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Biomedical subjects

M Saeed

Publications and source records attributed to M Saeed.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Contrast media for cardiothoracic MR imaging.

Contrast media have been used for the study of disease of the thorax. Most experience has consisted of the use of MR contrast media for improving the delineation of acute myocardial infarction, for demarcating the area of acute myocardial ischemia, and for demonstrating the area of potentially jeopardized myocardium after acute coronary occlusion. Contrast agents demonstrate the ischemic or jeopardized area as a zone of decreased signal intensity to normal myocardium. On the other hand, the magnetic susceptibility agents demonstrate the ischemic or jeopardized area as a zone of increased signal intensity to normal myocardium. Little experience exists concerning the use of MR contrast media for enhancing mediastinal and lung masses. The few reports to date demonstrate that contrast media can improve the conspicuity of thoracic masses. A new nonionic contrast medium, gadodiamide injection, has been shown to considerably increase S/N and C/N of thoracic masses. Further studies are necessary to define the role of MR contrast media in the evaluation of myocardial ischemia and thoracic masses in clinical practice.

Animals↗
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First pass of an MR susceptibility contrast agent through normal and ischemic heart: gradient-recalled echo-planar imaging.

Gradient-recalled echo-planar magnetic resonance (MR) imaging was used to monitor the first pass of a magnetic susceptibility contrast agent through the heart of normal rats and rats subjected to 60-minute occlusion of the anterior branch of the left main coronary artery. Each animal (six normal and six ischemic) received four doses (0.05, 0.1, 0.15, and 0.2 mmol/kg) of Dy-DTPA-BMA [diethylenetriaminepentaacetic acid-bis(methylamide)] administered as a bolus volume of 1.0 mL/kg. In both normal and ischemic rats, signal intensity in nonischemic myocardium was reduced by the contrast agent in a dose-dependent manner. Signal intensity in the ischemic zone was reduced much less, so that at a contrast agent dose of 0.1 mmol/kg or greater the ischemic zone was clearly defined as a high-intensity zone on echo-planar images. Plots of the change in the apparent T2* relaxation rate (delta R2*) during the peak bolus effect versus injected dose were well fit by straight lines for normal, nonischemic, and ischemic myocardium but not for blood in the left ventricle. No difference was seen between myocardial response in normal animals and in nonischemic regions in animals with coronary artery occlusion. These findings suggest that the contrast agent-induced changes in tissue T2* are monoexponential and support the idea that data derived from contrast transit studies may be useful for calculation of myocardial blood flow.

Animals↗
PubMedDate not supplied

Contrast media for MR imaging of the heart.

The role of contrast media for quantitative characterization of ischemic myocardial events with magnetic resonance (MR) imaging has advanced considerably in the past few years. Contrast material-enhanced MR imaging is useful for identifying and sizing myocardial infarcts and for distinguishing between occlusive and reperfused myocardial infarcts. Recent results suggest that contrast-enhanced MR imaging can also be used to identify areas of cell death in regions of reperfused myocardial infarction. With the aid of MR contrast media, fast MR imaging techniques may be useful in estimating regional myocardial perfusion. Although no simple relationship between signal intensity and concentration exists, contrast-enhanced MR perfusion imaging can demonstrate the presence and relative severity of hypoperfused myocardium. Combining myocardial perfusion imaging with the anatomic and functional information provided by other MR imaging techniques could make MR imaging a comprehensive noninvasive means of evaluating ischemic cardiac disease.

Animals↗
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First-pass contrast-enhanced inversion recovery and driven equilibrium fast GRE imaging studies: detection of acute myocardial ischemia.

The purpose of this study was (1) to monitor the dynamic effects of T1-enhancing and magnetic susceptibility contrast material on normal canine myocardium using inversion recovery (IR)- and driven equilibrium (DE)-prepared fast gradient-recalled echo (GRE) sequences and (2) to determine the relative value of T1-enhancing and magnetic susceptibility contrast material in detecting regions of ischemia in the same animal. Normal dogs (n = 5) and dogs with acute occlusion of the left anterior descending (LAD) coronary artery (n = 11) were studied using a 1.5-T MR imager. ECG-gated fast IR-prepared GRE images were acquired using TI/TR/TE of 700/7.0/2.9 msec and a flip angle of 7 degrees. Fast DE-prepared GRE images were obtained using a flip angle of 12 degrees and a DE delay/TR/TE of 60/10.2/4.2 msec. Sequential images were acquired to monitor transit of 0.05 mmol/kg gadodiamide injection and 0.2 and 0.4 mmol/kg sprodiamide injection. On slice-nonselective IR fast GRE images, gadodiamide caused significant enhancement of the normal myocardium and the left ventricular (LV) chamber blood. In dogs with LAD occlusion, the ischemic region was defined as an area of low signal intensity (SI). On DE-prepared GRE sequences, administration of sprodiamide resulted in a substantial decrease in signal from normal myocardium and LV chamber blood in normal dogs. In animals subjected to LAD occlusion, this contrast medium produced a transient decrease in SI from normal myocardium (P < .05) and no significant change in SI from ischemic myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMedDate not supplied

