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Biomedical subjects

J Copeland

Publications and source records attributed to J Copeland.

At least 91 records · Page 5Linked to original sources
PubMed1982

Increased regional myocardial perfusion after intracoronary papaverine in patients after coronary artery bypass grafting.

The objective of coronary artery bypass grafting (CABG) is to increase blood flow to ischemic areas of the myocardium. To determine if this was achieved, anterior wall myocardial perfusion was measured at rest and during intracoronary papaverine (5 mg), with the use of xenon-133 washout in 35 patients. Twelve control patients had no significant diameter narrowing (0% to 25%) of the left anterior descending coronary artery (LAD), 13 patients had greater than 50% narrowing of the LAD, and 10 patients had greater than 50% narrowing of the LAD with patent saphenous vein bypass grafts to the LAD. There was no significant difference in age. LVEDP, and global ejection fraction among the patients. There was no significant difference in anterior wall myocardial perfusion at rest between control subjects (61.0 +/- 3.7 ml/min/100 gm) and non-CABG LAD patients (60.2 +/- 5.4 ml/min/100 gm), or CABG LAD patients (63.4 +/- 4.8 ml/min/100 gm). After coronary arteriolar vasodilatation with papaverine, anterior wall perfusion increased in the CABG patients to 140.6 +/- 6.8 ml/min/100 gm. This was significantly greater (p less than 0.001) than the increase in the non-CABG LAD patients (72.8 +/- 8.1 ml/min/100 gm) but not different from the increase in the control subjects (145.3 +/- 8.4 ml/min/100 gm). In three cases, the same patients were studied before and after CABG with identical results. These data indicate that in patients with coronary disease, increases in myocardial perfusion are limited by the resistance of the proximal stenosis independent of vasodilatation distal to the stenosis. After successful CABG, the patent vein graft restores control of myocardial perfusion to the arteriolar bed.

Angina Pectoris↗
PubMed1981

The histopathologic evolution of recurrent herpes simplex labialis.

In a study of the natural history of recurrent herpes simplex labialis, we examined hematoxylin and eosin-stained sections of biopsies taken from lesions at various clinical stages. The earliest specific findings which could be recognized were changes within the epidermal cell nuclei, including peripheral clumping of chromatin, development of homogeneous "ground glass" appearance, and ballooning of nuclei. Eosinophilic intranuclear inclusion bodies were unusual and occurred in late lesions. Vacuolization was the earliest cytoplasmic alteration within keratinocytes. The herpes-induced changes began focally along the basal cell layer, but the entire epidermis was rapidly altered. Pilosebaceous units were commonly affected. Within the dermis, no cells with typical herpesvirus-induced changes were seen. In early lesions, mononuclear and polymorphonuclear inflammatory cells were equally prominent; in later lesions neutrophils were most numerous. Histopathologic changes of recurrent herpes simplex begin multicentrically within the epidermis and are present prior to the onset of physical findings.

Biopsy↗
PubMed1981

Legionnaires' disease following cardiac transplantation.

The first two cases of Legionnaires' disease in heart transplant patients are reported. Of interest in these cases were culture of the organism from sputum, diagnosis by percutaneous lung aspiration, bronchopleural fistula formation in the first case, which was then successfully treated with multiple-tube thoracostomies, early cavitation of lesions in both cases after the start of antibiotic therapy, positive direct fluorescent antibody staining from transtracheal aspirate 42 days after starting appropriate antibiotic therapy in the first case, apparent superiority of intravenous erythromycin therapy in the first case, and survival of both patients. Our laboratory isolated and identified the organism in both cases.

Adult↗
PubMed1976

Reliability of psychiatric assessment in older patients.

A number of the causes of psychiatric diagnostic disagreement are discussed in this paper. The use of the Geriatric Mental Status interview to achieve diagnostic reliability is examined in three studies in which U.S.--U.K. Cross-National Project psychiatrists rated and diagnosed thirty-two British and twenty-one American patients. There were no systematic differences between U.S. and U.K. team members in their diagnoses; and agreement on six principal diagnostic categories was achieved in about three-quarters of the cases. The reliability fo the ratings of psychopathology that formed the basis for the diagnoses was satisfactory and is reported in detail.

Aged↗
PubMed1976

The geriatric mental status interview (GMS).

The Geriatric Mental Status interview (GMS) is a semi-structured interview technique for assessing psychopathology in elderly patients. It is administered by a trained interviewer in a session of less than one hour. Between 100 and 200 question are asked and almost 500 items are rated. Twenty-one factor scores have been identified and the reliability of the ratings has been established. The interview is acceptable to the patient and is useful for making diagnostic distinctions and evaluation progress

Aged↗
PubMed1976

Assessment of the older psychiatric inpatient.

Instruments, whether used in psychometrics or in other fields, must have a practical application if they are to repay the care spent in their use and development. The Geriatric Mental State schedule was developed in response to the need to answer the question whether functional psychiatric disorders were being misdiagnosed as organic brain syndrome and, if so, to what extent this influenced treatment and outcome. In the hospitals studied it was found that American psychiatrists were more likely to diagnose organic brain syndrome than British psychiatrists. Although elderly patients with affective disorder were less likely to be given American patients was as good, if not better, than the outcome in the British patients.

Affective Symptoms↗
PubMed1975

Postoperative hemodynamics following aortic cross-clamping during aortocoronary bypass surgery.

Forty-one patients undergoing aortocoronary bypass surgery were divided into two groups: an "unclamped" group (17 patients) in whom the aorta was not cross-clamped during operation and a "clamped" group (24 patients) in whom the ascending aorta was cross-clamped during performance of distal anastomoses. Myocardial protection was provided during aortic clamping by cooling the anoxic heart with cold saline immersion. Immediate postoperative hemodynamic function was assayed in both groups, as was cardiopulmonary bypass time and cardiopulmonary bypass time/graft. Cardiopulmonary bypass time was 107 minutes in the unclamped group and 87 minutes in the clamped group (P less than 0.05). Cardiopulmonary bypass time/graft was 48 minutes in the unclamped group and 40 minutes in the clamped group (P less than 0.01). Results of hemodynamic studies with values for the unclamped group listed first were as follows: cardiac index (L/min/m2) 2.3 and 2.5 (NS), stroke index (ml/beat/m2) 23 and 25 (NS), left ventricular minute work index (kg-m/min/m2) 3.03 and 2.81 (NS), and stroke work index (g-m/min/m2) 31 and 30 (NS). These data indicate that aortic cross-clamping during performance of distal anastomoses expedites the performance of aortocoronary bypass surgery and does not adversely affect postoperative hemodynamics.

Adult↗