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Biomedical subjects

K M Kelly

Publications and source records attributed to K M Kelly.

At least 91 records · Page 5Linked to original sources
PubMed1988

Triple vessel coronary angioplasty: acute outcome and long-term results.

Triple vessel coronary angioplasty, defined as angioplasty of one or more lesions in each of the three major coronary arteries (left anterior descending, left circumflex, right coronary artery) was performed in 50 (11%) of 469 patients who had angioplasty of multiple vessels. There were 32 men and 18 women with a mean age of 56 years. All 50 patients had severe three vessel coronary disease and represent approximately 5% of patients with three vessel disease who had revascularization in this institution; 8 (16%) had previous coronary bypass surgery, and 23 (46%) had previous myocardial infarction. Unstable angina was present in 33 patients (66%) and 96% had Canadian Heart Association class III or IV angina; mean left ventricular ejection fraction was 57 +/- 11%. Angioplasty was performed in 176 vessels (3.5 vessels per patient, range 3 to 6) and in 250 lesions (5 lesions per patient, range 3 to 9); angiographic success was achieved in 240 lesions (96%) and 166 vessels (94%). Success in all vessels attempted was achieved in 40 (80%) of the 50 patients. Clinical success (angiographic success associated with clinical improvement) was obtained in all 50 patients in whom triple vessel angioplasty was performed; none of them required urgent bypass surgery and 5 patients (10%) had a non-Q wave myocardial infarction. In four other patients triple vessel angioplasty was planned but not performed because of failure to dilate the primary vessel; urgent bypass surgery was required in one of these, who developed a Q wave infarction. Thus, overall clinical success in 54 patients was 93%; the incidence rate of myocardial infarction was 11%, and that of urgent surgery 1.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Use of percutaneous gastrostomy in the intensive care patient.

We evaluated the use of percutaneous endoscopic gastrostomy in 30 ICU patients. There was a 14% incidence of minor complications, no major complications, and no mortality. We conclude that percutaneous endoscopic gastrostomy is a useful alternative to operative gastrostomy in the ICU patient.

Aged↗
PubMed1988

Effects of sodium bicarbonate in canine hemorrhagic shock.

We studied the use of sodium bicarbonate administration in a canine model of hemorrhagic shock to determine its effect on hemodynamics, arterial and venous blood gases, respiratory gases, and blood lactate levels. Thirteen dogs were anesthetized, paralyzed, mechanically ventilated, and hemodynamically monitored. Hypotension was induced and maintained at a mean arterial pressure of 40 to 45 mm Hg using controlled hemorrhage and reinfusion. After 2.5 h of shock, the dogs were randomized into two groups: one group (n = 6) received NaCl infusion; the other (n = 7) received sodium bicarbonate (1 mEq/kg followed by a continuous infusion of 2.5 mEq/kg.h for 2.5 h). CO2 production was increased in the alkali group, but there was no statistically significant difference between groups in any measured hemodynamic, blood gas, or respiratory gas variable. These included heart rate, BP, cardiac output, arterial and venous pH, CO2 production, and bicarbonate levels. Blood lactate levels, however, in the bicarbonate treated animals were significantly (p less than .01) higher than in the group treated with NaCl alone (10.1 +/- 3.2 vs. 5.1 +/- 1.2 mEq/L). These results are similar to the effects of bicarbonate found in other models of lactic acidosis, and suggest that bicarbonate therapy may have limited usefulness in the treatment of lactic acidosis.

Acidosis, Lactic↗
PubMed1988

The influence of lip repair with and without soft-tissue undermining on facial growth in beagles.

The present study was designed to test the hypothesis that undermining of the soft tissues on the surface of the maxilla at the time of lip repair in unilateral cleft lip, alveolus, and palate results in more severe craniofacial growth aberrations than lip repair alone. Sixty-seven purebred beagles were used in this experiment. The animals were divided into four groups: two control groups (unoperated and unrepaired) and two experimental groups (lip repair without undermining and lip repair with undermining). Lip pressures were monitored in all groups. Significantly higher lip pressures were observed in animals with soft-tissue undermining. Cephalometric measurements were analyzed using univariate and multivariate techniques. The results of this study indicate that lip repair performed with soft-tissue undermining results in more severe craniofacial growth aberrations than lip repair performed alone.

Analysis of Variance↗
PubMed1988

Role of animal models in experimental studies of craniofacial growth following cleft lip and palate repair.

The present study was designed to examine the role of the animal model on investigations of craniofacial growth. Identical experimental protocols were followed using 6-week-old rabbits and 8-week-old beagles. Three groups were used for each species, two control groups and one experimental group. The groups within each experimental model were compared for lip pressure, occlusion, and cephalometrics. Statistical analyses including analyses of correlations were used to evaluate dimensional craniofacial relations. The results of this study revealed that dimensional relations were significantly different in rabbits and beagles despite the similarities observed in overall craniofacial growth aberrations. Analysis of the results does not allow strong conclusions about which animal model (rabbits or beagles) is more appropriate for studying craniofacial growth.

Animals↗
PubMed1988

Simultaneous cleft lip and palate repair: an experimental study in beagles.

This study was designed to test the hypothesis that simultaneous lip and palate repair results in more severe craniofacial growth aberrations than lip repair or palate repair performed separately. Seventy-six purebred beagles were divided into five groups. Two of these groups were controls (unoperated and unrepaired animals); the three remaining groups were experimental (in one group only the lip was repaired, in another only the palate was repaired, and in the last the lip and palate were repaired simultaneously). Cephalometric measurements were analyzed using univariate and multivariate statistical techniques. In multivariate analysis, stepwise multiple regression and discrimination were applied to precisely assess the effects of the various surgical procedures. The results of this study indicate that simultaneous lip and palate repair results in more severe craniofacial growth aberrations than lip repair or palate repair performed separately.

