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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 25 patients with an acute thalamic stroke (infarct or hemorrhage) on CT or MRI scan and sensory dysfunction, among the 3,628 patients with first-time stroke included in the Lausanne Stroke Registry. Twelve patients had a right-sided infarct, 11 a left-sided infarct, and 2 a left-sided thalamic hemorrhage. Sensory symptoms or signs were the only clinical abnormality. The presumed causes of stroke were small artery disease in 21 patients including both cases of hemorrhage, emboligenic heart disease in 2, while the etiology of ischemic stroke was undetermined in 2 patients. Nine patients had a loss of all modalities of sensation with faciobrachiocrural distribution, 5 patients suffered dissociated sensory loss with faciobrachiocrural distribution and 11 patients showed a dissociated involvement of sensation with a partial distribution pattern. The inferolateral region (thalamogeniculate arteries) was involved in all patients. Six patients complained of pain and/or dysesthesias during the stroke; 5 of them had involvement of the nucleus ventrocaudalis (in 3 with damage to the nucleus ventro-oralis intermedius, and in one to the pulvinar) and 1 patient had involvement of the nucleus ventro-oralis intermedius. Eighteen patients complained of paresthesias in the contralateral part of the body; 16 of them had involvement of the nucleus ventrocaudalis (in 4 with damage to the nucleus ventro-oralis intermedius, in 1 with damage to the nucleus ventro-oralis intermedius, and nucleus ventro-oralis externus, and in one with damage to the nucleus parvocellularis and pulvinar). Four patients developed delayed pain and/or dysesthesias; all of them had involvement of the nucleus ventrocaudalis (in 1 with damage to the nucleus parvocellularis and pulvinar). Time lag from stroke onset to developing pain ranged from 2 to 15 days (mean 10.5 days). One patient with dissociated involvement of sensation with a partial distribution pattern had paresthesias and dissociated hemisensory loss involving position sense without pain and temperature sensations. This patient had involvement of the posterolateral part of the nucleus ventrocaudalis. In conclusion, sensory dysfunction and delayed pain are more often found in thalamic lesions that involve the nucleus ventrocaudalis, and nucleus ventro-oralis intermedius. Restricted sensory abnormalities correlate with very small lesions located in critical areas within these nuclei.
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PMID:Pure sensory syndromes in thalamic stroke. 963 71

Cardiovascular MRI is an active area of research, and the techniques and application are continuing to evolve. We have presented the basic categories of MRI techniques used to image the heart and have shown some examples of advanced techniques applied to the evaluation of congenital heart disease. The reader is referred to other articles for examples of these techniques in clinical practice.
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PMID:MRI for physiology and function: technical advances in MRI of congenital heart disease. 968 5

Twenty patients with malignant uveal melanoma were treated at the The Svedbergh cyclotron in Uppsala from 1989 to 1991. Each tumour received a total dose of 54.6 Gy in four equal fractions on four following days. After treatment the melanoma in all eyes showed decrease in size combined with irradiation retinopathy. In eight patients the treatment was successful after five years. Nine eyes had to be enucleated, two due to recurrence and seven due to neovascular glaucoma. Three patients died, two from metastases and one from heart disease. In all patients the visual acuity was dependent on the distance between the irradiation field and the macula or optic nerve. Each patient suffered from transient post irradiation skin erythema and permanent loss of eyelashes and eyebrows when these were included in the irradiation field. The development of secondary glaucoma was positively correlated with tumour volume, but not to the age or sex of the patients. Histological examination of all the enucleated eyes revealed residual viable tumour without obvious radiation damage: mitotic figures were not identified. MRI examination, performed before and after treatment, demonstrated a marked shift in water binding properties after irradiation. The final visual acuity was dependent on the location of the tumour.
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PMID:Proton irradiation of malignant uveal melanoma. A five year follow-up of patients treated in Uppsala, Sweden. 1005 9

