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Biomedical subjects

M F Sturridge

Publications and source records attributed to M F Sturridge.

At least 37 records · Page 2Linked to original sources
PubMed1987

Results of surgical repair for dissection of the ascending aorta.

Between 1970 and 1986, 40 patients had surgical treatment for dissection of the ascending aorta at the London Chest Hospital. The overall hospital mortality was 27.5%. Preoperative renal impairment and age greater than or equal to 60 years were both associated with a significantly increased hospital mortality. In the long term one patient was lost to follow up. There have been two late deaths among the remaining 28 patients (mean follow up 4.4 years). The functional state of the survivors is good, with only three having any cardiac disability.

Adolescent↗
PubMed1986

A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis.

To compare antibiotic regimens for their effectiveness in preventing or treating wound sepsis, well-defined criteria for outcome are needed. A method of assessing wound healing has been devised that defines carefully the characteristics to be considered and how they are to be awarded points. Objective criteria are also included in the assessment. Points are given for the need for Additional treatment, the presence of Serous discharge, Erythema, Purulent exudate, and Separation of the deep tissues, the Isolation of bacteria, and the duration of inpatient Stay (ASEPSIS).

Anti-Bacterial Agents↗
PubMed1986

A clinical trial of teicoplanin compared with a combination of flucloxacillin and tobramycin as antibiotic prophylaxis for cardiac surgery: the use of a scoring method to assess the incidence of wound infection.

A prospective randomized clinical trial is in progress to compare the efficacy of teicoplanin with flucloxacillin and tobramycin in the prevention of endocarditis and wound infection following cardiac surgery. To date, 198 patients have completed the trial, of whom 95 have received teicoplanin and 103 flucloxacillin and tobramycin. One patient developed prosthetic valve endocarditis 3 months after surgery covered by flucloxacillin and tobramycin. There was no significant difference in the incidence of sternal wound infection (P = 0.15). Severe sternal sepsis occurred in four patients in the teicoplanin group and two in the flucloxacillin/tobramycin group. There were more postoperative urinary tract infections among those given teicoplanin (15 of 95 patients compared to six of 103 patients P less than 0.05). The trial continues.

Anti-Bacterial Agents↗
PubMed1986

Changes in plasma vasopressin concentration in association with coronary artery surgery or thymectomy.

Plasma vasopressin concentrations in 14 patients undergoing coronary artery surgery were compared with those in eight patients undergoing thymectomy. Vasopressin concentrations increased similarly in both groups on sternotomy. A second, and more marked increase was noted in the patients requiring cardiopulmonary bypass. Haemodynamic stimuli could be responsible in both groups and might explain both the similarities and the differences between the groups.

Adult↗
PubMed1986

Electrical properties and response to noradrenaline of individual heart cells isolated from human ventricular tissue.

The analysis of the electrical properties and response to catecholamines of cardiac tissue is greatly simplified by the use of single cell preparations. In this study individual cells isolated from human ventricular tissue were used to estimate cellular sarcolemmal resistance and capacitance and to record the time course of the response to ionophoretically applied noradrenaline. The mean input capacitance of the cells is consistent with a surface membrane area of approximately 15,000 micron2 if the specific membrane capacitance is 1 microF X cm-2. This is larger than might be expected from the measured external dimensions of the cell and is compatible with the presence of surface membrane infoldings and caveolae. At membrane potentials close to -75 mV the mean cell input resistance was approximately 40 M omega, giving a specific membrane resistance of 6 omega X cm2 if mean membrane area is 15,000 micron2 and consistent with the assumption that the isolated cells have sealed intercalated discs under the experimental conditions used. Ionophoretically applied noradrenaline produced a pronounced prolongation of the plateau phase of the action potential, but this effect developed over many seconds. The slow onset of action is not compatible with the kinetics of free extracellular diffusion of catecholamine but may reflect molecular events that occur between noradrenaline binding to membrane receptors and the final cellular response. Under voltage-clamp conditions, the cells showed a time dependent inward current consistent with the rapid activation and decay of a sarcolemmal calcium conductance.

Action Potentials↗
PubMed1986

Antibiotic prophylaxis in cardiothoracic surgery in the United Kingdom: current practice.

A survey was conducted of the current practice of antibiotic prophylaxis in cardiac surgery throughout the United Kingdom. Most surgeons (84%) use a regimen covering a broad spectrum of bacterial species that is continued for two to three days after the operation. The most used regimens are a combination of beta lactamase resistant penicillin with an aminoglycoside (44%) or a single broad spectrum cephalosporin (30%). Just 16% of surgeons preferred a narrow spectrum regimen effective against only the Gram positive organisms commonly responsible for postoperative infection in these patients. Antibiotic prophylaxis has been adopted by all cardiac surgeons in the United Kingdom but is sometimes continued longer than is indicated by the clinical or experimental evidence.

Aminoglycosides↗
PubMed1985

Bypass grafting to the right coronary artery with and without endarterectomy: patency at one year.

