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Biomedical subjects

T Reynolds

Publications and source records attributed to T Reynolds.

At least 235 records · Page 13Linked to original sources
PubMed1976

The abnormal hepatic scan of chronic liver disease: its relationship to hepatic hemodynamics and colloid extraction.

To help explain the characteristic hepatic scan pattern of chronic liver disease, the degree of scan abnormality (scan score, SS) after administration of technetium-99m sulfur colloid (Tc) was compared with data obtained at hepatic vein catheterization in 28 patients. Although SS showed a correlation with wedged hepatic vein pressure (r = +0.491), the scan abnormality was not directly due to portal hypertension because it remained unchanged when the latter was relieved by portacaval shunt. Also, the scan abnormality was found to be unrelated to a low hepatic blood flow. Scan abnormality was not attributable primarily to hyperactivity of the reticuloendothelial (RE) cells of the spleen and bone marrow since fractional clearance (K) of Tc from the blood was decreased rather than increased in patients with abnormal scans. SS was inversely correlated with K or Tc (r = -0.575) and with hepatic extraction efficiency for Tc (r = -0.673), showing that the basic abnormality was poor extraction of the colloid by the RE cells of the liver with a resultant increase in the amount available for extrahepatic localization. Indirect evidence suggests that this poor extraction of colloid is due to intrahepatic shunts bypassing hepatic RE cells.

Blood Pressure↗
PubMed1976

Hepatic paraplegia.

A 53-year old cirrhotic patient is presented with spastic paraplegia as a sequel of chronic hepatic encephalopathy accompanying a spontaneous portasystemic anastomosis. We describe the clinical picture with the investigation, followed by a brief discussion on this rare syndrome.

Female↗
PubMed1975

Studies of renin and aldosterone in cirrhotic patients with ascites.

Plasma renin activity and aldosterone metabolism were investigated in patients with cirrhosis and refractory ascites. All patients initially showed marked elevations of plasma and renin activity and plasma aldosterone. Although metabolic clearance of aldosterone was reduced, increased secretion rate was the major factor leading to elevated plasma levels. The elevated plasma renin activity and plasma aldosterone were only minimally affected by posture, dietary sodium restriction, and diuretic administration, suggesting a near-maximal degree of secondary aldosteronism. In most patients plasma renin activity and plasma aldosterone returned to normal when spontaneous natriuresis appeared. However, in 2 patients during spontaneous diuresis and in all 3 given aminoglutethimide, sodium excretion was poorly correlated with plasma renin activity and plasma aldosterone, suggesting that other tubular and/or vascular factors are important in the intense sodium reabsorption found with cirrhosis and ascites.

Aldosterone↗
PubMedDate not supplied

Sonography of hemorrhagic ovarian cysts.

The sonographic appearance of hemorrhagic ovarian cysts (HOC) has received little attention aside from a recent report in adolescent girls. We reviewed the sonographic findings in 14 adults with 15 pathologically proven HOC to see whether there were any consistent sonographic findings that, along with the clinical history, might make possible the diagnosis. The majority (93%) of patients presented with the abrupt onset of lower abdominal or pelvic pain, and each, when clinically appropriate, had a negative serum pregnancy test. Sonographically, all of the masses were cystic except one. The cyst wall was thin and well defined in six cases and thick and irregular in eight. The majority (87%) had internal echoes. These echoes were scattered and low level or diffuse and homogeneous (27%) or complex and echogenic (53%) in nature. Two cysts had numerous septations, and another had a fluid--debris interface. If the pain subsides and the hematocrit remains stable, the premenopausal patient can be managed conservatively. Sonographic follow-up is recommended so that an underlying hemorrhagic ovarian cystic neoplasm can be excluded. This was present in three of our patients, two of whom were postmenopausal.

Adult↗
PubMedDate not supplied

"Rib-hooks," "pressure points," and "hugs": technical hints for improving two-dimensional echocardiographic imaging.

