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Biomedical subjects

D K Baird

Publications and source records attributed to D K Baird.

At least 19 recordsLinked to original sources

Long-bone fractures in llamas: six cases (1993-1998).

OBJECTIVE: To determine clinical and radiographic findings, treatment, and outcome for llamas with long-bone fractures. DESIGN: Retrospective study. ANIMALS: 6 llamas. PROCEDURE: Medical records of llamas admitted between 1993 and 1998 because of long-bone fractures were reviewed. Data collected included age, sex, type of fracture, method of fracture repair, and postoperative complications. The Fisher exact test was used to compare age and sex of the llamas with long-bone fractures with those of the hospital population of llamas. All owners were contacted by telephone to determine perceived postoperative problems and whether the llamas were able to perform as expected. RESULTS: Mean age was 160.8 days (range, 23 to 365 days). There was 1 male and 5 females. Fractures were more likely to occur in young llamas (< or = 1 year old) than in adults. Five of the fractures were attributed to traumatic episodes. Long bones affected included the tibia (n = 2), radius (2), femur (1), and humerus (1). Internal fixation with lag screws, plating, or both was performed on fractures of all llamas except 1; that llama was treated by use of confinement to a stall. None of the llamas had intraoperative complications, but postoperative complications were reported in 2 llamas. All fractures healed eventually, and clients were pleased with outcomes. CONCLUSIONS AND CLINICAL RELEVANCE: Long-bone fractures in llamas are uncommon. Several types of long bone fractures can be successfully repaired by use of internal fixation, resulting in few complications and minimal convalescent time.

Age Factors↗

Lethal postoperative coronary artery spasm.

BACKGROUND: Coronary artery spasm in the immediate postoperative period after a coronary operation is recognized infrequently. Its severity is variable and manifestations unpredictable. The diagnosis is usually made by an awareness of the possibility and thereafter by exclusion of other causes of myocardial ischemia. An opportunity for a positive diagnosis is rarely available. METHODS: The case reports of 3 patients with similar presentations of ischemic heart disease and with severe manifestations of coronary artery spasm in the postoperative period are presented. RESULTS: All 3 patients were women aged 55 to 60 years. All had single-vessel coronary artery disease involving the left anterior descending artery and underwent a left internal mammary artery bypass graft. Severe manifestations of myocardial ischemia of abrupt onset developed approximately 7 hours postoperatively in each patient. One patient died of severe hemodynamic deterioration from which resuscitation was unsuccessful. Another sustained a large anterior myocardial infarction despite graft patency. The third patient was supported by an intraaortic balloon pump and made a full recovery. CONCLUSIONS: The early diagnosis of coronary artery spasm is achieved by an awareness of the condition. The institution of early appropriate management may prevent its consequences.

Adult↗

Ameloblastic fibrosarcoma in a bull.

This report describes a malignant odontogenic neoplasm in a 7-year-old bull. The mass, involving the right mandible, was locally invasive and destructive. Histologically, it consisted of islands and cords of benign odontogenic epithelium, entrapped in a population of malignant mesenchymal cells. These morphological features are characteristic of ameloblastic fibrosarcoma in man, an odontogenic tumour not previously described in animals.

Animals↗

Tumor necrosis factor-alpha (TNF-alpha) in canine osteoarthritis: Immunolocalization of TNF-alpha, stromelysin and TNF receptors in canine osteoarthritic cartilage.

