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Biomedical subjects

T Gjørup

Publications and source records attributed to T Gjørup.

At least 73 records · Page 4Linked to original sources
PubMed1986

In vivo stability of in vitro labelled 99Tcm-red blood cells for radionuclide determination of left ventricular ejection fractions and volumes.

Serial determination of radionuclide left ventricular ejection fraction and volumes require a label that remains highly stable after introduction into the human circulation. We have evaluated the in vivo stability of 99Tcm-red blood cells (99Tcm-RBC) labelled in vitro by preparation with small amounts of a stannous agent in 19 patients with coronary artery disease. The distribution volume of 99Tcm-RBC was virtually identical to that of RBC labelled with 51Cr. Labelling efficiency expressed as the cell bound/total activity was more than 95% and remained high throughout 1 h after injection of the label. The effective in vivo half-times (T1/2) calculated from venous blood activity and externally recorded left ventricular end-diastolic frame activity were 342 +/- 103 min (mean +/- S.D.) and 306 +/- 92 min, respectively. A significant correlation, r = 0.86 (p less than 0.01) was found between the T1/2 values calculated from the two methods. Thus, a high in vivo stability of the label was demonstrated with considerable inter-patient variation. The labelling procedure seems suitable for serial performance of radionuclide cardiography within an hour after injection of 99Tcm-RBC. However, serial volume determination necessitates individual calculation of in vivo tracer decay from either venous blood or externally recorded activity in the left ventricular area during steady conditions.

Aged↗
PubMed1986

The influence of a background correction that considers the heart volume on radionuclide left ventricular ejection fraction determination.

A correction of background activity that considers the heart volume is introduced in radionuclide equilibrium cardiography. Left ventricular ejection fraction (LVEF) was determined in 19 patients with ischaemic heart disease by multigated equilibrium scan with 99Tcm-labelled red blood cells (99Tcm-RBC). Assuming that the majority of background activity in the ventricular and periventricular regions of interest arises from 99Tcm-RBC in lung tissue, a ventricular/periventricular background ratio was calculated from the distribution of 99Tcm-labelled macroaggregated albumin. The mean relative distribution of pulmonary 99Tcm-RBC activity in the ventricular region of interest was 0.590 (range 0.279-1.061) compared with the periventricular region. The modified background correction resulted in a mean LVEF of 43.0% (range 12.9-67.6%) compared with 46.8% (range 10.9-67.8%) with the standard correction, p less than 0.005. Since no attempt was made to calculate the proportion of 99Tcm-RBC activity arising from the myocardium and thoracic wall, this difference represents an upper limit of the general overestimation of LVEF obtained by the standard calculation. A further decrease in LVEF was seen when no background correction was applied. The present results suggest that standard LVEF calculation, by neglecting the background volume displaced by the cardiac blood pool, results in a slight overestimation of LVEF.

Background Radiation↗
PubMed1986

The endoscopic diagnosis of duodenal ulcer disease. A randomized clinical trial of bias and of interobserver variation.

In a randomized design we examined whether endoscopists are biased by knowledge of the radiologic diagnosis of duodenal ulcer and deformity of the duodenal bulb when recording the corresponding endoscopic diagnoses. A total of 156 patients had a barium meal and were subsequently randomized into 2 groups. In 74 of the cases the 2 endoscopists knew the result of the X-ray examination when doing the endoscopy; in 82 of the cases they did not. One endoscopist was significantly biased by his knowledge of the radiologic diagnosis of deformity of the duodenal bulb. Neither of the endoscopists was biased by his knowledge of the radiologic diagnosis of duodenal ulcer. In addition, the interobserver variation between the two endoscopists with regard to the endoscopic diagnoses of duodenal ulcer, deformity of the duodenal bulb, and duodenitis was examined. The interobserver variation was expressed by the overall agreement and by the kappa statistics, which adjusts the overall agreement for expected chance agreement. For duodenal ulcer, deformity of the duodenal bulb, and duodenitis, the overall agreements and kappa values were 0.91, 0.78, and 0.75, and 0.54, 0.42, and 0.33, respectively.

Adolescent↗
PubMed1985

Acute effects of alcohol on left ventricular function in healthy subjects at rest and during upright exercise.

Six healthy men, aged 23 to 30 years, were studied by radionuclide angiocardiography at rest and at 2 submaximal exercise levels in the upright position during increasing alcohol intoxication. At light intoxication (serum ethanol 23 mmol/liter), the median value of left ventricular (LV) ejection fraction (EF) at rest decreased by 5%. At heavy intoxication (serum ethanol 45 mmol/liter), the median LVEF decreased at rest by 11% and during 75% submaximal exercise by 6%, heart rate at rest increased (median 81 vs 62 beats/min), and systolic blood pressure decreased during 50% submaximal exercise (median 145 vs 163 mm Hg). No significant changes of plasma epinephrine concentrations were recorded, whereas plasma norepinephrine concentrations were increased by 24% at rest during light intoxication and by 30 to 38% during heavy intoxication. No changes of LVEF and plasma catecholamine levels were recorded after ingestion of isovolumic, isocaloric drinks as compared with values obtained before intake. Thus, influences of ingestion per se and repeated investigations of LV function were excluded. These findings suggest that in healthy subjects alcohol intoxication causes a dose-dependent impairment of cardiac contractility. Compensatory mechanisms may account for a reduced influence during exercise.

