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Biomedical subjects

F L Datz

Publications and source records attributed to F L Datz.

At least 91 records · Page 5Linked to original sources
PubMed1985

The role of nuclear imaging in the management of the first total artificial heart recipient.

On December 2, 1982, a permanent total artificial heart was implanted into the chest of a 61-year-old man with a progressive and irreversible cardiomyopathy. During the ensuing four-month hospitalization, a number of nuclear medicine procedures were obtained to assist in patient management. These procedures included gated cardiac radionuclide ventriculography, an I-123 iodoamphetamine scan for cerebral perfusion, and In-111 labeled leukocyte imaging. These radionuclide studies demonstrate the advantages of being able to monitor physiologic changes noninvasively and illustrate a potential role for nuclear cardiology in managing patients with a total artificial heart.

Amphetamines↗
PubMed1985

Utility of bladder lavage in Meckel's scanning.

Accumulation of radioactive urine in a bladder diverticulum on a Tc-99m pertechnetate scan simulated uptake in a Meckel's diverticulum. The abnormal activity was present even following bladder catheterization and drainage. However, saline lavage washed the residual activity out of the bladder, and prevented a false-positive diagnosis. In addition to preventing false-positive studies, bladder lavage may increase the sensitivity of the test by allowing the detection of Meckel's diverticuli that are obscured by residual bladder activity.

Diagnosis, Differential↗
PubMed1985

Improved detection of upper abdominal abscesses by combination of 99mTc sulfur colloid and 111In leukocyte scanning.

Indium-111-labeled leukocyte scanning is an excellent technique for detecting abdominal abscesses. However, since labeled leukocytes are normally taken up by the liver and spleen, diagnosing upper abdominal abscesses can be difficult. A prospective study was undertaken to see if having a technetium-99m sulfur colloid liver-spleen scan to compare with the 111In leukocyte scan would improve the reader's ability to diagnose or exclude upper abdominal abscesses. Ninety patients with suspected upper abdominal abscesses were examined with 111In leukocyte scans followed immediately by conventional 99mTc sulfur colloid liver-spleen scans in the same projections. In 57% of patients with upper abdominal abscesses and 26% of all patients studied, the 99mTc sulfur colloid scan was essential to diagnose or exclude an upper abdominal abscess. The liver-spleen scan was considered helpful in another 13%. The addition of a 99mTc sulfur colloid liver-spleen scan to the 111In leukocyte study is useful when evaluating patients with suspected upper abdominal abscesses.

Abdomen↗
PubMed1985

Detection of acute synthetic vascular graft infection with 111In-labeled leukocyte scanning: an animal study.

Synthetic vascular graft infection is characterized by late diagnosis due to indolent and nonspecific symptoms. Indium-111-labeled leukocyte imaging holds promise as a diagnostic tool to identify vascular graft infection, but reported data on its accuracy are somewhat sparse and conflicting. In this study, 13 mongrel dogs received Dacron aortic interposition grafts. Seven grafts were contaminated at the time of surgery by topical ATCC Staphylococcus aureus concentrated at 10(8) organisms/ml. Six control animals received no graft contamination. All infected animals were sacrificed on the second postoperative day after 111In leukocyte scanning. The results showed a sensitivity of 71%, specificity of 100%, and accuracy of 85% for the 111In leukocyte study in detecting early graft infections; false-positive leukocyte scans in the early postoperative period were not a problem as has been reported by others. These data indicate that leukocyte scanning for graft infection detection is likely to be clinically valuable.

Animals↗
PubMed1985

Lung scan perfusion defects limited to matching pleural effusions: low probability of pulmonary embolism.

