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Biomedical subjects

A R Graham

Publications and source records attributed to A R Graham.

At least 73 records · Page 4Linked to original sources
PubMed1984

Trial labor following previous cesarean section.

Elective repeat cesarean section continues to remain the standard of care in the United States. This paper is a study of 242 patients with previous cesarean section who requested and were allowed a trial of labor. One hundred sixty-six (69%) achieved successful vaginal delivery with no maternal or fetal mortality or significant morbidity. Review of the English literature indicates similar results in other independent studies. Continued accumulation of cases showing the efficacy of post-cesarean section trial of labor should encourage a reassessment of the continuing practice of elective repeat cesarean section.

Cesarean Section↗
PubMed1984

Effects of Monsel's solution in uterine cervix.

Monsel's solution applied to biopsy sites causes tissue necrosis that can persist for two weeks and impede reepithelialization. Granulation tissue in the healing phase contains iron pigment residue from the agent. The pigment encrusts upon collagen and is present in siderophages for up to three months. Occasionally pigment or necrotic residues incite a foreign body giant cell reaction. Awareness is recommended in order to avoid confusion. The agent's potential effect upon the basic disease is discussed.

Cervix Uteri↗
PubMed1983

Use of clonal assay in determination of urothelial drug sensitivity in carcinoma in situ of the bladder: clinical correlations in 5 patients.

Five patients with carcinoma in situ of the bladder, including 4 with associated grossly apparent tumors, were followed for 2 years or until invasive disease appeared while receiving intravesical chemotherapy. In vitro drug sensitivity determinations were made using the clonal assay. Of 9 retrospective and prospective in vitro/in vivo drug sensitivity correlations 7 proved correct. However, in vitro growth occurred in only 50 per cent of the urothelial samplings in which adequate cells were present. The assay has some potential use in selecting agents for intravesical chemotherapy but the problem of unpredictable and limited in vitro growth must be overcome.

Administration, Topical↗
PubMed1983

Fungal autofluorescence with ultraviolet illumination.

Fungal autofluorescence of hematoxylin and eosin (H & E)-stained tissue sections viewed under ultraviolet illumination was evaluated for diagnostic utilization. Cases examined included coccidioidomycosis, candidiasis, aspergillosis, mucormycosis, and histoplasmosis. The method was most useful in identifying Coccidioides immites, Candida spp., and Aspergillus spp. in sections from solid parenchymatous organs, loose connective tissue, granulomata, or necrotic tissue debris. The architectural detail of spherules, yeast forms, and hyphae was very well delineated. Histoplasma capsulatum was not autofluorescent in one specimen (a broncholith) and the cases of mucormycosis failed to demonstrate intrinsic hyphal autofluorescence but did show a "negative image" appearance against surrounding native tissue autofluorescence. The advantages of using fungal autofluorescence include the possibility, in some cases, of rapid organism identification without the use of special stains or where organisms may not be present on additional sections prepared for special stains, the decreased interference to fungal identification of certain background cellular components or debris, and the improved simultaneous evaluation of organism identification and architecture of the surrounding histologic milieu.

Aspergillosis↗
PubMed1983

Quantitative electron microscopic study of membranous glomerulopathy.

Primary and secondary membranous glomerulopathy (MGN) may be indistinguishable by light microscopy and immunofluorescence. It has been noted occasionally anecdotally that the distribution of subepithelial immune complex deposits by electron microscopy may differ between these two subgroups. The authors examined 23 cases of primary and 22 cases of secondary MGN and quantitated the percentage of glomerular basement membrane occupied by immune complexes for each group. Mean percentage involvement of GBM with deposits was 49% +/- 15% for the primary group and 16% +/- 15% for the secondary group; these were statistically significantly different at the P less than 0.05 level. When far-advanced disease cases (Churg Class IV) were eliminated from the groups, the mean percentage involvement of GBM was 48% +/- 15% and 12% +/- 7% for the idiopathic and secondary groups, respectively (P less than 0.01). The quantitative differences in involvement of the GBM with immune complex deposits between primary and secondary MGN may represent fundamentally different types of antigen-antibody complexes or variable patterns in deposition of complexes derived from the circulation or formed in situ.

Adult↗
PubMed1983

Popliteal aneurysms.

Although popliteal aneurysm is reportedly common, there are few series reporting large numbers, and little uniformity in the method of treatment. Review of 52 popliteal aneurysms in this series showed that when thromboembolic complications occurred, the amputation rate was 28 per cent. When the aneurysm was patent at presentation, amputation was the outcome in one in 20 cases (5 per cent), indicating that repair is not without risk. An unsatisfactory outcome was usually caused by excessive delay before reconstructive arterial surgery was undertaken. In most cases delay was caused by failure to recognize the presence of the popliteal aneurysm. This review confirms the susceptibility of elderly males and emphasizes the need for considering the diagnosis of popliteal aneurysm in cases of acute lower limb ischaemia. Alternative presentations include spontaneous venous thrombosis, pain and swelling behind the knee, rupture and mycotic infection.

