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Biomedical subjects

C E Green

Publications and source records attributed to C E Green.

At least 73 records · Page 4Linked to original sources

Radiographic evaluation of the patient with chest pain of suspected myocardial origin.

The evaluation of the patient with suspected angina pectoris is discussed and an approach presented which makes use of radiologic tests in conjunction with exercise testing to quickly and efficiently determine the likelihood and severity of coronary artery disease. The relative merits and limitations of chest radiography, cardiac fluoroscopy, nuclear medicine, and coronary arteriography are discussed.

Cardiac Catheterization↗

Functional integrity of isolated rat hepatocytes prepared by whole liver vs biopsy perfusion.

Isolated rat hepatocytes prepared by a newly developed, versatile biopsy perfusion method (HB cells) were compared with hepatocytes prepared by conventional whole liver perfusion (HP cells), immediately after isolation and after 6 h in suspension culture. Thirteen parameters were used to assess the functional integrity of these cells. Both methods produced high yields of metabolically active hepatocytes that were virtually indistinguishable from each other. After 6 h, the average viability of both cell isolates declined approximately 10%, mixed function oxidase activities were decreased approximately 25% at most, and GSH levels were actually increased; other parameters were not significantly changed. The data indicate that HB-cell isolates are at least as viable and metabolically active as HP cells, and, because the biopsy perfusion method can be applied to liver samples from any species, it facilitates comparative studies.

Animals↗

Angled angiography. General approach and findings.

Axial cineangiography involves precise and consistent techniques in film exposure and development techniques that place the pathologic specimen at a right angle to the x-ray beam. The authors discuss the techniques of generating each view and the best approach for imaging various specific lesions.

Angiography↗

Plain chest radiography of congenital heart disease in adults.

The plain chest radiograph can be an invaluable aid in the diagnosis of congenital heart disease in adults. Evaluation of the chest radiograph is made simpler and more accurate by the use of a systematic approach based on physiology. In many instances, a definitive diagnosis can be made; in others, only a differential diagnosis can be arrived at. The majority of adults with congenital heart disease will have some telltale abnormality on the chest radiograph that will occasionally furnish the first clue to the presence of a congenital anomaly.

Adult↗

Advantages of the caudocranial left anterior oblique left ventriculogram in adult heart disease.

Biplane axial left cineventriculography represents the most accurate diagnostic technique for evaluating acquired and congenital heart disease. However, data have accumulated to indicate that without angled views of the left ventricle, the diagnosis will be incomplete and inaccurate in a significant number of patients. Left ventriculography is the acknowledged standard for left ventricular performance. However, comparison of the conventional or nonangled left anterior oblique left ventriculogram with the angled views of the left ventricle obtained with either two dimensional ultrasound or radionuclide left ventriculography may in many cases be invalid because dissimilar views are compared. The cranial-left anterior oblique view allows more accurate assessment of the precise degree and extent of asynergy, left ventricular aneurysms and ventricular septal defects. Left ventricular outflow tract abnormalities such as discrete subaortic stenosis and the obstructive form of hypertrophic cardiomyopathy can easily be distinguished. Lesions involving the mitral valve, especially mitral valve prolapse, are readily evaluated. Lastly, comparison with noninvasive tests of left ventricular performance can be more accurately performed.

Adult↗

Characterization of isolated Fe-loaded rat hepatocytes prepared by collagenase perfusion.

Hepatocytes from livers of rats loaded by Fe-dextran treatment were isolated by an in situ collagenase perfusion technique and evaluated for their biochemical, cytochemical, and morphological characteristics in cell culture. Iron loads 15 times higher than in normal rat liver cells isolated in the same way were retained in the preparations with 40% present as hemosiderin. A simple centrifugation-mathematical approach is described for the calculation of Fe content in the hepatocyte (95%) and reticuloendothelial (5%) fractions in the isolates. The cells were cultured for 22 h without loss of protein synthesis capability or significant changes in cell count, viability, endogenous glutamate-oxaloacetate transaminase (GOT) or Fe and were morphologically similar in most respects to unloaded (normal) hepatocytes similarly cultured. Studies are in progress to assess the utility of these preparations as a model for Fe mobilization from Fe-loaded animals.

