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Biomedical subjects

J Angel

Publications and source records attributed to J Angel.

At least 73 records · Page 4Linked to original sources
PubMed1984

Bidirectional shunt in uncomplicated atrial septal defect.

The presence of right to left shunts at atrial level in 40 patients with an uncomplicated atrial septal defect was determined by measuring the pulmonary vein to systemic artery oxygen stepdown . In six patients (group 1) a sizeable right to left shunt was found: left atrial oxygen stepdown was greater than or equal to 0.7 vol%, mean right to left shunt 0.67 1/min/m2 (range 0.36-1.0), and arterial oxygen saturation between 84% and 90.5%. The patients in group 1 did not show any differences from those with left to right shunts alone (group 2) as regards sex, cardiac rhythm, heart rate, "a" wave and mean right atrial pressure, end diastolic right ventricular pressure, morphology of diastolic right ventricular pressure curves, pulmonary to systemic vascular resistance ratio, size of the defect, and coexistence of anomalous pulmonary venous drainage. Patients with coexisting right to left shunts were, however, significantly older and had smaller left to right shunts. Thus an appreciable number of patients with uncomplicated atrial septal defects have major right to left shunts which are unrelated to pulmonary hypertension or right heart failure. These shunts may be detected by the usual oximetric techniques and apparently develop with age, which suggests that they result from changes associated with chronic right volume overload.

Adolescent↗
PubMed1980

The role of reduced left ventricular enddiastolic volume in the apparently high prevalence of mitral valve prolapse in atrial septal defect.

Twenty-three patients with ostium-secundum atrial septal defect (ASD) were studied in order to investigate the etiology of angiographic mitral valve prolapse associated with ostium-secundum ASD. 12 patients (52%) had angiograhic MVP. Ventricular volumes, ejection fraction, segmentary contractility and oxygen step-up were analyzed in all patients. Patients with MVP had smaller enddiastolic and stroke volumes (73 +/- 21.8 ml/m2 and 46.6 +/- 18 ml/beat/m2) than patients without MVP (106.6 +/- 22 ml/m2 and 78 +/- 11.3 ml/beat/m2) (P less than 0.01). Oxygen step-up was greater in patients with MVP (P less than 0.05). No consistent differences in ejection fraction and segmentary contractility were found. Our findings suggest that angiographic MVP associated with ostium-secundum ASD is a functional disorder due to reduced left ventricular enddiastolic volume secondary to the atrial shunt.

Adolescent↗
PubMed1979

Case report: left ventricular echinococcosis diagnosed by coronary cineangiography.

This report presents a case of echinococcosis of the left ventricle treated surgically with success. Coronary cineangiography showed a circular capillary blush. This supports the view that this sign might well prove to be pathognomonic of this condition, as has been recently pointed out in another similar case. The diagnostic value of coronary cineangiography in left ventricular echinococcosis is emphasized.

Adult↗
PubMed1976

Comparative effects of morphine, meperidine and pentazocine on cardiocirculatory dynamics in patients with acute myocardial infarction.

The cardiocirculatory effects of the commonly used parenteral analgesics, morphine sulfate 15 mg, meperidine hydrochloride 100 mg and pentazocine 60 mg, each administered intravenously, were compared in 12 patients with acute myocardial infarction during cardiac catheterization and by echocardiogram. No untoward hemodynamic effects occurred following the administration of morphine or meperidine. In contrast, pentazocine produced significant (p less than 0.01 to less than 0.05) increases in systemic and pulmonary arterial pressures, left ventricular filling pressure, systemic vascular resistance, and systolic and diastolic dimensions; and decreases in left ventricular ejection fraction and mean velocity of circumferential fiber shortening. These deleterious actions of pentazocine appeared due to peripheral vasoconstriction and negative inotropic properties. Further, pentazocine-induced increases in left ventricular preload and afterload increased myocardial oxygen demands. Since this study demonstrates that pentazocine is hazardous in myocardial infarction, morphine and meperidine are the preferred analgesics in this condition.

Adult↗
PubMed1975

Idiopathic hypertrophic subaortic stenosis and Wolff-Parkinson-White syndrome. Changes of obstruction in left ventricular outflow depending on the type of ventricular activation.

A case of idiopathic hypertrophic subaortic stenosis (IHSS) associated with Wolff-Parkinson-White (WPW) syndrome is studied. On three occasions preexcitation was suppressed with an intravenous injection of ajmaline. The left ventricular outflow tract obstruction (LVOTO) was analyzed; when WPW syndrome activation disappeared, the obstruction decreased. The ventricular depolarization pathway is noteworthy as a factor in the severity of LVOTO in IHSS.

