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Biomedical subjects

R Gil

Publications and source records attributed to R Gil.

At least 73 records · Page 4Linked to original sources
PubMed1998

Electrocardiographic changes after alcohol septal ablation in hypertrophic obstructive cardiomyopathy.

OBJECTIVE: To report acute and mid-term electrocardiographic changes in patients with hypertrophic obstructive cardiomyopathy (HOCM) after alcohol ablation of the first large septal branch of the left anterior descending coronary artery; and to relate electrocardiographic data with the left ventricular outflow tract pressure gradients. PATIENTS: Nine consecutive symptomatic patients with HOCM (mean (SD) age 45 (12) years). METHODS: Analysis of baseline and post-procedure ECGs and 24 hour ambulatory monitoring (up to six months). ECG data were related to left ventricular outflow tract pressure gradients. RESULTS: One patient developed complete atrioventricular block requiring permanent pacing. The PR interval was significantly prolonged up to third month after ablation. Immediately after the procedure all patients developed right bundle branch block. At the sixth month of follow up, right bundle branch block was present in four patients. New anterior ST elevation developed immediately after ablation in five of the nine patients, and new Q waves in four. The QRS duration was significantly prolonged immediately after ablation and during follow up. There was significant but transient prolongation of QT-mean and QTc-mean intervals. QT dispersion, QTc dispersion, and JTc-mean interval were not affected. JT and JTc dispersions were transiently prolonged. No serious ventricular arrhythmias were recorded during Holter monitoring, either before or after the procedure. There were no significant correlations between the left ventricular outflow tract pressure gradient and QTc, QT-d, QTc-d, JTc, JT-d, JTc-d, or QRS duration before and after ablation. CONCLUSIONS: Alcohol septal ablation for HOCM induces significant changes in the resting ECG in most patients, despite the occlusion of a relatively small artery. The changes include new Q waves, new bundle branch block, transient anterior ST segment elevation, atrioventricular block, and transient prolongation of QT interval.

Adult↗
PubMed1998

Increased striatal dopamine transmission in schizophrenia: confirmation in a second cohort.

OBJECTIVE: The authors previously observed an increase in striatal dopamine transmission following amphetamine challenge in 15 untreated patients with schizophrenia compared to 15 matched healthy subjects. The purpose of this study was to replicate this finding in a new cohort of schizophrenic patients and healthy subjects. METHOD: Fifteen patients with schizophrenia and 15 healthy subjects matched for age, gender, ethnicity, and parental socioeconomic status were recruited for this study. Patients fulfilled DSM-IV criteria for schizophrenia, had no history of alcohol or substance abuse or dependence, and were neuroleptic free for a minimum of 21 days. Amphetamine-induced dopamine release was assessed by the reduction in dopamine D2 receptor availability induced by an acute amphetamine challenge (0.3 mg/kg, intravenous bolus). Reduction in D2 receptor availability was measured with single photon emission computed tomography and the D2 receptor radiotracer [123I]IBZM. RESULTS: No differences were observed between patients with schizophrenia and the comparison group in D2 receptor availability at baseline. Patients with schizophrenia exhibited a significantly larger reduction in D2 receptor availability following acute amphetamine challenge than the comparison group. In this study, the effect size was smaller than in the first study. Excess dopamine release following amphetamine was associated with transient emergence or worsening of positive symptoms. CONCLUSIONS: In this new cohort of subjects the authors replicated their initial observation of a dysregulation of striatal dopamine release in schizophrenia.

Adult↗
PubMed1998

[The evaluation of surgical revascularization of the left ventricular systolic function after surgery].

To determine the effects of coronary artery bypass grafting (CABG) on the left ventricular function the 83 patients aged 52 +/- 6 years with ischaemic heart disease were examined by a standard two dimensional echocardiography (ECHO) and exercise test (EXT) before CABG and 1, 3, 6, 12 month after CABG. The following parameters were measured: LV ejection fraction (LVEF) and wall motion score index (WMSI) according to 14-segmental model and the duration of exercise test with work load. In conclusion, in patients surgical revascularization can significantly improve left ventricular function 6 and 12 month after CABG. We didn't observe connection between left ventricular function and result of exercise-test.

Adult↗
PubMed1998

[Cerebral evoked potentials and semantic categorization].

