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Results 601 - 650 of 1019
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Cishek M B - - 1996
Immunosuppression can allow organisms which are not usually pathogenetic to cause disease. Invasive fungal disease is becoming increasingly prevalent because of the growing numbers of patients who are immunosuppressed. Aspergillus species frequently form large masses of fungal elements, thrombin, and fibrin, within the vasculature. These masses can then embolize, leading ...
Cass A S - - 1996
PURPOSE: Ungating using the Medstone* lithotriptor by 200 urologists was evaluated. MATERIALS AND METHODS: During 1994, 3,288 patients were treated by 200 urologists at 46 sites in 6 upper midwest states using 5 fixed and 3 mobile Medstone lithotriptors. Ungating was used with 58 treatments in 57 asymptomatic patients (1.8%) ...
Kovacs K A - - 1996
A previously healthy woman presented with ischemic cardiac pain and ST elevation suggestive of acute myocardial infarction following a 45 min argument. Despite receiving tissue plasminogen activator, she developed cardiogenic shock and objective evidence of recurrent ischemia, with only a small creatine kinase rise. Angiography revealed the unexpected findings of ...
Toney J F - - 1996
Septic shock is a common life-threatening problem, usually presenting with fever, tachycardia, tachypnea, and often a source of infection. The cardiac index is increased, with a decreased systemic vascular resistance, and a reversibly decreased ejection fraction with an increased end diastolic volume. The myocardial depression is most likely caused by ...
Sopher S M - - 1996
OBJECTIVE: To investigate the efficacy of internal cardioversion using low energy shocks delivered with a biatrial electrode configuration in chronic atrial fibrillation resistant to transthoracic shocks. METHODS: Low energy internal cardioversion was attempted in 11 patients who had been in atrial fibrillation for 233 (SD 193) days and had failed ...
Hata M - - 1996
To estimate coronary microcirculation during left heart bypass (LHB), we performed an experimental comparison study of LHB and intraaortic balloon pumping (IABP). LHB was performed with a BioMedicus BP-80 pump supporting half of the flow of cardiac output whereas the IABP was pumped in a 1:1 mode for cardiogenic shock ...
Geppert A - - 1996
Previous studies have suggested an improved clinical outcome when percutaneous cardiopulmonary support is combined with intraaortic balloon counterpulsation in patients with cardiogenic shock. We evaluated the effect of combined intraaortic balloon counterpulsation and percutaneous cardiopulmonary support therapy on coronary and cerebral blood flow by Doppler measurements in the coronary and ...
Shoemaker W C - - 1996
In the past, most investigators failed to consider time relationships in their studies of circulatory problems. Because of this, data obtained in middle- or late-stage shock during organ failure are often presented as being characteristic of specific shock syndromes. Even "early" studies are not physiologically early, but instead have often ...
Amrani M - - 1996
BACKGROUND: Heat-shock proteins are known to enhance cardiac resistance to ischemia. METHODS: To evaluate the kinetics of heat-shock protein 70 in relation to its effect on postischemic recovery of cardiac mechanical (cardiac output) and endothelial function (as percentage increase of coronary flow in response to 5-hydroxytryptamine), isolated rat hearts were ...
Strickberger S A - - 1996
Biphasic shocks are believed to be superior to monophasic shocks. Monophasic anodal shocks, as opposed to cathodal shocks, are associated with improved defibrillation energy requirements (DERs). However, it is unclear how the DER of anodal monophasic shocks compare with conventional biphasic shocks. Therefore the purpose of this study was to ...
Rigden L B - - 1996
INTRODUCTION: The purpose of this study was to determine the effect of direct current (DC) shocks on cardiac sympathetic innervation in humans using I-123-metaiodobenzylguanidine (MIBG) scintigraphy. Decreased efferent sympathetic neural function has been demonstrated following > 10-J DC shocks delivered through epicardial patch electrodes in dogs. To evaluate the effect ...
Usui M - - 1996
INTRODUCTION: The reason for the increased defibrillation efficacy of biphasic shocks over monophasic shock is not definitely known. METHODS AND RESULTS: In six anesthetized pigs, we mapped the epicardium after transvenous defibrillation shocks to compare the activation patterns following successful biphasic shocks with unsuccessful monophasic shocks of the same voltage. ...
