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Biomedical subjects

A Sjögren

Publications and source records attributed to A Sjögren.

At least 109 records · Page 6Linked to original sources

Electrocardiographic changes in right ventricular infarction. A case report.

ST segment elevations in leads CR4R or V4R indicating right ventricular (RV) involvement are sometimes seen in patients with acute inferior transmural infarction. Whether the RV lesion per se or the concomitant infarction of the posterior septum causes this ECG pattern is unknown. We describe a patient with anteroseptal transmural infarction who developed unusually marked ST segment elevations in lead V4R. At autopsy, extensive old fibrotic infarction was found, involving the anterior and lateral RV walls, as well as recent necrosis of the interventricular septum. These findings suggest that the ST segment elevation in V4R in patients with RV infarction may not be caused by the RV necrosis per se but rather by visualization of the posterior septum through the necrotic RV myocardium.

Acute Disease↗

Acute influence of LH and FSH on cyclic AMP formation in isolated granulosa cells of the rat.

A technique for the mechanical isolation of granulosa cells from the rat ovary is described. Cyclic AMP formation by the isolated granulosa cells of the follicles in various stages of development was studied in response to the administration in vitro of gonadotrophins. In granulosa cells from small to medium-sized follicles FSH but no LH stimulated cAMP formation, while in cells from pre-ovulatory follicles both gonadotrophins had a stimulatory effect. The effects of both gonadotrophins were transient with a maximal response after 15 to 60 min of incubation. In the presence of the phosphodiesterase inhibitor, 3-isobutyl-methylxanthine, the action of FSH was potentiated and prolonged while the response to LH was unaffected. These data indicate that both gonadotrophins activate the adenylate cyclase system of the isolated granulosa cells while FSH in addition stimulates the phosphodiesterase activity. Consecutive determinations of cAMP during and after the pre-ovulatory LH-FSH surge, demonstrated a rise of cAMP levels in granulosa cells from the pre-ovulatory follicles following endogenous gonadotrophin release. cAMP levels remained high or increased until the time of ovulation.

Animals↗

Complete heart block due to granulomatous giant cell myocarditis: report of 3 cases.

3 patients with chronic complete AV block were found at autopsy to have granulomatous giant cell myocarditis (GGCM). In 1 patient an unusual clinical course led to more extensive investigation including echocardiography which revealed ventricular septal abnormalities. A review of the literature is presented. Although GGCM is a rare disease echocardiography may be a useful screening procedure in patient with AV block especially in the presence of immunological disorders.

Adult↗

Ventricular arrhythmias prior to discharge and one year after acute myocardial infarction.

Ventricular ectopic beats (VEB) were studied in 100 consecutive patients prior to discharge after an acute myocardial infarction and again after 1 yr, on 6-h recordings. VEB were found in 71 patients prior to discharge. Reinfarction and sudden death taken together were significantly more common in the 35 patients who had severe VEB, i.e. multiform, paired, R-on-T or ventricular tachycardia (P less than 0.05). Reinvestigation after 1 yr of 73 survivors who had not reinfarcted revealed a nonsignificant overall increase in patients with VEB from 67 to 78% together with an increase in degree of severity. The intraindividual pattern, however, differed considerably. Several clinical findings including angina pectoris, heart fialure, hypertension, diabetes mellitus, hyperlipidemia, antiarrhythmic therapy, and smoking, failed to differentiate patients with increasing VEB severity from the remainder.

Acute Disease↗

Single right-sided precordial lead in the diagnosis of right ventricular involvement in inferior myocardial infarction.

The ST segment in a single right-sided chest lead, CR4R, has been studied in 92 consecutive patients with acute inferior transmural left ventricular myocardial infarction. A transient ST- segment rise of more than 1 mm. was recorded in 35 patients, and strongly indicated a significant extension of the infarction to the posterior free right ventricular wall according to autopsy findings. This ECG pattern was furthermore associated with right-sided heart failure, hypotension and oliguria. Left heart failure was also common. The short-term prognosis of patients with ST-segment elevation in CR4R was poor.

Aged↗

Pattern of enzyme activity following acute myocardial infarction with special reference to gamma-glutamyl transpeptidase.

The present study on 55 consecutive patients with acute myocardial infarction (AMI) draws attention to the relationship between different enzyme maxima in AMI, with special reference to serum gamma-glutamyl transpeptidase (S-GT). In more than 60% of the patients the S-GT was increased during the hospital stay. The S-GT rise nearly always began during the first days, reached a maximum within 5--8 days and normalized with 2--3 weeks. We failed to find the late increase in S-GT reported by others. The rise of S-GT is particularly common in patients with inferior infarction, with or without right ventricular involvement. We conclude that S-GT activity is not a useful early or late indicator of AMI but a very sensitive test for hepatic dysfunction in patients with AMI.