The presence and distribution of tumor necrosis factor-alpha (TNF-alpha), TNF receptors and stromelysin [matrix metalloproteinase 3 (MMP-3)] in articular cartilage were evaluated in an iatrogenically induced model of osteoarthritis (OA). Eleven adult male dogs were assigned randomly to a control group (N = 4) or an OA group (N = 7). Osteoarthritis was created by surgical transection of the cranial cruciate ligament of one stifle joint. Both femoral condyles were sampled 3 months post-surgery at necropsy and immunohistochemically analyzed for the presence of the aforementioned cytokines and receptors. Chondrocytes stained for TNF-alpha and TNF receptors in control articular cartilage, spanning an area encompassing most of the middle and deep zones. Positive matrical and chondrocytic staining for TNF-alpha, TNF receptors, and stromelysin was present in OA articular cartilage. Staining varied in intensity and distribution and was dependent of the severity of the lesion. Smooth muscle cells of arteries and arterioles (periarticular synovial membrane) were stained for only one (p55) of two TNF receptors; this staining was confined to control tissues. Results indicate that the differential expression of TNF-alpha and its receptors may be important in the normal maintenance of articular cartilage. The increased presence of TNF-alpha and its receptors in articular cartilage with mild osteoarthritic changes suggests a role in the development of early OA. Regulating TNF-alpha may be an important component in the treatment of OA.

Animals↗

Morphology of the musculus articularis genus in dog with description of ectopic muscle spindles.

The gross morphology of the musculus articularis genus and the location of muscle spindles at its point of insertion were studied in 18 adult dogs. The m. articularis genus was usually small and bipartite. From its originate on the cranial surface of the distal femur, it passed distally to terminate at the femoropatellar-joint capsule surface and extend into the synovial membrane. Although the m. articularis genus was usually composed of two parts, only a medial part was present in some dogs and was entirely absent in one specimen. Innervation to the m. articularis genus was provided by a branch of the femoral nerve. Muscle spindles were abundant in the termination of the muscle. spindles were abundant in the termination of the muscle. Frequently, the spindles were not in contact with muscle fibers (dissociated). Muscle spindles were located in close proximity to the surface of the synovial membrane. Morphological adaptations of the m. articularis genus support its potential function as a monitor of joint movement rather than an extensor of the stifle joint.

Animals↗

Upper gastrointestinal haemorrhage following coronary artery bypass grafting.

BACKGROUND: Upper gastrointestinal (UGI) bleeding is a relatively common and potentially fatal complication of coronary artery bypass graft (CABG) surgery. However, little is known of this problem, including its incidence, predisposing factors and safety of endoscopy in these patients. AIM: To document the incidence, site, predisposing factors and outcome of UGI bleeding following CABG surgery. Also, to assess the safety of UGI endoscopy in these patients. METHOD: Retrospective study of UGI haemorrhage following CABG at one institution between 1976 and 1991. RESULTS: Fifty-five of 10,573 patients (0.5%) suffered a major UGI haemorrhage (as defined by need for transfusion or presence of melaena or haematemesis associated with hypotension). Of 51 patients undergoing endoscopy or laparotomy, 42 (82%) bled from duodenal ulceration. Five patients bled from gastric ulcers and one each from oesophagitis and Mallory Weiss tear. Nine patients underwent endoscopic therapy, which initially arrested haemorrhage in eight patients. However, three patients rebled and required surgery. Eight patients underwent surgery as initial therapy, resulting in an overall surgical rate of 20%. One patient died due to multi system failure following surgery. There were no complications from endoscopy. Patients who bled were more likely to have received inotropic support post-operatively prior to the haemorrhage (p < 0.05) and tended to be older than controls (mean age 65.6 years vs 58.7 years, p < 0.01). Twenty-one of the patients (38%) who bled had a past history of peptic ulceration or dyspepsia compared with 9% of controls (p < 0.001). Seven (12.5%) had previously bled from peptic ulceration. Patients who bled were less likely to have received H2-receptor antagonists in the perioperative period than controls (4% vs 20%, p < 0.05). CONCLUSION: Upper GI haemorrhage following CABG is relatively frequent. It is usually secondary to duodenal ulceration. Endoscopy is a safe procedure in this patient group. Mortality did not differ between index patients who suffered a UGI haemorrhage and controls undergoing CABG who did not bleed.

Aged↗

Video-assisted thoracoscopy.

