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Biomedical subjects

E Garcia

Publications and source records attributed to E Garcia.

At least 199 records · Page 11Linked to original sources
PubMed1985

Collateral circulation in coronary artery disease.

The coronary arteriograms and left ventriculograms of 202 consecutive patients were reviewed. All had at least 75% diameter reduction of 1 or more major coronary arteries. In 127 patients (63%), at least 1 major branch was totally occluded. Collateral circulation was seen in 125 of these 127 patients (190 of 192 totally occluded arteries). Of the 75 patients without total occlusion, only 2 with 99% (or near-total) occlusion had demonstrable collateral circulation (2 of 208 arteries). In no patient with 75 to 98% diameter narrowing was collateral circulation demonstrated (0 of 164 arteries). An analysis was made of the relation between left ventricular (LV) segmental wall motion and the quality of collateral circulation in 190 totally occluded arteries among 125 patients. Of 126 arteries with good collateral circulation, LV contraction was normal in 21%, hypokinetic in 48% and akinetic/dyskinetic in 29%. Of 64 arteries with poor collateral circulation, LV contraction was normal in 23%, hypokinetic in 55% and akinetic/dyskinetic in 20%. There was no statistically significant difference between the effect of good or poor collateral circulation on LV function. These data indicate that collateral circulation cannot be seen angiographically unless there is total or near-total occlusion, and that the presence of collateral circulation does not correlate with LV wall motion abnormalities, i.e., akinetic area, despite good collateral flow or normal wall motion despite absent or poor collateral flow.

Collateral Circulation↗
PubMed1985

Digital signal and image processing in echocardiography. The American Society of Echocardiography.

Digital signal and image processing techniques are acquiring an increasingly important role in the generation and analysis of cardiac images. This is particularly true of 2D echocardiography, in which image acquisition, manipulation, and storage within the echocardiograph, as well as quantitative analysis of echocardiographic data by means of "off-line" systems, depend upon digital techniques. The increasing role of computers in echocardiography makes it essential that echocardiographers and technologists understand the basic principles of digital techniques applied to echocardiographic instrumentation and data analysis. In this article, we have discussed digital techniques as applied to image generation (digital scan conversion, preprocessing, and postprocessing) as well as to the analysis of image data (computer-assisted border detection, 3D reconstruction, tissue characterization, and contrast echocardiography); a general introduction to off-line analysis systems was also given. Experience with other cardiac imaging methods indicates that digital techniques will likely play a dominant role in the future of echocardiographic imaging.

Echocardiography↗
PubMed1985

Thallium-201 stress-redistribution myocardial rotational tomography: development of criteria for visual interpretation.

Despite high sensitivity and specificity for overall detection of coronary artery disease (CAD), planar stress-redistribution thallium-201 (Tl-201) scintigraphy remains suboptimal in localizing disease, because of overlap of myocardial segments. Single photon emission computerized tomography (SPECT), by providing three-dimensional representation of myocardial Tl-201, offers promise for improved localization of CAD. In 50 consecutive patients (22 normal and 28 with CAD), who underwent SPECT stress-redistribution Tl-201 imaging, we systemically developed visual interpretive criteria for perfusion abnormality on SPECT. For overall detection of disease, the best criterion for abnormality was greater than or equal to 8 sectors of moderately decreased Tl-201 uptake. With this criterion, the true positive and true negative rates for overall detection of disease were 96% and 91%, respectively. The best criterion for significant defect in the anterior or posterior coronary circulation was greater than or equal to 3 sectors of moderately decreased Tl-201 uptake. With this criterion, the true positive and true negative rates for anterior circulation disease were 71% and 100%, respectively. With respect to posterior circulation disease, the true positive and true negative rates were 100% and 50%, respectively. Regarding identification of dual circulation disease, the true positive and true negative rates were 71% and 82%, respectively.

Adult↗
PubMed1985

Bacterial gene expression and biotechnology.

