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Biomedical subjects

B Brandt

Publications and source records attributed to B Brandt.

At least 145 records · Page 8Linked to original sources
PubMed1985

Spiral vein graft: an alternative method for relief of superior vena caval obstruction following the Mustard repair.

This report describes our experience with an 11-year-old girl with superior vena caval syndrome following an intra-atrial baffle for transposition of the great arteries. She underwent a saphenous spiral vein graft with excellent relief of the obstruction. This method is presented as an alternative to the use of cardiopulmonary bypass for baffle revision and direct anastomosis of the innominate vein to the left atrial appendage when the latter is not feasible.

Blood Vessel Prosthesis↗
PubMed1984

Bronchial carcinoid tumors.

Forty-six patients with bronchial carcinoid tumors were operated on over a 37-year period. The results were reviewed with special reference to presenting complaint, histological diagnosis, location of the tumor, lymphatic involvement, and type of surgical resection. Age at operation ranged from 9 to 86 years (mean, 43.6 years). Presenting symptoms were hemoptysis in 21 instances, chronic cough in 17, and pneumonia in 15. The primary tumor was within the main bronchus in 17 patients. Twenty-one patients required pneumonectomy, and 20 had lobectomy or bilobectomy . Nine of the patients under-going pneumonectomy had severely damaged lung tissue distal to the lesion in the main bronchus. Six patients had metastases to hilar nodes. Four patients died of carcinoid tumor, but none with metastases died of carcinoid tumor. This series confirms the low malignancy potential of bronchial carcinoid tumors, even in the presence of lymphatic involvement. Although conservative resection is an attractive surgical option, only 10 of the 46 (22%) were potential candidates for such intervention. Standard surgical resection resulted in "cure" in 90% of the patients in the series.

Adenoma↗
PubMed1984

Monoclonal antibodies to serotype 2 and serotype 15 outer membrane proteins of Neisseria meningitidis and their use in serotyping.

A series of murine monoclonal antibodies to serotype 2 and serotype 15 strains of Neisseria meningitidis were produced which were specific for outer membrane proteins of classes 1, 2, 3, and 5. A panel of eight monoclonal antibodies that exhibited a high degree of serotype specificity when reacted with prototype strains of known serotype were selected for study. Each of the corresponding epitopes was localized on a specific outer membrane protein by means of immunoprecipitation, electroblotting, or both. The serotype 2a-, 2b-, and 2c-specific antibodies bound to the class 2 protein, the serotype 15-specific antibody bound to the class 3 protein, two antibodies (3-1-P1.2 and 3-1-P1.16) bound to class 1 proteins, and two antibodies (1-1-P5.1 and 3-1-P5.2) bound to class 5 proteins. Six of these monoclonal antibodies were used in a spot-blot procedure to survey 122 case isolates (groups B, C, Y, and W135) and 363 carrier isolates (all serogroups) for the presence of the 2a, 2b, 2c, 15, P1.2, and P1.16 epitopes. A total of 66% of the case isolates and 30% of the carrier isolates reacted with one or more of the monoclonal antibodies. The use of monoclonal antibodies for serotyping of meningococci appears to be feasible and easy and appears to have significant advantages over the use of polyclonal typing sera.

Antibodies, Bacterial↗
PubMed1984

Five years experience of breast augmentation using silicone gel prostheses with emphasis on capsule shrinkage.

The results of a five-year retrospective study on breast augmentation using silicone gel-filled prostheses are presented. A total of 115 breasts (45%) out of 254 developed capsules of type II-IV. The incidence in the hypoplasia group was 46%. The capsules were treated with closed and/or open capsulotomy. Biopsies showed fibrous capsules containing alcianophilic droplets, suggesting the presence of silicone in the tissue. The authors find the above incidences to be unacceptably high, and as the treatment is costly, we advocate a more restrictive approach towards operations for mammary hypoplasia.

Adolescent↗
PubMed1984

The intestine of ferret--a possible site of influenza virus replication.

Anal virus shedding and stimulation of the immune response were observed in ferrets after oral and rectal administration of influenza A/Hongkong/1/68 (H3N2) virus. Despite of the low pH in the stomach, the virus had reached the intestines after oral administration and was found in high concentration in faeces and in mucosal cells lining the colon. Using immunofluorescent staining, the virus antigen was detected in cytoplasm of columnar epithelial cells. Virus replication also occurred in the respiratory tract, probably as result of inhalation of anally shedded virus. However, the virus replication in the lungs did not seem essential for virus isolation from the intestines. Taking into account the very short food passage time in ferrets the results could indicate the replication of influenza A/Hongkong/1/68 virus in the digestive tract of ferrets.

Administration, Oral↗
PubMed1984

Coarctation of the aorta in infants.

