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Biomedical subjects

S Kansal

Publications and source records attributed to S Kansal.

At least 19 recordsLinked to original sources
PubMed2001

Bilateral Duane syndrome with bilateral congenital glaucoma.

Multiple ocular associations with Duane syndrome have been reported as summarized by DeRespinis et al. The most frequently noted include nystagmus, anisocoria, ptosis, optic nerve colobomas, and epibulbar dermoids. Less encountered abnormalities are optic nerve hypoplasia, heterochromia, and congenital cataract. To our knowledge, no reports of associated congenital glaucoma exist in the literature. We report a 10-year-old patient with bilateral Duane syndrome and bilateral congenital glaucoma who we have monitored for 7 months after birth.

Child↗
PubMed2001

Consecutive Descemet membrane detachment after successive phacoemulsification.

PURPOSE: To report a patient with consecutive Descemet's membrane (DM) detachments after successive phacoemulsification, review other reported patients with bilateral DM detachments, and explore the possibility of anatomic predisposition to DM detachment in some patients. METHODS: Our patient's course was reviewed along with the reported experience with three other patients with bilateral DM detachments. RESULTS: No clear underlying etiology of DM detachment was found in our patient or any of the other three reported patients reviewed. CONCLUSIONS: Some patients may be anatomically predisposed to DM detachment possibly because of an abnormality in the fibrillary stromal attachment to DM. Early postoperative surgical intervention often leads to satisfactory visual results.

Aged↗
PubMed2000

Split cord malformation with partial eventration of the diaphragm. Case report.

The authors describe the case of a 3-year-old girl who presented with a dorsal split cord malformation (SCM) and was found to have eventration of the diaphragm. Although the child did not undergo surgery for eventration, its presence suggests a need for careful preoperative planning and clinical evaluation to rule out or confirm the anomalies associated with spinal dysraphism or SCM.

Child, Preschool↗
PubMed1993

Regulation of sterol carrier protein-2 gene expression in rat liver and small intestine.

Sterol carrier protein-2 (SCP2) is a peroxisomal protein most highly expressed in non-steroidogenic tissues such as liver and small intestine. We have examined SCP2 gene expression during development and after alterations in lipid and bile acid metabolism and compensatory cell growth in the rat. The developmental expression of SCP2 displayed a biphasic pattern of relative mRNA abundance with a peak at day 19 to 20 of fetal life, reaching adult levels by day 14 and after day 14 in small intestine. In adult rats there was no effect on SCP2 mRNA abundance, or the relative proportions of the four SCP2 transcripts after gemfibrozil treatment, 30-fold changes in hepatic cholesteryl ester and triglyceride levels, bile ligation, compensatory hepatic or renal growth. However, immunoblot analysis of tissue homogenates revealed that SCP2 protein is decreased by 75% in the livers of gemfibrozil-treated animals and increased by 5-fold at 48 h in regenerating liver and in the remaining kidney after unilateral nephrectomy. Taken together these results suggest that SCP2 gene expression is developmentally regulated and modulated translationally or post-translationally in the adult rat by gemfibrozil and compensatory cell growth.

Animals↗
PubMed1983

Enhanced evaluation of treadmill tests by means of scoring based on multivariate analysis and its clinical application: a study of 608 patients.

Six hundred eight patients being evaluated for chest pain who did not have valvular disease, cardiomyopathy, left ventricular hypertrophy or bundle branch block, and were not receiving digitalis, had treadmill tests and coronary angiograms. In 351, various exercise variables were correlated by multivariate analysis to coronary artery disease (CAD). In men, significant variables were: (1) maximal heart rate achieved less than 80% of maximal predicted heart rate (Mx PHR), (2) ST-T change greater than or equal to 1 mm, (3) age greater than or equal to 55 years and (4) treadmill time (TT) less than 8 minutes. These variables rated diagnostic scores of 9, 6, 5, and 3, respectively. A score of greater than or equal to 7 was considered diagnostic of CAD. In a test group of 192 men in which ST-T change was compared with treadmill score, sensitivity was 65 versus 85%, specificity 79 versus 74% and accuracy 69 versus 83%. In women, maximal heart rate less than 90% of Mx PHR and TT of less than 6 minutes were significant, with an accuracy of 75%. Moreover, 89% of incomplete tests and 70% of tests in patients with previous myocardial infarction were also correctly diagnosed. This method allows convenient use of significant exercise variables for clinical purposes with improved results.

Adult↗
PubMed1983

A quantitative relationship of electrocardiographic criteria of left ventricular hypertrophy with echocardiographic left ventricular mass: a multivariate approach.

