PubMed Health⌕ Search

Biomedical subjects

S D Cha

Publications and source records attributed to S D Cha.

At least 19 recordsLinked to original sources
PubMed1994

Intracerebral hemorrhage complicating urokinase infusion into an occluded aortocoronary bypass graft.

Selective infusion of urokinase into occluded coronary bypass vein grafts is effective in restoring patency. We report the occurrence of intracerebral hemorrhage complicating an intra-graft urokinase infusion protocol. The patient had known cerebral vascular structural pathology without recent clinical complications. Caution with the use of thrombolysis in this setting is suggested.

Cerebral Hemorrhage↗
PubMed1993

More on ACT.

Explore the source record for details and available documents.

Angioplasty, Balloon, Coronary↗
PubMed1992

Radiation therapy for surgically proven para-aortic node metastasis in endometrial carcinoma.

The impact of para-aortic field radiation therapy upon survival was studied among 26 patients with para-aortic nodal metastases from carcinoma of the endometrium. Seventeen of these 26 patients received postoperative radiation therapy to the para-aortic field as a part of their primary therapy. Sixteen of the 17 also received adjuvant hormonal therapy. Nine of 17 patients (53%) are alive without evidence of disease (18-55 months) with a median survival time of 27 months. Of the remaining eight patients, six (35%) died of endometrial cancer at 6-38 months, with a median survival time of 14.5 months. Five of these patients had distant disease. Two of the 17 patients (12%) died of intestinal obstruction felt to be secondary to radiation enteritis, one of whom was disease free. No difference in survival was detected in patients treated with radiation therapy with microscopic versus macroscopic nodal involvement. Of the nine patients who did not receive para-aortic radiation, eight were treated with hormonal therapy (n = 6) or chemotherapy (n = 2). Seven patients died of disease from 5-28 months, with a median survival time of 13 months. One patient is alive at 12 months. Survival in the 17 patients treated with para-aortic radiation was better than the eight patients not treated with para-aortic radiation (p = 0.004). This survival difference remained significant for patients with microscopic but not macroscopic nodal disease. Para-aortic field radiation appears to improve survival, but has a significant complication rate, and should be reserved for patients with histologic evidence of para-aortic metastases.

Adenocarcinoma↗
PubMed1991

Correlation between the position of transducers and mitral valve gradient in mitral stenosis.

To assess the severity of mitral stenosis related to the level of transducers, the mitral valve gradient using pulmonary wedge and left ventricle was obtained from 15 patients. The mitral gradient was obtained with both transducers at mid chest level. Then, the level of each transducer was realigned with the catheter tip in the pulmonary capillary wedge and in the left ventricle using lateral fluoroscopy and the mitral gradient was re-measured. At the mid chest level, the mean mitral valve gradient was 14 +/- 6.2 mm Hg with a mitral valve area of 1.3 +/- 0.6 cm2. With the adjusted level of transducers, the mitral valve gradient was 18.7 +/- 6.8 mm Hg with a valve area of 1.0 +/- 0.5 cm2. The difference was that the level of catheter tip in the wedge was 3.5 cm below the mid chest level and the one in the left ventricle was 2.5 cm higher than the mid chest level. This result suggested that the mitral valve gradient obtained at mid chest level underestimated the severity of mitral stenosis.

Cardiac Catheterization↗
PubMed1990

Atrial natriuretic peptide response to ionic and nonionic contrast left ventriculography.

Atrial natriuretic peptide (ANP) levels were measured prior to and at 1 and 5 minutes postcontrast left ventriculography with an ionic contrast agent (diatrizoate), and a nonionic agent (iopamidol) and the results were compared. Since ionic contrast agents have been found to cause an increase in left ventricular end-diastolic pressure (LVEDP) and nonionic agents have been found to have less of an effect on LVEDP, we investigated the response of ANP levels, which have been found to increase secondary to increased LVEDP (atrial pressure), with both agents. A group of 38 patients who were scheduled for left heart catheterization for suspected coronary artery disease was included (19 in each group) and blood samples for ANP levels were drawn from the left ventricles. At the same time, heart rate, LVEDP, and left ventricular systolic pressure (LVSP) were also measured. It was found that the LVEDP increased significantly for both agents at 1 minute postventriculography, but no further change occurred at 5 min. Heart rate increased significantly in the diatrizoate group at 1 minute with a return of heart rate to preventriculography levels at 5 min, while the ANP level and LVSP remained unchanged at 1 minute postventriculography with both agents but increased significantly at 5 min in the diatrizoate group only. This difference in ANP response is not correlated with the LVEDP. The response of ANP may be related to heart rate and/or LVSP.

Atrial Natriuretic Factor↗
PubMed1990

Intravenous adenosine (adenoscan) versus exercise in the noninvasive assessment of coronary artery disease by SPECT.

