Asunto(s)
Neoplasias/diagnóstico por imagen , Técnica de Sustracción/tendencias , Tomografía Computarizada de Emisión/métodos , Tomografía Computarizada de Emisión/tendencias , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/tendencias , Neoplasias Esofágicas/diagnóstico por imagen , HumanosRESUMEN
The clinical value of magnetic resonance perfusion imaging (MRI) was investigated by quantitative comparison with (201)thallium-single-photon emission computed tomography ((201)TI-SPECT) and quantitative coronary angiography (QCA). Short-axis imaging was performed during dipyridamole administration in 13 patients with single-vessel coronary artery disease. Using inner and outer contours, the myocardium was divided into 30 contiguous, radial regions. Defining a perfusion defect as a region with less than 90% of maximum (201)TI intensity, nine patients had a matching perfusion defect, two had no defect on both (201)TI-SPECT or MRI, and one had a defect on (201)TI-SPECT but not on MRI. One patient had a defect on both modalities but with inaccurate localization. Three perfusion parameters were investigated: a) maximum contrast enhancement (MCE); b) slope of the signal intensity versus time curve; and c) inverse mean transit time (1/MTT). The sensitivity and specificity of MCE in the detection of perfusion abnormalities with TI-SPECT as the reference method were 71% and 71%, respectively (slope 77% and 61%, 1/MTT 44% and 70%). Furthermore, correlations were calculated per patient for the entire circumference of the short-axis myocardium. Median correlations were as follows: MCE 0.92, slope 0.91, and 1/MTT 0.40. Mismatches between (201)TI defects and defects on MRI resulted in low mean correlations (MCE 0.45, slope 0.46, and 1/MTT 0.26). There was a trend between severity of perfusion defects on MRI (using MCE) and QCA stenosis area (r = -0.56, P = 0.06). Thus, MRI and (201)TI-SPECT demonstrate fair agreement in the assessment of perfusion defects but show moderate correlation when the entire short-axis myocardium is correlated.
Asunto(s)
Angiografía Coronaria/métodos , Enfermedad Coronaria/diagnóstico , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/patología , Imagen por Resonancia Magnética/métodos , Anciano , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Miocardio/patología , Sensibilidad y Especificidad , Radioisótopos de Talio , Tomografía Computarizada de Emisión de Fotón Único/métodosRESUMEN
An evaluation is provided of dialysis, coupled on-line to column liquid chromatography, as a sample pretreatment procedure for macromolecule-containing biological samples. The influence of parameters such as acceptor phase flow rate, temperature, hydrophobicity of the analytes, pH, ionic strength and viscosity of the sample on the recovery and rate of dialysis is studied. In addition, methods to reduce the degree of drug-protein binding and thereby improve the recovery are reported. Diazepam, nitrazepam and oxazepam are used as model compounds. A method is reported for the fully automated determination of these compounds in human plasma using only 100 microliters of sample. Data on repeatability, linearity and detectability are given.
Asunto(s)
Ansiolíticos/sangre , Cromatografía Liquida/métodos , Proteínas Sanguíneas/metabolismo , Diálisis , Diazepam/sangre , Humanos , Concentración de Iones de Hidrógeno , Nitrazepam/sangre , Concentración Osmolar , Oxazepam/sangre , Unión Proteica , Temperatura , ViscosidadAsunto(s)
Ciclosporinas/farmacología , Prostaglandinas/orina , 6-Cetoprostaglandina F1 alfa/orina , Presión Sanguínea , Dinoprost , Dopamina/farmacología , Tasa de Filtración Glomerular/efectos de los fármacos , Humanos , Trasplante de Riñón , Prostaglandinas F/orina , Psoriasis/tratamiento farmacológico , Flujo Sanguíneo Regional/efectos de los fármacos , Tromboxano B2/orinaAsunto(s)
Ciclosporinas/efectos adversos , Dopamina/farmacología , Riñón/efectos de los fármacos , Adulto , Aldosterona/sangre , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Calicreínas/orina , Riñón/fisiología , Masculino , Persona de Mediana Edad , Prostaglandinas/orina , Renina/sangreAsunto(s)
Ciclosporinas/efectos adversos , Trasplante de Riñón/fisiología , Circulación Hepática/efectos de los fármacos , Hígado/efectos de los fármacos , Alanina Transaminasa/sangre , Azatioprina/uso terapéutico , Bilirrubina/sangre , Presión Sanguínea/efectos de los fármacos , Gasto Cardíaco/efectos de los fármacos , Ciclosporinas/uso terapéutico , Humanos , Hígado/metabolismo , Perfusión , Prednisolona/uso terapéutico , Trasplante Homólogo , Resistencia Vascular/efectos de los fármacosRESUMEN
To monitor the use of cardiotoxic drugs, adequate assessment of myocardial function is required. Although serial radionuclide left ventricular ejection fraction (EF) studies allow a simple and rapid assessment of the myocardial function without risk or discomfort to the patient, they appear not to be sensitive enough. Determination of the EF during cold application may be more sensitive. In this study we tested the feasibility of the cold pressor test (CPT) in relation to EF determination in 23 cancer patients. Only minor side effects were recorded. The response of heart rate to cold was similar to the response reported in healthy volunteers and patients with coronary artery disease. In selected cases EF determination during CPT appeared to be more sensitive than EF at rest. EFCPT may be an attractive alternative for EFexercise in cancer patients who cannot perform enough exercise to stress cardiac function adequately, but for a more definite conclusion a prospective comparative study is required.
Asunto(s)
Insuficiencia Cardíaca/diagnóstico , Volumen Sistólico , Adulto , Anciano , Antineoplásicos/efectos adversos , Frío , Enfermedad Coronaria/diagnóstico , Prueba de Esfuerzo , Femenino , Cardiopatías/inducido químicamente , Cardiopatías/diagnóstico , Insuficiencia Cardíaca/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , CintigrafíaRESUMEN
The congenital insensitivity to pain regroups some rare diseases which are mainly 5: congenital insensitivity to pain; congenital sensitive neuropathies; distal sensitive neuropathies; Riley-Day syndrome or hereditary dysautonomia; at last, miscellaneous troubles. Three different cases are reported in children: true congenital insensitivity to pain; hereditary dysautonomia or Riley-Day syndrome; congenital insensitivity to pain localised to a lower limb joined to amniotic disease and abnormality of this limb. The orthopedic symptoms (osteomyelitis, arthropathies as Charcot type, dislocations, fractures) lead often to diagnosis and they are an important step of the prognosis. Scoliosis seems to be frequent in this disease. The orthopedic and surgical treatment, according to each localization, is difficult and must emphasize the prevention of bones and joints injuries.
Asunto(s)
Quemaduras/complicaciones , Contractura/complicaciones , Fracturas Óseas/complicaciones , Hipoestesia/congénito , Preescolar , Contractura/terapia , Fracturas Óseas/terapia , Humanos , Hipoestesia/complicaciones , Hipoestesia/etiología , Lactante , Masculino , Ortopedia , Osteomielitis/etiología , Osteomielitis/terapiaRESUMEN
The authors have reviewed thirty seven cases of spinal stenosis associated with arthrosis. Twenty five of them had an associated static condition of the lumbar spine, either scoliosis of lordosis. An analysis of the relationship between these two syndromes has been made. It is concluded that the static lesion was the cause of root involvement and influenced the degree and rapidity of this involvement. The average age of the patient was 62.6 years. It is suggested that a number of static lesions of the spine in childhood should be diagnosed and treated, especially a horizontal sacrum.