This brief review article has been intended to give a few up-to-date examples of the dramatic impact that our knowledge of gene expression (especially bacterial gene expression) has had in the area of biotechnology. This area is in a state of such rapid growth that it has only been possible to present a limited overview of the subject matter. We have tried to illustrate our points with examples from work in which we have had some direct involvement. It should be apparent that continued increase in our understanding of gene expression should provide additional opportunities for expanded application of the new methodology.

Bacteria↗
PubMed1985

HLA antigens in hemophiliacs A with or without factor VIII antibodies in a Venezuelan Mestizo population.

Twenty-eight unrelated hemophilia A patients, seven of them with anti-factor VIII antibodies were typed for HLA-A, B, C antigens and 25 of them for HLA-DR. The results show a significant difference in HLA-DR4 frequency between hemophiliacs with antibodies who lack this antigen and hemophiliacs without antibodies, in whom HLA-DR4 is increased as compared to a healthy control series. This data suggests that DR4 may be associated with a factor preventing anti-factor VIII immunization.

Antibodies↗
PubMed1985

Slow regional clearance of myocardial thallium-201 in the absence of perfusion defect: contribution to detection of individual coronary artery stenoses and mechanism for occurrence.

As a result of the "spatially relative" nature of perfusion defect analysis of stress-redistribution thallium-201 (201Tl) scintigrams, hypoperfused myocardial segments may not appear as perfusion defects but they may demonstrate a slow washout rate of 201Tl that can be analyzed in a "spatially nonrelative" manner. Quantitative analysis of perfusion defects and slow washout rate of 201Tl was performed on scintigrams from 116 consecutive patients with adequate exercise tests, defined as achievement of 85% or more of age-predicted maximum heart rate or development of angina or ST segment depression. A total of 232 diseased and 116 nondiseased vessels were found in the patients. Additional analysis of slow washout rate significantly (p less than .05) improved sensitivity for detection of disease in the left anterior descending (from 74% to 82%), left circumflex (from 40% to 61%), and right coronary arteries (from 78% to 90%) without significant loss of specificity. This improvement resulted from the additional detection of 32 of 232 (14%) diseased vascular distributions when the isolated slow washout rate of 201Tl was also determined. In nine of these 32, isolated slow washout rate was associated with another region with isolated slow washout rate in the contralateral myocardial segment. Coronary arteriography revealed similar degrees of stenosis in the vessels supplying these segment pairs. In 13 of 32 cases, a perfusion defect and a slow washout rate were found in the contralateral segment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

A case of myocardial infarction in a patient with Werner's syndrome.

We report on a case of premature atherosclerosis in a patient with short stature, dysmorphic features, mild diabetes mellitus, hypertriglyceridemia, Mönckeberg's sclerosis, and the general appearance of premature aging, compatible with the diagnosis of Werner's Syndrome. The patient was referred to us after suffering a myocardial infarction at the age of 26.

Journal Article↗
PubMed1983

Cascade control of Escherichia coli glutamine synthetase. Purification and properties of PII uridylyltransferase and uridylyl-removing enzyme.

Uridylyltransferase, a component of the covalent modification cascade system that controls glutamine synthetase activity in Escherichia coli, has been purified to apparent homogeneity. The purification was facilitated by the use of an E. coli strain which carries multiple copies of a ColE1-hybrid plasmid containing the glnD gene that encodes uridylyltransferase and which overproduces its synthesis by 25-fold. Gel electrophoresis and high pressure liquid chromatography studies show that the native enzyme is a single polypeptide chain of Mr = 95,000 +/- 5,000. The purified enzyme catalyzes the uridylylation as well as the deuridylylation of the regulatory protein PII, demonstrating that a single bifunctional enzyme is involved in the covalent interconversion of PII. Gel filtration studies indicate that the enzyme undergoes slow irreversible aggregation during most steps of purification with a concomitant loss of activity.