Fifteen patients at a mean age of 58 underwent adenosine and maximal exercise thallium SPECT imaging. All scans were performed 1 week apart and within 4 weeks of cardiac catheterization. SPECT imaging was performed after the infusion of 140 micrograms/kg/min of adenosine for 6 minutes. Mean heart rate increment during adenosine administration was 67 +/- 3.7 to 77 +/- 4.1. Mean blood pressure was 136 +/- 7.2 to 135 +/- 6.2 systolic and 78 +/- 1.8 to 68 +/- 2.6 diastolic. No adverse hemodynamic effects were observed. There were no changes in PR or QRS in intervals. Five stress ECGs were ischemic. No ST changes were observed with adenosine. Although 68% of the patients had symptoms of flushing, light-headedness, and dizziness during adenosine infusion, symptoms resolved within 1 minute of dosage adjustment or termination of the infusion in all but one patient, who required theophylline. Sensitivity for coronary artery detection was 77% and specificity 100%. Concordance between adenoscans and exercise thallium scintigraphy was high (13/15 = 87%). In two patients, there were minor scintigraphic differences. The authors conclude that adenosine is a sensitive, specific, and safe alternative to exercise testing in patients referred for thallium imaging and may be preferable to dipyridamole.

Adenosine↗
PubMed1989

Aortic balloon valvuloplasty.

Fifty-eight patients with severe aortic stenosis underwent successful aortic balloon valvuloplasty. The mean aortic valve gradient was reduced from 65 +/- 22 to 32 +/- 13 mmHg with symptomatic improvement. The procedure is an effective palliative procedure for patients with high surgical risk.

Aged↗
PubMed1988

Clinical trial of the disposable transducer catheter.

We compared the intracardiac and intravascular pressures obtained by a conventional strain gauge transducer (CT) with a recently developed disposable high-fidelity transducer catheter (DT) during cardiac catheterization. CT was positioned at the patient's midchest level. The pressure measurements obtained by DT compared favorably with those of CT. Femoral arterial pressures by the two methods showed no statistical difference. Right heart pressures were similar using both transducers. However, right ventricular pressures by DT in five of eight patients were lower than that from CT. Higher pulmonary arterial pressures were noted in two of seven patients and higher pulmonary capillary wedge pressures were seen in four patients using DT compared to CT. None of these differences were of statistical significance. These pressure differences may be due to transducer position. Because the midchest position of CT does not precisely define the anatomic location of the cardiac chamber being studied, pressure measurements can be overestimated or underestimated. DT eliminates this problem, as well as overshooting and concern with air bubbles in the catheter system commonly associated with CT. Therefore DT may provide accurate hemodynamic measurements. It would appear to be useful regardless of patient position and may be useful in ambulatory hemodynamic determinations.

Blood Pressure↗
PubMed1987

Transcatheter embolization of hepatic arteriovenous fistula in Osler-Weber-Rendu disease--a case report.

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is associated with arteriovenous fistulas throughout the body that can cause hemodynamic abnormalities. Owing to their size and extent, surgical repair is often not feasible. A patient referred for presumed valvular heart disease is described. On the basis of oximetry data at cardiac catheterization, a large intrahepatic arteriovenous fistula was discovered by aortography. This finding and a history of recurrent epistaxis were consistent with Osler-Weber-Rendu disease. Owing to the size of the fistula, embolization of the right hepatic artery with Gianturco coils was chosen as treatment, with resultant symptomatic improvement and decreased arteriovenous shunting.

Arteriovenous Fistula↗
PubMed1986

Acute hemodynamic effects of nifedipine during supine exercise in patients with prior myocardial infarction.

Twelve male patients age 36-66, 8 on clinical doses of beta blocker, with old transmural myocardial infarction underwent rest and matched workload exercise before and 30 min after 20 mg sublingual nifedipine during cardiac catheterization. For the group, resting heart rate, aortic pressure, pulmonary wedge pressure, systemic vascular resistance, cardiac index, and left ventricular ejection fraction were normal. Exercise duration was 12.5 +/- 1.5 min. Comparing exercise before and after nifedipine, heart rate, cardiac index, and mean velocity circumferential fiber shortening increased, while mean aortic pressure, systemic vascular resistance, pulmonary wedge pressure, right atrial pressure, left ventricular end-diastolic volume and left ventricular end-systolic volume decreased with no significant change in double product, pulmonary arteriolar resistance and left ventricular ejection fraction. Therefore, for the range of left ventricular dysfunction in this study group and with 8 patients concurrently on beta blocker, nifedipine 20 mg s.l. produced significant improvement in hemodynamics at rest and exercise.

Adult↗