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Biomedical subjects

J Ge

Publications and source records attributed to J Ge.

At least 181 records · Page 10Linked to original sources
PubMed1995

[Alternative methods in interventional therapy of coronary heart disease].

Percutaneous high-frequency coronary rotablation using the rotablator is able to remove arteriosclerotic material from the vessel wall. A diamond-coated (30-80 microns) brass burr drill fastened to a flexible drive shaft rotating and tracking along a drill coaxial guide wire is used. The turbine rotates the drive shaft in excess of 150,000-190,000 rpm. High-frequency rotational angioplasty was successful in > 90% of patients, but in about 90% additional PTCA is necessary. No increase of bypass surgery compared to PTCA is observed. CK and CR-MB elevation is more often found than after PTCA. Vessel perforation is rarely observed. All vessels were open at 24-h control. The restenosis rate seems not be increased. The main indications for high-frequency rotational angioplasty are rigid and calcified sclerotic lesions which cannot be passed by conventional balloon catheters. Whether the restenosis rate can be reduced by this method will be judged in part by the COBRA study. In order to avoid acute complications of PTCA and to reduce restenosis rate, coronary stents were developed. Self-expandable and balloon expandable stents are available. It could be demonstrated that these stents can be used as a bail-out system and can block elastic recoil of coronary arteries. The major remaining problem is subacute closure of coronary vessels. In order to prevent thrombosis treatment with coumarine, acetylsalicylic acid, and dipyridamol is necessary. Coronary stents can be successfully delivered in more than 90% of the patients. In a highly selected patient group using single stents restenosis rate could be significantly reduced.

Angioplasty, Balloon, Coronary↗
PubMed1995

The changes of pattern reversal visual evoked potentials in normal infants.

PURPOSE: To study pattern reversal visual evoked potential (PVEPs) and determine the developmental character and mature time of visual function in normal infants at different months of age. METHODS: PVEPs were recorded from 115 normal infants at 3, 6, 9, 12 months age. P1 latency for different checks (1 degree 40', 25', 6') was analyzed and compared to those of normal adults. Changes of N1, N2 latency of PVEPs were also examined. RESULTS: P1 latency for all checks (1 degree 40', 25', 6') was significantly longer at 3 months than at 6 months of age (P < 0.05), but no significant differences can be seen after 6 months of age for larger (1 degree 40') and intermediate (25') checks (P > 0.05). P1 latency for larger checks (1 degree 40') reached adult level after 3 months of age, but not for the intermediate check (25'), while P1 latency for small check (6') presented the character of fluctuation. CONCLUSION: The visual system continued to develop after birth and appeared a certain regularity. Our results showed that P1 latency for larger check (1 degree 40') reached adult levels after 3 months of age. But P1 latency for intermediate check still has not reached adult levels after 3 months of age. To determine the age at which adult levels are finally reached, infants of 12 months and older must be tested. The reason why P1 latency for smaller check (6') presented the character of fluctuation should be the temporal tuning function developing much more slowly.

Child Development↗
PubMed1995

[The study of correlation between hemorrheology and fluorescein angiography in open-angle glaucoma].

PURPOSE: To observe the correlation between hemorrheology and arm-retinal filling time of fluorescein angiogaphy in patients with primary open-angle glaucoma. METHODS: The whole blood apparent viscosity in high (125 S-1), moderate (23 S-1) and low (1.2435 S-1) shear rates, plasma viscosity and hematocrit were measured in 50 cases (50 eyes) with primary open-angle glaucoma whose intraocular pressures were controlled. They also underwent fluorescein angiography. The duration from arm to retina arteria filling was named arm-retinal arteria filling time. RESULTS: There were positive correlation between the whole blood apparent viscosity in high and moderate shear rates, hematocrit and arm-retinal arteria filling time (P < 0.05-0.005). The higher blood viscosity, the longer arm-retinal arteria filling time. CONCLUSION: The blood viscosity in patients with primary open-angle glaucoma can affect the arm-retinal arteria filling time of fluorescein angiography. So, the increasing blood viscosity in patients with primary open-angle glaucoma can reduce the blood supply to the optic disc.

Adolescent↗
PubMed1995

[Trabeculectomy combined with extracapsular cataract extraction and posterior chamber intraocular lens implantation].