Ajmaline↗
PubMed1975

Effect of oral administration of large quantities of ascorbic acid on blood levels and urinary excretion of ascorbic acid in healthy men.

The influence of the daily ingestion of 1, 2, 3, and 5 grams of ascorbic acid on whole blood and plasma ascorbic acid levels and on the urinary excretion of ascorbic acid has been investigated. The ingestion of one gram of ascorbic acid per day for one week significantly increases plasma and whole blood levels over presupplementation levels, but larger amounts of ascorbic acid do not further increase plasma and whole blood ascorbic acid levels. Urinary excretion increases with intake, up to intakes of 3 grams per day but does not increase further when 5 grams of ascorbic acid is ingested per day. Upon discontinuing ascorbic acid supplementation the plasma and whole blood levels decline rapidly and the urinary excretion of ascorbic acid falls to presupplementation values within a few days. The results suggest that there is need for a detailed study of the routes of excretion of ascorbic acid at high levels of intake and that the safety of ingesting large quantities of ascorbic acid may be questioned.

Adult↗
PubMedDate not supplied

Postextrasystolic potentiation of systolic gradient in valvular aortic stenosis: clinical usefulness and analysis of hemodynamic factors.

To analyze the behavior of aortic valve gradient (AVG) after ventricular extrasystole (VE), we studied 36 pure valvular aortic stenoses (AS) free of coronary artery disease and obstructive hypertrophic cardiomyopathy, in whom basal (B) (74 +/- 32 mm Hg) and catheter-induced post-VE (110 +/- 50 mm Hg) AVG were obtained. In all 26 cases with valve area less than 0.70 cm2, the post-VE AVG was greater than or equal to 70 mm Hg. In 19 cases AVG after two or more consecutive VE were also obtained. Maximal post-VE AVG was obtained after multiple VE (19 cases) and/or after one VE causing a post-VE pause equal or longer than 1.7 basal cardiac cycles (post-VE RR greater than or equal to 1.7 B RR) (9 cases). Basal and postsingle VE AVG, up to a post-VE RR greater than or equal to 1.7 B RR, were a linear function of previous RR (r greater than or equal to 0.90), regression line slope increasing with AS severity (P = .05). Inotropic state measured by PEP/LVET only increased after multiple VE, P less than .01. AVG after multiple VE was independent of post-VE RR. Thus, 1) post-VE potentiation of AVG may be seen with fixed valvular AS without obstructive cardiomyopathy; 2) post-VE AVG is a function of compensatory pause after single VE and of increased inotropism after multiple VE; 3) analysis of maximal post-VE AVG generated as described is reliable and useful for assessing AS severity (post-VE AVG greater than or equal to 70 mm Hg meaning an aortic valve area less than 0.70 cm2) and may supplement valve area calculations.

Aortic Valve↗
PubMedDate not supplied

Regulation of synovial cell proliferation and prostaglandin E2 production by combined action of cytokines.

To study the causes of synovitis in rheumatoid arthritis (RA), we have analyzed the effect of several cytokines known to be secreted in RA joints, on synovial cell proliferation and prostaglandin E2 (PGE2) production. Recombinant interleukin-1-beta (IL-1-beta) and tumor necrosis factor-alpha (TNF-alpha) stimulated moderately the DNA synthesis and markedly the production of PGE2. Interferon-gamma (IFN-gamma) was often mitogenic but never induced PGE2 secretion. The association of IL-1-beta and TNF-alpha showed an additive effect on both parameters, whereas addition of IFN-gamma to either monokine reduced the proliferation and increased PGE2 release. Incubation with a crude T cell supernatant or a mixture of cytokines including IL-1-beta, TNF-alpha and IFN-gamma enhanced synovial cell growth and PGE2 production as compared to the effect elicited by each single cytokine. In contrast, interleukin-2 (IL-2) down regulated the synovial cell activation induced by the combined action of the three other cytokines. Taken together, our findings indicate that synovial cell proliferation is weakly stimulated, reaching a two-fold increase over background levels, whatever cytokines are used. Furthermore, proliferation can vary independently of PGE2 production. Nevertheless, the monokines IL-1-beta and TNF-alpha both exert agonistic effects on synovial cell activation, thus contributing to cartilage damage in RA, whereas IFN-gamma, IL-6 or IL-2 may rather play a regulatory role.

Arthritis, Rheumatoid↗