Amino Acids↗
PubMed1983

Clinical evaluation of seven-pinhole tomography for the detection and localization of coronary artery disease: comparison with planar imaging using quantitative analysis of myocardial thallium-201 distribution and washout after exercise.

The development of quantitative techniques to assist in the analysis of planar thallium-201 stress-redistribution scintigrams has led to improved abilities of this modality to detect the presence of and to localize significant coronary artery disease (CAD). This fact has encouraged the reevaluation of its capabilities relative to other types of scintigraphic data collection, including seven-pinhole tomography. We have undertaken a comparison of planar scintigraphy and seven-pinhole tomography to detect in 40 exercised patients (23 with angiographically demonstrated CAD, eight with normal coronary angiograms, and nine with less than or equal to 1% likelihood of having CAD) the presence of significant CAD and to localize it correctly to an individual coronary artery. Emphasis was placed on similar imaging conditions and on analysis of images by the same quantitative program of TI-201 distribution and washout. Both techniques were found to be highly sensitive and specific for disease detection and localization. Importantly, seven-pinhole tomography did not significantly improve results.

Coronary Disease↗
PubMed1983

D-homoandrostanes. 4. The incubation of some D-homo-5 alpha-androstanes with Rhizopus nigricans.

Nine dioxygenated D-homoandrostanes were incubated with Rhizopus nigricans to investigate the effect of D-ring modification on microbiological hydroxylation. Structure determination of the products by NMR spectroscopy, and in certain cases independent synthesis of their oxidised products, showed that in contrast to 5 alpha-androstanes the majority of the compounds were hydroxylated in the "reverse" mode, and only D-homo-5 alpha-androstane-3,17-dione was hydroxylated in the "normal" mode to any extent. Stereospecific ring D-hydroxylation at C(17 alpha) was observed for both D-homo-5 alpha-androstane-3,6- and 3,7-diones.

Androstanes↗
PubMed1983

Analysis of the degree of pulmonary thallium washout after exercise in patients with coronary artery disease.

An abnormal increase in pulmonary thallium activity may be visualized on post-stress thallium images in patients with coronary artery disease. Because this increased pulmonary thallium activity usually disappears by the time of redistribution imaging, this study was designed to assess whether measurement of the degree of pulmonary thallium washout between stress and redistribution might improve the detection of increased pulmonary thallium activity in patients with coronary artery disease. Quantitative analysis revealed abnormal (that is, greater than 2 standard deviations of normal values) pulmonary thallium washouts in 59 (64%) of 92 patients with coronary artery disease, but in only 2 (25%) of 8 subjects with angiographically normal arteries (p less than 0.06). By comparison, the visual analysis of pulmonary thallium washout and use of initial pulmonary to myocardial thallium ratio were significantly (p less than 0.05) less sensitive in detecting abnormality in patients with coronary artery disease. Abnormal pulmonary thallium washout was related to both the anatomic extent and functional severity of disease: it occurred with greatest frequency in patients with multivessel disease and in those with exercise-induced left ventricular dysfunction (p less than 0.005). When added to the quantitative analysis of myocardial scintigraphy, the analysis of pulmonary thallium washout increased the detection of coronary artery disease from 84 to 93% (p less than 0.05), but the sample size was too small to assess specificity. Thus, the analysis of pulmonary thallium washout is a useful diagnostic variable because it: 1) provides an objective measurement of abnormal pulmonary thallium activity and is more sensitive than other methods; 2) correlates with both the extent of coronary artery disease and the degree of exercise-induced left ventricular dysfunction, and 3) improves the sensitivity of quantitative myocardial thallium scintigraphy to detect the presence of coronary artery disease.

Aged↗
PubMed1983

Mechanism of phage-induced lysis in pneumococci.

