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PubMed1988

Bronchial compression by an enlarged left atrium in infants; a cause of hypovascularity of the left lung.

In three infants seen recently at our institution we noted signs of compression of the left main bronchus associated with enlarged left atria. None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected side. In addition, hypoperfusion of the left lung was noted in each case. We believe that bronchial compression due to an enlarged left atrium, with consequent hypoxic vasoconstriction as a clinically significant entity, which is not well described and may be unappreciated in infants in whom the typical signs of hyperinflation are absent.

Bronchial Diseases↗
PubMed1988

Qualitatively different induction of germ cell mutations by heavy ions. A dual target theory.

The problem of the dependence of the biological efficiency of ionizing radiation on the Linear Energy Transfer (LET) is still unsolved. Unexpected reactions of heavy ion irradiated cellular systems such as an increasing Relative Biological Effectiveness (RBE) up to a LET of about 100 keV/micron and then a decrease below 1 oblige to dismiss some conventional interpretations. Several years ago we suggested that, especially by higher ionization density in addition to the DNA, repair systems and (or) membraneous systems could also be injured (dual target theory). Our experiments with heavy ions at the Lawrence Berkeley Laboratory with LET's between 102-970 keV/micron on different types of mutations show a strict distinction between events connected with fusion modalities (repair or misrepair) and those associated with nonfusion. With very high LET misrepair reactions such as translocations disappear, suggesting the direct damage of the repair systems and confirming our previous experiments with peak pions and ions of LET's between 1100-4800 keV/micron.

Animals↗
PubMed1990

81mKr equilibrium radionuclide ventriculography for the assessment of right heart function.

Right heart 81mKr equilibrium radionuclide ventriculography was used to derive right ventricular ejection fraction (RVEF) in 12 healthy male volunteers. Anatomical lung subtraction using 99mTc-MAA perfusion scintigraphy was compared with conventional background correction and the effect of imaging projection on the techniques of image analysis evaluated. Both intra and inter observer variability were reduced by anatomical lung subtraction when compared to conventional background correction. In the right anterior oblique (RAO) projection, background corrected RVEF was lower than lung subtracted RVEF - 0.544 +/- 0.05 and 0.612 +/- 0.08 (mean +/- SD) (P less than 0.02). Lung subtracted RVEF in the anterior projection was lower than that with background correction (P less than 0.05) and lower than lung subtracted RVEF in the RAO projection (P less than 0.001). We conclude that optimal separation of right heart structures is achieved in the RAO projection and that reproducibility of the analytical technique is improved by anatomical lung subtraction.

Adult↗
PubMed1975

[Value and limitations of coronary blood flow measurement in man (author's transl)].

Attempts to measure coronary blood flow in man have made considerable progress during the last 25 years. The major techniques are based on the direct or indirect Fick principle; coronary flow is calculated from the arterio-coronary venous difference of inert gases or from the precordial recorded disappearance curve of radioactive gases or substances. The accuracy of the techniques depends upon the properties or the indicators used and the precision of their determination. All techniques applied hitherto are intricate and unsuitable for general use. -A lot of information is obtained about coronary circulation in health and disease by coronary flow measurements in man. Further studies in this field may influence pathophysiological and clinical concepts especially concerning coronary heart disease.

Absorptiometry, Photon↗
PubMed1995

Pulmonary scintigraphy at the bedside in intensive care patients with suspected pulmonary embolism.

OBJECTIVE: Performance of pulmonary scintigraphy (PS) for suspected pulmonary embolism (PE) in ICU patients normally involves the added risk of transporting unstable patients to the nuclear medicine unit (NMU) and poses technical difficulties in ventilating intubated patients. This retrospective study addresses the feasibility of performing PS as the bedside. MATERIAL AND METHODS: During a 2-year period, all ICU patients with suspected PE underwent PS at the bedside, performed with a mobile gamma-camera. 99mTc-labelled albumin macroaggregates were used for the perfusion studies. Gasified 99mTc or 81mKr gas was administered by an adapting technique in intubated patients. RESULTS: 45 patients were studied, 29 (64%) of whom were intubated and 21 (47%) of whom were in shock. PE was confirmed or excluded by PS in 49% of patients. Angiography was performed in 4 patients (8%). In the rest, a combination of low clinical and low or very low PS probabilities rendered PE highly unlikely. There was no evidence of PE in the subsequent follow-up. CONCLUSIONS: In ICU patients with suspected PE, PS can be performed at the bedside with a mobile gamma-camera. The risk of transporting unstable patients can thus be avoided.

