Search PubMed⌕ Search

Biomedical subjects

A Applebaum

Publications and source records attributed to A Applebaum.

11 recordsLinked to original sources
PubMed2000

Activation of mitogen-activated protein kinases in human heart during cardiopulmonary bypass.

Mitogen-activated protein kinases (MAPKs) have been shown to be activated in both in vitro and in vivo models of cardiac tissue in response to ischemia/reperfusion injury. We investigated whether MAPKs are activated in human heart during coronary artery bypass grafting (CABG) surgery. During elective CABG surgery of 8 patients, 3 right atrial appendage biopsies were obtained at baseline, at the end of cross-clamping, and after coronary reperfusion. The expression of the p38-MAPK, c-Jun N-terminal kinase (JNK), and extracellular signal-regulated kinases (ERK1/2) MAPKs was not altered during CABG. The phosphorylation and activation of both ERK1/2 and p38-MAPK were increased approximately 2-fold by ischemia and even more (8- and 4-fold, respectively) by reperfusion. Although the ischemic period did not result in a significant activation of JNK, an approximately 6-fold increase in JNK activity could be observed after reperfusion. In conclusion, distinct activation patterns of ERK1/2, p38, and JNK MAPKs can be observed in human heart during CABG.

Aged↗
PubMed1999

Surgical management of tetralogy of Fallot in the first year of life.

BACKGROUND: The surgical approach to tetralogy of Fallot (TOF) continues to evolve and now many centers favor early repair for TOF. METHODS: Our experience includes 82 consecutive patients less than 1 year old with TOF (n = 74) and TOF with pulmonary atresia (n = 8) who were operated on between January 1992 and March 1998. Mean age at repair was 5.2 +/- 1.2 months and mean weight was 4.5 +/- 0.4 kg. Seven patients (anomalous left anterior descending artery [n = 1], pulmonary atresia with hypoplastic pulmonary arteries [n = 6]), underwent palliative procedures in the neonatal period followed by complete repair. Forty-nine patients (59%) were symptomatic (severe cyanosis or hypoxic spells), and 33 patients (41%) were asymptomatic. A combined transatrial-transpulmonary approach was employed in 28 patients (34%), and transannular patch or conduit for reconstruction of the right ventricular outflow tract (RVOT) was required in 54 patients (66%). The mean Nakata index was 160 +/- 25 mm2/m2. RESULTS: There were no hospital deaths. Mean post-repair peak right ventricular/systemic pressure ratio was 0.48 +/- 0.1. There were no late deaths or reoperations during a mean follow-up of 23 +/- 5 months. All patients are currently asymptomatic and in New York Heart Association class 1. Postoperative evaluation by two-dimensional and Doppler echocardiography or cardiac catheterization showed minimal pulmonary artery stenosis with a mean pressure gradient of 15 +/- 6 mm Hg across the RVOT. CONCLUSIONS: Our experience suggests that early repair of TOF can yield excellent results and initial palliation does not preclude early complete repair.

Blood Pressure↗
PubMed1996

Barbarians at the gates? Combating some new threats to hospital security professionals.

This article shows how security directors can answer simplistic security formulas used by some consultants and contractors with meaningful measurements. It presents ideas and approaches for cost-cutting, and may help the security director, if called on, to cut costs in a way that will continue to provide the most security per dollar spent.

Consultants↗
PubMed1991

Coronary pathology predicts conduction disturbances after coronary artery bypass grafting.

Conduction disturbances after coronary artery bypass grafting may result from compromised septal blood flow. To examine this hypothesis we reviewed the preoperative coronary angiography of 55 consecutive patients undergoing coronary artery bypass grafting. Thirty-five patients had either no lesion or a discrete lesion in the left anterior descending coronary artery that did not include the septal perforator (type I anatomy). Twenty patients had a lesion of the left anterior descending coronary artery at the origin of the first septal branch, a lesion of the first septal artery, or a pair of lesions in the left anterior descending coronary artery that straddled the origin of the first septal artery; all lesions were proximal to the graft site (type II anatomy). None of the patients with type I anatomy had a major conduction disturbance after coronary artery bypass grafting. Eleven of the patients with type II anatomy had major conduction disturbances after coronary artery bypass grafting; right bundle-branch block in 1, right bundle-branch block and left anterior hemiblock in 2, left bundle-branch block in 5, and complete atrioventricular block that required pacemaker implantation in 3 (p less than 0.001). In the 20 patients with type II anatomy, the appearance of conduction disturbances correlated well with the absence of retrograde flow to the septal branches from the right coronary artery (p less than 0.01). Pathological lesions in the left anterior descending coronary artery that compromise flow in the first perforator and that do not provide an adequate circulation produce localized damage and conduction disturbances after coronary artery bypass grafting. This can be predicted from the preoperative angiographic anatomy.

Aged↗
PubMed1983

Constrictive pericarditis following coronary-artery bypass grafting in a patient with chronic asymptomatic pericardial disease.

Constrictive pericarditis is a rare complication of open-heart surgery. We describe a patient who was found at the time of coronary artery bypass surgery to have asymptomatic pericardial thickening and subsequently developed rapidly progressive constrictive pericarditis. At operation for pericardiectomy, the bypass graft to the posterior descending coronary artery was found to be strangled by fibrous tissue while the remaining two bypass grafts were patent. Following pericardiectomy, the patient made a good recovery.

Chronic Disease↗
PubMed1979

Coronary angiography after traumatic myocardial contusion.

A patient with myocardial trauma following blunt chest injury is presented who returned 4 months later with persistent cardiac symptoms. Left ventriculography showed asynergy of the mid-diaphragmatic surface of the left ventricle while coronary angiography showed normal coronary arteries. The value of cardiac catheterization and coronary angiography in patients in whom symptoms persist after traumatic myocardial contusion and in patients in whom additional coronary artery or other cardiac disease is suspected is emphasized.

Adult↗
PubMed1978

Ventricular ectopic rhythms due to rapid runaway pacemaker.

A patient initially had syncope due to a runaway pacemaker firing at an unusually rapid rate (30 impulses per second). The ventricular arrhythmia was characterized by numerous ectopic beats, with coupling intervals related to the length of the preceding cycle and runs of ventricular tachycardia with slight variations in the intervals between beats. This case demonstrates the clinical characteristics of a very rapidly firing, low-intensity, ventricular parasystolic focus.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Guide wire entrapment during PTCA: a potentially dangerous complication.

The tip of a "high-torque" floppy guide wire became entrapped in a coronary artery during elective PTCA in four patients. In two it was removed through the guiding catheter, in the third an operative intervention was needed in order to free the wire, and in the fourth the remnant was left in situ. Interventional cardiologists should be aware of this potential complication.

Adult↗