Earlier studies have suggested the possible role of host autolytic enzyme in the release of progeny phage from Dp-1 infected pneumococci. Several new experiments described here reinforce this notion. Specifically, the resistance of an autolysis-defective mutant to infection at low phage to cell ratios could be eliminated by prior 'coating' of the host bacteria with pneumococcal autolysin isolated from wild-type cells. Similar, productive infection was also possible by lowering the temperature of incubation to 30 degrees C, a condition that leads to a partial activation of the thermosensitive residual autolysin in the mutant cells. Other experiments, however, clearly indicate the role of the newly discovered phage-associated lysin (PAL), reported in the accompanying communication, in bacteriophage release and culture lysis; specifically, lysis was stimulated by reducing agents and inhibited by cardiolipin. It seems that both the host-related and the PAL activities are involved with Dp-1 induced lysis of pneumococci.

Bacteriolysis↗
PubMed1983

A phage-associated murein hydrolase in Streptococcus pneumoniae infected with bacteriophage Dp-1.

A phage-associated murein hydrolase activity capable of degrading pneumococcal cell walls was isolated and purified to homogeneity from the phage-induced lysate of an autolysis-defective pneumococcal mutant infected with the bacteriophage Dp-1. Some properties of the enzyme resembled those of the wild-type (host) pneumococcal murein hydrolase: cell walls prepared from ethanolamine-grown pneumococci were resistant to the enzyme; the activity was inhibited by the Forssman antigen and was sensitive to proteolytic enzymes. The phage-associated enzyme was not inhibited by antiserum prepared against the purified pneumococcal murein hydrolase; the activity was stimulated by reducing agents and was partially inhibited by cardiolipin. The subunit molecular weight of the phage-associated enzyme was somewhat smaller (31 000) than that of the pneumococcal hydrolase (35 000). This appears to be the first description of a phage-associated murein hydrolase activity in pneumococci.

Amidohydrolases↗
PubMed1983

Validation of a computerized edge detection algorithm for quantitative two-dimensional echocardiography.

An edge detection algorithm used in conjunction with digitized two-dimensional echocardiograms was applied to validate computerized two-dimensional echocardiographic (2DE) quantitation of cross-sectional areas of canine left ventricular chambers. Images were enhanced by space-time smoothing and dynamic range expansion, after which automatic edge detection was performed by convolving a Laplacian operator with the enhanced image. In an in vitro study of 29 myocardial slabs, computer-derived 2DE measurements of short-axis sections of the left ventricle were compared with manually derived 2DE data and validated against direct measurements of intraluminal areas of myocardial slabs. Correlations of both manually and computer-derived 2D echocardiograms vs direct measurements were equally satisfactory (r = .95 for both). Computer-derived measurements of perimeters tended to underestimate actual perimeters of the endocardial outlines of left ventricular sections. In 13 closed-chest anesthetized dogs, manually and computer-derived left ventricular short-axis areas measured by 2DE techniques showed a good correlation at both end-diastole (r = .91) and end-systole (r = .92). Left ventricular volumes reconstructed from 2DE images were compared with angiographically determined volumes. The computer-enhanced 2DE method correlated against angiography, with r = .93 for end-diastolic and r = .93 for end-systolic volumes. Left ventricular volume correlations between manually and computer-derived 2D echocardiograms were satisfactory, with r = .87 for end-diastole and r = .87 for end systole. We conclude that computerized enhancement and edge detection of 2D echocardiograms obtained in dogs provided accurate analysis of actual left ventricular cross-sectional areas and left ventricular volumes.

Animals↗
PubMed1983

Determination of cardiac output and ejection fraction with the dual cardiac probe.

Cardiac output and left ventricular ejection fraction were determined noninvasively at the bedside in 26 patients by using a dual scintillation probe. The probe is a nonimaging detector that records a high frequency time-activity curve of the passage of an intravenously injected radioactive bolus through the heart. Results were correlated with ejection fraction measured by biplane cineangiography (r = 0.80) and cardiac output determined by green dye dilution (R = 0.86). It is concluded that the dual probe provides an accurate noninvasive means of measuring these parameters, and that it may be particularly applicable to serial measurements in patients in the intensive care unit.

Journal Article↗