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Biomedical subjects

P Angelini

Publications and source records attributed to P Angelini.

At least 55 records · Page 3Linked to original sources
PubMed1994

Gianturco-Roubin stent placement for variant angina refractory to medical treatment.

A 43-yr-old man with mild, fixed obstruction of the left anterior descending (LAD) coronary artery and severe, uncontrolled variant angina underwent placement of an endovascular stent to preserve patency of the artery. The decision for stent placement was based on several factors, including refractoriness to medical treatment and standard balloon angioplasty, documented spasm localized to the proximal LAD lesion, and the morbidity, mortality, and costs associated with the surgical approach in this type of patient. At follow-up, there was moderate restenosis of the stented coronary segment; the vasospastic angina syndrome had totally resolved.

Adult↗
PubMed1994

Transmyocardial laser revascularization. Anatomic evidence of long-term channel patency.

Transmyocardial laser revascularization, a new surgical technique, is being tested in patients with chronic obstructive coronary artery disease that is refractory to conventional revascularization techniques and to maximal medical therapy. During the operation, which is performed on the beating heart through a left thoracotomy, a high-energy CO2 laser is used to bore transmural channels (1 mm in diameter) into the left ventricle. Each high-energy laser pulse is delivered during end diastole and transects the heart within 10 to 60 msec. The operation is based on the theory that blood will flow directly from the left ventricle into the channels and then into the myocardial vascular plexus. Restoring perfusion should alleviate ischemia in potentially viable myocardium and improve ventricular function. Recently, one of our patients died 3 months after transmyocardial laser revascularization of causes unrelated to the operation. Histologic analysis enabled us to obtain, for the 1st time, anatomic evidence of patent laser channels. Routine staining of cardiac tissue with hematoxylin and eosin revealed multiple patent channels, running perpendicular to and interconnecting with the native vasculature. Although reactive fibrous scar tissue had caused narrowing of the original laser tract, the channels had endothelialized and they contained red blood cells. These findings suggest that the laser channels were functional. We report this interesting case and briefly discuss the anatomic and physiologic phenomena involved in establishing camerosinusoidal blood flow by use of transmyocardial laser revascularization.

Coronary Disease↗
PubMed1993

In vitro evaluation of blood flow through autoperfusion balloon catheters.

The effective flow rates with human blood through an autoperfusion catheter cannot be monitored in vivo and have not been experimentally determined in vitro. The manufacturers (Advanced Cardiovascular Systems [ACS], Temecula, CA) have suggested that "the flow rate" through the Stack over the wire and the RX-60 monorail catheter is 60 ml/min with a pressure gradient of 80 mmHg. We measured human blood flow rates in vitro through these catheters under different continuous pressure regimens (between 40 and 120 mmHg), with varying hematocrit levels (between 25% and 62%). Measured blood flows at a gradient of 80 mmHg were found to vary from 32 to 65 cc/min, with hematocrit levels of 62-25%. Minor variations in the circuitry, besides the viscosity of the medium, cause significant changes in observed flow rates (such as kinking of the catheter and blood sedimentation). In vitro determinations of blood flows cannot automatically be transferred to the in vivo condition, primarily because in vitro determinations do not account for the systolic intramural pressure increase (which may overcome the aortic pressure). If such a phenomenon is also considered, then the in vitro flow rates reported here should be multiplied by a factor of 0.40-0.60 to determine effective in vivo flow rates. Such information is relevant for the clinical operator of angioplasty, especially in the treatment of patients at high risk for undergoing percutaneous transluminal coronary angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed1993

Mapping quantitative trait loci (QTLs) for resistance to Gibberella zeae infection in maize.

