Biomedical subjects
Publications and source records attributed to V Lopez-Majano.
A simple method of obtaining objective information consists in recording numerical information of the counts in each lung. Albumin macroaggregates labeled with 99Tc(m) and a gamma camera with a data processor were used.
2 cases of interstitial fibrosis of the Hamman-Rich type are presented. The patients were symptomatic, but had normal X-rays. They were suspected of having interstitial infiltration by pulmonary function tests. Diagnosis was confirmed by lung biopsy. Pulmonary function tests, especially the study of elastic properties of the lung, can be of primary help in the diagnosis of pulmonary interstitial infiltration and fibrosis when the patient's X-ray is normal.
In 52 patients with pulmonary embolism, the deep venous circulation of the lower extremities and the pulmonary arterial blood flow were studied with albumin macroaggregates labeled with technetium-99m. A gamma camera with a data processor was used for this study. At the beginning, the perfusion lung scintigrams were abnormal in all the patients, 42 of them also had abnormal phlebograms and in half of them the perfusion by lung scintigram became normal when the phlebograms were obtained. These findings establish the high incidence of deep thrombophebitis in the legs of the patients with pulmonary embolism and indicate that the leg is of the most important 'thrombi factory' and that the deep venous circulation of the extremities should be studied to determine the primary cause of the pulmonary embolism.
The femoral circulation of living dogs was studied with plastic carbonized microspheres 50 and 200 micra in diameter, labeled with Yterbium169. The femoral blood flow is distributed in the following way: 35% of the particles 50 micra in diameter went to muscle, 45% of the same particles went to skin and 20% to bone. When the particles were 200 micra in diameter 16% went to muscle, 65% to skin and 19% to bone.
Perfusion and ventilation lung scintigraphy are indicated: (1) for evaluating regional perfusion and ventilation, (2) for establishing a ratio between ventilation and perfusion in different areas of the lung, (3) when chest surgery is planned (especially for mapping out the extent of resection), (4) when surgery of the upper abdomen is to be performed, and (5) when global function studies are compromised. Regional ventilation and perfusion studies are invaluable in the diagnosis of pulmonary thromboembolism in which a perfusion defect is accompanied by well-preserved ventilation in the underperfused area. Regional function tests are indicated for evaluating the distribution of ventilation and pulmonary circulation in practically any chronic pulmonary disease, especially when global function studies, such as spirometry, show significant decreases.
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Regional lung function studies were obtained with a gamma camera. The ventilation was studied with 133Xe and radioactive particles and the pulmonary circulation with radioactive particles and the pulmonary circulation with radioactive particles. Some pathophysiologic patterns could be defined with this methodology, i.e. in chronic uncomplicated pulmonary embolism the pathophysologic pattern was normal ventilation with decreased or absent perfusion in the affected areas, when C.O.L.D. was associated with pulmonary embolism the ventilation with 133Xenon could be normal if the C.O.L.D. was mild but the inhaled particles deposited in foci. In bullous disease the inhaled 133Xenon reached the blebs with delay and that wash-out was prolonged, the particles did not reach the blebs, the perfusion was absent in the areas with blebs. Similar pattern was present in bronchial obstruction. In hilar masses the defect in perfusion and ventilation was usually larger than the one expected from the lesion.
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