INTRODUCTION: Cerebral evoked potentials represent variations in the electrical activity of the nervous system, excited by a sensory stimulus and which are recorded on the surface. They may be classified as endogenous or exogenous. Amongst the late endogenous evoked potentials (EEP) we may emphasize N400 which seems to represent the linguistic management wave, particularly for semantics. OBJECTIVE: To observe the EEP recorded throughout the process of carrying out a task involving sequential semantic categorization. PATIENTS AND METHODS: Nine healthy subjects carried out a task based on a paradigm of sequential reaction time (RT), similar to that designed by us in 1994. The data recorded were the RT and EEP at the level of the electrodes Fz, Cz and Pz in five lots of stimuli (in the first four lots the same list of words were repeated and in the fifth and final lot a different, new list appeared). CONCLUSIONS: It was seen that only N400 varied during the procedure. This variation was related to familiarity with the task. That is to say that the amplitude of N400 was reduced when the same words were repeated and increased when new words appeared for semantic classification. The reduction in parallel, although not significant for RT, allowed the reduction in N400 alone to be followed whilst the task was carried out. It may be the electrophysiological marker of the process of learning semantic categorization.

Adult↗
PubMed1998

[Procedural learning in aphasic patients].

OBJECTIVE: This study concerned the procedural learning of semantic categorization. PATIENTS AND METHODS: The procedure used was a serial reaction time in an group of aphasic patients. RESULTS: Group of aphasic patients performed slower reaction times with more errors than the controls, but everyone manifested a decreasing reaction time, even during new semantic material categorization. CONCLUSIONS: Our results showed that the semantic categorization could be facilitated by procedural learning. Furthermore, this study suggest that procedural learning of semantic categorisation is at least relatively independent from cerebral structures usually involved a group of aphasic patients.

Adolescent↗
PubMed1997

The AFT1 transcriptional factor is differentially required for expression of high-affinity iron uptake genes in Saccharomyces cerevisiae.

High-affinity iron uptake in Saccharomyces cerevisiae involves the extracytoplasmic reduction of ferric ions by FRE1 and FRE2 reductases. Ferrous ions are then transported across the plasma membrane through the FET3 oxidase-FTR1 permease complex. Expression of the high-affinity iron uptake genes is induced upon iron deprivation. We demonstrate that AFT1 is differentially involved in such regulation. Aft1 protein is required for maintaining detectable non-induced level of FET3 expression and for induction of FRE2 in iron starvation conditions. On the contrary, FRE1 mRNA induction is normal in the absence of Aft1, although the existence of AFT1 point mutations causing constitutive expression of FRE1 (Yamaguchi-Iwai et al., EMBO J. 14: 1231-1239, 1995) indicates that Aft1 may also participate in FRE1 expression in a dispensable way. The alterations in the basal levels of expression of the high-affinity iron uptake genes may explain why the AFT1 mutant is unable to grow on respirable carbon sources. Overexpression of AFT1 leads to growth arrest of the G1 stage of the cell cycle. Aft1 is a transcriptional activator that would be part of the different transcriptional complexes interacting with the promoter of the high-affinity iron uptake genes. Aft1 displays phosphorylation modifications depending on the growth stage of the cells, and it might link induction of genes for iron uptake to other metabolically dominant requirement for cell growth.

Ceruloplasmin↗
PubMed1997

Recurrent intracerebral hemorrhage.

Between 1984 and 1994, of the 375 patients admitted to our department for intracerebral hemorrhage (ICH), 24 (6.4%) had a recurrent ICH. There were 15 women and nine men and the mean age of the patients was 64.7 +/- 9.4 years (range 49-81) at the first bleeding episode and 68.7 +/- 7.5 years (range 57-83) at the second. The mean interval between the two bleeding episodes was 47.5 +/- 30.5 months (range 3 months to 14.8 years). Nine patients presented with more than one recurrence of ICH. Seventy-one percent of the patients were hypertensive. The site of the first hemorrhage was lobar in 17 patients, ganglionic (putamen, thalamus, or caudate nucleus) in six patients, and subdural in one. The recurrent hemorrhage occurred at a different location from the previous ICH. The most common pattern of recurrence was "lobar-lobar" (14 patients) and more rarely "ganglionic-ganglionic" (five patients), which was always observed in hypertensive patients. The outcome after the recurrent hemorrhage was usually poor, with severe cognitive impairment. By comparison with 81 patients followed up to 24 months (47.9 +/- 22.2 months) with isolated ICH without recurrence, only lobar hematoma and a younger age were risk factors for recurrences whereas sex and previous hypertension were not. The mechanisms of recurrence of ICH were multiple (hypertension, cerebral amyloid angiopathy). Control of blood pressure after the first hemorrhage may prevent ICH recurrences.