The purpose of this study was to evaluate the sensitivity of various electrocardiographic (EKG) criteria of left ventricular hypertrophy (LVH) in relation to echocardiographic left ventricular mass (LVME) and to assess the relative strength of various EKG variables used in the diagnosis of LVH by multivariate analysis. An attempt was also made to determine if a new combination of precordial and T-wave voltage could improve the sensitivity of EKG. In 89 patients, M-mode echocardiograms and standard EKGs were studied. Correlation of Romhilt-Estes point-score system with LVME was r = 0.621, sensitivity and specificity was 57 and 81%, respectively. Other voltage criteria had lower sensitivity. Various combinations of precordial and T-wave voltage were not superior. The quantitative relationship of individual EKG variable, QRS duration, S V1-3, R V4-6, strain T wave, left atrial abnormality, intrinsicoid deflection and axis, with LVM was, r = 0.661, 0.595, 0.429, 0.42, 0.347, and 0.225, respectively. By multivariate analysis, QRS duration, S V1-3, T-wave and R V4-6 voltage had F-value (relative strength) of 27.95, 27.15, 22.02, and 4.03, respectively, other variables were statistically insignificant. In conclusion, the most important EKG variables predictive of LVH are QRS duration, S V1-3, strain T-wave and lateral voltage in decreasing value. Rescoring these variables in accordance to their correlation to LVM may improve EKG sensitivity for the diagnosis of LVH.

Cardiomegaly↗
PubMed1981

Limited exercise testing soon after myocardial infarction. Correlation with early coronary and left ventricular angiography.

Forty-eight patients within 3 weeks of myocardial infarction underwent both limited treadmill graded exercise testing and coronary and left ventricular angiography. Nineteen (90%) of 21 patients with positive exercise tests (greater than or equal to 1 mm ST depression, angina, or both) had multivessel coronary artery disease. In the 27 patients with negative exercise test results, 15 (55%) had multivessel disease, 11 (41%) had single-vessel disease, and one (4%) had no coronary stenosis. Exercise-induced ST segment elevation occurred in 24 patients and predicted a significantly lower ejection fraction and higher angiographic abnormally contracting segment size. Patients experiencing angina during or after exercise had a significantly shorter 2-year survival (54% +/- 21%) than patients without exercise-induced angina (97% +/- 3%) (p less than 0.03). Thus limited exercise testing postinfarction is useful in evaluating the presence of multivessel coronary artery disease and left ventricular dysfunction and predicting long-term survival.

Adult↗
PubMed1979

Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.

Septal and left ventricular posterior wall (LVPW) thicknesses and their ratios were studied at the left ventricular outflow tract and left ventricular cavity in 66 patients with echocardiographically diagnosed left ventricular concentric hypertrophy, 20 with idiopathic hypertrophic subaortic stenosis (IHSS), and 34 normal subjects. Concentric hypertrophy was due to hypertension in 41 subjects and to valvular disease in 15 subjects. Septal thickness in normal subjects was related to body surface area (p less than 0.02). In 12% of normal subjects, 39% of patients with concentric hypertrophy and 95% with IHSS, the septal/LVPW ratio was greater than or equal to 1.3. Thirty-two percent of patients with hypertension, 78% with aortic stenosis, and 60% with aortic insufficiency had septal/LVPW ratios greater than or equal to 1.3 at left ventricular midcavity level. In conclusion, a septal/LVPW thickness ratio of greater than or equal to 1.3 is common in patients with concentric left ventricular hypertrophy and may also occur in normal subjects. A ratio greater than or equal to 1.5 may be more specific for genetically determined asymmetric septal hypertrophy.

Adult↗
PubMed1978

A quantitative technical quality assay method for electrocardiograms.

A method is presented for quantitative assessment of ECG technical quality to permit sensitive detection of performance trends of individual technicians or entire ECG laboratories. The common flaws in ECG recording technic are those which introduce ultra-low frequency artifact or baseline shift, powerline artifact, myographic and intermediate frequency artifact, clipping of waveforms, disconnection or reversal of electrodes and general faults of protocol adherence. Procedures for quantitating these attributes are presented and explained in order to arrive at a mean figure of merit for each ECG recording. Use of such a method can aid ECG technicians' understanding of the important features of tracing quality and provide an objective basis for the recognition of outstanding performance, on one hand, or the need for remedial training, on the other.

Electrocardiography↗
PubMed1978

A controlled study of a new ECG electrode system.

