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排序方式: 共有219条查询结果,搜索用时 15 毫秒
1.
Constantinos Anagnostopoulos Mark G. Gunning Dudley J. Pennell Robin Laney Haralambos Proukakis S. Richard Underwood 《European journal of nuclear medicine and molecular imaging》1996,23(8):909-916
We have validated ECG-gated emission tomography using technetium-99m methoxyisobutylisonitrile for the assessment of regional ventricular function by comparing it with cine magnetic resonance imaging (MRI). Gated tomography was performed at rest in 24 patients referred for myocardial perfusion imaging [17 males and seven females with a mean age of 58 years, nine of whom had had a previous myocardial infarction (MI)]. Scores were assigned to each of nine myocardial segments for wall motion and for thickening. Cine MRI was analysed in an identical fashion. Four out of 216 (2%) segments were uninterpretable by gated tomography because of inadequate tracer uptake. In eight patients without coronary artery disease (CAD), wall motion and thickening were normal by both methods. Gated tomography showed abnormal wall motion or thickening in all patients with previous MI and in five of seven patients with CAD but no prior MI. Association between wall motion and thickening was good (r
s=0.86). Overall, there was good agreement between gated tomography and MRI for both wall motion (178/212 segments, =0.66) and wall thickening (184/212 segments, =0.69). In segments with severely reduced perfusion, however, there was poorer agreement (=0.31). Interobserver and intraobserver agreement was high ( from 0.61 to 0.78). Thus, in patients investigated for CAD, there is good overall agreement between gated tomography and MRI but the agreement is lower in segments with severe perfusion defects. 相似文献
2.
Lamprakopoulos A Zorzos I Lykourinas M 《Scandinavian journal of urology and nephrology》2000,34(6):355-360
OBJECTIVE: The aim of this study was to assess the effect of local injections of betamethasone, hyaluronidase and lidocaine in patients with Peyronie's disease. MATERIAL AND METHODS: A total of 112 men who had a palpable plaque at the penis and suffered from painful erection and bending of penis was treated with a total of 12 injections containing betamethasone, hyaluronidase and lidocaine. Patients were classified into groups according to the duration of the disease (<6 months, 6-12 months or >12 months) as well as the size of the plaque (<10 mm, 10-20 mm or >20 mm). Pretreatment evaluation of patients and assessment of outcome were based on subjective criteria as well as measurement of the size of the plaque by means of ultrasound. Results were correlated to patients' characteristics. RESULTS: The overall response rate was 86%. Cure or improvement was noticed in 31% and 55% of patients respectively. Most of the patients (83%) had a duration of disease less than 12 months. Painful erection, bending of penis and plaque were absent in 97%, 32% and 31% of patients, respectively, after treatment. No severe complications were observed. The effect of treatment was strongly related to the duration of disease and the size of the plaque. CONCLUSIONS: The method is safe, well tolerated by patients and characterized by a high response rate in patients with a history of less than 12 months and a plaque not exceeding 20 mm. 相似文献
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OBJECTIVE: To investigate whether endothelin and aldosterone participate in the increased prevalence and severity of nephrosclerosis in human low-renin hypertension, analogous to observations in experimental hypertension. DESIGN: Comparison of endothelin, aldosterone and their relationships with proteinuria, in hypertensive patients with high aldosterone : renin ratios (HARR group, n = 14) or normal aldosterone : renin ratios (NARR group, n = 15). METHODS: Urine protein and radioimmunoassay measurements of plasma renin activity, endothelin and aldosterone were carried out in individuals taking their usual diet, and after salt loading and salt depletion. RESULTS: Compared with the NARR group, patients in the HARR group had higher blood pressure, greater salt sensitivity of their blood pressure, significantly greater urine protein and lower serum potassium concentrations, lower renin activities [0.14 +/- 0.03 ng AngiotensinI (AI)/l per s compared with 0.76 +/- 0.16 ng AI/l per s; P < 0.005], blunted renin-aldosterone responses to salt loading and salt depletion, enhanced catecholamine responses to salt depletion, and increased plasma endothelin (5.1 +/- 0.5 fmol/ml compared with 3.7 +/- 0.3 fmol/ml; P < 0.03). In the HARR group, endothelin and aldosterone concentrations were highly correlated, and both correlated with blood pressure and urine protein. In contrast, in the NARR group, endothelin and aldosterone did not correlate between them or with blood pressure, and only endothelin, not aldosterone, correlated with urine protein. Multivariate regression confirmed that the interaction between aldosterone and endothelin was the major predictor of urine protein in the HARR group (r = 0.442), whereas endothelin, renin and their interaction were predictors in the NARR group (r = 0.467). CONCLUSIONS: Our results concur with experimental evidence for participation of endothelin in renal damage of angiotensin-dependent hypertension and for that of an endothelin-aldosterone interaction in low-renin hypertension. We propose that combined pharmacological antagonism of endothelin and aldosterone may confer renal protection beyond blood pressure reduction in patients with low-renin hypertension, a population at high risk for hypertensive nephrosclerosis. 相似文献
5.
