[Simultaneous cerebral and coronary spasms].
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Biomedical subjects
Publications and source records attributed to G Jarry.
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The presented hybrid system allows precise temperature measurements in various sites of the circulation, from the acquisition and preprocessing of dilution curves. From haemodynamic data and left ventricular heat production, an in situ estimate of left heart efficiency is made available. A simplifying hypothesis allows the determination of total left ventricular heat production from three data inputs: (1) the coronary sinus blood flowrate, (2) the thermal coronary veno-arterial difference, (3) the ratio of thermodilution curves areas recorded in the aortic root and the coronary sinus, following a rapid injection in the left ventricular cavity of cold isotonic glucose. Experiments were performed on anaesthetized, artificially ventilated, closed-chest dogs, into which five catheters and probes had been inserted.
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1 degree Total left ventricular heat production was reliably estimated from the coronary blood flow, the coronary arteriovenous thermal difference and the thermodilution curve areas recorded in aortic root and in coronary sinus after injection of cold glucose solution into the left ventricular cavity. The assumption was made that the distribution of a cold solution, purposely introduced into the coronary arteries, obeys the same law as the heat generated by the myocardium. 2 degrees Temperature measurements were achieved with thermistors and a linear ohmmeter. Experiments were performed on thoracotomized dogs, allowing the utilization of an ultrasonic method for determination of the entire coronary sinus blood flow diverted through a cannula positioned in the coronary sinus. The spontaneous changes in acid-base balance and hemodynamic state, which were not systematically avoided, provided a fairly large interval of variation for coronary flow and myocardial oxygen consumption. 3 degrees Within the power interval of 0.5-2.2 watts per 100 g of left ventricular weight, there was a good linear correlation between left ventricular oxygen consumption and the sum of left ventricular heat production and external pressure power. 4 degrees These results suggest that the proposed method is a valuable approach for determination of the cardiac energetics in the in situ working heart. This method permitted repeated determinations of left myocardial heat production and may lead to a practical approach for measuring the left ventricular efficiency in intact animals.
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We report two cases of coronary-to-bronchial artery communication responsible for coronary steal. In both cases the anastomosis originated from the proximal circumflex artery and developed because of bronchiectasis. In both cases closure of the anastomosis was achieved successfully by embolization. To date, the patients remained free from symptoms.
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The authors report the case of a 35-year old woman with normal heart who voluntarily poisoned herself by swallowing 6 grams of naftidrofuryl. She developed disorders of atrioventricular conduction and a ventricular-like arrhythmia with collapse which resolves after mechanical ventilation. Data from the literature indicate that naftidrofuryl possesses class I electrophysiological properties which must not be ignored and which account for the cardiac effects observed in this particular case and in cases of parenteral overdosage already reported. By analogy with class I antiarrhythmic agents, treatment of naftidrofuryl poisoning with disorders of conduction could include the administration of molar sodium lactate.
Few studies have been devoted to the role of calcium blockers in stable angina of effort. For this reason, we undertook, a double-blind, randomized study with placebo, to compare the effects of diltiazem (D) and nifedipine (N) on the ergometric parameters of 20 patients with angina of effort and with mono- or multivessel disease. The study protocol extended over 3 weeks and included a reference stress test, 8 days of placebo followed by a repeat yesy, an then 15 days during which each patient received 180 mg of D and/or 30 mg of N in cross-over. A stress test was performed at the end of each week. The calcium blockers appeared to improve the effort tolerance, the duration of the ergometric test and the amplitude of the maximal ST segment depression. Diltiazem showed itself to be superior to nifedipine by the absence of side effects and by an improved cardiac performance on effort.
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