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Biomedical subjects

O Munck

Publications and source records attributed to O Munck.

At least 55 records · Page 3Linked to original sources
PubMed1988

Cardiac function after alcohol ingestion in patients with ischemic heart disease and cardiomyopathy: a controlled study.

Thirty male patients with ischemic heart disease and cardiomyopathy entered a controlled study of the acute effects of alcohol on cardiac function evaluated by right heart catheterization. Twenty patients, nine with angina pectoris and 11 with congestive heart failure, were studied during alcohol intoxication, and ten patients, five with angina pectoris and five with heart failure, served as a control group. The mean serum ethanol concentration in the alcohol group was 93 mg/100 ml (S.D. 17). The systemic arterial blood pressure was reduced by 6% in the alcohol group, P less than 0.05 compared with the control group. No significant changes occurred in the central venous pressure, the pulmonary artery pressure, the pulmonary capillary wedge pressure, or in cardiac output, stroke volume and total peripheral resistance. Alcohol intake in moderate doses has no measurable effect on pulmonary blood pressures or cardiac output in patients with ischemic heart disease and cardiomyopathy. Such an effect may, however, be masked by a reduction of afterload.

Aged↗
PubMed1987

Renal washout and vascular resistances.

Evaluation of the vascular transit through a transplanted kidney depends on the convolution of the arterial bolus in the renal vasculature. In order to stress the importance of the renal artery, an example where a moderate stenosis resembled allograft rejection is given. Interpretation of flow studies could reveal a stenosis if allograft biopsy is performed at an early stage.

Adult↗
PubMed1987

Bone metastases in primary operable breast cancer. The role of a yearly scintigraphy.

In 231 patients with primary operable breast cancer bone scintigraphies were performed yearly from the second to the 6th year until recurrence irrespective of localization was diagnosed, another cancer was detected, or the patient refused further follow-up or died. During the observation period (from 2 up to 7 years after surgery) 13 patients (5.6%) had bone metastases verified by X-ray or histology within 12 months after the last bone scintigraphy. The scintigraphy was positive in only 7 of these patients. The yearly incidence of bone metastases varied between 0.6 and 2.6%. Due to this low incidence and a low cost/benefit, we conclude that a fixed schedule of repeated scintigraphies in primary operable breast cancer patients otherwise free of apparent disease is not justified.

Bone Neoplasms↗
PubMed1987

Evaluation of radiocardiographic methods for determination of cardiac output and right and left ventricular ejection fractions using a cardiac phantom.

Cardiac output and ejection fractions of the cardiac ventricles are valuable measures of cardiac function. Noninvasive radionuclide techniques for determination of these measures are based on analysis of different data: first passage low frequency, first passage high frequency and multigated equilibrium data. We have evaluated the principles of these methods using a dynamic cardiac phantom. Radiocardiographic determinations of cardiac output and right and left ventricular ejection fractions showed excellent correlation against true phantom values: r = 0.993 (p less than 0.001), r = 0.978 (p less than 0.01) and r = 0.943 (p less than 0.05), respectively. Thus, the findings of the present study demonstrate a high validity of current radiocardiographic measures of cardiac function.

Cardiac Output↗
PubMed1987

Haemodynamic response to exercise in patients with alcoholic liver cirrhosis.

Physical work capacity was evaluated by a multistage bicycle exercise test in 29 patients, 22 men and seven women aged 35-61 years (mean 49) with alcoholic liver cirrhosis and in a sex- and age-matched control group. The maximal work load was reduced in the patient group, mean 122 vs. 186 watts in men (P less than 0.001), and 60 vs. 119 watts in women (P less than 0.005). Resting heart rate was higher in patients (91 vs. 78 beats X min-1, P less than 0.005), and the maximal heart rate was lower (159 vs. 170 beats X min-1, P less than 0.001) compared with controls. Thirteen of 29 (45%) patients compared with 5 of 29 (17%) control subjects had an increase in left ventricular ejection fraction of less than or equal to 5% during exercise (P less than 0.05). The present results suggest that an impaired capacity of the cardiac function to respond adequately to physical stress may at times contribute to the reduced physical work capacity seen in patients with alcoholic liver cirrhosis.

Adult↗
PubMed1987

Left ventricular performance in alcoholic patients without chronic liver disease.