Acute Disease↗

Attempted diagnosis of ventricular mural thrombi in acute mycardial infarction using 125I-labelled fibrinogen.

In an attempt to diagnose ventricular mural thrombi complicating acute myocardial infarction (AMI), 80 patients have been given 100 muCi 125I-labelled fibrinogen after admission to a CCU. Precordial radioactivity was recorded for the following 6 days over four sites corresponding to chest leads CR1-CR4. A sustained rise in radioactivity of at least 15% of initial recordings was classed as type A pattern, a minor rise or flattened response as type B pattern and a rapid decrease as type C pattern; 28% showed a type A, 19% a type B and 54% a type C pattern. There was no significant difference between the groups in incidence of pericardial friction rub but when patients with suspected pericarditis (as evidenced by characteristic pains) were added, pericarditis was significantly overrepresented in the type A group. Smaller infarctions (SGOT less than 100 U/1) were significantly more common in patients with a type C decay pattern. No differences were noted between the groups as regards type and site of the infarction. A sustained rise in precordial radioactivity after an AMI may be an indication of mural thrombosis but the influence of other factors secondary to an infarction, e.g. pericarditis, cannot be determined at present.

Acute Disease↗

The value of an oscilloscope in routine checking of pacemakers.

An evaluation has been made of the usefulness of the oscilloscope at routine check-ups of cardiac pacemakers. Measurements of 100 consecutive implanted pacemakers, obtained after their removal have been compared with changes in rate and changes in impulse duration and amplitude obtained at previous routine controls. Other changes in pacemaker characteristics have also been evaluated. Eight faulty pacemakers were found. Six had a decreased voltage, none however, less than 3.5 volts. Five of them had shown a decrease in rate by at least 7 impulses per minute, while in one QRS-synchronized pacemaker the synchronizing circuit did not function. In one pacemaker the stimulating rate had increased with 20 impulses while in one P-synchronized pacemaker the delay time had decreased. In 6 patients a significant decrease of the impulse amplitude was noticed without fall in voltage or electronic failure and in 3 others no decrease of the impulse duration was noticed in spite of decreased voltage at check after explantation. The present study therefore indicates that, at routine check-ups of the presently analyzed pacemakers with voltage depending stimulation rate, an analysis of the latter gives satisfactory information of pacemaker function and can be used instead of oscilloscope test, eventually in combination with electronic measurements of impulse duration.

Evaluation Studies as Topic↗

Selected psychosocial variables in the delay of reaching the coronoary care unit.

Sixty-one first admissions to a coronary care unit have been analysed regarding "delay period" from onset of chest pain to admission to the CCU in relation to psychosocial information, collected from the closest relative. On the whole, psychosocial variables seemed to play a modest role in the determination of the delay period. However, one "type A behavior" variable, inability to relax during leisure time, was related to a shorter delay period. Young subjects tended to have a relatively short delay.

Age Factors↗

Effect of quinidine on maintaining sinus rhythm after conversion of atrial fibrillation or flutter. A multicentre study from Stockholm.

In a controlled study comprising 176 patients, quinidine in the form of Kinidin Durules was found to reduced significantly the recurrence of the atrial fibrillation during a 1-year follow-up period after successful electric shock conversion. After one year, 51 per cent (52/101) of the patients in the quinidine group, and 28 per cent (21/75) in the control group remained in sinus rhythm (P smaller than 0.001). No less than 43 per cent of the patients converted to sinus rhythm during treatment with maintenance doses of quinidine sulphate before intended DC conversion. Gastrointestinal side-effects were not uncommon, and caused interruption of quinidine treatment in some cases.

Adult↗

Prediction of sudden death in patients discharged after acute myocardial infarction.

A follow-up was made of 475 patients discharged after an acute myocardial infarction. Sudden death, i.e. death within 2 hours after the onset of the final attack, was more common in patients below 60 years on admission than in the older age groups. Patients succumbing suddenly often had a history of an earlier myocardial infarction. They also had a higher incidence of inferior infarcts and more frequently showed ventricular tachycardia during the early hospital period than those dying more than 24 hours after the onset of the final episode. When comparisons were made with all patients dying after more than 2 hours' duration of the terminal attack no significant differences were noted for these or other parameters. Prediction of sudden death in immediate survivors of acute myocardial infarction thus seems elusive. Further studies of the relations between the incidence of ventricular ectopic activity during the early and late hospital phase of acute myocardial infarction and sudden death after discharge from hospital are implicated.

Acute Disease↗