Search PubMed⌕ Search

Biomedical subjects

D Slosman

Publications and source records attributed to D Slosman.

69 records · Page 4Linked to original sources
PubMed1990

Plasma D-dimer in suspected pulmonary embolism: a comparison with pulmonary angiography and ventilation--perfusion scintigraphy.

The diagnosis of pulmonary embolism remains a difficult issue. In a previous study of patients submitted to ventilation--perfusion (V-P) scintigraphy we suggested that measurement of D-dimer might be of value for ruling out the diagnosis of pulmonary embolism if the plasma level was less than 500 micrograms/l (ELISA). In the present paper, this cut-off was validated in a consecutive series of 21 patients who were submitted to pulmonary angiography. Sensitivity and specificity were 100% and 36%, respectively. When these data were pooled with the results obtained following V-P scintigraphy (total number of patients = 67), sensitivity, specificity, and positive and negative predictive values were 100%, 70%, 59% and 100%, respectively. It is therefore worthwhile to further evaluate the value of the plasma measurement of D-dimers, especially in patients with inconclusive lung scintigraphy.

Angiography, Digital Subtraction↗
PubMed1989

Laboratory diagnosis of pulmonary embolism: value of increased levels of plasma D-dimer and thrombin--antithrombin III complexes.

Plasma D-dimer (DD) and thrombin--antithrombin III complex (TAT) were measured with ELISAs in 99 patients investigated by 102 ventilation--perfusion lung scintigraphy because of suspected pulmonary embolism. High-probability lung scan was associated with increased DD (more than 500 ng/ml) and TAT (more than 4.1 ng/ml) levels (sensitivity of 100 and 70%, respectively). The corresponding figures of specificity were 81 and 42%. In the 56 patients with low-probability or indeterminate probability scans, 31 (55%) had DD concentrations of less than 500 ng/ml. These preliminary data suggest that a plasma DD concentration of less than 500 ng/ml might rule out the diagnosis of pulmonary embolism in suspected patients with an inconclusive lung scanning.

Adult↗
PubMed1987

Measurement of lung volume with 81Krm in a dynamic scintigram.

The meaning of 81Krm counts obtained in a dynamic series of gated lung ventilation scans was evaluated in terms of flow rate, lung volume, or the flow/volume ratio. Flow and volume signals were recorded together with scintigraphic events in 29 subjects breathing 81Krm and after its decay, 127Xe as a tracer of lung volume. Gated ventilation scans and respiratory signals were reconstructed. Statistical analyses were carried out for linear regressions between total normalized counts detected by the gamma camera and (1) flow rate, (2) lung volume and (3) flow/volume ratio. Inspiration and expiration were analysed separately. For both isotopes, the best correlation was obtained between counts and lung volume (r greater than 0.93). No correlation was obtained between counts and flow rate or flow/volume ratio. Thus, we conclude that 81Krm count variations in gated scans correlate well with tidal volume.

Humans↗
PubMed1986

Regional distribution of ventilation assessed by Kr-81m scintigraphy employing temporal Fourier transform.

Temporal Fourier analysis was applied to Kr-81m ventilation scintigraphy to determine the amplitude (AMP1) and phase (PHA1) of the first harmonic of a single composite respiratory cycle and to compare regional patterns in subjects with obstructive pulmonary disease (COPD) and nonobstructed subjects. Six nonobstructed subjects, three subjects with small airway disease, six subjects with COPD, and one subject with restrictive disease were investigated. The mean value of the functional PHA1 image (PHA1m) correlated negatively with 1-second forced expiratory volume (FEV1) (r = -0.801, P less than .001), with %FEV1/FVC (r = -0.636, P less than .01) and maximum midexpiratory flow rate (FEF25-75%) (r = -0.723, P less than .002), and correlated positively with residual volume (r = 0.640, P less than .01). PHA1m values for the six subjects with COPD were significantly higher (t = 2.359, P less than .05) than for the ten nonobstructed subjects. Display of phase and amplitude functional images permits a visual evaluation of the regional distribution of ventilation to be made. Regional abnormalities of air flow were detected in obstructed subjects, and the presence of airway obstruction could be predicted. Dynamic ventilation imaging, therefore, appears to be a potentially useful noninvasive technique to assess lung impairment on a localized level.

Adult↗
PubMed1985

Cobalt-57 bleomycin scanning for lung cancer detection: a prospective study in thoracic surgery.

