Relation of symptoms to impaired stomach, small bowel, and colon motility in long-standing diabetes.

Stomach, intestinal, and colonic transit were measured in males with insulin-requiring diabetes of greater than 10 years' duration to compare with symptoms and to estimate the medical significance. For all diabetics only the symptom constipation correlated with the appropriate regional delayed transit. Diabetics with delayed transit in any region, however, had more overall gastrointestinal symptoms. Diabetics with delayed transit had disease of significantly longer duration than those without delay. Delayed transit was common in the diabetics selected for study with 21 of 54 stomachs, 10 of 20 small intestines, and 14 of 20 colons showing impairment. Of 35 diabetics with impaired transit at one or more locations, only seven were judged of medical importance and five of these responded to treatment. In this study, delayed transit was frequent; in the one fifth requiring management, the symptoms related closely to the region impaired.

Evaluation of pulmonary perfusion in lung regions showing isolated xenon-133 ventilation washout defects.

Xenon-133 washout phase imaging is often used to help determine whether the etiology of a perfusion defect is embolic or due to pulmonary parenchymal pathology, such as chronic obstructive pulmonary disease. This study was designed to evaluate the pulmonary blood flow patterns associated with isolated defects on xenon washout images. Scintigraphic lung studies were reviewed until 100 cases with abnormal ventilation results were obtained. Ventilation abnormalities were compared with the corresponding perfusion scan results at the same anatomic site. Of the 208 individual lung regions with xenon abnormalities, 111 showed isolated washout defects (that is, with normal washin). Ninety-four of these 111 sites showed either normal perfusion or a small, nonsegmental corresponding perfusion defect. Three segmental perfusion defects were noted in association with isolated xenon retention. In each of these cases, however, the patient was felt actually to have pulmonary embolism. Thus, it is recommended that, for interpretation of scintigraphic images in the assessment of pulmonary embolism, lung pathology associated with isolated xenon retention not be considered a potential cause for large or segmental perfusion defects.