Gerard J. Fitzmaurice Anton Collins Haralambos Parissis 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2012,39(5):621-626
An intra-aortic balloon pump is one of the most valuable tools in the cardiac surgeon''s armament to assist in the management of the failing heart. Despite its widespread use, there are associated risks and complications, one of which is balloon rupture with associated entrapment. Numerous approaches for dealing with this complication have been described; here we review the previous experience with intra-aortic balloon pump entrapment and discuss potential management, with particular reference to a recent case of our own.Key words: Assisted circulation/adverse effects, counterpulsation/mortality, entrapment, intra-aortic balloon pumping/adverse effects/methods/mortality/rupture/standards/statistics & numerical data, risk assessmentCardiac surgery offers myriad interventions for possible use in an aging population that has a high prevalence of heart disease. This abundance of options has led to more complex cardiac surgery and to higher public expectations of successful outcomes.1 Against this background, any mechanism that facilitates survival is welcome.The intra-aortic balloon pump (IABP), first used by Kantrowitz in 1967 in a patient with cardiogenic shock, provides mechanical cardiac support via insertion of an inflatable balloon into the descending aorta; it is the most commonly used supportive tool for temporary cardiac assistance.1,2 The IABP works by reducing afterload and actively increasing coronary perfusion.2 The indications are varied but include ongoing ischemia refractory to medical therapy, a need for prophylaxis in high-risk patients before cardiac surgery, and postoperative ischemia and low cardiac output despite inotropic support.3
Intra-aortic balloon pump use, although priceless in improving postoperative survival in high-risk cardiac surgical patients and those with ventricular dysfunction, is not without risks.1,2 Balloon rupture, aortic or iliac artery dissection, thromboembolism, distal ischemia, and thrombocytopenia due to the mechanical action of the balloon on platelets are all potential complications of IABP use.1,4 Despite these risks, there are over 70,000 insertions annually in the United States alone. Of all cardiac surgical patients, 5% to 10% undergo IABP placement.5
Intra-aortic balloon pump rupture with associated entrapment of the balloon within the arterial tree is very rare. Because numerous approaches to deal with this complication have been described, we review the previous experience and discuss the potential management of IABP entrapment, with specific reference to a case of our own. 相似文献
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7.
