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C Tamm

Publications and source records attributed to C Tamm.

At least 19 recordsLinked to original sources
PubMed1998

Diagnostic accuracy of Doppler-echocardiography in unselected patients with suspected pulmonary embolism.

This study investigates the diagnostic value of echocardiography in patients with suspected pulmonary embolism. Doppler-echocardiography was performed in fifty consecutive patients, predominantly presenting in the emergency ward, with clinically suspected pulmonary embolism. Patients were classified as having or not pulmonary embolism by a sequential non-invasive strategy including lung scan, D-dimer measurement and lower limb venous compression ultrasonography, pulmonary angiography being performed in case of an inconclusive non-invasive work-up. The prevalence of pulmonary embolism was 36% (18 of 50 patients). Right ventricular dilatation on 2-D echocardiography associated to a tricuspid regurgitation velocity > or =2.7 m/s, corresponding to a pulmonary systolic pressure > or =39 mmHg, were present in 12 of the 18 patients (67%) with and in two of the 32 patients (6.3%) without pulmonary embolism. They were, however, absent in five of the 18 patients (28%), in whom the definite diagnosis of pulmonary embolism was made. The combination of these both echocardiographic criteria yielded a sensitivity of 67% and a specificity of 94%, positive predictive value was 86% and negative predictive value was 83%. The diagnostic performance of these two combined echocardiographic criteria, when present, permitted to reach in patients with a high clinical pre-test probability of pulmonary embolism the post-test probability values above 90%. On the other hand, the absence of these two Doppler-echocardiographic criteria did not allow to exclude pulmonary embolism, except in presence of a low pre-test probability. The findings of our study show that Doppler-echocardiography in patients with high clinical suspicion of pulmonary embolism may represent a potentially useful screening technique for the diagnosis of the disease permitting prompt initiation of treatment. However, the method does not allow to exclude pulmonary embolism in all patients with intermediate or high clinical suspicion of the disease.

Dilatation, Pathologic↗
PubMed1994

Substrate competition in postischemic myocardium. Effect of substrate availability during reperfusion on metabolic and contractile recovery in isolated rat hearts.

Normal myocardium can derive energy for contraction and relaxation from oxidative metabolism of a variety of substrates. This investigation examined the influence of substrate availability early during reperfusion on the substrate pattern of oxidative metabolism and recovery of contractile function. For this purpose, isovolumically beating isolated rat hearts, perfused retrogradely with erythrocyte-supplemented buffer containing 0.4 mmol/L palmitate and 11 mmol/L glucose, were subjected to 40 minutes of no-flow ischemia. Hearts were reperfused with medium containing selected concentrations of palmitate and glucose. The substrate pattern for oxidative metabolism was determined on the basis of myocardial release of 14CO2 after equilibration of the hearts during the initial 15 minutes of reperfusion with either [1-14C]palmitate or [U-14C]glucose. In continuously perfused control hearts, glucose oxidation was largely inhibited by palmitate. During postischemic reperfusion, oxidation of glucose was increased by 59% (P < .05) and 467% (P <.01) in hearts reperfused after the ischemic period with 11 mmol/L glucose plus 0.4 or 1.2 mmol/L palmitate, respectively. Oxidation of palmitate was concomitantly reduced during reperfusion at low (0.4 mmol/L) but not at high (1.2 mmol/L) palmitate concentration. Compared with hearts reperfused with medium containing 0.4 mmol/L palmitate as sole substrate, hearts reperfused with medium containing 11 mmol/L glucose with 0.4 mmol/L palmitate exhibited lower left ventricular diastolic pressure (69 +/- 5 versus 90 +/- 3 mm Hg [mean +/- SEM], P < .05), less release of creatine kinase (31 +/- 5 versus 59 +/- 7 U/g wet wt, P < .05), and better recovery of left ventricular pressure development (26 +/- 9 versus 6 +/- 4 mm Hg, P < .05). Omission of palmitate or increasing the palmitate concentration to 1.2 mmol/L did not significantly alter postischemic myocardial contracture and enzyme release. The findings support the view that glucose oxidation early during reperfusion may be crucial for functional recovery. The results further indicate that interaction of substrates of oxidative metabolism is altered in severely injured postischemic myocardium. Inhibition of glucose oxidation by fatty acids was partially reversed during reperfusion.

Adenosine Triphosphate↗
PubMed1992

Myocardial fatty acid oxidation during ischemia and reperfusion.