MR imaging characterization of postischemic myocardial dysfunction ("stunned myocardium"): relationship between functional and perfusion abnormalities.

Stunned myocardium has been detected in patients treated successfully with thrombolytic agents. The hypothesis of this study was that fast gradient echo (GRE) imaging could be used to characterize the regional functional and perfusion abnormalities that are indicative of myocardial stunning. This study was designed to monitor and correlate the extent of wall thickness and perfusion abnormalities as determined by fast (segmented k space) cine and contrast enhanced GRE imaging, respectively. Dogs were subjected to left circumflex (LCX) coronary artery occlusion (15 min) followed by 30-minute reperfusion (n = 8). Perivascular flow probes were used to continuously measure flow in left anterior descending (LAD) and LCX coronary arteries. Short-axis inversion recovery prepared fast GRE and cine images were acquired at baseline, at occlusion, and at 1, 10, and 30 minutes of reflow. Regional signal intensity and percent systolic wall thickening were determined at 26 equally spaced circumferential positions to compare the extent of functional and perfusion abnormalities. During occlusion and reperfusion, the ischemic region was demonstrated on contrast-enhanced images as a hypointense and hyperintense region, respectively. During occlusion, the extent of the perfusion defect (32% +/- 2% of the circumference of the equatorial slice) correlated closely (r = .74) with the extent of contractile dysfunction (35% +/- 2%). After reperfusion, there was transient recovery in the percent wall thickening (26% +/- 4% vs 36% +/- 4% normal), coinciding with the reactive hyperemic response, but this was followed by a significant decline in wall thickening at 10 minutes (19% +/- 4%) and 30 minutes (12% +/- 2%). Fast MR imaging may be useful to monitor postischemic myocardial abnormalities after thrombolytic therapy and the response to pharmacologic interventions.

Animals↗
PubMedDate not supplied

Comparison of albumin-(Gd-DTPA)30 and Gd-DTPA-24-cascade-polymer for measurements of normal and abnormal microvascular permeability.

The purpose of this study was to compare a new MR macromolecular contrast medium (MMCM), gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-24-cascade-polymer, to a well-studied prototype MMCM, for the potential of distinguishing tissues of varying endothelial permeability. Three tissue models of varying capillary permeability were studied in a total of 46 rats: normal myocardium (normal capillaries), subcutaneously implanted adenocarcinoma (mild capillary leak), and reperfused infarcted myocardium (high capillary leak). TI-weighted MRI was performed before and dynamically after injection of either albumin-(Gd-DTPA)30 or the cascade polymer (each .02 mmol gadolinium [Gd] per kg). Data analysis based on a two-compartment kinetic model yielded estimates of fractional blood volume (BV) (percentage) and fractional leak rate (FLR) (1 per hour). Permeability to the cascade polymer as reflected in FLR was considerable in normal myocardium (8.24 per hour), of similar value in tumors (8.55 per hour), but significantly greater in infarcted myocardium (39.17 per hour, P < .01) versus normal myocardium. The larger albumin-(Gd-DTPA)30 demonstrated minimal extravasation in normal myocardium (FLR .33 per hour); FLR in tumors was 100% higher (.66 per hour, P < .002) and FLR in reperfused capillaries was significantly greater (7.94 per hour, P < .001). Based on capillary permeability measurements, the cascade polymer may have limited utility for detection of mildly increased microvascular permeabilities. For severe tissue injury, the cascade polymer can resolve abnormal microvascular integrity.

Analysis of Variance↗
PubMedDate not supplied

Histologic confirmation of microvascular hyperpermeability to macromolecular MR contrast medium in reperfused myocardial infarction.