Recent advances in video-imaging and minimally invasive surgical instrumentation have expanded the role of thoracoscopy in the diagnosis and treatment of intrathoracic conditions. This prospective study describes the use of video-assisted thoracoscopy (VAT) in 100 consecutive patients. There were 70 males and 30 females with a mean age of 54.6. They underwent 103 VAT procedures with 41 thoracoscopic biopsies of lung, pleural, chest wall and mediastinal abnormalities, 32 for treatment of recurrent or persistent pneumothorax, 18 for thoracoscopic assessment of pulmonary and pleural tumours and 12 for thoracoscopic resection of peripheral lung lesions, chest wall, mediastinal and pleural tumours. Eighty-one patients had VAT procedures alone while the remaining 19 had VAT proceeding to thoracotomy. The mean operating time for VAT alone was 51 min (range 30-135 min). There were no operative deaths. There were 8 significant complications from which patients recovered fully. Patients who underwent VAT alone were shown to have earlier postoperative mobilization, reduction in parenteral analgesic requirement and reduced length of hospital stay compared to patients undergoing additional thoracotomy. A telephone survey of patients on returning home showed that patients undergoing VAT alone returned to full activity earlier than those who had thoracotomy (mean 9.0 vs mean 19.4 days). This study confirms that VAT is a safe and effective procedure in the management of pulmonary, mediastinal and pleural disease and the treatment of persistent and recurrent pneumothorax. Its role in the resection of pulmonary malignancy remains to be defined.

Activities of Daily Living↗

Ground reaction force profiles from force platform gait analyses of clinically normal mesomorphic dogs at the trot.

Force platform analysis of gait provides ground reaction force information that can be used to study limbs with normal or abnormal function. When combined, the interrelated variables of ground reaction forces give a more thorough description of gait than when used individually. To describe the pattern of ground reaction forces in clinically normal, conditioned, mesomorphic dogs, we studied the data from platform gait analyses of 43 dogs. Mediolateral (Fx), craniocaudal (Fy), and vertical (Fz) forces were measured and recorded. Torque (Tz) around the vertical axis also was calculated. Mean stance times for forelimbs and hind limbs were 0.278 and 0.261 second, respectively. Among dogs, ground reaction forces were normalized and expressed as percentage of body weight (%bw). The vertical (Fz) peak, average force during stance phase, and force vs time impulses were 106.68, 60.82, and 17.2 %bw in forelimbs, and were 65.11, 35.3, and 9.33 %bw in hind limbs. The forelimb braking/propulsive (Fy) peaks were -16.74 and +6.73 %bw. In hind limbs, these peaks were -3.76 and +7.69 %bw. The usual mediolateral force (Fx) pattern found in forelimbs was laterally directed, with average peak magnitude of 6.69 %bw, whereas the hind limb patterns were variable.

Animals↗

Predominant alpha 1-adrenoceptor-mediated contraction in the human internal mammary artery.

alpha-Adrenoceptor agonists and antagonists are widely used perioperatively for internal mammary artery (IMA)-coronary artery bypass operations. To determine subtypes of alpha-adrenoceptors in the human IMA, we studied responses of isolated human IMA segments to alpha-adrenoceptor agonists, antagonists, and electrical stimulation in organ baths. The IMA ring segments (3 mm long) were set up at a physiologic and comparable condition according to their own length-tension curves. alpha 1-Agonist methoxamine (MO) induced 2.65 +/- 0.70 g force and alpha 1, alpha 2-agonist norepinephrine (NE) induced 4.07 +/- 0.70 g force. The contractions induced by both MO and NE were totally abolished by alpha 1-antagonist prazosin (0.1 microM) but not alpha 2-antagonist yohimbine. alpha 2-Agonist UK14304 induced only 0.39 +/- 0.17 g force, which was significantly less than that induced by MO or NE (p < 0.001). Contractions induced by electrical field stimulation (2, 10, 20 Hz) were decreased by alpha 1-antagonist prazosin 1 microM (p < 0.01) but potentiated by alpha 2-antagonist yohimbine. These results strongly suggest that in the human IMA the postjunctional alpha-adrenoceptors are predominantly of the alpha 1-subtype and therefore the alpha-adrenoceptor agonist-induced contraction and the sympathetic nerve stimulation-induced contraction is mediated mainly by activation of the alpha 1-adrenoceptors.

