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Biomedical subjects

C D Morgan

Publications and source records attributed to C D Morgan.

At least 91 records · Page 5Linked to original sources
PubMed1987

Prevention of acute pulmonary edema after bone marrow transplantation.

In a retrospective review of 21 bone marrow transplantation procedures (BMT), we identified ten episodes of acute pulmonary edema coinciding with significant weight gain in the second week after BMT. When we prospectively observed nine consecutive BMT recipients, six patients developed acute pulmonary edema associated with significant (p less than 0.05) weight gain and an increase in echocardiographically determined left ventricular end diastolic diameter. These findings led to a prospective prophylactic intervention study of 30 consecutive BMT patients. Prophylactic intervention consisting of reduced fluid volume of parenteral alimentation, and diuretic therapy was instituted at any clinical sign of fluid overload. No episode of pulmonary edema occurred. The dramatic difference--acute pulmonary edema occurred in 16/30 untreated vs 0/30 treated cases--suggests that this post-BMT complication is critically related to fluid balance and can be prevented by careful clinical examination, close monitoring of weight change, avoidance of fluid overload and the appropriate use of diuretic therapy.

Adult↗
PubMed1986

Computer sleep stage scoring--an expert system approach.

This paper describes the application of the expert system concept to sleep stage scoring and is aimed at managing the large variability found in such records. The primary computational burden, sleep parameter calculation, can be relieved by recognizing major classes of recordings or 'somnotypes' having internally consistent sleep parameters for each class but significant differences between classes. The initiation and evolution of somnotypes so as to maintain accuracy while introducing a variety of sleep recordings is treated. The technique is demonstrated on seven all-night recordings resulting in 89.6% accuracy for about 5000 pages of data.

Computers↗
PubMed1986

Arthroscopic meniscus repair: a safe approach to the posterior horns.

Seventy arthroscopic meniscus repairs were performed using a technique that places posterior horn sutures through spinal needles from safe posterior corner punctures, thus avoiding injury to the posterior neurovascular structures. Follow-up averaged 18 months, with a range from 12 to 28 months. Associated anterior cruciate ligament instability (31%) was either stabilized surgically (13%) or braced postoperatively for pivoting activity (18%). Clinical results were excellent in 98.6% of patients, with only one second tear (1.5%) occurring 2 months postoperatively. Complications (2.8%) included one transient saphenous nerve irritation and one case of pyarthrosis. No major neurovascular complications occurred.

Adolescent↗
PubMed1985

Long-term results of tibiotalar arthrodesis.

One hundred and one tibiotalar arthrodeses were performed using a single surgical technique that has not been previously reported. The average follow-up was ten years (range, two to twenty-five years). The rate of pseudarthrosis was 5 per cent, four to five times less than in other recent large reports. Pseudarthrosis occurred only in patients with a sensory deficit. Secure fusion was radiographically documented in 95 per cent and the functional clinical result was good to excellent in 90 per cent. The ideal fusion position was found to be neutral or slight equinus angulation, and varus-valgus angulation equal to that of the contralateral side. More than 7 degrees of varus angulation of the heel was associated with symptomatic lateral metatarsalgia in all feet in which it occurred. Radiographic measurement documented an average 85 per cent (11-degree) increase in postoperative tarsal motion. Neither symptoms nor function correlated with the degree of tarsal hypermobility.

Adolescent↗
PubMed1983

Plasma measures of beta-endorphin/beta-lipotropin-like immunoreactivity in chronic pain syndrome and psychiatric subjects.

This study compared basal concentrations of plasma beta-endorphin/beta-lipotropin-like immunoreactivity and dexamethasone suppression of cortisol in seven chronic pain patients, seven psychiatric disorder patients, and seven normal volunteers. Pain patients and psychiatric patients showed significantly higher basal concentrations of beta-endorphin/beta-lipotropin-like immunoreactivity compared to normal volunteers. Pain patients also had significantly higher beta-endorphin/beta-lipotropin-like immunoreactivity than psychiatric patients, even though there was no significant difference in severity of depressive symptomatology as assessed by Beck and Hamilton scores. Resistance to dexamethasone occurred in 57% of pain patients. These results may indicate that biological markers for depression occur in populations of chronic pain patients, or may reflect levels of central nervous system arousal in response to stress, pain, or nonaffective phenomena.

Adult↗
PubMed1983

The spectrum of right ventricular involvement in inferior wall myocardial infarction: a clinical, hemodynamic and noninvasive study.

The clinical experience with 37 patients with acute transmural inferior wall myocardial infarction who were assessed for evidence of right ventricular involvement is reported. On the basis of currently accepted hemodynamic criteria, 29 patients (78%) had evidence suggestive of right ventricular infarction. However, only 5 (20%) of 25 patients demonstrated right ventricular uptake of technetium pyrophosphate on scintigraphy. Two-dimensional echocardiography or isotope nuclear angiography, or both, were performed in 32 patients; 20 studies (62%) showed evidence of right ventricular wall motion disturbance or dilation, or both. Twenty-one patients demonstrated a late inspiratory increase in the jugular venous pressure (Kussmaul's sign). The presence of this sign in the clinical setting of inferior wall myocardial infarction was predictive for right ventricular involvement in 81% of the patients in this study. It is suggested that right ventricular involvement in this clinical setting is common and includes not only infarction but also dysfunction without detectable infarction, which is likely on an ischemic basis.

Adult↗
PubMed1979

Hemodynamic monitoring: catheter insertion techniques, complications and trouble-shooting.

Hemodynamic monitoring is an important aspect of contemporary intensive care of the critically ill patient. The potential problems associated with invasive monitoring fall into two general categories: those related to technical pitfalls and those related to patient complications. An awareness of these problems combined with technical expertise and an understanding of cardiovascular physiology can minimize complications and make hemodynamic monitoring a safe and useful procedure.

Blood Pressure Determination↗
PubMed1972

Metabolism of isoprenaline in dog and man.

1. The metabolism of isoprenaline has been studied in man and dog following intravenous and oral or intra-duodenal administration.2. Intravenous isoprenaline was excreted largely unchanged in urine in both species. Only one-third of the radioactivity in urine was in the form of the O-methyl metabolite.3. After oral doses in man or intraduodenal doses in dogs, plasma radioactivity was almost entirely as conjugated isoprenaline and this metabolite accounted for more than 80% of radioactivity in urine.4. Catechol-O-methyl transferase may be less important than Uptake(2) in limiting the pharmacological action of isoprenaline.5. Pharmacological response (heart-rate increase) was related to plasma concentration of isoprenaline only after rapid intravenous injections. In dogs, following prolonged infusion or intraduodenal doses, heart rate returned to base-line values when plasma concentrations of isoprenaline were high.

Administration, Oral↗