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Biomedical subjects

M Dunn

Publications and source records attributed to M Dunn.

At least 181 records · Page 10Linked to original sources
PubMed1977

Clinical significance of the V wave in the main pulmonary artery.

Among 68 patients with mitral insufficiency who had right and left cardiac catheterization and left ventriculography, 6 had retrograde transmission of the left atrial V wave into the main pulmonary artery. All of these patients had mitral insufficiency of acute onset. The remaining 62 patients had chronic mitral insufficiency that was considered severe in 17. Pulmonary vascular resistance was lower in the group with acute insufficiency (mean 139 dynes sec cm-5) than in the group with chronic severe insufficiency (mean 631 dynes cm-5) (P less than 0.005). Nondistensibility of the left atrium and low pulmonary vascular resistance were the two factors favoring retrograde transmission of V waves. Because both factors are present in acute mitral regurgitation, this finding is helpful in differentiating patients with acute mitral insufficiency.

Acute Disease↗
PubMed1977

Interstitial cystitis, treated by prolonged bladder distension.

25 patients with interstitial cystitis were treated by prolonged bladder distension. 16 patients are symptom-free, but 5 of these have had 1 or more previous prolonged bladder distensions. 6 patients are improved, whilst 3 remain symptomatically unchanged. Prolonged bladder distension can be repeated successfully when symptoms return. These results suggest that prolonged bladder distension has a place in the treatment of interstitial cystitis.

Adult↗
PubMed1977

Urgency and urge incontinence of urine treated by prolonged bladder dystension: interim results.

Prolonged bladder distension has been used to treat patients with urgency and urge incontinence of urine. At follow-up varying from 14 to 24 months 17 out of 33 patients were symptom-free, 13 symptomatically improved and 3 unchanged. These results, as anticipated, are not so good as the initial early reported results, but are sufficiently encouraging for us to recommend prolonged bladder distension for the treatment of severe urgency and urge incontinence of urine.

Humans↗
PubMed1977

The structure of the rabbit urinary bladder after experimental distension.

The effect of prolonged bladder distension produced by elevating intravesial pressures under controlled conditions has been examined in rabits. Bladders were distended in vivo for 3 hr and studied at selected intervals during the postoperative period using light and electron microscopic techniques. In the acute phase, the continuity of the epithelium was partially destroyed and submucosal hemorrhages and edema were evident. However, these changes rapidly resolved and speciments obtained 7 days after distension were similar to controls. Using electron microscopy, smooth muscle cells were structrually unaffected by the experimental procedure and "junction" regions between adjacent cells were of normal appearance throughout the postoperative period. The arrangement and fine structure of autonomic nerves amongst detrusor smooth muscle were similar to those of control samples. These findings are discussed with reference to the findings of other workers and in relation to the use of bladder distension in the treatment of human detrusor instability.

Animals↗
PubMed1977

Social discomfort in the patient with spinal cord injury.

A 20-item inventory of social situations which might create anxiety and/or lead to aviodance in patients with spinal cord injury was administered to 40 male inpatients. The respondents rated each item on the basis of the amount of social discomfort they would feel in the situation. The results were analyzed by dividing the subjects into eight groups based on age, type of injury and length of time since injury. On the total score of the items rated as producing the most discomfort, older patients, regardless of type or duration of injury, perceived themselves as having more social discomfort in these situations than younger patients. Implications for social skills training programs and further assessment procedures are discussed.

Adult↗
PubMed1977

Specific glucocorticoid receptor in the iris--ciliary body of the rabbit.

The cytoplasm of the iris--ciliary body of the rabbit contains a receptor capable of specifically binding dexamethasone. This binding protein has a high affinity for dexamethasone (average KD = 2.0 X 10(-8) M), a low capacity (average 4.8 X 10(-13) mol of steroid bound per milligram of protein), and extreme heat sensitivity; it exhibits a pattern of competition virtually identical to that obtained with glucocorticoid receptors from other tissues and shows characteristic physicochemical behavior in various salt concentrations. The demonstration of a specific dexamethasone receptor in the iris--ciliary body provides the first direct biochemical evidence that these tissues may function as a target organ for glucocorticoids.

Animals↗
PubMed1976

Distension therapy for the unstable bladder: later results including an assessment of repeat distensions.