Adult↗
PubMedDate not supplied

Quantitative measurement of local blood flow with heat clearance.

Measurements of the local blood flow through organs by means of heated thermistor-probes enable one to perform continuous recordings of flow. The principle is based on the measurement between a heated and an unheated probe, both implanted in the tissue or placed on the superficial layer of the organ. The flow-measure for this type of blood flow recording is the heat transported from the heated site of the tissue. It is measured in cal-cm(-1)-sec(-1)-degree C(-1). This is the dimension of the heat conductance. Quantification of continuous blood flow measurements in ml flow/g tissue-min has been carried out with combinations of gas clearance and heat transport. It has now become possible to measure blood flow in ml blood-ml(-1) tissue-min(-1) solely with the aid implanted thermistors. Two types of local blood flow measurements are described. 1. Measurements with "slug heating" by which a thermistor is heated for a very short time and the temperature change is subsequently recorded. 2. The measurement of flow by sudden introduction of heat, if a heating coil around a micro-thermistor is switched on or off and the course of the tissue temperature is subsequently followed. It is proven, that the temperature of a point-shaped micro-thermistor in nonperfused tissue and in homogeneous perfused tissue differs only by an exponential factor (see article) where uslug is the temperature field after a slug injection of heat dependent on location, time, blood flow (phi) and partition coefficient for heat (lambda) and where index 0 = unperfused tissue. If the heater is not heated in the form of a delta function but is switched on and the temperature is subsequently recorded or if the heater, after a period of constant temperature, is switched off, the derivatives in respect to time differ only by an exponential factor and can be used as a measure of flow. The evaluation of blood flow is described in detail. The measurements show the following advantages, compared with former techniques: 1. Heat clearance and continuous blood flow measurements by means of heat transport measurements are both possible at the same site. 2. No other operation and procedures are necessary except implantation of the thermistor. 3. Turning on the heater does not affect the tissue and does not cause emotional reactions. As examples the measurements of local blood flow in brain tissue and in the myocardium of conscious animals are described.

Animals↗
PubMed1998

Evaluation by ventilation and perfusion scintigraphy in patients who developed postural hypoxemia in the supine position.

Ventilation and pulmonary perfusion scintigraphy were performed in 7 patients in whom postural change from the sitting position to the supine position decreased partial oxygen pressure in arteries (PaO2) by 15 mmHg or more. Six of these 7 patients were obese. Five patients had organic pulmonary disease or space occupying lesions of the liver. On lateral supine-position images taken by using the continuous inhalation method for 81mKr ventilation scintigraphy, ventilation was reduced in the dorsal area corresponding to a gravity-dependent area, but on pulmonary perfusion scintigrams, there were no marked changes compared to normal adults. The mismatch of ventilation to perfusion may have caused hypoxemia. Reduced ventilation was correlated with reduced PaO2. The distribution of 81mKr bolus gas inhalation suggested closure of the airway in the dorsal area at functional residual capacity (FRC), which means the resting expiratory level, in the supine position.

Adult↗
PubMed1994

Evaluation of the ventilation-perfusion ratio in lung diseases by simultaneous anterior and posterior image acquisition.

Ventilation and perfusion images were acquired during tidal breathing using 81mKr gas and 99mTc-MAA. Anterior and posterior functional images of V/Q and Q/V were simultaneously acquired in 34 subjects with various lung diseases and 6 healthy controls. Superimposed anterior and posterior images were constructed and histograms of the frequency distribution for ventilation, perfusion, and the V/Q ratio were displayed for both lungs as well as for the left and right lungs individually. Blood gas analysis and general lung function tests were also performed on the day before scintigraphy. A correlation between marked uneven distribution of V/Q and A-aDO2 was found. When the proportion of counts at V/Q < 0.67 and/or V/Q > 1.50 in the V/Q counts histogram was compared with A-aDO2, there was a significant positive correlation for anterior images (r = 0.684, p < 0.05), posterior images (r = 0.654, p < 0.05) and superimposed images (r = 0.696, p < 0.05). Superimposed images therefore showed the highest correlation. There was no correlation between the results of lung function testing and A-aDO2. Coronal SPECT images were also obtained in 15 patients and compared with the superimposed anterior and posterior planar images. There was a good correlation (r = 0.888, p < 0.001) between both the imaging methods regarding the marked uneven distribution of V/Q. Simultaneous anterior and posterior planar image acquisition reduces the examining time, is simple, and is noninvasive. The present results also suggest that it is useful for quantitative evaluation of the ventilation-perfusion ratio.

