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Biomedical subjects

I F Lane

Publications and source records attributed to I F Lane.

At least 19 recordsLinked to original sources
PubMed2000

Diagnosis and management of urinary retention.

Failure to empty the urinary bladder completely can be attributed to failure of detrusor contractile function, inappropriate outlet resistance, or both. For each of these mechanisms, anatomic, neurogenic, and end-organ (myogenic or idiopathic) abnormalities are possible. The approach to urinary retention involves systematic consideration of neurogenic, obstructive, and functional causes and requires understanding of the neurophysiology and pharmacology of micturation.

Animals↗
PubMed2000

Is there carotid artery aneurysm formation following saphenous vein patch endarterectomy?

The use of saphenous vein patching following carotid endarterectomy is reported to produce aneurysmal dilatation with the risk of thrombosis and possible rupture. The authors have studied patients who have had saphenous vein patch angioplasty following carotid endarterectomy to assess whether there is any progressive arterial dilatation. Thirty-five patients who had undergone saphenous vein patch carotid endarterectomy were age- and sex-matched with 31 subjects that had direct closure endarterectomy. All participants underwent carotid duplex scanning. The external diameters of the mid common carotid artery, the bulb and the proximal internal carotid artery were measured bilaterally. The diameters of the endarterectomized carotid were compared with the contralateral side using a paired t-test. Using an unpaired t-test, the saphenous vein angioplasty group was compared with the directly closed group. A graph was plotted of the ratio of internal carotid artery diameter of the saphenous vein angioplasty group (endarterectomized artery to the contralateral artery) against the length of follow-up, and the Pearson correlation coefficient was calculated. When the saphenous vein angioplasty group was compared with the directly closed group there was a significant difference between the carotid bulb (11.6 versus 9.7mm, P < 0.001) and internal carotid artery diameters (9.0 versus 7.0mm, P < 0.001). Longitudinal analysis of the saphenous vein angioplasty group showed that the increased diameter of the endarterectomized internal carotid artery progressed with time after surgery (r = 0.51, P < 0.005, and r = 0.56, P < 0.001). Vein patching increases the diameter of the internal carotid artery, and this may further increase with time possibly predisposing to aneurysm formation. Further longitudinal studies of paired data are required.

Adult↗
PubMed2000

Quantitative urinalysis in healthy Beagle puppies from 9 to 27 weeks of age.

UNLABELLED: To evaluate indices of renal function in healthy, growing Beagle puppies from 9 to 27 weeks of age and to determine whether indices change with age during this period. Animals-6 healthy Beagle puppies. PROCEDURE: Urine collections were performed at 2-week intervals in puppies 9 to 27 weeks old. Daily excretion of urinary creatinine, protein, sodium, potassium, chloride, phosphorus, and calcium were determined, as were quantitative urinalyses including endogenous creatinine clearance, urine protein-to-creatinine ratios (UPr/C), and fractional clearances of sodium (FNa), potassium (FK), chloride (FCI), calcium (FCa), and phosphorus (FP). RESULTS: Significant differences among age groups were detected for endogenous creatinine clearance, and daily urinary protein, potassium, calcium, and phosphorus excretion. Significant differences also existed among age groups for UPr/C, FNa, FK, FCI and FP. Age-related effects fit a linear regression model for FNa, UPr/C, daily phosphorus excretion, and daily protein excretion. Quadratic regression models were judged most appropriate for endogenous creatinine clearance, FK, daily chloride excretion, and daily potassium excretion. Endogenous creatinine clearance measurements higher than adult reference ranges were observed from 9 to 21 weeks of age. The FNa, FK, FCI, FCa, and FP were slightly higher than those reported for adult dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Selected results of quantitative urinalyses in healthy 9- to 27-week-old Beagle puppies differ with age and differ from those measured in adult dogs. Diagnostic measurements performed in puppies of this age range should be compared with age-matched results when possible.

Analysis of Variance↗
PubMed1999

Profound postanesthetic hypoglycemia attributable to glucocorticoid deficiency in 2 dogs.

Glucocorticoid deficiency was diagnosed as the cause of severe postanesthetic hypoglycemia in 2 dogs. Prior signs of systemic illness were not described in either dog; however, preoperative hematologic findings were consistent with glucocorticoid deficiency. Fasting hypoglycemia is a possible complication of chronic adrenal insufficiency primarily because of impaired gluconeogenesis.

Adrenocorticotropic Hormone↗
PubMed1999

Parenteral nutrition in the management of a dog with lymphocytic-plasmacytic enteritis and severe protein-losing enteropathy.

