Exercise tests involving isotopes were evaluated in 38 subjects presenting inferior myocardial necrosis. Cardiographic data were used to calculate sensitivity and specificity of the method in ...detection of subjects requiring surgical treatment. Sensitivity was 90% and specificity 62% when three criteria were employed: ECG of positive exertion, reversible diminished accumulation of thallium 201 outside the necrotic site or decrease in the fraction of ejection force. Examination of the fraction of ejection force improved the results of myocardial scanning using thallium and increased detection of subjects requiring surgery from 61% to 90%.
A registry was set up by the national college of cardiologists practicing in general hospitals in February 1993. The data concerned mode of admission, demographic details, initial clinical and ...haemodynamic evaluation and hospital outcome. Special attention was given to the electrocardiographic changes before and, in patients receiving thrombolytic therapy, after treatment. An analysis of predictive factors for mortality was performed both in the group of patients "revascularised" and in the group treated conventionally. One thousand and twenty three cases from 327 centres were analysed. There were 1292 men and 531 women, with an average age of 67.9 years. The average time interval from onset of symptoms to hospital admission was 5 h 30 min, 56.8% of patients arriving within 6 hours. 36.4% of the population underwent thrombolysis or angioplasty, 75% of patients under 75 years of age admitted before the 5th hours underwent a procedure of myocardial revascularisation. The hospital mortality was 14%, 8.7% in those revascularised and 17% in patients treated conventionally. Factors predictive of mortality were age, female gender, Killip Classes III or IV, systolic blood pressure of less than 100 mmHg, heart rate of more than 100/min and contraindications of thrombolysis. The maximum ST depression, the sum of ST depression, the sum of ST elevation and depression, were also significant predictive factors of a fatal hospital outcome in the whole population group and in patients treated conventionally. In the reperfused group, only the initial sum of ST elevation and depression was predictive of mortality: 120 minutes after the beginning of thrombolysis, the sum of ST elevations and of elevations and depressions was predictive of twice the mortality when the values exceeded 0.6 mv and 1.4 mv respectively.
The objective of the current research was to determine whether a freehand, or six degree-of-freedom (6 DOF), scanning method of ultrasonic image acquisition with real-time transducer localization ...would provide three-dimensionally reconstructed ultrasonic (US) images comparable to those reported using mechanical or electronic scanning systems. A standard ultrasound machine and a 6 DOF multi-channel tracking system were used to localize the position and orientation of the US transducer. All data were digitized and stored in real-time for image processing, reconstruction, and volume visualization. Image resampling algorithms were developed along with image preprocessing and postprocessing methods. From the results of this research, the authors conclude that appropriate resampling and enhancement of densely sampled freehand US image data provide high quality 3D US images which can be used in a medical diagnostic setting.< >
The authors report the case of a 28 year old woman admitted as an emergency at 15 weeks' amenorrhea for malaise with transient aphasia and orthopnoea due to massive thrombosis of a St Jude aortic ...valve prosthesis implanted two years previously. This complication occurred after relay of oral anticoagulants with subcutaneous heparin therapy. After a medico-surgical and obstetrical discussion, the indication for thrombolytic therapy with 50 mg of rt-PA over two hours was decided with an excellent clinical and echocardiographic, immediate and lasting result, without any maternal or foetal complication. This enabled pregnancy to be continued to term under oral anti-coagulant therapy. Caesarean section was performed at 8 months leading to the birth of a healthy child. Echocardiographic and radioscopic parameters in the post-partum period showed good prosthetic valve function with no indication for reoperation. This case is original by the absence of neurological and obstetrical complications of thrombolysis, the continuation of pregnancy to term and complete lysis of the thrombus without replacement of the valvular prosthesis.
