: 6, page: 40, stat: Journal Article,

Hepatobiliary scintigraphy of the compartmentalized gallbladder
Kramer EL; Rumancik WM; Harkavy L; Tiu S; Banner HJ; Sanger JJ
1985 Dec;145(6):1205-1206, American journal of roentgenology
— id: 25923, year: 1985, vol: 145, page: 1205, stat: Journal Article,

The value of the radionuclide angiogram in the prediction of perioperative myocardial infarction in patients undergoing lower extremity revascularization procedures
Pasternack PF; Imparato AM; Riles TS; Baumann FG; Bear G; Lamparello PJ; Benjamin D; Sanger J; Kramer E
1985 Sep;72(3 Pt 2):II13-II17, Circulation
To better define the group of patients at high risk of myocardial infarction (MI) and death associated with lower extremity revascularization procedures, resting gated blood pool studies were obtained in 100 such patients before surgery and results were correlated with the prevalence of perioperative MI. The results indicated that three patient groups could be distinguished on the basis of cardiac ejection fraction. Group I (n = 50) had preoperative ejection fractions ranging from 56% to 83%. None of the patients in group I suffered an acute perioperative MI. Group II (n = 42) comprised patients with ejection fractions ranging from 36% to 55%. There was a 19.0% prevalence of MI in group II, with one cardiac death. Group III included eight patients with ejection fractions ranging from 26% to 35%. There was a 75% prevalence of perioperative MI in these patients, with one cardiac death. All perioperative MIs occurred within the first 48 hr after surgery. Statistical analysis demonstrated a significantly higher prevalence of perioperative MI in patients with gated pool ejection fractions of 35% or less compared with the prevalence in patients with one or more of the other widely used clinical signs of increased cardiac operative risk (p less than .02)
— id: 18210, year: 1985, vol: 72, page: II13, stat: Journal Article,

A NEW TEST FOR THE EARLY DETECTION OF CARDIAC ABNORMALITIES IN BETA-THALASSEMIA MAJOR - THALLIUM SCINTIGRAPHY
Rey, M; Goodfield, P; Sanger, J; Rutkowski, M
1985 ;72(4):95-95, Circulation
— id: 30721, year: 1985, vol: 72, page: 95, stat: Journal Article,

Prospective evaluation of cardiotoxicity during a six-hour doxorubicin infusion regimen in women with adenocarcinoma of the breast
Speyer JL; Green MD; Dubin N; Blum RH; Wernz JC; Roses D; Sanger J; Muggia FM
1985 Apr;78(4):555-563, American journal of medicine
In order to test the possible cardiac-sparing effect of doxorubicin administered by six-hour intravenous infusion and to prospectively evaluate the role of resting left ventricular ejection fraction in monitoring these patients, 33 women with advanced breast cancer were treated with combination chemotherapy containing 5-fluorouracil, cyclophosphamide, and doxorubicin. Doxorubicin was administered via a femoral catheter as a six-hour infusion. Cardiac function was monitored prior to therapy and at intervals during therapy by history and physical examination and by measurement of resting left ventricular ejection fraction with gated pool radionuclide angiography. Twenty-six responses were observed (complete response, seven [21 percent]; partial response, 19 [57 percent]). Systemic toxicity included alopecia, myelosuppression, and nausea and vomiting. There was a progressive fall in resting left ventricular ejection fraction during treatment from a median baseline value of 0.63. Mean fall from baseline left ventricular ejection fraction at a cumulative doxorubicin dose of 200 to 300 mg/m2 was 0.06 (p less than 0.005); at 301 to 449 mg/m2 it was 0.09 (p less than 0.0005); and at 450 mg/m2 or greater it was 0.15 (p less than 0.0005). Clinical congestive heart failure developed in three patients. Even though the decrease in left ventricular ejection fraction was often within the 'normal range' (left ventricular ejection fraction 0.50 or greater), these changes were progressive and appeared to be part of a continuum of doxorubicin-induced myocardial damage. Steady-state infusion levels of doxorubicin in plasma ranged from 90 to 120 nM. They confirm the hypothesis that lower concentrations can be achieved by continuous infusion rather than by bolus infusion. In this study, however, administration of doxorubicin by six-hour infusion did not appear to have a major cardiac-sparing effect. Studies of anthracycline cardiac toxicity should include determination of baseline left ventricular ejection fraction and serial observations during therapy. Failure to include deteriorations in function above an arbitrary cutoff point or to make observations only at higher cumulative doses may underestimate drug-induced myocardial damage
— id: 15698, year: 1985, vol: 78, page: 555, stat: Journal Article,

