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Biomedical subjects

J J Cranley

Publications and source records attributed to J J Cranley.

At least 55 records · Page 3Linked to original sources
PubMed1981

Ischaemic myocardial fibrosis and aortic strongylosis in the horse.

The hearts and aortas of 2076 unselected horses of all ages were examined immediately after slaughter. Focal zones of fibrosis, observed in the myocardium of 14.3 per cent of hearts examined, were found in both atria and ventricles and were unrelated to age. Microscopically the majority of lesions involved myocardial fibre lysis and replacement fibrosis, although acute infarction was present in some cases. Intramyocardial arterioles in or adjacent to the lesions exhibited occlusive arteriosclerotic changes whereas those elsewhere remained patent. The evidence strongly suggests that the myocardial lesions were ischaemic in origin and related to the distribution of intramyocardial arteriosclerosis. Nodular fibrous plaques and mural thrombi associated with migrating larvae of Strongylus vulgaris were observed in the thoracic aorta of 9.4 per cent of horses. These intimal lesions were often present in the aortic bulb and proximal 10 cm of the thoracic aorta indicating that larval migration in this zone is common. Statistical analysis revealed a highly significant association between the occurrence of proximal aortic S vulgaris lesions and the presence of focal ischaemic lesions in the myocardium. The association was not the result of direct larval damage but appeared to be caused by microembolisation from parasitic lesions in the proximal aorta, producing obstructive arteriosclerotic lesions in myocardial arterioles.

Animals↗
PubMed1981

Complete dislocations of the knee with popliteal vascular injury.

Complete dislocation of the knee is rare, but is frequently associated with popliteal artery disruption. Prompt recognition and early revascularization are paramount for a successful and functional result. Arteriography is recommended in all cases of complete dislocation of the knee. Excision of the damaged arterial segment with saphenous vein bypass grafting is the treatment of choice. Associated venous and nerve injuries should be recognized and repaired early. Liberal use of compartment decompression procedures give better long-term results.

Humans↗
PubMed1981

Real-time B-mode carotid imaging in diagnosis of cerebrovascular disease.

We studied 1,044 patients by using real-time B-mode ultrasonic carotid imaging (BioSound), oculoplethysmography and carotid phonoangiography (OPG/CPA), and periorbital Doppler ultrasonography. One hundred and fifty of these patients underwent bilateral carotid arteriography; they form the basis of this study. The x-ray films were compared to the scans and other noninvasive studies. The quality of the B-mode scans were graded according to the severity of disease (the degree of diameter reduction of the arterial lumen by stenosis): grade I (0% to 39% stenosis), grade II (40% to 69% stenosis), and grade III (70% stenosis and greater). The overall results showed that the specificity of the scan was 86%, sensitivity for grade II disease was 75%, and sensitivity for grade III disease was 44%. Only 6 of 16 (38%) totally occluded vessels were identified correctly. The data reveal a direct correlation of scan quality with accuracy. Good-quality scans had 90% accuracy, whereas the accuracy of poor-quality scans was 48%. Four of 12 scan/arteriogram "mismatch" patients underwent carotid endarterectomy. In each instance the surgeon thought that the scan more accurately represented the disease process. When the scan was combined with OPG/CPA and the results agreed, there was a 91% accuracy rate. However, when the scan and OPG/CPA disagreed, the scan was more reliable in the grade I and II categories, whereas the OPG/CPA was much more reliable in grade III disease. The accuracy of this technique can be improved with the addition of a high-quality Doppler system. If technologic improvements can be made so that technically good scans can be obtained in all patients, then this may become the most reliable noninvasive cerebrovascular testing method.

Arterial Occlusive Diseases↗
PubMed1981

Newer prosthetic material compared with autogenous saphenous vein for occlusive arterial disease of the lower extremity.

This article reports our experience with 101 polytetrafluoreoethylene and 102 umbilical vein grafts inserted into the femoropopliteal and femorocrural arteries of 98 and 97 patients, respectively, during the last 5 years. These grafted extremities are compared to 416 saphenous vein grafts placed in similar arteries of 383 patients during the past 18 years. The operations were performed by seven surgeons associated in private practice. During this period of time, all records were collated by our research associate, R. M. Preuninger, Ph.D., and the life-table analyses of the data were computed by S. Mehta of the Gore-Tex Company, using the method of Peto et al.

