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Biomedical subjects

R A Schacht

Publications and source records attributed to R A Schacht.

16 recordsLinked to original sources
PubMed1983

Sequential early and delayed myocardial 99mTc pyrophosphate scans: evaluation of diffuse myocardial uptake.

Of 114 pyrophosphate (PPi) myocardial studies, eleven were selected to assess the significance of diffuse uptake observed in the images obtained early (2-3 h) following injection and compared with delayed scintigrams at 6-24 h. From the results of the late studies the patients were divided into two groups; those with no or minimal residual activity in the delayed study (five cases) and those with approximately the same intensity of delayed scans as in the early study (six cases). No significant abnormalities in cardiac enzymes or the EKG (obtained within 24 h) were noted in the patients of the first group. Cardiac enzymes, EKG abnormalities, indicating myocardial damage, or decreased radionuclide LVEF dysfunction were found in the patients of second group. We concluded that a late image is required in a case of diffuse PPi myocardial uptake in the early image, and myocardial damage may be present if there is persistently diffuse uptake of PPi in the late image.

Diphosphates↗
PubMed1982

Basal ganglia infarction demonstrated by radionuclide brain imaging.

Four cases of basal ganglia infarction demonstrated by radionuclide brain imaging are presented. Bilateral basal ganglia infarctions in two patients were probably related to methanol intoxication and meningoencephalitis, and unilateral basal ganglia infarctions in two other patients were presumably due to cerebral atherosclerosis and/or hypertension. Various causes and mechanisms of basal ganglia infarction as well as positive findings of radionuclide brain imaging are briefly reviewed.

Basal Ganglia↗
PubMed1977

Influenza virus pneumonia after renal transplant.

A 40-year-old woman who had recently undergone kidney transplantation was succesfully treated for diffuse influenza virus pneumonia. The illness was acute, with rapid onset, high fever, nonproductive cough, dyspnea, cyanosis, crepitations and rales over both lung bases, and associated arterial hypoxemia, leukopenia, and thrombocytopenia. Prophylactic use of antibiotics to prevent superimposed bacterial infection and reduction of immunosuppressive therapy to minimal dosage during the critical phase of the respiratory infection contributed to the patient's survival. An episode of graft rejection was reversed by resumption of immunosuppressive therapy at standard dosage levels.

Adult↗
PubMed1977

Clinically silent pericardial effusions in patients on long-term hemodialysis. Pericardial effusions in hemodialysis.

The danger of cardiac tamponade occurring when pericarditis is accompanied by pericardial effusion, as opposed merely to the presence of a friction rub without effusion, has been unclear. Forty patients on hemodialysis were studied by physical examination, chest x-ray film, and echocardiography for evidence of pericarditis and pericardial effusion. Only two patients developed a friction rub during the study and were placed on regional heparin. Ten of 11 patients who were positive on echocardiogram for pericardial effusion had unremarkable physical examinations. These 11 patients had cardiomegaly as noted on chest x-ray examination. Eighteen of 25 patients without effusion also had cardiomegaly on chest x-ray film. No patient remaining on systemic heparin and having a pericardial effusion developed cardiovascular complications during hemodialysis. This study suggests that while many patients on longterm hemodialysis have pericardial effusion undiagnosed on the basis of physical examination, but noted on echocardiogram, special precautions to prevent tamponade during hemodialysis are not necessary. Also, posterior-anterior chest x-ray film showing a normal-sized heart will usually exclude significant pericardial effusion.

Cardiac Tamponade↗
PubMed1976

Obstructive polyuric renal failure following renal transplantation.

In a previously nephrectomized patient with a well functioning renal allograft, acute renal failure with massive polyuria and hypertension developed. Relief of a periureteric obstruction resulted in rapid correction of all three. Pathogenesis of hypotonic polyuria is thought to be a defect in the collecting duct permeability to water, stimulating nephrogenic diabetes insipidus. Normal urinary dilution and acidification suggest intact function of the ascending loop of Henle and distal convoluted tubules. The quick reversal of polyuria and renal failure after obtaining relief of the obstruction suggest that both the decrease in the glomerular filtration rate and tubular dysfunctions are due to functional changes in the nephron rather than to organic damage, a possibility also borne out by the findings in a renal biopsy specimen showing normal glomeruli and intact tubular epithelial cells. Ureteric obstruction should be considered in any patient with renal failure and polyuria; it may be a correctable cause of hypertension.

Acute Kidney Injury↗
PubMed1976

Renal artery stenosis after renal transplantation.

Renal artery stenosis occurred in eight of fifty patients who received a renal transplant during a three year period. The evaluation and management of these cases is summarized. Trauma associated with kidney procurement, preservation, or arterial anastomosis as well as the rejection process itself may contribute to the development of these lesions. Arteriography may be indicated at an earlier stage in patients who respond poorly to medical treatment of repeated episodes of "rejection."

Adult↗
PubMed1975

Calcific cardiomyopathy in advanced renal failure.

Four uremic patients on maintenance hemodialysis developed intractable heart failure and atrioventricular block. All had persistently high (over 60) calcium-phosphorus products. At autopsy, all had metastatic myocardial calcification. Their inability to take phosphate-binding agents orally is responsible for this fatal complication.

Adult↗
PubMed1975

Severe hypertension in chronic renal failure treated successfully with Minoxidil.

In fifteen patients with severe hypertension, eight of whom had end-stage kidney disease, blood pressure could not be adequately controlled with conventional oral antihypertensive drugs. Minoxidil, an orally administered drug which lowers blood pressure by reducing total peripheral resistance, produced a substantial reduction in blood pressure in all patients who were treated, including patients who prior to its availiability would have been considered for bilateral nephrectomy.

Adult↗