The basic prerequisite for an efficient breeding program to improve levels of resistance to pathogens in plants is the identification of genes controlling the resistance character. If the response to pathogens is under the control of a multilocus system, the utilization of molecular markers becomes essential. Stalk and ear rot caused by Gibberella zeae is a widespread disease of corn: resistance to G. zeae is quantitatively inherited. Our experimental approach to understanding the genetic basis of resistance to Gibberella is to estimate the genetic linkage between available molecular markers and the character, measured as the amount of diseased tissue 40 days after inoculation of a suspension of Fusarium graminearum, the conidial form of G. zeae, into the first stalk internode. Sensitive and resistant parental inbreds were crossed to obtain F1 and F2 populations: the analysis of the segregation of 95 RFLP (restriction fragment length polymorphism) clones and 10 RAPD (random amplified polymorphic DNA) markers was performed on a population of 150 F2 individuals. Analysis of resistance was performed on the F3 families obtained by selfing the F2 plants. Quantitative trait loci (QTL) detection was based either on analysis of regression coefficients between family mean value and allele values in the F2 population, or by means of interval mapping, using MAPMAKER-QTL. A linkage map of maize was obtained, in which four to five genomic regions are shown to carry factors involved in the resistance to G. zeae.

Chromosome Mapping↗
PubMed1993

The right atrioventricular valvular apparatus in the chick heart.

The purpose of this study was to describe the detailed anatomy and histology of the right atrioventricular valve apparatus in the chicken. Newborn and adult chicken hearts were studied by anatomic description, light and scanning electron microscopy, and histologic (Masson's trichrome stain) and histochemical (Sirius Red stain) techniques. Our findings indicate the presence of an incomplete fibrous annulus, a great mural leaflet, and multiple microleaflets in the right atrioventricular apparatus of the chicken heart. The great mural leaflet, essentially muscular in structure, extended from the anterior and posterior juxtaseptal commissures and was subdivided into an anterior and a posterolateral region by the attachment of the anterolateral papillary muscle. The posterolateral region presented an intermediate cleft, subdividing this region into an anterior and a posterior portion. Multiple microleaflets, which adhered to the upper right side of the ventricular septum adjacent to the right atrioventricular orifice, inserted directly into the ventricular septum via short chordae tendineae, without papillary muscles. The microleaflets were composed of smooth subendocardial connective tissue, with varying amounts of type I, II and III collagen. In addition, we observed a central fibrous body, leading to fibrous continuity between the mitral and aortic valves and the mitral and right atrioventricular valves. An atrioventricular septum was also present.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Reduction of ischemia with a new flow-adjustable hemoperfusion pump during coronary angioplasty. The Coronary Hemoperfusion Ischemia Prevention Study (CHIPS) Investigators.

A new flow-adjustable pump for coronary hemoperfusion to prevent ischemia during routine coronary angioplasty was evaluated in a multicenter prospective study of 110 patients. The protocol included patients who had angina or ST segment elevation during a control balloon inflation of less than or equal to 3 min. Hemoperfusion was performed by means of a new large lumen angioplasty catheter utilizing the patient's renal vein or femoral artery blood. Vessels perfused were the left anterior descending coronary artery (n = 74), right coronary artery (n = 39), left circumflex artery (n = 9) and coronary vein grafts (n = 15). Mean (+/- SD) perfusion flow was 41 +/- 9 ml/min (range 17 to 70); mean perfusion time was 9.3 +/- 4 min (median 8.5, range 2 to 30). Chest pain score (0 to 4) decreased from 2.9 +/- 1 to 1.4 +/- 1 during hemoperfusion (p less than 0.001); ST segment elevation score (0 to 4) decreased from 2.6 +/- 1 to 0.7 +/- 1 (p less than 0.005) and inflation time increased from 1.3 +/- 0.9 to 7 +/- 4 min, (p less than 0.001). At least a 50% increase in tolerated inflation time was obtained in 104 patients (95%). Free plasma hemoglobin and creatine kinase levels did not increase significantly over baseline values. Angioplasty was successful in 107 patients (97%), with mean stenosis reduced from 87 +/- 11% to 20 +/- 17%; 3 patients had urgent bypass surgery, 2 (1.8%) had a myocardial infarction (1 Q wave, 1 non-Q wave) and 2 (1.8%) died later in the hospital of probable noncoronary causes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Prolapsing large aneurysm of the atrial septum simulating a right atrial mass.

