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Biomedical subjects

F Winsberg

Publications and source records attributed to F Winsberg.

At least 37 records · Page 2Linked to original sources

Left atrial myxoma: false negative echocardiographic findings in a tumor demonstrated by coronary arteriography.

A report of left atrial myxoma discovered at coronary arteriography by virtue of unusual tumor "vascularity" is presented in which establishing the diagnosis by means of echocardiography proved difficult. The difficulty may have been due to the highly vascular nature of the tumor with resultant loss of the acoustic reflectivity required for echocardiographic demonstration. Previous cases in which left atrial myxomas have shown arteriographically demonstrable "tumor vascularity" are reviewed.

Aged↗

Malapposition of the mitral valve: a two-dimensional echocardiographic sign of left ventricular dysfunction.

A pattern of mitral valve closure (malapposition) was observed in 75 of 1,267 patients examined with two-dimensional echocardiography. Criteria defining malapposition are: (a) the mitral valve leaflets exhibit a reduced area of coaptation during systole, (b) the angle at the point of coaptation of the anterior and posterior mitral valve leaflets becomes progressively more obtuse, approaching 180 degrees, and (c) the atrioventricular groove, the coaptation point, and the basal portion of the aortic root lie along the same vertical line. Malapposition appears to be the common denominator of previously described M-mode abnormalities seen in altered left ventricular hemodynamics and dysfunction.

Diagnosis, Differential↗

Ultrasonic measurement of the fetal ventricular system.

The ventricular systems of 178 fetal heads, ranging from 13 weeks gestation to term, were examined with ultrasonic "B" scans. The width of the frontal horns and of the third ventricle was measured. The distances between the temporal horns and between the sylvian fissures were also examined. The most important clinical measurement is that of the frontal horns. The combined width of the two frontal horns averaged 1.1 cm at 13 weeks and grew to an average of 2.4 cm at term. The 99% upper limits of confidence for these measurements were 1.45 cm and 2.78 cm, respectively. The frontal horn to BPD ratio decreased from 0.48 at 13 weeks to 0.25 at term. These measurements are considered important for the evaluation of possible ventricular dilatation in utero.

Cerebral Ventricles↗

The ultrasonic appearance of the umbilical cord.

We have used a combination of linear-array real time and contact sector scanning to image the umbilical veins and arteries. The best images are made perpendicular to the cord. The arteries spiral the vein and the cord is a tortuous structure. Thus there is considerable variability of the appearance of the arteries and veins depending upon the plane of the section.

Doppler Effect↗

Cardiovascular response to increasing theophylline concentrations.

The circulatory effects of plateau plasma theophylline concentrations of 5, 10 and 20 mg/l were examined in normal male volunteers using forearm plethysmography, systolic time intervals and echocardiography. Systemic arterial and forearm venous pressures were not significantly altered during theophylline infusions. Forearm blood flow increased an average 9.4% at 5 mg/l, 15.3% at 10 mg/l and 41.2% at 20 mg/l. Forearm venous distensibility was maximally increased by 20.9% at 10 mg/l. Changes in heart rate and systolic time intervals were apparent only at concentrations between 10-20 mg/l. Heart rates increased from 3-16 beats/min. The left ventricular ejection time index and isovolumetric contraction time were significantly reduced with an increase in the PEP/LVET ratio consistent with a reduction in cardiac pre-load and an increase in inotropy. However, the interindividual variability in circulatory responses was great and consistent alterations in cardiac stroke volume and ejection fraction were not observed in either the supine or 60 degrees passive-tilt positions. The variable responses cannot be due to variations in drug disposition between subjects since the range of plasma theophylline values at each concentration plateau was narrow.

Adult↗

Ultrasonic features of mitral annulus calcification. A report of 21 cases.

Twenty-one cases of echocardiographically visible mitral annulus calcification have been reviewed. Seventeen of these were also visible on chest radiographs, the remainder were proved by fluoroscopy. Factors which may lead to diagnostic confusion are: (a) failure to identify the posterior mitral leaflet (7/21); (b) diminished anterior leaflet mobility (mean 15 mm); (c) accoustic shadowing of the left ventricular wall (18/21); (d) pseudosystolic anterior motion. Fifteen of the 21 patients had aortic stenosis.

Aged↗

Estimation of cardiac chamber size by routine chest radiography and echocardiography.

The size of the left atrium and both ventricles was estimated by routine chest radiography and compared to echocardiographic single-chamber measurements. Left atrial size correlated well, but echocardiography appeared to be considerably more sensitive in detecting enlargement. Estimates of left ventricular size by radiography and echocardiography showed considerable discrepancy, since the single-dimension echocardiographic technique does not reflect lateral or inferior enlargement, which is readily visible on the radiography; however, ultrasound can distinguish left ventricular hypertrophy from dilatation. Right ventricular size cannot be assessed accurately using the single-diameter technique. The authors suggest that a combination of both techniques would be more accurate than either modality alone and that two-dimensional cardiac studies should prove more reliable than the single-diameter method.

Cardiomegaly↗