Repair of coarctation of the aorta in the first year of life by resection and end-to-end anastomosis has been reported to have a high rate of recurrence, and recent studies favor angioplasty techniques. Forty-seven consecutive infants less than 1 year of age who were operated upon over a 20 year period were analyzed. The hospital mortality was analyzed in three groups: Group I--two of 11 patients (18%) with coarctation; Group II--one of nine patients (11%) with coarctation and ventricular septal defect; Group III--12 of 27 patients (44%) with coarctation and major intracardiac anomalies. There was no difference in age or body surface area between survivors and nonsurvivors. Repair was performed by a resection and end-to-end anastomosis to the distal aortic arch in 43 and by patch angioplasty in four. Anastomosis was performed with 5-0 silk suture prior to 1972. Since then, 7-0 polypropylene suture has generally been used. Arm/leg pressure gradient was assessed at rest by the Doppler technique in 31 long-term survivors of the end-to-end anastomosis technique; 24 of them had polypropylene suture used and seven had silk suture. Recurrence of coarctation was defined as arm/leg gradient greater than or equal to 20 mm Hg. Actuarial freedom from recurrence at 5 and 10 years was 91% in the polypropylene group versus 57% and 44% in the silk group. Good long-term results with low incidence of recurrent coarctation achieved by end-to-end anastomosis with fine polypropylene suture justify continued use of this technique in preference to angioplasty techniques, which sacrifice the left subclavian artery or introduce prosthetic materials. Techniques chosen for coarctation repair should be compared with current operative techniques and not older studies.

Age Factors↗
PubMed1982

Anastomotic false aneurysms: a comparison of braided Dacron and polypropylene sutures.

False aneurysms continue to be a problem in vascular surgery and recently polypropylene suture has been incriminated as a major cause. In the last five years, 950 aortofemoral-popliteal reconstructive procedures were performed at our institution. Of these cases, there were 23 patients with anastomotic false aneurysms. We have reviewed this experience with special focus on suture material. In the 23 cases reviewed, there were a total of 29 false aneurysms. The average time interval from operation to clinical presentation of the false aneurysm was five years. Eighty per cent of the aneurysms were at the femoral site. The anastomoses were all end-to-side, and in 93 per cent the graft material was Dacron. The suture material that was used was divided equally between dacron and polypropylene. Aneurysms were blamed on broken suture in only one instance (silk). In 24 aneurysms where the graft had pulled away from the artery, the suture (10 polypropylene, nine Dacron, and two unknown) was noted to be intact. The suture line was not mentioned in one polypropylene and three Dacron related aneurysms. Retrospective review of these 29 false aneurysms leads us to the conclusion that there is no difference between polypropylene and braided Dacron as a factor in the formation of anastomotic false aneurysms in the period studied.

Aged↗
PubMed1982

Results of pulmonary resection for metastatic lesions.

We reviewed the role pulmonary resection for metastatic pulmonary lesions in our institution. Over a 22 year period, 142 patients underwent 153 thoracotomies. The operative mortality was 0.7%. Complete follow-up was obtained on 140 hospital survivors (99.3%). The actuarial 5 year survival rate for carcinoma was 24% (70% confidence limit 0% to 52%) and for sarcoma was 29% (70% confidence limit 0% to 61%). The survival rate to the end of the follow-up for patients with short disease-free intervals (less than 3 months) was 30%; with free intervals of 3 to 30 months, the survival rate was 27%; with long intervals (greater than 30 months), it was 24% (p = 0.8). Six of 29 lobectomy or pneumonectomy specimens has secondary metastases in the regional nodes, but actuarial 5 year survival rates following lobectomy, pneumonectomy, or segmental or wedge excision were not statistically different. Long-term follow-up revealed an overall survival rate of 26%, which was not influenced by tumor histology, disease-free interval, or extent of pulmonary excision. In view of these findings, we continue to advocate conservative excision of pulmonary metastases when the primary tumor is controlled and other organ systems are not involved, regardless of the tumor histology or the disease-free interval.

Adolescent↗
PubMed1982

[Male genitourinary ultrasound studies (MGUUS) (author's transl)].

The authors report their experience of male genitourinary ultrasound studies of the anterior pelvis over a period of 4 years and involving almost 500 patients. The authors first used a classical ultrasound apparatus in real-time via an anterior abdominal approach. They now have an Aloka mode B apparatus in real-time which by use of three approaches (anterior abdominal, rectal and urethral) offers the possibility of analysis of the male anterior pelvis with four planes of section: 1 sagittal and 3 transverse. Thus MGUUS provides 12 views of the male pelvis. The authors define the techniques used in the light of their experience with this apparatus. They then describe the normal ultrasound anatomy of the male anterior pelvis. Finally, they present their results in pathology with this technique. These results have been obtained in benign and malignant prostatic pathology, everyday routine, longitudinal analyses before and after treatment: surgery, radiotherapy and medical. The results are promising in more recent indications: tumours of the bladder, endocrine andrology, pathology of fertility and in the investigation of the pathological scrotum. Implantation of MGUUS at the centre of technical approaches in urology is felt by the authors to be a necessity, making possible the rational and economic use of the apparatus for both in- and out-patients and the cost of an ultrasound apparatus for every hospital department of urology would appear to be reasonable.

