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Biomedical subjects

J Gay

Publications and source records attributed to J Gay.

At least 109 records · Page 6Linked to original sources
PubMed1977

[Electrocardiogram in the "typical angina of effort with normal arteriography" syndrome].

This study related to 163 cases of chest pain with the typical clinical features of angina of effort (AE) selected from a continuous series of patients who had carotid arteriography (CA) for anginal pain. These 163 cases were divided into two groups: a study group (SG) consisting of 44 patients with a normal CA, and a control group (CG) which, when patients with ECG evidence of transmural necrosis had been excluded, consisted of 119 cases of coronary artery stenosis, almost all amounting to more than 75 percent. Among those with typical AE (without ECG evidence of transmural necrosis), the proportion of normal CA was 27 percent. It was reduced to 17 percent when those patients with ECG evidence of transmural necrosis were added to the CG. The clinical features of the pain were noted for the SG and the CG, as well as the incidence of "risk factors". By contrast, the SG contained significantly more young subjects and females than the CG (P less than 0.001). The proportion with normal ECGs at reat was the same in the two groups (32 percent). The proportion of non-ischaemic abnormalities of repolarisation was 32 percent in the SG and 18 percent in the CG. Ischaemic abnormalities of repolarisation were present in 23 percent of cases in the SG, and in 49 percent in the CG (p less than 0.01). The exercise test on a bicycle ergometer was carried out for 16 cases in the SG was positive in 7 (44 percent: one male, six females). Of the 33 tests in the CG, a positive response was obtained in 20 (60 percent: 18 males, 2 females) (NS). 37 percent of patients in the SG showed an abnormality of volume or of left ventricular kinetics on arteriography (5 cases) and/or elevation of the end-diastolic pressure before and after arteriography (9 cases). These findings are not significantly different from those in the CG. 9 patients in the SG were studied for myocardial metabolism under pacing: 2 were found to have abnormalities in lactate production.

Adult↗
PubMed1977

[Long-term results of aortocoronary bypass. 1. Clinical aspects].

Eighty patients undergoing one or several aorto-coronary bypass graft procedures had longterm clinical and arteriographic follow-up (mean follow-up period of two years, extremes 1 and 6 years). The indication fort operation in these patients was unstable angina in 39 (49%), threatened infarction in 16 (20%), Prinzmetal's angina in 8 (10%), and stable but incapacitating angina in 17 (21%). Significant lesions involved the three coronary trunks in 49 cases, two trunks in 25 cases, and one trunk in 6 cases. The longterm clinical results were excellent in 65% of cases, and fair in 26%; the procedure failed in 9% of cases. Angina pectoris either disappeared or improved in 96% of cases. After operation, myocardial infarctions occurred in 11 cases (14%), 7 of which were early and 4 late with a delay of 1 to 4 years. The pre-operative cardiac failure disappeared or decreased in 13 cases out of 16. Finally the quality of the clinical results does not seem to be influenced by the various indications for operation with the exception of Prinzmetal's angina, where the results have been excellent in all cases (8 cases out of 8).

Adult↗
PubMed1977

[Long-term results of aortocoronary bypass. 2 Angiographic aspects].

Follow-up arteriograms carried out between one and six years (mean follow-up period two years) in 80 cases of aorto-coronary bypass graft procedures showed a good correlation between the quality of the clinical results obtained -- as detailed in the first part of this article -- and a larger proportion of patent grafts: 82% of 130 grafts had remained patent, and 94% of patients have all or some of their grafts patent. Late occlusion of the grafts is rare, and does not appear to be influenced by abnormalities of the graft found at early follow-up, these abnormalities being fairly stable. These follow-up have especially shown the good correlation between the quality of the clinical results and the functional status of the coronary network in the long term, a function not only of the permeability of the grafts which have been carried out, but also of the complete or incomplete correction of the lesions of the three coronary trunks. Such a complete procedure which was carried out or could have been carried out in only 30% of the total patients, was then successful in 94% undergoing it. The clinical results should therefore lead us to carry out operations which remove the lesions as completely as possible.

Adult↗
PubMed1976

A double-blind comparative clinical trial of floctafenine and four other analgesics conducted in general practice.

Three hundred and twelve patients suffering from painful conditions were admitted to a multicentre, double-blind controlled trial, conducted in general practice in which five analgesics--floctafenine (Idarac), paracetamol, aspirin, dihydrocodeine and pentazocine--were compared. Overall ratings of analgesic effect placed floctafenine first in rank order. Floctafenine was statistically significantly superior in effect to pentazocine but not to the other three agents as far as doctor ratings were concerned; and superior to both pentazocine and dihydrocodeine in the opinion of patients. Fewer patients experienced side-effects on floctafenine than on the other four analgesics and this difference between floctafenine and pentazocine, and floctafenine and dihydrocodeine was statistically significant.