Patients with a new pleural effusion are often sent for a ventilation-perfusion scan to exclude a pulmonary embolism. This retrospective study assessed the probability of pulmonary embolism when a pleural effusion and a perfusion defect of similar size are the only significant imaging abnormalities. In 451 reports of patients who were scanned for suspected pulmonary embolism, 53 had perfusion defects secondary to pleural effusion without other significant perfusion defects. Using pulmonary angiography, venography, analysis of pleural fluid, clinical course, and other radiographic and laboratory studies to establish the final diagnosis, only two patients had documented venous thrombotic disease: one had pulmonary emboli, the other thrombophlebitis. Lung scans having significant perfusion defects limited to pleural effusions and matching them in size have a low probability for pulmonary embolism.

Adult↗
PubMed1985

No difference in sensitivity for occult infection between tropolone- and oxine-labeled indium-111 leukocytes.

There is considerable disagreement as to whether oxine or tropolone is the best labeling agent for indium leukocytes. We have previously looked at the sensitivity of oxine-labeled 111In leukocyte scans for occult infections and now present a similar group of patients imaged with tropolone-labeled 111In leukocytes. Thirty-four patients (38 studies) with possible occult infection were prospectively studied. Patients were imaged 1-4 hr after injection and again at 24 hr postinjection. The early tropolone images had a sensitivity of 53% while the delayed images at 24 hr had a sensitivity of 93%. Based on a previous study, oxine-labeled leukocyte scans have an early sensitivity of 33% and a delayed sensitivity (at 24 hr) of 95%. The differences in sensitivity between oxine and tropolone when imaged early and at 24 hr were not statistically significant. We conclude that there is no significant difference in the ability to detect infection between oxine- and tropolone-labeled leukocytes, both early at 1-4 hr, and on delayed imaging 24 hr after injection.

Abscess↗
PubMed1984

Comparative effects of diltiazem, propranolol, and placebo on exercise performance using radionuclide ventriculography in patients with symptomatic coronary artery disease: results of a double-blind, randomized, crossover study.

The effects of oral diltiazem (120 mg), propranolol (100 mg), and placebo on exercise performance and left ventricular function were compared before and during symptom-limited supine bicycle exercise by means of multigated radionuclide ventriculography in 12 patients with documented, symptomatic coronary artery disease; a double-blind, randomized crossover protocol was used. Diltiazem increased ejection fraction (EF) at submaximal exercise (+7.0 absolute percentage points, p less than 0.02) and maximal exercise (+8.1 percentage points, p less than 0.01). Exercise EF was increased by 13.6 percentage points (p less than 0.02) in patients with decreased ventricular function (resting EF less than 50%). Propranolol had no effect on exercise EF at any stage, even when patients with EF less than 50% were excluded. The increase in total exercise time was significant after diltiazem (+27%, p less than 0.01) but not after propranolol (+16%, p = NS). As expected, propranolol decreased both resting (-9 bpm, p less than 0.01) and exercise heart rates (-27 bpm, p less than 0.001), whereas diltiazem had no significant effect. Propranolol decreased resting diastolic blood pressure (-8 mm Hg, p less than 0.02), exercise systolic (-27 mm Hg, p less than 0.001) and diastolic (-9 mm Hg, p less than 0.01) blood pressures, and rest (p less than 0.01) and exercise (p less than 0.001) double product. Diltiazem decreased resting systolic blood pressure (-9 mm Hg, p less than 0.01) and both resting (-8 mm Hg, p less than 0.001) and exercise (-9 mm Hg, p less than 0.01) diastolic blood pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Pulmonary uptake in indium-111 leukocyte imaging: clinical significance in patients with suspected occult infections.

A retrospective review was undertaken to evaluate the frequency and significance of pulmonary activity noted on 306 indium-111 leukocyte studies involving 232 patients with suspected occult infections. Forty-eight studies showed pulmonary activity in one of two patterns of uptake, focal or diffuse. Fourteen of 27 studies (52%) with focal uptake and two of 21 studies (10%) with diffuse uptake were associated with infectious processes. Lung uptake of indium-111-labeled leukocytes was a poor predictor of pulmonary infection in patients studied for occult infection, although the focal pattern was more likely than the diffuse pattern to be associated with infection.