Adolescent↗
PubMed2004

Hyperpolarized 3He MRI and 81mKr SPECT in chronic obstructive pulmonary disease.

PURPOSE: During recent years, magnetic resonance imaging (MRI) using hyperpolarised (HP) 3He gas has emerged as a promising new method for the imaging of lung ventilation. However, systematic comparisons with nuclear medicine techniques have not yet been performed. The aim of this study was to compare ventilation imaging methods in 26 patients with chronic obstructive pulmonary disease (COPD) and nine lung healthy volunteers. METHODS: HP 3He MRI, 81mKr single-photon emission computed tomography (SPECT), high-resolution computed tomography (HRCT) and pulmonary function tests were performed. The three scans were scored visually as percentage of non-ventilated/diseased lung, and a computer-based objective measure of the ventilated volume in HP 3He MRI and 81mKr SPECT and an emphysema index in HRCT were calculated. RESULTS: We found a good correlation between HP 3He MRI and 81mKr SPECT for both visual defect score (r=0.80, p<0.0001) and objective estimate of ventilation (r=0.45, p=0.0157). In addition, both scans were well correlated with reference methods for the diagnosis of emphysema (pulmonary function test and HRCT). The defect scores were largest on 81mKr SPECT (the score on HP 3He MRI was one-third less than that on 81mKr SPECT), but the difference was reduced after normalisation for different breathing depths (HP 3He MRI at total lung capacity; 81mKr SPECT at tidal breathing at functional residual capacity). CONCLUSION: HP 3He MRI provides detailed ventilation distribution images and defect scores are comparable on HP 3He MRI and 81mKr SPECT. Additionally, new insights into the regional pulmonary microstructure via the apparent diffusion coefficient measurements are provided by HP 3He MRI. HP 3He MRI is a promising new diagnostic tool for the assessment of ventilation distribution.

Administration, Inhalation↗
PubMed1998

Absolute and effective cross-sections for low-energy electron-scattering processes within condensed matter.

Within the last two decades, a number of experimental techniques have been developed to measure mean free paths and absolute and effective cross-sections for various processes related to the interaction of low-energy electrons with condensed matter. In all of the experiments, a monochromatic electron beam impinges on a thin multilayer film composed of atoms and/or molecules condensed on a metal or semiconductor substrate held at cryogenic temperatures in an ultra-high-vacuum system. Depending on the apparatus, cross-sections are obtained from low-energy electron transmission (LEET), high-resolution electron energy loss (HREEL), x-ray photoelectron (XPS) spectroscopy, electron-stimulated desorption (ESD) of neutral and ions, or a combination of these techniques. Quasi-elastic and inelastic mean free paths have been extracted from LEET data. This method has also served to generate absolute cross-sections for electron trapping and fragment production from the dissociation of transient molecular anions. In amorphous ice, a complete set of absolute cross-sections for all inelastic losses by 1-20 eV electrons has been obtained from HREEL data. Effective cross-sections for neutral and ionic radical formation were generated by desorption and XPS experiments. These various methods are briefly described in this article, and the corresponding cross-sections in the range 0-20 eV summarized.

Argon↗
PubMed2005

On the nature of bonding in HCOOH...Ar and HCOOH...Kr complexes.

The chemical interaction in HCOOH...Ng (Ng=Ar, Kr) complex was analyzed by topological analysis of the electron density based on Atoms-In-Molecules theory. For all computationally stable equilibrium structures of 1:1 HCOOH...Ng complexes, an intermolecular bond path with a "bond" critical point was found and perturbation of formic acid (FA) atomic basins and electron density was observed. The intermolecular interaction between the two complex subunits can be classified, according to its nature, as a closed-shell van der Waals type of interaction. However, one of the computed structures (complex II), pictures a noble gas atom attached linearly to the acidic O-H tail of FA. In this particular case, the electron density at the intermolecular bond critical point was found to resemble a hydrogen-bonded system and thus, may be termed a hydrogen-bond-like interaction. This change in the nature of the interaction is also shown by large perturbations of the FA properties found for this complex structure. The structural and vibrational perturbations are larger than for the other three structures and they increase for the Kr complexes compared to the Ar complex. [Figure: see text]. Electron density analysis of HCOOH...Ng (Ng=Ar,Kr) complex.

Argon↗