Management of lymphocytic-plasmacytic enteritis in a dog with whipworm infestation, hypoproteinemia, and ascites is described. Short-term parenteral nutrition hastened normalization of serum proteins, resolution of diarrhea, and weight gain. A description of the potential benefits, limitations, and possible complications of parenteral nutrition in refractory inflammatory bowel disease is given.

Animals↗
PubMed1998

Leucocyte filterability: comparing diluted with undiluted blood.

Red blood cells and about 95% of white blood cells have an immediate and constant effect on the flow of undiluted or diluted blood through 5 microm filters. The remaining 5% of all leucocytes exert an increasing influence on flow such that the rate of flow of diluted and undiluted blood through these filters is continually declining over a period of 150 s. Analysis of this declining flow rate enables these cells to be counted and their rheological properties to be deduced. Approximately 50% of these slow leucocytes pass through the filters with a transit time of about 30 s and the remaining cells act as pore blockers for 150 s. The numbers and flow properties of slow leucocytes was approximately the same in blood from young women (25 years) and older men (65 years). However, the number of slow leucocytes was increased in a group of men (65 years) suffering from peripheral arterial occlusive disease. Dilution of the blood with phosphate-buffered saline increased the numbers of slow leucocytes in both of the older, but not the younger, group of volunteers. This effect was particularly noticeable in the patient group. It is recommended that filtration studies of the rheological profile of leucocytes can, and must, be performed with undiluted blood. The properties after dilution may sometimes, but not invariably, reflect changes ex vivo as well as inherent differences in the cells themselves.

Adult↗
PubMed1998

Methods for studying leukocyte filterability in undiluted blood from intermittent claudicants.

Leukocytes are characterised from their influence on the filterability of undiluted blood from patients with PAOD (intermittent claudicants - Fontaine Stage II) and a group of sex and age-matched controls. Undiluted blood was filtered through 5 microm Nuclepore (Hemafil) filters for 300 s, at 711 Pa and room temperature, using a custom-made constant pressure filtrometer. Four populations of leukocytes are identified in both groups. In the control group, 94.4% of the leukocytes are identified as fast leukocytes with a transit time of 1.8 s. The remaining white cells are recognised as slow flowing leukocytes and subdivided into three further sub-populations. The first of these (SL1; 2.8% of total leukocyte count) is characterised by a transit time of 31.7 s, a second population (SL2; 1.5% of total leukocyte count) by a transit time of 145.8 s while the remaining cells are identified as pore blockers (PB) under these conditions. A similar rheological classification is valid in the patients but the sum of the three minor populations is elevated compared to controls (p = 0.001) although there is no overall leukocytosis. The only significant difference in flow properties of any blood cells, between the two groups of volunteers, is seen in the major population of leukocytes with an elevated transit time of 2.4 s. Stepwise regression analysis identifies the concentration of fast leukocytes, SL2 and PB as the major variables affecting blood flow through the filter. It is argued that the higher concentration of SL2 and PB probably reflect the increased sensitivity of neutrophils to physical stimuli.

Aged↗
PubMed1997

Dynamic obstruction of the external iliac artery in endurance athletes and its relationship to endothelial function: the case of a long distance runner.

There have been recent reports of exercise induced claudication in endurance trained athletes attributed to narrowing of the external iliac artery. Most patients have been competitive cyclists, and intimal hyperplasia has been cited as the cause. The case is reported here of a long distance runner who presented with similar symptoms.

Adult↗
PubMed1997

The effects of platelet inhibitors on platelet uptake and restenosis after femoral angioplasty.

OBJECTIVE: To investigate the effects of two platelet inhibitors, aspirin and iloprost, on platelet uptake and restenosis at the site of angioplasty in patients undergoing femoral or popliteal angioplasty. EXPERIMENTAL DESIGN: Prospective, open, randomised group comparison. SETTING: Two university hospitals. PATIENTS: 43 patients undergoing femoral or popliteal angioplasty were randomised. INTERVENTIONS: Patients received either aspirin (300 mg/day), iloprost (8 hours/day i.v. infusion) or no antiplatelet medication during angioplasty and on the subsequent two days. MEASURES: Platelet uptake was measured using 111Indium-labelled platelets. Restenosis was assessed by repeat angiography at 3 months and clinical symptoms up to 12 months. RESULTS: Median changes in platelet uptake were similar in the three treatment groups, but all platelet radioactivity ratios > 2.0 occurred in the control group. Restenosis at 3 months was observed in 3 control, 5 aspirin and 1 iloprost patient. Further surgical intervention was performed in 3 control and 3 aspirin patients, but in none of the iloprost patients up to 12 months after angioplasty. CONCLUSIONS: Antiplatelet therapy may prevent large increases in platelet deposition at the angioplasty site, but the link between platelet deposition and restenosis was not substantiated in this study.

