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Biomedical subjects

B L Chang

Publications and source records attributed to B L Chang.

At least 73 records · Page 4Linked to original sources
PubMed1985

Affect and neutrality in physician behavior: a study of patients' values and satisfaction.

Physicians' emotional expressivity was contrasted with emotional neutrality in a study of consumers' preferences regarding physician behavior in the medical encounter. Two hundred twenty-seven health-science students completed instruments designed to measure the values they held regarding physicians' emotional expressions as well as their perceptions of and satisfaction with the emotional behavior of a physician presented in a videotape simulation. Overall, consumers attached a low value to neutrality and preferred affective behavior to it, although their previously held values did significantly influence their degree of satisfaction with neutral behavior by the physician. Values did not influence recognition of or satisfaction with the nonneutral emotions. This research also shed light on consumer reactions to other emotions including reassurance and humor.

Affect↗
PubMed1985

Comparative echocardiographic study of recovery of diastolic versus systolic function after brief periods of coronary occlusion: differential effects of intravenous nifedipine administered before and during occlusion.

The effect of intravenous nifedipine (5 micrograms/kg) on the recovery of myocardial function after occlusion of the left anterior descending coronary artery was studied in 18 closed chest dogs. Using computer-aided analysis of two-dimensional echocardiograms, systolic and diastolic function of ischemic segments in low papillary left ventricular cross sections were characterized, respectively, as holosystolic fractional area change and early diastolic velocity of luminal area change. The time required for systolic function to return to preocclusion values after a 1 minute untreated control occlusion (n = 12) was 5 to 10 minutes, and after a 2 minute occlusion (n = 6) it was 20 to 30 minutes. When nifedipine was administered during the occlusion, recovery after a 2 minute occlusion was accelerated slightly to 10 to 15 minutes. Recovery times of early diastolic function were substantially longer, and nifedipine effects were more pronounced. After a 1 or 2 minute control coronary occlusion, 60 to 75 minutes or 90 to 105 minutes were needed to return early diastolic function to normal levels. Nifedipine administered during a 1 or 2 minute coronary occlusion improved these recovery times to 10 to 15 minutes. When the dogs were treated with intravenous nifedipine before coronary occlusion, recovery after 1 or 2 minutes of acute ischemia was apparent as early as 2 minutes after reperfusion. Thus, intravenous nifedipine accelerates the recovery of myocardial function after brief periods of ischemia, and when administered before coronary occlusion, it assures very prompt recovery of function.

Animals↗
PubMed1984

Red cell velocity and autoregulation in the cerebral cortex of the cat.

This report deals with a comparison of total and regional cerebral blood flow with red cell velocity in the microcirculation of the ecto- and suprasylvian areas of the cerebral cortex of the cat and their response to changes in systemic blood pressure. Total and regional blood flows were measured during a steady-state with radioactive microspheres; a newly devised method, based on transillumination was employed for direct visualization of the microcirculation in the cerebral cortex. Craniotomy failed to influence either autoregulation or red cell velocity under the skull opening or of the total cerebral flow. Autoregulation of total and regional cerebral flow was present. In contrast marked pressure-dependent variations in microcirculatory red cell velocity occurred. A fall in systemic pressure was accompanied by a decrease in red cell velocity; return of pressure resulted in increased red cell velocity and in some instances, in an overshoot. Considerable inhomogeneity of red cell velocity in different microcirculatory vessels was encountered. In some cases a fall in systemic pressure led to complete disappearance of red cells.

Animals↗
PubMed1984

Microbubble dynamics visualized in the intact capillary circulation.

The potential for the use of contrast echocardiography to study myocardial perfusion has generated efforts to develop standardized echo contrast agents. The two methods used in this laboratory to generate microbubbles in solutions serving as contrast agents included the widely used hand-agitation method and the newer ultrasonic microcavitation (sonication) method. The latter has been demonstrated to generate smaller and more uniform microbubbles in an in vitro system. The present study was designed to observe, by direct microscopic examination of a cat mesentery preparation, the behavior and fate of the microbubbles in an in vivo system. The in vivo mesentery observations confirm the critical role of microbubble size in its unhindered passage through the capillary vasculature. The smaller and more uniform sonicated microbubbles passed rapidly through the microcirculation along with the red blood cells, whereas the larger microbubbles were observed to coalesce and interrupt the flow of blood and subsequently collapse or shrink.

