Biomedical subjects
Publications and source records attributed to J L Floyd.
Bone scintigraphy has proven utility in the early diagnosis of osteomyelitis, but the authors were unable to find any report of its specific application to mastoiditis. Three cases of mastoiditis are presented in which the bone scan findings predicted the histopathologic findings.
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We investigated the probability of obtaining a valid radiocardiogram with the first commercially available cardiac probe and a peripheral injection of the radiopharmaceutical. Measurements of left ventricular ejection fraction (LVEF) were obtained in a series of 15 patients undergoing cardiac catheterization. Probe LVEF determinations using central, peripheral and rapid sequential injections correlated well with each other and with ventriculography (r = .88--.98). By documenting its accuracy and precision, this study confirms the validity of a new technique for measuring LVEF.
The efficacy of single injection thallium-201 exercise stress and rest redistribution imaging in the evaluation of myocardiacl ischemia was compared with stress electrocardiography and coronary arteriography. Thallium-201 imaging was interpreted at two levels of sensitivity in order to define the circumstances under which it best serves as a screening modality for coronary arteriography. With the prevalence of coronary disease usually found in patients referred for coronary arteriography (75%), unprocessed thallium-201 imaging is as good as stress electrocardiography in identifying patients apt to show coronary artery abnormalities, but not much better than stress electrocardiography in delineating those patients unlikely to show coronary artery disease. In contrast, processed lesion enhanced images showing normal results virtually eliminate the possibility of significant arteriographic findings. With this screening technique, many patients may be spared unnecessary coronary arteriography.
Quality assurance examination of a commercially available radioimmunoassay kit for determination of serum myoglobin level conformed the measurement to be accurate, precise, and reproducible under all assay performance variables. Initial clinical evaluation in patients admitted to the Coronary Care Unit revealed comparable diagnostic parameters and earlier detection when compared with the present standard indicator of myocardial necrosis, creatine phosphokinase MB isoenzyme. Interpretation that an elevated myoglobin reflects acute myocardial infarction should be made only in the appropriate clinical context.
Arterial hemoglobin oxygen saturation was prospectively monitored in 103 consecutive patients undergoing office colonoscopy to determine the incidence of any clinical characteristics which might predict arterial desaturation to less than 90%. Baseline saturations were obtained prior to premedications and continuously during the examination using a finger mounted pulse oximeter. Intravenous premedication regimens varied from none to a maximal dose of 50 mg of meperidine and 10 mg of diazepam. All colonoscopies included cecal intubation and were performed by one investigator employing a video colonoscope. The incidence of desaturation was 41% without significant variation among the sedation groups. Age was positively correlated with desaturation (p less than 0.05). Sex, obesity, history of lung or heart disease, chronic cardiac medications, and baseline saturation percentage failed to be sensitive predictors of desaturation. No parameter could be correlated with prolongation of desaturation below 90%. No adverse outcomes or complications were noted during the periendoscopy period, suggesting that oximetry monitoring during outpatient colonoscopy may not be clinically useful.
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