Abstract
HE ABILITY OF living cells and tissues to function properly is directly linked to basic biochemical events. The term metabolism is used to described the integrated, concerted cellular biochemical processes that support cell and organ functions. Metabolism is the fundamental basis for understanding function and physiology in living systems. Therefore, any method or methods that provide localized metaboiic infor mation for clinical diagnostic use should be of significant value. A central issue in the study of most disease states is the correlation between the pathophysiology and the 'metabolic competence of the region incurring injury or disease. This problem is particularly important for conditions that involve compromised blood flow and oxy genation to an organ or part of an organ having obligatory requirements for these two compo nents. Myocardial infarction and cerebrovascu lar occlusion (stroke) are two prominent exam ples. Important elements in the clinical treat ment of infarction and stroke are determinations of the location, size, and extent of the injury, and a knowledge of the time course of metabolic impairment and the onset ofirreversible damage. Although there are techniques that use x-rays, ultrasound, and radionuclides (nuclear medi cine) for determining the size and location of injury, to date there is no clinically useful method of directly and noninvasivcly assessing the metabolic competence of an injured site. Even the use of essential biochemical substrates labeled with positron-emitting isotopes in emis sion tomography (PET) does not allow one to follow metabolic processes. In general, PET can only provide information on cellular uptake, and not utilization, of a particular biochemical sub strate. Thus, the noninvasive determination of metabolic function for characterizing the extent of deterioration and for the periodic monitoring of the efficacy of therapies on impaired regions would be extremely useful.
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