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Biomedical subjects

A Gottschalk

Publications and source records attributed to A Gottschalk.

At least 145 records · Page 8Linked to original sources
PubMed1979

Multiple gated cardiac blood pool imaging for left ventricular ejection fraction: validation of the technique and assessment of variability.

The intrinsic variability and accuracy of left ventricular ejection fraction determined by multiple gated cardiac blood pool imaging was evaluated in 83 patients. Ejection fraction by gated studies correlated well with data from first pass radionuclide angiocardiography (r = 0.94) and from contrast angiography (r = 0.84). Intra- and interobserver variabilities of absolute ejection fraction were minimal (mean +/- standard deviation 1.4 +/- 1.2 and 1.6 +/- 1.5 percent, respectively) and were not different for normal (ejection fraction 55 percent or greater) and abnormal patients. Ejection fraction was determined twice in 70 patients: on the same day at intervals separated by 1 to 2 hours (41 patients) and on 2 different days (29 patients). Ejection fraction ranged from 18 to 91 percent and was normal in 37 patients. There was no difference in mean serial variabilities of absolute ejection fraction for all repeat studies performed on the same and separate days (3.3 +/- 3.1 versus 4.3 +/- 3.1 percent (not significantly different). The mean variability of absolute ejection fraction for repeat studies in normal patients was significantly greater than in abnormal patients (5.4 +/- 4.4 versus 2.1 +/- 2.0 percent, P less than 0.01). The incidence rate of absolute interstudy changes of 5 percent or more was significantly higher in normal than in abnormal patients (P less than 0.01). This differential variability should be considered in interpreting sequential changes in left ventricular ejection fraction. To be attributed to nonrandom physiologic alterations, the absolute change in ejection fraction should be 10 percent or more in normal patients and 5 percent or more in abnormal patients.

Angiocardiography↗
PubMed1979

First-pass radionuclide assessment of right and left ventricular performance in patients with cardiac and pulmonary disease.

First-pass radionuclide angiocardiography allows noninvasive determination of right and left ventricular performance from a single study. Analysis is made from the high frequency components of the regional radionuclide time-activity curves. Both regional and global ventricular performance can be assessed at rest and during exercise. Sequential studies can be performed to evaluate therapeutic interventions. This technique has been applied in a broad spectrum of patients with cardiac and pulmonary disease and has been shown to have major clinical impact.

Adult↗
PubMed1979

A simple method of spleen imaging with 99mTc-labeled erythrocytes.

A simple technique of splenic localization with 99mTc-labeled red blood cells is described. A blood sample is obtained 30 minutes after administration of nonradioactive pyrophosphate. Pertechnetate is added to the sample and the blood is incubated for 35 minutes at 49 degrees C. One to two hours after reinjection, selective spleen imaging can be performed.

Child↗
PubMed1979

Imaging experimental infective endocarditis with indium-111-labeled blood cellular components.

The capability of radionuclide imaging to detect experimental aortic valve infective endocarditis was assessed with indium-111 (111In)-labeled blood cells. Sequential cardiac imaging and tissue distribution studies were obtained in 17 rabbits with infective endocarditis after administration of 111In-platelets and in five after 111In-polymorphonuclear leukocytes. Forty-eight to 72 hours after platelet administration, in vivo imaging demonstrated abnormal 111In uptake in all animals in the region of the aortic valve in an anatomically distinct pattern. Images of the excised heart showed discrete cardiac uptake conforming to the in vivo image and gross pathological examination. 111In platelet uptake in vegetations from the 17 animals averaged 240 +/- 41 times greater than that in normal myocardium and 99 +/- 15 times greater uptake in blood. In contrast, 111In-leukocyte cardiac imaging showed no abnormal aortic valve uptake 24 hours after tracer administration and the lesion myocardium activity ratio was only 5 +/- 2 (3 +/- 1 for lesion/blood activity). Four normal rabbits demonstrated neither positive 111In platelet scintigraphs nor abnormal cardiac tissue uptake. Likewise, noncellular 111In was not concentrated to any significant extent in three animals with infective endocarditis. This study demonstrates that 111In platelet, but not leukocyte cardiac imaging, is a sensitive technique for detecting experimental infective endocarditis. The imaging data conform to the cellular pathology of the infective endocarditis vegetation.