Animals↗
PubMed1984

Consumer values and subsequent satisfaction ratings of physician behavior.

The role of respondents' values in their evaluation of and satisfaction with medical care was explored in four health education settings. Two hundred and twenty-seven nursing, medical, and health psychology students completed a forced-choice instrument designed to measure their value preferences for technical quality of care, psychosocial concern, courtesy, and mutual participation style of interacting in a medical visit. They subsequently watched a standardized 14-minute videotape of a simulated physician-patient interaction and evaluated the physician's behavior from the patient point of view on the four dimensions using two popular methods for assessing patient satisfaction. Respondents' ratings of the medical encounter were more often significantly influenced by their values when the more subjective satisfaction measure was considered. In addition, respondents who valued technical quality more highly were more satisfied with the other three dimensions of physician behavior, while respondents who more highly valued psychosocial concerns were less satisfied with these three dimensions. Ratings of satisfaction with technical quality were not affected by respondents' values. The importance of these findings in assessing patient satisfaction is discussed.

Adult↗
PubMed1983

The effect of 5-hydroxytryptamine and arterial blood withdrawal on cerebral microcirculation in the cat, arterial permeability in the rabbit.

Studies dealing with the effect of 5-HT on cerebral cortical microcirculation of cats and on permeability of femoral arteries to RISA of rabbits are presented. The effect of 5-HT on cerebral cortical microcirculation was compared to that of arterial blood withdrawal and blood reinfusion. The effect of topical administration of 5-HT was also studied. Cortical microcirculation was observed by transillumination using a microtransilluminator. Motion pictures were taken at a speed of 400 frames/sec. and a magnification of 3000X. Permeability was investigated using arterial RISA uptake in vessels perfused in vitro, with continuous recording of perfusion pressure. Microcirculatory studies revealed that arterial blood withdrawal and injection of 5-HT diminished red cell velocity, although to a different degree. With blood withdrawal and reinjection, good correlation existed between blood pressure and red cell velocity. In contrast, no correlation between blood pressure and red cell velocity was found after intracarotid injection of 5-HT. Reactive hyperemia was noted during reinfusion of blood. Both arterial blood withdrawal and 5-HT injection resulted in disappearance of red cells in individual vessels (unperfused channels). Good correlation of blood pressure with capillary red cell velocity during arterial blood withdrawal suggests absence of autoregulation in this portion of the microcirculation. Topical administration of 5-HT caused general vasoconstriction. Permeability to 5-HT to RISA followed a parabolic curve. With slight arterial vasoconstriction, permeability declined, while it rose with severe vasoconstriction.

Animals↗
PubMed1982

Microcirculation of left atrial muscle, cerebral cortex and mesentery of the cat. A comparative analysis.

By means of transillumination (microtransilluminator and light pipe), comparative analyses were carried out on geometry, topography, and morphometry of microcirculation in the cerebral cortex, left atrial muscle, and mesentery of the cat using computer analysis. In addition, specific types of capillary distribution (concurrent, countercurrent, and asymmetric distribution) in these three organs were ascertained from images visualized on films. These parameters were related to their role in tissue oxygen supply. It was found that mean capillary diameter, mean intercapillary distance, total capillary length, and total capillary surface area differed significantly among the three organs. Differences in mean capillary tortuosity between cerebral and left atrial muscle and between left atrial muscle and mesentery also were significant. Mean capillary tortuosity in mesentery and cerebral cortex was of equal magnitude. In the cerebral cortex, a high degree of tortuosity and asymmetric capillary distribution favor tissue oxygenation. A similar situation exists in left atrial muscle, although some concurrent and countercurrent distribution could be detected. In the mesentery, the combination of high capillary tortuosity and concurrent capillary arrangement is unfavorable for tissue oxygenation.

Animals↗