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Biomedical subjects

J O Menzoian

Publications and source records attributed to J O Menzoian.

6 recordsLinked to original sources
PubMed1979

Is pulmonary angiography essential for the diagnosis of acute pulmonary embolism?

The records of 158 patients who underwent pulmonary angiography for the presumed diagnosis of acute pulmonary embolism were retrospectively reviewed. Of the 111 patients in the category of high probability for pulmonary embolism based on clinical impression, 60 patients (54 per cent) had a positive pulmonary angiogram. Of the forty-seven patients in the low probability group, ten (21 per cent) had a positive angiogram. Forty-eight of the seventy-three patients (66 per cent) with a high probability lung scan had a positive pulmonary angiogram. Eleven of twelve patients (92 per cent) with a high probability ventilation-perfusion scan had a positive pulmonary angiogram, and two of eight patients (25 per cent) with a low probability ventilation-perfusion scan had a positive pulmonary angiogram. The mean PO2 of patients with a positive pulmonary angiogram was 64 mm Hg, and the mean PCO2 30 mm Hg. The mean PO2 of patients with a negative pulmonary angiogram was 63 mm Hg and the mean PCO2 34 mm Hg. Based on these data, we believe that the accuracy of pulmonary angiography in diagnosing acute pulmonary embolism is much higher than that of the clinical impression, arterial blood gas determinations, and lung scanning technics.

Acute Disease↗
PubMed1978

Doppler ankle systolic blood pressure. Prognostic value in vein bypass grafts of the lower extremity.

The prognostic value of Doppler-derived ankle systolic pressure indices for predicting the patency of vein bypass grafts in the lower extremity was analyzed in 126 vein bypass grafts performed for limb salvage. Early or late graft failure was not found to correlate with the preoperative ankle systolic pressure index (ASPI). Intraoperative blood flow measurements did not correlate with the preoperative ASPI. An intraoperative graft flow of less than 0.7 at 24 to 48 hours, or an increase in ASPI of less than 0.4 were prognostic signs of early vein graft failure.

Adult↗
PubMed1978

Transposed basilic vein-brachial arteriovenous fistula. A reliable secondary-access procedure.

Over a two-year period, 25 transposed basilic vein-brachial arteriovenous fistulas were created as secondary vascular access procedures in patients undergoing chronic hemodialysis. The operative technique is described in detail. One-year patency rate by life-table analysis was 85%. There were two minor complications. The procedure is advocated as a reliable secondary-access procedure when a radial-cephalic arteriovenous fistula cannot be constructed or has failed.

Arteriovenous Shunt, Surgical↗
PubMed1978

Management of the upper extremity with absent pulses after cardiac catheterization.

Thirty-one patients had a delayed loss of brachial artery and radial artery pulse after cardiac catheterization; eleven of the patients had early embolectomy or a vein patch graft and 82% of these had immediate restoration of pulse and remained asymptomatic. Early surgery failed in two patients, requiring late vein bypass grafting for claudication. Twenty patients did not have early surgery, eleven (55%) remaining asymptomatic and nine (45%) developing ischemic symptoms. Five of these nine patients (25%) required late vein bypass grafting for severe claudication. Of the fifteen patients who lost their pulse and did not undergo surgery, the average Doppler forearm pressure immediately following the occlusion was 50 mm Hg (pressure index=0.46). The average Doppler pressure measured at the time of follow-up was 80 mm Hg (pressure index = 0.61). Early local surgery is highly successful in patients who lose their radial artery pulse after cardiac catheterization. Conservative nonoperative therapy may be successful but often results in late ischemic symptoms that may require late vein bypass grafting.

Arm↗
PubMed1977

Association of a circulating immunosuppressive polypeptide with operative and accidental trauma.

The serum from 109 traumatized patients was examined for immunosuppressive activity which might explain diminished host immune responsiveness following operative or accidental injury. Twenty-eight fo 31 (90%) severely tralmatized patients, 25 of 60 (42%) moderately traumatized patients, and 0 of 18 minimally traumatized patients developed serum which suppressed the response of normal human lymphocytes to phytohemagglutinin. The degree and duration of serum immunosuppressive activity paralleled the severity of the clinical course but did not correlate with serum cortisol or barbiturate levels. Suppressive sera were not cytotoxic. The immunosuppressive factor(s) was contained in a low molecular weight (less than 10,000 daltons) peptide fraction and was present in 5--10 times the amount recoverable from normal serum. By size and activity the trauma serum factor resembled immunoregulatory alpha globulin, a naturally-occurring serum inhibitor of T-lymphocyte reactions. Thus, depressed immunoreactivity following trauma may be due in part to high concentrations of an endogenous immunosuppressive polypeptide.

Adolescent↗