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Biomedical subjects

S Paulin

Publications and source records attributed to S Paulin.

At least 19 recordsLinked to original sources
PubMed1991

First-pass nuclear magnetic resonance imaging studies using gadolinium-DTPA in patients with coronary artery disease.

Nuclear magnetic resonance (NMR) imaging has been shown to accurately portray cardiac anatomy and function. To investigate the potential of NMR imaging for the assessment of coronary stenosis in patients with chest pain, ultrafast NMR imaging in conjunction with a T1 (longitudinal relaxation time) contrast agent was performed in 17 patients with chest pain who had undergone cardiac catheterization. These included 12 patients with significant coronary artery stenoses and 4 who underwent repeat NMR study after myocardial revascularization. Cardiac images at rest were obtained during rapid intravenous injection of gadolinium-DTPA (0.04 mM/kg). Electrocardiographic-gated images were acquired over 380 ms, with repetitive images obtained every 3 to 4 s. After contrast injection, there was pronounced signal enhancement in the right ventricular cavity, followed by enhancement in the left ventricular cavity and myocardium. Regional myocardium perfused by a diseased vessel demonstrated a lower peak signal intensity (p = 0.001) and lower rate of signal increase (p = 0.001) than did myocardium perfused by coronary arteries without stenosis. Repeat NMR study after revascularization showed an increase in peak signal intensity (p less than 0.002). These results demonstrate the clinical potential of dynamic gadolinium-DTPA-enhanced NMR imaging for the assessment of coronary artery disease in patients with chest pain. In combination with anatomic and functional NMR imaging, this technique has the potential to provide a comprehensive noninvasive cardiac evaluation of patients with suspected coronary artery disease.

Adult↗
PubMed1991

Coronary arteries: breath-hold MR angiography.

The authors describe a method for performance of ultrafast magnetic resonance (MR) angiography of coronary arteries with a standard clinical MR system and a body coil. Each image was obtained within a single breath hold by using an electrocardiography-gated, segmented, ultrafast, gradient-echo pulse sequence with an incremental excitation flip angle for the eight phase-encoding steps acquired per segment. By using overlapping 4-mm-thick sections, the coronary arteries were routinely depicted from the coronary ostia distally at MR in healthy subjects. Ultrafast MR angiography of the coronary arteries is feasible with use of a standard body coil. This technique offers considerable potential as an investigational tool and, with further development, may become a clinically useful imaging application.

Adult↗
PubMed1979

Cine-densitometric measurement of coronary arterial stenoses.

Computer-aided operator-interactive densitometry has been developed and applied to determine the percent stenosis for obstructive lesions in the coronary arterial tree. Phantom experiments performed to assess system linearity, accuracy of densitometric measurements, nonuniformity in image amplified response, and the interference of structure noise in measuring precision have been described. Three observers assessed the reproducibility of the method by repeating analyses on 20 stenoses in man recorded on 35-mm cine angiograms. Calculation of the intra- and interobserver errors found that their values significantly decrease with increasing percent stenosis. The reproducibility of the technique was also tested on stenoses that were exposed at multiple angles. The results agreed with those found for the intra- and interoperator errors. Limitations of the densitometric approach and desirability of further automation of the measurements are also discussed.

Cineangiography↗
PubMed1979

Medically refractory unstable angina pectoris. I. Long-term follow-up of patients undergoing intraaortic balloon counterpulsation and operation.

Of 82 patients with medically refractory unstable angina pectoris seen between October 1972 and January 1978, 60 patients underwent a combination of intraaortic balloon pump counterpulsation, cardiac catheterization and coronary revascularization. Most patients had atherosclerotic involvement of the vessels of the anterior left ventricular wall, 48 patients (80 percent) had abnormalities of left ventricular wall contraction and 22 patients (36 percent) had evidence of acute myocardial injury. One operative and one late death occurred. The perioperative infarction rate was 5 percent. Survivors, followed up for 3 to 63 months (mean 31 months), have done remarkably well; 77 percent are considered employable,and more than 90 percent are in functional class I or II.

Angina Pectoris↗
PubMed1979

Medically refractory unstable angina pectoris. II. Hemodynamic and angiographic effects of intraaortic balloon counterpulsation.

Of 60 patients receiving intraaortic balloon counterpulsation for angina refractory to maximal medical therapy, a subgroup of 10 patients underwent left ventricular angiography both with and without counterpulsation. Severe stenosis of the left anterior descending coronary artery was present in all 10 patients. Counterpulsation resulted in a significant decrease in systolic and end-diastolic left ventricular pressures and no increase in cardiac index. Left ventricular diastolic and systolic volume, ejection fraction and regional contraction patterns, often abnormal, were unchanged. However, mean normalized systolic ejection rate was improved by the addition of counterpulsation. It is concluded that intraaortic balloon counterpulsation has relatively little effect on the left ventricular volume of patients with medically refractory angina pectoris. The symptomatic improvement that takes place seems to occur mainly through the effect of counterpulsation on preload and afterload.

Administration, Oral↗
PubMed1979

Remote densitometric analysis of stenotic lesions.