Adolescent↗
PubMed1984

Decreased sensitivity of early imaging with In-111 oxine-labeled leukocytes in detection of occult infection: concise communication.

Imaging with leukocytes labeled with indium-111 oxine is a sensitive technique for detecting sites of occult infection. Traditionally, imaging is performed 24 hr after injection. We undertook a prospective study of 35 patients (40 studies) with possible occult infection to see whether a 24-hr delay in imaging is really necessary. Patients were imaged at 1-4 hr and again at 24 hr after injection. The early images had a sensitivity of only 33%, compared with 95% for the 24-hr images. Of the seven studies that were positive on both early and delayed images, 71% had more intense uptake at 24 hr. There were no false-positive early images. We conclude that imaging 1-4 hr after injection with In-111 oxine-labeled leukocytes has a low sensitivity for detecting occult infection. However, a positive early image is specific for a site of infection.

Adult↗
PubMed1984

Comparison of Tc-99m labeled liver and liver paté as markers for solid-phase gastric emptying.

A radionuclide marker for studies of solid-phase gastric emptying should have a high labeling efficiency and remain relatively stable during gastric emptying. The availability of materials and the ease of preparation are also considerations in selecting radionuclide markers. We have compared the stability of intracellularly labeled chicken liver, surface-labeled chicken liver, and labeled puréed meat (liver paté) incubated with hydrochloric acid solution or gastric juice. Intracellularly labeled chicken liver and labeled liver paté were also compared in gastric emptying studies in humans. Our in vitro results demonstrated labeling efficiencies greater than 92% for both intracellularly labeled liver and labeled liver paté. The paté labeled with Tc-99m sulfur colloid was more stable than Tc-99m surface-labeled liver in vitro and its preparation was easier than with the intracellular labeling technique. Gastric emptying studies on normal subjects demonstrated equal performance of the intracellularly labeled liver and the labeled liver paté. Labeled liver paté is thus an alternative to intracellularly labeled chicken liver in measuring solid-phase gastric emptying.

Adult↗
PubMed1983

A randomized trial of intracoronary streptokinase in the treatment of acute myocardial infarction.

Fifty patients with acute myocardial infarction were randomly assigned to receive either intracoronary streptokinase or standard (control) therapy within about three hours after the onset of pain. Coronary perfusion was reestablished in 19 of 24 patients receiving streptokinase. Streptokinase alleviated pain (as indicated by differences in subsequent morphine use). The Killip class was significantly improved after therapy with streptokinase, as were changes in radionuclide ejection fraction between Days 1 and 10 in surviving patients (+3.9 vs. -3.0 per cent, P less than 0.01). The echocardiographic wall-motion index also showed greater improvement after streptokinase treatment (P less than 0.01). Streptokinase therapy was associated with rapid evolution of electrocardiographic changes, which were essentially complete within three hours after therapy, but loss of R waves, ST elevation, and development of Q waves in the convalescent period were greater in the control group (P less than 0.01). The time required to reach peak plasma enzyme concentrations was significantly shorter after streptokinase. The incidence of early and late ventricular arrhythmias was not affected by treatment. We conclude that intracoronary streptokinase appears to have a beneficial effect on the early course of acute myocardial infarction.

Adult↗
PubMed1983

Effect of age on gastric emptying of liquid--solid meals in man.

A dual radioisotopic method was employed to study the rate of gastric emptying of meals in ten males with an average age of 31 years and 10 elderly males with an average age of 76.4 years. All study subjects were fed a standardized 900-g meal labeled with a liquid (111indium-DTPA) and solid (99mtechnetium-tagged liver) phase isotopic marker. There were no significant differences in solid food emptying rates between the young and aged men. A delay in liquid emptying, however, was observed in the aged men. The clinical significance of this observation is unknown.

Adult↗