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Biomedical subjects

P K Fulkerson

Publications and source records attributed to P K Fulkerson.

9 recordsLinked to original sources
PubMed1987

Crystallochemical characteristics of the inorganic phase of human calcific aortic valvar stenosis.

To determine the elemental composition of the mineral deposits found in human calcific aortic valvar stenosis and to verify by x ray diffraction crystal class previously reported by electron diffraction 138 quantitative energy dispersive analyses and x ray diffraction of pooled specimens were performed on samples of aortic valves excised from 12 patients. The principal components of the calcified portions of the valves were 38.15% calcium and 17.68% phosphorus. The weight percentage calcium to phosphorus ratio was 2.16 and an elemental distribution related to the simplest ideal unit cell formulation Ca10(PO4)6(OH)2 was determined as: (Ca0.952Mg0.044Na0.097K0.005)10 (P0.952S0.025C0.023)6O23.96(Cl0.0184O0. 982H)2. The hexagonal unit cell was found to have an a axis of 9.424 A(0.9424 nm); c axis of 6.787 A(0.6787 nm); volume of 522 A3(0.522 nm3); and density of 3.2 g.cm-3. On the bases of the composition, the axial dimensions, and the density the material was classified as the dahllite form of apatite. There was no evidence of crystalline cholesterol. Variations in elemental composition showed no significant correlation with age or sex of the patient; statistically, neither the cusp involved nor the location on the leaflet affected the mineral composition.

Aged↗
PubMed1979

Effectiveness of advanced paramedics in a mobile coronary care system.

The mobilized coronary care system in Columbus, Ohio, began with operation of a single vehicle with a physician in attendance. Currently, advanced emergency medical technician-paramedics work without direct physician supervision. When both experiences are compared, the results indicate that advanced emergency medical technician-paramedics working independently perform as well as physician counterparts.

Allied Health Personnel↗
PubMed1979

Calcification of the mitral annulus: etiology, clinical associations, complications and therapy.

This report reviews the clinical features of 80 patients with roentgenographically proved mitral annular calcification. The mean age of the group was 73 years, and there was a 2.5 to 1 female to male ratio. Evaluation for underlying cardiovascular disease revealed six patients with severe calcific valvular aortic stenosis; five patients with hypertrophic cardiomyopathy, 11 with mitral prolapse and 33 with significant arterial hypertension (blood pressure greater or equal to 150/96 mm Hg). Eighty-five per cent of the group (68 of 80 patients) had an underlying cardiac disorder associated with either chronically increased left ventricular systolic pressure or abnormal leaflet motion. Other cardiovascular abnormalities occurring as complications secondary to the mitral ring calcification included subacute bacterial endocarditis (three cases), arterial emboli (five episodes) and high grade atrioventricular block (16 cases). Twelve patients had severe mitral regurgitation; successful mitral valve replacement was carried out in four patients (all with myxomatous mitral tissue). Evidence of diffuse conduction system disease, not limited to the area of the cardiac fibrous skeleton, was found frequently (44 patients). Nine patients had sinus node dysfunction and 35 patients had electrocardiographic evidence of distal intraventricular (fascicular) block. Twenty-one patients eventually required pacemakers for management of symptomatic bradyarrhythmias. Atrial fibrillation was present in 23 patients. In this review it was found that calcification of the mitral annulus is frequently associated with or induces serious cardiovascular disease. Since some of these disorders may be modified by appropriate therapy, calcification of the mitral annulus should no longer be ignored as a benign marker of the elderly heart.

Adult↗
PubMed1979

Electrocardiographic voltage in pericardial effusion.

The usefulness of the electrocardiographic sign of "low voltage" in the diagnosis of pericardial effusion was investigated in 122 patients comprising three study groups. Sixty-four patients (group 1) had a pericardial effusion detected and measured by echocardiographic studies. The volume of the effusion showed no correlation with electrocardiographic voltage. A second group of 36 patients was identified as having low voltage on routine electrocardiograms. Only 13 (36 percent) had echocardiographically demonstrable pericardial effusion. Group 3 consisted of 22 patients who required pericardiocentesis. The ECGs obtained immediately after pericardiocentesis showed an increase in average voltage of 0.48 mm in the limb leads and 0.83 mm in the precordial leads for each 100 ml of fluid removed. This study demonstrates that a single ECG with "low voltage" is not useful in the diagnosis of pericardial effusion but that a reduction in the voltage of serial ECGs may suggest the development of pericardial effusion.

Echocardiography↗
PubMed1978

A paucity of chronic electrocardiographic changes with adriamycin therapy.

Serial electrocardiograms (ECGs) of 49 patients receiving adriamycin were analyzed for the development of persistent changes. The ECG changes were compared with those of a control group of 20 patients receiving other chemotherapeutic drugs, which were comparable to the additional chemotherapy received by the adriamycin patients. The only chronic ECG changes noted with adriamycin over control were the loss of P wave amplitude in the greater than 500 mg/m2 dose subgroup and the clockwise rotation of the precordial QRS in the 250-500 mg/m2 dose subgroup. In contrast, systolic time intervals demonstrated a gradual diminution in left ventricular function at increasing doses of adriamycin. The electrocardiogram itself appears to be of limited value in the assessment of cardiac toxicity with adriamycin therapy.

Antineoplastic Agents↗