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Biomedical subjects

L Gould

Publications and source records attributed to L Gould.

At least 55 records · Page 3Linked to original sources
PubMed1986

Long-term threshold stability with porous tip electrodes.

Experience with 163 unipolar tined porous endocardial electrodes is reported. One patient required repositioning of the electrode because of exit block. There were no other complications in the entire series of patients. All of the patients had low chronic stimulation thresholds. The mean pulse width 24 hours after implantation was 0.0534 +/- 0.0128 ms. Seventy-four patients were restudied six months after implantation. The mean pulse width threshold was then 0.07432 +/- 0.0775 ms. Fifty-four patients were evaluated one year after lead implantation. The mean pulse width threshold was then 0.0611 +/- 0.0230 ms. The pulse generator was reprogrammed to a lower pulse width in all of the patients. This permitted a substantial prolongation of the pulse generator life. The cost effectiveness of the pulse generator was also greatly improved by pacing with reduced pulse widths. In an additional 16 patients, the voltage amplitude was reduced from 5.0 volts to 2.5 volts. This permitted an even greater increase in the pulse generator longevity.

Electrodes, Implanted↗
PubMed1985

Effect of oral alcohol on left ventricular ejection fraction, volumes, and segmental wall motion in normals and in patients with recent myocardial infarction.

A first-pass nuclear angiogram and a multiple-gated acquisition study were obtained in 10 normal physicians and in 10 patients with a 7-to-10 day old transmural myocardial infarction. After the scan the subjects drank 2 oz. of whiskey. After 60 minutes, the multiple-gated acquisition study was repeated. In the normal group the left ventricular ejection fraction was 68% before and 72% after alcohol. The left ventricular end-diastolic volume increased from 89 to 97 ml while the left ventricular end-systolic volume decreased from 29 to 27 ml. The stroke volume rose from 61 to 70 ml/beat (p less than 0.05). The cardiac output increased from 4.0 to 5.0 l/min (p less than 0.05). In the infarction group, the left ventricular ejection fraction was 58% before and 56% after alcohol administration. The left ventricular end-diastolic volume fell from 111 to 96 ml, while the left ventricular end-systolic volume declined from 50 to 44 ml. The stroke volume fell from 61 to 52 ml/beat, while the cardiac output fell from 4.5 to 3.8 l/min. In the left ventricular infarction zones, alcohol produced in 9 of the 10 cardiac patients a decline in the left ventricular regional ejection fraction. In the normal group, alcohol produced no significant changes in the regional ejection fraction. The normal and the postinfarction patients responded differently to alcohol.

Adult↗
PubMed1985

Infectious endocarditis caused by Actinobacillus actinomycetemcomitans.

Actinobacillus actinomycetemcomitans is a very uncommon cause of infectious endocarditis. The organism was first described in 1912. Thjotta and Sydnes reported its isolation in pure culture from a long standing abscess which had developed after tooth extraction. Subsequently this organism was found to be part of the normal flora, and the organism was defined as a slow growing, fastidious gram negative bacillus. Carbon dioxide is essential for the growth of A. actinomycetemcomitans. Approximately 50 cases of endocarditis due to A. actinomycetemcomitans have been reported since the first case reported in 1964. The purpose of this report is to document a case of endocarditis due to A. actinomycetemcomitans and to stress the value of the echocardiogram in the assessment of patients with endocarditis.

Actinobacillus↗
PubMed1985

The Osborn wave in hypothermia.

A patient is reported who presented with fatal hypothermia. The electrocardiographic changes of a sinus bradycardia, prolonged QT interval and Osborn waves were documented and correlated with body temperature. The possible genesis of these electrocardiographic changes is reviewed in this article.

Bradycardia↗
PubMed1984

Alterations in lymphocyte subpopulations in type 1 (insulin-dependent) diabetes mellitus: exploration of possible mechanisms and relationships to autoimmune phenomena.

Previous studies have shown a variety of immunological abnormalities in Type 1 (insulin-dependent) diabetes, including disturbances in peripheral lymphocytes and anti-lymphocyte antibodies. We measured subsets of T and natural killer cells with monoclonal antibodies in patients with diabetes, and also assayed for anti-lymphocyte antibodies using dual colour immunofluorescence and flow cytometry. We found a significant decrease in numbers of Leu 3a (helper/inducer) cells in Type 1 diabetic patients of recent onset and intermediate levels in patients with longer duration of the disease. Leu 4 (pan T cell) levels were reduced in Type 1 diabetic patients of more than 4 months duration. Leu 7 (natural killer cells) were increased in Type 2 (non-insulin-dependent) diabetic patients. Individual Type 1 diabetic patients of recent onset showed low levels of Leu 7 and 11 a (natural killer cell) levels with normal 3a levels. Autoantibodies against Leu 3a + cells were present in higher titres in the Type 1 diabetic patients of recent onset than in control subjects. We conclude: (1) Leu 3a cells may be decreased in Type 1 diabetic patients of recent onset and return to normal with time; (2) low numbers of Leu 7 and 11a cells with normal numbers of Leu 3a may be seen in some Type 1 diabetic patients of recent onset, which may help explain previous reports of decreased suppressor cells; (3) Leu 7 levels may be increased in Type 2 diabetes; (4) autoantibodies against Leu 3a + peripheral lymphocytes may be seen in Type 1 diabetic patients of recent onset. These appear to be a marker of autoimmune phenomena rather than immunological mediators.

