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Biomedical subjects

G J Becker

Publications and source records attributed to G J Becker.

At least 145 records · Page 8Linked to original sources
PubMed1986

Effect of pregnancy on moderate renal failure in reflux nephropathy.

During a 10 year study of women with reflux nephropathy 20 women had plasma creatinine concentrations in the range 0.2-0.4 mmol/l (2.3-4.5 mg/100 ml). Six experienced pregnancies exceeding 12 weeks' gestation. Pregnancy was associated with rapid deterioration in function in all six, resulting in end stage renal failure in four women within two years after delivery despite adequate control of blood pressure. Of the 14 women who did not have a prolonged pregnancy, four had periods of uncontrolled hypertension, all of which were related to non-compliance or loss from follow up, or both. Uncontrolled hypertension was also associated with accelerated renal failure, and all four women progressed quickly to end stage renal failure. The remaining 10 women were observed for from five to 10 years; in all 10 renal function deteriorated slowly, and none reached end stage renal failure within seven years. It is concluded that pregnancy in patients with reflux nephropathy and moderately severe renal failure has a deleterious effect on renal function.

Adult↗
PubMed1986

Indeterminate lung imaging. Can the number be reduced?

During a 2 1/2-year period, 1131 patients with suspected pulmonary embolism had ventilation-perfusion lung scans; 150 of these patients also underwent pulmonary angiography. In a retrospective study, these 150 patients were re-evaluated using the reference criteria of Biello and Alderson, with 62% read as indeterminate. Twenty patients who had chronic obstructive pulmonary disease with retention of Xe-133 in greater than 50% of the lung fields without corresponding radiographic abnormality were included. Ventilation/perfusion matches and mismatches could be correctly determined in 15 of these patients. These 15 of 20 studies could be correctly reclassified as low-probability, while the other five remained indeterminate. With increasing intervals between ventilation/perfusion lung imaging and the onset of symptoms, the percentage of patients with proven pulmonary emboli correctly diagnosed as high probability continuously decreased, and the percentage of studies read as indeterminate constantly increased. Serial chest radiographs suggested that the development of infiltrates in the region of the embolus convert high-probability ventilation/perfusion scans to indeterminate.

Humans↗
PubMed1986

Intracoronary administration of streptokinase in a canine model. Disturbance in thromboxane A2-prostacyclin balance.

The potential impact of local intracoronary infusion of streptokinase (SK) on vascular prostaglandin synthetic pathways was studied in a canine model. Control animals (n = 10) underwent left coronary artery (LCA) infusion of 50,000 units SK for 90 minutes; experimental animals (n = 10) underwent LCA infusion of normal saline. Plasma samples for radioimmunoassay (RIA) of prostacyclin (PGI-2) and thromboxane (TXA-2) were obtained from the coronary sinus (CS) as follows: one sample preinfusion, six samples during infusion, and three samples postinfusion in each animal. Comparisons between control and experimental plasma levels of PGI-2 and TXA-2 were made for each sampling time. The PGI-2 levels remained at or below the lower limits of detectability by RIA (the most sensitive assay available) in both control and experimental animals. TXA-2 levels were higher in experimental than in control animals at all sampling times, with the most significant differences occurring in samples 3 (after 30 minutes of infusion, .001 less than P less than .01), 4 (after 45 minutes of infusion, .05 less than P less than .10), and 5 (after 60 minutes of infusion, .02 less than P less than .05). We suggest (1) it is unlikely that any of the beneficial effects of coronary streptokinase infusions are PGI-2-mediated, (2) that the TXA-2 increases in our model may represent a pathophysiologic-biochemical correlate of previously identified morphologic evidence of endothelial damage in animals infused with fibrinolytic agents, and (3) that our findings may indicate that fibrinolytic infusions produce competing effects: lysis of thrombi and endothelial injury with TXA-2 production.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1986

The Scimitar syndrome: CT findings in partial anomalous pulmonary venous return.

An anomalous pulmonary vein draining into the subdiaphragmatic inferior vena cava was initially demonstrated on computed tomographic (CT) scans. The diagnosis of scimitar syndrome was confirmed with digital subtraction angiography. In retrospect, the anomalous vein and dextroposition of the heart were shown on chest radiographs.

Female↗
PubMed1986

Fibrinolytic therapy.

The state of the art of fibrinolytic therapy is constantly changing; perhaps no other area of medicine is developing as rapidly. This paper presents the status of fibrinolytic therapy from the authors' viewpoint. Many statements are controversial. It is possible to find divergent opinions expressed by experts on almost any aspect of fibrinolysis. Objective data are rapidly accumulating, but because new substances continue to be developed, the present and future statuses of fibrinolysis remain unclear. The current results of fibrinolytic therapy are excellent but will be dwarfed by the effects of new compounds and techniques in the near future. Continued developments in this field will have a major impact on improved health care delivery.

Arterial Occlusive Diseases↗
PubMed1986

Cerebrovascular disease: evaluation with transbrachial intraarterial digital subtraction angiography using a 4-F catheter.

Three hundred sixty-one patients underwent intraarterial digital subtraction angiography for definite or probable occlusive vascular disease of the carotid arteries. Examinations were performed with 65-cm-long, 4-F aortic catheters. A transbrachial approach was used. Images were good or excellent in nearly all cases. No postprocedural neurologic deficits or hematomas occurred. Permanent pulse deficit occurred in two patients, and temporary deficit occurred in three patients, an improvement over the frequency found in previous transbrachial series using 6-8-F catheters. While these results establish the efficacy of this technique, they also indicate a possible greater relative safety in men than in women.

Angiography↗
PubMed1986

Recent subsegmental splenic infarction: hypervascular appearance on angiography.

The authors describe a case of a focal splenic infarction with a hypervascular appearance on selective splenic arteriography. This appearance of splenic infarction has never before been reported. Angiographers should be aware of this unusual presentation of splenic infarction when they encounter an unexplained focal hypervascular area.

Angiography↗
PubMed1986

Digital subtraction venography in central venous obstruction.

Thirty-five patients had central venous digital subtraction venography (DSV) to assess its value in detecting central line/shunt patency (13 patients) and central venous obstruction (22 patients). All examinations were easily performed and provided diagnostic images without conventional venographic supplementation. The disadvantages of DSV are outweighted by the advantages, which include saving time and money, superior contrast resolution, flexibility of image display, and reduced dosage of contrast agent.

Aged↗
PubMed1986

Rapid improvement in severe lupus glomerular lesions following intensive plasma exchange associated with immunosuppression.

We report our experience of intensive plasma exchange (PE) in the treatment of 12 females with severe diffuse proliferative lupus nephritis. All had active disease with crescentic lesions demonstrated on biopsy immediately before PE. Nine patients were also treated with high dose steroids, three patients with low dose steroids and most patients also received cytotoxic therapy. Eight of the 12 patients were biopsied immediately after a course of PE. All but one patient (low dose steroid group) showed considerable diminution of histologic activity with resolution of crescentic lesions. Plasma exchange may accelerate such resolution over conventional therapy, prevent subsequent sclerosis and preserve functional renal tissue.

Adolescent↗