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Biomedical subjects

A Gooch

Publications and source records attributed to A Gooch.

14 recordsLinked to original sources
PubMed2002

Outcome of consecutive pregnancies in a patient with Bombay (Oh) blood group.

A young lady with a rare Bombay (Oh) blood group had two successive uneventful pregnancies. Her serum contained a potent high-titre anti-H and serological as well as chemiluminescence tests, suggesting that the antibody was haemolytic. Her husband was of the normal H status. Theoretically, both babies should have been positive for the H antigen and should have suffered from haemolytic disease of the newborn. This apparent conundrum could be owing to the weak expression of the H antigens on the infant red cells.

ABO Blood-Group System↗
PubMed1994

FPTT is a low-incidence Rh antigen associated with a "new" partial Rh D phenotype, DFR.

BACKGROUND: Several Rh D phenotypes with partial D antigens are recognized. Some partial D antigens are associated with low-incidence Rh antigens. New partial D antigens are revealed by an atypical pattern of reactions with anti-D. STUDY DESIGN AND METHODS: The reactions of D variant cells with panels of monoclonal anti-D and with antibodies to low-incidence antigens were compared to those of known D categories to identify a new Rh D phenotype. The inheritance of partial D antigens was studied by Rh phenotyping of the families of the probands. Standard serologic methods were used and family data were analyzed. RESULTS: A new Rh D phenotype, to be called DFR, was identified in 17 probands, two of whom had made anti-D. The partial D antigen carries epD3, epD4, and epD9 and lacks epD8. The presence of other D epitopes is ambiguous; different answers were obtained for the same sample with different monoclonal anti-D of the same apparent epitope specificity. The immunoglobulin class of the anti-D was important: IgG were more successful than IgM monoclonal anti-D in detecting the partial D of DFR. Family studies showed that DFR traveled with Ce more frequently than with cE. The low-incidence antigen FPTT (International Society of Blood Transfusion number 700048) was found on all DFR samples. Family studies demonstrated that FPTT is, as suspected, part of the complex Rh system. CONCLUSION: The partial D of the Rh D phenotype, DFR, is recognized by its pattern of reactions with monoclonal anti-D and its association with the low-incidence antigen FPTT, FPTT has now been numbered Rh50.

Antibodies, Monoclonal↗
PubMed1983

Anatomic and clinical analysis of 96 Beall prostheses explanted over a 13-year period.

Over 13 years, 96 Beall prostheses (80 Teflon, 16 Pyrolite) explanted at surgery were examined for durability, material wear, and clinical symptoms leading to surgical indication for excision were evaluated. The Teflon valves showed progressive disc wear and notching and two cases of disc escape from the cage; the Pyrolite discs were intact in all prostheses. The Dacron-Velour covering common to both types showed dehiscence at the inlet, significantly more severe after the third implant year in the Teflon (p less than 0.005) than in the Pyrolite prostheses. Sixty-nine (85 percent) cases with Teflon valves showed clinical manifestations of congestive heart failure due to prosthetic dysfunction; in 50 there was significant hemolytic anemia. Seven (44 percent) of the 16 Pyrolite disc valves were excised primarily because of dysfunction. The degree of hemolysis with the Pyrolite valves was usually mild. These data clearly suggested the advisability of early excision of the Beall Teflon prostheses in symptomatic patients and a close follow-up in patients with the Pyrolite models.

Adult↗
PubMed1976

Late thrombosis of the aortic Bjork-Shiley prosthesis. Its clinical recognition and management.

Seven cases of massive thrombosis of an aortic Bjork-Shiley prosthesis were encountered among 433 valvular implants. Four patients died before treatment could be instituted, and three underwent repeat surgery successfully. Anticoagulation therapy was probably well maintained in four, and poorly maintained in three patients. These cases illustrated the need for a high index of suspicion and prompt recognition of this complication in patients with Bjork-Shiley prostheses. The diagnosis of massive thrombosis should be suspected with the rapid onset of (1) signs of congestive heart failure, (2) absence or attenuation of valvular clicks, (3) aortic regurgitation, or (4) hemolytic anemia. Salvage of these patients requires emergency replacement of the thrombosed prosthesis or removal of the thrombus.

Aged↗
PubMed1976

Results of mitral valve replacement with the Beall prosthesis in 209 patients.

In this 3 year study of 209 patients who underwent mitral valve replacement with the newer Beall prostheses (Models 104 and 105) the operative mortality rate was 5.2 per cent. None of these deaths was related to the valve. This prosthesis features a larger frustrum area and a "turtle-neck" sewing ring which permits its rapid insertion with a continuous suture technique. Of the 20 (9.5 per cent) late deaths, two were due to thrombosis of the valve. Among the 178 survivors, 17 developed thromboembolic complications; however, 10 of these patients recovered. Late clinical results have been quite satisfactory in over 90 per cent of the survivors. In the 15 patients who underwent hemodynamic studies postoperatively, the cardiac index and pulmonary artery pressure showed significant improvement; however, they still had transvalvular gradients at rest. The improvement in the design of this prosthesis has been an important factor in lowering the operative risk and improving the late results of mitral valve replacement.

Adult↗
PubMed1975

Iatrogenic arteriovenous fistula: a complication of percutaneous subclavian vein puncture.

A case of iatrogenic subclavian arteriovenous fistula is reported. An intracath had been inserted percutaneously into the left subclavian vein to monitor the central venous pressure during aortic valve surgery. On the second postoperative day a thrill and continuous murmur were detected at the left subclavian region. Left subclavian arteriogram and catheterization studies confirmed the diagnosis of subclavian arteriovenous fistula. The lesion was treated surgically with satisfactory results.

Aortic Valve↗