Left ventricular performance was studied non-invasively in 24 chronic alcoholics without liver disease. Twelve patients who had abstained from drinking for at least one month (group A) and 12 sex and age matched patients who had ceased drinking during the preceding 24 hours (group B) were studied at rest and during 50% submaximal exercise. Cardiac output and stroke volume were measured by first passage and left ventricular ejection fraction by multigated radionuclide cardiography. Twelve healthy sex and age matched controls were also studied. Haemodynamic variables were similar in group A and the controls, except that in group A left ventricular end systolic volume index did not decrease during exercise. In group B the heart rate was increased both at rest and during exercise and plasma noradrenaline concentrations were increased. The stroke volume index did not increase significantly during exercise in group B. In addition, the increase in left ventricular ejection fraction was smaller in group B than in controls. End systolic contraction was reduced in group B patients and diastolic blood pressure was increased. These results suggest that cardiac abnormalities in chronic alcoholics may be reversed after cessation of drinking if no chronic liver disease is present. Recent alcohol consumption increases sympathetic nervous activity, impairs cardiac contractility, and increases afterload during physical stress.

Adult↗
PubMed1987

Autonomic nervous control of postprandial hemodynamic changes at rest and upright exercise.

Postprandial hemodynamic changes were studied in healthy subjects at rest and during exercise in the upright position with and without autonomic blockade of the heart. At rest cardiac output increased 61% mostly because of a stroke volume increase accomplished by left ventricular end-diastolic dilation. These changes seemed to be dependent on the autonomic nervous system, whereas the postprandial heart rate increase did not. During exercise cardiac output was 23% higher after food intake due to a rise in both stroke volume and heart rate. These changes were apparently under influence of the autonomic nervous system, whereas left ventricular dilation was not. The present findings indicate that most of the postprandial changes in the central circulation are under control of the autonomic nervous system.

Adult↗
PubMed1987

Influence of normal central venous pressure on onset of function in renal allografts.

The central venous pressure was kept above 5 cmH2O during the perioperative and early postoperative period as guidance for fluid replacement in 31 patients receiving a renal graft (group B). In 30 other transplant recipients the central venous pressure was not measured (group A). The two groups were otherwise comparable. Onset of graft function within the first 3 postoperative days was significantly more frequent in group B than in group A (62% vs. 30%), despite absence of difference in the measurable warm and cold ischemic periods. Fluid replacement guided by the central venous pressure thus is concluded to reduce the number of kidneys with delayed function in the immediate postoperative period.

Body Weight↗
PubMed1987

The renal handling of sodium and water is not affected by the standard-dose cisplatin treatment for testicular cancer.

Renal clearances of 51Cr-EDTA, lithium, sodium and potassium were measured before and after each of four consecutive treatment series with cisplatin in 15 men with testicular cancer. Since lithium is reabsorbed like sodium and water in the proximal tubules, but not reabsorbed to any measurable degree in the remainder of the nephron, lithium clearance equals the amount of fluid delivered from the end of the proximal straight segment to the thin descending limb of the loop of Henle. From the clearances of lithium and sodium, distal tubular reabsorption can be calculated. Lithium clearance and all other parameters of glomerular filtration and renal sodium handling remained normal throughout the study (with the exception of a fall in fractional sodium excretion after the first treatment series). Plasma magnesium declined during all four treatment periods, signifying renal magnesium wasting.

Adult↗
PubMed1987

First-pass radionuclide determination of cardiac output: an improved gamma camera method.

A technique for noninvasive determination of cardiac output by aid of first-pass radionuclide cardiography is described. After intravenous injection of 10-15 mCi technetium-99m-(99mTc) labeled red blood cells the method requires acquisition of a first passage time-activity curve recorded with a gamma camera over the left ventricle, the background corrected left ventricular count rate recorded after complete mixing of the tracer in the circulation, and determination of the distribution volume of the tracer. The method was applied in 14 patients with heart disease of various origins and evaluated against the conventional tracer dilution technique with arterial sampling of blood activity. Cardiac output determinations by external counting ranged from 2.30 to 8.56 l/min, mean +/- s.d. 4.50 +/- 1.66 l/min and by arterial blood sampling from 1.88 to 8.96 l/min, mean +/- s.d. 4.52 +/- 1.71 l/min. An excellent correlation was demonstrated between the two techniques, r = 0.978 (p less than 0.001). When no background subtraction was applied to the left ventricular counts at equilibrium, radionuclide cardiac output values were approximately 40% higher than those obtained by arterial sampling. The new first-pass radionuclide cardiographic technique may prove a useful tool in the noninvasive evaluation of cardiac function, especially in patients with arrhythmias and/or valvular incompetence.