A macromolecular MR contrast medium (MMCM) designed to permit histochemical staining and specific tissue localization, albumin-(biotin)10-(Gd-DTPA)25 (Bio-Alb-Gd), was used in a rat model of reperfused myocardial infarction to confirm the presence and distribution of microvascular hyperpermeability. T1-weighted spin-echo images were acquired before and after administration of Bio-Alb-Gd. An avidin-biotin-complex (ABC) stain, specific for the biotinylated MR contrast medium, was used to define the MMCM distribution and to detect any regional change in microvascular permeability related to infarction. Immediately after Bio-Alb-Gd administration, the infarcted region was enhanced, with greatest signal intensity noted at the rim and less at the center. There was a gradual increase in signal intensity of the initially hypointense central region. The steady increase in signal intensity of the central region suggested convection transport of MMCM through the interstitial space and its influx into cellular compartment after leakage from the vascular compartment. Histologic findings confirmed regional microvascular hyperpermeability corresponding to the site of infarction and a predominant rim distribution of the MMCM. Bio-Alb-Gd was identified at high microscopic power in the intravascular, interstitial, and intracellular spaces at the periphery of reperfused infarcted myocardium. Bio-Alb-Gd can be used as an MR contrast medium in reperfused infarcted myocardium to confirm the existence and to localize altered microvascular permeability to macromolecules. Bio-Alb-Gd contrast technique removes all the ambiguity between the distribution of the MR or other imaging contrast agent and the distribution of the substrate for histochemical staining.

Albumins↗
PubMedDate not supplied

Contrast-enhanced 3D-TOF MRA of peripheral vessels: intravascular versus extracellular MR contrast media.

MR contrast media have been used to improve MR angiography (MRA). Their effect has been particularly beneficial for extracranial MRA. This study evaluated the efficacy of a new formulation of ultrasmall superparamagnetic iron oxide particles (USPIO) on three-dimensional (3D) time of flight (TOF) MRA in the pelvis and lower limb circulation. Each of six dogs received 3 mg/kg of USPIO and .2 mmol/kg of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) bis-methylamide (BMA) by intravenous infusion on separate examinations. Precontrast and postcontrast 3D-TOF MRA images of the lower extremities were acquired over the course of 45 minutes postinjection. Signal intensity (SI) was measured on axial views along the external iliac, femoral, and popliteal arteries. USPIO provided clear demarcation of the major primary, secondary, and tertiary vessels and the improved contrast-to-noise ratio (CNR) was maintained for 45 minutes. Gd-DTPA-BMA provided less signal enhancement than USPIO. The increase in CNR with this agent had significantly declined by 15 minutes after injection. The major vessels could no longer be visualized at 30 and 45 minutes after injection of Gd-DTPA-BMA This study demonstrates the efficacy of USPIO as a contrast medium for 3D-TOF MRA. It was concluded that USPIO provided effective and persistent enhancement of the peripheral vessels.

Animals↗
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Urinary tract injury in patients with blunt chest trauma: the value of postaortographic abdominal radiographs.

Patients who require thoracic aortography for blunt decelerating chest trauma often sustain injury to other organ systems due to the magnitude and mechanism of injury. Hospital records and radiographs of 117 consecutive, injured patients studied with thoracic aortography were evaluated to assess the accuracy, value, and limitations of postaortographic abdominal plain radiography for detection of major genitourinary injury. In summary, major urinary tract injury occurred with a frequency of 6%, enough to justify a rapid, low cost, noninvasive screening procedure. Postaortographic plain films of the abdomen were found to be an accurate (95%) screen for detection of major urinary tract injury. The sensitivity for detection of patients with renal injury was 100%. The ability to correctly predict patients who may be safely observed (no significant renal injury) was 100%. One limitation of this technique was the poor diagnostic quality found in 15% of the abdominal radiographs, most commonly caused by excessive superimposed bowel gas. Postaortographic pelvic radiographs were believed to be valuable for detection, but not exclusion, of bladder rupture.

Adult↗
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Limitations of angiography for mesenteric ischemia caused by midgut carcinoid tumors.

