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Biomedical subjects

R Henry

Publications and source records attributed to R Henry.

At least 145 records · Page 8Linked to original sources

Gated first pass radionuclide ventriculography. Methods, validation, and applications.

Electrocardiographic gating provides an alternative method of acquiring first pass radionuclide ventriculograms from both ventricles. This report details the methods of acquisition and analysis, provides validation and reproducibility data, and describes applications of gated first pass radionuclide ventriculography using a count-based method. Left ventricular ejection fractions measured by gated first pass were correlated quite closely with gated blood pool ventriculography (n = 43; r = 0.95) but less well with contrast angiography (n = 23; r = 0.72). The right ventricular ejection fractions measured by gated first pass compared favorably with gated blood pool ventriculography (n = 32; r = 0.93). When one observer processed the images two times, the reproducibilities of RVEF (n = 10; r = 0.99) and LVEF (n = 10; r = 0.88) were excellent. Similarly, when two observers processed the images independently, the reproducibilities of RVEF (n = 11; r = 0.99) and LVEF (n = 11; r = 0.98) were excellent. The first pass studies were obtained in a right anterior obliquity, which provided the best atrioventricular chamber separation and provided a different view of global ventricular function and segmental wall motion from that provided by the standard blood pool views.

Adolescent↗

Biosynthetic human insulin and proinsulin have additive but not synergistic effects on total body glucose disposal.

Recent studies from our laboratory have demonstrated that human biosynthetic proinsulin has a much slower MCR than insulin as well as a greater effect on hepatic than on peripheral tissues. Since both of these features make proinsulin potentially useful as an adjunct to insulin, the present study was undertaken to characterize the biological effects of combined infusions of insulin and proinsulin. As an initial study, multiple euglycemic clamp studies were performed in six normal subjects to construct dose-response curves for insulin- and proinsulin-mediated glucose disposal. Insulin infusion rates of 0.63, 1.67, 5, and 10 micrograms/M2 X min were compared to proinsulin infusion rates of 2.75, 7.5, 22.5, and 45 micrograms/M2 X min. Analysis of these dose-response curves indicated that proinsulin-mediated glucose disposal was approximately 7% that of insulin. Each subject also received a combined infusion of insulin (0.63 micrograms/M2 X min) and proinsulin (2.75 micrograms/M2 X min). The mean (+/- SE) glucose disposal rate obtained during the combination study (319 +/- 21 mg/M2 X min) was similar to that predicted by adding the results from the individual hormone infusions (307 +/- 21 mg/M2 X min). Analysis of the dose-response curves for insulin and proinsulin was also useful in predicting the glucose disposal rate during the combination study (290 +/- 19 mg/M2 X min). Thus, using either approach to predict the glucose disposal rates, insulin and proinsulin appeared to have additive effects on total body glucose disposal.

Adult↗

The effects of biosynthetic human proinsulin on carbohydrate metabolism.

Large quantities of biosynthetic human proinsulin have recently become available through recombinant DNA technology. Since the in vivo effects of human proinsulin have not been studied in man, we compared the dose-response relationship for stimulation of glucose disposal and suppression of hepatic glucose output by proinsulin and insulin. Ten normal subjects were studied using the euglycemic glucose clamp technique. The human proinsulin and insulin infusion rates were chosen to achieve steady-state proinsulin levels 10-fold higher than insulin levels on a molar basis, based on previous observations that porcine proinsulin has approximately 10% the potency of insulin. Proinsulin infusion rates of 2.75, 7.5, 22.5, and 45 micrograms/m2/min were compared with insulin infusion rates of 0.63, 1.67, 5, and 10 micrograms/m2/min. Primed, continuous infusions of insulin yielded steady-state levels within 25 min, whereas proinsulin levels did not reach a steady state for 120-180 min. The metabolic clearance rate of insulin was 11-12 ml/kg/min at the lower infusion rates but fell to 8.4 ml/kg/min at the highest infusion rate. The metabolic clearance rate of proinsulin was 3.0-3.5 ml/kg/min at all infusion rates. Dose-response analysis demonstrated that proinsulin-mediated glucose disposal was approximately 8% that of insulin. In contrast, proinsulin-mediated suppression of hepatic glucose output was approximately 12% that seen with insulin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Bronchiolitis.