PURPOSE: To evaluate the effect of trabeculectomy combined with extacapsular cataract extraction and posterior chamber intraocular lens implantation (triple surgeries) on the patients of coexisting cataract and glaucoma. METHODS: 18 cases (19 eyes) of coexisting cataract and glaucoma treated by the triple surgeries were reviewed. Mean follow-up was 14.7 months (rangs from 2 to 20 months). RESULTS: Intraocular pressure was controlled satisfyingly in all cases except one case required additional treatment of the anti-glaucoma drug. 78.9% of patients achieved 0.3 or better visual acuity. The operation complications consist of anterior uveitis and hyphaema. However, all of them were controlled within 14 days. CONCLUSION: The triple surgeries are safe and have definite effect on controlling the IOP and improving visual acuity.

Adult↗
PubMed1994

Extent of atherosclerosis and remodeling of the left main coronary artery determined by intravascular ultrasound.

This study used intravascular ultrasound (IU) to assess the incidence and extent of left main coronary artery (LMCA) disease and the effects of arterial remodeling. Sixty-nine patients undergoing cardiac catheterization were imaged with a 20 MHz rotational-tip IU device. Nine of the 69 studies (13%) could not be analyzed because of technical (n = 2) or anatomic (n = 7) reasons. Of the remaining 60 patients, 38 (63%) had at least 1 lesion in the left coronary artery perfusion territory by angiography; significant LMCA stenosis was present in 2 patients (3%). Intravascular ultrasonography demonstrated plaques in 27 of 60 LMCAs (45%), 6 of them in patients with normal angiograms. Twenty-four plaques (89%) were eccentric and calcium was present in 4 (15%). The mean minimal lumen diameter was 4.9 +/- 0.8 mm, the maximal lumen diameter was 5.6 +/- 0.8 mm, the planimetered lumen area was 22.6 +/- 6.0 mm2, the plaque area was 3.9 +/- 5.8 mm2, the vessel area was 26.5 +/- 5.9 mm2, and the area stenosis was 13 +/- 19%. In the 27 patients with plaque, plaque area was 8.7 +/- 5.7 mm2 and the area stenosis was 30 +/- 17%. The vessel area was significantly larger in diseased LMCAs (p < 0.001) and correlated with plaque area (r = 0.46). IU examination of the LMCA was feasible in 87% of patients and was more reliable for delineating plaques than angiography.

Aged↗
PubMed1994

Assessment of spontaneous coronary artery dissection by intravascular ultrasound in a patient with unstable angina.

We describe a case of spontaneous coronary artery dissection that gave rise to post infarction unstable angina. An ambiguous angiographic appearance was shown by intracoronary ultrasound to arise from an extensive coronary dissection. The dissection membrane separating true and false lumina and features to suggest sluggish flow and early thrombosis in the false lumen were observed. No increase in lumen calibre was evident on ultrasound after PTCA (probably a consequence of the relatively large ultrasound catheter blank), but coronary flow reserve measured with intracoronary Doppler did improve and the patient remained stable and free of angina following the procedure.

Angina, Unstable↗
PubMed1994

Identification of the gene encoding a novel HLA-B39 subtype. Two amino acid substitutions on the beta-sheet out of the peptide-binding floor form a novel serological epitope.

Serological analysis suggests the existence of a novel HLA-B39 subtype (HLA-B39N) in the Japanese population. To identify this novel allele, a gene encoding HLA-B39N was cloned and the exons were sequenced. A gene encoding HLA-B39N (B*3904) and B*39011 differs by two nucleotide substitutions at codons 11 and 12 whereas B*3904 and B*39013 differ by three nucleotide substitutions at codons 11, 12, and 312. One nucleotide difference at codon 11 produces a change from serine in B*3901 to alanine in B*3904 whereas another difference at codon 12 changes valine in B*3901 to methionine in B*3904. The residues 11 and 12 are located on the beta-sheet out of the peptide-binding floor and are completely buried in the molecule. These results suggest that the substitutions at these residues alter the conformation of other residues forming epitopes of alloantibodies. Analysis of HLA-B*3901 genes in the Japanese population showed that both B*39011 and B*39013 were observed in the Japanese population. The present study suggests that B*3904 may have evolved from B*39011 rather than B*39013.

Amino Acid Sequence↗
PubMed1994

A cytotoxic human hybridoma monoclonal antibody (TrJ6) defining an epitope expressed by HLA-DQ4 and -DQ5.

