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Biomedical subjects

H H Bell

Publications and source records attributed to H H Bell.

12 recordsLinked to original sources

Comparison of lovastatin (20 mg) and nicotinic acid (1.2 g) with either drug alone for type II hyperlipoproteinemia.

Our study indicates that the combination of nicotinic acid (1.2 g/day) and lovastatin (20 mg/day) is more effective than either drug alone in reducing total and LDL cholesterol. Although HDL cholesterol was not significantly improved by these doses of agents over the duration of this study, LDL/HDL and HDL/total cholesterol ratios were improved due to the beneficial actions on total and LDL cholesterol. No serious side effects or changes in serum chemistries were observed, and the combination was well tolerated.

Aged↗

Coronary artery bypass in women: long-term survival.

During a 6-year period ending December, 1976, 385 female patients underwent coronary artery bypass at the Mid-America Heart Institute. This group constituted 14.6% of the total experience. The operative (thirty day) mortality was 1.3%, which is not significantly greater than that experienced by male patients operated on concurrently. A total follow-up of 2,015 patient-years was obtained. The incidence of nonfatal acute myocardial infarction was 2.0 per 100 patient-years of follow-up, and the incidence of repeat coronary artery bypass was 0.8 per 100 patient-years. The actuarial survival was 90% at 5 years and 75.3% at 10 years. Of the 46 deaths (early or late), 58.7% were cardiac in nature. Although the absolute survival of women is as good as that observed in men, the female patients did not achieve the expected survival pattern of a matched (for age and sex) general population as is observed in our male patients undergoing coronary artery bypass. These results obtained with coronary artery bypass justify the use of similar criteria for the application of this therapy in men and women.

Actuarial Analysis↗

Left heart myxomas.

Separate left ventricular and left atrial myxomas were detected with echocardiography in an asymptomatic young adult with a systolic murmur. Successful surgical removal of both tumors was performed without complications. The value of echocardiography in evaluating heart murmurs of uncertain origin is demonstrated by this unique case.

Adult↗

Coronary artery bypass surgery for left main coronary artery disease.

The course of 146 consecutive patients with significant occlusive disease of the left main coronary artery who underwent coronary artery bypass surgery during a 4 year period is reviewed. Preoperatively, 11 patients were in New York Heart Association functional class II, 57 in class III and 78 in class IV. Seventy patients had progressive angina and 12 unstable angina. There were two operative deaths (surgical mortality rate 1.4 percent). Seven patients (4.8 percent) had a perioperative acute myocardial infarction. Complete follow-up has been achieved in the surgical survivors over an average period of 18.1 months; 77 percent of the surviving patients are completely asymptomatic and 19 percent are in functional class II. Four patients (2.8 percent) had a nonfatal late postoperative myocardial infarction and five (3.5 percent) died during the late postoperative period (3.3 percent annual mortality rate during a 2 to 47 month follow-up period). Postoperative cardiac catheterization studies performed in 35 patients an average of 12.1 months postoperatively revealed 78 percent of 80 grafts and patency of at least 1 graft in 93 percent of patients. Results of 42 (89 percent) of 47 near maximal treadmill stress tests were abnormal preoperatively compared with results of 14 (26 percent) of 54 postoperatively; in 74 percent of patients having both a preoperative and postoperative stress test, abnormal preoperative test results converted to normal after surgery. This study suggests that direct myocardial revascularization may offer an effective means of improving both the quality and duration of life in a patient with significant occlusive disease of the left main coronary artery.

Adult↗

Coronary bypass surgery after renal transplantation.

Aortocoronary bypass surgery was performed in three patients with incapacitating angina pectoris who had previously had successful renal transplantation. All patients had initial symptomatic improvement. Although two have mild angina pectoris, there is objective improvement in their exercise tolerance and in ischemic ST-T changes on treadmill exercise testing. One patient, who also had resection of a left ventricular aneurysm, remains free of angina but is symptomatic from congestive heart failure. There were no postoperative complications. To our knowledge, these three cases are the first in which aortocoronary bypass surgery has been performed successfully in patients who have had renal transplantation. Anticipated problems with infection in view of the immunosuppressive therapy and renal problems postoperatively were not encountered.

Adult↗

The role of pattern goodness in the reproduction of backward masked patterns.

Four experiments investigated the role of pattern goodness in backward masking using five- and four-dot patterns constructed by placing dots in the cells of a 3 x 3 matrix. In Experiment 1, subjects rated the goodness of these patterns and the results replicated previous work showing that good patterns had few alternatives. In Experiment 2, the dot patterns were the target stimuli in a backward masking task using a variety of masking stimuli. For all masking, good patterns were reproduced more accurately than poor patterns. In Experiment 3, the goodness of the masking stimulus was varied. The results indicated that good patterns were reproduced more accurately (replicating Experiment 2) and that good patterns were less effective as stimulus than were poor patterns. In Experiment 4, a long interstimulus interval which precluded masking was used to determine whether goodness affected encoding or memory. At these intervals, there were no differences among patterns, suggesting that the effect of pattern goodness was on rate of encoding. These results demonstrate the importance of configural properties in pattern perception.

Discrimination, Psychological↗

On the relation between time and space in the visual discrimination of velocity.

Is the perception of velocity determined by the prior discrimination of spatial and temporal distances? Two experiments sought to answer this question by comparing the discriminabilities of moving stimuli varied in spatial extent, temporal duration, or in redundant combinations of both variables. The subject's task was to identify which of two alternative stimuli was presented on each trial. A set of four stimuli was constructed from two values of spatial extent and two values of temporal duration. Separate conditions required discrimination of each of the six possible pairs of these stimuli. Experiment 1 examined continuous motion and Experiment 2 examined apparent motion for stimuli with short (50 versus 65 msec) and with long (500 versus 650 msec) interstimulus intervals. With continuous motion and with good apparent motion (short intervals), the discrimination between the different-velocity bivariate pairs was too accurate to be attributed only to discriminations of the spatial and temporal extents of the motion. This did not occur with poor apparent motion. Evidently, time and space are perceptually related.

Adolescent↗

Postinfarctional rupture of the interventricular septum.

During a nine year period, 36 patients have been treated at the Mid-America Heart Institute for postinfarctional rupture of the interventricular septum. Twenty-two (61%) of the patients were male and the average age was 68.9 years. Coronary angiography revealed that 48% of the patients had single vessel coronary artery disease. Eight patients, under medical treatment, stabilized with congestive heart failure. One of these patients was operated upon early and six patients initially managed medically underwent delayed operation 1-6 months after septal rupture without operative mortality. Twenty-eight patients presented with or acutely developed the low cardiac output syndrome following septal rupture. None of eight such patients managed by medical treatment alone survived. The other twenty patients underwent emergency operation within seven days of occurrence of the ventricular septal rupture with seven operative deaths. In the entire surgical group, there were six late deaths and fourteen patients are currently surviving five months to six years and seven months postoperatively. It is concluded that patients who develop postinfarctional ventricular septal rupture and resultant low cardiac output syndrome should undergo prompt diagnostic studies and emergency surgical therapy. Those patients who stabilize with congestive heart failure are initially best managed medically and should undergo delayed surgical repair.

Aged↗