Between January 1979 and December 1981, 142 patients undergoing surgery to the right coronary artery agreed to have repeat coronary arteriography one year later. Thirty patients underwent combined endarterectomy and bypass grafting to the right coronary artery. The patency of these grafts was compared with that of grafts in 69 patients undergoing direct grafting to the right coronary artery and in 43 with grafting to the posterior descending coronary artery. There were two hospital deaths and one late death. No patients developed new inferior Q waves on the electrocardiogram. Repeat coronary arteriography at one year showed that 21 (72%) of the 29 grafts were patent after combined endarterectomy and bypass grafting to the right coronary artery. Sixty three (94%) grafts to the right coronary artery and 40 (93%) grafts to the posterior descending coronary artery were patent at one year. Direct grafts to the right coronary artery or its posterior descending branch had a significantly higher patency rate at one year than grafts to the endarterectomised right coronary artery. Graft patency after the combined procedure correlated with the extent of atherosclerosis in the posterior descending coronary artery. It was not influenced by treatment with platelet antagonists. Endarterectomy of the right coronary artery was most successful when it allowed a single graft to perfuse both the large posterior descending and left ventricular branches.

Adult↗
PubMed1981

Intact individual heart cells isolated from human ventricular tissue.

The intricate architecture of heart muscle, comprising irregularly shaped cells which interdigitate in a complex three-dimensional array, has often compromised clear interpretation of experimental data obtained from the whole organ. One approach to minimise some of the difficulties is to use individual muscle cells in suspension, and data have already been reported using myocytes isolated from mammalian ventricles. It is difficult, however, to extrapolate results obtained from animal tissues to situations of medical relevance in man. Intact isolated muscle cells were obtained from human ventricular tissue by modifications of methods used for isolating smooth muscle, atrial, and ventricular tissue from animals. Electrical studies showed that these myocytes had functional characteristics similar to those observed in the whole heart. Such cells will prove a useful preparation for studies on both the mechanisms underlying myocardial performance in normal and diseased states and the response of heart tissue at the cellular level to conditions found during cardiac surgery.

Action Potentials↗
PubMed1980

[Thymectomy for myasthenia gravis (author's transl)].

The indications for thymectomy in the treatment of myasthenia gravis have changed over the years. Now it is considered in all but the mildest forms and in the elderly that are kept under medical management; 129 patients were treated surgically, 57 males and 78 females; respectively 30 and 17 per cent had a tumour and the average age was 35 years. The operation was carried out through a median sternotomy with no operative deaths but 3 late deaths and 70 per cent were improved or in remission.

Adult↗
PubMed1979

Reoperation for recurrent angina.

Forty patients with persistent or recurrent angina after an aortocoronary bypass procedure underwent a second operation. The cause of recurrent angina, defined by angiography, was thought to be isolated graft failure in 13 patients, progression of disease in ungrafted vessels in 4, incomplete revascularisation in 2, and stenoses distal to patent grafts in 1. More than one factor was responsible in 20 patients. There was 1 early postoperative death and 3 perioperative myocardial infarctions. Thirty-four patients have been followed for more than 3 months (4 to 63 months). Of these, 17 had previously bypassed vessels regrafted and 5 are sympton free, 4 have mild angina, and 8 have severe angina. Ten patients had previously ungrafted vessels grafted and 4 are sympton free, 3 have mild angina, 2 have severe angina, and 1 is limited by breathlessness. Seven patients had a combined procedure and 4 are sympton free, 1 has mild angina, and 2 have severe angina. Reoperation can be carried out safely but the results are less satisfactory than for a primary procedure.

Adult↗
PubMed1979

Anomalous origin of the left anterior descending coronary artery from the pulmonary trunk.

An extremely rare congenital abnormality is reported in which the anterior descending branch of the left main coronary artery arises independently from the pulmonary trunk in a young patient who presented with unstable angina. Its clinical presentation, angiographic identification and surgical treatment are described. It appears to be a distinct entity with few of the features of the classical form of anomalous origin of the left main coronary artery.

Adult↗
PubMed1978

Results of aortocoronary bypass operations. Follow-up in 343 patients.

Three hundred and forty-three patients who had aortocoronary bypass graft operations for disabling angina were followed up for from 6 months to 5 years (average 2 years). 80 per cent had multiple grafts and 20 per cent had additional endarterectomy. The overall mortality within one month of operation was 5 per cent, and in those who had vein graft procedures only was 4 per cent. 11 per cent had a postoperative myocardial infarction (6% perioperative) and there were 3 per cent late deaths. At 3 years 90 per cent are surviving. 80 per cent are asymptomatic without treatment. The mean angina grade was 0.3 at the latest follow-up, compared with 2.5 before operation; maximum exercise tolerance was also significantly improved (P less than 0.001). When angina recurred, it did so in 80 per cent of the cases within 12 months of operation and was usually attributable to inadequate revascularisation. Ventricular function as assessed by preoperative ventriculography was the factor most clearly related to survival rate and the early excellent results of coronary bypass operations seem to be maintained up to 5 years. It is, therefore, reasonable to continue to advise operation if only for relief of angina.

Adult↗