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Biomedical subjects

Y Kishon

Publications and source records attributed to Y Kishon.

52 records · Page 3Linked to original sources

Complete heart block in an adult with corrected transposition of the great arteries treated with permanent pacemaker.

A 53-year-old patient with corrected transposition of the great arteries developed complete heart block with fainting episodes. After temporary pacing through the endocardium of the venous (anatomically left) ventricle, a permanent epicardial pacemaker was implanted. This case shows the progressive nature of the atrioventricular conduction disturbances, which are very common in association with this congenital cardiac anomaly.

Heart Block↗

Intoxication with ajmaline in an infant.

We present a case of overdosage of ajmaline in an infant. The appearance of atactic gait and clonic tonic seizures were followed by loss of consciousness, apnea, supraventricular tachycardia, left bundle-branch block, and a prolonged Q-T interval. Cardiopulmonary resuscitation, gastric lavage, and forced diuresis were followed by complete recovery. Continuous electrocardiographic monitoring is mandatory in these cases, and the use of a cardiac pacemaker, respirator, and therapy with antiarrhythmic agents should be considered.

Accidents, Home↗

Current problems in cardiology.

Many achievements in medicine in general, and in cardiology in particular, are the result of joint endeavors by cardiologists, surgeons, research workers and engineers. This paper deals briefly with some of the devices which have been developed as a result of this interdisciplinary cooperation. They included cardiac pace-makers, the use of computers in the analysis of electrocardiograms and echocardiograms in intensive coronary care units (ICCU) and in catheterization laboratories. Finally, the use of an intra-aortic balloon pump and other cardioassist devices will be mentioned. The joint efforts of medical and engineering workers have helped to improve diagnosis of acute myocardial infarction and to improbe techniques and results of cardiac surgery. Finally, it is anticipated that through this combined work, more intensive epidemiologic studies will be made possible, new risk factors uncovered with analysis of their significance - all of which will ad to the prevention of heart diseases.

Biomedical Engineering↗

Haemodynamic studies in dogs with chronic bile-duct ligation.

1. Dogs with bile-duct ligation retain salt and water and form ascites. The present study was under-taken to examine the role of haemodynamic factors in the aetiology of this sodium retention. 2. Haemodynamic studies were performed in five dogs before and 5 weeks after bile-duct ligation. 3. After the operation there was an insignificant fall in mean arterial pressure, a significant rise in mean cardiac index and significant fall in mean total peripheral resistance. 4. It is concluded that heart failure is not a factor in renal sodium retention of the dog with bile-duct ligation, since the central venous pressure was not elevated. 5. The haemodynamic pattern and the tendency to salt retention in the dog with chronic bile-duct ligation closely resemble findings reported in patients with cirrhosis of the liver, and it is suggested that oedema formation in patients with cirrhosis of the liver and dogs with chronic bile-duct ligation shares a common aetiology.

Animals↗

Pulmonary hydatid embolization. Report on 2 operated cases and review of published reports.

Two patients with pulmonary hydatid embolization are described and commented upon in the light of 43 similar published cases. The diagnosis was strongly suspected from the medical history and the chest x-ray films and supported by angiocardiography. The angiocardiographic features of this condition have not been described previously in detail. They include amputation and filling defects of pulmonary artery branches, which are typically located proximal to a rounded tumour-like opacity seen on the plain x-ray film. Both patients underwent successful embolectomy.

Adult↗

Blood gas and acid-base balance during cardiopulmonary resuscitation by intrathoracic and abdominal pressure variations.

The blood gases and acid-base balance in a modified cardiopulmonary resuscitation (CPR) technique, based on intrathoracic and abdominal pressure variations by means of circumferential chest and abdominal balloon inflation, were examined in seven mongrel dogs. CPR proceeded for periods lasting 30 min or more and was monitored by measurements of aortic and right ventricular pressures and carotid blood flow during the compression (artificial systole) and the relaxation phase (artificial diastole). The carotid blood flow was 21.7 +/- 7.8 (mean +/- SD) ml/min, which was 0.18 +/- 0.6 (mean +/- SD) of the baseline mean carotid flow. Arterial blood was well oxygenated throughout the experiments, and low PCO2 levels (5-9 mm Hg) caused an initial severe alkalosis (pH = 7.94). However, a gradual decline in the pH was observed, reaching a value of 7.34 +/- 0.11 in the arterial blood after 30 min of CPR. The venous blood had a very low oxygen content (less than 25.5%) with a low PO2 and a normal PCO2 (43.7 +/- 7.3 mm Hg) throughout the experiment. A gradually developing metabolic acidosis was reflected in the pH values, and an increase in base deficit from 2.25 +/- 5.6 meq/1 prior to CPR to 16.7 +/- 3.2 meq/1 after 30 min of CPR was observed. High arteriovenous differences in oxygen content (greater than 66.4%) and CO2 tension (30.1-41.5 mm Hg) with a slowly developing metabolic acidosis were noted. Thus, CPR by thoracic and abdominal pressure variations is associated with a slowly developing metabolic acidosis which is the result of the combination of hyperventilation and a low perfusion state.

Abdomen↗