Hsia P W - - 1996
Previous studies have suggested that variations in the underlying ventricular fibrillation (VF) waveform may be one of the factors responsible for the probabilistic nature of defibrillation. The heart appeared to be more susceptible to defibrillation at higher absolute VF voltages (AVFV). This study investigated in an open-chest canine model (n ...
Fabritz C L - - 1996
INTRODUCTION: Induction of ventricular fibrillation (VF) by T wave shocks is of clinical interest due to the correlation between the upper limit of vulnerability (ULV) and the defibrillation threshold (DFT). However, the ULV has not yet been defined precisely in reference to the entire "area of vulnerability" (AOV), which is ...
Newby L K - - 1996
OBJECTIVES: This study sought to readdress the definition of uncomplicated myocardial infarction and to apply clinical criteria for early discharge of such patients in the thrombolytic era. BACKGROUND: Previous studies proposed early hospital discharge at day 7 to 10 after acute myocardial infarction. The potential for earlier discharge of patients ...
Kapoor R - - 1996
We investigated the role of polymorphonuclear leukocytes (PMNLs) in cardiac depression and cytotoxicity during hemorrhagic shock and reinfusion. The dogs were assigned to four groups: I (sham), 4 h duration; II, 2 h of shock followed by reinfusion for 2 h; III, shock and reinfusion in neutrophils depleted with immune ...
Miralles A - - 1996
Myocardial infarction due to myocardial tissue embolism of the right coronary is a rare cause of early graft failure. We report one case with such a complication, in a 44-year-old man who was transplanted with a graft from a 32-year-old male donor. Prolonged refractory cardiogenic shock developed after orthotopic heart ...
Metrangolo L - - 1995
OBJECTIVE: To assess the relative contributions of changes in vascular tone and changes in cardiac function to hemodynamic recovery from septic shock. DESIGN: Case series, observational study. SETTING: Multidisciplinary department of intensive care in an academic hospital. PATIENTS: Sixty-seven patients with septic shock (prolonged hypotension, signs of tissue hypoperfusion, signs ...
Auyeung Y - - 1995
BACKGROUND: Recent studies have shown that improved myocardial salvage after heat-shock pretreatment correlates with the amount of induced cardiac heat-shock protein (HSP)72. However, heat shock also induces myocardial catalase activity, potentially reducing free radical-mediated ischemic injury. The aim of the present study was to determine whether catalase inhibition with 3-amino-1,2,4-triazole ...
Rodgers K G - - 1995
Few presentations to the emergency department are as critical or dramatic as the patient in shock. Cardiovascular disasters that commonly present with shock include massive pulmonary embolism, cardiac tamponade, aortic dissection and aneurysm, and cardiogenic shock associated with acute myocardial infarction. Because patients in "cardiovascular shock" have similar clinical presentations ...
Greenstein A - - 1995
PURPOSE: We evaluated the occurrence of cardiac arrhythmias during nonsynchronized extracorporeal shock wave lithotripsy. MATERIALS AND METHODS: A total of 125 nonsynchronized shock wave lithotripsy treatments was performed using a spark plug lithotriptor. RESULTS: Asymptomatic unifocal ventricular premature contractions occurred during 23 treatments (18.4%) and were more frequent during therapy ...
Knisley S B - - 1995
INTRODUCTION: Defibrillation shocks produce extension of the myocardial action potential repolarization time (AP extension) in nonischemic myocardium. AP extension may synchronize repolarization in the heart because the extension increases when shock timing is increased. We tested whether AP extension occurs and whether it increases when shock timing is increased in ...
Böhm M - - 1995
OBJECTIVE: Increased inhibitory G-protein alpha-subunits (Gi alpha) have been reported to be related to adenylyl cyclase desensitization in the failing human heart. In order to investigate whether this cellular alteration occurs already at the stage of hypertensive cardiac hypertrophy or in catecholamine-refractory cardiogenic shock, Gi alpha levels were studied in ...
Brady P A - - 1995
Concern has been raised regarding the ability of a nonthoracotomy integrated lead system to redetect ventricular fibrillation following failed defibrillation shocks due to diminution in postshock intracardiac electrogram amplitude. Whether such a problem could occur with other lead systems is not known, leading to uncertainty regarding a potential ongoing risk ...
