Browsing by Author "Van Heerden, P. D. R."

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    99mTc-MIBI stress-rest myocardial perfusion scintigraphy in patients with complete left bundle branch block
    (2001) Ellmann, A.; Van Heerden, P. D. R.; Van Heerden, B. B.; Klopper, J. F.
    Background. Patients with complete left bundle branch block (LBBB) often show a false-positive ischaemic pattern in the interventricular septum on thallium-201 (201Tl) stress-rest myocardial perfusion scintigraphy. Equivocal results have been reported with technetium-99m labelled hexakis-methoxyisobutyl isonitrile (99mTc-MIBI) in such patients. The aim of this retrospective study was to determine the effect of LBBB on the septal uptake of 99mTc-MIBI during stress-rest single photon emission computed tomography (SPECT) scintigraphy. Methods. We studied 75 consecutive patients with LBBB, referred for 99mTc-MIBI stress-rest SPECT. Studies were evaluated by visual analysis using a semi-quantitative grading technique. In all patients with abnormal septal segments, the presence or absence of ischaemic heart disease was confirmed either clinically or by means of angiographical examination. Results. Forty-three patients (57.3%) had completely normal studies. Only 15 (20%) had septal abnormalities (11 with reversible and 4 with fixed defects), while 17 patients (22.7%) had abnormal segments in areas other than the interventricular septum. Except for 1 patient lost to follow-up, ischaemic heart disease was confirmed in all the patients with septal changes. Conclusion. We conclude that 99mTc-MIBI is more specific than 201Tl for identifying ischaemic heart disease in the presence of LBBB.
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    Binneaarse radio-isotoop angiografie karotis-kaverneuse fistels
    (Health and Medical Publishing Group (HMPG), 1975) Van Heerden, P. D. R.; Rose Innes, A. P.; Klopper, J. F.
    The use of intravenous radio isotope angiography in 3 cases of unilateral carotid cavernous sinus fistula is described. The lesion gives a characteristic image pattern distinguishable from that of arteriovenous malformation in this region. An abnormal registration of intense radioactivity is seen in the early phases, accurately localised to the cavernous sinus, with a distinctive sigmoid shaped configuration. Rapid disappearance of this accumulation of isotope follows, accompanied by a paradoxical apparent increase in blood flow to the ipsilateral hemicranium. This is attributed to the massively arterialised venous drainage. This technique of demonstrating the cerebral circulation dynamically is considered a valuable diagnostic supplement to the static scintiscan and to conventional roentgen arteriography in this lesion.
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    Die effek van heparien-geinduseerde styging in vrye plasmatiroksien op die hartritme na miokardiale infarksie
    (Health and Medical Publishing Group (HMPG), 1985-12) Van Heerden, B. B.; Klopper, J. F.; Weich, H. F. H.; Van Heerden, P. D. R.
    It is well known that an acute myocardial infarction is accompanied by a rise in levels of plasma free fatty acids (FFA), which may lead to a subsequent increase in cardiac arrhythmias. Administration of heparin to patients after an acute myocardial infarction gives rise to an increase both in plasma FFA levels and plasma free thyroxine levels. If administered without a fatty meal the rise in FFA is not accompanied by an increase in arrhythmias. The effect of the heparin-induced rise in plasma free thyroxine on cardiac rhythm has never been investigated. The aim of the present study was to investigate a possible arrhythmic effect of a heparin induced increase in plasma free thyroxine in a group of patients with acute myocardial infarction. We were able to confirm a significant heparin-induced rise in plasma free thyroxine levels, as measured by the effective thyroxine ratio. Although a slightly significant increase in ventricular premature beats could be demonstrated after heparin administration when using the Wilcoxon rank sum test for statistical analysis (but not when the paired t-test was utilized), no significant correlation with free thyroxine levels could be found. Heparin administration to patients suffering from myocardial infarction seems to be safe in terms of a possible arrhythmic effect.
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    Metastatiese verkalkinge soos aangetoon met tegnesium-99m-pirofosfaatbeenflikkergrafie : gevalbesprekinge
    (Health & Medical Publishing Group, 1982) Louw, N. W.; Klopper, J. F.; Van Heerden, P. D. R.