Expression of Cardiac Cytokines and Inducible Form of Nitric Oxide Synthase (NOS2) in Trypanosoma cruzi-infected Mice. Journal of Molecular and Cellular Cardiology (1999) 31, 75-88. Both cardiac cytokine and inducible nitric oxide synthase (NOS2) expression have been implicated in the cardiac dysfunction associated with myocarditis and cardiomyopathy. Chagas' disease, caused by Trypanosoma cruzi, is an important cause of cardiomyopathy. We examined the effect of T. cruzi (Brazil strain) infection with or without verapamil treatment on the expression of cytokines and NOS2 in the heart. Messenger RNA for NOS2, IL-1beta, and TNF-alpha was induced in the myocardium of infected mice, and Western blot analysis as well as immunohistochemistry demonstrated a significant increase in NOS2 protein. Verapamil treatment reduced the expression of cardiac NOS2 protein and the mRNAs for NOS2, TNF-alpha, and IL-1beta. Infection-associated increases in cardiac L-citrulline were also reduced by verapamil treatment. Verapamil-treated infected mice that survived for 80 days exhibited less inflammation and fibrosis compared to untreated mice. Gated MRI and echocardiography revealed an increased right ventricular inner diameter (RVID) in untreated but not in verapamil-treated infected CD1 mice. This suggests that the infection-associated expression of cytokines and NOS2 in the heart correlate with the severity of myocarditis and the effect of verapamil. The RVID was significantly increased in infected wild-type (WT) compared to infected syngeneic NOS2 knockout (NOS2-/-) mice. Fractional shortening was decreased and myocardial L-citrulline was increased in infected WT mice. These data suggest that NO generated from cardiac NOS2 may participate in the pathogenesis of murine chagasic heart disease.
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PMID:Expression of cardiac cytokines and inducible form of nitric oxide synthase (NOS2) in Trypanosoma cruzi-infected mice. 1007 17

Localized (1)H-MR spectroscopy is sensitive to motion and has mostly been applied to the brain. For the human heart, cardiac and respiratory motion lead to displacements on the order of the localized voxel and lead to substantial variations of voxel content, lineshape, water suppression, and signal phase and amplitude. Combined respiratory and cardiac double triggering can avoid these complications to a large extent. Three methods of double triggering are evaluated, with reproducibility established in nine subjects for a method based on respiratory modulation of the ECG amplitude and a visual feedback mechanism. Quantitated with respect to water, within-subject reproducibilities for this setup were 9% for trimethylammonium compounds, 10% for creatine/phosphocreatine, and 13% for lipids. ANOVA showed significant differences between subjects which may relate to natural variability between subjects or exact location within the heart. Unresolved issues for this technique are its susceptibility to precise placement of ECG electrodes and the reasons for failure in 20% of examination. With this technique it is possible to investigate open questions in cardiac pathophysiology, such as the creatine content in chronic heart disease. Variants of this triggering method may also improve cardiovascular MRI methods relying on data acquired in several heartbeats. Magn Reson Med 42:903-910, 1999.
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PMID:Methods and reproducibility of cardiac/respiratory double-triggered (1)H-MR spectroscopy of the human heart. 1054 49

Our goal was to establish right ventricular (RV) volume and ejection fraction (EF) values in normal volunteers with fast magnetic resonance (MR) imaging using a breath-hold technique, to assess the frequency and severity of RVEF abnormality in cardiac patients and to compare RV with left ventricular (LV) data. We performed simultaneously derived RV and LV fast cine measurements in 52 normals and 325 patients with coronary artery disease (CAD), acquired valvular disease (VD), cardiomyopathy (CM), or congenital heart disease (CHD). RVEF was reduced in 31% (102) of all patients, in 50% dilated CM, 39% CHD, 34% CAD, and 22% acquired VD patients. Solitary abnormally low RVEF was found in only 15/325 (5%) of all patients, whereas combined with LVEF deterioration in 87/172 (51%) patients. RVEF reduction was mild in 64%, moderate in 25%, and severe in 11%. Although RVEF correlated significantly (r = 0.55, P < 0.001) with LVEF, the predictive value of LVEF for RVEF was low. We conclude that RV volumes can be routinely assessed with fast MRI and should be performed in addition to LV evaluation in CHD, in right-sided VD, and in all patients with an abnormal LVEF.J. Magn. Reson. Imaging 1999; 10:908-918.
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PMID:Right ventricular volumes and ejection fraction with fast cine MR imaging in breath-hold technique: applicability, normal values from 52 volunteers, and evaluation of 325 adult cardiac patients. 1058 3

