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Biomedical subjects

J E Codd

Publications and source records attributed to J E Codd.

90 records · Page 5Linked to original sources
PubMed1976

Comparative evaluation of renal transplant rejection with radioiodinated fibrinogen 99mTc-sulfur collid, and 67Ga-citrate.

The diagnostic accuracy, ease, and technical feasibility of imaging with 131I-or 125 I-fibrinogen, 99mTc-sulfur colloid, and 67 Ga-citrate in renal transplant rejection are compared. Radiofibrinogen data resulted from literature review, radiocolloid data from 125 studies in 52 transplant patients, and gallium citrate data from 24 examinations in seven renal transplant patients performed simultaneously with the radiocolloid studied. Specificity of graft labeling during rejection appears to be similar with radiofibrinogen, 99mTc-sulfur colloid, and 67Ga-citrate. For routine clinical use 99mTc-sulfur colloid surpasses radiofibrinogen and radiogallium because of its better imaging qualities with a permissible radiation dose, leading to better separation of positive and negative results. The 99mTc-sulfur colloid accumulates in areas of intravascular fibrin thrombosis in acute and chronic rejecting renal transplants. Hence, the mechanisms for accumulation of 99mTc-sulfur colloid and labeled fibrinogen in rejecting transplants would seem to be similar. Such physiologic properties as rapid blood clearance and such physical properties as short physical half-life combine to produce reliable graft visualization with adequate definition, thus favoring 99mTc-sulfur colloid as the single agent of choice for clinical evaluation of renal transplant rejection at this time.

Animals↗
PubMed1975

Implantable pacemakers in children.

Permanent pacemakers were implanted in 12 children, ages 2 weeks to 6 years. The cause of the arrhythmia was congenital in three, postoperative in six, viral in one, and unknown in two. One operative death occurred on the second postoperative day. Two late deaths occurred five and 10-1/2 years postoperatively. The late deaths were in patients with good cardiac capture in whom the block followed repair of tetralogy of Fallot. Ventricular arrhythmias were believed to be the cause of death. Reoperation was required 37 times: for pacemaker exhaustion, 17; electrode problems, 15; wound problems, four; and arrhythmia, one. Nine of 12 patients are alive nine months to ten years eight months postoperatively. The remaining three survived for eight to ten years. Frequent reoperation and dilligent correction of defective pacing is rewarded with long, active lives in children requiring implantable pacemakers.

Adolescent↗
PubMed1975

Further evaluation of 99m-Tc sulfur colloid accumulation in rejecting renal transplants in man and a canine model.

Renal transplant accumulation of 99m-Tc sulfur colloid was evaluated in 41 patients. Ninety-five examinations were performed comparing transplant with bone marrow activity and clinical or pathological diagnosis. 99m-Tc sulfur colloid accumulated in acute or chronic rejection as long as the vascular supply of the grafted kidney was not severely impaired. Accumulation was marked in chronic rejection, slight in acute rejection and absent in normally functioning transplants or in those with acute tubular necrosis. In the 10 dog models, no accumulation was seen in autografted transplants and early accumulation was demonstrated within the hyperacutely rejecting kidneys of allografted dogs.

Angiography↗
PubMed1975

67Ga citrate in renal allograft rejection.

Eight renal allograft recipients were examined on 31 occasions following administration of 99mTc sulfur colloid and 67Ga citrate. Transplant accumulation of each agent was compared and collated with the clinical diagnosis. The procedures matched in 25 instances (81%). Gallium accumulated in the graft producing a false positive result in 2 instances of acute tubular necrosis with anuria, and failed to accumulate within the graft in one case of chronic rejection and in 2 instances of acute rejection. Both radioagents failed to accumulate in 3 patients with acute rejection following heparin therapy. These data indicate that 99mTc sulfur colloid is superior to 67Ga citrate in establishing the diagnosis of transplant rejection and also provides more timely information.

Gallium Radioisotopes↗
PubMed1975

Myocardial injury and bypass grafting. Value of serum enzymes in diagnosis.

To clarify the value of serum enzymes in the detection of intraoperative and postoperative myocardial injury associated with coronary artery bypass grafting, we evaluated 70 consecutive patients (151 grafts). We used electrocardiograms and serial determinations of serum levels: serum glutamic oxaloacetic transaminase (SGOT), creatinine phosphokinase (CPK), lactic dehydrogenase (LDH), and LDH isoenzymes on Days zero, 1, 3, 5, 7, and 10. Patency of all grafts 1 week postoperatively was 92 per cent. Fourteen patients (20 per cent) had ECG evidence of acute myocardial infarction (AMI) or ischemia lasting longer than 48 hours. This incidence of AMI was attendant with no deaths or discernible changes in postoperative ventriculography. LDH-1 (cardiac fraction) was elevated in all patients with myocardial injury. Late elevation of LDH-1 occurred in 2 patients at the time of postoperative catheterization, 1 of whom had negative findings on ECG. Diagnostic correlation was not observed with total LDH, CPK, or SGOT. Predisposing factors to AMI included preinfarction angina (4 of 14 patients), occluded grafts (4 of 14), and a bypass time greater than 120 minutes.

Angina Pectoris↗
PubMedDate not supplied

Coronary graft flow and glucose tolerance: evidence against the existence of myocardial microvascular disease.

Patients having coronary bypass for stable angina pectoris were grouped on the basis of the two hour plasma sugar of the glucose tolerance test: Group I, 120 mgs% (159 grafts); Group II, 120-150 (93 grafts); Group III, 150-200 (131 grafts) and Group IV, 200 (57 grafts) or patients receiving therapy for diabetes mellitus (10 patients, 21 grafts). Five of 10 diabetic patients had genetic evidence of diabetes and an average duration of therapy of 6.5 years. Blood flow was measured in 461 grafts with an electromagnetic flow probe after discontinuation of cardiopulmonary bypass in a stable state, after a 30 second graft occlusion and after injection of 15 mg of papaverine into the graft. Mean arterial pressure, graft flow and coronary resistance for each succeeding group did not vary significantly when compared with Group I. Analysis of phasic flow in 10 grafts to the left anterior descending indicates that the same proportion of flow occurs during systole and diastole in the basal state and after pappaverine. Coronary flow and resistance in patients with abnormal glucose metabolism and maturity onset diabetes do not provide evidence for the existence of myocardial microangiopathy.

Blood Pressure↗