Explore the source record for details and available documents.

Asthma↗

Regional myocardial perfusion at rest and during intracoronary papaverine in patients with coronary artery disease.

Regional myocardial perfusion was measured in 32 patients with the xenon-133 washout technique at rest and after 5 mg of intracoronary papaverine. Areas of decreased perfusion and/or decreased vasodilation were identified visually from computer-generated functional images. The locations of arteries and stenoses, obtained from identically positioned cineangiograms, were overlaid on the functional images. Perfusion rates for 62 myocardial regions were calculated and correlated with the percentage of stenosis. There was no association between degree of stenosis and perfusion at rest. Regional myocardial perfusion increased after papaverine in regions supplied by coronary arteries without stenoses (0% to 25%), 88.6 +/- 4.7 ml/min/100 gm. This increase was significantly greater (p less than 0.001) than the increase in regions supplied by 51% to 75% stenoses (23.7 +/- 6.3 ml/min/100 gm), or 76% to 99% stenoses (12.9 +/- 6.3 ml/min/100 gm), or 100% stenoses (2.5 +/- 3.8 ml/min/100 gm). Thus there was an inverse relationship between the increase in myocardial perfusion stimulated by papaverine and the degree of coronary artery stenosis measured angiographically. In regions supplied by two stenoses in series, vasodilation produced less of an increase than a single stenosis of a similar degree.

Cardiac Catheterization↗

The effect of pulmonary hypertension on systolic function of the right ventricle.

This study sought to determine if the right ventricular ejection fraction (RVEF) could be used to diagnose pulmonary hypertension noninvasively. The right ventricular ejection fraction was measured with gated blood pool radionuclide ventriculography and compared to hemodynamic measurements made within 48 hours in 57 subjects. There was a significant inverse relationship between the RVEF and pulmonary artery pressure (r = .57, p less than .001) and the sensitivity of RVEF greater than .45 in diagnosing pulmonary hypertension was .76. Other significant determinants of right ventricular function, including right coronary disease, left ventricular function and tricuspid regurgitation, were also considered.

Cardiac Output↗

An improved method of right ventricular gated equilibrium blood pool radionuclide ventriculography.

Gated blood pool radionuclide ventriculography provides a means for obtaining repeated studies of both cardiac ventricles with a single dose of radionuclide. Quantitative assessment of right ventricular (RV) function using this technique has been complicated by several technical problems. We describe a new method of RV blood pool analysis which attempts to solve these problems using well-established concepts for left ventricular (LV) blood pool analysis: (1) variable regions of interest; (2) computer edge detection with operator intervention; and (3) computer selected background. Results showed a strong linear correlation between gated first pass RV ejection fraction (RVEF) and the gated blood pool RVEF (n = 22; r = 0.93; blood pool RVEF = 0.03 + 0.89 X first pass RVEF; Sy.x = 0.04). There was also a strong linear correlation between LV and RV stroke counts in patients without valvular regurgitation, intracardiac shunts, or ventricular aneurysms (n = 19; r =0.86; RV counts = 72 + 0.94 X LV counts; Sy.x = 116). In terms of both of these validation standards this method proved superior to three published methods of RV blood pool analysis that used hand-drawn regions, and is suitable for analysis of rest, exercise, and intervention studies of RV function.

Adult↗

Increased regional myocardial perfusion after intracoronary papaverine in patients after coronary artery bypass grafting.

