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Biomedical subjects

J Kidery

Publications and source records attributed to J Kidery.

11 recordsLinked to original sources
PubMed1991

The APE nebuliser--a new delivery system for the alveolar targeting of particulate technetium 99m diethylene triamine penta-acetic acid.

We report the validation of a new delivery system--aerosol production equipment (known by the acronym APE), which generates a particulate aerosol of technetium 99m diethylene triamine penta-acetic acid (DTPA) with a mass-median aerodynamic diameter of 0.35 microns and a geometric standard deviation of 1.8 Twenty subjects were studied; in group 1 were 12 healthy men with normal spirometry; in group 2 were 8 men with AIDS who had mildly abnormal lung function following an episode of pneumocystis pneumonia-spirometry FEV1 3.08 (0.73) L, FVC 4.83 (0.82) L [mean (SD)]. The APE nebulizer was used to form a particulate aerosol with 200 MBq of 99mTc DTPA, which was collected in a 35 1 reservoir of air, which was subsequently inhaled. The mean (SD) inhalation time was 4.7 (0.44) min. The output of the nebulizer (% of activity inhaled) was 82%. Using planar imaging, the penetration index (right lung) in group 1 was 0.93 (0.18), mean (SD), and in group 2 it was 0.91 (0.12). There was virtually no tracheal deposition and extrapulmonary deposition (oropharynx and stomach) was less than 5% of the aerosol delivered. Single-photon emission tomography (SPET) studies carried out in five patients from group 1 confirmed homogeneous intrapulmonary deposition of 99mTc-DTPA. In view of the excellent intrapulmonary deposition of 99mTc-DTPA produced by the APE nebulizer, it may provide an alternative to conventional ventilation studies using radioactive gases.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The importance of 201Tl scintigraphy in stress tests for the diagnosis of silent myocardial ischemia].

Using thallium scintigraphy after a load (LTS), the authors tested suspected silent myocardial ischaemia (SIM) in subjects without angina pectoris. They examined 21 active pilots suspected of SIM after a previous ECG loading test (LET) and 33 patients with diabetes type I and II. In six pilots (28.6%) they found on LTS accumulation defects suggesting ischaemic disorders of the large coronary arteries. All except one had during submaximal load during LTS obvious depression of the ST segment on the ECG. Except one, in another five pilots small depressions of the ST segment were associated with normal LTS. Twelve diabetic patients (36.4%) had obvious minor accumulation defects on LTS. Only two had on the ECG a ST depression under 2 mm during LTS. Based on data in the literature suggesting a higher sensitivity and specificity of LTS, as compared with LET and the possibility of a false positive diagnosis of SIM from LET alone, the authors recommend when SIM is suspected to use also LTS. A more detailed diagnosis of SIM is essential not only with regard to the assessment of work capacity but also for the long-term follow-up of patients with SIM for assessment of its incidence, impact and prognosis in our population.

Adult↗
PubMed1989

Determination of left ventricular wall motility injury by factor analysis in patients with advanced ischemic heart disease.

Left ventricular phase and amplitude images (Fourier analysis, PAI) and factor analysis images (FAI) from gated radionuclide ventriculography were obtained in 235 patients after myocardial infarction (MI) and in 44 patients with well documented ischemic heart disease (IHD) in order to assess areas of regional left ventricular motility injury (LVMI). The sensitivity of FAI for LVMI detection was higher than with PAI (36.3% vs 22.7% in patients without MI; 76.6% vs 68% in those after anterior MI; and 53.2% vs 31.9% after posterior MI, respectively). In 2.9% of all patients PAI were unclear due to small time activity amplitudes and heart rate irregularity, whereas FAI could be easily assessed. Significantly decreased left ventricular ejection fraction was observed predominantly after anterior MI in connection with distinct signs of LVMI in a large area of anterior wall or in the anteroseptal and/or apical region. Areas of LVMI could be sharply delineated in FAI; however, in contrast to PAI, FAI is unable to distinguish between dyskinetic and akinetic regions. The use of both PAI and FAI is recommended for more detailed detection of regional LVMI in patients with IHD.

Coronary Disease↗
PubMed1989

[Topography of foci of perfusion defects after myocardial infarct on standard ECG and thallium stress scintigraphy].

