Loperamide (Imodium, Janssen-Ortho Inc, North York, Ontario/McNeil Consumer Products, Guelph, Ontario) is a synthetic piperidine derivative used for the treatment of both acute and chronic diarrhea. It exerts its action via cholinergic, noncholinergic, opiate and nonopiate recep­tor-mediated mechanisms. After oral administration, little systemic absorption takes place. About 40% ofa2 mg dose is excreted in the [...]

Gelb and associates have described the physiologic characteristics of malignant unilateral mainstem bronchial obstruction in patients treated with laser therapy. In their most recent series, eight patients without a prior history of COPD had a restrictive pattern on flow volume loops, four with associated air flow obstruction. After treatment, all patients had an increase in [...]

The perfusion lung scan was of substantial clinical utility in our setting; 36 percent of patients referred with suspected pulmonary embolism had normal lung scans. These patients were spared further investigation and treatment for venous thromboembolism. The frequency of normal perfusion scans in patients with suspected pulmonary embolism ranges from 13 to 49 percent. The [...]

The results indicate that patients with suspected pulmonary embolism and a normal perfusion lung scan have an excellent prognosis without anticoagulant therapy. Symptomatic venous thromboembolism was rare on follow-up in our patients with normal perfusion scans (0.6 percent [three of 515 patients]). Further, two of the three patients with venous thromboembo­lism on follow-up had predisposing [...]

Patients The 515 consecutive patients with clinically sus­pected pulmonary embolism and normal perfusion scans ranged in age from 14 to 93 years (mean, 45 years); 154 (30 percent) were men and 361 (70 percent) were women. Their clinical characteristics are shown in Table 1. Of the 515 patients, 361 patients (70 percent) were outpatients at [...]

Rtiients Between 1981 and 1988,1,420 consecutive patients with clinically suspected pulmonary embolism were referred to the Thromboem­bolism Service at Chedoke-McMaster Hospitals and were studied prospectively. The 515 (36 percent) of these patients who had normal perfusion lung scans are the subject of this report. The findings in the patients with abnormal perfusion scans have been [...]

The perfusion lung scan is a pivotal test in the diagnosis of pulmonary embolism. In this test, which reflects the relative distribution of pulmonary blood flow, intravenously injected particles of radio­active macroaggregated albumin lodge in the pulmo­nary microcirculation. The distribution of these par­ticles is measured by scanning the chest with a gamma camera in several [...]