To date, most applications of cardiovascular MRI relate to the evaluation of major vessels rather than the heart itself. However, MRI plays a major role in the evaluation of specific types of cardiovascular pathology, namely intracardiac and paracardiac masses, pericardial disease, and congenital heart disease. In addition, because the visualization of cardiovascular anatomy with MR is non-invasive and permits three-dimensional analysis but also allows functional assessment of the cardiac pump, it is clear that MRI will have a growing and significant impact over the next years. We review some of the technical aspect of cardiac MRI and describe the current and potential clinical and investigative applications of this new methodology.
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PMID:MR imaging of the heart: functional imaging. 1066 14

Investigation of blood flow in the heart and vessels may provide insight into the function of the cardiovascular system and aid patient management decisions. Phase velocity cine magnetic resonance imaging (PVC MRI) is a powerful and accurate noninvasive technique to quantitate and analyze blood flow. This article describes the principles, performance, and potential limitations of PVC MRI measurements. Clinical applications of PVC MRI are then reviewed with an emphasis on the assessment of congenital heart disease.
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PMID:Blood flow measurement by magnetic resonance imaging in congenital heart disease. 1067 14

Cranial irradiation may lead to accelerated atherosclerotic changes to small or medium sized arteries, but stroke associated with pituitary irradiation is not frequent. A patient treated with Gamma Knife radio-surgery (GKRS) for a pituitary adenoma suffered a cerebral infarction with internal carotid artery occlusion 4 years after radiosurgery. The patient was a 35-year-old male presenting with a visual disturbance. Endocrinological tests were normal. MRI revealed a 4.3 by 4.3 cm diameter invasive macroadenoma of the pituitary, projecting toward the suprasellar region and with cavernous sinus involvement with encasement of both internal carotid arteries (ICAs). GKRS was performed for residual tumor after a transcranial resection. The maximum dose was 40 Gy and the dose to the right carotid artery was below 20 Gy. The delayed hemiparesis was accompanied by a right capsular lacunar infarct shown on MRI. The images also showed a marked reduction in tumor size. Total, right ICA occlusion was confirmed by Doppler ultrasound. The patient had no history or signs of heart disease or metabolic disorder which could predispose to cerebrovascular
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PMID:Cerebral infarction with ICA occlusion after Gamma Knife radiosurgery for pituitary adenoma: A case report. 1068 1

Recent progress in cardiopulmonary resuscitation techniques improved the survival rate of patients with acute cardiopulmonary disturbances. However, severe cerebral complications remained frequently in patients who survived the acute stage. Early prediction of cerebral prognosis is important to optimize the management of these patients. We examined the relations between radiological findings (Xe-CT and MRI) and cerebral prognosis. Patients included in this study were selected from all patients with hypoxic encephalopathy admitted to our hospital. There were 11 men and 10 women. Causes of hypoxic encephalopathy were heart disease (11 cases), suffocation (4 cases), CO intoxication (2 cases), asthma (1 case), pneumothorax (1 case), anaphyraxy shock (1 case) and electric shock (1 case). Xe-CT and MRI were carried out 3 weeks after the onset. Cerebral blood flow (CBF) of the patients was measured at rest and 15 minutes after intravenous administration of acetazolamide (1 g). The prognosis was evaluated 3 months after the onset in accordance with Glasgow Outcome Scale (GOS). Low hemispheric CBF (30 ml/100 g/min), poor reactivity of acetazolamide challenge test (10 ml/100 g/min), presence of hyperintensity areas in the basal ganglia in T1 weighted images (T1WI) and T2 weighted images (T2WI) are the factors associated with poor outcome in hypoxic encephalopathy.
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PMID:Cerebral circulation and prognosis of the patients with hypoxic encephalopathy. 1075 Mar 55


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