Focal pulmonary edema. Correlation with perfusion lung scan
Tiu S; Liu D; Kramer EL; Sanger JJ
1985 Aug;10(8):583-585, Clinical nuclear medicine
Pulmonary embolism is diagnosed by a mismatched perfusion-ventilation lung scan. The probability is increased further when there is an associated 'hot spot' in the perfusion study caused by focal pulmonary edema
— id: 25924, year: 1985, vol: 10, page: 583, stat: Journal Article,

81mKr gas and 99mTc-MAA V/Q ratio images for detection of V/Q mismatches
Kramer EL; Sanger JJ
1984 ;9(8):345-350, European journal of nuclear medicine
Methods for creating ventilation/perfusion ratio images have been reported previously using radioxenon. With the availability of 81mKr gas, corresponding ventilation and perfusion views in multiple projections to evaluate for V/Q mismatch may be performed more readily. A technique for the creation of a functional V/Q ratio image to highlight V/Q mismatches to aid in the evaluation of pulmonary embolism is described. By removing nonpertinent and distracting information and by converting a 'cold spot' imaging modality to a 'hot spot' modality, these functional images aid in the synthesis of the information provided by the ventilation and perfusion images. The limitations due to technical artifacts and the advantages of using these functional images are described
— id: 25929, year: 1984, vol: 9, page: 345, stat: Journal Article,

Esophageal reflux demonstrated on a hepatobiliary scan
Kramer EL; Sanger JJ
1984 Mar;9(3):161-162, Clinical nuclear medicine
Gastroesophageal reflux was a fortuitous finding on a hepatobiliary scan in a patient who had a history of esophagogastrectomy and complained of regurgitation in the supine position
— id: 25928, year: 1984, vol: 9, page: 161, stat: Journal Article,

Radionuclide scanning--new applications in urology
Kramer EL; Sanger JJ
1984 May;23(5):468-477, Urology
The current status of nuclear renal scanning and function evaluation is summarized. The indications for renal imaging are discussed. Techniques for measurement of split and total renal function are reviewed. Special attention is given to the role of renography (conventional and diuretic) in the evaluation of the obstructed kidney
— id: 25926, year: 1984, vol: 23, page: 468, stat: Journal Article,

The value of radionuclide angiography as a predictor of perioperative myocardial infarction in patients undergoing abdominal aortic aneurysm resection
Pasternack PF; Imparato AM; Bear G; Riles TS; Baumann FG; Benjamin D; Sanger J; Kramer E; Wood RP
1984 Mar;1(2):320-325, Journal of vascular surgery
To define the group of patients at high risk for myocardial infarction (MI) and death associated with abdominal aortic aneurysm repair, resting gated blood pool studies were obtained on 50 such aneurysm patients preoperatively. The results indicated that three groups could be distinguished among these patients by cardiac ejection fraction. Group I (n = 25) had preoperative ejection fractions ranging from 56% to 85%. None of the patients in group I suffered an acute perioperative MI. Group II (n = 20) comprised patients with ejection fractions ranging from 36% to 55%. There was a 20% incidence of MI in group II but no cardiac deaths. Group III included five patients with ejection fractions ranging from 27% to 35%. There was an 80% incidence of perioperative MI in these patients, with one cardiac death and one cardiac arrest. All perioperative MIs occurred within the first 48 hours after surgery. In addition there was a 50% incidence of perioperative MI among all those patients who were 80 years of age or older. These results indicate guidelines for the management of patients undergoing abdominal aortic aneurysm repair based on their preoperative ejection fraction. The data further suggest that the noninvasive gated blood pool method of determining ejection fraction may serve a more broadly useful function in helping to determine which of those patients about to undergo major surgical procedures are at high risk for perioperative MI
— id: 18211, year: 1984, vol: 1, page: 320, stat: Journal Article,