Adolescent↗
PubMed1984

Mitral valve prolapse.

Mitral valve prolapse is a very common condition. It occurs in 4-5% of the population. It may be idiopathic or associated with a number of other conditions. Myxomatous degeneration is the underlying mechanism of mitral valve prolapse. Most patients with mitral valve prolapse have no symptoms. When symptoms do occur, palpitations, chest pain and dyspnea are the major complaints. The midsystolic click occasionally followed by the late systolic murmur are the typical physical findings. The echocardiogram plays a big role in the diagnosis of mitral valve prolapse. The beta blockers are used in the treatment of the symptomatic patient.

Adrenergic beta-Antagonists↗
PubMed1984

Value of radionuclide angiogram for the diagnosis of Ebstein's anomaly.

A radionuclide angiogram in a patient with Ebstein's anomaly showed a very dilated right atrium with a minimally enlarged right ventricle and a normal sized left ventricle. This study led to the establishment of a definitive diagnosis by means of an echocardiogram. Late close of the tricuspid valve was demonstrated. In addition prolapse of the tricuspid and mitral valves was documented. A tricuspid valve prolapse has never been reported in this condition.

Blood Pressure↗
PubMed1984

Vasodilator drugs.

This article demonstrates conclusively that systemic vasodilator therapy is an important new medical treatment for acute and chronic heart failure. Initially, vasodilators were used only when digitalis and diuretics could not adequately treat congestive heart failure. Now many clinicians view the vasodilators as equal or even better alternatives than digitalis and diuretics. There is no doubt that vasodilator therapy is one of the major advances in the treatment of heart failure.

Calcium Channel Blockers↗
PubMed1983

Squamous cell carcinoma of the splenic flexure of the colon.

A partially obstructing lesion of the splenic flexure was discovered during a barium enema examination, and subsequent colonoscopy and biopsy demonstrated a squamous cell carcinoma. This is the first reported instance of squamous cell carcinoma of the colon in which the splenic flexure has been involved. The case is discussed, and the recent literature on this entity is reviewed.

Carcinoma, Squamous Cell↗
PubMed1983

One monitored case of sudden death.

A 90-year-old female had a Holter monitoring recording because of a syncopal episode. She developed a fatal cardiac arrest during the recording. A severe bradycardia was the initiating fatal dysrhythmia. This was followed by ventricular tachycardia and fibrillation and finally cardiac standstill.

Aged↗
PubMed1983

Electrophysiologic properties of furosemide in man.

Furosemide has been extensively used in the treatment of heart failure and its effect on cardiovascular dynamics are well established. Clinical relief of the symptoms of pulmonary congestion frequently precedes any demonstrable diuretic effect, suggesting that extra renal factors may also be involved. More recent studies on the extra-renal action of furosemide showed an increase of venous capacitance as an early hemodynamic effect of the drug. In spite of furosemides wide use in the treatment of heart failure and hypertension, there is no information on the electrophysiologic properties of the drug in man. The present study involving 8 human subjects was undertaken to determine what effect intravenously administered furosemide has on the human conduction system.

Aged↗
PubMed1983

Noninvasive assessment of left ventricular wall stress in chronic congestive heart failure patients.

Therapy with prazosin can improve the condition of patients with congestive heart failure due to its vasodilating action. Therefore nine patients with volume overloaded left ventricles due to aortic insufficiency and mitral insufficiency received 1 mg. of prazosin four times a day for two weeks. Peak and end-systolic wall stress were estimated using a noninvasive echocardiographic technique. The peak systolic wall stress in this group was 155 x 10(3) dynes/cm2 which is similar to the reported normal value. However, the end systolic wall stress was 101 x 10(3) dynes/cm2 which is much higher than the reported normal values. Following the administration of oral prazosin, the end systolic stress was normalized while the peak systolic stress was reduced below normal. As a result of therapy with prazosin, the ejection fraction, the percentage of change in the minor axis, and the velocity of circumferential fiber shortening significantly increased. Thus, the oral administration of prazosin can improve left ventricular function in patients with mitral insufficiency and aortic insufficiency.

Adult↗