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Biomedical subjects

B Soto

Publications and source records attributed to B Soto.

At least 55 records · Page 3Linked to original sources
PubMed1987

Morphology of occlusive coronary lesions during acute myocardial infarction: an angiographic and clinical analysis.

In an attempt to identify angiographic and clinical predictors of reperfusion, 42 patients who received intracoronary streptokinase during the early phase of myocardial infarction were analyzed. The different morphologies (regular and irregular) of the occlusive lesions did not show a significant relation with the response (reperfusion vs nonreperfusion) to intracoronary streptokinase; neither did the presence of angiographically visualized thrombus in the infarct-related artery favor reperfusion. Among the clinical variables analyzed (previous myocardial infarction, previous angina, diabetes mellitus, hypertension, use of tobacco, and hyperlipidemia), a history of previous angina was significantly related to absence of reperfusion (p = 0.001). Although the presence of thrombus showed a trend toward reperfusion (p = 0.1), overall, our angiographic observations did not contribute to predicting the response to streptokinase. Further studies are needed to identify morphologic criteria favoring reperfusion and select groups of patients most likely to benefit from it.

Adult↗
PubMed1987

Nimodipine-treated subarachnoid hemorrhage associated with acute pseudo-obstruction of the colon.

Nimodipine is being used with increasing frequency in the prevention or treatment of vasospasm due to subarachnoid hemorrhage. Few side effects have been described. An acute pseudo-obstruction of the colon (Ogilvie's syndrome) in a patient treated with an intravenous infusion of nimodipine is reported. The possible relationship between this serious complication and the use of this drug is discussed.

Acute Disease↗
PubMed1987

Role of computed tomography in nonobstructive coarctation.

Two cases of nonobstructive or pseudocoarctation of aorta evaluated by computed tomography are presented. Clinical features along with chest radiography and computed tomography findings provided specific information, making further workup by catheterization and angiography unnecessary. As most cases of nonobstructive coarctation are asymptomatic and require no treatment, its recognition is of great practical importance.

Aortic Coarctation↗
PubMed1987

Evaluation of aortic insufficiency by Doppler color flow mapping.

The color Doppler echocardiographic studies and aortic angiograms of all patients who had these procedures performed within 2 weeks of each other between October 1984 and August 1985 were reviewed to determine whether any parameters of the regurgitant jet visualized by color Doppler study predicted the severity of aortic insufficiency as assessed by angiographic grading. Patients with an aortic valve prosthesis were excluded. Twenty-nine patients had aortic insufficiency and had adequate color Doppler studies for analysis. The mean time between color Doppler examination and angiography was 2.3 days (range 0 to 12). The maximal length and area of the regurgitant jet were poorly predictive of the angiographic grade of aortic insufficiency. The short-axis area of the regurgitant jet from the parasternal short-axis view at the level of the high left ventricular outflow tract relative to the short-axis area of the left ventricular outflow tract at the same location best predicted angiographic grade, correctly classifying 23 of 24 patients. However, the jet could be seen from this view in only 24 of the 29 patients. The height of the regurgitant jet relative to left ventricular outflow tract height measured from the parasternal long-axis view just beneath the aortic valve correctly classified 23 of the 29 patients. Mitral stenosis or valve prosthesis, which was present in 10 patients, did not interfere with the diagnosis or quantitation of aortic insufficiency by these methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Color Doppler assessment of mitral regurgitation with orthogonal planes.

We evaluated 147 patients with adequate color Doppler and angiographic studies for mitral regurgitation. Sixty-five patients had no mitral regurgitation by both color Doppler and angiography and 82 patients had mitral regurgitation by both techniques. Thus the sensitivity and specificity of color Doppler for the detection of mitral regurgitation was 100%. Three two-dimensional echocardiographic planes (parasternal long and short axis, apical four-chamber view) were used to analyze variables of the mitral regurgitant jet signals in the left atrium. The best correlation with angiography was obtained when the regurgitant jet area (RJA) (maximum or average from three planes) expressed as a percentage of the left atrial area (LAA) obtained in the same plane as the maximum regurgitant area was considered. The maximum RJA/LAA was under 20% in 34 of 36 patients with angiographic grade I mitral regurgitation, between 20% and 40% in 17 of 18 patients with grade II mitral regurgitation, and over 40% in 26 of 28 patients with severe mitral regurgitation. Maximum RJA/LAA also correlated with angiographic regurgitant fractions (r = .78) obtained in 21 of 40 patients in normal sinus rhythm and with no evidence of associated aortic regurgitation. Other variables of the regurgitant jet such as maximal linear and transverse dimensions, maximal area, or maximal area expressed as a percentage of the LAA in one or two planes correlated less well with angiography. Color Doppler is a useful noninvasive technique that is not only highly sensitive and specific in the identification of mitral regurgitation but also provides accurate estimation of its severity.

