Biomedical subjects
Publications and source records attributed to R Boyes.
Conventional lifting gear based on steel components can be safely used in a laboratory where acetone is used provided that: (a) the circumstances under which significant amounts of acetone vapour will be present are known and can be controlled and (b) operating practices are imposed to prevent the use of the lifting gear at times when acetone vapour may be present in explosive concentrations.
A syndrome heralded by fever, deterioration of graft function, respiratory failure accompanied by pulmonary infiltrates has been termed "transplant lung." We hemodynamically studied eight such patients. At the height of their illness, pulmonary artery wedge pressure (PAWP) was elevated to 19.3 +/- 2.6 mm Hg along with mean pulmonary artery pressure (PAP) of 35.0 +/- 3.8 mm Hg in presence of increased cardiac index (CI) of 4.9 +/- 0.9 L.m2.min. Pathophysiology of pulmonary edema appears to include high left ventricular filling pressures, pulmonary hypertension, alterations of oncotic hydrostatic gradient, and increased cardiac output. A partial reversal of pulmonary hypertension was observed with dialysis or diuresis. Our data suggest incipient renal failure and fluid accumulation as the etiology of hemodynamic pulmonary edema in "transplant lung."
A patient is presented in whom pulmonary artery catheter insertion fortutiously demonstrated persistent left superior vena cava on two separate occasions. Further studies with venogram and a first pass nuclear scan demonstrated total absence of the right superior vena cava. Although this anomaly is commonly associated with intracardiac defects and rhythm disturbances only the latter was seen in our patient. Invasive hemodynamic monitoring is frequently performed in the majority of modern intensive care units. The bedside technique used for insertion of a Swan-Ganz catheter using only pressure monitoring for advancing the catheter has relatively few complications. One such complication is misplacement along an anomalous route where the catheter may take to the heart. We have recently treated a patient on two separate occasions who had a persistent left superior vena cava with absent right superior vena cava.