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Biomedical subjects

P De Vernejoul

Publications and source records attributed to P De Vernejoul.

16 recordsLinked to original sources
PubMed1992

Comparison of thallium myocardial scintigraphy after exercise and transoesophageal atrial pacing in the diagnosis of coronary artery disease.

Forty-nine patients admitted for assessment of chest pain underwent coronary angiography, planar Thallium 201 myocardial scintigraphy after submaximal exercise (TE) and transoesophageal atrial pacing (TAP). Early hypofixation with redistribution after 4 h indicated ischaemia. The criterion for a myocardial infarction (MI) was a fixed perfusion defect. Coronary angiography was carried out in all patients. Sixteen patients (group 1) had no MI and over 50% narrowing of at least one main coronary vessel. Ischaemia was noted in 10 of the 16 patients during exercise, and in 14 of the 16 patients during atrial pacing. The sensitivity for the prediction of coronary stenosis was 62% for TE and 87% for TAP. Nineteen patients (group 2) had had a previous MI. Reversible ischaemia was noted in 10 of the 19 patients during exercise, and in 11 of the 19 patients during TAP. Four of 14 patients with normal coronary arteries (group 3) had a reversible ischaemia with TE, and three of these same patients developed a positive scan with TAP. The respective specificities were 71% and 78%. Comparison of segmental hypoperfusion after TE and TAP gave identical results in 72 of the 80 segments studied in group I (90%), and in 88 of the 95 segments studied in group 2 (92%). The localizing value of TAP was good in left anterior descending (12 out of 18) and right coronary disease (16 out of 19), but poor in left circumflex stenosis (3 out of 9) misclassified as right coronary disease in four patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Postinfarction segmental asynergy: correction after angioplasty. Predictive value of exercise thallium scintigraphy].

The aim of this study was twofold: to evaluate the frequency of reversibility of segmental post-subendocardial infarction asynergy after coronary angioplasty, and to test the predictive value of the redistribution phenomenon during stress Thallium scintigraphy with respect to the reversibility of segmental asynergy. The inclusion criteria for this study were: previous postsubendocardial myocardial ischaemia with residual resting or effort ischaemia documented with or without the Thallium test, segmented asynergy documented by quantitative analysis of the ventriculography, complete correction of coronary angioplasty of stenotic single or double vessel disease, a balanced coronary distribution or dominant left coronary in cases of lesion of the circumflex artery. Out of 254 consecutive angioplasty procedures 39 patients met these inclusion criteria. The location of the subendocardial infarct (SEI) was anterior in 17 cases and inferior in 22 cases. The study protocol included a Thallium scintigraphy from the 10th day after SEI, ventriculography 24 hours later, angioplasty and control ventriculography 24 hours after angioplasty. Comparison of the two ventriculographies opposed Group A (reversible asynergy) and Group B (irreversible asynergy) according to criteria defined in 15 normal subjects whose average regional ejection fraction (REF) was 0.53 +/- 0.11. This result enables definition of normal segmental motion if the REF greater than 0.30 (mean--2 SD); hypokinetic if the REF greater than 0.30 or akinetic if the REF less than 0.10 (mean--4 SD). An increase of REF of 0.15 (50% of the minimal normal value) allowed definition of reversibility of asynergy. By these criteria, 19 patients (48.7%) had reversible asynergy after PTCA; 20 had definitive asynergy (51.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Value of thallium 201 myocardial scintigraphy under transesophageal atrial stimulation for the diagnosis of coronary disease].

Fifty patients hospitalized for chest pain underwent coronary angiography, and thallium-201 myocardial scintigraphy after exercise (TE) and under transesophageal atrial stimulation (TST). The double product mean during exercise was 2,223 +/- 579 beats x cmHg/min and 2,313 +/- 420 beats x cmHg/min under TST (NS). The criterion of positivity was early hypofixation. Thallium redistribution 4 hours after administration is indicative of reversible ischemia. Thirty-six patients had more than 50% narrowing in at least one of the three principle coronary arteries. The predictive sensitivity for coronary stenosis was 83% for TE and 94% for TST. The respective specificities were 71 and 78%. The comparison of segmental hypoperfusion after exercise and under TST gave similar results in 230 of the 250 segments studied (92%). Thus, TST provides and alternative diagnostic method to TE for the detection of coronary artery disease and can be performed in patients for whom the usual stress test is not possible, most particularly when dipyridamole is counter indicated because of a bronchospastic factor.