An unusual case of a large, prolapsing atrial septal aneurysm in a patient with an otherwise normal heart is described. The aneurysm caused right atrial obstruction and resulted in a "tumor effect." The patient experienced debilitating symptoms for years before receiving an appropriate diagnosis and curative surgical treatment.

Blood Vessel Prosthesis↗
PubMed1991

Twelve-lead electrocardiographic evaluation of ischemia during percutaneous transluminal coronary angioplasty and its correlation with acute reocclusion.

The sensitivity of the surface 12-lead electrocardiogram and that of standard (limb-lead) monitoring for the detection of ischemia during percutaneous transluminal coronary angioplasty were compared in 115 patients. The purpose was to identify the electrocardiographic leads that provide the most sensitive indicators of coronary ischemia during percutaneous transaluminal coronary angioplasty and to evaluate the "ischemic fingerprint" that is obtained with 12-lead electrocardiogram during balloon inflation as a predictor of abrupt reocclusion after successful percutaneous transaluminal coronary angioplasty procedures. During balloon inflations of 30 seconds, ischemia was detected in 61 of 145 vessels (42%) by limb-lead monitoring alone versus 130 of 145 vessels (90%) by 12-lead electrocardiography (p less than or equal to 0.001). In the nine patients (7.8%) who experienced abrupt reocclusion within 24 hours, the electrocardiogram during chest pain after percutaneous transaluminal coronary angioplasty was identical to that obtained during percutaneous transaluminal coronary angioplasty ("ischemic fingerprint"). None of the six patients who had chest pain after percutaneous transaluminal coronary angioplasty without evidence of abrupt reocclusion reproduced their ischemic fingerprint. The suggested optimal leads for monitoring ischemia are as follows: left anterior descending coronary artery, V2, and V3; circumflex artery, V2, and V3; and right coronary artery, III and aVF.

Adult↗
PubMed1991

[The treatment of gastrointestinal infections with ciprofloxacin].

The authors have evaluated the efficacy and tolerability of ciprofloxacin, a new broad-spectrum fluor-quinolone, in the therapy of gastrointestinal infections. The authors have studied 24 patients suffering from above-mentioned infections clinically diagnosed (11 microbiologically diagnosed too). All the patients took ciprofloxacin tablets 500 mg b.i.d. for 10 days (average). All the patients were restored to health and the tolerability was excellent.

Adolescent↗
PubMed1990

Coronary arteries in truncus arteriosus.

The origin and distribution of the coronary arteries was described in 39 autopsy specimens of truncus arteriosus (TA). The specimens were classified according to the number and the patterns of the truncal cusps. The position of the truncal cusps was defined in relation to intracardiac structures, namely, the atrioventricular orifices. Bicuspid truncal valves were observed in 8 cases (21%), tricuspid in 22 cases (56%) and quadricuspid in 9 cases (23%). All tricuspid valves had 2 anterior and 1 posterior cusp. Great variability in the origin of the coronary arteries was observed, with a tendency for the right coronary artery to arise from the anterior right quadrant and for the left coronary artery to arise from the anterior and left quadrant. Such a tendency was observed in 50% of the bicuspid, in 59% of the tricuspid and in 66% of the quadricuspid valves. The anatomic right ventricle was always observed to be vascularized by a right coronary artery, and the anatomic left ventricle by a left coronary artery, even in cases in which there was a single coronary trunk. The anterior surface of the right ventricle was crossed by a right coronary artery in 5 cases. A single coronary artery was observed in 7 cases (18%). Embryologic considerations are offered, especially regarding the relation between the observed variability in coronary artery patterns in TA and the absence of the truncal septation.

Coronary Vessel Anomalies↗