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101.
Dr. Robert L. Geggel David R. Fulton Harvey L. Chernoff Richard Cleveland Thomas J. Hougen 《Pediatric cardiology》1987,8(4):279-283
Summary An infant girl is described who had cor triatriatum and partial anomalous pulmonary venous connection of the left pulmonary
veins to the coronary sinus, the first report of this combination of lesions. The infant also had a Dandy-Walker malformation
and multiple facial and intrathoracic hemangiomas. The cardiac diagnosis was made by two-dimensional echocardiography. Cardiac
catheterization and angiography confirmed the findings and also demonstrated a persistent left superior vena cava draining
to the coronary sinus. The infant underwent successful surgical repair. Partial anomalous pulmonary venous connection and
left superior vena cava not infrequently are associated with cor triatriatum. Although two-dimensional echocardiography is
sensitive for the detection of cor triatriatum, preoperative cardiac catheterization is necessary to identify unequivocally
systemic and pulmonary venous connections. 相似文献
102.
103.
Paul Wexberg MD BM Richard Pacher MD Suzanne Rdler MD Katharina Kiss MD Gilbert Beran MD Michael Grimm MD Gerald Maurer MD Dietmar Glogar MD FESC 《The Journal of heart and lung transplantation》2002,21(12):583-1263
BACKGROUND: Endothelin, a peptide with strong vasoconstrictive and mitogenic properties, has been found to increase after cardiac transplantation. We therefore assessed the association between its precursor peptide, big endothelin-1, and intimal hyperplasia and coronary flow reserve after heart transplantation. METHODS: Thirty-five patients without hemodynamically significant coronary artery disease after heart transplantation were investigated: Average peak flow velocity in the left anterior descending artery (LAD) was assessed by intracoronary Doppler at baseline as well as after injection of adenosine; coronary flow reserve was calculated as a ratio of both and was corrected for patient age and baseline average peak flow velocity. Lumen, intima + media and total vessel area were measured by intracoronary ultrasound. The plasma concentration of big endothelin-1 in venous blood was determined by radioimmunoassay. RESULTS: Patients with elevated big endothelin-1 levels (>2 fmol/ml) tended to have a decreased corrected coronary flow reserve (2.60 +/- 0.9 vs 3.21 +/- 1.0, p = 0.078). They also had a significantly larger intima + media area (5.82 +/- 2.9 vs 2.37 +/- 2.9 mm(2), p = 0.004) and total vessel area (18.36 +/- 5.8 vs 12.81 +/- 4.8 mm(2), p = 0.012) than those with normal plasma concentrations. CONCLUSIONS: Our study suggests an association between elevated big endothelin-1 plasma levels and the development of intimal hyperplasia and reduction of coronary flow reserve after cardiac transplantation. 相似文献
104.
105.
106.
Jeffrey H. Coben MD 《Academic emergency medicine》2002,9(11):1176-1183
OBJECTIVE: To obtain consensus among a panel of experts on performance measures useful for evaluating the quality of hospital-based domestic violence (DV) programs. METHODS: The Delphi process of consensus development was used with a panel of 18 experts including DV researchers, program planners, and advocates. Three rounds were conducted over a period of six months, with each round involving the completion of a written questionnaire. Panelists were instructed to concentrate on structure and process measures of DV program performance. Health outcome measures were not considered. During each round, panelists rated (scale of 1-5) their level of agreement with each measure, in terms of the measure's usefulness for evaluating hospital-based DV programs. Data were entered into SPSS on a personal computer and frequency distributions, measures of central tendency, and variance were computed for each measure. Consensus development was defined as a reduction in the item-specific variance from one round to the next. RESULTS: A total of 37 performance measures were agreed upon. These measures fell within nine different domains of DV program activities, including: Policies and Procedures, Hospital Physical Environment, Hospital Cultural Environment, Training of Providers, Screening and Safety Assessment, Documentation, Intervention Services, Evaluation Activities, and Collaboration. CONCLUSIONS: A number of measures have been identified as useful for evaluating hospital-based DV programs. Use of these measures should assist researchers, program planners, and administrators in assessing the quality of hospital-based DV programs. 相似文献
107.
David C. Cone MD Susan M. Nedza MD MBA James J. Augustine MD Steven J. Davidson MD MBA 《Academic emergency medicine》2002,9(11):1085-1090
This paper reports the proceedings of the discussion panel assigned to look at clinical aspects of quality in emergency medicine. One of the seven stated objectives of the Academic Emergency Medicine consensus conference on quality in emergency medicine was to educate emergency physicians regarding quality measures and quality improvement as essential aspects of the practice of emergency medicine. Another topic of interest was a discussion of the value of information technology in facilitating quality care in the clinical practice of emergency medicine. It is important to note that this is not intended to be a comprehensive review of this extensive topic, but instead is designed to report the discussion that occurred at this session of the consensus conference. 相似文献
108.
Dr. Med. Wolfgang Rutsch Horst Schmutzler 《Cardiovascular and interventional radiology》1986,9(5-6):245-252
Reestablishing myocardial perfusion during evolving myocardial infarction may limit the ultimate extent of infarction if viable
myocardial tissue is present when recanalization of the occluded vessel is achieved. This will result in improved left ventricular
function and decreased mortality. In addition to their therapeutic benefits, recanalization procedures have contributed greatly
to our knowledge of acute myocardial infarction. It has been demonstrated that myocardial infarction most often occurs after
thrombotic occlusion of a coronary artery. This has settled a controversy that has preoccupied cardiologists for decades.
Selective intracoronary administration of fibrinolytic agents is followed by recanalization in approximately 80% of cases.
Therapeutic failures are attributable to occlusion caused by other factors, to inactivation of streptokinase by high antibody
concentrations, and to insufficient concentrations of streptokinase at the thrombus as a results of unfavorable flow conditions.
This study is dedicated to Prof. Dr. Med. Horst Schmutzler on the occasion of his 60th birthday. 相似文献
109.
110.
Michael C. Dalsing MD Melissa Kevorkian BS Beth Raper BA Craig Nixon MS Stephen G. Lalka MD Dolores F. Cikrit MD Joseph L. Unthank PhD Malcolm B. Herring MD 《Annals of vascular surgery》1989,3(2):127-133
This study evaluates the potential for endothelial seeding of a collagen-impregnated Dacron graft with or without surface modifiers (fibronectin, heparin) to attach and retain these cells during flow. Human umbilical endothelial cells were harvested, cultured, labeled with Indium111-oxine and seeded onto 30 mm X 4 mm diameter grafts. Six graft surfaces were studied: 1) a collagen-impregnated Dacron graft, HemashieldR (C); 2) C + fibronectin (C + F); 3) C + heparin (C + H); 4) C + F + H; 5) HytrelR + F (Hyt + F); and 6) Hyt + F + H. Radioactive loss determined the percentage attachment and then percentage retention of labeled inoculum after a one-hour in vitro perfusion. Scanning electron and light microscopy demonstrated the endothelium on the graft surface following perfusion. Fibronectin-coated grafts had a significantly higher percentage attachment than those without fibronectin (ANOVA, P less than 0.05). However, the percentage retention following perfusion was similar for all Dacron grafts and statistically inferior to the HytrelR grafts studied (ANOVA, P less than 0.05). SEM evaluation of the C + F + H graft surface was qualitatively the most impressive Dacron surface for seeding, yet was inferior to the HytrelR graft. We conclude that fibronectin benefits the initial attachment of endothelium to collagen-coated Dacron rivaling the HytrelR surface. Fibronectin does not improve percentage retention of the HemashieldR surface during perfusion, therefore, some of its initial benefit is lost. 相似文献