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R Dean

Publications and source records attributed to R Dean.

24 records · Page 2Linked to original sources

The accuracy of antimicrobial disk sensitivity testing in urinary tract infections.

Fifty bacterial strains shown resistant to ampicillin, cephalothin or tetracycline by Kirby-Bauer disk diffusion susceptibility testing were isolated from patients with urinary infections. Inhibitory activity in urine of volunteers given these antimicrobial agents and tube dilution sensitivity testing indicated that agar disk diffusion gradients do not provide sufficiently high antimicrobial concentrations to predict accurately clinical efficacy.

Ampicillin

Thromboxane A2 does not contribute to arrhythmogenesis during evolving canine myocardial infarction.

During the healing phase of evolving myocardial infarction, inflammatory cells invade the affected region and produce metabolites that may influence electrophysiological parameters and the genesis of malignant arrhythmias. We have recently shown an increased synthetic capacity within an evolving infarct for thromboxane A2 (TXA2), a metabolite that has been implicated in arrhythmias associated with early ischemia. The present study used both in vivo and in vitro procedures to define the electrophysiological and arrhythmogenic effects, if any, of thromboxane during evolving myocardial infarction. Thirty-three dogs divided into three groups were studied 3-7 days after transient left anterior descending coronary artery ligation. One group (n = 24) was examined by programmed electrical stimulation in the conscious state and, of the five dogs in this group with sustained ventricular tachycardia (VT), none demonstrated consistent limitation of inducibility by selective inhibition of thromboxane synthetase using three different agents. In the second group, (n = 5) regional conduction velocity was assessed using detailed three-dimensional activation analysis from 232 simultaneous intramyocardial sites, and no change was induced by the thromboxane synthetase inhibitor OKY-1581 in either normal or infarcted myocardial zones during sinus rhythm or with pacing. In the third group (n = 4), isolated ventricular muscle was studied in vitro using both intracellular transmembrane action potential recordings and surface extracellular maps from 48 simultaneous points. Neither intracellular action potential parameters nor extracellularly recorded activation patterns were altered by superfusion with the stable thromboxane analog STA2, the activity of which was verified by bioassay. Thus, despite increased synthetic capacity for thromboxane generation, the presence of TXA2 does not directly influence either electrophysiological indices or arrhythmogenesis.

Action Potentials

The effect of intentional hemodilution on P50.

Ten patients (Group I) scheduled for major vascular surgery received banked blood and twelve patients (Group II) also scheduled for major vascular surgery were administered intentional hemodilution with autologous blood. Both groups of patients were studied to determine the effects of banked blood and autologous blood respectively on P50. The mean pre-operative P50 for Group I and Group II patients were 26.2 mmHg and 26.3 mmHg respectively. The mean postoperative P50 for Group I and Group II patients were 24.7 mmHg and 28.4 mmHg respectively. There was a significant increase in P50 in patients (Group II) who received autologous blood when compared with Group I patients who received banked blood (p less than 0.001). Our data on P50 in Group I patients who received banked blood showed that there was a significant decrease confirming the results of previously published studies. The Authors conclude that intentional hemodilution is an efficacious alternative technique to banked blood administration for patients undergoing major vascular surgery.

Blood Transfusion