Assessment of hemodynamic significance of isolated stenoses of the left anterior descending coronary artery using thallium-201 myocardial scintigraphy.

This study tests the hypothesis that the results of stress thallium-201 myocardial perfusion scans (TI-201) are related to the mean transstenotic pressure gradient of coronary stenoses independent of the percent luminal diameter narrowing seen at angiography. The 22 study patients (20 men, 2 women, mean age 47 years, range 30 to 62) had no previous myocardial infarction. Each underwent a symptom-limited, erect bicycle TI-201 test off antianginal therapy, shortly before percutaneous transluminal coronary angioplasty for isolated left anterior descending coronary artery stenosis.

Localization of exercise-induced myocardial ischemia with single view and biplanar radionuclide ventriculography: validation in single vessel coronary disease.

The ability of single view and biplanar radionuclide ventriculography (RVG) to determine the location of myocardial ischemia during maximal graded supine bicycle exercise was assessed in 50 patients with chest pain, no prior myocardial infarction, and a single coronary stenosis of greater than or equal to 50% luminal diameter narrowing at coronary angiography. A biplane collimator was used so that both right anterior oblique (RAO) gated first-pass and left anterior oblique (LAO) equilibrium RVG could be performed at rest and exercise. Results were compared with those obtained using 4-view 201Tl myocardial scintigraphy in the same patients.

Prognostic significance of left ventricular ejection fraction after acute myocardial infarction. A bedside radionuclide study.

The prognostic significance of left ventricular ejection fraction measurements obtained at the bedside was assessed in 171 patients as soon as possible after acute myocardial infarction. Ejection fraction was measured with a radionuclide first pass portable probe method within a mean of 24 hours of the onset of major symptoms. The results were related prospectively to the subsequent incidence of ventricular fibrillation in hospital, and to hospital and postdischarge deaths in a mean follow up period of 15 (range 9-21) months.

A new antiserum with conformational specificity for LHRH: usefulness for radioimmunoassay and immunocytochemistry.

We have produced and characterized a new high titer, highly specific antiserum for luteinizing hormone-releasing hormone (LHRH), and demonstrated its usefulness for radioimmunoassay (RIA) and immunocytochemistry. The antiserum can be used at a final dilution of 1:500,000 to 1:600,000 for RIAs with a sensitivity of 0.2 pg/tube.

Value of combined assessment of global and segmental ventricular contraction with right anterior oblique ECG-gated first-pass and left anterior oblique equilibrium radionuclide ventriculography.

A semi-automated, variable-region-of-interest method of analysis was used to measure both global and segmental left ventricular (LV) and global right ventricular (RV) contraction with ECG-gated first-pass and equilibrium radionuclide ventriculography. Normal values were defined in 20 healthy volunteers, and in 24 symptomatic patients, the results were compared with right anterior oblique (RAO) contrast left ventriculography. The global LV ejection fraction (LVEF) obtained by equilibrium imaging in the left anterior oblique (LAO) projection correlated closely with the results obtained by the gated first-pass method in the RAO projection (r = 0.

Nufenoxole, a new antidiarrhoeal agent, inhibits fluid secretion in the human jejunum.

Nufenoxole is an orally active antidiarrhoeal agent which binds to opioid receptors in the brain and myenteric plexus of the intestine. A perfusion technique has been used to investigate the effect of nufenoxole (1 mg/kg intrajejunally) on water and solute transport stimulated by the secretagogue, dioctyl sodium sulphosuccinate, in the human jejunum in vivo. Nufenoxole reversed the direction of jejunal transport of salt and water from net secretion to net absorption.

Enalapril for severe congestive heart failure. A double-blind study.

The effects of the new, orally administered converting-enzyme inhibitor, enalapril (MK-421), were studied in 12 ambulatory patients with severe cardiac failure who were also receiving digoxin and diuretic agents. The study was double-blind, parallel, placebo-controlled and randomized. The clinical characteristics and pretreatment exercise performance were similar in the two groups of patients.

Scintigraphic localization of a recurrent phaeochromocytoma by means of iodine-131 metaiodobenzylguanidine.

A new adrenomedullary scintigraphic imaging agent, iodine-131-labelled metaiodobenzylguanidine (MIBG), was used to localize a recurrent phaeochromocytoma in a 27-year-old man in whom the site of tumour could not be determined by any other means. MIBG scintigraphy is easy to perform and is highly specific for functioning aberrant adrenomedullary tissue. It complements other methods for localization of phaeochromocytoma and, under some circumstances, it may become the initial imaging procedure of choice in the screening of patients in whom the biochemical or clinical evidence suggests the presence of such tumours.

A stewardship challenge: reconciling faith and finances.