65 patients after previous myocardial infarction well documented by electrocardiography were investigated by 201-Tl scintigraphy after submaximal ergometry. Topographic results of the scintigraphy in three planes were compared with the location of previous infarction demonstrated by standard electrocardiography. 30% of disagreements and partial agreements in more than half the patients were caused predominantly by inability of electrocardiography to qualify a true ischaemic necrosis in the interventricular septum, by limited ability to localize exactly the site of myocardial infarction and by underestimating its size, in particular in the posterior left ventricular wall, where the lesion often extends to the lateral wall. Some principal disagreements of both methods in different findings on the anterior and posterior left ventricular walls stress the low value of standard electrocardiography for exact topographic diagnosis of the infarct site. The authors express their opinion that the size of myocardial infarction and its influence on left ventricular function measured by non-invasive methods in the acute state would be more important for the prognosis of the patient.

Adult↗
PubMed1989

A comparison of radionuclide and contrast left ventriculography and coronary angiography in patients after myocardial infarction.

61 patients after myocardial infarction were investigated by selective coronarography, contrast (LVG) and gated radionuclide ventriculography (RNV, rest and mild exercise). Left ventricular ejection fraction (LVGEF and RNVEF, resp.) and regional contractility disturbances were determined (in RNV by Fourier transform and factor analysis). A high correlation of rest LVGEF and RNVEF was found, with lower RNVEF values. A significantly lower rest RNVEF with no change during exercise was observed in comparison to 29 control persons. The ability of RNV to detect regional wall contractility impairment was nearly the same as that of LVG. RNVEF was negatively influenced by LAD obstruction and furthermore in combination with other main coronary artery jeopardy. Gated RNV is a valuable noninvasive method that could replace contrast LVG in the assessment of left ventricular function.

Adult↗
PubMed1986

Equilibrium radionuclide right ventriculography at rest and during exercise in patients with pulmonary hypertension.

Using the method of equilibrium radionuclide ventriculography (RNV), the right ventricular ejection fraction (RVEF) at rest and at a standard workload of 250 kpm per min was determined in 25 control subjects and in 30 patients with pulmonary hypertension (8 patients with chronic obstructive bronchopulmonary disease, 12 with recurrent pulmonary embolism and 10 with pure mitral stenosis). In the same week as RNV, pulmonary artery pressure was registered in patients with pulmonary hypertension at rest and at standard workload. RVEF was significantly higher (45 +/- 5%) in normal subjects than in patients with pulmonary hypertension (33 +/- 5%) and during exercise increased, whereas in patients with pulmonary hypertension it did not markedly change or decreased. The RVEF correlated at rest (r = -0.6293, p less than 0.001) and during exercise (r = 0.6980, p less than 0.05) with the degree of pulmonary hypertension at rest and during exercise. The results show a good correlation between the RVEF and the degree of pulmonary hypertension in patients with pulmonary hypertension at rest and during exercise.

Adult↗
PubMed1983

Equilibrium radionuclide ventriculography in men after transmural myocardial infarction.

Using equilibrium radionuclide ventriculography, the authors investigated left ventricular ejection fraction in 10 healthy men and in 57 men who had undergone their first transmural myocardial infarction (MI) 4 to 7 months earlier, were below 65 years of age and did not present signs of heart failure at the time of examination. Resting ejection fraction in healthy men amounted to 63 +/- 5%, in patients with uncomplicated MI to 54 +/- 7%, and in patients with clinical manifestations of heart failure in the acute phase to 37 +/- 8%. Patients with anteroseptal MI showed a negative correlation between the ejection fraction, on the one hand, and the sum of Q wave voltages in the precordial ECG map and the maximum value of serum creatine kinase in the acute phase of MI, on the other hand. The ejection fraction correlated with the degree of pulmonary hypertension during exercise. At work load of 50 W the ejection fraction measured in 31 patients was not significantly different shortly before discharge from hospital and 6 months after the onset of MI.

Adult↗
PubMed1981

Emission computer tomoventriculography.

The method of equilibrium radionuclide ventriculography relies on ECG synchronized scintigraphic data acquisition. In addition, the authors used respiratory phase synchronization. Combining the equilibrium radionuclide ventriculography with emission computer tomography (ECT), they obtained transverse heart images in different phases of the cardiac cycle. Through addition of the third dimension the images enhance the quality of studies of the heart.

Cardiac Output↗