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Biomedical subjects

J C Cleveland

Publications and source records attributed to J C Cleveland.

At least 73 records · Page 4Linked to original sources
PubMed1980

Plasma lipoprotein patterns in patients hospitalized for coronary artery bypass surgery.

Preoperative plasma samples from coronary artery bypass surgery patients were analyzed for relative levels of high-density lipoproteins (HDL) and low-density lipoproteins (LDL) in order to assess the HDL:LDL ratio as an indicator of risk for coronary heart disease. Fasting blood samples were drawn from bypass patients prior to surgery, and bypass patient mean plasma lipid data were compared with values from three other groups: randomly selected, newly admitted hospitalized patients; acutely ill student outpatients; and healthy hospital employees. Sudan Black B prestained plasma samples were electrophoresed on polyacrylamide gels, and HDL:LDL ratios were determined by densitometric gel scan and automatic peak integration. Of the four study groups, the bypass patient group had the lowest mean HDL:LDL ratio; the low ratios were due particularly to reduced levels of HDL2. Chemical analyses indicated that the bypass patient group also had lower mean HDL-cholesterol and higher mean total cholesterol and triglyceride levels than the other groups. When group age and sex differences were taken into account, the bypass group, especially males, also had low ratios. The results also strongly indicated that stresses involved with illness and hospitalization unrelated to clinical coronary heart disease (CHD) can adversely affect lipoprotein patterns.

Adolescent↗
PubMed1980

Further evaluation of the circular sequential vein graft technique of coronary artery bypass.

Our study reports a series of circular sequential vein grafts in 21 patients with highly symptomatic triple-vessel coronary artery disease. Four or more distal anastomoses were done in each patient. Thirteen of the patients were restudied, and the results revealed a 97% patency rate for distal anastomoses (58 out of 60) at 4 to 13 months after operation. One patient died 2 months after operation. Postmortem examination revealed a desmoplastic, fibrotic reaction at the proximal anastomosis of the circular graft, with 3 of 4 distal anastomoses patent. Twenty of the 21 patients in this series are now alive with asymptomatic cardiac status 14 to 22 months after operation. The finding by Grondin and associates [1] of increased patency rate with this technique for distal anastomoses is confirmed. The circular sequential vein graft represents a particularly advantageous technique for patients in whom 4 to 6 distal anastomoses are needed for complete revascularization and in whom one or more vessels have limited runoff. The obvious disadvantage of this technique is that all distal anastomoses depend on a single proximal anastomosis.

Adult↗
PubMed1979

Mast cells in human aorta.

Aortic specimens from 111 autopsy and 23 surgical cases were examined by light and electron microscopy. Differential mast cell counts were made of three aortic segments (ascending, thoracic, and abdominal) and layers (intimal, medial, adventitial). The mast cell counts varied considerably from case to case and sector to sector and generally showed no correlation with age, sex, or atherosclerotic severity. However, intimal mast cells were fewer in number in areas of lipid accumulation than in areas of diffuse intimal thickening without lipid accumulation. The reduction in the number of intimal mast cells may play a part in the localization of atherosclerosis.

Adolescent↗
PubMed1978

Destructive aortic valve endocarditis from Brucella abortus: survival with emergency aortic valve replacement.

Brucella abortus infection of the aortic valve caused acute aortic regurgitation leading to severe left ventricular failure in a 62-year-old man. He made an excellent recovery after emergency aortic valve replacement. This is the third reported case of successful heart valve replacement for Brucella endocarditis and the second such case involving the aortic valve.

Acute Disease↗
PubMed1977

Fatal air embolism to the right side of the heart during pneumonectomy for carcinoma. Result of broncho-azygous vein communication and positive-pressure ventilation.

A 59-year-old white man had an extensive bronchogenic carcinoma of the right upper lobe. During the course of pneumonectomy, the patient died unexpectedly. At autopsy, massive right-sided air embolism was evident, associated with broncho-azygous vein communication. The cause of the air embolism and subsequent death was almost certainly related to positive-pressure ventilation, allowing entry of air into the systemic venous system through the broncho-azygous vein communication. Because of the clinical implications of this problem, the case is reported, and suggestions for management are offered.

Autopsy↗
PubMed1975

The role of intraaortic balloon counterpulsation in patients undergoing cardiac operations.

Intraaortic balloon counterpulsation (IABC) was used to assist 60 patients undergoing cardiac operations for reasons of acute left ventricular failure (18 patients) or electively for indications in high-risk coronary and valvular heart disease (42 patients). Nine of 18 patients achieved hemodynamic stability when treated for acute perioperative or postoperative cardiogenic shock. Four of these died from problems unassociated with postoperative left ventricular failure and 5 were long-term survivors, indicating a potential salvage of 50%. In 42 high-risk patients, IABC was used electively to control preinfarction angina before operation (21 patients) and prophylactically to prevent postoperative low-output failure in another 21 patients with severe coronary and valvular heart disease. Thirty-nine, or 93%, of these patients survived. There were no deaths in the preinfarction angina group, 1 death in the group with coronary disease and ejection fractions less than 30%, and 2 deaths in those with valvular heart disease and congestive failure. Seven patients developed thrombotic or ischemic complications, but no permanent damage resulted. IABC is an important form of assistance for any patient with preoperative, intraoperative, or postoperative left ventricular failure and adds safety and hemodynamic stability for the high-risk patient with preinfarction angina or poor ventricular function.

Assisted Circulation↗