Early detection of coronary artery disease.
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Biomedical subjects
Publications and source records attributed to J Forrester.
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The ability of left ventricular angiography to detect regional ischemic dysfunction was assessed in 10 closed-chest dogs during the course of acute balloon occlusion of the anterior descending coronary artery. During the 2-minute period of occlusion, serial cineangiography revealed a sequence of wall motion abnormalities over the anteroapical region almost identical to that observed using directly implanted gauges. This sequence consisted of progressive reduction in regional systolic shortening with eventual replacement by systolic expansion. These changes preceded both electrocardiographic ST-segment and hemodynamic alterations, and were readily observed by gross subjective inspection of the cineangiograms, but with an intraobserver variability of 22%. Frame-by-frame motional analysis of the ventricular perimeter relative to its centroid of mass allowed more precise characterization of regional dysfunction. These data are consistent with previous studies demonstrating that regional wall motion abnormalities are both sensitive and specific markers of acute ischemia, and support the use of computerized left ventricular angiography for the quantitative assessment of clinical ischemic dysfunction.
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Acetaminophen is a readily available, widely used drug which has been thought safer than aspirin. Overdosage which may result in fatal hepatic necrosis is commonly seen in the United Kingdom but is rarely reported in the United States. In a two-month period, three patients were admitted to a general hospital because of acetaminophen overdose, suggesting that this problem may occur more commonly than expected. They were successfully treated with N-acetylcysteine. Our experience in management of these three patients is presented and the pertinent literature concerning diagnosis and treatment of acute acetaminophen intoxication in briefly reviewed.
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General examination of the eye was carried out in 22 patients with systemic lupus erythematosus (SLE) and in 10 with scleroderma. 3 of the SLE and 2 of the scleroderma patients had keratoconjunctivitis sicca. Fluorescein angiography showed abnormalities of the retinal vasculature in one of a subgroup of 12 SLE patients and one of 10 scleroderma patients. None of the 12 SLE patients had abnormalities of the choroidal vasculature, while 5 of the 10 scleroderma patients had patchy areas of nonperfusion of the choroidal capillary bed.
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