Mesenteric ischemia associated with carcinoid tumors often presents with nonspecific abdominal pain and is usually due to mesenteric branch artery occlusion caused by elastic vascular sclerosis. Mesenteric ischemia was defined by the operative findings of cyanosis or infarction. Eleven patients with intraabdominal metastatic carcinoid tumor were evaluated by angiography. Angiographic narrowing and occlusion of multiple peripheral jejunal and ileal intramesenteric branch arteries was present in 3 patients with mesenteric ischemia, but also occurred in 5 of 8 patients without mesenteric ischemia. Other angiographic abnormalities included staining of the primary tumor (5) or metastases (6), tenting of small mesenteric vessels (5), and occlusion of draining mesenteric veins (2). We conclude that in patients with midgut carcinoid tumors, angiographic narrowing and occlusion of peripheral mesenteric arteries most likely represents elastic vascular sclerosis, is indicative of mesenteric invasion of tumor, but correlates poorly with the presence of ischemia in the subtended bowel. Alternatively, a normal selective arteriogram should exclude mesenteric ischemia as the cause of abnormal pain.

Adult↗
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Bleeding following endoscopic sphincterotomy: angiographic management by transcatheter embolization.

Transcatheter embolization is a well-established and effective method for the control of bleeding from the upper gastrointestinal tract and often represents the preferred alternative to more invasive surgical management. The applications of this technique for the management of bleeding following endoscopic sphincterotomy have not been reported previously. Of five patients referred for arteriography with life-threatening postsphincterotomy bleeding, active bleeding from branches of the gastroduodenal artery was demonstrated in four. Embolization of this vessel with Gelfoam controlled the bleeding in all three patients in whom it was attempted. Arterial stenosis and spasm precluded such treatment in one patient. The fifth patient was not bleeding at the time of arteriography. There were no complications from these procedures. Our experience shows that postsphincterotomy bleeding can be safely and effectively controlled by transcatheter embolization, thereby avoiding surgery which is associated with significant morbidity and mortality in this setting.

Adult↗
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CT findings in xanthogranulomatous pyelonephritis with coexistent renocolic fistula.

A case of diffuse xanthogranulomatous pyelonephritis of the kidney with an associated renocolic fistula is reported. Computed tomography demonstrated typical findings with an enlarged poorly functioning kidney with multiple near-water-density masses replacing the renal parenchyma surrounding a central staghorn calculus. A mottled gas collection within the renal parenchyma was secondary to a renocolic fistula rather than a pyogenic abscess.

Abscess↗
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Computed tomography of primary retroperitoneal malignancies.

The CT examinations and medical records of 33 patients with primary retroperitoneal malignancies were reviewed. Computed tomography findings were then compared with those from scans performed on 122 patients with non-Hodgkin lymphoma who presented during the same time interval. Primary retroperitoneal neoplasms had three distinct CT appearances. Twenty-one patients (64%) had large soft tissue masses. Seven patients (21%) had masses with fatty density components, and five patients (15%) had tumors that were primarily of water attenuation. With the exception of those liposarcomas that contained recognizable fat, CT could not distinguish among the different cell types. Seventeen patients with non-Hodgkin lymphoma had large dominant retroperitoneal soft tissue masses that resembled primary retroperitoneal malignancies. In most cases, however, CT was able to differentiate these tumor masses from primary retroperitoneal tumors. Although 19 of 20 sarcomas of soft tissue attenuation were heterogeneous, only six of the 17 lymphomas presenting as dominant masses had such an appearance. Computed tomography is extremely helpful in initially evaluating patients with primary retroperitoneal tumors and in assisting the surgeon in planning his or her approach by accurately defining tumor extent.

Adolescent↗
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Alpha-adrenoceptor blockade by phentolamine causes beta-adrenergic vasodilation by increased catecholamine release due to presynaptic alpha-blockade.

We tested whether the alpha 1- and alpha 2-blocking agent phentolamine can be used to assess the contribution of alpha-adrenergic constriction in circulatory control. In 15 conscious dogs at rest, phentolamine (2 mg/kg i.v.) caused hypotension (-17 mm Hg mean arterial pressure), vasodilation (-29% total peripheral resistance), tachycardia, and an increase in cardiac output, oxygen consumption, and plasma catecholamines. Following beta-adrenoceptor blockade (2 mg/kg i.v. nadolol), phentolamine still produced hypotension and increased plasma catecholamine levels, but neither vasodilation nor augmented oxygen consumption. During beta-blockade, phentolamine caused a 28-fold decrease in the vasoconstrictor response to norepinephrine infusions. An equihypotensive dosage of the alpha 1-adrenoceptor blocking agent prazosin (1.2 mg/kg i.v.) did not elevate heart rate, cardiac output, plasma catecholamines, or oxygen consumption. The prazosin-induced vasodilation was not attenuated by prior beta-blockade, in contrast to the phentolamine-induced vasodilation. It is concluded that phentolamine increased catecholamine release by presynaptic alpha 2-blockade, thereby suppressing the autoinhibition of transmitter release. This excess of catecholamines causes a rise of oxygen consumption and vasodilation by beta-adrenergic stimulation. Under beta-blockade, this excess competitively counteracts the postsynaptic vascular alpha-blockade. The combination of pre- and postsynaptic effects invalidates the use of phentolamine in the assessment of alpha-adrenoceptor-mediated vasoconstrictor tone.

