PubMed Health⌕ Search

Biomedical subjects

E P Wraight

Publications and source records attributed to E P Wraight.

At least 73 records · Page 4Linked to original sources
PubMed1985

Does left ventricular aneurysmectomy improve ventricular function in patients undergoing coronary bypass surgery?

Fourteen consecutive patients undergoing left ventricular aneurysmectomy and coronary artery bypass grafting were studied by multiple gated ventricular scintigraphy at rest and during exercise before and at six weeks and six months after surgery. All had congestive heart failure and 12 angina pectoris. Before operation left ventricular ejection fraction fell significantly with exercise, as did the regional wall motion score. Six weeks after surgery all surviving patients were free of angina, with an improvement in functional class; the total exercise workload improved significantly, but resting left ventricular ejection fraction was unchanged; the regional wall motion score improved in both the anterior and left anterior oblique projections, although extensive areas of abnormal contraction persisted. Exercise left ventricular ejection fraction improved significantly after operation at six weeks, and previous exercise induced abnormalities of regional contraction were abolished. Six months after operation angina pectoris had recurred in one patient, but there was no further change in ventricular function in the remainder. Although resting ejection fraction is not improved, symptoms, exercise workload, and exercise ventricular function can be improved by aneurysmectomy and coronary artery bypass grafting, but the respective contribution of these two procedures remains uncertain.

Adult↗
PubMed1985

Quantification of intracardiac shunts by gold-195m, a new radionuclide with a short half life.

Gold-195m, a radionuclide with a short half life (30.5 s) was used to quantify left to right intracardiac shunts. The results of this method were compared with those obtained with technetium-99m, a method that was validated against oximetry. In five patients the pulmonary to systemic flow ratio (greater than 3:1) obtained by both radionuclides indicated that the level of shunting was too high to be measured accurately. In one patient fragmentation of the bolus meant that no satisfactory gamma fit could be obtained. In the remaining 16 patients there was no significant difference between two successive 195mAu studies. The agreement between 99mTc results and 195mAu results was excellent. Oxygen administration, straight leg raising exercise, and the use of oblique projections did not affect the values of the pulmonary to systemic flow ratio. The technique of quantification of intracardiac shunts by 195mAu gives reproducible and accurate results and the low radiation dose means that it is suitable for use in children with suspected left to right shunts.

Adolescent↗
PubMed1984

Regional cerebral perfusion imaging in the elderly.

Tomographic emission scintigraphy of the brain using a stationary gamma-camera and rotating slant hole collimator, following intravenous injection of 123I-n-isopropyl p-iodoamphetamine, yields high quality images of regional cerebral blood flow. The technique has been used on 20 geriatric patients and is non-invasive, well-tolerated, and hitherto only associated with trivial adverse effects. It appears to be particularly useful in supporting a clinical diagnosis of multi-infarct disease but the demonstration of zones of underperfused but not necessarily infarcted cerebral tissue may well have wider research implications.

Aged↗
PubMed1984

The use of 99Tcm-DTPA aerosol ventilation scintigraphy in the diagnosis of pulmonary embolism.

Pulmonary scintigraphy is now established as a sensitive and noninvasive method for diagnosing pulmonary embolism (PE). The diagnostic specificity is increased if the perfusion study is combined with assessment of regional ventilation. The latter is usually performed using radioactive gases, either 133Xe or 81Krm, but these have some disadvantages. We report here a method for ventilation scintigraphy using 99Tcm-DTPA aerosol, previously described for the measurement of lung permeability, and present our findings in 20 patients. The system is easy to use and six-view images obtained can be readily compared with perfusion images. No data processing is required and any hospital with gamma camera facilities can use the system. Thus patients with suspected PE can have combined V/Q scintigrams to establish the diagnosis of PE and unnecessary treatment can be avoided.

Aerosols↗
PubMed1984

Evaluation of indium scintigraphy in patients with active inflammatory bowel disease.

Recent reports have indicated a possible role for 111Indium leucocyte scintigraphy in the management of patients with acute inflammatory bowel disease. Our experience with this technique in 15 patients (nine with ulcerative colitis, six with Crohn's disease) is described. Perfect agreement was not obtained between scintigraphic appearances and other conventional means in the assessment of extent of disease. Good correlation, however, was found between disease activity and recovery of labelled leucocytes in the faeces. While this latter finding could be used as an objective means of assessing response to therapy, it is concluded that conventional indium scintigraphy, using indium oxine-labelling of mixed leucocytes, is insufficiently reliable to replace usual methods for determining extent of disease in patients with inflammatory bowel disease.

Colitis, Ulcerative↗
PubMed1983

Yttrium-90 therapy and 99MTc pertechnetate knee uptake measurements in the management of rheumatoid arthritis.

Twenty-eight knees with chronic arthritis and effusion were treated with intra-articular 90Y. Synovial activity was assessed by measuring 99mTc pertechnetate uptake. There was a significant difference in uptake between controls and patients. Those who had a good response to 90Y (15 patients) showed a significant decrease in uptake, not seen in those who failed to respond. The pattern of 90Y distribution was examined and appeared to correspond to areas of increased synovial activity; these patterns and their significance have not been previously reported. Factors which could help to predict response to 90Y are discussed.

Aged↗
PubMed1983

Effects of coronary artery bypass grafting on left ventricular function assessed by multiple gated ventricular scintigraphy.

