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Biomedical subjects

E McGough

Publications and source records attributed to E McGough.

7 recordsLinked to original sources
PubMed1996

Bone marrow transplantation. New strategies for treating malignant disease.

In the years since the world's first successful bone marrow transplant (BMT) was performed at the University of Minnesota in 1968, the field of bone marrow transplantation has evolved rapidly. Stem cells can be obtained from a variety of sources: bone marrow from a matched sibling or unrelated donor (allogeneic transplant), bone marrow or peripheral blood from the patient (autologous transplant), and umbilical cord blood that was collected and stored after delivery for later use by the infant, a matched sibling, or an unrelated patient. Bone marrow transplantation is a widely accepted and successful therapy for treating a variety of malignant and nonmalignant diseases. Continuing research should yield new methods to ensure successful engraftment and to prevent or reduce complications post-BMT. Many patients with cancer have been cured with BMT. However, much work remains to improve survival and to better manage complications. New approaches under investigation may expand the availability of transplantation and improve short- and long-term survival and quality of life.

Adult↗
PubMed1986

Repair of atrioventricular septal defects in infancy.

Fifteen infants less than 12 months of age with complete atrioventricular septal defects underwent repair of the defect between January, 1981, and December, 1984. The average age at operation was 8 1/2 months and the average weight was 5.7 kg. Eight of 15 (53%) infants had preoperative mild to moderate mitral insufficiency. Pulmonary artery hypertension was present in all infants and 13 of 15 infants had a pulmonary arterial resistance greater than 4 units (mean 8.8 units). Operative indication was based on pulmonary artery hypertension, congestive heart failure, and failure to thrive. Ventricular distention was utilized during operative repair to assess location of valve incision, level of attachment of valves to the patch, and cleft approximation. It was also used to check the competency of the mitral repair once complete. The average circulatory arrest time was 55.7 minutes. There were no operative deaths. There were two late deaths. We conclude that ventricular distention is the key to the operation, and operative repair is safe in infants with atrioventricular septal defects.

Atrioventricular Node↗
PubMed1983

Idiopathic multiple systemic aneurysms in a child.

A 3-year-old child had ischemia of the left-sided upper extremity secondary to embolic disease. Arteriography showed multiple idiopathic saccular aneurysms of the left subclavian artery. Coronary arteriograms were normal. Cerebral arteriography showed ectasia of the right common carotid artery, and abdominal aortography, aneurysms of the splenic and phrenic arteries. The patient underwent brachial artery embolectomy, proximal and distal aneurysm ligation, and placement of a carotid to axillary artery polytef bypass graft. Microscopic analysis indicated intimal proliferation, normal elastic tunica media vasorum, and no evidence of an inflammatory process. Electron microscopy showed no evidence of rickettsiae. The patient's clinical appearance was similar but not identical to that of Kawasaki disease, Takayasu's disease, or periarteritis nodosa. Workup of the patient and subsequent surgical exploration failed to demonstrate a definitive cause.

Aneurysm↗
PubMed1983

Predictive value of intramural pH and other risk factors for massive bleeding from stress ulceration.

We have devised and validated an indirect method for measuring the intramural pH in the stomachs of patients in the intensive care unit and have assessed its value in predicting the occurrence of massive hemorrhage from stress ulceration. The 103 patients, studied on an average of 3.8 +/- 0.6 consecutive days, were assigned to one of five groups: no bleeding, weakly positive guaiac, strongly positive guaiac, massive bleeding from an extragastric site, and massive bleeding from stress ulceration. The pH in gastric juice, arterial blood, and the wall of the stomach, PCO2 and PO2 in gastric juice and arterial blood, and [HCO3-] in arterial blood were recorded, together with history of treatment with antacids, cimetidine, and heparin and the number of risk factors known to be associated with bleeding from stress ulceration. Massive bleeding from stress ulceration occurred in 7 patients, all of whom were receiving antacids. Six of these patients died. A logistic analysis of the data obtained showed that the occurrence of bleeding from stress ulceration was best predicted by consideration of the combination of the number of risk factors and intramural pH (p less than 0.0001). Prediction by these variables was not improved by inclusion of any of the other variables recorded. Bleeding from stress ulceration was only seen in patients whose intramural pH had fallen below the lower limit of normality. The data indicate that intensive care unit patients would be better monitored if the intramural pH were measured, and that the occurrence of massive bleeding from stress ulceration would be better averted by maintaining the intramural pH at normal levels.

Adolescent↗
PubMed1980

Recovery of cardiac function with total transapical left ventricular bypass.

Transapical left ventricular bypass which withdraws blood directly from the left ventricular apex through a roller pump and outflow filter with return to the femoral artery has been applied in 6 patients with cardiac failure. All patients required total TALVB (with the aortic valve closed) for periods of one to 144 hrs, and 2 patients had recovery of life-sustaining myocardial function, allowing removal of the TALVB system. One patient had complete recovery without other organ dysfunction. Total TALVB continuously decompresses and unloads the left ventricle throughout systole and diastole, and maintains the circulation in otherwise terminal circumstances.

Adult↗
PubMed1979

Separation of conjoined thoracopagous twins joined at the right atrial.

A case of conjoined thoracopagous twins with a shared atrial myocardium who were successfully surgically separated is described. Twin B had hypoplastic right heart syndrome and was dependent on Twin A for oxygenation of her blood. The twins were surgically separated by dilating Twin B's ductus arteriosus with an infusion of prostaglandin E1 and creating an aortopulmonary shunt to increase her pulmonary blood flow; both twins survived the operation. However, 1 week after surgery Twin B had hepatic and renal failure and died.

Adolescent↗