Animals↗

The comparative metabolism and toxic potency of aflatoxin B1 and aflatoxin M1 in primary cultures of adult-rat hepatocytes.

Both aflatoxin B1 (AFB1) and a hydroxylated metabolite, aflatoxin M1 (AFM1), were potent cytotoxins and genotoxins to primary cultures of rat hepatocytes. However, AFB1 stimulated the release of lactate dehydrogenase into the culture medium and the loss of viable cells from the monolayer at lower doses than did AFM1. The lowest toxic doses of AFB1 and AFM1 were 0.05-01 and 0.6 microgram/culture, respectively. Genotoxicity, determined by an assay for stimulation of DNA repair, was apparent at lower doses than was cytotoxicity. AFB1 was again more potent than AFM1, stimulating DNA repair at 0.025 microgram/culture, compared to the lowest genotoxic dose of AFM1 of 0.05 microgram/culture. At higher doses (1.2-2.4 microgram/culture) the responses due to both aflatoxins in the cytotoxicity and DNA-repair assays were approximately equal. The metabolism of a low dose (c. 0.17 microgram/culture) of [14C]AFB1 and [3H]AFM1 by cultured hepatocytes differed significantly. After 1 hr, 50% of the [14C]AFB1 remained unchanged in the culture medium, whereas about 18 hr were required for the same amount of [3H]AFM1 metabolism to occur [14C]AFB1 was metabolized to AFM1, to polar metabolites recovered in the aqueous phase after chloroform extraction, and to metabolites covalently bound to hepatocyte macromolecules. [3H]AFM1 was also metabolized to polar metabolites and to forms bound to macromolecules. The degree of covalent binding of the aflatoxins correlated with their cytotoxicity and genotoxicity at lower doses. After a 24-hr incubation, 12.5% of the dose of [14C]AFB1 was covalently bound to macromolecules compared to 1.5% of [3H]AFM1. Although AFM1 was less potent than AFB1 in cytotoxicity, DNA-repair and covalent-binding assays using primary cultures of hepatocytes, AFM1 was still active at relatively low doses and therefore is probably a potent hepatotoxin in vivo.

Aflatoxin B1↗

Inheritance and expression of lysine plus threonine resistance selected in maize tissue culture.

Selection for resistance to growth inhibition by lysine plus threonine in equimolar concentrations (LT) in tissue cultures of maize yielded a stable resistant line, LT19. Genetic analysis of progeny of plants regenerated from LT19 showed that LT resistance was inherited as a single dominant nuclear gene, temporarily designated Ltr(*)-19. Tissue cultures initiated from resistant embryos required 5-10 times higher levels of LT to inhibit growth than did cultures from LT-sensitive embryos. LT resistance in Ltr(*)-19 was expressed as much reduced inhibition of root and shoot growth in the presence of LT. The free pool of threonine was increased 6 times in cultures initiated from immature embryos of LT-resistant plants, and 75-100 times in kernels homozygous for Ltr(*)-19, as compared to cultures and kernels from LT-sensitive embryos and plants, respectively. Overproduction of free threonine increased the total threonine content in homozygous Ltr(*)-19 kernels by 33-59%. The results demonstrate that LT resistance selected with tissue culture methods is heritable and is expressed in cultures, seedlings, and kernels. Furthermore, they demonstrate a method to obtain amino acid-overproducer mutants in maize, which have the potential to increase substantially specific amino acids in kernels. The capability to increase specifically the nutritionally limiting amino acid(s) could have important nutritional implications for the grain of cereals and other crops.

Journal Article↗

Etiologic significance of enlargement of the left atrial appendage in adults.

