Biomedical subjects
Publications and source records attributed to I Surveyor.
Two patients with suspected splenic injury following blunt external trauma are presented. Neither underwent splenectomy, and the changes on serial radioisotope scans provided a useful guide by which to assess the resolution of the splenic injury.
Thirty-three patients with aortic valve disease, fifteen with regurgitation, eleven with stenosis and seven with mixed disease, undergoing assessment for valve replacement which included adequate coronary angiography, were studied. A symptom limited graded treadmill exercise test was undertaken with administration of 40-70 MBq of 201Tl. Myocardial imaging was started within 15 minutes and repeated after four hours using a 37 PM tube Searle gamma camera. Myocardial images were read independently by three observed. Of the 33 sets of images, 21 were -ve, 5 +ve, 2 I (Indeterminate) and 5 D (Difference of opinion). Eight of the 33 patients had significant coronary artery disease (CAD) and of these three were scored +ve (all triple vessel). Two patients without CAD were scored +ve. Eight subjects developed angina during exercise testing, of whom four had CAD, and four with CAD did no develop angina. Historically, 13 of the 33 subjects had typical angina, six having CAD; an additional eight had other significant chest pain, two having CAD. In these subjects with severe aortic valve disease, exercise testing and myocardial imaging with 201 TI was of little value in detecting CAD. All patients with CAD gave a history of significant chest pain.
Steatorrhoea and subtotal villus atrophy due to gluten enteropathy was found to occur in a 27 year old female, who had histologically proven chronic active hepatitis six years ago. She had abnormal elevation of immunoglobulins IgG, IgM, and IgA, decreased level of complement C4 and a positive test for HLA-B8. The SGOT was persistently mildly elevated, but her latest liver biopsy (6 years after onset) showed only changes of chronic persistent hepatitis. She had good symptomatic and histological (jejunal biopsy) improvement with gluten-free diet.
The radioisotope spleen scan was reviewed in 29 patients with suspected trauma of the spleen who had been admitted for observation to a surgical ward. At the time of the study, all patients had stable pulse rates and blood pressures. The scans of six patients showed space defects and, of these, splenic injury was subsequently proven operatively in five patients. As a detector of splenic trauma, the radionuclide scan proved to be reliable. Although the findings of radioisotope scanning are not specific for trauma, the interpretation of the scan in conjunction with other observations increases the accuracy of diagnosis.
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A modified collimator and standard gamma camera have been used to measure regional cerebral blood flow following inhalation of radioactive xenon. The collimator and a simplified analysis technique enables excellent statistical accuracy to be achieved with acceptable precision in the measurement of grey matter blood flow. The validity of the analysis was supported by computer modelling and patient measurements. Sixty-one patients with subarachnoid haemorrhage, cerebrovascular disease or dementia were retested to determine the reproducibility of our method. The measured coefficient of variation was 6.5%. Of forty-six patients who had a proven subarachnoid haemorrhage, 15 subsequently developed cerebral ischaemia. These showed a CBF of 42 +/- 6 ml X minute-1 X 100 g brain-1 compared with 49 +/- 11 ml X minute-1 X 100 g brain-1 for the remainder. There is evidence that decreasing blood flow and low initial flow correlate with the subsequent onset of cerebral ischaemia.