The two-dimensional echocardiographic image has improved greatly over the past decade due in great part to improved technology. Yet it should be remembered that the skill of the cardiac sonographer is still an important factor in acquiring an adequate echocardiographic examination. This article has presented new approaches and adjustments to the standard approaches in acquiring routine two-dimensional images. It is the belief of the authors that the cardiac sonographers may improve their two-dimensional imaging by using the rib hooks, pressure points, and hugs described.

Echocardiography↗
PubMedDate not supplied

The determination of aortic valve area by the Gorlin formula: what the cardiac sonographer should know.

The application of the Gorlin formula in the cardiac catheterization laboratory is the standard of reference for the determination of aortic valve area. The continuity equation now enables the cardiac sonographer to determine aortic valve area noninvasively in the echocardiography laboratory. The comparison of the results obtained by the two methods is inevitable. The cardiac sonographer should have a basic understanding of the theory and pitfalls of the Gorlin formula so that when conflicting results are obtained, the possible reasons why will be clear.

Aortic Valve↗
PubMedDate not supplied

The evaluation of the abdominal aorta: a "how-to" for cardiac sonographers.

A thorough evaluation of the abdominal aorta can be readily achieved by use of the standard views of the echocardiographic examination. The ultrasound evaluation of the abdominal aorta represents a logical extension of the standard echocardiographic examination of the adult patient. This article provides the information needed to carry out a complete ultrasound examination of the abdominal aorta including the anatomy, the vascular disease, and the steps involved in accomplishing the ultrasound examination of the abdominal aorta.

Aortic Dissection↗
PubMedDate not supplied

Doppler flow velocity patterns of the superior vena cava, inferior vena cava, hepatic vein, coronary sinus, and atrial septal defect: a guide for the echocardiographer.

Pulsed-wave Doppler provides the echocardiographer the advantage of range resolution; confusion as to the source of Doppler shift information is unusual. One area of the heart that may lead to interpretive difficulties, however, is the right atrium because the right atrium receives blood flow from three venous sources and from the left atrium when an atrial septal defect is present. Our article presents information on the normal pulsed-wave Doppler spectral displays for the superior vena cava, inferior vena cava, hepatic vein, and coronary sinus. Because it is clinically pertinent, methods on how to differentiate these normal venous flow patterns from atrial septal defect flow will be emphasized.

Blood Flow Velocity↗
PubMedDate not supplied

Visualization of the hepatic veins: new approaches for the echocardiographer.

Visualization and cardiac Doppler interrogation of the hepatic veins has become an important and integral part of the routine echocardiographic examination. The challenge lies in adequate visualization of the hepatic veins by use of the standard subcostal approach. This article proposes alternate approaches when the standard view yields unsatisfactory visual and cardiac Doppler information.

Echocardiography, Doppler↗
PubMedDate not supplied

The JH/LVOH method in the quantification of aortic regurgitation: how the cardiac sonographer may avoid an important potential pitfall.

Color flow Doppler allows for methods in which to quantitate the severity of valvular regurgitation. In particular, the regurgitant jet height/left ventricular outflow tract height (JH/LVOH) method of quantitating the severity of aortic regurgitation has been validated and is routinely used in the adult echocardiography laboratory. A potential pitfall exists in the measurement of the LVOH. This article points out this potential source of error and, in addition, proposes steps that may be taken by the cardiac sonographer to avoid this potential measurement pitfall.

Aorta↗
PubMedDate not supplied

The role of the cardiac sonographer in the evaluation of the heart transplant recipient.

The sonographer should have a basic understanding of the indications, surgical technique, survival rate, electrocardiographic findings, chest radiographic findings, and complications for orthotopic cardiac transplantation. The sonographer should also have a thorough understanding of the normal echocardiographic and Doppler findings in these patients and the possible echocardiographic and Doppler findings during acute early rejection. This article has presented those findings in a review form to enable the sonographer to consult the information presented before the echocardiographic and cardiac Doppler examination is carried out. In addition, a sample echocardiographic and cardiac Doppler worksheet has been provided.

Cyclosporins↗
PubMedDate not supplied

Effect of troglitazone on fibrinolysis and activated coagulation in patients with non-insulin-dependent diabetes mellitus.