Genital Diseases, Male↗
PubMed1982

Aortofemoral bypass grafting: Microvel.

One hundred seventy-five patients underwent elective aortofemoral bypass during the years from 1976 to 1979. One hundred eighteen of these patients received a knitted double velour prosthesis (Microvel) and the remainder received standard knitted Dacron. All patients had been followed for a minimum of 12 months. Early graft thrombosis occurred in three limbs, and these were restored by reoperation for 100 per cent patency at discharge from the hospital. The operative mortality was three patients (1.7%). Complications included myocardial infarction (three/one death), renal failure (one/one death), respiratory failure (one/one death), cerebrovascular accident (four), and superficial wound infection (five). Late complications were infrequent, but included seven graft limb occlusions in six patients (3.4%), and one graft infection, one ureteral obstruction, and one false aneurysm. Among the 256 symptomatic extremities, claudication was completely relieved in 199 (78%) and substantially improved in an additional 48 (18.5%). Hemodynamic assessment with arm/ankle or arm/high thigh indices improved in parallel with symptomatic relief. Thus, only nine (3.5%) symptomatic extremities failed to improve with the proximal reconstruction, requiring distal reconstruction or amputation. The authors remain advocates of aortofemoral grafting with end-to-end proximal anastomosis and hooding of the distal anastomosis over the profunda origin for most aortoiliac occlusive diseases. Our recent experience with double velour graft and this technique have been very satisfactory.

Adult↗
PubMed1982

Thrombosis of the Björk-Shiley prosthesis: illustrative cases and review of the literature.

Thrombosis of the Björk-Shiley prosthetic cardiac valve may occur in any valve position and regardless of anticoagulant status. Four illustrative cases are presented to demonstrate management problems. Review of cases reported in the literature suggests the minimal incidence of thrombosis of Björk-Shiley prostheses is about 2% in the aortic position and about 4% in the mitral position. Prevention of this complication appears to require continuous systemic anticoagulation with warfarin; even temporary interruption or alteration of anticoagulant regimen may be detrimental. Although changes in anticoagulation may rarely precipitate sudden thrombosis, in most cases a period averaging 10 months is required for pannus of organized thrombus to build up enough to cause acute thrombosis and malfunction of the valve. Operation to remove thrombus or replace the prosthesis is usually required for left-sided cardiac prostheses, but thrombosed valves in the tricuspid position may be successfully treated with fibrinolytic medical therapy.

Adult↗
PubMed1981

Scalene node biopsy in advanced carcinoma of the cervix uteri.

To determine the incidence of scalene node metastasis from carcinoma of the cervix uteri, all patients with advanced carcinoma of the cervix who underwent scalene node biopsy as part of a pretreatment evaluation at the University of Iowa Hospitals and Clinics have been reviewed. In 40 patients, left scalene node biopsy was indicated because of (1) metastatic para-aortic nodes (25); (2) palpable scalene nodes (2); and (3) other evidence of metastasis or unresectability. Of the 25 patients with metastasis to para-aortic nodes, seven (28%) had metastasis to the scalene node. None of these was palpable preoperatively. Because scalene node involvement indicates that the disease is beyond the scope of both surgical and radiation treatment, routine scalene node biopsy is recommended in those patients with para-aortic node metastasis.

Adult↗
PubMed1981

Ligation of patent ductus arteriosus in premature infants.

In the operating room, 66 preterm infants weighing between 710 and 2,700 gm (23 less than 1,000 gm) underwent ligation of a patent ductus arteriosus (PDA). Respiratory distress syndrome was present in 53 patients; the rest had apnea-bradycardia syndrome. PDA ligation was indicated for intractable congestive heart failure in 52 patients or progressive respiratory failure in 14. There were no intraoperative deaths. Fifteen infants died 1 to 120 days postoperatively. Seven deaths resulted from intracranial bleeding, 3 from diffuse coagulopathy, and 1 from respiratory failure. The condition of patients with heart failure improved postoperatively, with the mean left atrium to aorta ratio reduced from 1.56 to 1.02 (p = 0.05). Respiratory function improved in 25 patients extubated by the third postoperative day. Late follow-up (one to five years) of the 51 survivors showed 1 late death. Seventeen survivors had roentgenographic evidence of bronchopulmonary dysplasia. Infants with bronchopulmonary dysplasia required longer postoperative ventilation (mean, 21.5 days compared with 4.75 days). Twenty-four infants were normal. Ligation of PDA in preterm infants has low intraoperative risk and improves the condition of those with heart and respiratory failure. Late follow-up showed good recovery of nearly two-thirds of the patients.

Child, Preschool↗