A newly marketed resting ECG electrode system was compared with conventional metal suction and plate electrodes, electrode cream and patient cable. Two experienced technicians were given special training in the use of the new electrode, electrolyte and patient cable system and alternated daily in using new and conventional equipment. Nearly equal numbers of perfect-scoring ECGs were recorded with each system, attesting to the impartiality of the technicians. A total of 1,062 ECGs were evaluated, 554 with the new system and 508 with the conventional one. ECG tracings were evaluated by electrocardiographers unaware of which system was used for each. A quantitative scoring system was used to measure the technical quality of each tracing in terms of baseline drift, powerline artifact and myographic plus miscellaneous artifacts. The new system received mean scores of 2.33, 3.08, and 2.72, respectively, while the conventional electrodes received scores of 2.56, 3.03 and 2.79. We concluded that the two types of electrodes produced ECGs of essentially equal quality.

Electrocardiography↗
PubMed1978

Interesting approaches to the diagnosis of angina pectoris.

Twelve different approaches to laboratory diagnosis of angina pectoris are reviewed here. They employ no fewer than seven different means of intentionally provoking a disparity between myocardial requirement and supply: dynamic exercise, hypoxia, prandial stress, raised systemic vascular resistance, paced tachycardia, mental stress, and exposure to normal environment. Of these, only dynamic exercise and the diverse combinations of stresses in the normal environment are capable of altering the heart's oxygen requirement-supply ratio threefold or more, accounting for the successful results from tests using these means of stress. The reviewed tests use three different means of detecting myocardial ischemia provoked by stress: electrocardiography to indicate impaired ventricular repolarization, indirect graphic records sensitive to impairment of mechanical ventricular function, and detection of insufficient myocardial perfusion patterns by radioactive tracer. The latter approach is particularly appealing because it directly reflects the pathophysiologic anomaly of interest. It should be remembered, however, that the basic differences in these methods of detecting ischemia make them complementary to each other and encourage their use in combination for improved diagnostic sensitivity.

Angina Pectoris↗
PubMed1976

Stress testing with ST-segment depression at rest. An angiographic correlation.

Near maximal graded exercise tests and coronary angiograms were compared in 37 patients with a history of chest pain and with ST segment depression at rest, who were free of obvious nonischemic causes of ST depression. Additional ST depression of 0.1 mV or more occurred with exercise in 26 patients and 23 of these had obstruction of one or more coronary arteries (sensitivity = 0.92). Eleven patients showed no additional ST-segment depression with exercise, and nine of these had normal coronary angiograms (specificity = 0.75). Patients with no increase in ST depression on exercise developed the highest heart rates; those with asymptomatic additional ST depression achieved intermediate rates; and those with anginal attacks during testing demonstrated the least heart rate acceleration. Those with less coronary obstruction exercised longer on the treadmill than those with more obstruction. Those showing added ST depression were predominantly men (18 of 26) and were older (mean 54 years) than those who did not (mean 44 years). No test complications were encountered. This study suggests that safe and effective stress testing may be accomplished not only in persons with normal resting ECGs but also in selected patients who have abnormal ST segments at rest.

Adult↗
PubMed1975

Ischemic myocardial injury following aorto-coronary bypass surgery.

To assess the incidence of acute myocardial injury following aorto-coronary bypass surgery 151 patients (136 men and 15 women) were evaluated by studying serial preoperative and postoperative ECGs and SGOT, LDH and CPK levels. The mean age of men was 49.1 and of women, 53.1 years. Following surgery 15 patients (group I, 9.9 percent) developed new myocardial infarction as judged by Q wave criteria, 33 patients (group II, 22.5 percent) developed significant ST-T changes, and 103 patients (group III, 68 percent) had no significant ECG change. Mean postoperative SGOT values were: group I,126.2; group II, 100.6; and group III, 72.8. Only the difference in SGOT values between group I and III was significant (P less than 0.01). There was no correlation between type and site of surgery and the incidence of myocardial infarction. There were five deaths (3.3 percent). The combination of death and diagnosed myocardial infarction amounted to 12.6 percent of patients for this widely used elective procedure.

Adult↗
PubMedDate not supplied

Direct measurement of left ventricular ejection time from echocardiographic posterior wall excursion time: validation of technique.

Echocardiography has proven useful in determining systolic time intervals. Left ventricular mean velocity of circumferential fiber shortening has been calculated utilizing the left ventricular ejection time measured in several manners, usually from the echocardiographic aortic valve opening time or indirect carotid pulse tracing. Left ventricular ejection time is related to the time of posterior wall excursion in patients without conduction defects or segmental wall motion abnormalities. Thus, a single echocardiographic view can measure ventricular diameters and approximate ejection time simultaneously without other echocardiographic or phonocardiographic measurements which may be cumbersome to obtain, particularly during dynamic echocardiographic studies.

Adult↗