We have generated a cytotoxic human hybridoma monoclonal IgM lambda antibody, designated TrJ6, that is specific for a new epitope shared by HLA-DQ4 and -DQ5. TrJ6 strongly killed all ten DQ4-bearing cells and weakly killed all four DQ5-bearing cell lines. In contrast, none of the 36 cell lines lacking DQ4 and DQ5 antigens was recognized by TrJ6. This was confirmed by fluorescence cytometry. The specific binding of TrJ6 to a DQ4-bearing line was efficiently blocked by IIB3 (murine anti-DQ8+9+4+5+6 mAb) and TrG6 (human IgG mAb against DQ4+5+6), confirming that TrJ6 is specific for a polymorphic DQ epitope. TrJ6 can be used to distinguish DQ5+ from DQ6+ B-lymphoblastoid cells. DQ4 beta and DQ5 beta chains share one unique residue (Ser-74) and one relatively unique residue (Val-75), which may therefore need to be coexpressed in order for the TrJ6 epitope to be formed. Alternatively, Ser-74 alone contributes critically to the allospecificity of this epitope. In addition, one or more of three residues unique for DQ4 (Leu-56, Glu-70, and Asp-71 on the DQ4 beta chain) could also contribute to the TrJ6 epitope because TrJ6 reacted stronger with DQ4- than with DQ5-bearing cell lines.

Amino Acid Sequence↗
PubMed1994

Intravascular ultrasound imaging in acute aortic dissection.

OBJECTIVES: This study was performed to determine the potential of intravascular ultrasound in the detection and delineation of aortic dissection. BACKGROUND: Intravascular ultrasound is a new technique capable of displaying real-time cross-sectional images of arterial vasculature. Its clinical use has been explored mostly in coronary and peripheral arterial circulation. METHODS: Intravascular ultrasound imaging of the aorta was performed using a 20-MHz ultrasound catheter in 28 patients with suspected aortic dissection. All patients underwent contrast angiography; 7 had computed tomography; and 22 had transesophageal echocardiography. RESULTS: Imaging of the aorta from the root level to its bifurcation was performed in all patients in an average of 10 min. No complications occurred. Dissection was present in 23 patients and absent in 5. In the patients without dissection, intravascular ultrasound revealed normal aortic anatomy. In all 23 patients with dissection, intravascular ultrasound demonstrated the intimal flap and true and false lumena. The longitudinal and circumferential extent of aortic dissection, contents of the false lumen, involvement of branch vessels and the presence of intramural hematoma in the aortic wall could also be identified. In cases where aortography could not define the distal extent of the dissection, intravascular ultrasound did. CONCLUSIONS: Our experience in this series of patients with aortic dissection indicates that intravascular ultrasound could be valuable in the identification and categorization of aortic dissection and in the description of associated pathologic changes that may be clinically important. It can be performed rapidly and safely and could serve as an alternative or adjunct diagnostic procedure in patients with aortic dissection.

Acute Disease↗
PubMed1994

Spontaneous plaque rupture visualized by intravascular ultrasound.

An intravascular ultrasound examination was performed in order to evaluate an angiographically complicated lesion. Intravascular ultrasound was able to demonstrate spontaneous plaque rupture in a patient with recent acute subendocardial infarction. The inconclusive angiographic appearance was clarified by the intravascular examination and led us to conclude that the myocardial infarction was due to plaque rupture with subsequent thrombotic occlusion, which had spontaneously resolved by the time of the study.

Aged↗
PubMed1994

Vessel wall changes in the proximal non-treated segment after PTCA. An in vivo intracoronary ultrasound study.

Intimal disruption is known to induce prolonged intimal functional disturbance and is thought to be one of the mechanisms contributing to restenosis after PTCA. Although such damage can be induced by minimal trauma, the inevitable far greater disruption caused by passage of the PTCA apparatus through the stenosis does not appear to induce significant angiographically documented intimal proliferation. Pathological studies, however, have suggested that such a process might occur. Intravascular ultrasound allows in vivo study of vessel wall shape and constitution and is a far more sensitive detector of coronary atheroma than angiography. In this study we sought to determine the frequency of such functional disturbances and to assess their significance with respect to restenosis. The study group comprised 18 patients who underwent IVUS examination immediately after PTCA and at 6-months follow-up. They were analysed for luminal dimensions and vessel wall changes at the site of PTCA and at the level of the proximal non-treated segment. Seven patients (38%) had restenosed at follow-up IVUS examination; two patients had angiographically demonstrated luminal narrowing proximal to the PTCA site whereas seven had new intimal thickening in the proximal non-treated segment demonstrated by IVUS. Six patients had no intimal changes in either PTCA treated or untreated segments. Proximal intimal thickening was seen more frequently in those in whom increased intimal thickening at the PTCA site was noted. A trend (P < 0.1) was found towards an increased rate of new proximal vessel disease in those patients who had angiographically restenosed. IVUS demonstrates new intimal thickening in proximal non-treated segments in a considerable number of or patients undergoing PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

A novel HLA-A determinant recognized by a cytotoxic human hybridoma IgG1 monoclonal antibody (TrJ14).