Animals↗
PubMed1987

Naloxone in renal ischemia: a functional and microanatomical study.

Naloxone HCl (Nx) improves cardiopulmonary performance, reverses cellular hypoxia, and stabilizes lysosomal membranes in shock states. However, no detailed study has yet explored its potential role in renal ischemia, which is inevitable in transplantation and surgical and nonsurgical conditions associated with hypotension and shock. This functional and microanatomical study was carried out on dogs subjected to renal warm ischemia with contralateral nephrectomy. Group I (control; N = 4) had bilateral renal dissection and right nephrectomy. Groups II-IV had their kidney pedicles cross-clamped for 60 min and then reperfused. Group II (N = 9) ischemic kidneys received no treatment. Group III (N = 6) kidneys were flushed with pure Nx HCl (2 mg/kg) during ischemia. Group IV (N = 6) dogs received one iv Nx bolus (2 mg/kg) before clamping and another dose before declamping. Biopsies for adenine nucleotides, histology, and ultrastructure were obtained before ischemia, before reflow, and 15 min and 7 days after reflow. Serum creatinine and blood urea nitrogen were measured daily. Ischemia induced significant renal dysfunction, which was reversed by systemic Nx. Nx offered a remarkable protection against postischemic structural damage. Seventy percent of Group II cortical sections showed grade 4 acute tubular necrosis (ATN), and severe residual damage after a week. Eighty-three percent of Group IV sections showed grade 1 ATN and no residual damage after a week. One week survival was 33% in Group II and 100% in Group IV. Nx can be useful in prevention of acute renal failure in clinical situations with arterial hypotension and shock.

Acute Kidney Injury↗
PubMed1987

A simple technique to accurately determine intra-abdominal pressure.

The determination of intra-abdominal pressure (IAP) may be useful in a variety of clinical situations. Despite this, invasive IAP monitoring is seldom performed due to the risks involved. Using a standard canine model of increased IAP, we evaluated the accuracy of transurethral bladder catheter pressure in reflecting IAP. Throughout the range of IAP studied (10 +/- 5 to 70 +/- 10 mm Hg), bladder pressure did not differ significantly from the direct measurement of IAP. We conclude that the measurement of bladder pressure using a standard transurethral bladder catheter provides an accurate determination of IAP.

Abdomen↗
PubMed1986

Multimodal sensory discrimination deficits in Korsakoff's psychosis.

A consistent impairment in odor identification was observed among a group of 21 amnesic patients, diagnosed as having Korsakoff's psychosis. In a subsequent study of eight Korsakoff and matched alcoholic control subjects, a comparable olfactory deficit was again demonstrated, as well as impairment in color discrimination and auditory perception. No such deficit was observed for a picture identification task designed to control for the non-sensory demands of the olfactory test. Stepwise multiple regression analysis showed a significant correlation between odor identification scores and the concentration of the primary metabolite of norepinephrine in lumbar cerebrospinal fluid. The data demonstrate a consistent coincidence between memory impairment and deficient sensory perception among patients with Korsakoff's psychosis.

Adult↗
PubMed1984

Hyperdense renal masses: a CT manifestation of hemorrhagic renal cysts.

Eleven patients with sharply circumscribed round to ovoid renal cysts measuring 70-90 H on CT are reported. The cysts were hyperdense on unenhanced scans, measuring 30-60 H greater than the adjacent parenchyma, and either hypodense, isodense, or hyperdense on enhanced scans. Four patients had polycystic kidney disease; of the other 7 patients, the cysts were cortical in 6 and parapelvic in 1. Eight patients had a solitary cyst and 3 had multiple cysts. Sonography demonstrated internal echoes and/or lack of increased through-transmission in 6 patients. Pathological analysis was available in 6 cases and indicated a benign, hemorrhagic renal cyst. This hyperdense CT appearance is characteristic of some hemorrhagic renal cysts, though differentiation between benign and malignant cysts requires cyst puncture and/or surgery.

Adult↗
PubMed1983

Communicative behavior of adults with an autistic four-year-old boy and his nonhandicapped twin brother.

Sixteen female preschool teachers were videotaped playing in dyads with a nonverbal, socially unresponsive autistic 4-year-old boy and his nonhandicapped fraternal twin brother. Eight adults were informed that the autistic child had a language disability and did not talk or understand much language; eight adults were not informed about any differences between the children. Language to the autistic child was simpler, more concrete, and more often accompanied by gestures than language to his brother for both groups of subjects. Informed teachers made greater speech modifications to the autistic child and were more successful at keeping him on-task than uninformed adults. The theoretical and practical implications of communicative adjustments to children with language and social impairments are discussed.

Adult↗
PubMed1979

Estrogen and progestin binding in cytosols of ovarian adenocarcinomas.

Because a few ovarian adenocarcinomas respond favorably to endocrine therapy, we tested the hypothesis that some ovarian adenocarcinomas have functional similarity with sex-hormone-sensitive endometrial and breast tumors. Cytosols from 23 ovarian adenocarcinomas and 27 control tissues were examined for receptorlike estrogen and/or progestin binding. Eight of 16 primary ovarian adenocarcinomas had estrogen and/or progestin receptorlike components; among the metastases tested, one third retained estrogen binding. No correlations were found between binding characteristics and histopathologic grade. The presence of estrogen binding in a lung lesion helped confirm recurrent ovarian disease. Estrogen binding occurred in specimens from women with no histories of exposure to exogenous estrogen. Because tamoxifen and nafoxidine could inhibit estradiol binding, it is likely that antiestrogens will prove beneficial against some ovarian cancers.

Adenocarcinoma↗