    Two cases of chronic renal failure showing very interesting technetium-99m-pyrophosphate bone scans are presented. In both cases striking uptake of activity was shown in the left ventricle of the heart, the mucosa of the stomach and in both lungs. This picture was attributed to metastatic calcification in these organs. Cases of metastatic calcification demonstrated with bone-seeking agents have been presented previously, but have mainly shown intense uptake of activity in the lungs and in a few cases, and to a lesser degree, in the stomach. However, we believe that our cases are unique in showing especially the left ventricle of the heart as well as the mucosa of the stomach with exceptional clarity.
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    A simple automated system for the routine production of (99m)Tc by methyl ethyl ketone extraction
    (HMPG, 1974-05) Klopper, J. F.; Van Heerden, P. D. R.; Muller, U. D.; Baard, W. P.
    A relatively simple, automated system for the rapid, efficient and safe routine production of 99Tc(m)O4 from 99Mo03 by the metyl ethyl ketone (MEK) extraction technique is described. The 4 phases of the extraction process (bubbling of air, phase separation, drawing off of 99Tc(m) in MEK, and evaporation to dryness) are controlled by an automatic timer, suction pressure pump and solenoid switches. The eluate was found to contain neither bacterial organisms or pyrogens nor significant levels of alumina and radioisotopic impurities. With this system it is possible to make use of locally produced 99Mo, even of low specific activity for the routine production of 99Tc(m) in any concentration required.
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    Two simple inexpensive photographic methods for viewing ECG-gated radionuclide blood pool images
    (HMPG, 1979-04) Van Heerden, P. D. R.; Baard, W. P.; Klopper, J. F.; Reyneke, N. J.; Weich, H. F. H.; Blake, R. S.; Przybojewski, J. Z.
    Although the ECG-gated radionuclide blood pool scan (GBPS) has become an established method for studying regional myocardial wall motion, it is usually performed with the aid of an expensive computer system. A simple, inexpensive method was developed to view gated radionuclide blood images by a film loop and a photographic motion detection (PHOMOT) technique. These techniques were compared with left ventricular cine angiography in 15 patients. Segmental wall movement (78 segments) showed identical results in 92% of cases. In all patients the same diagnosis was arrived at by GBPS and cine angiography. The photographic techniques developed offer a simple screening procedure to reduce cardiac catheterization in patients with suspected abnormalities of left ventricular wall contraction.
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    Ventilasiestudies van die long met kripton-81m
    (HMPG, 1981-08) Klopper, J. F.; Van Heerden, P. D. R.; Baard, W. P.
    During a 2-year study period it was found that krypton-81m was useful in routine clinical practice. During this period 1563 technetium-99m perfusion studies and 807 krypton-81m ventilation studies were performed. A distinct advantage of krypton-81m was the ease with which multiple views could be obtained. These views could be directly compared with those of preceding perfusion studies. However, interruptions in the regular supply of rubidium-81/krypton-81m generators affected 17.1% of perfusion studies and xenon-127 should be a suitable substitute for these periods.
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    Die waarde van flikkergrafie in die hantering van enkelnodules van die tiroied
    (HMPG, 1977-04) Van Heerden, B. B. see Van Heerden, Barend B.; Van Heerden, P. D. R.; Van Zyl, J. A.; Bouwer, E. L.; Van Heerden, Barend B.
    ENGLISH ABSTRACT: The value of radionuclide scanning of the thyroid gland was investigated in 125 patients with solitary thyroid nodules. Fifty seven of the 95 patients with 'cold' nodules underwent surgery. The incidence of malignant nodules in this group was 16%, therefore surgery is recommended for all solitary 'cold' nodules. Of the 30 patients with 'warm' nodules, 20 were treated surgically and in only 1 patient was the nodule malignant. This incidence is probably not significant. Surgery is, however, also recommended for all solitary 'warm' nodules because of the possibility of toxic change. Accurate planning of the surgical procedure depends on any function of the nodule in question and this can be determined with certainty only by radionuclide scanning.