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Biomedical subjects

D Kavanagh-Gray

Publications and source records attributed to D Kavanagh-Gray.

16 recordsLinked to original sources
PubMed1990

Effect of raised alveolar pressure on leukocyte retention in the human lung.

To determine whether an increase in alveolar pressure delays the passage of leukocytes (WBCs) through the lung by compressing the lung capillaries, we measured the concentration of WBC across the lung in response to a forced expiratory maneuver. In 20 human subjects, blood was sampled from catheters placed in the pulmonary artery (PA) and left ventricle (LV) before, during, and after a forced expiratory maneuver held for greater than or equal to 20 s against an occluded airway. Pressures were recorded at the mouth and from both catheters. A significant fall in LV WBC (P less than 0.01) but not in PA WBC occurred during or immediately after the maneuver in 18 subjects, with a mean maximum decrease of 26 +/- 12% (SD) from base line (range 9-46%). Between 1 and 3 min after the maneuver, there was an increase in LV and PA WBC (P less than 0.01) above base line. The neutrophil and lymphocyte counts showed similar changes, but erythrocyte and platelet counts remained unchanged. The degree of fall in LV WBC correlated closely (r = 0.68, P less than 0.01) with the changes from lung zone 3 to zone 2 and 1 conditions, as determined from the pressure changes. We conclude that WBCs are retained in the lung during a forced expiratory maneuver because of alveolar capillary compression.

Adolescent↗
PubMed1989

Two-year follow-up study of coronary bypass surgery. Psychologic status, employment status, and quality of life.

This study is a prospective report of the cases of 135 patients who were slated for coronary artery bypass grafting and selected according to designated criteria. Patients received, in addition to an interview, a comprehensive cognitive, neuropsychologic, and personality assessment 2 weeks before operation and 3, 12, and 24 months after operation. Of the available sample, 82.3% completed the full study. There was no evidence of intellectual or neuropsychologic impairment after operation. Most patients returned to preoperative status 3 months after bypass grafting. Further improvement may continue 12 and 24 months after operation. The personality tests revealed that anticipation of the operation resulted in signs of emotional arousal and distress, which dissipated after a successful surgical outcome. Similarly, return to work and quality of life was enhanced. The current study represents the first systematic, longer-term follow-up of the psychologic and social consequences of coronary artery bypass grafting operations. The findings of this study are discussed within a model of social reconstitution after the successful resolution of a life-threatening medical condition.

Adult↗
PubMed1983

Complications of coronary arteriography.

In a prospective study of coronary arteriography with Judkins' technique the rate of major complications in 713 patients was 2.1%, a rate similar to or lower than those reported from other studies, even though more major complications were considered in this study. No deaths occurred. Although the rate of "other" complications was noted as part of the quality care survey, it cannot be compared with that in other studies, since the latter did not consider events such as hematoma or incomplete catheterization. The low complication rate may be related to expeditious procedures, familiarity with the Judkin's technique and the operators' experience. Local quality care assessment or clinical review committees should formally evaluate the complication rates for operative and invasive procedures performed in their own institutions.

Angiography↗
PubMed1978

Efficacy of systemic heparinization in maintaining patency of the incised and cannulated brachial artery.

Alternate members of a group of 100 cardiac patients subjected to right and left heart catheterization studies and angiography received 5000 units of heparin intravenously prior to arterial cannulation. There was no instance of arterial occlusion among these 50 patients, while in 6 of the control group the incised brachial artery became occluded. No complications of heparinization were observed. It is recommended that, where no contra- indications exist, all patients subjected to brachial artery incision and cannulation receive systemic anticoagulation.

Adolescent↗
PubMed1977

Syndrome X: case report.

Transmural myocardial infarction occurred in a 48-year-old woman with syndrome X -- atypical angina pectoris and angiographically normal coronary arteries. Before the infarction her electrocardiogram had been normal at rest but showed ischemia after exercise. Angiography 3 months after infarction revealed a normal coronary tree but hypokinesia of the posterior left ventricular wall.

Angina Pectoris↗
PubMed1974

Angiographic evidence of coronary occlusion and resolution.

A case of myocardial infarction with angiographically demonstrated occlusion of the left anterior descending coronary artery is presented. Repeat angiography 18 months later revealed patent coronary arteries despite persistent electrocardiographic infarction pattern. Coronary artery occlusion resulting in infarction may not, therefore, be permanent.

Adult↗
PubMed1970

Kinking of the aorta (pseudocoarctation): Report of six cases.

Six patients with pseudocoarctation (or buckling) of the aorta were studied clinically and by means of cardiac catheterization. They are presented to bring this rarely reported and benign condition again to the attention of the practitioner. There were four males and two females, aged 2 months to 44 years. Coexisting congenital cardiac lesions were ventricular septal defect and aneurysm of the right coronary sinus in one patient, and bicuspid aortic valve in two others. All patients presented systolic ejection murmurs at the base, well transmitted to the back, and an ejection click was heard in two. Angiography revealed the typical buckled shadow in all. No complications resulted from the presence of the pseudocoarctation, but since aneurysms above and below the kink have been reported, periodic examination of such patients is advised.

Adult↗
PubMed1967

Non-synchronized direct-current countershock in cardiac arrhythmias.

One hundred and thirty-two direct-current shocks were administered to 82 patients in an attempt to convert supraventricular tachyarrhythmias. Sinus rhythm was restored in 74 patients. In at least seven instances the shock was delivered during the T wave. Ventricular fibrillation did not occur. One episode of ventricular tachycardia and one of third-degree heart block followed countershock and terminated spontaneously. Excessive digitalis was considered to be a contributing factor in these two arrhythmias. Non-synchronized countershock is considered a safe and effective method of converting atrial fibrillation and flutter.

Arrhythmias, Cardiac↗
PubMed1966

Factitious aortic valve insufficiency.

One hundred consecutive aortograms, performed with careful attention to recommended technical details, were reviewed to identify cases of "factitious" aortic valve insufficiency, viz. aortic regurgitation seen during aortography for which there is no clinical evidence. Five patients with this condition were identified. Two of these subsequently underwent mitral valve replacement under cardiopulmonary by-pass. Aortic insufficiency was not detected during this procedure and the aortic valve appeared to be anatomically normal at postmortem examination. That factitious aortic insufficiency may exist should be remembered when aortography is used to differentiate aortic from pulmonary valve insufficiency.

Aortic Valve Insufficiency↗
PubMed1965

Recommended criteria for cardiac catheterization in patients with aortic valve disease.

Criteria for selection of patients with aortic valve disease for cardiac catheterization are described, based on a study of 81 cases. Children with aortic stenosis warrant catheterization at the time when the clinical diagnosis is made, but in adults this examination may be deferred until symptoms appear or left ventricular hypertrophy is recognized. In patients with pure aortic insufficiency catheterization may be deferred until symptoms appear. When severe stenosis and insufficiency co-exist, the valve is usually heavily calcified. Thirty-seven per cent of patients with aortic valve disease have co-existing mitral lesions and these patients are usually women, are fibrillating and, as a rule, have atrial enlargement in contrast to those with aortic valve disease only. On rare occasions, patients with mitral valve disease have clinically silent but angiographically demonstrable aortic insufficiency; therefore, aortography should precede open-heart correction of a mitral lesion so as to detect minor degrees of aortic insufficiency.

Adolescent↗