Adult↗
PubMed1987

Determination of cardiac output by first passage radiocardiography: theoretical considerations and phantom studies.

Non-invasive determination of cardiac output by aid of precordial first passage radiocardiography may prove a useful tool in the management of cardiac disorders. The basic concepts of a method together with theoretical assumptions necessary for the clinical application of the method are described. The principle of the technique was tested in a cardiac phantom model with adjustable stroke volume and heart rate, in which background problems were avoided. First passage radiocardiography gave highly accurate cardiac output determinations compared with the 'true' phantom values, r = 0.998 (p less than 0.001).

Cardiac Output↗
PubMed1987

Planar stress thallium-201 scintigraphy. First experiences with a new circumferential programme.

A new computer programme was used in 22 patients referred for suspected ischaemic heart disease (IHD) or for assessment of the size of a suspected ischaemic or infarcted area. An interpolative method was used to construct the net myocardial images. Initial imaging in three projections was started at five minutes after thallium-201 injection and delayed imaging three hours after the injection. The data were presented as analog images, circumferential profile curves, and washout curves. The calculated delayed/initial count ratio is an important measure of redistribution. In the 12 patients referred to detect clinically or electrocardiographically suspected IHD, the diagnosis IHD was made by the cardiologists on the basis of current routine criteria and the thallium test. The technique was found useful in localising and assessing the size of a suspected ischaemic or infarcted area in nine of 10 patients. Our experience with the new programme confirms the experience of others that a combination of analog images and computer processed data gives much more precise information than the visual inspection of the analog pictures alone.

Adult↗
PubMed1986

Prospective, randomised, double-blind study of radionuclide determination of left-ventricular ejection fraction in acute myocardial infarction.

In a controlled, randomised, double-blind study to see whether knowledge of left-ventricular ejection fraction (LVEF) could reduce the frequency of left-sided heart failure after acute myocardial infarction, LVEF was determined a few days before hospital discharge in a consecutive series of 60 patients. Subsequently, the patients were randomly assigned to two groups. The cardiologist responsible for their treatment was aware of the LVEF result in group I but not in group II. A month after hospital discharge there was no significant difference in the LVEF between the groups. 2 months after discharge there were no significant differences between the groups in clinical and radiological signs of left-ventricular heart failure or the use of drugs. The cardiologist's clinical estimate of the LVEF and the result of the radionuclide determination were significantly correlated. Thus, the use of LVEF did not change the clinical outcome. The need for randomised controlled studies in the evaluation of diagnostic methods is emphasised.

Adult↗
PubMed1986

90-minute 99mTc-MDP scintigraphy and 131I-hippuran renography in recently allotransplanted kidneys: evaluation of renal ischemia.

Renal ischemic damage in 31 transplanted kidneys was evaluated by renal scintigraphy with 99mTc-methylene diphosphonate and 131I-hippuran renography. The renal uptake of phosphate was monitored for 100 s at 10-min intervals during 90 min following injection. The average uptake of radioactivity in the graft on the 60-, 70-, 80-, and 90-min scintigram was calculated. Grafts with an average uptake of 99mTc-MDP of 150% or below had a significantly more frequent onset of function within the first 3 days following operation than grafts with an average uptake above 150%. Renography was shown to be an equally good method for predicting the onset of function. The success rate (correct prediction of onset of function) was almost equal for the two methods, but in 11 patients the results of the two methods diverged. An obvious degree of overlap limits the usefulness of both methods in any one particular patient. It is concluded that renal scans with 99mTc-MDP and 131I-hippuran renography are complementary in the assessment of ischemic damage following transplantation.

Graft Survival↗
PubMed1986

Interobserver variation in the detection of metastases on liver scans.

Two specialists in nuclear medicine and two trainees independently read 106 liver scans for abnormalities suggestive of metastases. The four observers made a positive diagnosis with a significantly different frequency. The overall agreement between pairs of observers was 0.83-0.87. After adjusting for the expected chance agreement, kappa-values between 0.66 and 0.74 were obtained. No difference was found in the level of agreement between the two specialists or between the two trainees. After a consensus conference where the observers tried to unify their diagnostic interpretation, another 106 scans were read for abnormalities suggestive of metastases. The conference did not increase the level of agreement. Scintigraphic lesions that especially imply a risk of disagreement are pointed out.

Colloids↗