Adult↗
PubMed1985

Scintigraphic demonstration of subcutaneous abscesses with 99mTc-labeled leukocytes.

Our initial experience with the clinical application of autologous leukocytes labeled in vitro with technetium 99m is reported. An injection of 3.6 X 10(8) leukocytes (83% of which were polymorphonuclear) labeled with 6.4 mCi 99mTc was administered to a patient with subcutaneous abscesses in order to evaluate the in vivo stability of the labeling and cellular function. Scintigraphic examinations demonstrated marked accumulations of radioactivity at the sites of inflammation, suggesting that 99mTc was efficiently bound to the cells and that the migration of polymorphonuclear leukocytes was not disturbed by the labeling procedure.

Abscess↗
PubMed1985

Bilateral subdural haematoma demonstrated at scintigraphy of the brain.

Bilateral subdural haematoma is not a rare disorder, but only a few cases diagnosed at brain scintigraphy have been reported. Bilateral subdural haematoma was demonstrated at scintigraphy in a 66-year-old man. Subsequent computerized-tomography scanning of the brain also demonstrated the lesion. After bilateral burr-hole aspiration, the patient made a good recovery.

Aged↗
PubMed1985

Right ventricular ejection fraction determined in three projections.

The right ventricular ejection fraction (RVEF) was successively determined in three projections in ten healthy volunteers aged 28-53, mean 37 years, with a first-pass technique using 99Tcm-labelled red blood cells and a gamma camera coupled to a computer. In the anterior-posterior projection (AP) the mean RVEF was 39.3%, range 26-49%, in the left anterior oblique (LAO) 43.7% (36-58), and in the right anterior oblique (RAO) 44.5% (36-54). These mean values do not differ significantly (P = 10%). The results from one of the subjects were withdrawn, as they deviated markedly from the general pattern, and the data were reanalysed from the remaining 9 subjects. Now the mean RVEF in the AP projection was 38.2%, which is significantly lower (P = 1%) than the corresponding RVEF of 44.3% in the LAO projection and of 45.2% in the RAO projection. Our results suggest that when using the classic first-pass technique, the right ventricle histograms will in any projection be influenced by the activity in the right atrium and the large vessels.

Adult↗
PubMed1985

The endoscopic diagnosis of gastric ulcer. A randomized clinical trial of interobserver variation and bias induced by knowledge of the radiological diagnosis.

A critical evaluation of the endoscopic diagnosis of gastric ulcer was carried out. In a randomized design it was elucidated whether endoscopists are biased by knowledge of the radiological diagnosis when interpreting their endoscopic findings. In addition, the interobserver variation of the endoscopic diagnosis was determined. A total of 156 patients had a barium-meal examination and were subsequently endoscoped by the same two physicians in one session. Before the endoscopy, the patients were randomized in two groups. In 74 patients the physicians knew the radiologic result at the endoscopy; in 82 they did not. One endoscopist was significantly influenced by his knowledge of the radiological diagnosis. The interobserver variation, expressed as the kappa coefficient, was 0.54 and 0.60, respectively, in the two groups. The disagreement especially concerned small ulcers.

Adolescent↗
PubMed1985

Anal abscess imaged with 99mTc-labeled leukocytes. Case report.

Abscess imaging with leukocyte scintigraphy is described in a case report. Autologous leukocytes were separated from whole blood in a patient with localized inflammation in the perineal region and labeled with 99mTc, an ideal radionuclide for clinical examination with gamma camera. Scintigraphic investigations demonstrated a deep-lying anal abscess. The procedure may prove useful for detection of occult infections and may provide a new diagnostic approach in fever of unknown origin.

Abscess↗
PubMed1984

Danish patients' attitudes to scientific-ethical questions. An interview study focusing therapeutic trials.

One hundred and fourteen in- and out-patients from a department of internal medicine were interviewed, on the basis of a questionnaire with the following key questions: 1) Their attitudes to medical trials with man as the subject. 2) Their emphasis on informed consent. 3) Their attitudes to inclusion of patients not being able to give informed consent. 4) Their attitudes to tentative participation in 4 concrete projects. In all, 98% considered doctors' and patients' collaboration on new therapeutical methods both necessary and desirable. Eighty-eight per cent considered information of patients participating in trials a prerequisite. Eighty-six per cent accepted participation in scientific trials based on the guarantee of the doctors responsible. Of these 86%, 58% felt that a scientific-ethical committee's accept of the project implied an extra element of security. Seventy-five per cent replied that patients not being able to give informed consent themselves could be included in scientific trials. The majority, 77%, added that patients' relatives would then have to accept, 20% that such trials could be based on the participating doctors' responsibility, and only 2% that such a responsibility was to place on scientific-ethical committees. In the 4 concrete projects, answers followed a uniform trend: full information of patients was demanded by approximately 80%, and acceptance of participation resting with responsible doctors in more than 80%. Less than half of these 80% felt that evaluation by a scientific-ethical committee would add to patients' security.

Adolescent↗