Filippos K. Triposkiadis Javed Butler Georgios Karayannis Randall C. Starling Gerasimos Filippatos Kathy Wolski John Parissis Charalabos Parisis Dimitrios Rovithis Konstantinos Koutrakis John Skoularigis Christos-Konstantinos Antoniou Christina Chrysohoou Christos Pitsavos Christodoulos Stefanadis John Nastas Themistoklis Tsaknakis Lilian Mantziari Georgios Giannakoulas Haralambos Karvounis Andreas P. Kalogeropoulos Gregory Giamouzis 《International journal of cardiology》2014
Aims
The role of low-dose dopamine infusion in patients with acute decompensated heart failure (ADHF) remains controversial. We aim to evaluate the efficacy and safety of high- versus low-dose furosemide with or without low-dose dopamine infusion in this patient population.Methods and results
161 ADHF patients (78 years; 46% female; ejection fraction 31%) were randomized to 8-hour continuous infusions of: a) high-dose furosemide (HDF, n = 50, 20 mg/h), b) low-dose furosemide and low-dose dopamine (LDFD, n = 56, 5 mg/h and 5 μg kg− 1 min− 1 respectively), or c) low-dose furosemide (LDF, n = 55, furosemide 5 mg/h). The main outcomes were 60-day and one-year all-cause mortality (ACM) and hospitalization for HF (HHF). Dyspnea relief (Borg index), worsening renal function (WRF, rise in serum creatinine (sCr) ≥ 0.3 mg/dL), and length of stay (LOS) were also assessed. The urinary output at 2, 4, 6, 8, and 24 h was not significantly different in the three groups. Neither the ACM at day 60 (4.0%, 7.1%, and 7.2%; P = 0.74) or at one year (38.1%, 33.9% and 32.7%, P = 0.84) nor the HHF at day 60 (22.0%, 21.4%, and 14.5%, P = 0.55) or one year (60.0%, 50.0%, and 47%, P = 0.40) differed between HDF, LDFD, and LDF groups, respectively. No differences in the Borg index or LOS were noted. WRF was higher in the HDF than in LDFD and LDF groups at day 1 (24% vs. 11% vs. 7%, P < 0.0001) but not at sCr peak (44% vs. 38% vs. 29%, P = 0.27). No significant differences in adverse events were noted.Conclusions
In ADHF patients, there were no significant differences in the in-hospital and post-discharge outcomes between high- vs. low-dose furosemide infusion; the addition of low-dose dopamine infusion was not associated with any beneficial effects. 相似文献8.
George Giannakoulas Sophia-Anastasia Mouratoglou Michael A. Gatzoulis Haralambos Karvounis 《International journal of cardiology》2014
Background
The development of pulmonary arterial hypertension (PAH) in patients with congenital heart disease (CHD) is multifactorial with a number of biomarkers serving as mediators of neurohormonal activation [B-type natriuretic peptide (BNP) and its N-terminal-pro-fragment (NT-proBNP)], endothelial dysfunction [asymmetric dimethylarginine (ADMA)] and cellular proliferation [vascular endothelial growth factor (VEGF)].Methods
We systematically reviewed the literature for trials studying the role of these biomarkers in the clinical evaluation, prognosis and management of patients with PAH related to CHD (CHD–PAH).Results
Twenty-six studies were included in the systematic review, involving a total of 1113 patients with CHD–PAH. These patients had higher BNP, NT-proBNP and ADMA levels and higher VEGF expression when compared with healthy controls. Baseline and serial values of plasma levels of natriuretic peptides were shown to be significant predictors of survival. ADMA concentration was elevated in patients with CHD–PAH when compared with patients with simple CHD without PAH, whereas VEGF expression was particularly high in patients with CHD and persistent PAH after corrective surgery of the underlying heart disease.Conclusion
Right heart dysfunction, endothelial inflammation and proliferation are mirrored by plasma levels of the corresponding biomarkers among patients with CHD–PAH. There is early evidence to suggest that natriuretic peptides, in particular, may be a simple and effective tool for determining prognosis and timing for therapeutic interventions in patients with CHD–PAH. 相似文献9.
Iraklis Perysinakis Alexander M. Nixon Ioannis Spyridakis George Kakiopoulos Charalampos Zorzos Ilias Margaris 《International journal of surgery case reports》2014,5(12):1098-1101
INTRODUCTION
Primary malignant hepatic mesotheliomas are extremely rare. We report the case of a patient with primary intrahepatic malignant mesothelioma who was treated in our department.PRESENTATION OF CASE
A 66-year old male patient was admitted to our department for the evaluation of anemia. An abdominal computed tomography scan revealed a large space occupying lesion in the right liver lobe.DISCUSSION
The tumor was subsequently resected and a diagnosis of primary intrahepatic malignant mesothelioma was made after pathologic examination. The patient did not receive adjuvant therapy and is currently alive and free of disease, 36 months after the resection.CONCLUSION
To our knowledge this is the eighth adult case of primary intrahepatic malignant mesothelioma reported in the literature. These tumors are rarely diagnosed preoperatively. Absence of previous asbestos exposure does not exclude malignant mesothelioma from the differential diagnosis. Proper surgical treatment may offer prolonged survival to the patient, without adjuvant therapy. 相似文献10.