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Biomedical subjects

E Isik

Publications and source records attributed to E Isik.

7 recordsLinked to original sources

Primary chylopericardium.

Primary chylopericardium is a rare entity. Here we describe a 36-year-old, asymptomatic male in whom pericardial effusion was detected by chest X-ray and echocardiography on routine health control. After pericardiocentesis that revealed the chylous nature of the fluid, partial pericardiectomy without duct ligation was carried out. In the follow-up period, there was no evidence of pericardial fluid on chest X-ray and echocardiography, at three months after the procedure.

Adult↗

Spironolactone does not prevent restenosis after coronary stenting in humans.

INTRODUCTION: In animal studies, aldosterone enhanced neointimal proliferation by increasing extracellular accumulation of collagen and potentiating the effects of angiotensin II. Spironolactone, an aldosterone antagonist, is a potent inhibitor of neointimal proliferation. We conducted a placebo-controlled, double-blind, randomised study to assess the effect of spironolactone on angiographic 6-month in-stent restenosis. MATERIALS AND METHODS: Of the 310 randomised patients with significant coronary artery disease, 258 patients were available for analysis: 128 constituted the placebo group and 130 were assigned to receive spironolactone. Eligible patients were randomly assigned to receive a dose of 50 mg spironolactone or placebo orally twice a day for 6 months. The primary endpoint was the angiographic restenosis (>50% stenosis) rate at follow-up angiography. RESULTS: At 6-month follow-up angiography after stenting, there was no difference between the 2 groups in minimal lumen diameter, percent diameter stenosis, late loss, and net gain. Angiographic restenosis occurred in 46 (35.4%) of 130 patients receiving spironolactone and 50 (39.0%) of 128 in the placebo group with an odds ratio (OR) of 0.85 with a 95% confidence interval (CI) of 0.49 to 1.46 (P = 0.62). Restenosis rate was found in 60 (32.9%) of 182 lesions in the spironolactone group, and 61 (35.5%) of 172 lesions in the placebo group with an OR of 0.89 with a 95% CI of 0.56 to 1.42 (P = 0.89). CONCLUSIONS: Spironolactone did not reduce the incidence of in-stent restenosis as compared with placebo in human, contrary to the fact that reduction of neointimal formation in animal models has been observed upon administration of spironolactone.

Adult↗

PTCA in chronic total occlusions: clinical results with a wire system.

The authors discuss the use of a wire system in chronic total occlusion, noting the factors that affect primary success and the clinical results. Percutaneous transluminal coronary angioplasty was performed on 29 patients with single-vessel disease. The mean age of the patients was fifty-three +/- three years. The authors used routine angioplastic techniques with the wire system. Fifteen of the lesions were functional and the others were in total anatomic occlusion. The primary success rate was 69%. Primary success was 88%, 48%, and 75%, in the left anterior descending, left circumflex, and right coronary artery, respectively. In 4 cases the wire did not cross the occlusion. One patient required direct-current cardioversion for ventricular fibrillation during the procedure, and 1 patient sustained a non-Q wave myocardial infarction following the procedure. There were no deaths.

Adult↗

Late hemodynamic changes in percutaneous mitral valvuloplasty.