Acetaminophen↗
PubMed1976

[Long term results of surgical treatment of obstructive myocardiopathy by intervention on the interventricular septum].

An analysis of the results of septal myotomy or myectomy in 26 adults with obstructive cardiomyopathy (OCM) with a mean follow-up period of more than 5 years lead to the conclusion that this treatment brings about, at the price of a mortality rate of about 10%, a sustained improvement in function, a reliable correction of the left ventricular gradient, and an improved long term survival rate by comparison with the rate among patients treated medically.

Adolescent↗
PubMed1976

[Diagnosis of myxomas of the left auricle by ultrasonic echography].

The two case histories of myxoma of the left auricle reported in this paper illustrate how echography is a diagnostic method which is non-invasive, simple, and relatively accurate provided that different angles of incidence are used, and especially the "root aorta-left auricle" incidence. It is indicated especially in cases with variable mitral murmurs on auscultation, but also where there is a very large left auricle, heart failure of unknown cause, or even an apparently straightforward case of mital stenosis. Moreover, as one of these case histories demonstrates, the technique allows both short and long term postoperative follow-up to be carried out with ease and safety, so that a possible recurrence can be picked up later.

Adolescent↗
PubMed1975

[Obstructive cardiomyopathy. A new surgical method of treatment].

A case of treatment of obstructive cardiomyopathy by insertion of a disc mistral prosthesis (Cooley's technique) is reported. The result obtained was satisfactory from a clinical, haemodynamic and angiocardiographic standpoint. The mode of action of this technique is discussed.

Adult↗
PubMed1975

[Epicardial cartography and surgical treatment by simple ventriculotomy of certain resistant re-entry ventricular tachycardias].

Intraventricular reentry has been prooved by pre-operative electrophysiological studies in two patients without coronary artery disease and resistant ventricular tachycardia. A simple ventriculotomy oriented by epicardial mapping during tachycardia was successfull with a background of 9 and 14 months respectively. In addition, delayed epicardial potentials put into evidence an intraventricular reentry in human myocardium. This new method holds promises for the treatment of some resistant ventricular tachycardia.

Adult↗
PubMed1975

[Long-term course of nonoperated tricuspid insufficiency following surgical correction of mitral and mitro-aortic valve diseases].

This study concerns 120 patients with tricuspid incompetence (TI) combined with mitral or mitral-aortic valve disease. This first part is devoted to the 48 patients TI of whom was not corrected, and the long-term course (average 40 months) after mitral-aortic lesions correction was analysed. Assessment of the degree of TI at operation differed markedly from its pre-operative clinical assessment; surgical findings agreed with the clinical estimations in 10 of 12 cases of TI considered to be negligible, but only in 4 of 24 cases with a TI considered as intense clinically. The long-term unfavourable courses (TI with persistent right ventricular failure) were more common in the group of TI considered intense clinically (59%) than in the TI considered clinically as negligible (23%). Assessment by the surgeon during operation of the degree of TI seemed a less accurate element of valuation of the long-term prognosis. The mean pulmonary artery pressure measured at operation did not have, in the patients studied, a significant influence on the long-terme course after mitral-aortic valve correction. On the contrary, the results were less favourable in the group of patients whose TI was old-standing and in the group of patients with a cardio-thoracic ration higher than 0.65. It seems therefore legitimate to recommend correction of both the cases of TI considered to be intense by the surgeon, and those considered to be intense clinically, even if the surgeon finds them to be negligible. This attitude is the more justified the older the TI and the larger the heart enlargement.

Aortic Valve↗
PubMed1975

[Long-term course of tricuspid insufficiency operated during the surgical correction of mitral and mitro-aortic valve diseases].

This study concerns 120 patients with tricuspid incompetence (TI) combined with mitral or mitral-aortic valve disease. This second part is devoted to the 72 patients whose TI was corrected together with the mitral-aortic valve lesions, and the long-term post-operative course (average 40 months) was analysed. The results were correlated with pre-operatice clinical intensity of the TI: un unfavourable course (persistent TI and right ventricular failure) was noted in 56% of the cases of TI judged to be intense and in 29% only of the cases of TI judged to be clinically negligible (p is less than 0.5). The course varied according to the mode of tricuspid valve repair with a good long-term result in 37% of the 30 cases with Kay's annuloplasty, 62% of the 26 prosthetic valve replacements and 69% of the 13 cases treated by Carpentier's annuloplasty. This latter technique seems to represent the most efficient means of correction for TI, when the anatomical lesions allow for it. In the group of the patients studied, the course is independent from the degree of heart enlargement and from the pulmonary artery pressure level before operation.

Aortic Valve↗