Biomedical subjects
J P Sutton
Publications and source records attributed to J P Sutton.
Surgical treatment of ventricular septal rupture complicating myocardial infarction.
A review of postinfarction ventricular septal defects repaired surgically at Providence Hospital over the past 6 years is presented. Although this complication of myocardial infarction carries a high mortality rate, a lower rate can be achieved with early operative intervention. Preoperative pharmacologic reduction of preload, afterload, and intra-aortic balloon pumping are only temporizing measures to allow delineation of concomitant lesions. Operative mortality does not appear to be influenced by posterior location of the ventricular septal defects.
Evoked potential maps in learning disabled children.
Some childhood learning disabilities are associated with altered synchrony patterns of brain evoked potentials. Scalp recorded electrical synchrony between selected brain regions was measured in response to visual, auditory and somatosensory stimuli and compared between a group of learning disabled children and a group of normal children. Statistically significant inter-group differences revealed stimulus dependent greater inter-regional EP synchrony in the learning disabled group. These findings support the notion that some childhood learning disabilities reflect, in part, altered connections between selected brain regions.
Ceftriaxone levels in blood and tissue during cardiopulmonary bypass surgery.
One gram of ceftriaxone was given intravenously to 15 patients approximately 2 h before cardiopulmonary bypass surgery. Ceftriaxone levels in plasma (mean +/- standard deviation) were 60.4 +/- 18.8 micrograms/ml (range, 17.0 to 96.0 micrograms/ml) at the beginning of bypass, 44.2 +/- 16.6 micrograms/ml (range, 9.4 to 78.6 micrograms/ml) at the end of bypass, and 19.6 +/- 9.6 micrograms/ml (range, 4.2 to 47.1 micrograms/ml) the following morning, 18.1 to 24.7 h after infusion of ceftriaxone. Concentrations in the sternal bone were 4.7 +/- 2.1 micrograms/g (range, 1.0 to 10.1 micrograms/g; tissue-to-plasma ratios, 0.066 +/- 0.036). Concentrations in the atrial appendage were 7.7 +/- 1.8 microgram/g (range, 3.6 to 10.2 micrograms/g; tissue-to-plasma ratios, 0.143 +/- 0.062). These data suggest that a single dose of ceftriaxone might be useful for prevention of infection due to susceptible pathogens.
Left ventricular myxoma: report of a successful surgical excision and review of the literature.
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Comparison of cefamandole and cefazolin during cardiopulmonary bypass.
In a randomized comparison, concentrations of cefazolin were found to exceed those of cefamandole in serum, atrial appendage, and sternal bone in patients undergoing cardiopulmonary bypass. No postoperative infections and no antibiotic-related complications occurred in either patient group.
Endocarditis related to transvenous pacemakers. Syndromes and surgical implications.
Two cases of microbial endocarditis related to transvenous pacemakers illustrate syndromes whose pathogenesis we consider to be distinctive. Acute Pseudomonas aeruginosa endocarditis related to a pacemaker developed in a 75-year-old man, an event which to our knowledge has not been previously described. There was no evidence of generator site infection, and the sequence of events indicated metastatic implantation of bacteria on traumatized endothelium. A 76-year-old women with a 3 year history of local generator site infection and recurrent fever was found to have extensive vegatative Staphylococcus epidermidis endocarditis at cardiotomy. The sequence of events indicated gradual spread of infection locally, related to the contaminated foreign body. Awareness of these separate pathogenetic mechanisms should facilitate recognition and appropriate management. Removal of the entire pacing system and prolonged antibiotic therapy were considered to be essential to cure of infection in both instances.
A near fatal complication of sutureless electrode placement.
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Recent experiences with surgery for acquired diseases of the mitral valve.
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Bronchial disruption secondary to blunt thoracic trauma. A case report.
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Aortic valve replacement. Prosthesis related complications.
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Surgical therapy of type II dissecting aneurysm.
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Isolated splenic vein occlusion. Review of literature and report of an additional case.
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Carcinoma of the thyroid.
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