Biomedical subjects

N Mirow

Publications and source records attributed to N Mirow.

24 records · Page 2Linked to original sources

PubMed1996

Ultrasound examination of stenotic mitral valves: an in vitro study.

To determine the feasibility of currently used, intravascular ultrasound catheters (12.5 and 20 MHz, 6F and 9F, Boston Scientific Corp., Watertown, MA) for mitral valve disease, ten excised mitral valves from patients with severe mitral stenosis were examined. The specimens were fixed in a glass cylinder perfused with water. The valves were planimetered with the intravascular ultrasound system and investigated regarding pathomorphological changes. The depth field of penetration was between 1.5 and 2 cm (3 to 4 cm diameter) in the 20 MHz catheter and between 2 and 2.5 cm (4 to 5 cm diameter) in the 12.5 MHz catheter. A good correlation of the experimentally recorded valve areas could be ascertained with the Gorlin formula (r = .71, P < .05), the Doppler echocardiography method (r = .69, time method (r = .75, p < .05), and with the two-dimensional echocardiography method (r = .69, P < .05). These results show a sufficient feasibility of the currently used, intravascular ultrasound catheters and enable further steps to be taken with regard to evaluating mitral valve morphology in vivo.

Aged↗

PubMed1996

Pathomorphological characteristics of resected mitral valves after unsuccessful valvuloplasty.

OBJECTIVE: Percutaneous mitral valvuloplasty has been shown to be an acceptable alternative to surgery as treatment for selected patients with severe mitral stenosis. We examined hemodynamic, echocardiographic, and pathomorphologic findings in a series of 308 patients undergoing balloon valvuloplasty, 41 of whom underwent subsequent surgery, in search of possible predictors of an unsuccessful outcome. INTERVENTION AND RESULTS: Patients with severe mitral stenosis underwent Inoue single ballon valvuloplasty over a 48-month period and had follow-up for a mean of 14.5+/-16.8 months (range 1 to 64 months). Of the 308 patients, 267 (Group I) were clinically improved and stable throughout follow-up, while subsequent surgery was required in 41 (Group II) after 38.2+/-143.5 days (range 1 to 1212). Significant differences between the groups were observed for NYHA class (2.7+/-0.6 vs 2.9+/-0.6, p<0.05), mitral valve area (1.0+/-0.3 vs 0.9+/-0.2 cm2, p<0.01) and left atrial endsystolic dimension by echo (51.3+/-8.0 vs 55.4+/-10.2 mm, p<0.01). Two of the 41 Group II patients underwent surgery for left to right shunting, 1 for tamponade and 2 were lost to follow-up. The excised mitral valves of the remaining 36 patients all showed calcification and/or fibrosis: 9 homogenous, 5 non-homogenous; 19 were classified as having a funnel-shaped deformity, and 3 did not fit into a discrete category. Among the funnel-shaped valves, 13 had a tear versus 6 where dilation was primarily accomplished by stretching. Only one of 9 valves with homogenous calcification was torn, whereas a tear was noted in 3 of the 5 with non-homogenous calcification. CONCLUSION: Funnel-shaped valves and those with non-homogenous distribution of calcification and/or fibrosis appear to be least suitable for balloon valvuloplasty.

Adult↗

PubMed1995

Enhancement of neutrophil function by in vivo filgrastim treatment for prophylaxis of sepsis in surgical intensive care patients.

PURPOSE: To determine the kinetics of leukocyte counts and of oxygen radical production of neutrophils from postoperative/posttraumatic patients with or without infusion of filgrastim (recombinant human granulocyte colony-stimulating factor, rhG-CSF) as prophylaxis against sepsis. METHODS: Twenty postoperative/posttraumatic patients with a Therapeutic Intervention Scoring System (TISS) score greater than 30 were included in this study. In the 10 patients of the study group, filgrastim (1 microgram/kg/d) was infused continuously within the first 3 days and tapered to 0.5 microgram/kg/d on the following 4 days or until discharge from the surgical intensive care unit. Ten patients without administration of filgrastim served as controls. Oxygen radical production of isolated neutrophils of these patients was tested by N-formyl-methionyl-leucyl-phenylalanine (FMLP)- and zymosan-induced chemiluminescence from serial blood samples, taken until the 16th postoperative day. RESULTS: Compared with the first postoperative day, in vitro FMLP-induced neutrophil chemiluminescence was significantly increased during the following 4 postoperative days in the patients with filgrastim infusion; however, only during the first 2 postoperative days in the control group. The increase in the FMLP-induced neutrophil chemiluminescence was significantly greater (P < .05) in the study group than in the control group on the third and on the fourth postoperative day. Tapering of filgrastim by 0.5 microgram/kg/d in the study group resulted in a reduction of FMLP-induced neutrophil oxygen radical production within 48 hours. In contrast, zymosan-induced neutrophil chemiluminescence was not measurably affected in both groups. Leukocyte count of the study group significantly (P < .05) exceeded the leukocyte count of the control group from the third up to the 10th postoperative day. None of the patients treated with filgrastim developed sepsis; however, three patients within the control group did. CONCLUSIONS: Prolonged enhancement of neutrophil count and function induced by rhG-CSF may be useful in the prophylaxis of sepsis in posttraumatic/postoperative patients at high risk of sepsis.

