A method for quantitative estimation of split renal function using a computerized gamma camera system is described. 42 children and adolescents with existing or preexisting vesicoureteric reflux and recurrent urinary tract infection were investigated. Total renal clearance of DTPA was calculated with a disappearance curve derived from the largest extrarenal area in the field of view of a gamma camera with diverging collimator. Split renal function was estimated with the slopes of second phase renograms. The plasma disappearance clearance of DTPA, calculated using one compartment model with two late blood samples, gave similar results with the clearance estimated from the body disappearance curves. The proportional planimetric renal parenchymal areas had good correlation with the split clearance estimated from renogram slopes. The method offers data on renal function and urinary tract dynamics which is very valuable in the follow-up of children with recurrent urinary tract infection and vesicoureteric reflux.
No abstract
The principal mechanism of controlling heat loss during the first postnatal hour is the constriction of skin vessels, thus reducing radiation and the temperature gradient between skin and environment (2, 4). Because of lack of suitable methods, our knowledge is only fragmentary concerning the immediate response of the peripheral circulation at birth.Thermography offers a method to map out the heat distribution of the skin and by cinethermography sudden changes in temperature can be recorded almost continuously. METHODSAn AGA Thermovision model 661 was used. The equipment is made up of two basic units: an infrared camera and a modified oscilloscope that displays the thermal picture on its screen. The relation between temperature and radiation intensity is highly nonlinear. Therefore the instrument's calibration can be directly interpreted in terms of temperature only for a restricted range of temperature around the calibration temperature. The range is 20°C to 40°C for the instruments used (5).The camera equipment used was a Bolex 16 mm cinecamera fitted with a 50/60 Hz synchronous motor. The gear ratio has been chosen so that every other thermovision picture is filmed, i.e. the cine frame rate is 8 frame/second. The equipment also includes a phasing device, so that frame begins to be exposed at the same moment as the thermovision picture sweep commences.The camera was placed in the delivery room about 2 m from the labour bed. The thermograph was turned on at least 15 min before expected labour in order to reach satisfactory stability of the equipment. The temperature of the delivery room was about 24°C. The recording began at the moment when the vertex first appeared. In all fullterm babies, skin temperature of the center of both palms and heels, epigastrium and back (between the scapulae) were measured with an electrical thermometer type "Sekunden Thermometer", using skin applicator. The response time of this electrode was 2-3 sec. Registrations were made within 10 sec, at 1, 3 and 5 min after birth in order to get a rough control of the temperature changes seen on the thermal picture and of the degree of cooling during the first 5 min. In a few infants, temperatures of the skull, cheeks and nose were also measured with the skin applicator.
The body disappearances and the liver mean transit times of a hepatobiliary tracer, 99mTc-diethyl IDA, were measured from 100 cholescintigraphies of 98 patients. Fifteen patients had no hepatobiliary disease; their mean body disappearance was 6.6, SD 1.1%/min, and mean liver mean transit time 32, SD 19 min. The values within 2 SDs, disappearance greater than or equal to 4.4%/min and mean transit time less than or equal to 70 min, were used as reference values. Disappearance constants below 4.4%/min were observed 29% and mean transit times exceeding 70 min in 49% of the examinations performed on patients with some hepatobiliary abnormality. The calculated parameters were compared with the levels of serum bilirubin and ASAT. Disappearance constants below 4.4%/min were seen in 33% and mean transit times exceeding 70 min in 55% of the patients who had either abnormal serum bilirubin or ASAT due to a hepatobiliary disease. The correlation between the serum bilirubin and the disappearance was -0.13, and between ASAT and body disappearance it was -0.28. The corresponding correlation coefficients of serum bilirubin and ASAT with the liver mean transit times were 0.33 and 0.44. Long mean transit times in relation to bilirubin and ASAT were seen in some acute cases. Short mean transit times in relation to bilirubin and ASAT were seen with falling serum levels of the latter.
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