Adult↗
PubMed1986

[Renal scintigraphy under hyperdiuresis in upper urinary tract dilatations].

Emphasis is placed on the existence of two types of dilatation of the upper excretory tract: obstructive and non-obstructive lesions. Renal scintigraphy with technetium-labelled DTPA combined with a Lasilix test was performed in 34 patients (26 operated and 8 treated medically) with a total of 41 dilated renal units. Intra-operative exploration in the 17 reno-ureteral units assessed as being the site of obstruction on scintigraphy confirmed the lesion in the 14 cases of anomalies of the pyelo-ureteral junction and the 3 mega-ureters. For as long as the obstructed zone is not resected the dilated urinary tract fails to empty. In the other 12 units, the scintigraphy diagnosis of non-obstructive hypotony was confirmed by the operation and the subsequent course (notably in the 10 cases of reflux in the wide ureters reimplanted with a good result without resection of end of ureter).

Child↗
PubMed1985

Quantitation of renal function with 99Tcm-DMSA. A comparison with creatinine clearance in children with single kidney.

To study the accuracy of renal function quantification with 99Tcm-DMSA we compared DMSA renal uptake and creatinine clearance in 16 cases of children with single kidney. The age of the patients ranged from two months to fourteen years. Creatinine clearance was normalized to 1.73 m2. DMSA uptake was measured 7 h after intravenous injection. Background subtraction was used and soft tissue attenuation was taken into account. The uptake was normalized in percentage of the injected activity. A significant correlation was found between creatinine clearance and DMSA uptake (rt = 0.866, p less than 0.01). Normal creatinine clearance range in children (80 to 120 ml min-1/1.73 m2) allowed determination of normal uptake range (36 to 60%). This study indicates that in case of asymmetrical renal impairment renal uptake will reflect split renal creatinine clearance. Since the former is much easier to measure, DMSA should play an important role in the evaluation of differential renal function.

Adolescent↗
PubMed1985

[Myocardial infarction caused by electric injury. Value of coronarography].

The authors report the case of a 54 year old surgeon who received an electric shock from his diathermy equipment. The shock caused an anteroseptal myocardial infarction complicated by an apical aneurysm. The clinical course was followed up by myocardial and cavitary scintigraphy. Coronary arteriography was carried out after convalescence and showed proximal occlusion of the left anterior descending artery and an apical aneurysm on ventriculography. Myocardial infarction after electrical injury is a rare event and its pathogenesis remains controversial. Although electrical currents can damage the walls of the coronary arteries, they may also have a direct thrombogenic effect. This would appear to be the most probable mechanism in the case reported in which the myocardial lesions corresponded to acute occlusion of the left anterior descending artery, perhaps favoured by the presence of an atheromatous plaque. Coronary arteriography was the most helpful investigation in assessing the physiopathology of this rare event.

Coronary Angiography↗
PubMed1975

[Radioisotope measurement of coronary flow with atrial stimulation in the normal subject and in patients with coronary disease].

The induction of atrial systole by stimulation is a means of demonstrating insufficiency of myocardial perfusion, even where there is a normal coronary flow under basal conditions in a genuine case of coronary atherosclerosis. The method, which entailed the use of radiocardiography with potassium 42, was first checked for reproducibility. The coronary flow was then measured under basal conditions, and subsequently during or after atrial stimulation at 150/min. in a group of 50 controls and coronary patients. Under atrial stimulation, the value increases by an average of 15 per cent in the controls, and decreases by an average of 32 per cent in cardiac patients with vessels which are patent on coronary angiography. The coronary moiety of the cardiac output increases by an average of 27 per cent in the controls, but does not change significantly in the coronary group. After aorto-coronary by-pass, the coronary moiety of the cardiac output is increased significantly during stimulation when the by-pass is patent.

Adult↗
PubMed1975

[Continuous measurement, using 2 isotopes, of extravascular pulmonary water. Application of a new method or the analysis of supply and pulmonary capillary filtration in normal man].

Measurement of pulmonary interstitial fluid may be useful in clinical medicine for early diagnosis or measurement of interstitial and/or alveolar pulmonary edema. A modification of the double dilution method of CHINARD and GORESKY is proposed. Compared to previous methods, this technique, using two isotopes gamma emitters, is rapid, simple, reproductible and may be repeated. The values obtained in normal subjects at rest 3.5 +/- 0.5 ml/kg, are comparable with those of other authors. They increase considerably in cases of fluid load.

Body Water↗