Adult↗
PubMed1982

Immunoglobulin and complement demonstration in kidney following transport medium preservation.

Transport media have been widely utilized for the preservation of immunoglobulins and complement in skin biopsies submitted for direct immunofluorescence. Critical studies have been performed to evaluate the quality of immunoreactivity maintained following such handling of skin specimens. We assessed the degree of immunoreactant preservation in kidney specimens derived from 2 murine models of renal disease, namely the NZW/BiNJ and the C57BLKsJ-db/db strains. There was excellent preservation of glomerular immunoglobulin and complement through 48 h of transport medium holding time, with especially good maintenance of granular staining patterns. While fresh-frozen tissue is preferable for direct immunofluorescence study of renal disease, acceptable preservation of immunoreactants may be maintained for a moderate period of time by transport medium utilization.

Animals↗
PubMed1982

Herniation pit of the femoral neck.

A round to oval radiolucency surrounded by a thin zone of sclerosis is often identified in the proximal superior quadrant of adult femoral necks. Although usually recognized as incidental and benign, these radiolucencies may be of clinical concern in patients with hip symptoms. The true nature and genesis of these radiolucencies have not been explained. This article relates these radiolucencies to common acquired degenerative changes developing on the surface of the femoral neck in adults (the reaction area) and shows that the radiolucency represents a subcortical pit or cavity formed by herniation of soft tissue contents through defects in the surface of the reaction area. The formation of this pit and its relation to the commonly seen femoral neck radiolucency has not been previously described. The name "herniation pit" is suggested for these lesions.

Adult↗
PubMed1982

Management of ischemia of the foot beyond arterial reconstruction.

During a 20 year period, the outcome of 719 amputations in 552 patients demonstrates that, in a majority of patients, conservation of the foot or knee can be achieved. Two hundred and eighty-seven local amputations of the foot performed upon 249 patients resulted in satisfactory healing in 167 of the 237 surviving patients, with a hospital mortality of 4.8 per cent. In 246 patients, 277 below knee amputations were performed with healing in 192 of 220 survivors but with a 10.5 per cent hospital mortality. Midthigh amputations were reserved for those patients with quite extensive gangrene and gross ischemia. In 155 such patients, the hospital mortality was almost 30 per cent.

Amputation, Surgical↗
PubMed1981

Control of the upper infrarenal aorta.

Variations in technique used to control the infrarenal aorta in a variety of circumstances are described. Usually direct clamping of the aorta below the renal arteries is appropriate. Alternatives include suprarenal, supracoeliac, and intrathoracic clamping, balloon catheters and external pressure. Renal vein ligation improves access to the infrarenal aorta but in the occasional patient produces renal congestion.

Aorta, Abdominal↗
PubMed1981

A quantitative light- and electron-microscopic study of type IV nuclear bodies in crescentic glomerulonephritis.

Type IV nuclear bodies were found in all renal biopsies obtained from 14 patients with crescentic glomerulonephritis (CGN) and in 8 of 43 control patients studied by light and electron microscopy. The mean ratio of Type IV nuclear bodies per 10 tubular cross-sections examined was 0.67 +/- 0.27 for the CGN cases, which was significantly different from 0.09 +/- 0.26 obtained for the controls (P less than 0.05). Type IV nuclear bodies were most commonly seen in the epithelial cells of proximal tubules but were also seen occasionally in interstitial fibroblasts and cells of a collecting duct and a developing crescent.

Acute Kidney Injury↗
PubMed1980

Amyloidosis presenting as priapism.

A sixty-five-year-old white man presented with sudden onset of painful, priapism. Review of pathologic specimens at the time of surgical decompression revealed massive amyloid infiltration. Purpura, organ enlargement, gastrointestinal bleeding, and congestive heart failure developed subsequently. Postmortem examination revealed widespread amyloidosis. To our knowledge this is the first report of amyloidosis presenting with priapism.

Aged↗
PubMed1980

Counterimmunoelectrophoresis employing coccidioidin in serologic testing for coccidioidomycosis.

Counterimmunoelectrophoresis, was performed for serologic testing for coccidioidomycosis, employing coccidioidin and spherulin as antigens. Results obtained by counterimmunoelectrophoresis were compared with results obtained by complement-fixation and radial immunodiffusion. Of the 37 sera positive by complement-fixation, 28 were positive by counter-immunoelectrophoresis utilizing coccidioidin, whereas only 11 were positive by counterimmunoelectrophoresis utilizing spherulin (although an additional 14 were positive with counterimmunoelectrophoresis employing spherulin when the quantity of spherulin was increased by 50 to 100%). Thirty-three of these complement-fixation-positive sera were positive by immunodiffusion. Counterimmunoelectrophoresis performed with coccidioidin detected antibodies to C. immitis in all patients who had complement-fixation titers greater than 1:4. When combined with latex agglutination, counterimmunoelectrophoresis utilizing coccidiodin had an 86% correlation with complement-fixation for the detection of positive sera.

Antigens, Fungal↗