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Biomedical subjects

Y Charuzi

Publications and source records attributed to Y Charuzi.

34 records · Page 2Linked to original sources
PubMed1981

Intracoronary thrombolysis in evolving myocardial infarction.

After experimental studies in dogs confirmed the feasibility and safety of rapid intracoronary thrombolysis by local infusion of Thrombolysin (streptokinase and plasmin), intracoronary thrombolysis was attempted in 20 patients with evolving myocardial infarction who were hospitalized within 3 hours from the onset of symptoms during the day and within 2 hours at night. Thrombolysin was infused in the immediate vicinity of the site of coronary occlusion using a 0.85 mm outer diameter catheter advanced through the lumen of the Judkins catheter. Reperfusion was achieved in four patients after an average of 43 minutes of Thrombolysin infusion at a rate of 2000 IU/min and in 15 patients after an average of 21 minutes of Thrombolysin infusion at a rate of 4000 IU/min. The failure to open the artery in one patient may have been caused by our inability to advance the infusion catheter close to the site of occlusion. Rethrombosis occurred in one patient 8 days after reperfusion and 2 days after discontinuation of anticoagulants because of a history of chronic alcoholism. Wall motion and perfusion studies showed improvement following reperfusion. Patency of the artery was achieved an average of 4 hours after the onset of symptoms. The need for earlier reperfusion is emphasized.

Adult↗
PubMed1981

Intracoronary thrombolysis in acute myocardial infarction: experimental background and clinical experience.

Occlusive intracoronary (IC) thrombosis was produced experimentally in dogs by placement of a copper coil. The thrombus was consistently lysed by application of Thrombolysin (streptokinase and plasminogen) at the site of occlusion, 1 to 6 hours after thrombosis. Thrombolysin has no toxic effect on the coronary artery wall or the myocardium. Reperfusion after 30 to 60 minutes of occlusion frequently resulted in ventricular fibrillation, but gradual reperfusion reduced the probability of ventricular fibrillation. Intramyocardial bleeding was noted after reperfusion in areas of advanced necrosis and was shown to be the consequence, rather than the cause, of necrosis. The reperfused myocardium remained hypocontractile, but in contrast to the occlusion period, its mechanical function could be enhanced by inotropic stimulation. After experimental studies confirmed the feasibility and safety of IC thrombolysis, the technique was applied within 3 hours of onset of pain in 29 patients with evolving acute myocardial infarction (AMI) and showing ST elevations without pathologic Q waves. Nitroglycerin (NTG), 0.1 mg, was injected into the occluded coronary artery to rule out spasm; NTG failed to open the occluded artery. A special, very flexible, radiopaque No. 2 French catheter was advanced through the angiography catheter to the site of occlusion. Thrombolysin was infused at a rate of 4000 to 6000 IU/min until patency was achieved, followed by 2000 IU/min for 60 minutes. Lysis of clot was achieved in 27 of 29 patients. The single death (unrelated to the procedure) occurred subsequently in a patient in whom the artery was not reopened. After successful thrombolysis, 12 patients underwent elective coronary bypass surgery because of multiple stenoses. The need for early reperfusion is emphasized for effective IC thrombolysis therapy in evolving AMI.

Animals↗
PubMed1980

Ventricular aneurysm: cross-sectional echocardiographic approach.

Current angiographic indexes of ventricular function have proved inadequate for prognostication in patients with ventricular aneurysm. Cross-sectional echocardiography can visualize residual myocardium in all four walls of the left ventricle. A new echocardiographic technique of calculating residual myocardium is presented. The echocardiographic technique yielded identical information to that of contrast angiography (r = 0.97). An index of residual myocardium was generated from the cross-sectional echocardiogram that correlated with the clinical state of the patients. In patients treated medically it predicted those patients likely to die within 6 months (p < 0.005). Preliminary observations in patients having aneurysmectomy revealed that there were good surgical results in those with an index of residual myocardium of 0.42 or greater, but more patients are necessary to establish the lower limit of a surgically acceptable level of residual myocardium.

Adult↗
PubMed1977

Lignocaine: a new technique for intravenous administration.

Current practices of intravenous lignocaine administration may result in a significant drop in blood level between the peak serum level from the initial bolus and the subsequent steady state from the constant infusion. This can cause a significant interval when plasma lignocaine levels are less than therapeutic, and ventricular ectopy may occur. To eliminate this subtherapeutic interval, a new therapeutic approach was devised. Seven patients were studied who had no evidence of congestive heart failure or liver disease. Lignocaine was infused at a rate of 25 mg/min; infusion dosages were selected by patient weight. The above therapeutic regimen eliminated the subtherapeutic hiatus and did not result in clinical toxicity. Therefore, this new infusion technique has significant clinical advantages in patients who require therapy with intravenous lignocaine.

Adult↗
PubMedDate not supplied

Paradoxical motion of the posterior left ventricular wall seen in healthy subjects in the upright position.

Paradoxical motion of the posterior left ventricular wall in patients in the upright but not in the supine position was demonstrated in a high percentage of normal volunteers. There was no significant difference in age, body surface area, heart rate, and blood pressure between the groups, with or without paradoxical motion. This echocardiographic finding probably represents a physiologic phenomenon and should be taken into consideration during the interpretation of upright exercise echocardiograms.

Adolescent↗