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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. Rock lobsters can walk in all directions. In the present study, we report the organization of the motor output of the three muscles which control the mero-carpopodite joint (M-C): the extensor E, the flexor F and the accuracy flexor FA, during unrestrained locomotion (fig. 1). 2. During lateral walking, movements of the M-C joint provide most of the propulsive force, whereas during forward and backward walking this joint function more as a strut (fig. 2). Corresponding differences are observed in the motor discharge in the different walking modes. During lateral walking, discharge in the M-C extensor and M-C flexor alternates, whereas during forward and backward walking these antagonists are coactivated (fig. 3 and 4). 3. We have also examined the effects of alterations of proprioceptive feedback: the FA tendon has been cut to eliminate MCO afferents during walking. This ablation does not modify the burst period and the temporal structure of the output pattern is largely unaffected (fig. 5, 6 and 7). MCO may influence the motor output of a given muscle depending upon whether it participates in the return stroke or the power stroke.
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PMID:[Walking in Crustacea: motor program and peripheral regulation (author's transl)]. 92 39

A new pulse contour cardiac output computer, operating from the aortic pressure wave form was tested in cardiac surgical patients. Reference cardiac output was measured by thermal dilution technique. Satisfactory agreements were obtained between the thermal dilution and the COC-pulse-contour cardiac outputs when rapid variations of cardiac output occurred as well as slowly developing changes. The results show that the computation of the stroke volume from the aortic pressure wave form offers a simple, clinically useful method for on-line monitoring of cardiac output in critically ill patients. Possible error sources are discussed.
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PMID:[On-line monitoring of cardiac output with a new pulse contour computer (author's transl)]. 108 30

Transient ischemic attacks (TIAs) are reversible neurological deficits due to cerebral ischemia in a vascular territory lasting less than 24 hours, usually less than one hour. The natural course of TIAs is variable. One third of the patients suffer from a subsequent completed stroke with lasting disability, one third of the patients continues to experience TIAs and in one third no further symptoms are encountered. TIAs are a warning symptom of a generalized vascular process, myocardial infarction being the most common cause of mortality and ischemic brain infarction being the most common cause of morbidity. Clinical parameters--besides age--seem to be of minor prognostic relevance. Vascular risk factors should be evaluated in all TIA patients; especially, a cardiac work up including 2D-echocardiography and an exercise stress test should be performed. Duplex sonography of craniocervical vessels shows atherosclerotic lesions in a considerable proportion of patients with TIA; however, localization of these lesions does not always correspond to clinical symptomatology. Some angiographic features are of prognostic relevance. Computed tomography (CT) and magnetic resonance imaging (MRI) show ischemic lesions in a considerable proportion of patients, which connects TIAs directly to ischemic brain infarcts. The extent and localization of these lesions are of some prognostic relevance. Blow flow studies on single photon emission computed tomography (SPECT) and studies of brain metabolism on positron emission tomography (PET) are abnormal in many TIA patients for prolonged periods and also have some prognostic impact. TIA patients probably are a heterogeneous group with a common symptom. A detailed diagnostic work-up may have implications on a more specific and efficient therapy.
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PMID:[Prognosis after transient ischemic attacks]. 187 47

A 37-year-old man was admitted to our clinic 3 hours after the onset of cerebrovascular accident with right hemiparesis and total aphasia. On admission, we started combined administration of mannitol, vitamin E, phenytoin (Sendai Cocktail) and perfluorochemicals to protect ischemic brain. Left cerebral angiography revealed occlusion of the left middle cerebral artery involving its perforating arteries. Following the performance of angiography, vascular balloon catheter was introduced into the embolus, and fibrinolytic agent (urokinase) was continuously injected. Soon after the injection of 240,000 unit urokinase, recanalization of left middle cerebral artery was shown by repeated cerebral angiography performed 5.5 hours after the onset. On his clinical course, left hemiparesis and aphasia were improved step by step, and 1 week later, he could walk by himself with minor neurological deficits. Further examination revealed that myxoma was located on left atrium by echocardiography. Within 1 week, the patient was transferred to cardio-surgical unit, and myxoma was successfully removed. Now he is in good health and has returned to his job. Usually cerebral embolisms result from atrial myxoma cause severe cerebral infarction. Here we reported a case of cerebral embolism by myxoma and recanalized using fibrinolytic agent by balloon catheter injection. The damage will be reduced if the duration of occlusion is limited, so this method will be helpful to treat cerebral embolism.
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PMID:[A case of cerebral embolism caused by atrial myxoma--superselective fibrinolytic therapy]. 344 2

