John S. Belko

Blended Scintiscans of Lungs with a Dual Detector System

The most important clinical application of radioisotope lung scanning appears to be in the diagnosis of pulmonary embolic disease. With experience, however, it has become evident that conventional single-plane lung scanning does not adequately define the total pulmonary vasculature. Because of the depth of the human chest, large areas of lung lying beyond the range of effective collimation are undetected. To correct this, some investigators have scanned both anteriorly and posteriorly in sequential fashion (1). Completeness of coverage, however, was gained at the expense of doubling the duration of the procedure, generally forty to sixty minutes. This poses a serious limitation in acutely ill patients where its application should be most useful. We have attempted to solve this problem by using a high speed instrument with dual opposed detector heads to permit simultaneous scanning of the anterior and posterior portions of the lung. Right and left lateral views were made possible by this arrangement. In ad...

Problems in the diagnosis and management of pulmonary embolism

Despite advances in instrumentation and techniques used to diagnose pulmonary embolism, clinical and postmortem data continue to indicate that it is still grossly underdiagnosed. Reasons for this revolve around problems relating to the clinical picture, laboratory studies, electrocardiography, radiography, lung scanning, and pulmonary angiography. The primary difficulty in the diagnosis of pulmonary embolism concerns the protean nature of the disease which permits it to masquerade as virtually any cardiopulmonary disorder. Once suspicion is aroused, the problem of diagnosis is compounded by the lack of specific laboratory tests. Routine chest radiography may show a number of nonspecific changes although the complete picture is exceptional. Electrocardiography may be useful, but it lacks both specificity and sensitivity. Radionuclide lung scanning, despite its lack of specificity, is currently the most useful diagnostic screening procedure because of its simplicity and safety. Selective pulmonary angiography, with its limitations of resolution, remains the only specific means for diagnosing pulmonary embolism. The limitations of both clinical and laboratory techniques, therefore, constitute the major problem in pulmonary embolism detection. An awareness of these problems should lead to earlier and more frequent identification of the patient with pulmonary embolic disease.

The Effect of Intravenous Injection of Emulsified Vitamin K, on the Hypoprothrombinemia Induced by Tromexan

TROMEXAN (ethyl biscoumacetate; 3, 3′ carboxymethylenebis- [4-hydroxycoumarin] ethyl ester also known as B.O.E.A., D.E.A. and Pelentan) has been proved to be an effective agent for inducing hypopro...