Animals↗
PubMedDate not supplied

Beta-adrenergic activation of the renin-angiotensin system following alpha 2-, alpha 1-, or nonselective alpha-blockade in conscious dogs: no relation to the changes in blood pressure.

We analyzed the role of the renin-angiotensin system following alpha 2-, alpha 1-, or nonselective alpha-blockade in an intact organism in which both postsynaptic alpha-adrenoceptor types contribute to adrenergic vasoconstriction. In conscious dogs, alpha 2-blockade (0.3 mg/kg rauwolscine, n = 10) increased mean arterial pressure by 40 mm Hg, while hypotension by 8 mm Hg occurred following nonselective alpha-blockade (1.5 mg/kg phentolamine, n = 9) and by 20 mm Hg following alpha 1-blockade (1.2 mg/kg prazosin, n = 10). Plasma angiotensin II (pg/ml) rose by 103 +/- 28 (SEM), 143 +/- 48, and 58 +/- 15 following alpha 2-, nonselective alpha-, or alpha 1-blockade, respectively. While alpha 2- or nonselective alpha-blockade induced tachycardia and substantial elevations of plasma catecholamines, alpha 1-blockade did not. Beta-Blockade (2 mg/kg nadolol) attenuated the elevations of angiotensin following alpha 2- or nonselective alpha-blockade by 100 and 88%, respectively, without affecting the alpha 1-blockade-induced elevation, which is mainly mediated by the hypotension. Pretreatment with 3 mg/kg captopril reduced the pressure increase induced by alpha 2-blockade from 40 to 13 +/- 10 mm Hg and aggravated the decline in blood pressure induced by nonselective alpha-blockade from 8 to greater than 50 mm Hg. In anesthetized, spinalized dogs, both types of alpha-blockade competitively antagonized the pressor effect of the alpha 2-agonist azepexole by the same degree. It is concluded that, in the intact animal, the central and peripheral presynaptic augmentation of sympathoexcitation induced by alpha 2- or nonselective alpha-blockade leads to a strong beta-adrenergic activation of the renin-angiotensin system, independent of the concomitant changes in blood pressure. The constrictive action of the activation contributes substantially to the compensation of the vascular adrenoceptor blockade induced by nonselective or alpha 2-selective blockade in the intact organism.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

Sympathetic control of myocardial oxygen balance in dogs mediated by activation of coronary vascular alpha 2-adrenoceptors.

Recent observations on sympathetic constriction of the poststenotic coronary bed without dilatory reserve indicate the involvement of postsynaptic alpha 2-adrenoceptors, which are commonly regarded as noninnervated, hormonal receptors. Therefore, we characterized the vascular alpha-adrenoceptor activated during the competition between sympathetic constriction and metabolic dilation of the nonstenosed coronary bed by analyzing myocardial oxygen balance. In 39 anesthetized, spinalized open-chest dogs with bilateral cervical vagotomy, the left decentralized stellate ganglion was stimulated while mean aortic pressure was kept constant. Stimulation at 1 and 10 Hz lowered coronary venous oxygen saturation by 2.5 +/- 0.3 (SEM) and by 11.1 +/- 0.8 saturation %, respectively, in experiments under beta-blockade (4 mg/kg nadolol, n = 21). In experiments without beta-blockade (n = 18), the saturation response was similar. Under beta-blockade, alpha 2-blockade by rauwolscine (0.03 and 0.3 mg/kg) attenuated the decline in saturation induced by 10 Hz stimulation to 0.56 +/- 0.08 (p less than 0.01) of the control response and to 0.30 +/- 0.06 (p less than 0.001), respectively, whereas alpha 1-blockade by prazosin (0.012 and 0.12 mg/kg) modified this response only to 0.94 +/- 0.06 (NS) and to 0.75 +/- 0.08 (0.1 greater than p greater than 0.05). Without beta-blockade, similar attenuations to 0.36 +/- 0.07 (p less than 0.001) by 0.3 mg/kg rauwolscine and to 0.80 +/- 0.09 (NS) by 0.12 mg/kg prazosin were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