TrJ14 is a cytotoxic human IgG1 lambda hybridoma mAb that recognized a novel HLA-A epitope expressed by lymphoblastoid B cells that are homo- or heterozygous for A2, A3, A11, A30, A31, A33, A68 and A69. Based on these results, the HLA type of cell line TEM (10w9057) was retyped as A66. When peripheral blood T cells isolated freshly from 265 HLA-typed normal individuals served as targets, TrJ14 killed cells expressing two TrJ14-positive HLA-A alleles, as well as the majority of cells having one TrJ14-positive and one TrJ14-negative HLA-A antigen. However, TrJ14 failed to recognize or reacted weakly with most HLA-A2 and -A3 heterozygous normal T cells when A2 or A3 was coexpressed together with a TrJ14-negative antigen. The serological reactivity of TrJ14 correlated with the amino acid valine and aspartic acid at positions 76 and 77 of the alpha 1-domain helix. These amino acids were shared exclusively by all the identified TrJ14+ alleles.

Amino Acid Sequence↗
PubMed1994

Intravascular ultrasound imaging of angiographically normal coronary arteries: a prospective study in vivo.

Intravascular ultrasound imaging (IVUS) was performed to elucidate the discrepancy between clinical history and angiographic findings and to measure the diameter and area of the lumen of the normal left coronary artery in 55 patients who presented with chest pain but had normal coronary angiograms. The left coronary artery (LCA) was scanned with a 4.8F, 20 MHz mechanically rotated ultrasound catheter at 413 sites. Atherosclerotic lesions were identified at 72 (17%) sites in 25 patients. The mean (SD) (range) plaque area was 5.55 (3.56) mm2 (2-26 mm2) and it occupied 28.8 (9.6)% (13-70%) of the coronary cross sectional area. Calcification was detected at 24 (33%) atherosclerotic sites in nine patients. The correlation coefficients for the lumen dimensions measured at normal sites by IVUS and by angiography were r = 0.93 (SEE = 0.43) mm for lumen diameter and r = 0.89 (SEE = 4.27) mm2 for lumen area (both p < 0.001). 16 of the 30 patients in whom no atherosclerotic plaques were detected in the LCA lumen by IVUS had no risk factors of coronary artery disease. The cross sectional area of 90 consecutive images of left main coronary artery (LMCA), proximal left anterior descending coronary artery (proximal LAD), and mid LAD was measured in these 16 subjects. The mean (SEM) areas at end diastole were LMCA 17.33 (7.98) mm2; proximal LAD 13.56 (5.85) mm2; mid LAD 9.75 (4.67) mm2. During the cardiac cycle the cross sectional area changed by 10.2 (4.0)% in the LMCA, by 8.3 (4.7)% in the proximal LAD, and by 9.8 (4.0)% in the mid LAD. In 11 patients with plagues the change in cross sectional area in plague segments (5.8(3.1)%) was significantly lower than in the segments from patients without plagues (p < 0.001). Lumen area reached a maximum in early diastole rather than in late diastole. IVUS can imagine atherosclerotic lesions that are angiographically silent; it also provides detailed information about plague characteristics. The variation in coronary cross sectional area during the cardiac cycle should not be ignored during quantitative analysis. Maximum dimensions in normal segments are reached in early diastole. Further studies are needed to clarify the clinical significance of atherosclerosis detected by IVUS in patients presenting with chest pain but normal coronary angiography.

Adult↗
PubMed1994

Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging.

