A head-within-a-head.
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Biomedical subjects
Publications and source records attributed to A Moallem.
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Although many radiopharmaceuticals are "targeted" for specific tissues or organs, they may be incorporated into nonspecific sites to the extent that they are readily diffusible. There may be local hyperemia with "leaky" neovascularity or capillaries and perhaps also diminished lymphatic or venous removal from the affected area. Two cases are reported in which abscesses were visualized serendipitously. One was visualized on a Tc-99m MDP bone scan following nephrectomy, the other on a patient with a pelvic abscess and nonvisualized left kidney but with enhancement of the rim of a large pelvic abscess.
Tc-99m DTPA aerosol is often swallowed during inhalation for lung ventilation scans. The authors evaluated a 16-year-old girl with a known history of mixed collagen disorder (positive lupus anticoagulants) for symptoms of cough and acute shortness of breath. Tc-99m DTPA accumulated in the distal esophagus during aerosol inhalation and remained there at the end of the perfusion study, a period of approximately 1 hour. This serendipitous observation antedates clinical signs and symptoms of dysphagia.
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A new observation is reported wherein 99m Tc-MDP is incorporated into recanalizing thrombophlebitis. In one patient with subacute disease, inflammatory vascularity is appreciated during the first one to two minutes after injection. Both patients showed evidence of late phosphate uptake in their greater saphenous veins two hours later. Intravenous isotope injections may be given in an arm vein: foot injections are not required.
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The amplitude and duration of P waves in Leads II (P II), P terminal force in V1, (PV1) and the sums of P II and PV1 were compared in 37 subjects with left atrial size obtained by echocardiographic technique in 36 instances and with hemodynamic estimates of pulmonary capillary wedge pressures in 16 cases. The 22 females and 15 males were subdivided into the following groups. Group I, four normal subjects, Group II, 11 patients with predominant aortic insufficiency (two of whom had a mild mitral insufficiency); Group III, 14 patients with mitral valve disease, seven of whom had mitral insufficiency (two with minimal aortic insufficiency) Group IIIa) and seven had mitral stenosis (Group IIIb); Group IV, eight patients with miscellaneous disorders, i.e., coronary artery disease (5), hypertension (2), and idiopathic hypertrophic subaortic stenosis (1). Good correlations were obtained between left atrial size and P in Lead II (P II) (r = 0.74; p less than 0.001) and between P terminal force in V1 (PV1) and left atrial size (r = -0.69; p less than 0.001). In Group IV good correlation between PV1 and atrial size was noted. Some correlation between the sum of P II and PV1 and left atrial size (r = 0.51; p less than 0.02) was noted, but a better correlation was obtained in the patients with aortic insufficiency (r = 0.80; p less than 0.01). Pulmonary capillary wedge pressures were not reflected in changes in P II or PV1, except for the group with mitral stenosis (Group IIIb). Adding P II to PV1 improved the correlation with wedge pressure for the entire group.
A case of anomalous origin of the left coronary artery from the pulmonary artery in a 5-year-old child is presented. Surgical correction by means of a direct subclavian-coronary anastomosis was performed at normothermic temperatures without cardiopulmonary bypass. Pre- and postoperative studies including angiography are presented. The rationale for this approach and its benefits are compared to previously utilized surgical techniques. We feel that this method is superior in that it creates a two-coronary system without utilizing prosthetic or vein bypass grafts. It thus can be used in infancy, allows for future growth and development, and is not subject to the inherent deficiencies of prosthetic or vein grafts. All 4 known cases of subclavian-coronary anastomosis previously reported are discussed.
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