Polymyxin B and low-dose hydrocortisone treatment in a patient with uroseptic shock in a rural health unit.

Sepsis has a high mortality rate; thus, in the intensive care unit, early diagnosis and adjunctive treatments are crucial. However, generally, most patients with sepsis from rural area initially visit the emergency department at a rural hospital and are managed in general medical wards in Japan. Here we report on an 81-year-old Japanese female manifesting septic shock caused by the upper urinary tract infection of extended-spectrum beta-lactamase-producing secondary to the left ureter obstruction by the urothelial carcinoma.

Late gadolinium enhancement on cardiac magnetic resonance represents the depolarizing and repolarizing electrically damaged foci causing malignant ventricular arrhythmia in hypertrophic cardiomyopathy.

Background: The presence of a myocardial scar detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) has been described as a predictor of all-cause mortality in hypertrophic cardiomyopathy (HCM). However, the detailed spatial relationship between LGE site and electrical abnormality is unclear in high-risk HCM with malignant arrhythmia.

Objective: The purpose of this study was to elucidate the detailed relationship between the site on CMR imaging and the electrically damaged site, a potential origin of ventricular arrhythmias in patients with HCM.

Site of transmural late gadolinium enhancement on the cardiac MRI coincides with the ECG leads exhibiting terminal QRS distortion in patients with ST-elevation myocardial infarctions.

Large infarcts are associated with a terminal QRS-distortion in ST-elevation myocardial infarction (STEMI) patients. Late gadolinium enhancement (LGE) on the cardiac MRI (CMR) can depict an infarct distribution. However, less is known about the relationship between the LGE findings and QRS-distortion on admission, including the best ECG-lead location to reveal the QRS-distortion (DIS-lead) in STEMI patients.

Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]).

To determine the relation between aortic wall thickness (WT) and aortic distensibility (AD) with traditional cardiovascular risk factors in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, 1,053 participants in MESA who underwent cardiac magnetic resonance imaging were consecutively selected for the measurement of aortic WT and AD. Double inversion-recovery fast spin-echo images of the thoracic aorta were obtained to measure average and maximum WT. AD was measured at the same level using a gradient-echo cine sequence.

[Usefulness of phase-sensitive inversion recovery in delayed enhanced cardiac MRI].

Background: Delayed-enhancement MRI is a technique that has significant clinical usefulness, particularly for myocardial viability determination in ischemic heart disease. Delayed enhanced images have been acquired by using the inversion recovery(IR)method. It is necessary for the IR method to select optimal inversion time(TI).

Magnesium attenuates isoproterenol-induced acute cardiac dysfunction and beta-adrenergic desensitization.

Sympathetic nervous activation is a crucial compensatory mechanism in heart failure. However, excess catecholamine may induce cardiac dysfunction and beta-adrenergic desensitization. Although magnesium is known to be a cardioprotective agent, its beneficial effects on acute cardiac dysfunction remain to be elucidated.

Cardiovascular function in multi-ethnic study of atherosclerosis: normal values by age, sex, and ethnicity.

Objective: MRI provides accurate and high-resolution measurements of cardiac anatomy and function. The purpose of this study was to describe the imaging protocol and normal values of left ventricular (LV) function and mass in the Multi-Ethnic Study of Atherosclerosis (MESA).

Subjects And Methods: Eight hundred participants (400 men, 400 women) in four age strata (45-54, 55-64, 65-74, 75-84 years) were chosen at random.

Surgical ventricular remodeling for patients with clinically advanced congestive heart failure and severe left ventricular dysfunction.

Background: Surgical ventricular remodeling (SVR) is an accepted therapy for post-infarction ventricular remodeling. Current literature on SVR outcomes has focused on heterogeneous populations with regard to left ventricular function and New York Heart Association (NYHA) class. We assessed outcomes after SVR in patients with advanced congestive heart failure (CHF) (NYHA Class III/IV) and a pre-operative ejection fraction (EF) < or =20%.

Inhaled nitric oxide modifies left ventricular diastolic stress in the presence of vasoactive agents in heart failure.

Nitric oxide (NO) inhalation therapy has been widely used in several diseases with pulmonary hypertension. However, application of NO inhalation therapy remains controversial in heart failure. Cardiovascular effects of inhaled NO (iNO) were evaluated in dogs before and after induction of heart failure with and without infusion of vasoactive agents.