Usefulness of technetium pyrophosphate scintigraphy in demonstrating cardiac amyloidosis in persons aged 85 years and older.
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Aged↗
Biomedical subjects
N G Nolan
Publications and source records attributed to N G Nolan.
Prognostic implications of left ventricular function during exercise in asymptomatic patients with aortic regurgitation.
Few data are available that address the prognostic implications of the response of the left ventricle (LV) to exercise in asymptomatic patients with aortic regurgitation (AR) who have normal resting LV function. Thirty-one such patients were contacted two to seven years after rest and exercise radionuclide ventriculography. Eleven had had significant cardiovascular events. Event-free survival at forty-eight months was 64%. Ten of eleven events occurred in 21 patients with decline in ejection fraction (EF), but the magnitude of decline did not further separate the group with regard to prognosis. Eight events (73% of total events) occurred in the 11 patients (35% of total patients) with an EF during exercise of 0.55 or less. The short and intermediate outlook for asymptomatic patients with AR and normal resting LV function is good regardless of the response of the EF to exercise, but an exercise EF less than or equal to 0.55 does identify a relatively high-risk subset for deterioration beyond twenty-four months.
Adolescent↗
Specificity of 99mTc-pertechnetate in scintigraphic diagnosis of Meckel's diverticulum: review of 100 cases.
Numerous reports in the recent literature have questioned the value of abdominal scanning with pertechnetate in the diagnosis of Meckel's diverticulum. In an attempt to evaluate further the specificity of pertechnetate in this condition, the clinical data and scintigrams of 100 patients with suspected Meckel's diverticulum were reviewed. The scintigram correctly identified Meckel's diverticulum before operation in seven of eight patients. One false-negative study occurred in 33 patients who underwent laparotomy. Conditions suggested as possible causes of false-positive studies (hydronephrosis, arteriovenous malformations, and intussusception) were found to give negative scans.
Adolescent↗
Radioisotope scintigraphy in diagnosis of Barrett's esophagus.
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Adult↗
Thyroid radioiodine uptakes and scans in euthyroid patients.
A substantial increase in the dietary iodide intake in many communities has caused a major increase in the total iodide pool in the body and a consequent decrease in the normal thyroid radioiodine uptake. Because of the pronounced regional variations in iodide supplementation of food, and because the effects of this additional dietary intake on radioiodine uptake are so large, a redefinition of the normal range of thyroid radioiodine uptake values in patients seen at this institution was thought to be indicated. The results of 6-hour and 24-hour thyroid radioiodine uptake studies in 44 euthyroid subjects, with scan data on the 20 who were studied with 123-I, are consistent with other reports indicating that the current normal thyroid radioiodine uptake values are lower than those accepted several years ago.
Adult↗
Sequential blood volume changes in patients undergoing total hip arthroplasty.
Adequacy of transfusion based exclusively on clinical observations of hemodynamic changes and quantities of blood lost during total hip arthroplasty (THA) in 15 adults was tested by serial measurements of 51-Cr red-cell volume (RCV), 125-I RISA plasma volume (PV), and peripheral hematocrit (Hv) determined immediately before and 2 and 48 hours after operation. Blood transfusion and intravenous-fluid therapy were based on clinical observations and designed to restore blood volume (BV) to within 10 percent of its preoperative level prior to the isotopic determination 2 hours postoperatively. (When that determination showed a BV less than 90 percent, transfusions were given to restore it to between 90 and 100 percent). Isotopic data 2 hours after operation showed that the BV reduction--thought clinically to be less than 10 percent in every case--averaged 21.6 percent (range: 6 to 39 percent) and was shared by RCV and PV. Isotopic measurements 48 hours after operation showed that patients whose BV at 2 hours was within 10 percent of the preoperative BV were able to compensate for an average continuing RCV reduction of 23.9 percent by expansion of PV, resulting in an average BV reduction of 11.4 percent. Hv was a valuable guide for transfusion therapy at 48 hours, but not 2 hours after operation. In view of inadequacy of blood replacement based on clinical observations and the magnitude and variability of the 2 hour postoperative isotopically measured BV reductions in our patients, we recommend obtaining a derived BV by measuring PV and Hv preoperatively and 2 hours postoperatively as a further guide to transfusion therapy for each patient under-going THA. This is simpler and more practical than the two-isotope technique and is more sensitive than clinical observation alone. If clinical observation had been supplemented with a derived BV in our 15 cases, 80 percent instead of 30 percent would have had their BV restored to within 10 percent of the preoperative BV.
Adult↗