The objective of this study was to determine if treatment of non-insulin-dependent diabetes mellitus (NIDDM) patients with the "insulin sensitizer" troglitazone, both as monotherapy and in combination with insulin, corrects the impaired fibrinolysis and activated coagulation associated with NIDDM. Patients participating in two clinical trials comparing troglitazone and placebo in patients with NIDDM were studied at the time of randomization and after 26 weeks of treatment. Eighteen patients were treated with troglitazone (ten in combination with insulin and eight as monotherapy) and eight were treated with placebo (four in each trial). Plasma concentrations of plasminogen activator inhibitor (PAI-1), prothrombin fragment F1+2, fibrinogen, and von Willebrand Factor (vWF) activity were measured. Plasma PAI-1 concentrations fell significantly from a mean of 68.8 +/- 32.3 ng/mL to 40.4 +/- 20.4 in the troglitazone treated group, but did not change significantly in the placebo treated group. Plasma PAI-1 concentrations were elevated in 15 patients treated with troglitazone and fell to normal in eight of them. There was no significant change in plasma F1+2, vWF, and fibrinogen, but plasma C-peptide and triglyceride concentrations fell significantly with troglitazone. This study demonstrates that troglitazone treatment is associated with a significant fall in plasma PAI-1 antigen concentrations in patients with NIDDM and, therefore, may have a beneficial effect on fibrinolysis.

Adult↗
PubMedDate not supplied

Plasma homocysteine concentrations in type II diabetic patients in India: relationship to body weight.

Hyperhomocysteinemia has been established as a risk factor for cardiovascular disease and occurs with a high prevalence in patients with type II diabetes and microvascular disease. In order to determine whether plasma homocysteine concentrations vary with body-mass index in patients with type II diabetes, we measured plasma homocysteine in lean, normal weight, and overweight subjects living in India. Plasma homocysteine concentrations were significantly lower in the lean persons with diabetes when compared to those who were obese and compared to control subjects (p < 0.02). We conclude that plasma homocysteine concentrations are lower in lean persons with type II diabetes and that this efficiency in homocysteine metabolism may contribute towards protection from cardiovascular disease in this population.

Adult↗
PubMedDate not supplied

A comparison of healing rates on two pressure-relieving systems.

The authors have previously reported the preliminary results of a randomized-controlled trial comparing the relative efficacy of two pressure-relieving systems: Huntleigh Nimbus 3 and Aura Cushion, and Pegasus Cairwave Therapy System and ProActive Seating Cushion (Russell et al, 2000). Although both the mattresses and cushions were effective treatments for pressure ulcers, the Huntleigh equipment was demonstrated to be statistically more effective for heel ulcers, but no differences were demonstrated for sacral ulcers. This article gives a more detailed analysis of the 141 patients assessed using computerized-image analysis of the digital images of sacral ulcers captured during the trial and specifically discusses the healing rates and other patient characteristics. Ninety-eight per cent of ulcers examined were deemed superficial (Torrance grade 2a, 2b, 3). Precision of image analysis assessed by within- and between-batch coefficients of variation was excellent: calibration CV 0.93-1.84%; area CV 4.61-5.72%. The healing rates on the two mattresses were not shown to be statistically different from each other.

Beds↗
PubMedDate not supplied

VACUTEX capillary action dressing: a multicentre, randomized trial.

This article describes a preliminary study comparing the effect of VACUTEX capillary action wound dressing vs standard protocol for the treatment of sloughy and necrotic wounds. The study was carried out over a period of 5 months. Randomization was computer generated and batches of trial numbers and dressing allocation were delivered to each of the three study sites, sealed in opaque envelopes to ensure blinding of allocation. A total of 35 patient participants were recruited (17 VACUTEX 14, standard protocol, three withdrew, one died). All participants gave their consent to enter the study. All participants were assessed and photographs were taken on days 1, 8, 15, 22 and 29. Nursing assessments of size, site, depth, severity, tissue type of wound and causation were collected, as were demographic factors including mental status, primary/associated medical history, weight, height, and ethnic origin.

Absorption↗