Multiple sclerosis and the role of the MS nurse consultant.
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Glucocorticoids↗
Biomedical subjects
L Rath
Publications and source records attributed to L Rath.
Quantification of left ventricular function with an automated border detection system and comparison with radionuclide ventriculography.
Quantification of 2-dimensional echocardiograms with a recently developed automated border detection (ABD) system provides on-line estimation of left ventricular (LV) function. Previous studies showed that short-axis cavity area measurements with the ABD system approximate manually traced cavity areas obtained with conventional 2-dimensional echocardiography. Further clinical validation needs a comparison of LV function between the ABD system and established methods. Fractional area change and ejection fraction measured by the ABD system were compared with ejection fraction measured by radionuclide ventriculography. Echocardiographic measurements were obtained from LV short-axis views at the level of the papillary muscles. Calculation of ejection fraction by the ABD system was based on an algorithm using a modified ellipsoid model. Forty-six patients underwent echocardiography on the same day as radionuclide ventriculography. Patients were included in the study if > or = 75% of the endocardium was visualized with conventional 2-dimensional echocardiography. Twenty-seven of 46 patients (59%) had a technically adequate, conventional echocardiogram. Fractional area change with the ABD system was highly correlated with ejection fraction from radionuclide ventriculography (r = 0.92; SEE 8.4%). Ejection fraction determined by the ABD system and radionuclide ventriculography also showed a strong linear relation in the 23 patients without severe wall motion abnormality (r = 0.90; SEE 9.5%). It is concluded that LV function measurements by the ABD system and radionuclide ventriculography have a strong linear relation.
Adolescent↗
[Necrotic pheochromocytoma presenting with shock and abdominal pain].
Pheochromocytoma is a rare tumor, the diagnosis of which is based on a history of hypertension, and symptoms, signs and laboratory data associated with increased release of catecholamines. The combination of pheochromocytoma and shock is uncommon, but when it does occur, is often associated with necrosis of the tumor. We report an unusual case of a patient whose clinical findings suggested fulminating septic shock. Only at postmortem was the diagnosis of pheochromocytoma made.
Abdominal Pain↗
A new method of bile duct cannulation allowing bile collection and re-infusion in the conscious rat.
A technique is described for collection of bile from the surgically-prepared, conscious rat after a postoperative recovery period of 7 days. This model can also be used to study enterohepatic recirculation.
Anesthesia↗
Diagnosis of recent myocardial infarction with quantitative backscatter imaging: preliminary studies.
Acute myocardial ischemia and chronic myocardial infarction may be recognized with ultrasound tissue characterization techniques because of myocardial acoustic changes caused by reduced perfusion and/or collagen deposition. Our purpose was to study the acoustic properties of recent myocardial infarction when the predominating pathologic finding was myocardial edema and leukocytic infiltration. We used a new quantitative backscatter imaging system to study 18 patients 9 +/- 5 days after myocardial infarction (eight patients with anteroseptal myocardial infarction and 10 with inferior myocardial infarction) and 20 normal subjects. The cyclic variation of relative integrated backscatter (end-diastolic minus end-systolic) was calculated from on-line measurements. Standard parasternal long- and short-axis and apical four- and two-chamber views were obtained. In the anteroseptal myocardial infarction group, the cyclic variation of relative integrated backscatter was lower in the septum (1.5 +/- 1.6 dB) than in the posteroinferior wall (3.2 +/- 1.2 dB); however, the sample size of only three patients (of eight patients imaged) in the latter group prevented statistical comparison. The cyclic variation of relative integrated backscatter in the infarcted septum was less than the measurement obtained in the septum of the control group (4.3 +/- 2.4 dB, p less than 0.05). In the inferior infarction group, the cyclic variation of integrated backscatter in the posteroinferior wall (1.8 +/- 1.7 dB) was not significantly different from the measurement obtained in the septum (3.7 +/- 3.6 dB); however, the cyclic variation in the posteroinferior wall was significantly less than that obtained in the control group posteroinferior wall (5.7 +/- 1.7 dB, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Coronary Angiography↗
Cyclic variation of ultrasound backscatter in normal myocardium is view dependent: clinical studies with a real-time backscatter imaging system.
Real-time ultrasound backscatter imaging is a new method of evaluating relative integrated backscatter in a clinically applicable manner. The potential clinical utility of real-time backscatter imaging of diseased tissue depends on recognition of normal variations in cyclic backscatter when measured from different echocardiographic image orientations. The view dependence of cyclic backscatter variation was studied in normal human volunteers. In twenty normal male subjects (mean age 28 +/- 5 years) cyclic variation in integrated backscatter (diastolic minus systolic backscatter) was assessed in multiple left ventricular regions with four standard two-dimensional echocardiographic views (parasternal long-axis and short-axis views, and apical two-chamber and four-chamber views). M-mode backscatter imaging was performed from the standard parasternal long-axis view. Cyclic variation in backscatter was present in the septum only when imaged from the parasternal long-axis view (2.7 +/- 3.1 [standard deviation] decibels [dB], p less than 0.01 for diastole versus systole). The posterior wall of the left ventricle demonstrated cyclic variation of integrated backscatter when imaged from both the parasternal long-axis (4.6 +/- 1.6 dB, p less than 0.01) and short-axis views (2.8 +/- 2.2 dB, p less than 0.01). Cyclic variation in integrated backscatter was not demonstrated in inferoseptal, septal, or lateral wall regions when imaged from the parasternal short-axis view. The apical views did not demonstrate cyclic variation in integrated backscatter in any of the segments studied.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