Moscucci M - - 1995
Despite advancements in the pharmacologic treatment of acute myocardial infarction and the introduction of mechanical hemodynamic support, in-hospital mortality rates for cardiogenic shock have remained between 70% and 80%. In addition, the proven beneficial effects of thrombolytic therapy in reducing mortality in acute myocardial infarction have not been paralleled by ...
McGrath L B - - 1995
Following myocardial ischemia, heat shock proteins (HSPs) have been found to be associated with a reduction in infarct size and enhanced postischemic functional recovery. Stress-induced regulation of the HSPs is mediated by the activation and binding of the heat shock transcription factor (HSF) to a specific DNA sequence located in ...
Saetung P - - 1995
The first case of idiopathic arterial calcification of infancy in a 7-month-old Thai infant was reported. The patient succumbed to cardiogenic shock. Widespread fragmentation and calcification of internal elastic lamina accompanied by intimal fibroblastic thickening involved mainly medium-sized muscular arteries accompanied by intimal fibroblastic thickening were noted. Coronary involvement was ...
Raggi P - - 1995
A 29-year-old woman with acquired immunodeficiency syndrome (AIDS) was admitted to the intensive care unit with a diagnosis of septic shock. During intensive hemodynamic support with intravenous dopamine, she developed electrocardiographic ischemic changes compatible with an acute injury pattern. The pattern disappeared readily and was not followed by any subsequent ...
Idriss S F - - 1995
A method of defibrillation threshold determination that utilizes low-strength shocks delivered in a benign rhythm would be desirable. Because the two-dimensional epicardial potential gradient (PG) is a shock parameter that is linked to defibrillation, we examined whether the epicardial PG measured for shocks delivered in paced rhythm could be used ...
Harel Y - - 1995
A 6-year-old child was found under a heavy bookcase that compressed her chest. On admission to the emergency room she was found to be dyspneic with a systolic murmur and complete atrioventricular (A-V) block. Her condition deteriorated rapidly, leading to cardiogenic shock and loss of consciousness. Echocardiographic Doppler evaluation demonstrated ...
Murgatroyd F D - - 1995
OBJECTIVES: This study investigated the efficacy and tolerability of low energy shocks for termination of atrial fibrillation in patients, using an endocardial electrode configuration that embraced both atria. BACKGROUND: In animals, low energy biphasic shocks delivered between electrodes in the coronary sinus and right atrium have effectively terminated atrial fibrillation. ...
Bethell D B - - 1995
The clinical, the 12-lead, and the 24-hour electrocardiographic findings in 15 consecutively studied Vietnamese children (aged 7 months to 16 years) with severe diphtheria were documented. Five patients died, three from respiratory arrest and two from cardiogenic shock; one of these two patients had complete heart block that necessitated insertion ...
Toeda T - - 1995
The prognosis of left main coronary stenosis complicating cardiogenic shock is very poor. Unprotected left main coronary stenosis usually preclude percutaneous transluminal coronary angioplasty because of the appearance of elastic recoil and the risk of hemodynamic collapse after acute closure of the artery. An 85-year-old woman with no history of ...
Robinson B L - - 1995
In vitro studies suggest that interventions targeted at myocardial gene regulation of endogenous cytoprotective elements, such as heat-shock protein, may attenuate myocardial ischemic injury. We tested the hypothesis that heat shock-induced expression of myocardial heat-shock protein before ischemia accelerates functional recovery of postischemic stunned myocardium in the intact circulation. Sixteen ...
Wearden P - - 1995
Over the past five years, the use of extracorporeal life support in the adult population has gained acceptance. Indications have ranged from respiratory failure secondary to trauma, and adult respiratory distress syndrome, to cardiac failure secondary to a number of causes. The results of extracorporeal life support, when applied to ...
Böhm M - - 1995
PURPOSE: The aim of the study was to investigate the mechanisms of myocardial catecholamine refractoriness in septic shock. METHODS: The inhibitory guanine nucleotide-binding proteins (Gi alpha) were studied with pertussis toxin labeling and radioimmunologically in myocardium from patients who died while in catecholamine-refractory septic shock and from patients who died ...
Levine GN - - 1995
The adverse impact of the development of cardiogenic shock in the setting of acute myocardial infarction was first described by Killip and Kimball in 1967. While the in-hospital mortality rate in patients with myocardial infarction and no evidence of heart failure was only 6%, the mortality rate in those patients ...
