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Biomedical subjects

A Gerber

Publications and source records attributed to A Gerber.

At least 127 records · Page 7Linked to original sources
PubMed1983

The Kock continent ileostomy.

Over a four and one-half year period, we have performed 100 Kock continent ileostomies with one nonpouch-related mortality. The large majority of these operations have been conversions of existing conventional ileostomies. Modifications in the surgical technique have gradually lowered the complication rate, and postoperative revisions are now required less frequently than for conventional ileostomies. Slippage of the nipple valve, the most troublesome complication of the Kock pouch operation, is currently seen in 4.1 per cent of the patients. Eversions of the nipple valve have been eliminated, and fistulas are now seen rarely. The so-called pouchitis, a postoperative complication noted in 10 per cent of the patients, is usually well controlled with metronidazole. Kock pouches performed upon patients in whom the original diagnosis was Crohn's ileocolitis have been followed by a high incidence of postoperative fistulas, but patients with Crohn's colitis have thus far fared as well as patients with ulcerative colitis. The over-all success rate for the Kock pouch operation in this series of patients is 97 per cent.

Adolescent↗
PubMed1983

An enzyme-linked immunosorbent assay for lactose synthase (galactosyltransferase) in serum and its application as a tumor marker in ovarian carcinoma.

This assay for lactose synthase (galactosyltransferase, EC 2.4.1.22) in serum involves two sequential incubations: serially diluted standard or sample antigen is reacted with a fixed amount of antibody; unbound antibody is then adsorbed to wells of antigen-coated microtiter plates and determined by a second antibody directed against the first antibody and coupled to phosphatase. The standard curve is linear for galactosyltransferase concentrations of 10 to 600 micrograms/L. The within-assay CV of a serum sample was 9.3% (SD 4.1%), the between-assay was 3.8% (SD 2.4%). Serum galactosyltransferase concentrations computed from three different dilutions yielded CVs of 6.5% (SD 5.7%, n = 14). We evaluated the method's accuracy by recovery analysis and by comparing enzyme activity in serum with that of purified galactosyltransferase from human milk. The normal reference interval, as estimated from data on 27 healthy blood donors, was 60-436 micrograms/L (mean 224, SD 101 micrograms/L). We applied the assay to samples of serum from ovarian carcinoma patients grouped according to tumor burden. We also determined galactosyltransferase in ascites fluid and found these values useful for diagnosis, whereas determinations in serum may serve mainly for patient monitoring.

Ascitic Fluid↗
PubMed1982

The case against routine operative cholangiography.

We reviewed 500 consecutive cholecystectomies during which operative cholangiography was performed only when there were clinical indications for common duct exploration. Negative operative cholangiograms obviated the necessity for exploration in a substantial number of cases. Cholecystectomy without operative cholangiography was performed in 438 patients. From the average experience of those employing routine cholangiography (6 percent incidence of unsuspected stones), we presumably missed common duct stones in about 26 patients, but those stones either passed spontaneously or caused no problems. A single patient requiring reoperation for a retained stone was not a candidate for cholangiography at the original operation. No common duct injuries occurred in the series. We conclude that routine operative cholangiography is unnecessary for either finding unsuspected common duct stones or detecting ductal anomalies.

Aged↗
PubMed1982

Adult respiratory distress syndrome in children.

Twenty patients (age 2 weeks to 15 years) who fulfilled strict selection criteria for adult respiratory distress syndrome were identified during a 3 1/2-year period. The underlying disease was intra-abdominal infection/septicemia in seven, hypovolemic shock, near drowning, closed space burn, or cardiogenic shock caused by nupercaine intoxication in two each, and miscellaneous in five. The mean time of artificial ventilation with PEEP was 18 days (range 5 to 92), and the mean time of FIO2 greater than or equal to 0.5 while on the ventilatory 139 hours (range 12 to 648). PEEP levels were most often between 8 and 15 cm H2O. Eight patients had a pulmonary air leak. Eight patients died (40% mortality). Death was nearly always related to unresolved basic medical or surgical problems and multiple organ failure. Treatment of ARDS includes elimination of the cause of ARDS, early institution of mechanical ventilation with PEEP, prompt recognition and treatment of superimposed infections, and careful management of additional organ failures.

Adolescent↗
PubMed1981

Congenital mesoblastic nephroma.

Neonatal renal neoplasms are rare: most are congenital mesoblastic nephroma. In the past this neoplasm has been confused with Wilms' tumor, which in part may account for some of the more favorable prognosis ascribed to Wilms' tumor in children less than 1 yr of age. Congenital mesoblastic nephroma is usually a benign tumor. The recommended treatment is surgical excision. This is a report of two cases of congenital mesoblastic nephroma in infants who were treated successfully by nephrectomy.

Humans↗
PubMed1981

Occupational exposure to aromatic amines: benzidine and benzidine-based dyes.

Large-scale production of aromatic amines that serve as intermediates in the aniline dye industry began in this country during World War I. In the United States, the first known occupationally induced aromatic amine cancers of the bladder were observed at a dye factory in 1931. Additional cases of benzidine-related bladder cancer was subsequently reported at this same facility and at numerous other dye works in this country and throughout the world. In 1974, the Occupational Safety and Health Administration promulgated a standard to control the production and use of benzidine in the workplace. Although hazards associated with benzidine exposure have been reduced, a carcinogenic risk due to benzidine-based dye exposure is now apparent. In addition, several dyes produced from o-tolidine and o-dianisidine, carcinogenic compounds structurally related to benzidine, have demonstrated metabolism to their respective parent compounds. The history of occupational bladder cancer in the United States is traced and measures taken by the Occupational Safety and Health Administration to reduce exposure to this hazard are described.

Animals↗
PubMed1980

Tissue binding of antimicrobial agents in vitro: a critical study focusing on the concentration of the tissue homogenate used.

In vitro tissue binding of clindamycin, trimethoprim and rifampin to serial dilutions of canine tissue homogenates was studied. For all three drugs tested, the percentage of bound drug tended to be linearly related to the logarithm of the percentage of tissue homogenate. Tissue binding studies of antimicrobials looking at a single concentration or tissue homogenate may give erroneous results that do not reflect tissue binding in vivo.

Animals↗
PubMed1979

[In vitro study on the problem of optimal gentamicin therapy in leukopenic patients: short injections or parenteral infusions?].

Killing curves of Pseudomonas aeruginosa were performed in an in vitro system simulating in-vivo gentamicin kinetics, i.e. decay of the antibiotic concentration with a 2.1 h halflife time. Minimal inhibitory concentrations (MIC) of gentamicin killed 99.999% of the initial Pseudomonas inoculum whereas 99.99% were killed at a continuously falling gentamicin concentration (starting from the MIC level) in the same period of time. Regrowth of persistent germs occurred only after 6 hours in cultures exposed to falling gentamicin concentrations, and after 8 hours in cultures kept at the MIC. Thus, a postulated superiority of gentamicin infusions over intermittent gentamicin therapy could not be demonstrated in vitro. Intervals between bolus injections of gentamicin should probably not be longer than 6 hours.

Colony-Forming Units Assay↗