In this study, the development of intraoperative angioscopy, the value of the information obtained, and the problems encountered with the procedure are reported. Eight angioscopes, 1.5 to 2.8 mm in diameter, with a line resolution of greater than 0.4 mm at 5 mm, were used. One-hundred ten angioscopic investigations were performed in 46 patients; 24 at peripheral bypass surgery and 22 at coronary artery bypass surgery. These included 68 arteries, 28 new anastomoses, six old grafts, five laser angioplasties, and three in situ vein grafts. The most important finding was that angioscopic data provide information not available from probes or angiography. Angioscopic findings were responsible for a change in surgical procedures in 12 patients (26%) including three anastomotic revisions, three alterations in graft site placement, and two repeat thrombectomies. The most significant technical problems were lack of steerability and insufficient irrigation, which resulted in poor angiographic images. Further technical development is necessary before routine intraoperative angioscopy is practical. Nevertheless, if these problems are resolved, angioscopy will provide unique, high-resolution information which can directly alter surgical therapy.

Angioplasty, Balloon↗

PubMed1981

Intracoronary thrombolysis in evolving myocardial infarction.

After experimental studies in dogs confirmed the feasibility and safety of rapid intracoronary thrombolysis by local infusion of Thrombolysin (streptokinase and plasmin), intracoronary thrombolysis was attempted in 20 patients with evolving myocardial infarction who were hospitalized within 3 hours from the onset of symptoms during the day and within 2 hours at night. Thrombolysin was infused in the immediate vicinity of the site of coronary occlusion using a 0.85 mm outer diameter catheter advanced through the lumen of the Judkins catheter. Reperfusion was achieved in four patients after an average of 43 minutes of Thrombolysin infusion at a rate of 2000 IU/min and in 15 patients after an average of 21 minutes of Thrombolysin infusion at a rate of 4000 IU/min. The failure to open the artery in one patient may have been caused by our inability to advance the infusion catheter close to the site of occlusion. Rethrombosis occurred in one patient 8 days after reperfusion and 2 days after discontinuation of anticoagulants because of a history of chronic alcoholism. Wall motion and perfusion studies showed improvement following reperfusion. Patency of the artery was achieved an average of 4 hours after the onset of symptoms. The need for earlier reperfusion is emphasized.

Adult↗

PubMed1973

A functional classification of metropolitan communities.

Explore the source record for details and available documents.

Classification↗

PubMed1972

Time and consistency as measures of psychological distance.

Explore the source record for details and available documents.

Decision Making↗

PubMedDate not supplied

Group dynamics training for manned spaceflight and the CAPSULS mission: prophylactic against incompatibility and its consequences?

On February 7, 1994, four Canadian Astronauts were sealed off in a hyperbaric chamber at the Canadian Government's Defense and Civil Institute for Environmental Medicine in Toronto, Canada. This space lab training mission lasted seven days and was the first to be conducted with astronauts outside of Russia. The objective of this mission was to give Canadian astronauts, space scientists and the staff of the Canadian Space Agency (CSA), the opportunity to gain first hand experience on preparational and operational aspects of a typical space mission. Twenty-one scientific experiments involving six countries from several disciplines were involved in this mission. This paper describes the goals and preliminary results of a psychological experiment/training program that used the CAPSULS mission as a test bed for its application in the manned space flight environment. The objective of this project was to enhance the understanding of small group behaviour with a view to maximizing team effectiveness and task accomplishment in teams living and working in isolation under difficult and confined conditions. The application of this model in the light of future missions is a key thesis in this paper.

Aerospace Medicine↗

PubMedDate not supplied

Psychological considerations of man in space: problems & solutions.

With concrete plans for long duration flight taking form a new impetus is lent to preparing man for this hostile and unnatural environment. Cramped conditions, isolation from family and loved ones, work stress, fear, and incompatibility with fellow crew, are but a few of the problems suffered by astronauts and cosmonauts during their long missions in orbit about the earth. Although criteria for selection of crew is one aspect of attacking the problem, it has not solved it. Notwithstanding good selection, team combination, and counselling before flight, problems have still occurred with unwanted consequences. Incompatibility of team members, far from being the exception, has been frequent. This has been detrimental both physiologically and psychologically for the individual as well as for the operational success and safety of the missions. Because problems will inevitably occur in future long duration missions, especially when they are of international and multi-cultural nature, the importance of dealing with them is underlined. This paper takes a different approach towards ameliorating these problems, namely that of psychological group training before a mission.

Adaptation, Psychological↗

PubMedDate not supplied

Transesophageal echocardiographic assessment of pulmonary venous flow after single lung transplantation.

Transesophageal echocardiography was used to evaluate pulmonary venous flow velocity and pulmonary venous diameter of both the transplanted and native lungs in six single lung transplant recipients. Mean pulmonary venous velocity (50 +/- 10 versus 27 +/- 8 cm/sec) and pulmonary venous diameter (1.39 +/- 0.16 versus 0.98 +/- 0.18 cm) were significantly greater in the transplanted lung than in the native contralateral lung. An index of allograft perfusion, QD-transesophageal echocardiography (pulmonary venous velocity x pulmonary venous diameter), correlated highly with previously measured technetium 99m-labeled macroaggregated albumin quantitative lung perfusion studies (r = 0.94). A pressure gradient in pulmonary venous flow velocity across the left atrial anastomosis was detected in two patients (8 and 12 mm Hg). Analysis of previous resting supine and upright incremental hemodynamic exercise testing showed no significant differences in these two patients with respect to maximum oxygen uptake, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index, or pressure-flow relationships. Therefore these left atrial anastomotic gradients did not appear to adversely affect the pulmonary vascular response to incremental exercise. Transesophageal echocardiography may be an invaluable technique in the expedient evaluation of cardiac function and allograft perfusion after lung transplantation.

Adult↗