Cerebral blood flow was measured in relative terms with Tc99m-hexamethylpropyleneamineoxim (HMPAO) and single photon emission computed tomography (SPECT) in 28 female schizophrenic patients (20 acute and 8 chronic) classified according to DSM-III. Eleven normals served as controls. The acute patients were classified according to positive and negative symptoms. Patients with predominantly positive symptoms showed by and large normal and homogeneous cerebral isotope uptake. Those with negative symptoms, and the chronic patients, showed inhomogeneous tracer uptake with multiple regions of hypoperfusion in slices 4-6 cm above the orbitomeatal line. The findings support in principle the notion that schizophrenia with negative or chronic symptoms does not affect the whole brain homogeneously. Brain imaging with Tc99m-HMPAO and SPECT might be used to distinguish various types of schizophrenia.
Regional cerebral blood flow (rCBF) was measured in relative terms with Tc99m-hexamethylpropyleneamineoxim and single photon emission computed tomography in 11 patients undergoing electroconvulsive therapy (ECT). The patients suffered from major depressive disorder (n = 8) or schizoaffective disorders (n = 3). rCBF was measured under general anesthesia 3 days prior to the ECT treatment and coinciding with the ECT stimulation. ECT caused a redistribution of the tracers uptake. The uptake became more pronounced in frontal parts of the brain and in the basal ganglia than in posterior parts of the cortex, and the thalamus. This selective effect of ECT on rCBF may be related to catecholaminergic projections to anterior parts of the brain.
We studied the effect of correction of anemia with erythropoietin on left ventricular systolic and diastolic function at rest and exercise in 17 chronic hemodialysis patients by means of maximum exercise testing and equilibrium gated radionuclide angiocardiography on three occasions: 1) initial--before erythropoietin administration, 2) intermediate--at the time when the target hemoglobin level reached 100 g/l, and 3) long-term--after 12 months of therapy. After correction of anemia, the patients showed a significant improvement in their response to exercise regarding maximal work load achieved, exercise duration and recovery time. Ejection fraction and peak ejection rate remained unchanged during therapy. At rest, peak filling rate was reduced from 2.62 +/- 1.0 (baseline) to 2.28 +/- 0.9 (intermediate) end-diastolic volume per second, p < 0.01, while no significant difference was observed during exercise. The time to peak filling rate was prolonged significantly during EPO therapy from 157 +/- 30 to 177 +/- 28 ms at rest, p < 0.05, and from 101 +/- 24 to 130 +/- 27 ms during exercise, p < 0.01. By the time of the late study, there were no significant differences between the late and intermediate study. In conclusion, amelioration of anemia with erythropoietin in hemodialysis patients produced improvement in exercise capacity, but diastolic function worsened with therapy and this effect was maintained during the long-term treatment, while systolic function at rest and exercise remained unchanged.
SummaryThe present report describes a rare case of triatrial heart, cor triatriatum dextrum in a 31-year-old woman in whom the anomaly was incidentally detected by radionuclide angiocardiography. Subsequent assessment with two-dimensional echocardiography and right heart catheterization confirmed the presence of a membrane subdividing the right atrium into two distinct chambers. To the best of our knowledge, this is the only case in which this cardiac anomaly was demonstrated by radionuclide technique.
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