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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

171 records · Page 10Linked to original sources
PubMedDate not supplied

[Hemodynamic effects of atrial overstimulation in patients with ischemic heart disease].

Auricular over-stimulation is used by some researchers to study patients under suspicion of coronary heart disease. In this paper we discuss the changes in telediastolic pressure of the left ventricle (PT-DVI), stimulating the right auricle with increasing frequencies sent through an external pacemaker. When the ventriculography and coronarography were over, the Sones catheter was left into the left ventricle. An electrode-catheter was introduced through vein in the right auricle, the distal end being very close to the sinusal node, where the electric catch as accomplished. Through this stimulator the cardiac frequency was increased in 20 heart beats more than the basal cardiac frequency and the PTDVI was simultaneously measured every 3 minutes. Through the coronarographic study, the patients were classified in: normal, bi-vascular and tri-vascular. The increase and decrease of PTDVI was calculated in relation to the results obtained during the last minutes of over-stimulation compared with the basal figures. Most of the patients showed a decrease in PTDVI no matter what the vascular engagement was. Our results show there is no difference between the response and the coronary obstruction degree so, this evidence is of no value to judge the functional situation of the left ventricle.

Adult↗
PubMedDate not supplied

[Comparative study of coronariography and radiocoronariography in ischemic cardiopathy. Preliminary report].

25 patients with ischemic heart disease were studied by selective coronariography and radiocoronariograpy with 3mCi of human albumin macroaggregates labeled with 99mTc, injected selectively into each coronary artery. Gammagraphic images were then obtained. 17 cases (68%), had coronary obstructions and 8 patients (32%), had a normal coronary angiogram. Of all patients studied, 23 (92%), had areas of hypoperfusion. Patients with coronary obstructions had corresponding image defects. 6 cases with normal coronary angiography had areas of hypoperfusion and finally 2 cases had normal images in both studies. All patients wit EC6 necrosis had abnormal radiocoronariography. The macrocirculation is studied by coronary angiography, while the microcirculation is visualized by radiocoronariography. Both technique are complementary. We conclude that radiocoronariography should be performed routinely after coronary angiography in the study of ischemic heart disease, with special emphasis in cases with normal angiograms.

Angiocardiography↗
PubMedDate not supplied

Enhancement of immune responses to suramin correlates with antineoplastic activity in BALB/c-mice.

The antiparasitic naphthylurea suramin (SUR) could be shown to exert immunomodulating and antimetastatic activity in BALB/c-mice. Regular intraperitoneal administration of SUR yielded significant weight gain of spleen and significant enhancement of peritoneal macrophage activity in chemiluminescence assays. The number of thymocytes per mg organ weight did not show evident differences in control and SUR treated groups; however, determinations of lymphocyte subsets revealed up-regulation of mature cells expressing helper/inducer (L3T4) or cytotoxic/suppressor (Lyt-2) phenotypes but down-regulation of immature cells presenting both L3T4/Lyt-2 antigens. Accordingly, administration of SUR obviously accelerated murine thymocyte maturation. Counts of BALB/c-mice peripheral blood lymphocytes (PBL) revealed evident (but statistically non-significant) increases after SUR administration. The determination of activated T-cells expressing interleukin (Il-2) receptors further proved that SUR induced a potent immunostimulation since these cells were significantly enhanced after treatment. To evaluate the antimetastatic activity of SUR, sarcoma L-1 cells were intravenously inoculated into BALB/c-mice. In this model system the number of experimental lung metastases significantly decreased, as compared to control mice which received injections of saline solution. Accordingly, SUR can be regarded as an immunomodulating and antimetastatic substance which seems to be promising for clinical trials in oncology.

Animals↗
PubMedDate not supplied

[Coronary angioplasty with the Monorail system via 6 French diagnostic catheters].

We studied the use of "Monorail" system with Express (Scimed) balloon catheters for coronary angioplasty through 6 French (F) "high-flow" diagnostic catheters (Novoste, USCI). Prospectively, from July 1992 to January 1993, angioplasty of 31 lesions in 24 patients was attempted (1.3 lesions/procedure). Twenty procedures were of a single lesion and four were multi-vessel angioplasty. Fourteen lesions were in the left anterior descending or in its branches, 10 in the left circumflex or in its branches, 6 in the right coronary artery, and one in the distal anastomosis of an internal mammary artery graft. Thirteen lesions (42%) were type A, 17 (55%) type B and one (3%) type C. Balloon sizes varied between 2.0 and 3.5 mm. Twenty-nine lesions could be successfully dilated (93.5%); two cases were unsuccessful due to an acute occlusion in one and residual stenosis of more than 50% in the other. For only one case, another balloon catheter different from the "Monorail" system was necessary to complete a multi-vessel angioplasty. Coronary visualization and manipulation of the balloon through the tip of the diagnostic catheter were satisfactory in all cases, except with the 3.5 mm balloon catheter. Coronary angioplasty with "Monorail" system balloon catheters through 6 F "high-flow" diagnostic catheters is feasible and provides a high success rate in simple and moderately complex selected lesions, including multivessel angioplasty with advantages of smaller artery punction and the feasibility of performing coronary angioplasty with the same catheter used for diagnostic angiography.

Adult↗
PubMedDate not supplied

[Coronary angioplasty in patients not accepted for surgical treatment. The initial experience of the Ignacio Chávez Instituto Nacional de Cardiología].