Fifty-one patients were divided into two groups: 20 patients with proven rheumatic mitral valve disease (RMVD) and 31 patients with left atrial enlargement (LAE) of a nonrheumatic etiology. The latter group included patients with ischemic papillary muscle dysfunction, mitral valve prolapse, and congestive cardiomyopathy. Radiographic studies showed that enlargement of the left atrial appendage (LAAE) was present in 18 of 20 rheumatics but in only one of 31 non-rheumatics. There was no direct relationship between enlargement of the LAA and radiographic or echocardiographic left atrial size, degree of pulmonary venous hypertension (PVH), or presence of atrial fibrillation. It is postulated that rheumatic inflammation of the LAA allows it to dilate out of proportion to the body of the left atrium. In the adult patient with radiographic findings of PVH, LAAE is a valuable and specific radiographic sign of rheumatic mitral valve disease.

Adult↗

The importance of angled right anterior oblique views in improving visualization of the coronary arteries. Part I: Caudocranial view.

Three hundred patients were examined to determine the value of the caudocranial right anterior oblique view (RAO) in revealing or improving visualization of lesions in the proximal and mid-left anterior descending artery (LAD), the origins of the septal and diagonal arteries, and the distal branches of the right coronary artery (RCA). The proximal and mid-LAD were shown to greater advantage in 80% of cases, the diagonal arteries in nearly 75%, the septal vessels in more than 90%, and the posterior descending and posterolateral branches of the distal RCA in more than 80%; in addition, the cranial RAO view revealed previously unsuspected lesions in 7% of the proximal and mid-LAD arteries and 26% of the septal vessels. In addition to superior visualization, this view gives satisfactory exposure even in extremely large patients and may also be helpful in coronary angioplasty.

Adult↗

The importance of angled right anterior oblique views in improving visualization of the coronary arteries. Part II: Craniocaudal view.

The craniocaudal right anterior oblique view (RAO) of the left coronary artery was employed for 100 angiograms. Visualization of the proximal and left distal circumflex, first and second marginal, and proximal left anterior descending artery (LAD) and its branches was compared with that on the non-angled RAO projection. Diagnostic accuracy was increased with the caudal RAO view in 88% of proximal circumflex segments, 69% of distal circumflex segments, 52% of first marginal segments, 33% of second marginal segments, and 33% of proximal LAD systems. Of 68 lesions identified, 15 (22%) were seen only on the caudal RAO view. The authors feel that this projection is a valuable and necessary addition to routine views of the left coronary artery, and that optimum evaluation is achieved by routine use of a combination of caudal, non-angled, and cranial RAO views.

Coronary Angiography↗

Experimental Sarcocystis suicanis infections: disease in growing pigs.

Four groups of 6 pigs each were given 5 x 10(5) to 3 x 10(6) sporocysts of a Georgia isolate of Sarcocystis suicanis. Only the 6 pigs given 3 x 10(6) sporocysts became acutely ill at postinoculation days (PID) 12 to 15, and 3 of the 6 diet at PIG 14 or 15. Clinical signs included purpura of the skin of the ear, snout, and buttocks and dyspnea, muscle tremors, and severe locomotor difficulties. Clinical abnormalities were accompanied by laboratory findings of pyrexia, severe anemia, leukopenia, thrombocytopenia, megathrombocytosis, prolonged prothrombin time and activated partial thromboplastin time, and hypofibrinogenemia. Seemingly, excessive intravascular coagulation may be involved in the pathogenesis of this disease in swine. Pigs given 5 x 10(5) to 1 x 10(6) sporocysts did not exhibit clinical signs; however, leukopenia and thrombocytopenia were demonstrated in the pigs at all dosage levels. Growth rates were impaired in surviving pigs. Second-generation schizonts containing merozoites were found in vascular endothelium of pigs dying on PID 14 or 15. Nonsuppurative myocarditis and hepatitis were present. Numerous developing cysts were in the musculature of pigs enthanatized on PIG 35 to 52. Cyst dissolution and resorption occurred concomitantly, indicating that swine may be able to clear the infection.