Aged↗
PubMed1996

Feline urodynamic procedures.

Urodynamic procedures are those studies which investigate the process of storage and evacuation of urine in the lower urinary tract, usually by recording pressure or flow characteristics in the urinary bladder or urethra. Cystometric techniques, urethral pressure profilometry, electromyography, and evoked potentials have been adapted for use in cats. The applications and limitations of each of these techniques are discussed.

Animals↗
PubMed1996

Pharmacologic management of feline lower urinary tract disorders.

Pharmacological recommendations for the treatment of lower urinary tract disorders in cats are rapidly evolving as more is learned about the physiology and pathophysiology of the feline urinary bladder and urethra. Recent investigations and clinical observations have led to reconsideration of previously prescribed treatments and to the use of new and alternative pharmacologic agents. Pharmacologic agents used in the management of common lower urinary tract disorders in cats, including urinary tract infections, idiopathic lower urinary tract inflammation, urinary incontinence, urine retention, and urinary elimination disorders, are reviewed.

Animals↗
PubMed1996

Comparison of clinical follow-up and duplex surveillance of infrainguinal vein bypasses.

The evidence in support of surveillance has been principally based on the favourable primary-assisted patency of stenosed grafts following revision (60-80% at 5 years) compared with the poor secondary patency of revised occluded grafts (20-40% at 5 years). Both the capital cost and workload generated by surveillance are considerable. More information is needed on the benefits of surveillance compared with clinical follow-up. A retrospective comparison of 50 vein grafts (44 reversed, six in situ) undergoing colour-coded duplex surveillance and 50 vein grafts (46 reversed, four in situ) under clinical follow-up, with duplex scans obtained only when clinically indicated, has been performed. Four (8%) stenoses of > or = 50% were identified in the surveillance group. One 50% proximal anastomotic stenosis failed to progress on sequential scans. Three stenoses were treated (one mid graft, two popliteal) by vein patch angioplasty (two cases) and transluminal angioplasty (one case). Both groups were followed-up for 12 months. Secondary patency at 12 months (88% surveillance; 80% clinical follow-up) was not significantly different (P = 0.3). Similarly, limb salvage at 12 months (94% surveillance; 88% controls) was not significantly different (P = 0.4). A large randomized prospective study comparing duplex surveillance and clinical follow-up is warranted.

Adult↗
PubMed1996

The influence of total knee arthroplasty on lower limb blood flow.

Ischaemic complications of total knee arthroplasty (TKA) are unusual and tend to occur in patients with peripheral vascular disease (PVD). A prospective study was undertaken to investigate the effect of TKA on blood flow in patients without clinical evidence of PVD. Ankle brachial index (ABI) did not alter post-operatively and no changes in arterial waveforms were found. Unless there is clinical evidence of PVD, TKA under tourniquet control is therefore very unlikely to cause ischaemic complications.

Aged↗
PubMed1996

Colour-coded duplex assessment alone before carotid endarterectomy.

This study assessed whether carotid colour-coded duplex imaging can provide sufficient information to investigate patients before carotid endarterectomy. One hundred patients with symptomatic carotid artery disease (amaurosis fugax 24, transient ischaemic attack 38 and established stroke 38) were assessed by both colour-coded duplex imaging and arch angiography. Stenoses were graded at angiography using the linear method from the European Carotid Surgery Trial and on duplex using peak systolic velocity criteria. Angiograms were also analysed for any arch or intracerebral pathology which would alter surgical management. In defining 70-99 per cent stenoses, duplex had a sensitivity of 98 per cent, specificity 96 per cent, positive predictive value of 96 per cent, negative predictive value 98 per cent and accuracy 97 per cent compared with angiography for both symptomatic and asymptomatic carotids (chi 2 = 1.22, 1 d.f., P = 0.25). With respect to the symptomatic carotid arteries angiography gave different information from duplex in six patients (6 per cent): definition of 70-99 per cent carotid stenosis was different (four), visualization was poor on duplex (one) and an intracerebral aneurysm was identified by angiography. One patient died following arch angiography as a result of mesenteric thrombosis. Carotid duplex imaging alone would appear to be sufficient to assess most patients before carotid endarterectomy as an accurate, safe and relatively cheap investigation compared with angiography. In cases where duplex assessment does not allow full visualization of the carotid bifurcation angiography is required.

Adult↗
PubMed1995

Evaluation of results of preoperative urodynamic measurements in nine dogs with ectopic ureters.