Animals↗
PubMed1979

Imaging experimental myocardial infarction with indium-111-labeled autologous leukocytes: effects of infarct age and residual regional myocardial blood flow.

The external imaging patterns and the kinetics of infiltration of indium-111 labeled polymorphonuclear leukocytes (PMNs) occurring in the course of the inflammatory response associated with myocardial infarction were studied in dogs subjected to closed-chest anterior wall infarction. The effects of infarct age and regional residual myocardial blood flow upon PMN infiltration were investigated and quantified, and the capacity of indium-111 PMNs to image the experimental infarction was evaluated qualitatively. The epicardial accumulation of indium-111 PMNs occurred primarily in infarct zones with residual blood flow of 0.6 times normal and was maximal (14.8 +/- 3.8 times normal) in the lowest blood flow zone (less than 0.1 times normal). PMN accumulation in the endocardial infarct zones occurred in the regions with blood flow less than 0.6 times normal and was maximal (26.8 +/- 4.9 times normal) in the lowest blood flow zone. However, contrary to the maximal epicardial infiltration period, which occurred within the first 24 hours after infarction, the maximal endocardial infiltration occurred at 72 hours after infarction. In both endocardium and epicardium, PMN uptake was minimal at 120 hours after infarction. In vivo cardiac images were abnormal and revealed discrete, anatomically distinct areas of increased myocardial radioactivity uptake in the anterior wall of all dogs studied within 24--96 hours after infarction. All images obtained 120 hours after infarction were negative. Thus, indium-111 PMNs provide a noninvasive means of in vivo imaging of the inflammatory response to myocardial infarction and allow quantification of this response at a tissue level.

Animals↗
PubMed1979

Response of right ventricular ejection fraction to upright bicycle exercise in coronary artery disease.

The right ventricular (RV) response to exercise was assessed in 32 patients with angiographically documented coronary artery disease and in 14 normal controls without cardiopulmonary disease. The relationships between exercise RV reserve, exercise left ventricular (LV) reserve, and the presence of proximal right coronary stenosis were also evaluated. RV and LV ejection fractions were determined using first-pass radionuclide angiocardiograms. The normal response to exercise was at least a 5% absolute increase in RV and LV ejection fractions. In the group with coronary artery disease, RV ejection fraction either decreased or remained the same with exercise (abnormal exercise RV reserve) in 19 of 32 patients. LV exercise reserve was abnormal in 26 of 32 patients. All 19 patients with abnormal exercise RV reserve had abnormal exercise LV reserve, and all six patients with normal LV reserve had normal RV reserve. There was a significant linear relationship between the direction and magnitude of change from rest to exercise of LV ejection fraction and RV ejection fraction (r = 0.77). In contrast, the RV response to exercise was not primarily dependent upon the presence or absence of proximal right coronary stenosis. These data suggest that abnormal exercise RV reserve occurs frequently in coronary artery disease and that the concomitant LV response to exercise appears to be its major determinant.

Adult↗
PubMed1979

Radiolabeled liposomes as metabolic and scanning tracers in mice. II. In-111 oxine compared with Tc-99m DTPA, entrapped in multilamellar lipid vesicles.

We describe the organ distribution of positively and negatively charged multilamellar lipid vesicles (MLV) labeled with Tc-99m DTPA or In-111 oxine in mice. The organ distribution of MLV (In-111 oxine) is fairly constant throughout 72 hr, indicating that the radiotracer remains associated with cellular structures at the site of MLV uptake. In animals injected with MLV (Tc-99m DTPA), on the other hand, there is continuous leakage of radioactivity from the involved organs. This can be explained by the release of the radiotracer following MLV destruction in the organs. MLV (IN-111 oxine) may be used to study MLV uptake by different organs, whereas MLV (Tc-99m DTPA) may be a good indicator of the destruction rate of lipid vesicles. Various conditions bearing on liposome kinetics merit further study in order to assess the potentialities of these vectors as diagnostic or therapeutic agents.