Adrenergic alpha-Agonists↗

Vertical ground reaction force distribution during experimentally induced acute synovitis in dogs.

The pattern of vertical ground reaction force redistribution among limbs during episodes of acute synovitis of the stifle in 12 mixed-breed dogs was investigated as an adjunct to a blinded nonsteroidal anti-inflammatory drug efficacy study. Without regard to drug efficacy groupings, the redistribution of vertical forces before and during the acute synovitis episode was evaluated by analysis of gait, using a force platform. Acute synovitis was induced by intrasynovial injection of sodium urate crystals. Simultaneously, each dog was given 1 of 4 treatment regimens, including IV injection of sterile saline solution (as a negative control), phenylbutazone (as a positive control), or 1 of 2 proprietary nonsteroidal anti-inflammatory drugs. Postinjection analyses took place at 2, 4, 8, 12, 24, and 36 hours. The peak vertical force redistribution in the 3 untreated limbs of the dogs was described. The greatest redistribution was observed 4 hours after substance injection when the synovitis was clinically at maximum. Thereafter, there was steady improvement and the dogs had a clinically normal gait 24 hours after substance injection. During synovitis, peak vertical force increased in the contralateral hind limb. During the more severe synovitis episodes, force was decreased in both forelimbs. There was good correlation between severity of lameness and peak vertical force response in the contralateral hind limb. Results of the study indicate that the untreated limbs of the same animal should not be used as a control during acute lameness studies.

Animals↗

Inhibitory effects of glyceryl trinitrate on alpha-adrenoceptor mediated contraction in the human internal mammary artery.

1. Sympathomimetic amines have been considered to be related to vasospasm. Previous studies showed that the human internal mammary artery (IMA) was capable of weak beta-adrenoceptor mediated relaxation and that alpha-adrenoceptor agonists may induce contraction in the human IMA. 2. We investigated the effects of glyceryl trinitrate (GTN), a vasodilator agent often used perioperatively, on alpha-adrenoceptor mediated contraction in the human IMA. 3. Discarded human IMA segments were taken from 37 patients who underwent IMA--coronary artery bypass graft operations and equilibrated in an organ bath. 4. A specially designed technique was used to normalize the vessel segments under the pressure similar to the in vivo situation. Noradrenaline (NA), phenylephrine (PE), and methoxamine (MO) were used to contract the vessel segments. 5. GTN fully relaxed PE or MO (submaximal concentration) induced precontraction. Therapeutic plasma concentration of GTN relaxed 40-90% of the PE induced contraction (2.82 g, EC50 = 7.92 +/- 0.06 -log M) and 20-90% of the MO induced contraction (1.8 g, EC50 = 7.63 +/- 0.16 -log M). Pretreatment by the therapeutic plasma concentration of GTN inhibited the contraction induced by NA, PE in a different range. It reduced the NA induced contraction (6.9 g) by 14.8-38% (P greater than 0.05) and the PE induced contraction (4.3 g) by 7.9-39.3% (P greater than 0.05). The alpha 1-adrenoceptor antagonist prazosin, at the therapeutic plasma concentration, nearly totally abolished the NA or PE induced contraction (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Agonists↗

Persistent ductus arteriosus in adults. A review of surgical experience with 25 patients.

OBJECTIVE: To review the clinical features, operative details and course of adults with persistent ductus arteriosus. DESIGN: Retrospective study. Information on subjects was obtained by case records review. SETTING: The Cardiothoracic Unit, Royal Prince Alfred Hospital, Sydney. PATIENTS: Twenty-five adults aged 16 years and over with persistent ductus arteriosus, from 1974-1990. INTERVENTION: Surgical division or ligation of persistent ductus, via left thoracotomy or median sternotomy. MAIN OUTCOME MEASURES: Preoperative clinical features; postoperative mortality and morbidity. RESULTS: There was a high incidence of symptoms in this group of adults with persistent ductus arteriosus, many having anatomical (aneurysm, calcification) and/or haemodynamic (heart failure, pulmonary hypertension) complications. There was one death (mortality, 4%) of a young woman with significant preoperative pulmonary hypertension. The remaining 24 patients (96%) left hospital completely well between 4 and 12 days after surgery. CONCLUSIONS: Persistent ductus arteriosus, although primarily a paediatric problem, may present in adulthood. Closure by operative means (or in selected cases, by interventional catheter) is warranted in all adult subjects with left to right shunt, other than for patients over 60 years of age with neither heart failure nor cardiomegaly.

