[Perfusion and ventilation pulmonary scintigraphy in the diagnosis of the operability of primary bronchial cancers]. / Les scintigraphies pulmonaires de perfusion et de ventilation dans le diagnostic d'opérabilité des cancers bronchiques primitifs.

Ventilation scintigraphy using Munsch's technique with Xenon 133 combined with perfusion scintigraphy using 99m Tc albumin particles in microspheres are of considerable interest in the preoperative evaluation of bronchogenic carcinoma. Basing themselves on 95 cases, the authors discuss the manner in which the tumor affects ventilation and perfusion. In the 70 cases of matching ventilatory and perfusion scans, scintigraphy alone is not sufficient to demonstrate the exact perfusion obstruction mechanism. On the other hand, if there is a V/Q mismatch (21 cases) and if the perfusion defect is more extensive than the ventilation defect or the radiological opaque area, this normally implies a mediastinal extension of the tumor, and tends to make any carcinologically valid ablation highly risky. Comparison of the perfusion and ventilation scans with the radiological data and spirometric values showed that 9 patients presented with abnormal pulmonary radiographs outside the tumor areas. Six of these cases involved tuberculous sequelae. Forty-four of the ninety five patients (46.3%) showed normal ventilation and perfusion scans outside the tumor areas. Of the 91 patients undergoing spirometry, 39 suffered from ventilatory obstruction and pathological ventilation and perfusion scans and 18 presented with scintigraphic anomalies outside the tumor are a but did not suffer from ventilatory obstruction.

[Assessment of ejection fraction and left ventricular and diastolic volume by non-invasive methods: echocardiography and isotopic technics. Comparison with angiography in 30 patients]. / L'évaluation de la fraction d'éjection et du volume télédiastolique du ventricule gauche par les méthodes non invasives: échocardiographie et techniques isotopiques. Comparaison avec les données angiographiques à propos de 30 patients.

Three methods of measuring the ejection and the left ventricular end-diastolic volume were compared in 30 consecutive patients (all adults, 3 normal, 3 congestive cardiomyopathy, 6 mixed aortic valve disease, 9 pure aortic stenosis and 9 pure aortic incompetence). The haemodynamic and angiographical data was compared to the results of M-mode echocardiography and gammaangiocardiography. The global results of the ejection fractions were compared: angiography gave the lowest values (0,58 +/- 18). The non-invasive methods gave very similar results (0,67 +/- 15 for the echo and gammaangio). A better correlation was obtained in the group with pure aortic incompetence; the results in pure aortic stenosis were not reliable. The global results of end-diastolic volume showed constant underestimation by the non-invasive methods compared to angiography. The choice of method in each technique may influence the results obtained; each laboratory should determine its normal values; results should not be accepted without a critical assessment. Standardisation of techniques would be desirable.

[Tests concerning aeration or ventilation modalities of voluminous emphysematous bullae (author's transl)]. / Tests permettant de juger des modalités de ventilation ou d'aération des volumineuses bulles emphysémateuses.

The authors recommend the use of two functional tests to evaluate the aeration and ventilation modalities of large emphysematous bullae: diffusing capacity by apnea method and ventilation scintigraphs using Xenon 133. In 56 bullous emphysema cases studied, a favorable correlation was observed between the results provided by the two techniques.

[Value of an automatic chronometer in epicardial mapping]. / Intérêt d'un chronomètre automatique dans la réalisation de cartographies épicardiques.

The use of a digital display automatic chronometer during epicardial mapping is reported. The epicardial potential recorded by a tripolar electrode is transformed electronically by amplification, filtering, rectifying negative deflections and then summation. The interval between the reference signal (electrical impulse or other cardiac potential) is calculated automatically and displayed at an adjustable rate. The presence of a delay increases the range of application of the apparatus. Epicardial mapping is thus simplified and shortened.

[Variations of the cerebral blood flow after hyperbaric oxygenation in traumatic coma]. / Etude des variations de débit sanguin cérébral après oxygénation hyperbare dans le coma traumatique

We have previously shown (Ref. I) the absence of variations in average cerebral blood flow, measured by the method of LASSEN, following treatment of traumatic coma by means of hyperbaric oxygenation patients presenting with brainstem contusion, during 2 hours of HBO (at 2.5 times atmospheric pressure) measurements of cerebral blood flow were made using a single detecting probe, before and two hours after terminating HBO. Measurements in 9 patients demonstrated variations in cerebral flow greater than predicted by experimental error (+/- 4%): 5 measurements (these with initial flow less than 31 ml/mn/100 g increased following OHB, while 4 measurements (these with initial flow greater than 31 ml/mn/100 g) decreased following OHB. In order to determine the significance of these variations, we studied the correlation between two methods of calculating cerebral blood flow : the exponential (bicompartimental) method, and the stochastic method, assuming lambda the coefficient of partition, tobe equal to I. These two method of calculation appear to be independant ; thus, the observed correlation (r = 0.74, p less than 0.01) tends to validite the measured variations in flow. This finding is further supported by the calculated correlation between the change in flow as measured by the exponential and that measured by the stochastic method (r = 0.684, p less than 0.05). Thus, we feel that measured changes in flow represent changes in cerebral perfusion, and cannot be attributed to the method of calculation. The bio exponential method of calculation of flow, D = Dg + Dw (with Dg = fg. Wg = "index of grey perfusion" and Dw = fw. Ww = "index of white perfusion", where fg = lambda1. (see article), and where Wg and Ww represent the percentage of the grey and white substance) permit calculation of a highly significant correlation between the change in flow and the grey perfusion index (r = 0.83, p less than 0.01). This correlation, previously described in the literature, appears to explain the observed findings in terms of the variations in perfusion of the grey compartment. However, there exists an equally significant correlation, but negative, between the variations of the grey and white perfusion index (r = 0.824, p less than 0.01). This correlation seems to indicate the presence of an inverse relationship between flow to grey and white substances, tending to minimize the variations of the total flow after OHB. We can then formulate an explanatory hypothesis: if one assumes that the diminution of intracranial pressure during OHB, by decreasing cerebral edema, hastens the recovery of perfusion in the damaged zones, then the response to therapy with hyperbaric oxygenation should differ, depending on whether the tissues were healthy or damaged. Healthy tissues should show a decrease, while damaged zones should show an increase in flow following OHB. This mechanism would appear to explain, in relation to lesions located predominantly in grey or white matter, the observed negative correlation between blood flow to the two compartments.