The effect of coronary artery bypass grafting on global left ventricular ejection fraction and regional contraction was studied in 56 consecutive patients with chronic stable angina pectoris by means of multiple gated ventricular scintigraphy at rest and during dynamic supine exercise before and six weeks after myocardial revascularisation. Before operation, exercise induced a significant fall in ejection fraction and regional wall motion score. Six weeks after operation 52 patients were symptomless. Resting ejection fraction and regional wall motion score were unchanged but during exercise ejection fraction increased significantly, and the previous exercise induced regional wall motion abnormalities were abolished. All four patients with persisting angina showed the same pattern as before operation, with a fall in left ventricular ejection fraction and regional wall motion score during exercise. Multiple gated ventricular scintigraphy affords a safe, objective, reproducible, and non-invasive means of assessing serial ventricular function at rest and during exercise in patients with ischaemic heart disease. The technique confirms that coronary bypass surgery abolishes exercise induced abnormalities of left ventricular function, but has no influence on resting function.

Angina Pectoris↗
PubMed1983

Reduced faecal blood loss in patients receiving choline magnesium trisalicylate ('Trilisate') when compared with aspirin.

A study was carried out in 16 healthy male volunteers to compare the effects on faecal blood loss of comparable daily doses of choline magnesium trisalicylate (3 g) and acetylsalicylic acid (2.4 g) given over a period of 7 days. Faecal blood loss was measured by 51Cr labelling of red cells. Haematological parameters were also monitored. Faecal blood loss and the reduction in haemoglobin levels were significantly less in the choline magnesium trisalicylate group than in the acetylsalicylic acid group. No significant differences were detected in the partial thromboplastin time, prothrombin time or bleeding time in either group.

Adolescent↗
PubMed1983

High renal activity on bone scintigrams. A sign of hypercalcaemia?

Various abnormalities of the renal tract can be detected from the renal images seen on 99Tcm methylene diphosphonate (MDP) bone scintigrams. Diffusely increased renal parenchymal activity has been associated with cytotoxic and other drug therapy, radiation nephritis, iron overload and cirrhosis. A further association--with hypercalcaemia--is reported here. In a retrospective study, 1950 bone scintigrams were reviewed and a significant relationship between high renal activity and hypercalcaemia was found. This was subsequently confirmed by a small prospective study. None of the patients whose bone scintigrams showed this association had evidence of nephrocalcinosis on X rays. It is postulated that in these hypercalcaemic patients there may be high tissue calcium in the kidneys which results in the high uptake of MDP, and it is suggested that serum calcium be measured in patients with previously unsuspected hypercalcaemia whose bone scintigrams exhibit the finding of high parenchymal renal activity.

Bone Neoplasms↗
PubMed1983

Tc-99m labeled HIDA imaging in suspected biliary leaks after liver transplantation.

Tc-99m labeled HIDA imaging has been used to investigate suspected biliary leaks following orthotopic liver transplantation. In two patients the diagnosis of bile leakage was confirmed and appropriate surgical intervention undertaken. In a third patient, despite clinical suspicion, no leakage was apparent on HIDA imaging, and unnecessary surgery was avoided. HIDA imaging is a useful, noninvasive technique for confirming biliary leakage after liver transplantation.

Adult↗
PubMed1982

The role of internal mammary scintigraphy in radiotherapy planning in patients with breast carcinoma.

The pathological status of internal mammary chains at the time of presentation in patients with carcinoma of the breast carries important prognostic significance. The aggressive treatment of involved nodes may alter the course of disease favourably in terms of survival and local recurrence. Methods of accurately localising and assessing the state of the internal mammary chain have been described previously. We present here the preliminary results of a series of patients studied with radioisotope techniques to assess anatomy and status of the nodes with special reference to radiotherapy planning.

Antimony↗
PubMed1981

Isotopic scanning of bone in the diagnosis of osteomalacia.

Results of a study performed over 18 months in 21 elderly patients showed that isotopic bone scanning is a sensitive technique for the detection of osteomalacia. It can be used not only to indicate the presence of the disease but the response to treatment.

Aged↗
PubMed1980

Selenomethionine liver scanning in the diagnosis of hepatoma.

Liver subtraction scans using 99Tcm sulphur coloid and 75Se-selenomethionine were carried out in 58 patients with suspected hepatoma. Of the 18 patients with hepatoma proven by histology, 16 showed selective concentration of selenomethionine in the tumour, giving a true positive rate of 89%. Of the 40 patients who did not have hepatoma, 32 scans showed no evidence of selective concentration of selenomethionine, giving a true negative rate of 80%. The false positive rate was 8% in non-cirrhotic patients with focal disease, but 55% in patients with cirrhosis. It is concluded that combined scanning with this technique is useful in non-cirrhotic patients in distinguishing hepatoma from other causes of focal disease, but that the technique is not useful and frequently misleading in patients with cirrhosis.

Carcinoma, Hepatocellular↗
PubMed1980

Technetium 99m methylene diphosphonate scanning in Thompson hemiarthroplasties.

Fourteen patients who had had Thompson hemiarthroplasties at least ten months previously were scanned using 555 MBq (15mCi) 99Tcm methylene diphosphonate. No hips were infected, the control group of eight firmly fixed prostheses showed a weak diffuse uptake pattern whilst five of six patients with loose prostheses showed a characteristic focal distribution of increased uptake.

Aged↗
PubMed1979

Role of lacrimal scintigraphy and subtraction macrodacryocystography in the management of epiphora.

Fifty-one patients were investigated by subtraction macrodacryocystography (SMDCG, 103 systems) and by lacrimal scintigraphy (LS, 105 systems). It was found that these investigations complemented each other and between them the precise site of obstruction in the lacrimal drainage apparatus could be determined in 80%. The radiation dosage to the lens in SMDCG significant, and it is therefore recommended that the patients with lacrimal obstruction should: (1) have lacrimal puncta dilated with a probe to No. 1 diameter and be forbstruction is still uncertain, then and only then should SMDCG be performed.

Child, Preschool↗