Coronary angioplasty has shown its efficacy in "high-risk" patients for surgical treatment (severe left ventricular failure, serious pulmonary or systemic disease). We studied a subgroup with multivessel coronary heart disease treated with coronary angioplasty because they were no candidates for surgery due to unsuitable coronary anatomy. Revascularization rate was determined in each patient as revascularization percentage obtained, compared with all the technically suitable lesions for coronary angioplasty. Ten patients (mean age 63 years) were studied, eight of them had unstable angina. Overall, 44 lesions were considered technically suitable for angioplasty and thirty-five could be dilated, technical success rate was 88% (31/35 lesions) and revascularization rate was 71% (31/44 lesions). Primary success rate was achieved in nine patients. Clinical follow-up varied from two to thirteen months (mean 7.8 months); eight patients have remained asymptomatic (class I of NYHA), another patient had stable angina and the other one had sudden death six months after the procedure. In conclusion, we demonstrated a high success rate in a short and long term with coronary angioplasty in a subgroup of patients with multivascular coronary heart disease that had been rejected for surgery due to unsuitable coronary anatomy.

Aged↗
PubMedDate not supplied

[Endoscopic ligation with elastic bands in the prevention of hemorrhage recurrence caused by esophageal varices. Study of 45 patients].

The aim of the present study was to determine the usefulness of elastic band ligation in the prevention of hemorrhage recurrence by esophageal varices. Forty-five patients without known hepatocarcinoma who had survived a hemorrhagic variceal episode were included in the study. Seventeen patients (38%) were Child-Pugh A, 22 (49%) B, and 6 (13%) C, with the hepatitis C virus and alcohol being the etiology of cirrosis in 55 and 20% of the cases, respectively. The first ligation session was performed between the third and fifth days after the hemorrhagic episode and the posterior sessions were carried out at intervals of 2-4 weeks. The ligation sessions were performed without antibiotic prophylaxis and with placement of an overtube. A mean of 4 +/- 2 bands were placed per session (range, 1-8) and the mean number of sessions required per patient to achieve erradication of the varices was 3.5 +/- 1.5 (range, 2-8). The rate of bleeding recurrence was 17.7% (9 episodes, five by variceal rupture and four by ulcer secondary to ligation). All the episodes of bleeding recurrence occurred between the sessions, with the mortality being 11% (5/45 patients). In the 40 remaining patients the varices were erradicated although 19 (47.5%) required one or two additional sessions of sclerotherapy. The accumulated percentage of patients free of bleeding recurrence was 82% during a mean follow-up of 10.2 +/- 6.7 months. Ten lesions of dislaceration of the esophageal mucosa caused by placement of the were observed overtube. In conclusion, endoscopic elastic band ligation is a useful technique for the erradication of esophageal varices an in the prevention of bleeding recurrence.

Esophageal and Gastric Varices↗
PubMedDate not supplied

[Determination of the real value of the ventricular volume using angiographic methods].

The developing of cuantitative angiographic procedures for evaluating the left ventricular efficiency have displaced most of the simple hemodynamic methods. The calculation of the left ventricular volume by usual ventriculography yields, as a rule, magnified values. The purpose of this paper is to determine the equation of the regression line means of which the real left ventricular volume can be calculated. A series of 12 normal hearts obtained from accidentaly deceased adult individuals (this necropsy material was afforded by the Forensic Medicine Department of México City). Previously measured amounts of a contrast substance were injected into the left ventricular cavity. The heart was filmed in a position equivalent to the chest RAO. The volume of the left ventricle was calculated using monoplane Sandler and Dodge cineventriculographic method. The results were submitted to statistic analysis. Confrontation of calculated and real values rendered a significative "r" (0.7374) and a non-significant "p" (0.001) the regression equation obteined was: y=36.97 + (0.39 x) in which: y=real left ventricular volume. x=calculated left ventricular volume.

Angiocardiography↗
PubMedDate not supplied

[Hemodynamic evaluation in acute myocardial infarct. Application to the treatment of contractile insufficiency syndromes of the left ventricle].

Even though the coronary care units have reduced to a minimum the mortality due to arrhythmias, the syndromes of left ventricular failure are responsible for the greatest part of hospital deaths in patients with acute myocardial infarction. The poor results depend upon the extensive destruction of left ventricular mass. The management in these cases should be directed to improve the performance of viable muscle as well as to preserve thejeopardized ischemic myocardium that is potentially viable. These goals may be adequately pursued by continuous hemodynamic characterization of left ventricular function. The experience of the Coronary Care Unit of the Instituto Nacional de Cardiología de México in the study of 30 of these patients is presented. Hemodynamic evaluations were performed by means of a Swan-Ganz catheter and cardiac output determinations by the thermodilution technique. The studies may be performed with a minimum of risk. Central venous pressure measurements do not adequately indicate the status of the left ventricle. Its function may be evaluated by the use of end diastolic pulmonary artery pressure which reflects, quite accurately, the left ventricular filling pressure in these patients. Continuous hemodynamic monitorization facilitates the proper manipulation of the determinants of ventricular performance (preload, afterload, cardiac rate and contractility) and permits an attempt to improve the balance between available oxygen and myocardial oxygen requirements. Hemodynamic studies and ventricular function curves are presented in selected patients with acute myocardial infarction. The mortality due to left ventricular failure and cardiogenic shock in patients with acute myocardial infarction remains extremely high. However, it is only through the early recognition by continuous hemodynamic monitorization and the aggressive management of the patient with incipient left ventricular failure that the number of survivors may be increased.

Female↗