Animals↗
PubMed1979

Indium-111-labeled human polymorphonuclear leukocytes: viability, random migration, chemotaxis, bacterial capacity, and ultrastructure.

Human polymorphonuclear leukocytes (PMNs) were labeled with indium-111 oxine in ethanol, and the effects of the labeling procedure, radioactivity, and concentrations of oxine and ethanol on PMN function and structure were studied in vitro. The standard labeling procedure did not alter the viability, random migration, chemotaxis, bactericidal capacity, or the ultrastructure of PMNs. Exposure to higher doses of radioactivity, or to higher concentrations of ethanol, had no appreciable effects on random migration and chemotaxis of PMNs. A dose-dependent reduction in their random migration and chemotaxis was observed when higher concentrations of oxine were used. These results indicate that In-111-labeled PMNs are structurally intact and have normal in vitro locomotion and bactericidal activity. Indium-111-labeled PMNs should be suitable for studying the kinetics and distribution of these cells in health and disease.

Blood Bactericidal Activity↗
PubMed1979

Comparison of two micromethods for determination of lipoprotein cholesterol in plasma.

We compared the results obtained by a micromethod for the determination of plasma lipoprotein cholesterol, in which electrophoresis is used to separate the lipoprotein fractions (beta-, pre-beta-, and alpha-lipoproteins), with those determinations with ultracentrifugation (low-density, very-low-density, and high-density lipoproteins). Precision of determination (coefficient of variation, CV, %) was the same for beta- and low-density lipoproteins (1.6%), and for pre-beta- and very-low-density lipoproteins (3.7%); however, determination of alpha-lipoprotein cholesterol was more precise (1.4%) than that of high-density lipoprotein cholesterol (3.1%). Analytical recovery of lipoprotein cholesterol was the same for both methods (98--100%) and the results were closely correlated (r = 0.943). The procedure has been used to determine the cholesterol content of plasma lipoprotein fractions of apparently healthy adults (both sexes). Lipoprotein cholesterol concentrations in our population sample compare well with those reported for other groups of similar age, in particular Stanford long-distance runners.

Adult↗
PubMed1979

[Ethanol in parenteral feeding and its effect on liver metabolism].

Investigations of the leucine aminopeptidase (LAP) and the gamma-glutamyl transpeptidase (gamma-GT) as a dimension for a damage of the liver cells under ethanol infusion did not show any damage of the liver parenchyma with a slow infusion velocity and a limited ethanol quantity (25 g daily). Since especially in the postoperative phase a sufficient caloric nutrition improves the therapeutic results, one could make use of the possibility of ethanol supply. This is mainly recommendable for patients who should demand only a small infusion volume or such a one which should not carry a high quantity of sugar (for instance diabetics). The parenteral ethanol application in the postoperative phase is frequently indicated for the immobilisation of alcoholics.

Adult↗
PubMed1978

Assessment of cardiac performance with quantitative radionuclide angiocardiography: right ventricular ejection fraction with reference to findings in chronic obstructive pulmonary disease.

A reproducible noninvasive technique for measuring righ ventricular ejection fraction was developed using first pass quantitative radionuclide angiocardiography. Studies were obtained in the anterior position with a computerized multicrystal scintillation camera with high count rate capabilities. Right ventricular ejection fraction was calculated on a beat to beat basis from the high frequency components of the background-corrected right ventricular time-activity curve. In 50 normal adults, right ventricular ejection fraction averaged 55 percent (range of 45 to 65 percent). This radionuclide measure of right ventricular function was reproducible, with minimal inter- and intraobserver variability, and was sensitive to changes in inotropic state induced with isoproterenol. In 36 patients with chronic obstructive pulmonary disease, right ventricular ejection fraction ranged from 19 to 71 percent. All 10 patients with corpulmonale, as well as 9 additional patients, had an abnormal right ventricular ejection fraction. Arterial oxygen tension and forced expiratory volume were depressed significantly more in patients with abnormal right ventricular ejection fraction than in subjects with normal right ventricular function. There was no relation between abnormalities in right and left ventricular ejection fraction.

