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Biomedical subjects

H J Proctor

Publications and source records attributed to H J Proctor.

At least 55 records · Page 3Linked to original sources
PubMed1977

Factors limiting extremity function following vascular injury.

The clinical management of 47 patients with vascular injuries of the extremities is presented with emphasis on functional results. The method of restoration of vascular continuity or the presence of associated fractures or venous injury had little bearing on either the success of arterial repair or functional result. The most significant factor adversely affecting restoration of extremity function was the presence of associated major proximal nerve injury.

Adolescent↗
PubMed1977

Recovery of brain energy metabolism following a period of combined hypoxia and hypotension.

Rats were "stressed" by a 30-min period of hypoxia (FIO2 = 7.5%) and hypotension (x arterial pressure = 30 mm Hg), and then "resusciated" by restoring FIO2 = 30% and reinfusing shed blood to restore arterial pressure toward baseline values. Concentrations of brain phosphocreatine, ATP and lactate were measured after "stress" and 20, 60, and 120 min after "resuscitation". A biphasic response was noted in which ATP was initially restored to baseline values by "resuscitation", and then progressively decreased. Physiologic mechanisms to explain the observed data are presented.

Adenosine Diphosphate↗
PubMed1977

Effects of hypoxia, acidosis and peripheral vascular resistance on endocardial viability ratio.

In view of the increasing frequency in which cardiac output is pharmacologically altered, the endocardial viability ratio was evaluated experimentally in the dog as an additional means by which cardiac function might be monitored. The endocardial viability ratio provided useful information for cardiac function in situations of decreased peripheral resistance. The limitations of the endocardial viability ratio were evident in conditions of acidosis, hypoxia and increased peripheral resistance. Additional work is indicated prior to firmly establishing the endocardial viability ratio as a useful clinical monitor.

Acidosis↗
PubMed1977

Role of glucose-6-phosphate in cerebral dysfunction following hypoxia and hypotension.

Rats were "stressed" by a 30-minute period of breathing 7.5% oxygen combined with hemorrhagic hypotension (x arterial pressure = 25 mm Hg), and then "resuscitated" by restoring the inspired oxygen concentration to 30% and reinfusing the blood previously removed to produce hypotension. We have previously noted in initial return of brain adenosine-triphosphate to normal after this "stress" followed by a progressive decline during the post-resuscitation period. In this study, substrate deficiency was investigated as a possible etiology for the decreased adenosine-triphosphate. Glucose and glucose-6-phosphate concentrations in the brain were measured before "stress" and after resuscitation and were found not to change, indicating no deficiency of substrate.

Animals↗
PubMed1976

Concomitant pneumococcal appendicitis, peritonitis, and meningitis.

A 9-year-old boy developed pneumococcal meningitis and peritonitis following appendectomy. Subsequent pathologic examination showed Gram-positive diplococci in the appendix. Cultures of the peritoneal fluid, blood, and spinal fluid showed Diplococcus pneumoniae. The experience illustrates the danger of assuming that all pneumococcus peritonitis is the primary variety and the advisability of routine Gram stain of the peritoneal fluid at operation in order to select the appropriate antibiotic.

Appendicitis↗
PubMed1975

Intra-aortic balloon counterpulsation: potential for therapy in hemorrhagic shock with associated myocardial failure.

After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope of their ventricular function curve was reduced to either 75% (Group I), 50% (Group II), or 25% (Group III) of their baseline value. Resuscitation was attempted in all dogs by the intravenous infusion of shed blood plus additional balanced salt solution. This infusate was administered to maintain either the mean aortic pressure within 15 mm Hg of the baseline value or a left atrial pressure of 15 mm Hg, whichever occurred forst. One half of the dogs received, in addition, intra-aortic balloon counterpulsation. All dogs not receiving counterpulsation expired within two hours. There was no apparent effect of counterpulsation on Group I animals. Three of five animals (Group II) and four of five animals (Group III) receiving counterpulsation survived to the end of the experiment with significant (p smaller than .01) improvement in the parameters monitored. The utilization of counterpulsation as an adjunct to treatment in hemorrhagic shock is suggested.

Animals↗
PubMed1975

An investigation of endocardial viability ratio in myocardial failure following prolonged hemorrhagic shock.

Previous work has documented prolonged survival in dogs subjected to hemorrhagic shock when intra-aortic balloon counter-pulsation (IABC) was instituted in the presence of a 25%-50% reduction in the slope of the left ventricular function curve. Little benefit was noted in the presence of a 75% reduction in slope. In this study, myocardial failure was created in ten dogs by varying periods of hemorrhagic shock. The Endocardial Viability Ratio (EVR) was selected as a method of assessing coronary subendocardial perfusion and was evaluated as a potential method of selecting patients with myocardial failure most likely to benefit from IABC by noting the correlation between EVR and the slope of a simultaneously constructed left ventricular function curve. A significant correlation (r equals .72, p smaller than .001) was noted. The data suggest that a major factor in myocardial failure following hemorrhagic shock is deficient subendocardial coronary perfusion. Variability in data points would make selection of patients on the basis of EVR difficult.

Animals↗
PubMed1974

Erythrocyte 2,3-diphosphoglycerate in endotoxic shock in the subhuman primate: response to fluid and-or methylprednisolone succinate.

The effects of shock as a result of Escherichia coli endotoxin on certain hemodynamic and biochemical parameters and mortality were studied in the baboon. The ability of methylprednisolone succinate (MPS) in massive doses and/or rapid infusion of a buffered electrolyte solution to influence the results was then examined. Shock secondary to Escherichia coli endotoxin was associated with a decrease in RBC 2,3-DPG. This fall in RBC 2,3-DPG was not significantly influenced by MPS. Likewise, MPS did not prevent the changes in oxygen metabolism or systemic hemodynamics, nor was it associated with any decrease in mortality associated with endotoxic shock. Buffered electrolyte solution therapy improved both hemodynamics and mortality, but did not significantly protect against changes in RBC 2,3-DPG.

Animals↗