258 research outputs found

    Positron emission tomography detects evidence of viability in rest technetium-99m sestamibi defects

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    AbstractObjectives. The purpose of this study was to determine the relative value of single-photon emission computed tomographic (SPECT) imaging at rest using technetium-99m methoxyisobutyl isonitrile (technetium-99m sestamibi) with positron emission tomography for detection of viable myocardium.Background. Recent studies comparing positron emission tomography and thallium-201 reinjection with rest technetium-99m sestamibi imaging have suggested that the latter technique underestimates myocardial viability.Methods. Twenty patients with a previous myocardial infarction underwent rest technetium-99m sestamibi imaging and positron emission tomography using fluorine (F)-18 deoxyglucose and nitrogen (N)-13 ammonia. In each patient, circumferential profile analysis was used to determine technetium-99m sestamibi, F-18 deoxyglucose and N-13 ammonia activity (expressed as percent of peak activity) in nine cardiac segments and in the perfusion defect defined by the area having technetium-99m sestamibi activity <60%. Technetium-99m sestamibi defects were graded as moderate (50% to 59% of peak activity) and severe (<50% of peak activity). Estimates of perfusion defect size were compared between technetium-99m sestamibi and N-13 ammonia.Results. Sixteen (53%) of 30 segments with moderate defects and 16 (47%) of 34 segments with severe defects had ≥60% F-18 deoxyglocose activity considered indicative of viability. Fluorine-18 deoxyglucose evidence of viability was still present in 50% of segments with technetium-99m sestamibi activity <40%. There was no significant difference in the mean (± SD) technetium-99m sestamibi activity in segments with viable (40 ± 7%) and nonviable segments (49 ± 7%, p = 0.84). Of the 18 patients who had adequate F-18 deoxyglucose studies, the area of the technetium-99m sestamibi defect was viable in 5 (28%). In 16 patients (80%), perfusion defect size determined by technetium-99m sestamibi exceeded that measured by N-13 ammonia. The difference in defect size between technetium-99m sestamibi and N-13 ammonia was significantly greater in patients with viable (21 ± 9%) versus nonviable segments (7 ± 9%, p = 0.007).Conclusions. Moderate and severe rest technetium-99m sestamibi defects frequently have metabolic evidence of viability. Technetium-99m sestamibi SPECT yields larger perfusion defects than does N-13 ammonia positron emission tomography when the same threshold values are used

    Corporate governance and employees in South Africa.

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    Focusing on employees as stakeholders, we analyse corporate governance initiatives in South Africa encouraging and requiring companies to look beyond their shareholders' interests. Successive non-binding codes and the provisions of the recent Companies Act 2008 promoting this have been lauded by many commentators. The 2008 Act provides certain opportunities for employees and their representatives to exercise influence at the margins. We nevertheless question how far current corporate governance initiatives are adequate to promote employee interests. On the basis of three case studies of how companies have responded to employees as stakeholders, we conclude that in fact more stringent regulation is required

    Stadium Architecture and Regional Economic Development: International Experience and the Plans of Durban

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    For the FIFA World Cup 2010, South Africa plans to invest heavily. The positive economic effects that the country is hoping for stand in contrast to almost all statistical ex-post studies. This contribution emphasises that these results, usually from research under-taken in the USA, can only be generalised to a limited degree. The density of sports venues in developed countries is so high, that the marginal effects of new stadia are necessarily limited. We also emphasise that stadium design around the world was not hitherto adequately targeted towards positive economic effects. The example of Durban and its plans for a new iconic stadium is used to illustrate fundamental principles of stadium design and their embedding in a re-urbanisation process that have to be undertaken in order to consciously achieve positive regional economic effects

    ‘We secured the tussac’: Accounts of ecological discovery, exploitation and renewal in the Falkland Islands

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    Sheep farms dominate the Falkland Islands landscape and have for over a century. The introduction of sheep, and several other species, has significantly transformed the ecology of this archipelago—the near elimination of tussac grass being one of the most notable changes. Tracing back to early accounts of tussac grass in the ‘Falklands’, this paper captures its discovery, exploitation and current stage of renewal, including a closer look at the connections between tussac and livestock farming, as well as parallel trends in other countries. We narrate changing relations between people and tussac grass using a combination of interview data, historical accounts and scientific literature. Tussac is presented as a historical bellwether of shifting trends in local farm and environmental management in this isolated archipelago. Shifts in land ownership, grazing management methods and conservation efforts are bringing momentum to a period of renewal across the Falklands

    Numerical simulation of ultrasonic flowmeters

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    Iterative PNS method for attached flows with upstream influence

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