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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Thoracic aorta ; Trauma ; Aorta rupture ; Spiral CT ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the other 473 patients, we are aware of no false-negative SCT examination. Our limited series shows a sensitivity of 100 % and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is concluded that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1619-7089
    Keywords: Technetium 99m ; Methoxyisobutylisonitrile ; Myocardial perfusion scintigraphy ; Coronary bypass operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eighteen patients were examined at rest by technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) myocardial scintigraphy 1 day before and 1 week after aorto-coronary bypass operation with planar and single photon emission tomography (SPET) imaging. One day postoperatively, a planar scintigraph in the intensive care unit (ICU) was done. Inter-observer variability was 3.8% for all examinations and for SPET alone, 3.9%. The quality of the planar images taken under emergency conditions in the ICU was quite comparable with those taken under routine conditions. The postoperative myocardial infarction in a patient who died 6 days later could clearly be demonstrated. In 16.2% of all segments which were hypoperfused at rest on preoperative scintigraphy, an amelioration of perfusion could be shown in the 1 st week after the bypass operation. 99Tc-MIBI proved to be a useful agent to assess perioperative perfusion, in the ICU as well as under standard conditions.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1619-7089
    Keywords: Technetium 99m ; Methoxyisobutylisonitrile ; Myocardial perfusion scintigraphy ; Coronary bypass operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eighteen patients were examined at rest by technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) myocardial scintigraphy 1 day before and 1 week after aorto-coronary bypass operation with planar and single photon emission tomography (SPET) imaging. One day postoperatively, a planar scintigraph in the intensive care unit (ICU) was done. Inter-observer variability was 3.8% for all examinations and for SPET alone, 3.9%. The quality of the planar images taken under emergency conditions in the ICU was quite comparable with those taken under routine conditions. The postoperative myocardial infarction in a patient who died 6 days later could clearly be demonstrated. In 16.2% of all segments which were hypoperfused at rest on preoperative scintigraphy, an amelioration of perfusion could be shown in the 1 st week after the bypass operation.99Tc-MIBI proved to be a useful agent to assess perioperative perfusion, in the ICU as well as under standard conditions.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1440
    Keywords: Bronchial neuroendocrine tumor ; Mitral insufficiency ; Aortic insufficiency ; Carcinoid heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A female patient suffering from a bronchial neuroendocrine tumor with unilateral leftsided carcinoid heart disease is reported. Repeated x-ray films of the chest showed a slowly growing lung tumor in the left lower lobe. The patient refused any diagnostic or therapeutic procedure to define the type of the tumor. During the follow-up of 24 years she developed severe mitral and moderate to severe aortic insufficiency, both invasively quantified by thermodilution techniques. During surgery for double valve replacement the patient died from left ventricular heart failure. Necropsy revealed the typical pattern of a bronchial neuroendocrine tumor without metastases. Examination of the heart disclosed the characteristic deposits of fibrous tissue on the cusps of both the mitral and the aortic valves whereas the right heart showed no abnormalities. Review of the literature suggests the unilateral left-sided carcinoid heart disease to be a very rare finding, its pathogenesis remains to be elucidated.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical microbiology & infectious diseases 13 (1994), S. 12-18 
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clinical and laboratory data on infectious complications in 100 consecutive heart transplant recipients were analyzed retrospectively. The mean length of follow-up was 651±466 days. All patients received a basic immunosuppressive regimen including cyclosporine (whole blood target trough level 400–600 µg/l), azathioprine (1 mg/kg/day) and prednisone (0.15 mg/kg/day). Early rejection prophylaxis consisted of polyclonal rabbit antithymocyte globulin (ATG) (4 mg/kg/day for 4 days) in the first 57 patients and monoclonal murine OKT-3 (5 mg/day for 14 days) in the remaining patients. The primary cause of death was infection in three patients and rejection in 16 (p〈0.001). The incidence of infection was 0.96/patient/year (n=179); 95 infections were nosocomial (53 %), 47 community-acquired (26 %) and 37 opportunistic (21 %). The number of hospitalizations due to infections was fewer than that due to rejection (53 versus 246 respectively, p〈0.0001), but the mean length of hospital stay was longer in the first group (13.85±10.92 days versus 3.48±2.28 days, p〈0.001). Previous early rejection prophylaxis with OKT-3 was associated with a greater number of opportunistic and nosocomial infections compared to prophylaxis with ATG (p〈0.05), as was treatment with ATG and steroid pulses compared to steroid pulses alone in cases of opportunistic infection (p〈0.05).
    Type of Medium: Electronic Resource
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