[Intracoronary diagnosis in coronary angioplasty. Extended information with new techniques].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to K Selin.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Work postures and movements of the upper limb were analysed for 12 'mouse' operators and 12 'non-mouse' computer operators employed in word-processing work. Measurements were carried out during correction of a given text. 'Mouse' operators spent 64% of the working time with the operative wrist deviating more than 15 degrees towards the ulnar side, while 'non-mouse' operators spent 96% of the time with the corresponding wrist in neutral position towards radial deviation. The rotation in the shoulder was at all times in neutral position towards inward rotation for 'non-mouse' operators, while 'mouse' operators worked 81% of the time with the shoulder rotated outward more than 30 degrees. 'Mouse' operators corrected a longer text during the given time. Our observations showed long periods of strenuous working postures for 'mouse' operators compared to 'non-mouse' operators. We believe that further investigations need to be carried out on the effects of word-processing techniques and to develop ergonomic work station designs for the 'mouse' and other non-keyboard input devices.
The addition of sodium to nonionic contrast media has reduced the incidence of arrhythmias in animal models. The influence on cardiac function and safety of sodium addition to the nonionic contrast medium iohexol (Omnipaque) was studied in a randomized, double-blind trial in patients undergoing cardioangiography. Fifty-nine patients received iohexol 350 mg I/ml with NaCl 28 mmol/l and 58, iohexol only. ECG changes after contrast injections were evaluated with continuous computerized dynamic vectorcardiography (VCG). QRS-vector difference (QRS-vd), which reflects changes in the QRS-complex, was chosen as the main parameter. Both contrast media caused changes in the QRS-complex, but there was no significant difference between the two. No serious arrhythmias were observed. Both contrast media were well tolerated. No beneficial effects from enriching iohexol with sodium were found. VCG was found to be a valuable tool in the study of contrast medium-induced ECG changes.
Intraoperative lobar torsion occurred in 4 of about 2000 patients subjected to thoracotomy. Two of the patients died. Early diagnosis and proper management are of great importance to the outcome. Temporary deflation of the diseased lung by using double lumen endobronchial tube is a potential risk. Early progressive lobar opacity without signs of atelectasis on conventional chest radiograph is indicative of this serious complication. Computerized tomography and bronchoscopy are of diagnostic value. Exploratory thoracotomy must be performed without delay. The injured parenchyma should be sacrificed unless the diagnosis is obtained very early. When the injured lobe or lung is rotated back into normal position the airways may be flooded with serosanguinous fluid which promptly has to be removed. If an attempt is made to save the lobe or the lung, tracheostomy for frequent suction of the airways is indicated in order to prevent "spill-over" and dangerous postoperative hypoxia.
The dimension, contractility, and regional wall motion of the right and left ventricles were scored on the angiograms of 13 patients with arrhythmogenic right ventricular dysplasia. In 10 patients the right ventricle was enlarged, in eight the contractility of the right ventricle was reduced, and in all but one patient there were regional wall motion abnormalities of the right ventricle. The most common abnormality of regional wall motion was mild hypokinesia. There were bulging or dyskinetic areas in seven patients. Regional wall motion abnormalities of the left ventricle were found in five patients, two of whom also had bulging or dyskinetic areas. The reproducibility of right ventricular dimension, contractility, and regional wall motion scores was generally fair but varied unexpectedly both within and between two observers (Kendall's Tau 0.38-0.92). The score values of regional wall motion for some of the segments differed considerably within and between observers. One of the observers consistently gave higher scores than the other. These data suggest that a more objective approach is needed for evaluating angiographic changes in arrhythmogenic right ventricular dysplasia.
Explore the source record for details and available documents.
Coronary sinus flow (CSF) was measured in seven patients with normal coronary arteries (group A) during intracoronary injections of 6 ml arterial blood, 6 ml blood from the coronary sinus, 3 and 6 ml isotonic saline, 3 and 6 ml hypertonic glucose, and 6 ml of a contrast agent (sodium metrizoate). In 10 patients with coronary artery disease (group B), CSF was measured after administration of 6 ml isotonic saline, 6 ml sodium metrizoate, and 6 ml of another contrast medium (iohexol). In group A, arterial blood did not affect CSF, while coronary sinus blood induced a 33% increase. After 6 ml isotonic saline, there was a 35% increase in flow and after hypertonic glucose an increase of 70%. Metrizoate induced a rise in flow of 109%. In group B, the increase in CSF after intracoronary injection of saline, metrizoate, and iohexol was 30%, 83%, and 67%, respectively. Blood from the coronary sinus, in contrast to arterial blood, induced a marked rise in peak flow, suggesting a role for reactive hyperemia secondary to myocardial hypoxia in this response. A similar mechanism might have been operative after injection of isotonic saline, as well as after the hyperosmolar contrast agents. However, additional mechanisms mediated by the high osmotic pressure of these substances, such as induction of the Bezold-Jarisch reflex, which will induce coronary vasodilation, may have played a role. Finally, when hyperosmolar agents are used, the possibility of some direct vasodilating properties of the agents cannot be excluded.