Discordance between chest x-ray and gallium scan
Tiu S; Kramer EL; Sanger JJ; Benjamin DD
1984 Apr;14(2):149-151, Seminars in nuclear medicine
— id: 25927, year: 1984, vol: 14, page: 149, stat: Journal Article,

Pseudomembranous colitis: a possible role for Gallium scanning
Kramer EL; Charap M; Sanger JJ; Tiu SS
1983 Oct;78(10):632-633, American journal of gastroenterology
A case of antibiotic-associated pseudomembranous colitis is presented in which the Gallium scan was the first diagnostic modality to alert the clinicians to the existence of an inflammatory bowel process. The mechanism of localization of the radiopharmaceutical in inflammatory bowel disease is discussed. Although colonoscopy is far more specific and should be the first-line diagnostic tool used in assessing the presence of pseudomembranous colitis, Gallium scanning may have a role in the follow-up of treatment and in cases of relapse
— id: 18896, year: 1983, vol: 78, page: 632, stat: Journal Article,

Detection of lacrimal gland infiltration on routine bone scintigraphy
Kramer EL; Sanger JJ; Benjamin DD; Tiu S
1983 Nov;8(11):546-549, Clinical nuclear medicine
We report a bone scan finding of bilaterally and symmetrically increased uptake at the lateral orbital rims in a patient with disseminated Hodgkin's disease. Computerized axial tomography (CT) demonstrated lacrimal gland enlargement, presumably due to infiltration by Hodgkin's disease. Both the radionuclide bone scan and CT findings, as well as the other physical and radiographic manifestations of Hodgkin's disease, resolved after chemotherapy. Infiltration by Hodgkin's lymphoma is a rare cause of lacrimal gland enlargement. We believe that this pattern of uptake on a routine bone scan should alert the physician to possible lacrimal gland disease, which could then be more definitively evaluated by CT examination
— id: 25930, year: 1983, vol: 8, page: 546, stat: Journal Article,

Radioxenon retention in the skeleton on a routine ventilation study
Kramer EL; Tiu S; Sanger JJ; Benjamin DD
1983 Jul;8(7):299-300, Clinical nuclear medicine
Marked retention of radioxenon by the skeletal structures during a routine ventilation scan is described. Xenon uptake by bones occurs largely in the intraosseous fat. Augmented uptake in this case may be related to the patient's prolonged steroid therapy
— id: 25931, year: 1983, vol: 8, page: 299, stat: Journal Article,

Radioisotopic evaluation of congenital lobar emphysema
Mitnick JS; Kutin NS; Braunstein P; Sanger J
1981 Jun;6(6):266-267, Clinical nuclear medicine
— id: 63019, year: 1981, vol: 6, page: 266, stat: Journal Article,

The electronic librarian
Sanger, J.J.
1979 ;ns-27(11):44-44, Kilobaud: Microcomputing
This program represents a system for cross-indexing journals magazine articles or other information. The system was written using BASIC-E, a CP/M-based compiler, primarily for its ready availability, simplicity of disk I/O coding and relative speed of operation. However, the system could be implemented, with relatively minor changes, on any disk-based BASIC computer supporting random access files
— id: 98876, year: 1979, vol: ns-27, page: 44, stat: Journal Article,