Animals↗

Acquired coronary-to-bronchial artery communication: a possible cause of coronary steal.

An unusual case of an acquired coronary-to-bronchial artery communication is presented. Collateral flow to the lung was provided by the right coronary circulation following obstruction of pulmonary blood flow by chronic pulmonary emboli. A coronary steal phenomenon may have caused an exacerbation of cardiac symptoms by further reducing already compromised coronary blood flow in a patient with atherosclerotic coronary artery disease.

Bronchial Arteries↗

Effects of intracoronary administration of contrast materials on left ventricular function in the presence of severe coronary artery stenosis.

The effects of intracoronary administration of contrast materials on regional and global left ventricular (LV) function were assessed in anesthetized dogs with segmental myocardial ischemia produced by critical stenosis of the circumflex coronary artery. Effects caused by sodium meglumine diatrizoate (R76), sodium meglumine calcium metrizoate (ISO), and metrizamide were evaluated. In the nonischemic state R76 produced an early (0-10 seconds) decrease in LV contractility followed by a late (10-20 seconds) positive inotropic effect. In the presence of regional ischemia there was prolongation of the negative inotropic effect. ISO produced only positive inotropic effects without significant differences between responses in the nonischemic and ischemic states. Metrizamide produced almost no alterations in LV function.

Animals↗

Improved cineangiographic evaluation of hypertrophic cardiomyopathy by caudocranial left anterior oblique view.

Seven patients with hypertrophic cardiomyopathy and one with discrete subaortic stenosis were studied with axial left ventriculography (caudocranial left anterior oblique view). In addition to the angiographic findings described on conventional views, the mitral valve, ventricular septum, and posterior left ventricular wall were better profiled than with conventional views and thus better evaluated. Systolic anterior motion of the anterior leaflet of the mitral valve was readily identifiable, which is usually not the case in nonangled views. From our experience, we strongly recommend that caudocranial left ventriculography be the procedure of choice in patients suspected of left ventricular outflow tract abnormalities and that biventricular angiography be abandoned for diagnostic purposes.

Adolescent↗

Advantage of the cranial-right anterior oblique view in diagnosing mid left anterior descending and distal right coronary artery disease.

The value of the cranial-right anterior oblique view in uncovering or improving the arteriographic visualization of lesions in the mid left anterior descending coronary artery, the origin of its diagonal and septal branches and the distal branches of the right coronary artery was analyzed in 300 consecutive patients. The cranial-right anterior oblique view was compared with standard and other angled views. In the mid left anterior descending artery the view provided improved visualization over the other views in 80 percent of cases and uncovered lesions in 7 percent. In the septal arteries, the view improved visualization in more than 90 percent of cases and uncovered lesions in 26 percent. In the diagonal branches, the view improved visualization in nearly 75 percent of cases. In the distal right coronary artery there was improved visualization of the posterior descending and posterolateral branch arteries in more than 80 percent of cases. The cranial-right anterior oblique view was also the most advantageous view from a technical standpoint, yielding satisfactory exposure factors in obese and extremely heavy patients.

Adult↗

Axial cineangiographic evaluation of the posterior ventricular septal defect.

The posterior or inlet ventricular septal defect may occur as an isolated anomaly or in combination with other defects. Axial cineangiography is the best means to delineate the anatomy of this defect as well as to exclude the presence of other ventricular septal defects. The posterior ventricular septal defect can be recognized in the four chamber view by obliteration of the septum by contrast medium flowing across the defect. Anterosuperior extension into the perimembranous region is identified by obliteration of the septum in the long axial oblique view. The presence of a posterior ventricular septal defect can be suspected on the basis of a two dimensional echocardiogram or electrocardiographic left axis deviation. When this is the case, the four chamber view should be performed first so that contrast material in the liver blood pool from a previous injection does not interfere with image quality.

Cineangiography↗