Inhibition of fatty acid oxidation is an early event in myocardial ischemia that most likely contributes to tissue injury by the accumulation of potentially toxic intermediates such as acylCoA and acylcarnitine. After reperfusion both myocardial oxygen consumption and fatty acid oxidation may rapidly recover to preischemic levels, even when contractile function remains depressed. The mechanisms underlying the apparent dissociation between contractile function and oxidative metabolism early during reperfusion are still controversial. In isolated rat hearts subjected to 60 min of no-flow ischemia myocardial oxygen consumption and oxidation of palmitate were lowered during reperfusion by 3 mM of NiCl2 and by 6 microM of ruthenium red. The results provide indirect evidence for the hypothesis that intracellular calcium transport may be involved in the mechanisms responsible for the high oxidative metabolic rate early after reperfusion.

Acute Disease↗
PubMed1990

Effects of atrial natriuretic factor on angiotensin-II-and phorbol ester-stimulated protein kinase-C and prostacyclin production in cultured rat aortic smooth muscle cells.

The vasoconstrictor hormone angiotensin-II (AII) raises cytosolic free calcium and stimulates protein kinase-C (PKC) activity in vascular smooth muscle cells (VSMC). Phorbol-12-myristate-13-acetate (PMA) directly activates PKC in these cells. Both of these agonists stimulate prostacyclin production. Several studies have shown that atrial natriuretic factor (ANF) does not interfere with the AII-induced early calcium response. We, therefore, examined the effects of ANF on PKC activity and prostacyclin production in cultured rat aortic VSMC. PKC activity was determined in the membranous and cytosolic fractions after anion exchange chromatography. ANF (10(-7) M) inhibited by 44 +/- 3% and 39 +/- 8% the increase in membranous PKC activity induced by AII and PMA, respectively. ANF (10(-7) M) inhibited PMA-stimulated prostacyclin production, whereas AII-induced prostacyclin production remained unaffected. Thus, our results suggest that some biological effects induced by ANF in VSMC are mediated by an inhibition of membranous PKC activity.

Angiotensin II↗
PubMed1989

Interaction of oxindanac and frusemide in man.

Oxindanac, a moderately active cyclo-oxygenase inhibitor in vitro, is a new antiinflammatory agent under clinical investigation. Its effects on frusemide-induced natriuresis have now been studied. Eight male volunteers receiving frusemide 40 mg b.d. were also given either oxindanac 300 mg b.d. or placebo in two consecutive periods separated by a treatment-free period, according to a randomized cross-over study design. Urinary prostaglandin excretion (PGF2 alpha) fell by 75% after 3 days on oxindanac. Frusemide-induced renin activity reached 66% of the control value in the presence of oxindanac. However, the natriuresis induced by frusemide did not differ significantly whether oxindanac or placebo was administered, despite the inhibitory action of the former on prostaglandin synthesis in vivo.

Adult↗
PubMed1985

High performance liquid chromatographic assay of disaccharides and oligosaccharides produced by the digestion of glycosaminoglycans with chondroitin sulphate lyases.

In high performance liquid chromatographic procedures hitherto described, SiO2, NH2 and RP columns have been used for the analysis of disaccharides produced by the digestion of glycosaminoglycans with the chondroitin sulphate lyases AC and ABC. The use of a potent anion exchanger offers the following advantages over these columns: superior separation characteristics for non-sulphated disaccharides, and improved column performance, coupled with more stable analytical conditions. Elution with dilute saline solutions permits separation of the two non-sulphated disaccharides from chondroitin and hyaluronate. The sequential application of chondroitinase AC and ABC permits the determination of hyaluronate, the chondroitin sulphate isomers and the dermatan sulphate isomers by high performance liquid chromatographic separation of the products of enzymatic hydrolysis. In a previously described method, hyaluronate lyase was used for the determination of hyaluronate. It has been found, however, that omission of the hyaluronate lyase step results in superior accuracy in the high performance liquid chromatographic separation of the non-sulphated disaccharides. The enzymatic analysis of human articular cartilage glycosaminoglycans has repeatedly yielded a fraction which is not digestable by chondroitinase AC, but is completely digestable by chondroitinase ABC. More extensive characterization has disclosed that this fraction differs structurally from chondroitin sulphate. Enzymatic characterization indicates that it should presumably be assigned to dermatan sulphate.

Cartilage↗