The cardioangiographic findings in 50 women 40-54 years of age were compared with those of a series of 69 men with infarction recruited from the same catchment area and investigated according to the same principles. Women less often had left ventricular abnormalities than men; this difference was mainly confined to patients with non-Q wave infarctions. There was no difference in the prevalence of left ventricular abnormalities among women and men with Q wave infarctions. No major sex difference was found in the prevalence of coronary abnormalities. Collaterals were less common in women than in men.
A set of electrocardiographic criteria for the diagnosis of coronary artery disease was evaluated in two different groups of patients examined by computer aided 12 lead exercise electrocardiographic stress testing and coronary arteriography. One group consisted of patients with severe angina pectoris and the other of patients who had suffered a myocardial infarction three years before the study. Angiographically determined categories of patients could be identified with satisfactory precision by the electrocardiographic criteria under test in the patients with angina pectoris but not in those with infarction. A new method of classifying patients on the basis of data from coronary arteriography improved the correlation with ST segment analysis compared with conventional classification.
Explore the source record for details and available documents.
Amipaque, ioxaglic acid and Isopaque Coronar 300 were compared in a double blind investigation of coronary angiography in patients with ischemic heart disease. Amipaque affected systolic blood pressure and ECG less than the other contrast media. Ioxaglic acid appeared to give more ST and T changes than Isopaque Coronar.
Bilateral spontaneous pneumothorax with almost complete collapse of the lungs in a 29-year-old man is reported. On admission to hospital the patient was in moderate respiratory distress, but the arterial blood gases were normal. Initially he was treated with bilateral tube drainage. Thoracotomy with parietal pleurectomy was later done on the right side to prevent recurrence.
Iohexol (350 mg I/ml) has been compared with meglumine-Na-Ca metrizoate (370 mg I/ml) in selective coronary angiography in 37 adult patients. Iohexol was very well tolerated and resulted in only minor changes in blood pressure and ECG parameters. Changes in blood pressure and R-R interval were significantly more marked following injections of metrizoate than after injections of iohexol. Arrhythmias were not observed following injections of iohexol, while two patients had AV block II after injection of metrizoate. Both contrast media gave similar and adequate demonstration of the coronary vessels. The findings suggest that iohexol has distinct advantages over metrizoate in selective coronary angiography.
In 10 patients coronary sinus blood flow (CSBF) was measured during and after injection of iohexol and meglumine-Na-Ca metrizoate in the left coronary artery. Oxygen saturation, lactate concentration and hematocrit were determined in the aorta and coronary sinus before and after a second injection of the two contrast media. The increase in CSBF was significantly more marked and sustained after injection of metrizoate than after iohexol and myocardial arterio-venous oxygen difference was significantly lower. Myocardial oxygen consumption and lactate metabolism were not adversely affected by any of the contrast media. The fall in hematocrit in coronary sinus blood was significantly greater after metrizoate.
During a 10-year period 28 patients with shrinking pleuritis with atelectasis (SPA) were observed and operated upon. This lesion has been given different names in the literature, for instance rounded atelectasis, pleuroma, pulmonary pseudotumour, and lung folding. All patients except two were operated upon because of a diagnosis of pulmonary tumour. However, at operation no tumour was found. The aetiology and pathogenesis of SPA are discussed on the basis of X-ray, operative, and histopathological findings.
The first investigation of iohexol in human cardioangiography is presented. Slight subjective reactions as well as moderate and transient influence on hemodynamics and ECG parameters were recorded. Analysis of serum enzymes indicated no myocardial injury. Good or excellent films of the left ventricle, aortic root and coronary arteries were obtained.
Iopamidol, a new non-ionic contrast medium with low osmolality, was compared with Isopaque Coronar during selective coronary angiography in 16 patients. Iopamidol caused significantly less bradycardia, less ECG changes and less fall in blood pressure than Isopaque Coronar. No subjective adverse effects such as chest pain, vomiting, nausea or sensation of heat occurred. The results indicate that Iopamidol has advantages as a contrast medium for coronary angiography.