Eighty-five calcified mitral valves were examined histologically and histochemically and 28 valves were examined in the scanning electron microscope. Different forms of calcification were discovered in rheumatic sclerosis of the mitral valve: dust-like, laminar petrifact, large-tuberous petrifact with protein apoplexy. The cardiac valve calcification in rheumatic fever is preceeded by local dystrophic changes of collagen fibers which undergo swelling, homogenization, and become picrinophilic. Qualitative changes in collagen predispose to calcium salts adsorption by collagen fibers. Scanning electron microscopy revealed the features of three-dimensional structure of petrifactions at various stages of their development. Dust-like petrifactions are microplates of lime with smooth surface, laminar petrifacts consist of accumulations of these microplates. The surface of large-tuberous petrifacts is irregular, ulcerated, covered with thrombotic masses.
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PMID:[Morphogenesis of mitral valve calcification in rheumatism and the significance of the petrifications in surgical practice]. 727 94

Lung contusion has been identified as a primary blast injury. These experiments addressed a fundamental and overt endpoint of primary blast injury, incapacitation (performance decrement). Respiration, hemodynamics, and blood gases were measured in sheep undergoing incremental exercise challenge before and 1 h after simulated blast exposure of the thorax. Pathologic examination of lung tissue was performed after exposure and exercise testing. Blast overpressure was simulated in the laboratory using a compressed air-driven shock tube. Three levels of lung injury (Levels 1-3, 'Trivial', 'Slight', and 'Moderate' injury, respectively) were examined for effects on maximal oxygen consumption (VO[2max]), an index of cardiorespiratory fitness. Resting hemodynamics and blood gases were relatively normal an hour after exposure, immediately before exercise. However, Levels 1-3 lung injury were associated with average 4.8, 29.9 and 49.3% VO(2max). decreases, respectively. These performance decrements for Levels 2 and 3 were significantly different from respective controls (non-exposed). Exercise caused significant hemoconcentration in sheep under control conditions, before exposure (resting 9.5 +/- 0.9, end-exercise 11.8 +/- 0.9 g/100 ml). Blast exposure resulted in average decreases of 4.9 +/- 3.4, 12.8 +/- 4.0, and 12.6 +/- 3.3% in exercise-induced hemoconcentration for Levels 1-3 injury, respectively. Normal exercise-induced hemodynamic increases were also attenuated after exposure. Levels 2 and 3 injury resulted in average 22.6 +/- 2.9 and 18.5 +/- 11.2% stroke volume decreases, and also 22.3 +/- 8.4 and 29.0 +/- 14.2% cardiac output decreases, respectively, during exercise. While blast lung pathology and pulmonary function changes could account for post-blast performance decrements, these experiments suggest that in sheep, early after exposure, diminished hemoconcentration and cardiac disfunction may also contribute to decreased exercise performance.
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PMID:Maximal exercise performance-impairing effects of simulated blast overpressure in sheep. 921 15

The authors report two cases of Bartonella endocarditis in native valves. The first case was a 15 year old North African Girl who lived in poor social conditions and was admitted to hospital with pyrexia and congestive heart failure. Investigations revealed massive mitral regurgitation due to ruptured chordae tendinae, vegetations on the pulmonary valve with severe pulmonary hypertension due to persistent ductus arteriosus. After antibiotic therapy, the patient underwent surgery for mitral valve replacement, pulmonary valvuloplasty and closure of the patent ductus arteriosus. The second case was a 39 year old man with no fixed abode with a history of alcoholism who presented with a recurrent ischaemic stroke in a context of infection with a murmur of aortic regurgitation. Echocardiography showed a vegetation on the aortic valve with grade III/IV regurgitation requiring aortic valve replacement with a homograft after antibiotic therapy. The aetiological diagnosis was made a posteriori by the finding of high antibody titres and specific genetic amplification of Bartonella. In patients with negative blood cultures, Bartonella infection should be looked for systematically especially in those living under poor social conditions. The practical diagnostic investigation of endocarditis with negative blood cultures is reviewed.
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PMID:[Bartonella endocarditis on native valves. Apropos of 2 cases]. 983 93

