摘要:

The recent introduction of newer scintillation cameras, convenient radiopharmaceuticals and innovative data-processing systems has hastened the use of radionuclide methods in the evaluation of cardiac function. This review familiarizes the primary internist with physics and instrumentation required in understanding cardiovascular nuclear images. Basic principles underlying the gated cardiac blood-pool scan and the first-pass study are described. Authoritative references are given to readers seeking more complete information. The major emphasis of the review, however, is on the clinical applications of these techniques. The role of these noninvasive methods in myocardial infarction, diagnosis and prognosis of ischemic heart disease, assessment of cardiomyopath-ies, study of idiopathic hypertrophic subaortic stenosis and left atrial myxoma is discussed. Finally, mention is made of newer applications: evaluation of nitroglycerin action on viable but ischemic myocardium and determination of the hemodynamic effects of propranolol in patients with coronarv-artery disease.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The effects of nicotinyl alcohol tartrate (Roniacol) and clofibrate (Atromid-S) on plasma cholesterol, triglycerides and lipoprotein cholesterol concentrations were compared in 19 patients with hyperlipoproteinemia in a 32-week, double-blind, crossover trial. Determination of serum clofibric acid concentrations, used to check compliance, allowed us to detect an error in the order in which the drugs were dispensed. Both drugs decreased (p <0.01) plasma cholesterol approximately 17% in patients with type II hyperlipoproteinemia. Nicotinyl alcohol reduced plasma triglycerides by 20% in six and clofibrate in eight of the nine patients with type IV hyperlipoproteinemia, although the mean effect, was not statistically significant due to the large variance. Both drugs decreased (p <0.02) very low density lipoprotein (VLDL) cholesterol in the type IV patients; however, clofibrate increased (p <0.05) low density lipoprotein (LDL) cholesterol, whereas nicotinyl alcohol did not. Neither drug altered high density lipoprotein (HDL) levels significantly. In future studies, the effect of hypolipidemic drugs on the major classes of plasma lipoproteins should be determined in addition to the response of plasma lipids.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Systolic time intervals (STI) were determined in 14 hypothyroid patients who did not have congestive heart failure or atrial fibrillation, and who were not taking cardiotropic drugs. Compared to normals, there was a significant decrease in the left ventricular ejection time (LVET) and there were significant increases in the pre-ejection period (PEP) and the PEP/LVET ratio. The prolongation of the PEP primarily reflected lengthening of the isovolumic contraction time. Serial recordings during thyroxine therapy in seven patients showed consistent changes in STI toward normal values. These results in hypothyroid patients complement our earlier data in hyperthyroid patients; they indicate that STI's are a sensitive measure of the heart as an end organ over the entire range of thyroid hormonal activity.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Quantitative bacteriological analysis of the aerobic fecal microflora of 75 patients indicated that, at the time of admission to hospital,Escherichia coliwere the predominant fecal aerotolerant bacteria. Subsequent fecal samples showed a progressive supplantation ofE colibyKlebsiella, EnterobacterandProteus. At the end of 21 days of hospitalization,E coliremained predominant in only 30 patients. None of the patients had received antibiotics, undergone surgery or been subjected to x-ray studies of the gastrointestinal tract. The cause of the change of fecal flora in these patients is unknown, and no change of flora was observed in a control group of nonhospitalized persons, also studied for 21 days. The appearance ofKlebsiella, EnterobacterandProteusas predominant in the fecal flora of hospitalized patients may be an important factor in the natural history of hospital-associated infections.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The aerobic fecal and oropharyngeal bacterial flora was examined in 75 patients hospitalized, but not given antibiotics; in 70 patients given antibiotics during hospitalization and in 25 nonhospitalized controls. In all subjects, when first examined, normal throat flora were predominant. At the end of 21 days, however, a gram-negative bacilli became predominant in 17 (22.7%) of the Hospital Group and 33 (47.1%) of the Antibiotic Group. Newly appearing genera of gram-negative bacilli in the pharynx were almost always represented those present in the fecal flora. The Hospital Group all had recognizable components of the normal oropharyngeal flora present at 21 days, but 12 (17.1%) of the Antibiotic Group had no demonstrable normal oropharyngeal flora at 21 days. The findings suggest that hospitalization alone can be associated with the appearance of gram-negative bacilli in the oropharynx, and that the intestinal tract is their most likely point of origin.