Satoh H - - 1995
A percutaneous left ventricular assist system (PLVAS) using a modification of the Dennis method was developed and implemented in 8 patients. Transseptal cannulation was performed under biplane fluoroscopy and/or transesophageal echocardiogram without encountering any problems. All the patients were in a state of severe cardiogenic shock, caused by acute myocardial ...
Dillmann W H - - 1995
In this overview four questions were discussed related to heat shock proteins and myocardial ischemia. Heat shock proteins are chaperones which associate with malfolded proteins and prevent their aggregation into large damaging complexes. In myocardial ischemia, the inducible heat shock protein 70 (hsp70), the mitochondrial heat shock protein 60 and ...
Emmerich K - - 1995
This study reports on 16 patients suffering from cardiogenic shock in the setting of acute myocardial infarction (11 men, five women; average age: 52.5 +/- 14 years) treated by means of primary coronary angioplasty: These 16 patients were part of a total population of 261 patients suffering from acute myocardial ...
Walcott G P - - 1995
The upper limit of vulnerability hypothesis for defibrillation states that a successful defibrillation shock must both stop the fibrillation wave fronts on the heart at the time that the shock is delivered and not start new wave fronts that will lead to reentrant circuits being formed, causing the heart to ...
Garber P J - - 1995
OBJECTIVES: To investigate the effect of an increase in aortic pressure combined with rapid tissue plasminogen activator infusion on hemodynamic stability and patency of the infarct-related artery in patients with acute myocardial infarction complicated by profound hypotension or cardiogenic shock. BACKGROUND: Thrombolytic therapy improves mortality in relatively stable patients with ...
Rady M - - 1994
A focused review of the physiologic mechanisms of colloid and crystalloid fluid resuscitations for acute critical illness is presented. This review suggests that postresuscitation plasma volume, cardiac output, left ventricular mechanical performance, and global and microcirculatory O2 supplies are more favorable with colloid therapy. Conversely, crystalloid may adversely affect microcirculatory ...
Moorman A F - - 1994
Why the embryonic heart can function without one-way valves and without a conduction system, and why the embryonic atrium and ventricle function essentially as they do in the adult, are elementary questions in cardiac embryology. These questions can now be addressed, thanks to the recent development of molecular cell markers, ...
Osswald S - - 1994
BACKGROUND: Certain biphasic waveforms with specific time ratios of positive and negative components require less energy for successful defibrillation of the fibrillating ventricles than monophasic waveforms. However, if more efficient waveforms were also to be associated with more injurious effects on myocardial function, they might not provide a true biological ...
Sasson Z - - 1994
This report describes two cases of cardiotoxicity associated with the use of 5-fluorouracil (5-FU) in the treatment of neoplastic disease, and reviews the literature to date. The manifestations of cardiac toxicity were significant ventricular dysfunction during continuous infusion of 5-FU, accompanied by symptoms resembling cardiac ischemia in one case and ...
Feltes T F - - 1994
OBJECTIVE: To quantitate ventricular systolic mechanics in septic children. DESIGN: Prospective wall-stress analysis was compared to standard ejection phase indices. SETTING: University-based pediatric intensive care unit. PATIENTS: Fifteen children with sepsis (hemodynamically stable, n = 5; in shock, n = 10). MEASUREMENTS AND MAIN RESULTS: Left ventricular ejection phase indices: ...
Kurose M - - 1994
There has been no report regarding therapy of extracorporeal life support (ECLS) that showed stunned myocardium echocardiographically and electrocardiographically in patients with acute myocardial infarction. ECLS was performed in eight patients with cardiogenic shock or arrest unresponsive to catecholamines and intra-aortic balloon pumping following myocardial infarction; these patients required prolonged ...
Yamanaka O - - 1994
A woman with a pheochromocytoma crisis initiated by cardiogenic shock showed severely impaired left ventricular contraction at the time of admission. Heart failure was improved rapidly, and an endomyocardial biopsy performed on the 11th day of admission showed findings compatible with "catecholamine cardiomyopathy". Regarding the pathogenesis of short-duration left ventricular ...
Bartel A G - - 1994
Direct angioplasty is an accepted treatment for acute myocardial infarction and has resulted in stabilization and improvement in the clinical, electrocardiographic, and hemodynamic consequences of acute myocardial infarction. This case demonstrates the effectiveness of coronary perfusion as a method of resuscitation during cardiogenic shock and asystole in a patient with ...
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