51 patients with urgency and urge incontinence of urine and enuresis have been treated by prolonged bladder distension. At recent follow-up, 16 patients were symptom free, 25 substantially improved and 10 symptomatically unchanged, at a mean of 13 months after distension. 13 patients whose symptoms relapsed after a previous distension or who failed to obtain a satisfactory improvement have had a further distension for a more prolonged period. The early results in this group are not as good as for patients having first distensions, although 2 patients have become symptom free, and 6 have shown a substantial symptomatic improvement.

Adolescent↗
PubMed1976

Left ventricular function and coronary obstruction as predictors of survival following aorta-coronary bypass.

A retrospective analysis was undertaken of clinical data and catheterization studies of 151 consecutive unselected patients who underwent aorta-coronary bypass at the University of Kansas Medical Center between 1971 and 1973. The purpose was to determine the effect of preoperative left ventricular function and extent and severity of coronary artery obstruction on operative mortality rate and long-term survival. The postoperative follow-up period ranged from 10 to 49 months and averaged 26 months. Left ventricular function was assessed by qualitative analysis of left ventricular angiograms. Severity of coronary obstruction was quantified by scoring coronary arteriograms according to the system of Friesinger and associates. Patients with normal or near normal ventriculograms were considered to have good left ventricular function. Patients showing moderate or severe impairment of contraction were considered to have poor left ventricular function. Obstruction scores ranging from 2 to 7 points were classified as low scores, and scores from 8 to 15 points were classified as high scores. Four groups of patients were identified based upon preoperative left ventricular function and obstruction severity: Group I, 29 patients with good left ventricular function and low scores; Group II, 22 patients with poor left ventricular function and low scores. Group III, 28 patients with good left ventricular function and high scores. Elective aorta-coronary bypass in these three groups was accompanied by no operative or late deaths. Group IV comprised 72 patients with poor left ventricular function and high scores. In this group there was a 10 per cent operative mortality rate (7 of 72 patients) and a 5 per cent year late mortality rate. Relief of angina occurred equally in all groups. Thus operative risk can be prospectively determined by analysis of left ventricular function and severity of coronary obstruction. Surgical treatment resulted in negligible operative and late mortality rates (0 per cent) in all patients except those in whom poor ventricular function was accompanied by severe and diffuse coronary artery obstruction. Operation should be offered to this latter group (Group IV) despite the higher operative and postoperative risk because of salutary postoperative results.

Adult↗
PubMed1976

A nurse clinician's role in the management of hypertension.

The nurse has assumed more responsibility for patients with hypertension, not only in their education, but also in their follow-up. In this study the physician was aware of each patient's progress through conference with the nurse clinician. In addition, the nurse clinician consulted the physician about any problems or questions that arose. The nurse also served an educational role by informing patients about their disease and the side effects of the medications being used in their therapy. Since the physician was aware of the progress of these patients, his time was freed for other purposes. The nurse clinician's role in the management of hypertension was beneficial not only to the patient, but also to the physician.

Adult↗
PubMed1975

Idioventricular tachycardia with angina pectoris.

Idioventricular tachycardia (IVT) occurred in a patient with angina pectoris on three separate occasions associated with stress induced angina. It occurred immediately after a Master's test, a treadmill exercise test, and following an episode of paroxysmal atrial tachycardia which was precipitated by endocardial pacing. His bundle electrograms demonstrated that the rhythm was ventricular in origin. Cardiac catheterization documented the presence of severe coronary artery disease. Idioventricular tachycardia is often seen with acute myocardial infarction. It is rarely seen with angina or with exercise testing. To our knowledge this is the first reported case of IVT which could be repeatedly produced by stress induced angina.

Angina Pectoris↗
PubMed1975

A study of the bladder blood flow during distension in rabbits.

This study has shown that there is a linear relationship between bladder blood flow and bladder pressure. At a bladder pressure of 80 mm Hg (blood pressure in rabbits varying from 90/60-100/70 mm Hg) the blood flow in the bladder is minimal. It is suggested that bladder distension at 80 mm Hg in rabbits leads to hypoxia in the bladder wall as a result of the reduced blood flow. Prolonged bladder wall hypoxia occurring as a result of prolonged bladder distension may be responsible for selective necrosis of bladder tumours.

Animals↗