Patients displaying an abnormal chest X-ray, in some cases, cause a difficult diagnostic problem. A differential diagnosis between benign and malignant lesions is important to determine the choice of treatment i.e. whether or not to perform a thoracotomy. In a prospective study, we have examined the role of 57Co-bleomycin scanning for prethoracotomy assessment of 60 patients with a high clinical probability of lung cancer. For these patients, a sensitivity of 89%, a specificity of 84% and an accuracy of 88% were found. However, as a consequence of the six false-negative scans (two in-situ carcinomas and four stage I carcinomas), bleomycin scanning cannot be regarded as adequate for obviating thoracotomy in patients with a high clinical probability of lung cancer but a negative scan. Nevertheless, the technique is useful for the assessment of tumour size and for the detection of hilar, mediastinal and extra-thoracic metastases, with consequences for TNM staging. It has been found that the tumour dimension correlates well with the actual anatomo-pathologic size determined after surgical examination (r2 = 0.65 and p less than 0.01). Therefore, with an accuracy around 90% for the diagnosis of lung cancer, 57Co-bleomycin scanning offers a major tool for use in clinical investigation.

Adenocarcinoma↗
PubMed1985

Single photon emission computed tomography study of human cancer: utilization of 57Co-labelled bleomycin.

The sensitivity and specificity of single photon emission tomography with 57Co-labelled bleomycin (57Co-BLM) for the detection of cancer was determined from a prospective study involving a large group of patients selected to investigate roentgenographic abnormalities. Eighty-four of the 104 patients studied had malignant disease, of whom 76 had a positive scintigram. Eighteen of the 20 patients with benign disorders had a negative scintigram. The sensitivity and specificity was therefore 90.5 and 90% respectively. For the subset of patients who underwent investigation below the diaphragm, the sensitivity was 85.7%, while for investigation above the diaphragm, it reached 95.2% (this excluded reconstructions on the bladder level, because it produced large artifacts). This study leads to the conclusion that SPECT can be used specifically to investigate unidentified X-ray abnormality and diagnose malignancy using 57Co-BLM. In addition, we propose further investigation to evaluate the usefulness of this method in staging cancer.

Aged↗
PubMed1985

57Co-labelled bleomycin scintigraphy for the detection of lung cancer: a prospective study.

The sensitivity and specificity of scanning with 57Co-labelled bleomycin for the diagnosis of lung cancer were determined from a prospective study involving a large group of patients with an abnormal chest roentgenogram. A semi-quantitative analysis of the scintigram was obtained by defining an index in terms of the excess isotope uptake within the tumour. Malignant pulmonary lesions were found in 121/175 patients and 113 had a positive scan. Benign pulmonary disorders were found in 54 patients, 45 of whom had a negative scan. The sensitivity and specificity were therefore 93% and 83% respectively. Bayes' theorem was then used to determine the predictive value of this test, either positive or negative, when the prevalence of disease varied from 10 to 90%. A receiver operating characteristic curve permits the choice of an appropriate value of the tumour uptake index to minimize the false positive fraction without classifying too many true positives as false negatives.

Adenocarcinoma↗
PubMed1985

SPECT study of the fluid distribution in the intra-abdominal space during intraperitoneal treatment of ovarian cancer.

Only limited progress has been achieved in the treatment of ovarian cancer, the most common fatal gynaecological malignancy. Peritoneal dialysis with drugs known to be effective in ovarian cancer and large intraperitoneal fluid volumes (Belly Bath) have been used. The two critical determinants for a successful intraperitoneal chemotherapy programme are: (1) complete accessibility of the drug to all tumour-bearing areas; and (2) drug penetration into the residual tumour masses. We show that the scintigraphic technique in tomographic mode after administration of MAA-99Tcm-containing dialysate is a valuable adjunct for evaluation of patients undergoing intraperitoneal chemotherapy.

Adenocarcinoma↗
PubMed1984

[Application of computerized tomoscintigraphy in the detection of tumors using cobalt-57-marked bleomycin].

57Co-bleomycin scanning dates from the early 1970s, when the first results were presented by Renault et al. Since then there have been numerous publications concerning the high sensitivity of this type of study in the detection of pulmonary or cerebral neoplasms. In the region below the diaphragm, however, sensitivity was poor due to hyperactivity of the kidney, liver and bladder. To eliminate this problem the authors have used single photon emission computerized tomography (SPECT), and their department is currently investigating the sensitivity of this technique for the detection of neoplasms. Two typical cases are described which illustrate the value of this method in the detection of cancer.

Abdominal Neoplasms↗
PubMed1983

[Scintigraphy using labeled bleomycin and lung neoplasms].

Bleomycin is the term for a group of antibiotics produced by cultures of the fungus Streptomyces verticulus, the anti-tumor cell potential of which was shown by Umezawa. Use of this property as a tumor specific marker radiolabelled with cobalt-57 was recognized by Renault in 1971. Since then there have been numerous publications concerning the good sensitivity of this type of study in the detection of neoplasms. Our department is currently investigating the sensitivity and specificity of this technique for the detection of pulmonary tumors. We describe here two typical cases illustrating the interest of this method in the diagnosis and staging of lung cancer.

Aged↗