BACKGROUND: In autopsy, myocardial bridging is a common finding. With coronary angiography, a systolic compression, mainly of the left anterior descending coronary artery, is observed in 1% to 3% of the patients. Controversy exists concerning the functional importance of this finding. To obtain a functional insight into the myocardial bridging, intravascular ultrasound and intracoronary Doppler were performed. METHODS AND RESULTS: Intracoronary ultrasound and Doppler were performed in 14 patients with angiographic evidence of systolic vessel compression ("milking effect") in the left anterior descending coronary artery. The 4.8F, 20-MHz ultrasound catheter could not be advanced through the entire myocardial bridge segment in 6 of the 14 patients studied because the lumen was < 1.6 mm. In these patients, only the proximal parts of the bridge segment were scanned. The changes in cross-sectional shape during the cardiac cycle were determined for both the normal proximal segment and the bridge segment by use of a semiautomatic computer program. Intracoronary Doppler (20 MHz) was performed in 7 patients with a 3F catheter. A highly characteristic systolic eccentric or concentric compression with delayed relaxation in diastole of the myocardial bridging segment was clearly visualized in all patients. The cross-sectional lumen area variation was 40 +/- 25% in the bridging segments and 9 +/- 7% in the normal segments (P < .01). No atherosclerotic lesions were detected in the bridge or the distal segment in the 8 patients in whom the IVUS catheter was successfully advanced through the entire myocardial bridge. However, atherosclerotic plaques were found in the segments proximal to the bridge in 12 of 14 patients (86%). The resting mean flow velocity was 6.4 +/- 1.2 cm/s; the maximal mean flow velocity after intracoronary administration of 10 mg papaverine was 14.1 +/- 3.4 cm/s. The coronary flow velocity reserve was 2.2 +/- 0.7. A highly characteristic pattern showing a prominent peak in coronary velocity in early diastole was observed in 86% of patients, and this pattern was enhanced after injection of intracoronary papaverine. CONCLUSION: Intravascular ultrasound demonstrated a characteristic systolic compression of the bridge segments. The delayed compression release may explain the characteristic sharp early diastolic peak in coronary flow velocity found with intracoronary Doppler in vessels with myocardial bridging. Reduced coronary flow reserve may be related to this phenomenon, possibly explaining signs of ischemia detected in some of the patients, but may alternatively be a result of the presence of atherosclerosis in the segment proximal to the bridge in these patients.

Blood Flow Velocity↗
PubMed1994

[The comparative study of pattern visual evoked potential in the normal infants and adults].

This paper presents the pattern visual evoked potential (PVEP) results and comparative study between the two groups of 65 normal infants at the age of 3, 6, 9, 12 months and 18 normal adults. The different pattern spatial frequency stimulations (74', 25', 6') were given to the infants and adults. In the infant group, the latencies of P1 components of PVEP delayed significantly and amplitudes of PVEP decreased significantly between 74' and 6' spatial frequency with the spatial frequency of stimulation increasing. In the same spatial frequency stimulation, when 3 months infant group was compared with the 6, 9, 12 months infant and adult groups, the latencies of N1 and P1 waves showed significant difference, but no difference was found in the amplitudes of P1 wave. Our results might indicate that the visual function expressed by low, medium, and high spatial frequency in infants from 6 to 12 months could reach the level in adults, and in 3 months infants, not maturely develop.

Adult↗
PubMed1994

[Therapy of cardiogenic shock in acute myocardial infarct].

Cardiogenic shock in acute myocardial infarction patients is the most common cause of in-hospital death. Various studies showed, that 60 to 100% of patients in cardiogenic shock will die, if no early reperfusion of their coronary artery could be established. The incidence of cardiogenic shock has decreased during the last years, most likely due to early thrombolytic therapy and administration of nitroglycerin. Reasons for cardiogenic shock are either necrosis of 40% or more of the left ventricular wall, right heart infarction, or complications which can be treated by the surgeon, like papillary muscle rupture, ventricular septal defect or rupture of the free ventricular wall. Diagnosis is based on clinical criteria, echocardiography, and on hemodynamic monitoring. The hemodynamic criteria for cardiogenic shock are a cardiac index of < 2.2/l, and an increased wedge pressure of > 18 mm Hg; additionally, diuresis is usually < 20 ml/h. Therapy can be divided into the following categories: a) pharmaceutical interventions to increase cardiac output like vasodilators or positive inotrope drugs; b) mechanical support systems; c) acute interventions with the aim of reperfusion; d) acute surgical interventions addressing complications like papillary muscle rupture, ventricular septal defect or rupture of the free ventricular wall. While steps a) and b) are able to stabilize the hemodynamical situation in patients with cardiogenic shock, they are rarely the definitive treatment. Point c), reperfusion of the coronary artery, can be divided in thrombolysis or acute PTCA. Thrombolysis failed to show a beneficial effect in most studies, either after intravenous or intracoronary application. On contrast, acute PTCA showed to be of great benefit in various studies with a technical success rate of 54 to 100% and a survival rate of patients from 58 to 100%. Thus, emergency PTCA is the treatment of choice in cardiogenic shock. Point d), surgical interventions can be divided in acute bypass grafting, which should be reserved for patients with severe multivessel disease, left main involvement, or failed PTCA. Furthermore, acute heart transplantation is effective, but will be possible in a minority of patients only. The last part of surgically manageable complications are surgery of papillary muscle rupture and ventricular septal defect. Results of early surgery in papillary muscle rupture or ventricular septal defects are much better than delayed interventions. Rupture of the free wall is usually a fatal event. In summary, the most successful therapy of cardiogenic shock is early emergency PTCA.(ABSTRACT TRUNCATED AT 400 WORDS)

Angioplasty, Balloon, Coronary↗