Abnormalities, Multiple↗

Mitral valve replacement combined with coronary artery operation: determinants of early and late results.

Mitral valve replacement combined with coronary artery bypass grafting has been reported as being associated with a higher mortality than either mitral valve replacement or coronary artery bypass grafting alone. Cause of mitral valve disease and severity of mitral regurgitation have been reported as related to mortality. To study the correlation of the cause of mitral valve disease and severity of mitral regurgitation to hospital mortality and long-term survival, we analyzed the results of 135 patients undergoing mitral valve replacement and coronary artery bypass grafting between June 1974 and August 1989. The hospital mortality was 11.8% (16/135). Fifteen preoperative and operative variables were tested for correlation with hospital or late mortality using univariate tests and multivariate regression. Advanced age (greater than 60 years), New York Heart Association functional class, and wall motion score were independently associated with hospital mortality (p less than 0.05). The cause of mitral valve disease and severity of mitral regurgitation were not related to hospital mortality or long-term survival (p greater than 0.05). The follow-up rate was 96.6% for the hospital survivors (115/119). Mean follow-up was 52.6 +/- 4.1 months. There were 35 late deaths. Survival was 91.9%, 89.9%, 78%, and 49.9% at 1, 2, 5, and 10 postoperative years, respectively. Preoperative New York Heart Association functional class and use of catecholamines during the postoperative intensive care period were independently related to late survival (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The importance of age as a predictor of atrial fibrillation and flutter after coronary artery bypass grafting.

The purpose of this study was to identify factors associated with atrial fibrillation and flutter after coronary artery bypass grafting. The study group consisted of a consecutive series of 5807 patients who underwent coronary artery bypass grafting alone and who were in sinus rhythm preoperatively. Atrial fibrillation and flutter were identified during continuous monitoring or by clinical symptoms and signs; they occurred in 17.2% of the patients. The prevalence of atrial fibrillation and flutter was directly related to age at operation, varying from 3.7% in patients aged less than 40 years to 27.7% in patients aged 70 and over. In a multivariate analysis, age remained the most important independent predictor of atrial fibrillation and flutter (p less than 0.001). Other independent predictors of atrial fibrillation and flutter were chronic airflow limitation (p = 0.006), preoperative beta-adrenergic blockers (p = 0.011), and chronic renal failure (p = 0.04). Extent of coronary disease at catheterization, history of a previous myocardial infarction, heart size on chest x-ray film, and all operative factors measured, apart from year of operation, were unassociated with atrial fibrillation and flutter. Thus atrial arrhythmias after coronary artery bypass operations are most strongly related to advanced age and are unassociated with preoperative left ventricular function and extent of coronary disease.

Age Factors↗

Total intracardiac repair for tetralogy of Fallot in adults.

The anatomic and clinical features of 47 patients who were 18 years of age or older at the time of total intracardiac repair for tetralogy of Fallot are reviewed. Twenty (43%) patients had had previous palliative surgery. Of 14 pulmonary-systemic shunts, 9 (64%) remained patent. The location of the ventricular septal defect was infracristal in 90% of patients. The predominant right ventricular outflow tract obstruction was at the infundibulum in 30%; another 64% of patients had combined valvular and infundibular obstruction. Total intracardiac repair was achieved; hospital mortality was 8.5%. Morbidity was minor, and hemorrhage was a significant problem in only 2 patients. Thirty-five patients have been followed from 11 months to 15 years after surgery. There were 4 late deaths; the actuarial 10-year survival rate was 82%.

Abnormalities, Multiple↗