Immunogenicity of Entamoeba histolytica antigen fractions.
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Biomedical subjects
Publications and source records attributed to M Alam.
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A novel epoxy sterol isolated from the marine mollusc Planaxis sulcatus has been identified as 9 alpha,11 alpha-epoxycholest-7-ene-3 beta,5 alpha,6 beta-triol by spectrometric methods.
Transthoracic echocardiography is of limited value in intensive care units primarily because of mechanical ventilators, surgical wounds, and the inability to position the patient to his left side. Imaging from the transesophageal window overcomes these problems, resulting in good-quality study in these patients subsets. We performed both transthoracic and transesophageal echocardiography with color-flow Doppler tests in 121 patients in various critical care units. The transesophageal ultrasound test was valuable in identifying patients with suspected left-sided native and prosthetic valve vegetations, prosthetic mitral but not aortic valve regurgitation, native mitral and aortic valve pathoogy, and aortic dissection and in determining cardiac etiology of systemic emboli, hypotension, hypoxia, and heart failure. Based on transesophageal echocardiographic findings, additional information was provided in 38 (32%) patients, resulting in appropriate surgery in 22 instances. In conclusion, transesophageal echocardiography is a useful tool in evaluating critically ill patients.
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Transesophageal echocardiography with color flow Doppler studies was performed on 12 consecutive patients who had left atrial mass identified by transthoracic echocardiography. In two patients with atrial myxoma, transesophageal study identified the tumor by its attachment to the atrial septum. In all instances, the tumors were larger and more mobile by transesophageal study and influenced the decision to operate early on an asymptomatic patient. In six instances the masses in the atria were deemed to be thrombi because of associated spontaneous echo contrast, location in the left atrial appendage, mitral valvular disease or prosthesis, atrial fibrillation, congestive heart failure, and enlarged left atrial chamber. In two patients the left atrial masses on transesophageal imaging were large vegetations attached to the mitral valve with ruptured chordae tendineae. In two patients, because of superior quality images obtained by transesophageal imaging, the atrial mass lesions were deemed to be a prominent muscle band between the left atrial appendage and left upper pulmonary vein. In conclusion, transesophageal echocardiography is superior to transthoracic imaging in elucidating the cause and significance of atrial mass lesions and helps in guiding appropriate therapy.
Transesophageal echocardiography with color flow Doppler studies was performed on 10 consecutive patients who had right atrial masses identified by transthoracic echocardiography. In one patient with right atrial myxoma, transesophageal study identified the tumor by its attachment to the atrial septum and ruled out the transthoracic finding of possible additional tumor mass in the right ventricle. In two instances the mass in the atria were deemed to be thrombi because of lack of attachment to the atrial septum, atrial fibrillation, and enlarged right atrial chambers. In all patients, the thrombi appeared larger by transesophageal study and was associated in one instance with atrial septal defect. The atrial septal defect was not identified by the transthoracic study and probably accounted for stroke of the patient through paradoxical emboli. In six patients, because of superior quality images rendered by transesophageal imaging, the right atrial mass lesions were deemed to be anatomic variants, which included prominent eustachian valves, remnants of Chiari network, and thickened atrial septum. We concluded that transesophageal echocardiography is superior to transthoracic imaging in elucidating the cause and significance of right atrial mass lesions and that it helps in guiding appropriate therapy.
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