The objective of coronary artery bypass grafting (CABG) is to increase blood flow to ischemic areas of the myocardium. To determine if this was achieved, anterior wall myocardial perfusion was measured at rest and during intracoronary papaverine (5 mg), with the use of xenon-133 washout in 35 patients. Twelve control patients had no significant diameter narrowing (0% to 25%) of the left anterior descending coronary artery (LAD), 13 patients had greater than 50% narrowing of the LAD, and 10 patients had greater than 50% narrowing of the LAD with patent saphenous vein bypass grafts to the LAD. There was no significant difference in age. LVEDP, and global ejection fraction among the patients. There was no significant difference in anterior wall myocardial perfusion at rest between control subjects (61.0 +/- 3.7 ml/min/100 gm) and non-CABG LAD patients (60.2 +/- 5.4 ml/min/100 gm), or CABG LAD patients (63.4 +/- 4.8 ml/min/100 gm). After coronary arteriolar vasodilatation with papaverine, anterior wall perfusion increased in the CABG patients to 140.6 +/- 6.8 ml/min/100 gm. This was significantly greater (p less than 0.001) than the increase in the non-CABG LAD patients (72.8 +/- 8.1 ml/min/100 gm) but not different from the increase in the control subjects (145.3 +/- 8.4 ml/min/100 gm). In three cases, the same patients were studied before and after CABG with identical results. These data indicate that in patients with coronary disease, increases in myocardial perfusion are limited by the resistance of the proximal stenosis independent of vasodilatation distal to the stenosis. After successful CABG, the patent vein graft restores control of myocardial perfusion to the arteriolar bed.

Angina Pectoris↗

[A non-invasive clinical-pharmacological method for measuring the beta-adrenolytic activity (author's transl)].

Description of a non invasive model to determine the negative-chronotropic effect, which leads to well stabilized parameters by tailoring. Basis of the model is the work-induced tachycardia at which the work-induced increase of frequency is measured at a specified time after 10 preliminary ergometries for the elimination of training effects. The parameter for the effect is the difference of frequencies at nominal time before and after administration of beta-adrenolytic drug. The relevance of the model is shown at the example of acebutolol (Neptal 400) in various high dosages.

Acebutolol↗

Synthesis and pyrogenic effect of 3 alpha, 7 alpha-dihydroxy-5 beta-androstan-17-one and 3 alpha-hydroxy-5 beta-androstane-7, 17-dione.

The first chemical synthesis of 3 alpha, 7 alpha-dihydroxy-5 beta-androstan-17-one and 3 alpha-hydroxy-5 beta-androstane-7, 17-dione is reported. In this method, the 17 beta-side chain of commercial chenodesoxycholic acid was degraded in 6 steps after selective protection of the hydroxyl groups: 3 alpha-OH by a tert-butyldimethylsilyl group and 7 alpha-OH by an acetoxy group. The capacity of 3 alpha, 7 alpha-dihydroxy-5 beta-androstan-17-one and 3 alpha-hydroxy-5 beta-androstane-7, 17-dione to release a pyrogen by human leukocytes was investigated by two independent methods: supernatants from leukocytes incubated with a steroid are injected to rabbits whose fever is measured, or tested by the Limulus Test (a pyrogen detection technique). The 7-keto substituted etiocholanolone still possessed pyrogenic activity, while the 7 alpha-hydroxyl substituted one did not.

Animals↗

Appendiceal carcinoma mimicking primary bladder cancer.

We report the first case of adenocarcinoma of the appendix invading the bladder. Because invasive bladder cancer was diagnosed intially the pelvis was irradiated preoperatively. At operation a primary appendiceal neoplasm invading the bladder was discovered and a right hemicolectomy and en block partial cystectomy were done. This treatment is recommended for appendiceal adenocarcinoma that invades the bladder.

Adenocarcinoma, Mucinous↗

Impending asphyxia induced by anticoagulant therapy.

A case is presented of spontaneous haemorrhage into the floor of the mouth occurring in a patient receiving anticoagulants. Spread of interstitial haematoma to the submucosal tissues of the pharynx and larynx caused respiratory embarrassment necessitating a tracheostomy. The genesis and management of such a problem are discussed, and it can be appreciated that close co-operation between the otolaryngologist, haematologist and anaesthetist is essential.

Acenocoumarol↗