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Biomedical subjects

R Burow

Publications and source records attributed to R Burow.

6 recordsLinked to original sources

First-pass studies of acute lung injury.

Mild hydrochloric acid was introduced to a caudal lung section in each of eight dogs to induce injury. Transits of 99mTc-labeled red blood cells (RBC) and [123I]iodoantipyrine (IAP) injected intravenously were recorded by a scintillation camera. Lungs and blood samples were analyzed post-mortem. Peak-to-equilibrium ratios (P/E) of RBC time-activity curves were computed to be 3.83 +/- 0.54 for the control lung, 2.58 +/- 0.55 for the injured lung and 2.23 +/- 0.58 for the injured caudal section. For IAP, the respective results were 3.78 +/- 0.29, 2.02 +/- 0.18 and 1.77 +/- 0.17. The decrease of P/E in injured areas was attributed to reduced blood flow. Using mean transit times of the tracers, we computed extravascular lung water per unit blood volume to be 0.35 +/- 0.18 for the control lungs and an increased value of 0.68 +/- 0.24 for the injured lungs. These results displayed sensitivity to injury, but were gross underestimates relative to the corresponding values of 2.04 +/- 0.54 and 4.56 +/- 1.85 in post-mortem analyses.

Animals↗

Fourier phase parameters with possible diagnostic importance as obtained from the radionuclide ventriculograms of normal baboons with and without cardiac catheterization and under prolonged anaesthesia.

The possible diagnostic importance of parameters defined from radionuclide ventriculograms and Fourier phase analysis was investigated for data from normal baboons (Papio ursinus) under prolonged anaesthesia (7 hours). Of the 14 animals, 7 were studied using indwelling cardiac catheters. Phase angle differences between the electromechanical activation of the septum and left lateral wall (LLW), and again between the activation of the septum and the apex indicated no significant differences (p greater than 0.05) for the consecutive hourly values for both catheterized and non-catheterized baboons. Consequently, average values and their ranges (mean +/- 1 S.D.) were obtained for these parameters in each group, and they did not differ significantly between the two groups. As could be expected, the activation delays between the septum and LLW, and the septum and apex differed with the latter being significantly longer. The phase angle histogram parameters of atrial peak width, left ventricular plus right ventricular peak width, (LV + RV), LV-to-RV peak separation and LV-to-atrial peak separation were similarly analysed and found not to change significantly between hourly measurements or because of catheterization. Therefore mean normal values and ranges were also obtained for these parameters, possibly to serve as baselines in the diagnosis of subtle conduction pathology.

Anesthesia, General↗

Phase mapping from left ventricular radionuclide ventriculograms: interobserver reliability and accuracy of the programme.

Phase analysis of data from radionuclide ventriculograms is known to provide space-time information on the mechanical emptying of pixels located in the ventricular regions. It could therefore perhaps be useful for detecting abnormal sequences of contraction of the ventricles as well as to localize sites of premature electromechanical action. The phase programme used in this investigation is designed to trace the electromechanical action of the ventricles from colour-coded phase images (first harmonic Fourier transform), not only visually from a cinematic representation, but particularly from a data output of x, y coordinates and phase angles of sites chosen as they empty in the ventricular regions. Six healthy baboons were subjected to conventional radionuclide ventriculography, performed hourly for the duration of 11 h under anaesthesia. The programme was used by two independent observers to map the progression of emptying for each of the thus acquired 66 left ventricular phase images. The interobserver reliability and the accuracy achieved in mapping normal contraction patterns was found to be good. Abnormalities which appeared during the prolonged anaesthesia and which were confirmed with 12 lead electrocardiography were likewise detected consistently.

Animals↗

The sensitivity of radionuclide and thermodilution techniques to detect cardiac dysfunction in the baboon model during prolonged anaesthesia.

This study was undertaken to evaluate the fluctuations of cardiac parameters in a baboon model during pentobarbitone anaesthesia which will serve as a baseline control for shock studies. Thermodilution and radionuclide methods were used to determine cardiac parameters. Radionuclide studies were repeated without any cardiac catheters to assess the effect of these on cardiac performance. The results represent baseline fluctuations in cardiac parameters against which cardiac dysfunction can be diagnosed in shock studies. The results also indicate that cardiac catheterisation does not affect cardiac performance significantly.

Anesthesia, Intravenous↗

Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific.

To determine the usefulness of thallium-201 scintigraphy for identifying left main coronary artery disease, the results of scintigraphy at rest and during exercise were compared in 24 patients with 50 percent or greater narrowing of the left main coronary artery and 80 patients with 50 percent or greater narrowing of one or more of the major coronary arteries but without left main coronary involvement. By segmental analysis of the scintigrams, perfusion defects were assigned to the left anterior descending, left circumflex or right coronary artery, singly or in combination, and the pattern of simultaneous left anterior descending and circumflex arterial defects was used to identify left main coronary artery disease. Of the 24 patients with left main coronary artery disease, 22 (92 percent) had abnormal exercise scintigrams. Despite this high sensitivity, the pattern of perfusion defects was not specific; the "left main pattern" was found in 3 patients (13 percent) with left main coronary artery disease but also in 3 (33 percent) of 9 patients with combined left anterior descending and left circumflex arterial disease, 4 (19 percent) of 21 patients with three vessel disease and 3 (6 percent) of 50 patients with one or two vessel disease but excluding the group with left anterior descending plus left circumflex arterial disease. The pattern of perfusion defects in the patients with left main coronary artery disease was determined by the location and severity of narrowings in the coronary arteries downstream from the left main arterial lesion. Concomitant lesions in other arteries were found in all patients with left main coronary disease (one vessel in 1 patient, two vessels in 7 patients and three vessels in 16). For this reason, it is unlikely that even with improvements in radiopharmaceutical agents and imaging techniques, myocardial perfusion scintigraphy will be sufficiently specific for definitive identification of left main coronary artery disease.

Coronary Circulation↗

Pathologic basis of thallium-201 scintigraphic defects in patients with fatal myocardial injury.

Using a quantitative, computer-aided circumferential profile technique, we have shown that thallium-201 scintigrams with large defects can identify a group of patients with a high mortality after acute myocardial infarction. To determine whether high-risk thallium scintigrams predict poor survival because of a critical loss of myocardium, we correlated infarct size in 24 autopsied patients with the extent of thallium defect in three views. Of 13 patients with large defects (computer score greater than or equal to 7.0) eight (62%) had greater than 25% loss of left ventricular (LV) myocardium, but five (38%) had smaller infarcts (4--24% of LV myocardium), suggesting that part of the scintigraphic defect was related to ischemia without necrosis. Eight of the nine patients with loss greater than or equal to 25% LV myocardium had large defects. In 10 of 11 patients with small defects (computer score less than 7.0), infarcts involved less than 20% of LV myocardium. Although scintigrams with large defects predicted a critical loss of myocardium in over 60% of our patients, they included an important second group, in which the scintigraphic defect appeared to reflect a small infarct and a large surrounding area of reversibly ischemic myocardium.

Adult↗