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Biomedical subjects

P S Reynolds

Publications and source records attributed to P S Reynolds.

6 recordsLinked to original sources
PubMed2001

Comparison of transcranial color-coded sonography and magnetic resonance angiography in acute ischemic stroke.

BACKGROUND AND PURPOSE: This study was designed to assess the accuracy of transcranial color-coded sonography (TCCS) as compared to magnetic resonance angiography (MRA) for detecting intracranial arterial stenosis in patients with acute cerebral ischemia. METHODS: The authors prospectively identified 120 consecutive patients admitted with acute ischemic stroke and performed both TCCS and MRA with a mean interval of 1 day. TCCS data (sampling depth, peak systolic and end diastolic angle-corrected velocity, mean angle-corrected velocity, and pulsatility index) for middle cerebral arteries (MCAs) were compared to MRA data and classified into 4 grades: normal (grade 1): normal caliber and signal; mild stenosis (grade 2): irregular lumen with reduced signal; severe stenosis (grade 3): absent signal in the stenotic segment (flow gap) and reconstituted distal signal; and possible occlusion (grade 4): absent signal. The cutoffs were chosen to maximize diagnostic accuracy. RESULTS: Interobserver agreement for MRA grading resulted in a weighted-kappa value of 0.776. The rate of poor temporal window was 37% (89/240). Doppler signals were obtained in 135 vessels, and the angle-corrected velocities (peak systolic, end diastolic, mean) were significantly different (P = .001, P = .006, and P < .001) among the MRA grades: grade 1 (100, 47, 68 cm/s), grade 2 (171, 72, 110 cm/s), grade 3 (226, 79, 134 cm/s), grade 4 (61, 26, 39 cm/s). Additionally, an angle-corrected MCA peak systolic velocity > or = 120 cm/s correlates with intracranial stenosis on MRA (grade 2 or worse) with high specificity (90.5%; 95% confidence interval = 78.5%-96.8%) and positive predictive value (93.9%) but relatively low sensitivity (66.7%; 95% confidence interval = 61.2%-69.5%) and negative predictive value (55.1%). CONCLUSION: Elevated MCA velocities on TCCS correlate with intracranial stenosis detected on MRA. An angle-corrected peak systolic velocity > or = 120 cm/s is highly specific for detecting intracranial stenosis as defined by significant MRA abnormality.

Acute Disease↗
PubMed2001

Lack of relation between severity of stroke and severity of extracranial internal carotid artery lesions in Taiwanese first-ever ischemic stroke patients.

BACKGROUND AND PURPOSE: The authors attempt to determine whether hemodynamically significant extracranial internal carotid artery (ICA) lesions correlate with the severity of first-ever hemispheric ischemic stroke. METHODS: Carotid duplex was used to evaluate carotid arteries. The National Institutes of Health Stroke Scale was used to describe the severity of the stroke and was stratified as follows: 1-6 = mild, 7-15 = moderate, > 15 = severe. Duplex findings were categorized according to velocity criteria into < 50% stenosis if ICA peak systolic velocity (PSV) (cm/s) < 140 and > 50% stenosis if ICA PSV > 140 or ratio of ICA and common carotid artery in PSV > 2. No detectable flow at ICA was considered occlusion. Stroke subtype was classified according to TOAST criteria. RESULTS: Two hundred nineteen consecutive patients were enrolled, including 127 with mild, 65 with moderate, and 27 with severe stroke. The prevalence of ICA stenosis > 50% in each group was 3.6%, 1.4%, 0.9%, respectively. Two patients in the severe group had total ICA occlusion. The overall prevalence of significant ICA lesions was 6.8%. CONCLUSIONS: There is no positive correlation of stroke severity with the severity of duplex findings, which may be due to low prevalence of significant ICA lesions or other stroke mechanisms. Most of the patients had mild stroke, and the majority had ICA stenosis < 50%. Small-vessel occlusion tended to have mild severity of stroke. Intracranial artery lesions or other factors causing stroke in Taiwanese should be investigated. Given the low incidence of significant extracranial carotid disease in symptomatic Taiwanese stroke patients, routine screening of symptomatic Taiwanese for extracranial carotid artery disease does not provide enough information to determine stroke mechanism, and transcranial Doppler should be added to the screening tests.

Acute Disease↗
PubMed1993

Pathological sequelae of implantation of intracorporeal left ventricular assist devices in the calf.

Thromboembolic complications have previously been a major pathological complication of left ventricular assist device (LVAD) insertion and appear to be a consequence of the use of smooth polyurethane linings. Textured biomaterial surfaces are designed to attract a stable coagulum which becomes organized to form a neointima. We describe the pathological changes following experimental implantation of textured-surface LVADs in calves. The incidence of systemic embolization from such linings appears to be low. Surface modifications with cell seeding offer the possibility of further reduction in incidence of this problem. However, degradation of prosthetic valves may be a potential source of emboli and infection. With these complications minimized, the most significant pathological changes observed appear to relate to the device haemodynamics. At present renovascular changes associated with systemic hypertension appear to be the greatest potential problem for the long-term use of these devices.

Animals↗
PubMedDate not supplied

Metabolic response to air temperature and wind in day-old mallards and a standard operative temperature scale.

Most duckling mortality occurs during the week following hatching and is often associated with cold, windy, wet weather and scattering of the brood. We estimated the thermoregulatory demands imposed by cold, windy weather on isolated 1-d-old mallard (Anas platyrhynchos) ducklings resting in cover. We measured O2 consumption and evaporative water loss at air temperatures from 5 degrees to 25 degrees C and wind speeds of 0.1, 0.2, 0.5, and 1.0 m/s. Metabolic heat production increased as wind increased or temperature decreased but was less sensitive to wind than that of either adult passerines or small mammals. Evaporative heat loss ranged from 5% to 17% of heat production. Evaporative heat loss and the ratio of evaporative heat loss to metabolic heat production was significantly lower in rest phase. These data were used to define a standard operative temperature (Tes) scale for night or heavy overcast conditions. An increase of wind speed from 0.1 to 1 m/s decreased Tes by 3 degrees -5 degrees C.

Animals↗