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  • 1
    ISSN: 1432-1238
    Keywords: Left ventricular function ; Weaning ; Inspiratory pressure support ; Chronic obstructive pulmonary disease ; Coronary artery disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Determine the evolution of left ventricular ejection fraction during weaning. Design Prospective study. Setting Intensive care unit of a university teaching hospital. Patients and participants 12 consecutive mechanically ventilated patients, without documented coronary artery disease, suffering from acute exacerbation of chronic obstructive pulmonary disease and able to be weaned. Measurements and results Left ventricular ejection fraction was determined during mechanical ventilation, inspiratory pressure support (10 cmH2O) and spontaneous ventilation with constant inspiratory oxygen fraction using technetium99m radionuclide angiography. Spontaneous ventilation induced a significant decrease in left ventricular ejection fraction from 54.5±12.4 to 47.0±13% (p〈0.01). Inspiratory pressure support induced a slight but non-significant decrease in left ventricular ejection fraction from 55.0±12.1 to 50.3±12.4%. Left ventricular ejection fraction was homogeneously reduced by spontaneous ventilation without patent regional wall motion abnormalities of the left ventricle. Myocardial201thallium imaging performed 15 min after weaning showed a normal perfusion in the left ventricle anterior and posterior free wall. Conclusion Weaning of patients suffering from chronic obstructive pulmonary disease without coronary artery disease induced a significant reduction in left ventricular ejection fraction. The non significant decrease in left ventricular ejection fraction observed with inspiratory pressure support suggested that our results might be explained by a weaning induced increase in afterload.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1619-7089
    Keywords: Dual-isotope studies ; Factor analysis ; Thallium thyroid uptake ; Thyroid nodule
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to identify malignant thyroid nodules using iodine-123 and thallium-201 simultaneous dynamic acquisition. The image sequences acquired were processed by factor analysis of spectral and dynamic structures (FASDS). Some 49 patients were investigated, and their diagnoses were confirmed by histological examination. Data processing enables the estimation of the spectra of the two isotopes and the evaluation of the kinetics and spatial structures related to each tracer. The superimposition of thallium and iodide sum images allowed us to delineate the nodule accurately. Two groups were defined: 21 patients who had 201T1 uptake in the nodule, and 28 who had none. In the first group, 5 nodules were carcinomas, whereas all nodules in the second group were benign. The results of the 201T1 dynamic study improved the diagnosis of carcinoma as the number of false-positive cases decreased. FASDS succeeds in extracting spectral and kinetic information, proving its usefulness in clinical diagnosis.
    Type of Medium: Electronic Resource
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