The pill is discussed. Discovery of the pill was carried out by Dr. G. Pincus. He developed a substance called norethynodrel. Through Professor Marker's work progesterone was made available. Dr. Pincus and Dr. J. Rock started clinical trials with progesterone in Puerto Rico. The chief effect of progesterone in the 20 day pill is to prevent the release of the ripe egg. It also disrupts the normal sequence of hormones that make the lining of the womb receptive to a fertilized egg. Small amounts of a substance resembling estrogen are added to the progesterone to reduce the unpleasant side effects produced by progesterone. Oral contraceptives should not be used by women with thrombophlebitis, thromboembolic disorders, cerebral apoplexy or past history of these conditions, markedly impaired liver function, known and suspected carcinoma of the breast, uterus, and cervix, estrogen dependent neoplasms, jaundice, diabetes, congestive cardiac failure, epilepsy, or severe allergic conditions. It is also advised that oral contraceptives not be used by nursing mothers in the first 6 months and by those with vaginal bleeding. There are side effects to the contraceptives, and certain precautions should be taken before oral contraceptives are prescribed. Physical examinations should be carried out. The patient with history of psychic depression should be carefully observed on orals, and if severe depression occurs, use of the pills should be discontinued. British studies have shown higher mortality and hospitalization rates due to thromboembolic disease in oral contraceptive users than in nonusers.
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PMID:The pill. 1225 8

Two hundred and fifty-one patients with a persistent foramen ovale (PFO), mean age 43.3 +/- 12.4 years, underwent catheter closure between 6/1995 and 6/2001. One hundred and forty-one had an ischemic stroke, 99 a transient ischemic attack (TIA) or prolonged reversible ischemic neurologic deficit, 5 peripheral arterial embolism, 4 suffered from decompression sickness after diving and 2 had transient global amnesia. Fifty-nine of them had multiple events in spite of antiplatelet or anticoagulant therapy. The patients received five different devices: 13 Rashkind Occluders, 20 Amplatzer septal Occluders, 109 Amplatzer PFO-Occluders, 73 CardioSEAL and 36 STAR-Flex devices. Time of fluoroscopy was 8.3 +/- 4.5 min. In three patients a device embolized and had to be removed from the groin vessels. We saw five inguinal or retroperitoneal venous hematomas with the need for operation in one patient. One early and one late perforation of the left atrium caused by a guide wire and a left-atrial disc, respectively, also needed surgery. Fourteen patients had documented late arrhythmias. Six patients with atrial fibrillation needed drugs or cardioversion while the other patients with runs of supraventricular tachycardia, atrial flutter and multiple extrasystoles needed no therapy. On transesophageal echocardiography (TEE) 6 months after implantation we found four significant residual leaks. These patients had the defect closed with a second device. In addition a secundum atrial septal defect (ASD) was closed in 17 patients (mean age 38 +/- 10.5 years) with Amplatzer septal Occluders (12) and CardioSEAL devices (5). These patients had experienced eight strokes and nine TIAs, 3 of them had had multiple events. Two of these patients had a significant residual defect and one had atrial flutter following the procedure. Two hundred and two PFO-patients and 12 ASD patients were followed for 6-62 (24.6 +/- 14.2) months; 2 died due to a traffic accident and a myocardial infarction, respectively. Four patients had another neurologic event following PFO-closure. We now overlook 210 patients with 348.6 symptom-free patient years and have a 1-year recurrence rate of neurologic events of 1.9%. Catheter closure of the PFO and atrial septal defect is a simple, effective and quick method which ensures a high closure rate, avoids life-long anticoagulation and has a low recurrence rate of neurologic events.
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PMID:[Interventional occlusion of foramen ovale and atrial septal defects after paradoxical embolism incidents]. 1244 68

Rock bass (Ambloplites rupestris) are a widespread centrarchid species with both riverine and lacustrine populations. After precipitation events, rivers often carry elevated silt loads, where as lakes generally remain free from suspended silt and sediment. To examine the physiological effects of silt on rock bass, we conducted a series of experiments using fish from Lake Opinicon and the Grand River in Ontario. Ultrasonic Doppler flow probes were surgically affixed around the ventral aorta to monitor cardiovascular performance. After recovery from surgery replicated treatment groups were exposed to incremental increases in silt load (made from bentonite slurry), while cardiac output and its two components, heart rate and stroke volume, were measured simultaneously. Although both groups of rock bass responded significantly to low concentrations of silt (10 NTU), the response by riverine rock bass was rapidly extinguished by acclimation or physiological adjustment. Compensatory mechanisms to minimize cardiac (and respiratory) disruption attributable to increases in suspended silt appear to be inherent in rock bass of riverine origin. These fish appear to fully compensate for interference in gas exchange at the gill surfaces 60 min after initial exposure. In contrast, individual lacustrine rock bass were highly variable in their response to elevated silt concentrations. Changes in stroke volume and cardiac output suggested no clear compensatory mechanism or strategy to cope with increased silt levels.
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PMID:Effects of incremental increases in silt load on the cardiovascular performance of riverine and lacustrine rock bass, Ambloplites rupestris. 1472 Apr 85


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