Adolescent↗
PubMed1986

Spectrum of hearts with one underdeveloped and one dominant ventricle.

Hearts with one underdeveloped and one dominant ventricle form a spectrum of anomalies extending from the heart with two clearly adequate chambers to those with a true single ventricle. An angiographic concept of grouping such hearts is presented. 129 patients with unequal ventricles underwent catheterization and cineangiography between 1974 and 1983. The age at first catheterization ranged from one day to 24 years (mean 3.9 years). Male-female ratio was 2:1. Five groups of hearts (with their relative frequencies in the spectrum) were established: dominant left ventricle (53%); dominant right ventricle (20%), each with normally related chambers; dominant left ventricle (20%); dominant right ventricle (3%), each with ventricular inversion; true single ventricle (5%). The incidence of atrial anatomy, venous return, intracardiac connections and associated lesions within each group was assessed. From the standpoint of deranged physiology as well as surgical implications there are more similarities than differences among these hearts. The fact that one ventricle will not generate an adequate stroke volume after repair is overwhelmingly more important than most other considerations. For the diagnostic and surgical approach, we believe that the system offers many advantages.

Adolescent↗
PubMed1986

Aortic dissection masquerading as gastrointestinal disease.

Presentation of aortic dissection (AD) typically includes chest and/or abdominal pain. Gastrointestinal (GI) symptoms other than abdominal pain are uncommon. Two patients with AD are described in whom the dominant presenting symptom was GI hemorrhage. Mesenteric infarction complicated acute Type I dissection in one patient whose clinical manifestations simulated ulcerative colitis. In the other patient an old, small asymptomatic Type III AD resulted in a false aneurysm in the retroperitoneum which ruptured into the duodenum. In the latter case an antemortem diagnosis was not made as angiography was limited to the visceral arteries and the abdominal aorta without appreciation of the significance of a focal compression of the abdominal aorta. The possibility of AD thus should also be considered in the evaluation of a patient with acute GI bleeding.

Aortic Dissection↗
PubMed1986

Digital and conventional chest imaging: a modified ROC study of observer performance using simulated nodules.

A modified receiver operating characteristic (ROC) study was performed in which five readers were asked to locate multiple nodules on images of an anthropomorphic phantom obtained with a prototype digital radiographic chest unit and with a conventional chest unit. Results indicate that when nodules were projected over the lungs, a significantly greater number (significant at the 5% level) were identified on conventional radiographs, whereas for nodules projected over the mediastinum, the digital images were notably superior (difference significant at the 2% level). An error analysis of the multiple nodule problem and pseudo-ROC curves are presented. The modified ROC study does not suffer from the positional ambiguity inherent in most ROC studies and is efficient in acquiring data.

Analog-Digital Conversion↗
PubMed1986

Congenital pulmonary vein stenosis: a radiographic study.

Seven patients with congenital pulmonary venous stenosis were retrospectively evaluated. Chest radiographs and pulmonary angiograms were interpreted without knowledge of anatomic findings, and results were correlated with autopsy data. Bilateral foci of stenosis of varying severity were found in all patients but occurred with greater frequency and severity in the left-sided pulmonary veins. Chest radiographic findings revealed asymmetric pulmonary vascularity in all patients. Shunt vascularity was seen in three right upper zones and three right lower zones but was not observed in any of the left lung zones. In seven patients angiograms revealed asymmetry in the size and number of pulmonary arterial branches. Arterial vascularity was increased in two right upper zones and four right lower zones but was not increased in any of the left lung zones. Pulmonary veins from 22 zones were visualized. Pulmonary venous opacification was delayed, asymmetric, and asynchronous in the majority. Venoatrial stenosis was seen in veins from 18 zones. Congenital pulmonary vein stenosis can be suspected based on chest radiographic findings of asymmetry of pulmonary vascularity between both lungs as well as regional discrepancies in the vascularity within each lung. Pulmonary angiography can support the diagnosis.

Angiography↗
PubMed1986

New cineradiographic methods for assessment of Bjork-Shiley valve integrity.

The Bjork-Shiley prosthesis has been used extensively for valvular replacement since 1969. Despite its widespread use, it is subject to complications that can be assessed with cineradiography. New methods are presented for assessment of incomplete closing and opening angles that occur with valvular malfunction. Alternative methods of cineradiographic measurement are compared with each other and with the new method. The new method is an appropriate alternative when the conventional double-profile method cannot be used and distributes the burden of performance and complexity between the technologist and radiologist. This new method is shown to be accurate to within 1 degree.

Aortic Valve↗