Percutaneous intraaortic balloon support--repeat insertion through the same site.
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Angina Pectoris↗
Biomedical subjects
M W Sharon
Publications and source records attributed to M W Sharon.
Reactive hyperemia following total and subtotal coronary occlusion in the awake dog.
This study examined the reactive hyperemia following total and subtotal coronary artery occlusions. Studies were carried out in awake dogs with electromagnetic flowmeters and hydraulic occluders on the left circumflex coronary artery; the regional distribution of perfusion was examined with radionuclide-labeled microspheres. Reactive hyperemia following total and subtotal occlusions resulted in similar mean blood flow debt repayments of 451 +/- 34% and 492 +/- 51%, respectively. However, the distribution of perfusion was markedly different, with the ratio of subendocardial to subepicardial blood flow being 1.77 +/- 0.22 after total occlusion and 4.14 +/- 0.73 after subtotal occlusion (p less than 0.01). Further examination of the pattern of perfusion during reactive hyperemia demonstrated a direct relationship between the local blood flow debt and blood flow during the subsequent reactive hyperemia. These data demonstrate that coronary reactive hyperemia does not occur uniformly throughout the distribution of the vascular bed served by the previously occluded artery, but rather is coupled to the degree of hypoperfusion during the preceding occlusion.
Animals↗
A supervised training program in flexible sigmoidoscopy: evaluating skills from residency training to clinical practice.
To assess the effectiveness of a training program in flexible sigmoidoscopy for family practice residents, we prospectively studied the performance of four residents during their training and after graduation. One hundred and four training exams performed with the assistance of an experienced gastroenterologist were compared with 118 unassisted post-training, post-residency exams. The mean depth of insertion for the post-training period was 51.1 +/- 1.2 cm, which was significantly greater (P less than .05, Student's t test) than the mean training period depth of 47.6 +/- 1.2 cm. There was no significant difference in the identification of polyps or cancer between the training and post-training periods. The mean duration of an exam was 17.3 +/- 0.6 minutes in the post-training period. No significant complications were encountered in either period. The residency trained family physicians obtained results similar to those reported by trained endoscopists in depth of examination and pathology detected, although their examinations required more time. We conclude that this model of training was effective in the development of flexible sigmoidoscopy procedural skill for family practice residents.
Clinical Competence↗