Percutaneous mitral valvuloplasty (PMV) was performed in 57 patients with mitral stenosis. Twenty-three women and 34 men (mean age 28 +/- 10 mean +/- SD) were included in the study. A single-balloon (trefoil or bifoil) technique was used in 49 patients and a double-balloon (trefoil + monofoil) technique in eight. After a 3-month follow-up period, right- and left-sided cardiac catheterization was repeated. In the single-balloon group there was improvement in the mitral valve gradient (16.10 +/- 5.99 to 4.41 +/- 2.03 mm Hg), mean left atrial pressure (22.65 +/- 6.13 to 9.76 +/- 3.01 mm Hg), and mitral valve area (0.89 +/- 0.22 to 1.95 +/- 0.46 cm2/m2). Mean pulmonary artery pressure and mean pulmonary wedge pressure decreased to 19.33 +/- 4.19 mm Hg and 10.73 +/- 2.60 mm Hg from 32.94 +/- 7.90 mm Hg and 21.49 +/- 5.98 mm Hg. Cardiac output increased to 6.86 +/- 0.56 L/min from 5.57 +/- 0.66. All improvements were statistically significant (p less than 0.001). In the double-balloon study group, mitral valve gradient (23.75 +/- 2.77 to 4.50 +/- 1.94 mm Hg), mean left atrial pressure (31.63 +/- 3.57 to 9.50 +/- 1.94 mm Hg), mean pulmonary artery pressure (44.00 +/- 6.36 to 18.88 +/- 7.10), and mean pulmonary wedge pressure (29.25 +/- 3.73 to 10.25 +/- 1.85 mm Hg) all improved significantly (p less than 0.001). Mitral valve area and cardiac output increased from 0.89 +/- 0.15 to 2.44 +/- 0.44 cm2/m2 (p less than 0.001) and from 5.46 +/- 0.76 to 7.15 +/- 0.52 L/min (p less than 0.002), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Multivariate correspondence analysis of a visually screened EEG. Application to a study of psychotropic drugs compared with placebos (author's transl)].

Eighty-seven EEG recordings were obtained from 9 healthy volunteers, medical students who were part of a controlled, double-blind, randomized study. After a first control recording, they received orally, at 1 week interval, either 3 placebos or 3 compounds: yohimbine chlorhydrate (4 mg), propranolol (40 mg), a psychotropic compound in experimentation. The polygraphic recordings were obtained 2 or 6 h after placebos or active compounds. Four EEG channels were recorded simultaneously (T4-C4, T3-C3, P4-O2, P3-O1). The EEGs were sampled at 200 Hz, for 120 successive epochs, free of artifacts. The recordings of 5 min were then submitted to spectral analysis followed by data reduction providing characteristic spectral parameters. A descriptive questionnaire of EEG made of 100 items was filled out by two electroencephalographists for each of 87 recordings. The items, with dichotomic choices, described 4 EEG frequency bands: delta, theta, alpha, and fast frequencies (beta). For each frequency band the following was evaluated: frequency, amplitude, asymmetry, morphology, relative abundance, irregularity, lability of frequency, diffusion, dominant localization, EMG activity and superposition of rhythms. The number of periods of drowsiness in 5 min and fluctuations of rhythms were also ascertained in the same way. The items were coded on punch cards and submitted to a first analysis of correspondences. The 3 factorial planes were plotted with the projections of each item together with the centers of gravity of placebos and treatments. The first factor can be interpreted as a bipolar axis 'mental activation-diffused vigilance', the first pole being characterized by a 'beta cluster' and the second by alpha and theta superimposed clusters. The second factor can be also considered as a bipolar axis 'drowsiness -quiet wakefulness', the first pole being characterized by a 'theta cluster' and a larger 'delta cluster' containing a smaller 'alpha cluster' of labile alpha rhythm intermingled with slower rhythms. In respect to the barycentric centers of gravity, yohimbine and propranolol are opposed to the placebo center along the factor-two axis. This may be considered as an 'anti-sedation effect'. However, along the first factor axis, the propranolol center can be associated with a greater diffusion of vigilance than the yohimbine center.

Adult↗

Brain natriuretic peptide and the severity of aortic regurgitation: is there any correlation?

We aimed to evaluate the correlation between aortic regurgitation severity and brain natriuretic (BNP) levels as a marker for left ventricular dysfunction. Sixty consecutive male patients (mean age 22 +/- 3 years) with isolated chronic aortic regurgitation were enrolled in the study together with a control group of 30 age-matched healthy volunteers (group A). Patients were classified with regard to aortic regurgitation vena contracta width as follows: group B, < 3 mm, mild (n = 16); group C, > or = 3 and < 6 mm, moderate (n = 26); group D, > or = 6 mm, severe (n = 18). BNP measurements were performed with a fluorescence immunoassay kit. BNP levels were increased in patients with aortic regurgitation, and severity of regurgitation had a significant influence on BNP levels. This effect can be explained by the volume loading effect of aortic regurgitation.

Adult↗