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Biomedical subjects

R S Kuzo

Publications and source records attributed to R S Kuzo.

10 recordsLinked to original sources
PubMed2001

Early assessment of regional myocardial blood flow and metabolism in thrombolysis in myocardial infarction flow grade 3 reperfused myocardial infarction using carbon-11-acetate.

OBJECTIVES: The aim of this study was to investigate the prognostic value of carbon-11-acetate (acetate) positron emission tomography (PET) after successful reperfusion of myocardial infarction (MI). BACKGROUND: Acetate PET allows the measurement of both myocardial flow and oxidative metabolism. The prognostic value of acetate measurements performed early (within 24 h) after Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 reperfused MI is unknown. METHODS: In 18 patients with TIMI flow grade 3 reperfusion of their first MI, a dynamic acetate study was performed within 24 h of the acute event. At five days, nitrogen-13-NH3 (NH3) and fluorine-18-labeled fluorodeoxyglucose (FDG) PET studies were performed. Infarct-related areas were classified as "PET viable" or "PET nonviable," as assessed with NH3 and FDG, according to previously established criteria. At five days and three months, radionuclide angiography was performed for evaluation of left ventricular (LV) function. RESULTS: In infarct-related regions, myocardial blood flow, FDG uptake and oxygen consumption were decreased, compared with remote regions. However, oxygen consumption values, as measured with acetate in both PET-viable and PET-nonviable areas, as assessed with NH3 and FDG, were not significantly different (p = NS). A significant linear correlation was observed between global LV ejection fraction at three months and oxidative metabolism in the infarct-related area (r = 0.8, p < 0.0001). Multivariate analysis revealed that oxidative metabolism measurements in reperfused myocardium was the only significant predictor for recovery of LV function at three months (p < 0.05). CONCLUSIONS: Measurement of oxidative metabolism early after TIMI flow grade 3 reperfusion of MI offers important prognostic value concerning LV function at follow-up.

Acetates↗
PubMed2000

Subsequent pulmonary embolism: risk after a negative helical CT pulmonary angiogram--prospective comparison with scintigraphy.

PURPOSE: To determine whether a helical computed tomographic (CT) scan that is negative for pulmonary embolism (PE) is a sufficiently reliable criterion to safely withhold anticoagulation therapy. MATERIALS AND METHODS: Patients with negative helical CT scans were prospectively compared with patients with negative or low-probability scintigrams. In a 460-bed university hospital and clinic, 1,015 adult patients underwent either scintigraphy or helical CT for possible PE for 25 months. Five hundred forty-eight patients who had negative images and were not receiving anticoagulation therapy were prospectively followed up for 3 months for clinical, new imaging, death certificate, or autopsy evidence of subsequent PE. Ninety-seven patients were lost to follow-up. RESULTS: Subsequent PE was found in two (1.0%) of 198 patients with negative CT scans, none of 188 patients with negative ventilation-perfusion (V-P) scans, and five (3.1%) of 162 patients with low-probability V-P scans (not statistically significant). Patients in the helical CT group were hospitalized more often, had more severe disease, had more substantial PE risk factors, and had a higher death rate. No deaths were attributed to PE in either group. CONCLUSION: The frequency of clinical diagnoses of PE after a negative CT scan was low and similar to that after a negative or low-probability V-P scan. Helical CT is a reliable imaging tool for excluding clinically important PE.

Adult↗
PubMed1996

Blastomycosis.

Blastomycosis is a relatively uncommon disease, even in its endemic region. The clinical course and symptoms are highly variable; patients may be asymptomatic or present with severe, fulminant disease. Antifungal agents are effective against pulmonary and disseminated disease, but relapses and reactivation can occur. The radiographic findings are nonspecific, and patients are often assumed to have bacterial pneumonia, malignancy, tuberculosis, or sarcoidosis before the correct diagnosis is made.

Adult↗
PubMed1996

Nosocomial pneumonia.

Nosocomial pneumonia continues to be a major problem plaguing hospitalized patients, especially those on ventilators. Gram-negative bacteria and S. aureus are the most common causitive organisms. Alteration of the normal oropharyngeal flora and contamination of the respiratory tract from the pharynx and stomach are now recognized to be important factors in its development. As there is no definitive diagnostic test, nosocomial pneumonia remains a clinical diagnosis; however bronchoscopy with protected specimen brush cultures and BAL are diagnostic methods under study. Noninvasive radiologic examinations and clinical criteria have poor specificity in diagnosis.

Cross Infection↗
PubMed1995

Magnetization transfer magnetic resonance imaging of parenchymal lung disease.

RATIONALE AND OBJECTIVES: Magnetic resonance imaging with magnetization transfer (MT) contrast recently has been described as a method that may provide additional information about the macromolecular composition of tissue. Magnetization transfer contrast images were compared to conventional gradient-recalled echo images in a variety of pulmonary parenchymal diseases and normal lung. METHODS: Single-slice gradient echo images were obtained with and without an off-resonance radio frequency pulse on a 0.1T MR scanner. The change in signal intensity between identical regions of interest on non-MT and MT images was determined in 13 patients with known lung disease, five healthy volunteers, and three postmortem atelectatic dog lungs. RESULTS: No significant change in signal intensity (MT effect) was observed in fat, flowing blood, normal lung, atelectatic lung, or in acute pulmonary edema. Chronic parenchymal lung disease showed the greatest MT effect, 37.7% +/- 7.5. Acute infectious lung disease showed an intermediate degree of MT effect, 19.5% +/- 3.0. CONCLUSIONS: Magnetization transfer contrast magnetic resonance imaging of pulmonary disease is feasible at low field strength and may be useful in the characterization and differentiation of pulmonary parenchymal abnormalities. Magnetization transfer contrast appears to be proportional to the amount of interstitial fibrosis in lung parenchyma, while acute inflammatory cell infiltration exhibits less MT effect and acute pulmonary edema exhibits very little.

Adult↗
PubMed1995

Internal mammary compartment: window to the mediastinum.

PURPOSE: To determine the role of internal mammary ultrasonography (US) in assessment of the mediastinum. MATERIALS AND METHODS: In 66 patients (age range, 2 days to 18 years old; mean age 6.5 years) US imaging with spectral and color Doppler was used to examine the internal mammary region. Forty-four patients were suspected to have mediastinal masses; 22, vascular abnormalities. RESULTS: Five patients had abnormal internal mammary arterial flow (reversed in one). Internal mammary vein flow was reversed or absent in 10 patients with vein obstruction or Glenn shunts. Eight of 23 patients with lymphoma had internal mammary adenopathy. None of six patients with infectious mediastinal adenopathy and no patients with other benign mediastinal masses or vascular abnormalities had visualized internal mammary nodes. CONCLUSION: US and Doppler imaging of the internal mammary vessels and nodes provide valuable information about the nature of mediastinal masses and vascular disease. Flow pattern in the internal mammary vessels may elucidate abnormalities of central vessels.

Adolescent↗