Aged↗
PubMed1980

Noninvasive flow techniques in the diagnosis of cerebrovascular disease.

The accuracy of oculoplethysmography (OPG) and carotid phonoangiography (CPA) singly and in combination, the Doppler velocity detector, and photoplethysmography (PPG) was checked by measurement of the degree of stenosis as shown on arteriograms in 308 internal carotid arteries. In a second study using arteriographic measurement in 210 internal carotid arteries, the comparative accuracy of the fluid-filled (Kartchner) and the air-filled (Zira) OPG, each with and without CPA, was assessed. In the first study the specificity in arteries with less than 40% diameter reduction varied from 88% for the PPG to 97% for the Doppler examination. The sensitivity in arteries with more than 40% diameter reduction varied from 17% for the Doppler examination to 80% for the combination of OPG plus CPA. For arteries with a reduction in diameter greater than 70%, the sensitivity varied from 67% for the CPA to 87% for the OPG plus CPA. The sensitivity of the OPG plus CPA for total occlusions was 93%. For bilateral carotid artery stenosis over 40%, the sensitivity varied from 50% for the CPA to 82% for the combined OPG plus CPA. In the second study, for arteries with less than 40% stenosis the specificity varied from 86% for the Zira computed readout to 93% for the OPG(K). In the second study, when retrospectively analyzed, the sensitivity for arteries with more than 40% stenosis varied from 74% for the Zira computed readout to 88% for the combined OPG(K) plus CPA. For arteries with greater than 70% diameter reduction the sensitivity varied from 79% for the Zira readout to 100% for OPG plus CPA. For bilateral carotid artery disease with greater than 40% diameter reduction, the sensitivity ranged from 50% for OPG(Z) to 77% for OPG(Z) plus CPA.

Angiography↗
PubMed1979

Use of umbilical vein graft as an arterial substitute.

Seventy reconstructions, 14 to the popliteal artery above the knee, 40 to the popliteal artery below the knee, and 16 to the tibioperoneal arteries were performed with the Dardik umbilical vein graft tanned in glutaraldehyde. Indications for use included absence of or inadequate saphenous veins, or for expediency during emergency or complex procedures. The cumulative patency rate (calculated by the life table method) for the total group was 77% at 18 months. The failures are further analyzed according to the type of procedure, the grade of disease, and the distal runoff vessel. Early failures were attributed primarily to poor runoff and not to intrinsic properties of the graft. Our overall experience with the umbilical vein graft has been good. Further long-term follow-up is necessary.

Aged↗
PubMed1977

Extending the vascular examination by noninvasive means.

The Doppler and phleborheographic technics are highly accurate and convenient methods of diagnosing acute deep venous thrombosis, which cannot be detected reliably by clinical examination. Extent of occlusive disease can be more quantitatively estimated by the Doppler method in the peripheral arteries of the limbs and by oculoplethysmography and phonoangiography in the carotid arteries. Noninvasive methods permit screening of patients suspected of arterial or venous disease and provide physicians with an objective means of assessing therapeutic results.

Blood Pressure Determination↗
PubMed1977

Arterial embolism.

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Coronary Disease↗
PubMed1976

The diagnosis of deep venous thrombosis. Fallibility of clinical symptoms and signs.

One hundred twenty-four patients, with 133 involved extremities having the clinical diagnosis of deep venous thrombosis of the lower extremity, were studied by phleborheography and phlebography. Seventy-two limbs were proved to have deep venous thrombosis and 61 to have no evidence of thrombi in the deep veins. Classic symptoms of muscle pain and muscle tenderness, swelling, and the presence of a positive Homans sign obtained by dorsiflexion of the foot were found to occur with approximately equal frequency in those limbs with and without deep venous thrombosis.

Diagnosis, Differential↗
PubMed1975

Phleborheographic technique for diagnosing deep venous thrombosis of the lower extremities.

There has been further experience with a new plethysmographic technique for diagnosing deep venous thrombosis of the lower extremity. Now called phleborheography, this technique is highly practical and noninvasive and can be conveniently performed in the laboratory, at the bedside or in the office of the physician by a technician. Interpretation of the permanent tracing may be learned by a physician in a short period of time. Since development of a new specifically designed instrument, the accuracy of the test is approximately 96 per cent when correlatewith phlebography.

Chronic Disease↗