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Biomedical subjects

C J Strachan

Publications and source records attributed to C J Strachan.

At least 37 records · Page 2Linked to original sources
PubMed1980

Hyperviscosity and thrombotic changes in idiopathic and secondary Raynaud's syndrome.

Whole-blood viscosity (measured at 128, 23 and 0.2 s-(1) was significantly increased in 29 females with Raynaud's syndrome, 13 males with vibration-induced Raynaud's syndrome, and 18 males with calf claudication secondary to atherosclerosis, as compared with 50 healthy controls matched for sex, age and smoking habit. Viscosity was higher at low temperature (27 and 22 degrees C) in all three types of vascular disease and, despite symptoms of cold hypersensitivity, patients with Raynaud's syndrome did not show selective hypersensitivity at low temperature. Patients with vascular disease, irrespective of aetiology, also showed an increase in the acute-phase reactants haptoglobin, fibrinogen, and factor VIII antigen, together with reduced fibrinolytic activity and minor activation of platelets. These alterations in viscosity and haemostatic factors in vascular disease are probably related to the degree, rather than the aetiology, of endothelial damage and their cumulative effect may contribute to local stasis and thrombosis, particularly in cold extremities.

Adult↗
PubMed1979

One-dose antibiotic prophylaxis against wound infection after appendicectomy: a randomized trial of clindamycin, cefazolin sodium and a placebo.

Two hundred and fifty patients were admitted to a prospective randomized trial of single dosage prophylaxis against wound infection after appendicectomy. There were 12 exclusions, 72 patients received placebo, 81 received 600 mg i.m. clindamycin phosphate and 85 received 1 1 g i.m. cefazolin sodium, the agent being given in the anaesthetic room. Clindamycin produced a significant reduction in the overall rate of wound infection from 33 per cent in the controls to 17 per cent. In cases with a gangrenous or perforated appendix the infection rate in controls was 78 per cent; this was reduced to 44 per cent by a single dose of clindamycin. Cefazolin significantly reduced the number of aerobic organisms isolated from wound infections, but did not significantly reduce the incidence of wound infection. We conclude that anaerobic organisms are more important than faecal aerobic organisms in the pathogenesis of wound infection after appendicectomy.

Adult↗
PubMed1979

Fibrinolytic activity of tissue surfaces during surgery.

A non-invasive method has been developed for the study of tissue surface fibrinolytic activity during surgery in man. Surface exudate was collected using a filter-paper disc which was then applied directly to a fibrin plate or used to prepare a euglobulin fraction. The method detected the intraoperative increase in fibrinolytic activity. At 45 minutes from the start of surgery the increase in lytic activity for tissues was four to eight times greater than that of venous blood taken simultaneously. The technique may be used to compare regional differences in tissue fibrinolysis, to determine the effect of excess local fibrinolysis on postoperative bleeding, and to study the relation between low fibrinolytic activity and postoperative adhesion formation.

Exudates and Transudates↗
PubMed1978

The assessment of aorto-iliac disease by static isotope angiology.

In 48 patients with severe claudication isotope images of the aortofemoral arteries have been assessed for the severity of disease in 417 anatomical segments and compared with arteriography. An overall correlation of 80 per cent was found; 87 per cent of patent and 76 per cent of occluded segments were correctly identified, but only 68 and 54 per cent of segments with minor and major disease respectively. Underestimation of disease occurred in only 6 per cent.

Adult↗
PubMed1978

The clinical scope and potential of isotope angiology.

Arterial imaging using a gamma-camera to follow an intravenously injected bolus of 98Tcm has been performed in over 200 patients. The technique has been found useful in the evaluation of emergency vascular problems, in routine cases where arteriography cannot be performed or is inadvisable and in the assessment and follow-up of patients with intermittent claudication and digital vessel disease.

Arteries↗
PubMed1978

The assessment of digital vessel disease by dynamic hand scanning.

A method of assessing hand and digital vessel perfusion is described. It involves an intravenous injection of Tc99m pertechnetate with monitoring of the isotope uptake in the hands and fingers by a gamma camera equipped with a small computer. The technique allows visual evaluation of the arterial supply and a means of quantifying digital perfusion. An evaluation of the technique in normal hands, in patients with digital vessel disease from vibration trauma, Raynaud's and embolism from an ulnar artery aneurysm is described. The potential of the technique in quantifying response to treatment is illustrated by sequential isotope hand scans in a patient treated for obliterative disease of the fingers.