Cytometrographic studies and urethral pressure profiles were performed to objectively assess the functional status of the urinary bladder and urethra in 9 dogs with congenital ectopic ureters. Functional abnormalities of the urinary bladder or urethra were detected in 8 of 9 (89%) dogs. Cystometrographic evidence of reduced bladder capacity was detected in 4 (44%) dogs, and abnormalities in urethral pressure profiles were consistent with urethral incompetence in 6 (67%) dogs. Dogs with urethral pressure profile abnormalities were treated with phenylpropanolamine hydrochloride, and the urethral pressure profile was reevaluated. Urethral pressure measurements obtained before surgery (3 dogs) and after phenylpropanolamine (6 dogs) were used to predict the likelihood of continence after surgery. Predicted outcomes included continence maintained without medication (3 dogs), continence maintained with phenylpropanolamine (2 dogs), and persistent incontinence despite phenylpropanolamine administration (4 dogs). After surgical repair of ectopic ureters, 2 of 9 (22%) dogs were continent without medication, and 2 (22%) maintained continence with phenylpropanolamine treatment. Various degrees of incontinence persisted in 5 of 9 (56%) dogs, 4 of which had urethral incompetence that had been documented as poorly responsive to phenylpropanolamine administration prior to surgery. Predicted outcomes were consistent with actual outcomes in 8 of 9 (89%) dogs, with predictions of incontinence proving accurate in 4 of 4 (100%) dogs and predictions of continence proving accurate in 4 of 5 (80%) dogs. Urodynamic assessment of dogs with ectopic ureters appears to be valuable for identifying concurrent functional abnormalities of the urinary bladder and urethra and for predicting postoperative outcome.

Animals↗
PubMed1995

Flush saphenofemoral ligation and multiple stab phlebectomy preserve a useful greater saphenous vein four years after surgery.

PURPOSE: Flush saphenofemoral ligation, with multiple cosmetic stab phlebectomy, successfully treats saphenofemoral reflux and superficial varicosities. The long-term effect on the residual greater saphenous vein (GSV) requires evaluation. METHODS: Noninvasive triplex ultrasound assessment of the residual GSV for potential use as a vein graft was used. We evaluated the independent objective and subjective cosmetic outcomes. We also used analysis to determine the correlation between GSV reflux, symptoms, and cosmetic outcome. RESULTS: Seventy-two limbs were assessed at a median follow-up of 4 years (interquartile range 3 to 5 years). Fifty-nine limbs had patent GSVs above and below the knee. The mean length patent was 51 cm, and the mean internal diameters above and below the knee were 3.6 and 2.8 mm, respectively. In 65% of cases the vein had suitable ultrasonic characteristics, suggesting that it would be suitable for use as a conduit for a vascular bypass graft. Sixty-two limbs were considered a symptomatic success and 61 an objective cosmetic success. There was no correlation between the symptomatic and cosmetic outcome and the presence of superficial GSV reflux (linear regression analysis). CONCLUSIONS: These findings support the effectiveness of the procedure of flush saphenofemoral ligation and multiple stab phlebectomy with regard to cosmetic and symptomatic outcome and may preserve the GSV for use as an autologous bypass graft.

Esthetics↗
PubMed1995

Lupus anticoagulant in patients with peripheral vascular disease: a prospective study.

OBJECTIVE: To assess the incidence of lupus anticoagulant (LAC) in patients with peripheral vascular disease. DESIGN: Prospective clinical study. SETTING: University Hospital. MATERIALS: 20 patients with claudication (group 2), 20 patients with critical ischaemia (group 3) and 20 patients prior to elective abdominal aortic aneurysm surgery (group 4) were compared to 20 general surgical controls (group 1). CHIEF OUTCOME MEASURES: Venous blood samples for coagulation assay. MAIN RESULTS: Positive results for LAC by the Dilute Russell's viper venom time (DRVVT) with the platelet neutralisation procedure were present in 26 out of 60 vascular patients compared with none of the 20 general surgical controls. The three vascular groups showed a similar prevalence of LAC and this differed significantly from that in the control group (chi 2 = 10.94, p = 0.0009). Of the 26 positive results only three were associated with an abnormal activated partial thromboplastin time (APTT), which has previously been used as a marker for the presence of LAC activity. Fibrinogen levels were raised in seven of 20 patients in group 2 but were normal in the remaining vascular groups (p = 0.001). The mean factor VII level (124.1 units dl-1) in group 2 was higher than the mean of the remaining vascular patients (109.3 units dl-1, p < 0.05). CONCLUSIONS: The high prevalence of LAC in patients with peripheral vascular disease and the associated increased risk of early graft thrombosis may justify routine testing by DRVVT prior to reconstructive vascular surgery. Treatment of these patients with antiplatelet agents or formal anticoagulation perioperatively should be considered.

Aged↗