Aged↗
PubMed1997

[Invasive maxilar sinusitis by Rhizopus oryzae].

We herein present a diabetic with non Hodgkin lymphoma patient that had been treated with steroids and developed fungal invasive sinusitis. The patient had intensive facial pain that did not respond to antibiotics and on clinical inspection had a necrotic lesion on right nasal area. A smear and biopsy tissue showed broad non septate hyphae and on cultures Rhizopus oryzae was isolated. There was an unfavorable outcome, and the patient died even though liposomal Amphotericin B was administered and surgical treatment was performed.

English Abstract↗
PubMed1997

On-line three-dimensional intracoronary ultrasound for guidance of catheter based interventions.

Intracoronary ultrasound (ICUS) provides valuable information on the distribution and composition of atherosclerotic plaque. For this reason its use for guidance of interventional procedures has been advocated. Recently, on-line systems of three-dimensional reconstruction have been introduced and offer great potential for guidance of interventional procedures since valuable details on longitudinal architecture of the plaque under treatment are obtained. In this article we review the current clinical application of three-dimensional (3-D) ICUS and report our experience with the use of an on-line 3-D ICUS system for guidance of interventional procedures. In our experience 3-D reconstruction of ICUS proved to be a feasible method facilitating device selection and guidance of catheter based interventions.

Catheter Ablation↗
PubMed1997

Is quantitative angiography sufficient to guide stent implantation? A comparison with three-dimensional reconstruction of intracoronary ultrasound images.

Intracoronary ultrasound (ICUS) frequently reveals stent underexpansion despite a satisfactory angiographic result by visual assessment. Whether on-line quantitative coronary angiography (QCA) alone can guide optimal stent deployment is still unknown. The aim of the study was to assess the usefulness of quantitative coronary angiography in the evaluation of optimal stent expansion, confirmed with a new on-line system of 3-D reconstruction of ICUS. The results obtained with 3-D ICUS were compared with the measurements achieved with QCA analyses in 49 patients (70 stents: 31 Palmaz-Schatz, 22 Wallstent, 7 Cordis, 6 Micro-stent, 2 Gianturco-Roubin, 2 Multi-Link). Following delivery of the stent, high pressure intrastent balloon inflation (14.2 +/- 3.3 atmospheres) was performed in all 70 stents. Optimal stent implantation by QCA was defined as minimal lumen diameter post-stenting > or = 90% of the reference diameter preintervention. Percent diameter stenosis (% DS) post-stenting was defined as minimal lumen diameter divided by the reference diameter post-stenting. The on-line 3-D ICUS reconstructions and measurements were performed processing the images on-line in the catheterization laboratory with an automated contour detection algorithm based on acoustic quantification. ICUS criteria for optimal stent expansion were defined as: 1) complete apposition of stent struts to vessel wall; 2) minimal stent lumen cross-sectional area > or = 80% of the average lumen area of the proximal and distal reference segments; 3) symmetry index (minimum divided by maximum lumen diameter) > 0.7. Ninety-seven percent of the deployed stents met the QCA criteria. Whilst 3-D ICUS documented complete stent apposition to the vessel wall in all cases and a symmetric expansion in 65 of 70 lesions (93%), the stent minimal lumen area was > or = 80% only in 30 out of 70 stents (43%). The diagnostic sensitivity and specificity at 10% residual diameter stenosis provided by QCA for optimal stent expansion compared to 3-D ICUS criteria were 86 and 45%, respectively. In conclusion 3-D ICUS criteria of adequate stent expansion were achieved only in 43% of patients despite the application of aggressive strategies of stent deployment leading to optimal results with quantitative angiography. Ten percent residual diameter stenosis provided by QCA may be an acceptable alternative for optimal stent deployment in clinical practice. The clinical benefit of an ICUS guided approach of stent deployment and of a lower cost strategy using on-line QCA guidance should be compared in large prospective randomized studies.