Adult↗
PubMed1978

The noninvasive assessment of aortoiliac disease: a comparison of dynamic isotope angiology with thigh brachial pressure index.

In 41 patients with severe claudication, the time taken for an intravenously injected isotope bolus of TC99m pertechnetate to pass from the aortic bifurcation to the common femoral arteries was measured using a gamma camera and computer. This isotope transit time (ITT) then was correlated with the severity of aortoiliac disease determined arteriographically. Highly significant differences in ITT were found between normal vessels and those with minor stenosis of less than 50%, major stenosis of 50% or more, or complete occlusion. With major disease there was a longer ITT than with minor disease (P less than 0.01). ITT gave a greater degree of differentiation between disease groups than did thigh/brachial pressure index, as measured by Doppler ultrasound in the same patients, and was not influenced by superficial femoral artery occlusion.

Aorta↗
PubMed1977

Prophylactic use of cephazolin against wound sepsis after cholecystectomy.

A trial of antibiotic prophylaxis with cephazolin against postoperative wound sepsis was carried out on 201 patients undergoing routine cholecystectomy. Wound sepsis occurred in 11 out of 65 controls (16.9%), who were not given the drug; two out of 63 patients (3.2%) given a single dose preoperatively; and four out of 73 patients (5.5%) given the single preoperative dose plus a five-day course postoperatively. The difference between the controls and patients given the single preoperative dose was significant.

Cefazolin↗
PubMed1977

The influence of biliary disease on the excretion of cefazolin in human bile.

Forty-five patients with varying biliary pathology were injected with one gram of intramuscular cefazolin sodium prior to surgery. Serum, gallbladder bile, and common duct bile levels were measured. The type of biliary disease did not influence serum levels (mean, 29 mug per milliliter) which reached a peak one hour after injection. Mean common duct bile levels were reduced from 52 mug per milliliter in nonjaundiced patients to 4 mug per milliliter in those with jaundice (p less than 0.001). Patients with radiologically functioning gallbladders had significantly higher mean gallbladder bile levels (21 mug per milliliter; p less than 0.005). Surprisingly, the mean gallbladder bile level in acute cholecystitis was 25 mug per milliliter. As the minimum inhibitory concentration of cefazolin for organisms commonly found in the bile is 0.5 to 6 mug per milliliter, we suggest that cefazolin sodium may be of value in the treatment of biliary disease, particularly acute cholecystitis.

Bile↗
PubMed1976

Fibrin subunits in venous and arterial thromboembolism.

The subunit fibrin composition of thrombi of both venous and arterial origin was examined by sodium dodecyl sulphate gel electrophoresis. The thrombi were recovered by surgical intervention and all had the same fibrin subunit composition. The alpha chains were cross-linked as alpha-chain polymers alpha (p), the gamma chains as gamma-chain dimers (gamma-gamma) while the beta chains were not crosslinked; a further subunit of molecular weight 33 000 was shown to be present in all the fibrins examined and was a degradation fragment of the beta or gamma chains. This data suggests that the crosslinked alpha chains are rate limiting to the lysis of thrombi in vivo. The digestion of pulmonary emboli by plasmin yielded soluble degradation products which were identified as D dimer and E, the latter fragments being the major products obtained by the lysis of in-vitro made plasma clots. The similarity of the composition and lysis of thrombus fibrin to that formed in vitro augurs well for the justification of in-vitro research on mechanisms in thrombolysis.

Electrophoresis, Polyacrylamide Gel↗
PubMed1976

Factors involved in the detection of pulmonary emboli by labelling techniques.

Experiments were set up to assess quantitatively the problem of detecting, by scanning and gamma-camera, labelled pulmonary emboli in the presence of background radioactivity. In vitro, a relative concentration of radioactivity of 2:1 was required to detect a 1-1 cm diameter "hot spot". The results in vivo suggest that the level of radioactivity of a pulmonary embolus situated in the centre of the lung field should be at least six times that of the circulating blood.

Animals↗