Adolescent↗

PubMed1994

Do barbiturates impair zymosan-induced granulocyte function?

PURPOSE: The dose-response relationship of commercially available preparations of methohexital, pentobarbital, phenobarbital, and thiopental and their respective drug-free solutions on granulocyte function was investigated to evaluate whether suppression of neutrophil chemiluminescence is mediated by the barbiturates themselves or by their drug-free solutions. Furthermore, it was assessed whether suppression of chemiluminescence is due to an interaction mainly with neutrophils or to free radical scavenging. METHODS: The dose-response effects of the four barbiturates on granulocyte function were tested by zymosan-induced neutrophil chemiluminescence and, in addition, in a cell-free chemiluminescence system. RESULTS: Methohexital and pentobarbital did not influence zymosan-induced neutrophil chemiluminescence, whereas phenobarbital and thiopental decreased neutrophil chemiluminescence in a dose-dependent fashion. Nonphysiological osmolality (531 mosmol/kg) caused this impaired neutrophil chemiluminescence at the greatest concentration of phenobarbital. Thiopental solely suppressed neutrophil chemiluminescence drug specifically. Because thiopental also reduced chemiluminescence generated in a cell-free system, free radical scavenging might contribute to the impaired neutrophil chemiluminescence observed with thiopental. CONCLUSIONS: With the exception of thiopental, barbiturates do not impair oxygen radical production during phagocytosis of neutrophils.

Cell-Free System↗

PubMed1994

Do barbiturates and their solutions suppress FMLP-induced neutrophil chemiluminescence?

The dose-response relationship of four commercially available barbiturates (methohexitone, pentobarbitone, phenobarbitone and thiopentone) and of their drug-free solutions on the production of oxygen radicals by neutrophils were tested by N-formylmethionyl-leucyl-phenylalanine (FMLP)-induced granulocyte chemiluminescence and in a cell-free chemiluminescence system. Methohexitone had no effect on neutrophil chemiluminescence. Pentobarbitone, phenobarbitone and thiopentone dose-dependently decreased FMLP-induced chemiluminescence and cell-free chemiluminescence. Suppression of neutrophil chemiluminescence by pentobarbitone and phenobarbitone was due to effects of the drug-free solutions and an osmolality greater than 360 mosmol kg-1. Only thiopentone suppressed granulocyte chemiluminescence drug-specifically. The physicochemical properties of commercially available barbiturate preparations and their solutions, as well as free radical scavenging capacity, have to be considered if these preparations are used to evaluate drug-specific effects on the production of oxygen radicals by neutrophils.

Barbiturates↗

PubMed1993

Benzodiazepines and their solvents influence neutrophil granulocyte function.

We have examined the effects of commercially available preparations and drug-free solvents of diazepam (Valium, Diazepam-Lipuro) and midazolam (Dormicum) by N-formylmethionyl-leucylphenylalanine (FMLP)- and zymosan-induced polymorphonuclear cell (PMN) chemiluminescence and in a cell-free chemiluminescence system. In the case of Valium, drug-free solvent and diazepam suppressed PMN chemiluminescence. With Diazepam-Lipuro, the solvent stimulated and diazepam inhibited PMN chemiluminescence. With midazolam (Dormicum), only the active drug depressed PMN chemiluminescence. FMLP-induced PMN chemiluminescence was depressed 10-100 fold more by diazepam and midazolam than zymosan-induced chemiluminescence.

Diazepam↗