Angiocardiography↗
PubMed1997

[Amyotrophic lateral sclerosis and cognition disorders. Neuropsychological study of a population of 26 patients].

Typical amyotrophic lateral sclerosis (ALS) is described as a motoneuron disease which spared cognitive functions. Recent studies reported cognitive impairement associated with classical ALS. Gallasi and al. (1985) detect subtle cognitive impairement sparing memory in a population of 22 patients affected with sporadic motoneuron disease. Iwasaki and al. (1990) finds lower scores, including memory tests. Our study evaluated 26 patients compared with 26 control subjects with neurospychological tests (rapid evaluation of cognitive function fluency, Weschler adult intelligence scale, Wisconsin cards, Rey scheme, memory tests - Luria -, trail making, visual retentional test of Benton Violon Seyll test). All the neuropsychological tests were significantly lower for the patients group. The cognitive impairement is global: memory and frontal functions were not spared and this impairement is also subtle. It may easily go undetected without tests. We cannot isolate a cortical or subcortical profile of the deterioration.

Aged↗
PubMed1996

Quantification of the minimal luminal cross-sectional area after coronary stenting by two- and three-dimensional intravascular ultrasound versus edge detection and videodensitometry.

The use of 2-dimensional intravascular ultrasound (2-D IVUS) to improve the outcome of coronary stenting has gained clinical acceptance, and recently 3-D IVUS has been introduced to clinical practice. However, there have been no comprehensive studies comparing the measurements of the coronary dimensions after stenting obtained by the different approaches of IVUS and quantitative coronary angiography. We examined the minimal luminal cross-sectional area of 38 stents using 2-D IVUS, 3-D IVUS, and 2 standard methods of quantitative coronary angiography, edge detection (ED) and videodensitometry (VD). Correlations between 2-D IVUS and ED (r = 0.72; p < 0.0001), VD (r = 0.87; p < 0.0001), and 3-D IVUS (r = 0.81; p < 0.0001) were higher than the correlations seen between 3-D IVUS and ED (r = 0.58; p < 0.0005) and VD (r = 0.70; p < 0.0001). The measurements by 2-D and 3-D IVUS (8.32 +/- 2.50 mm2 and 8.05 +/- 2.66 mm2) were larger than the values obtained by the quantitative angiographic techniques ED and VD (7.55 +/- 2.22 mm2 and 7.27 +/- 2.21 mm2). Thus, concordance was seen among all of the 4 techniques, confirming the validity of using IVUS for determination of the minimal luminal cross-sectional area after coronary stenting. A particularly good correlation was found between VD and IVUS, perhaps because measurement of the luminal area is the basic quantification approach of both techniques, whereas the lower correlations of ED with IVUS and VD may be explained by the dependence of ED on the angiographic projections used, which is especially important in eccentric stent configurations.

Aged↗
PubMed1996

Single photon emission computerized tomography imaging of amphetamine-induced dopamine release in drug-free schizophrenic subjects.

The dopamine hypothesis of schizophrenia proposes that hyperactivity of dopaminergic transmission is associated with this illness, but direct observation of abnormalities of dopamine function in schizophrenia has remained elusive. We used a newly developed single photon emission computerized tomography method to measure amphetamine-induced dopamine release in the striatum of fifteen patients with schizophrenia and fifteen healthy controls. Amphetamine-induced dopamine release was estimated by the amphetamine-induced reduction in dopamine D2 receptor availability, measured as the binding potential of the specific D2 receptor radiotracer [123I] (S)-(-)-3-iodo-2-hydroxy-6-methoxy-N-[(1-ethyl-2-pyrrolidinyl) methyl]benzamide ([123I]IBZM). The amphetamine-induced decrease in [123I]IBZM binding potential was significantly greater in the schizophrenic group (-19.5 +/- 4.1%) compared with the control group (-7.6 +/- 2.1%). In the schizophrenic group, elevated amphetamine effect on [123I]IBZM binding potential was associated with emergence or worsening of positive psychotic symptoms. This result suggests that psychotic symptoms elicited in this experimental setting in schizophrenic patients are associated with exaggerated stimulation of dopaminergic transmission. Such an observation would be compatible with an abnormal responsiveness of dopaminergic neurons in schizophrenia.

Adult↗