Adult↗
PubMed1978

Radionuclide assessment of ventricular performance during propranolol withdrawal prior to aortocoronary bypass surgery.

The effects of oral propranolol upon left ventricular performance were assessed in 18 patients with angiographically documented coronary artery disease in whom propranolol was tapered prior to elective aortocoronary bypass surgery. Left ventricular ejection fraction, ejection rate, and regional wall motion were obtained on three occasions with first-pass radionuclide angiocardiographic techniques. Patients were studied at peak propranolol dose ( +/- SEM) 224 +/- 29 mg./day; serum propranolol level, 85 +/- 22 ng./ml.), intermediate dose (99 +/- 9 mg./day; serum propranolol, 30 +/- 6 ng./ml.), and 24 hours following discontinuation of propranolol therapy. Heart rate increased significantly (62 +/- 2.3 vs 67 +/- 3.0 vs 73 +/- 2.3 beats/minute, p less than 0.001) during propranolol withdrawal, while systolic blood pressure did not change significantly (114.7 +/- 4.3 vs 110.3 +/-3.0 vs 113 +/- 3.0 mm. Hg, p greater than 0.05). There was no significant change in ejection fraction (59.1 +/- 2.4 vs 60.4 +/- 2.0 vs 59.2 +/- 2.5 per cent) or ejection rate 2.80 +/- 0.18 vs 2.87 +/- 0.18 vs 2.92 +/- 0.20 sec.-1) as propranolol was tapered (p greater than 0.05). No patient demonstrated a change in regional wall motion in response to propranolol withdrawal. The results of this study suggest that oral propranolol in commonly used clinical dosages does not significantly affect radionuclide measures of left ventricular performance in the basal state.

Administration, Oral↗
PubMed1978

Variability in sequential measures of left ventricular performance assessed with radionuclide angiocardiography.

The variability of left ventricular ejection fraction, normalized mean ejection rate and regional wall motion was evaluated from first pass quantitative radionuclide angiocardiograms obtained with a computerized multicrystal scintillation camera. Three radionuclide studies separated by an average of 4.3 days were obtained in each of 20 patients. Ejection fraction and ejection rate obtained on the first, second and third studies did not differ significantly. The mean (+/- standard deviation) variability of sequential ejection fraction measurement was 4.4 +/- 3.6 percent, and of sequential ejection rate was 0.56 +/- 0.47 sec(-1). Variations in measurements were not related to fluctuations in heart rate or blood pressure. Variability in ejection rate was significantly greater in patients with normal function than in those with abnormal function. Regional wall motion analysis was constant in 19 of 20 patients. Thus, sequential quantitative radionuclide angiocardiography allows reproducible serial assessment of left ventricular performance that can be performed with a low level of intrinsic variability.

Adult↗
PubMed1978

The use of ultrasound to enhance the diagnostic utility of the equivocal liver scintigraph.

Using state-of-the-art technology in nuclear medicine and ultrasound, directed ultrasound examinations were performed with attention to equivocal areas identified on hepatic isotope studies. In 100 patients studied prospectively, 100 equivocal radionuclide findings were identified. Proven diagnoses were obtained in 99 cases. Overall accuracy figures were 74% for scintigraphy and 93% for ultrasound. Scintigraphy in general showed high sensitivity, but ultrasound showed greater specificity and accuracy. It was concluded that a directed ultrasound examination is accurate and useful when the hepatic scintigraph is equivocal for any reason.

Adolescent↗