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Biomedical subjects

J A Chalmers

Publications and source records attributed to J A Chalmers.

At least 19 recordsLinked to original sources
PubMed1990

The use of an implantable left ventricular assist device following irreversible ventricular fibrillation secondary to massive myocardial infarction.

A TCI1 rough surface left ventricular assist device (LVAD) was implanted in a 47-year-old man who had sustained a recent massive myocardial infarction complicated by ventricular failure which remained unresponsive to intra-aortic balloon pump therapy and which was further complicated by irreversible ventricular fibrillation. Following implantation of the device and while awaiting a suitable donor organ for transplantation, further extension of the previous infarct resulted in left ventricular rupture and massive haemorrhage which led to his death. We report the successful use of the device in providing haemodynamic support, but caution against inordinate delay in bridging to transplantation patients who are at risk of extension of infarction.

Heart-Assist Devices↗
PubMed1989

The importance of Ca2+ for glucose-induced priming in pancreatic islets.

Experiments have been performed to determine the importance of Ca2+ in the induction of priming by high, stimulatory concentrations of glucose in pancreatic islets. It is shown, in paired islets, that as little as 15 min exposure to 16.7 mM glucose in the presence of Ca2+ induced priming and an enhanced response to a subsequent glucose challenge. In contrast, exposure to 16.7 mM glucose for 15-60 min in the absence of extracellular Ca2+ failed to induce priming. From this and other data, it appears that Ca2+ is essential for the induction of priming and that Ca2+ synergizes with some aspect of glucose metabolism beyond the triose stage in stimulus-secretion coupling, to produce the primed state.

Animals↗
PubMed1989

A concealed impalement injury of the chest--an unusual intrathoracic foreign body.

Penetrating injuries of the chest in civilian practice are rare. A case is presented of an unusual injury with a large wooden chair fragment which remained concealed for several days until the development of life threatening complications. Aspects of the evaluation of penetrating thoracic injuries are discussed.

Acute Kidney Injury↗
PubMed1989

Aortic valve replacement with frozen irradiated homografts. An 18-year experience.

Between May 1968 and April 1981, 339 patients underwent isolated aortic valve replacement using frozen irradiated homografts. All the operations were carried out by the same surgeon (EJMW) using the same technique. Thirty-two patients were lost to follow-up at various stages and the long-term results of the remaining 307 patients are reported. Two hundred and thirty-four were males and 73 females. Their ages ranged between 10 and 75 years, with a mean age of 53. The dominant lesion was aortic stenosis in 195 cases (63.5%), aortic regurgitation in 68 (22.1%), and mixed aortic valve disease in 44 (14.3%). Early mortality was 8.8% and late mortality during the 5-18 year follow-up period was 49.6%. Re-operations for homograft failure were carried out in 112 patients (40%), with an early mortality of 25%. The results are compared with those of other major series using antibiotic sterilized homograft valves.

Adolescent↗
PubMed1989

Temporary mechanical ventricular support: Part 1.

Temporary mechanical circulatory support is currently indicated in postcardiotomy cardiogenic shock and if necessary as a bridge to cardiac transplantation. This support is presently required in 1% of adult patients undergoing cardiac surgery. Cardiac function and quality of life in long-term survivors following hospital discharge has been excellent.

Assisted Circulation↗
PubMed1989

Temporary mechanical ventricular support: Part 2.

Temporary mechanical circulatory support is currently indicated in postcardiotomy cardiogenic shock and if necessary as a bridge to transplantation where no ventricular recovery is expected. Which mechanical support system to employ as a bridge to transplantation remains debatable. Implantable devices presently used are prototypes of proposed permanent devices for the treatment of severe heart failure in patients for whom transplantation is not suitable or available.

Assisted Circulation↗
PubMed1987

An immunohistochemical analysis of human aortic fatty streaks.

Recent studies have shown both macrophages and lymphocytes in very early intimal lesions of experimental aortic atherosclerosis. The authors obtained fresh samples of human aortic wall, which had been removed in the course of aortocoronary bypass graft surgery. Intimal fatty streaks were identified macroscopically and six were studied immunohistochemically. The fatty streaks contained foam cells that were virtually all labeled by antibodies directed against members of the mononuclear phagocyte series (RFD-2 and RFD-7). Macrophages demonstrated acid phosphatase activity and marked expression of HLA-DR, suggesting activation. Other monoclonal antibodies (UCHT-1, OKT-4, and RFT-8) identified T lymphocytes, of both helper and suppressor phenotypes, within the fatty streaks. T lymphocytes of suppressor phenotype appeared to predominate over helper cells. B lymphocytes were not detected. The presence of activated macrophages and T lymphocytes in the fatty streaks indicates that components of a cell-mediated immune response are present. Such an immune process may be important in the pathogenesis of human atherosclerosis.

Aged↗
PubMed1982

Treatment of endometriosis with reduced dosage schedules of danazol.

Experience of the treatment of endometriosis with danazol compares very favourably with the previous use of an oestrogen-progestogen combination in this condition. Symptoms were relieved more rapidly and for longer periods of time. The response to various dose regimes of danazol reveals that 200 mg daily may be adequate for most cases.

Body Weight↗
PubMed1979

Follow-up of patients with endometriosis treated with danazol.

Since 1975, 65 cases of endometriosis have been treated with danazol, and in an attempt to retain effective management with a minimum of side effects, three different dosage scheme providing 600 mg (Group 1) 400 mg (Group 2) or 200 mg daily (Group 3) have been used. At present 20 cases in Group 1, 16 in Group 2 and 12 in Group 3 are available for assessment and the results are here presented.

Adult↗
PubMed1977

Danazol treatment and follow-up of patients with endometriosis.

In conclusion, we find that danazol has proved to be highly effective as a treatment for endometriosis. On the dosage used, we have not achieved the freedom from side-effects which we had hoped for, but in general these have been much less severe than those with combined oestrogen progestogen preparations. We propose continuing the trial with a reduced dosage of 400 mg daily in the hope of further reducing the incidence of side-effects.

Danazol↗