As financial constraints have tightened in recent years, Catholic health care facilities have undergone the double pressure of having to safeguard the integrity of their Christian mission while maintaining economic viability. The conflict between faith and finances, however, represents a tension that has been felt since Biblical times. The dichotomy between ministry and money can be traced from Scripture's admonition that money is the root of all evil, through the Manichean heresy of the early Church, right up to the conflict that today's sponsoring congregations experience in seeking to reconcile multimillion-dollar budgets with their efforts to maintain a simple life-style and raise the existence level of the poor.

Hepatobiliary scintigraphy.

The recently acquired ability to tag 99mTc to a number of chemicals which are excreted avidly by the liver and concentrated in the gallbladder has enabled improved diagnosis of acute cholecystitis. This article gives a brief overview of the imaging technique.

Acute intravenous and sustained oral treatment with the beta1 agonist prenalterol in patients with chronic severe cardiac failure.

Prenalterol, a beta1 agonist, was given in a single blind acute intravenous study to seven patients with cardiac failure (New York Heart Association class II and III). It was then given in a double blind crossover study of sustained oral prenalterol to six of them. As a result of dose titration studies the oral dose of prenalterol given was 100 mg twice a day in all patients.

Right and left ventricular function at rest and with exercise after the Mustard operation for transposition of the great arteries.

Right and left ventricular function was assessed in 25 children (mean age at study 12.2 years and at operation 2.6 years) after a Mustard repair for transposition of the great arteries.

Identification of estrogen-responsive LHRH neurons in the guinea pig hypothalamus.

Intracellular recordings, dye-labeling and immunocytochemistry were performed in arcuate and cell-poor zone (ARC-CPZ) neurons in hypothalamic slices obtained from cycling, female guinea pigs. The hypothalamic slices were perfused with artificial medium for 9-10 hours during which time intracellular recordings were made through procion yellow electrodes and KC1/KCitrate-filled electrodes. 17 beta-Estradiol (E2) in concentrations of 10(-9) to 10(-8) M hyperpolarized and/or inhibited the spontaneous activity of 42 out of 102 ARC-CPZ neurons.

Distribution of immunoreactive substance P neurons in the hypothalamus and pituitary of the rhesus monkey.

The distribution of immunoreactive substance P (IR-SP) neurons was examined in the hypothalamus and pituitary gland of the rhesus monkey by using the peroxidase-antiperoxidase immunocytochemical technique. Immunoreactive SP cell bodies were observed in the arcuate nucleus, in the region lateral to the arcuate nucleus, and in the median eminence (ME). Immunoreactive SP cells were also seen in the periventricular area of the dorsal tuberal region.

Oral beta-adrenergic blockade with metoprolol in chronic severe dilated cardiomyopathy.

A double-blind crossover trial was performed to assess the effect of metoprolol in 10 patients (mean age 55 years) with severe dilated cardiomyopathy. All patients clinically had idiopathic dilated cardiomyopathy; however, at coronary angiography, four had occult coronary disease. All were in New York Heart Association functional class III with a left ventricular ejection fraction less than 35% as assessed by rest radionuclide ventriculography.

Distribution of substance P neurons in the epithalamus of the rat: an immunohistochemical investigation.

Substance P (SP) immunoreactivity was studied in the epithalamus of intact and superior cervical ganglionectomized female rats by using the peroxidase-antiperoxidase immunocytochemical technique. Cells containing immunoreactive SP were located in the medial habenula, and SP fibers were observed in the lateral habenula, habenular commissure, pineal stalk, and the pineal organ. Bilateral removal of the superior cervical ganglia did not affect the immunocytochemical staining of SP-containing cells and fibers 15-30 days later.

Comparison of supine and erect bicycle exercise electrocardiography in coronary heart disease: accentuation of exercise-induced ischemic ST depression by supine posture.

Exercise-induced electrocardiographic ST depression was compared during supine and erect graded bicycle exercise in 43 patients with chest pain but no prior myocardial infarct; all had greater than or equal to 1 mm of ST depression during either erect or supine exercise; 16 had multivessel, 24 had 1-vessel and 3 had no coronary artery disease. Supine exercise used 4 minutes/stage and erect exercise used either 4 minutes or 3 minutes/stage with identical graded work loads for both postures. Chest pain occurred in 31 patients during erect and in 29 during supine exercise.

Incremental value of clinical assessment, supine exercise electrocardiography, and biplane exercise radionuclide ventriculography in the prediction of coronary artery disease in men with chest pain.

The incremental value of clinical assessment, exercise electrocardiography (ECG) and biplane radionuclide ventriculography (RVG) in the prediction of coronary artery disease (CAD) was assessed in 105 men without myocardial infarction who were undergoing coronary angiography for investigation of chest pain. Independent clinical assessment of chest pain was made prospectively by 2 physicians. Graded supine bicycle exercise testing was symptom-limited.