In conventional densitometric evaluation of stenoses the digitized angiogram is displayed on a multi-grey-level scope to facilitate operator interaction. With a remote terminal, linked to the computer with regular telephone lines, such display is unacceptably slow. To circumvent this difficulty, the projection of the original image is used for interactions through a sonic pen digitizer interfaced to the computer. A coordinate system can be defined on the projected image, in addition to the blood vessel segment to be analyzed by the operator. The computer can retrieve these features on the stored-pre-digitized image to carry out the quantitative evaluation of the stenosis. This method reduces the time of analysis and allows several institutions to share the same computing facility.

Absorptiometry, Photon↗
PubMed1979

Coronary arteriography in 486 patients--arteriographic pathology and prognosis.

The coronary arteriographic findings and prognosis in a series of 486 non-surgically treated patients were analyzed. A semiselective injection was used. The number and causes of deaths were obtained from the census registry after a follow-up period of 7--12 years. The material comprised normal arteriograms in 26% of the patients, wall irregularities at most in 17%, obstruction of at least half the diameter in 37%, and unclassifiable arteriograms in 19%. A mean of 1.8 obstructed arteries per patient was found in the group with obstructive arterial lesions and among these patients the left anterior descending artery was most often engaged. In the same group the cardiac mortality at seven years was 20%. There were no significant differences between deceased and survivors with regard to clinical data. The arteriograms themselves offered more information about the prognosis. Normal arteries or wall irregularities at most implied excellent prognosis with regard to death in coronary heart disease. The seven-year mortality was 36% among patients with coronary artery occlusions, which is significantly higher than 14% among those with arterial stenosis. Materials from the USA and Canada have displayed a much higher mortality than our study in spite of comparable arteriographic findings.

Adolescent↗
PubMed1978

Biplane angiographic volumetry using the right anterior oblique and half-axial left anterior oblique technique.

Half-axial biplane left ventriculography was performed using the right anterior oblique view and a left anterior oblique projection obtained by angling the lateral image intensifier in a caudo-cranial direction so that the long axis of the left ventricle was more nearly perpendicular to the horizontal beam. Cardiac output showed a linear correlation with outputs determined by the thermodilution method.

Angiocardiography↗
PubMed1978

Differential effects of sodium meglumine calcium metrizoate on the inotropic state of normal and ischemic myocardium.

Sodium meglumine calcium metrizoate was injected into isolated blood-perfused canine hearts to evaluate the effect of contrast agents containing calcium on normal and ischemic myocardium. Under normal perfusion pressure and mild ischemia, this contrast agent produced a positive inotropic effect, but during profound ischemia, this positive effect was followed by a period of myocardial depression. These findings indicate that the addition of an inotropic agent to contrast medium can produce a paradoxical depressant effect which can be deleterious to the ischemic myocardium.

Animals↗
PubMed1978

Cyanosis in uncomplicated atrial septal defect with normal right cardiac and pulmonary arterial pressures.

A patient with cyanosis in an uncomplicated ostium secundum atrial septal defect without pulmonary hypertension is described. There were no anatomic abnormalities in right-sided cardiac valves or venous return and no evidence of right ventricular hypoplasia or hypertrophy; however, the diastolic pressure curve suggested a decreased compliance. We suggest that this unusual finding may be a result of intrinsically abnormal right ventricular compliance.

Adult↗
PubMed1977

Leg phlebography: the incidence, nature and modification of undesirable side effects.

A prospective study was performed to elucidate the side effects of contrast medium phlebography for the diagnosis of deep vein thrombophlebitis (DVTP). The phelbograms were obtained with the patient in a semi-erect position, with an average dose of 125 ml of contrast medium infused continuously over 7-12 min. Renografin 60, or the same agent diluted to three-quarter strength, was used. The major side effects were pain during the study and a symptom complex resembling DVTP starting 12-36 hours after the study. Both were more common with the standard contrast medium (pain: 59.0% vs. 30.0%; delayed reaction: 24.0% vs. 7.5%), although the percentage of positive studies was unchanged (about 35.0%). Side effects were more frequent and severe than previously thought, but their incidence can readily be lowered.

Contrast Media↗
PubMed1977

[Human celosomias].

Definition and nomenclature of celosomia are based on a historical review which provides a system of classification. Morphology and organogenesis of celosomia were studied on 64 embryonic and foetal bodies. The anatomical study of 6 cases of human celosomia provided a definition of the characteristics of major celosomia, by showing the constant elements of the syndrome (particularly the parietal malformation) and the anomalies frequently found in each of the different types:--anterior (or superior) celosomia;--middle celosomia, including laparoschisis;--posterior (or inferior) celosomia, among which exstrophy of the bladder may be either one of the constant elements of the syndrome, or a limited form of the inferior celosomia;--total celosomia, of which one case was studied for this report, and of which the major forms, the schistosomia, chelinosomia and strophosomia types, seem to constitute forms of transition with other types of monstruosity. With improved knowledge of anatomy and organogenesis the possibilities of treatment have improved over the past few years, but still remain limited in the more monstrous forms of celosomia.

Abdomen↗