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Radioactive methylfolate (14C-5CH3H4PteGlu) (10–14 μg/Kg) was fed to four lactating women presenting with breast abscesses necessitating cessation of lactation. The appearance of radiofolate in milk, plasma and urine over the next 24 hours was investigated. In spite of a minimal postabsorption rise of plasma biofolate, plasma radiofolate (including a dialysis-resistant (bound) fraction) increased steadily to 1.26 to 5.11 μg/l at 24 hours. Urinary radiofolate excretion was considerable. Total milk biofolate rose significantly by 15 to 28 μ/l, in contrast with a much smaller radiofolate fraction (1.95–3.88 μg/l) which at 24 hours was comparable with that of plasma. Milk radiofolate included a dialysis-resistant fraction rising to 0.75 to 1.15 μg/l at 24 hours. On chromatography (Sephadex-DEAE-A50) plasma, urine and milk showed a nonbound radiofolate peak suggestive of 10-CHO H4PteGlu. This folate may originate predominantly from the apocrine mammary glands. Thein vivolabelled radiofolate milk binder could not be identified chromatographically, but it was shown that thein vitromilk binders of PteGlu and SCH3H4PteGlu could be separated chromatographically.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Five of 300 women with sarcoidosis had galactorrhea. Basal prolactin levels were mildly but significantly elevated when compared to controls and sarcoidosis patients without galactorrhea. Prolactin levels responded to thyrotropin releasing hormone and L-dopa administration, but not chlorpromazine. Luteinizing hormone and follicle-stimulating hormone concentrations responded normally to luteinizing hormone-releasing hormone in all sarcoidosis patients studied, as did growth hormone to insulin hypoglycemia. These results indicate that galactorrhea in sarcoidosis is an uncommon phenomenon, probably due to hypothalamic dysfunction and associated with mildly elevated prolactin levels.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The effect of a chronic glucose osmotic diuresis on electrolyte homeostasis was evaluated in alloxan diabetic rats with urine volumes greater than 1 50 ml/day and glycosuria of 4 to 10 gm/day. Results were compared with control rats for periods up to 84 days. Sodium and potassium intake and urinary losses were significantly higher in diabetic animals throughout the study periods. Negative Na balance, however, persisted for only four days, and negative K balance for only 1 8 days. Blood volumes were elevated probably secondary to the osmotic effect of hyperglycemia (serum glucose > 600 mg %). Plasma renin activity decreased progressively, in part because of an early decrease in renin substrate at a time when renin concentration was normal. Despite hyperkalemia, mean plasma aldosterone was not increased compared with that in control rats, suggesting diabetic rats had relative hypoaldosteronism. Although three diabetic rats became hypertensive, no significant difference in mean blood pressure was observed between the groups. The results suggest that diabetic rats have losses of Na and K early in their diabetes, following which mechanisms to conserve Na and K are activated preventing further electrolyte depletion despite continuation of the osmotic diuresis. Decreased renin activity with inadequate stimulation of aldosterone would contribute to K conservation. Maintenance of Na balance must be explained by increased Na intake and other renal Na conserving mechanisms.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Ten patients with a mean age of 34.1 years with infective endocarditis (55% of cases due toStaphylococcus aureus) were treated with cephradine. The peak serum levels of cephradine (8–42 μg/ml) were 3− to 17-fold higher than the minimum inhibitory concentrations of cephradine against pathogenic strains of S aureus (1.2–4 μg/ml). Patients treated with cephradine became afebrile in 2 to 13 days of therapy, and their white blood cell count returned to a normal level in 3 to 30 days. Cephradine therapy was well tolerated without any incidence of phlebitis. The drug could be administered by three different routes. Cephradine is a useful cephalosporin for treatment of nonenterococcal gram-positive endocarditis in young heroin addicts.

ISSN:0002-9629    

出版商:OVID    

年代:1979

数据来源: OVID