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Biomedical subjects

B Eiseman

Publications and source records attributed to B Eiseman.

At least 55 records · Page 3Linked to original sources
PubMed1978

Evaluation of technetium scanning for myocardial contusion.

Myocardial contusion is a serious problem not easily diagnosed. Laboratory and clinical studies carried out on myocardial infarction suggested that Technetium scanning might clarify this diagnostic dilemma. Radionuclide imaging with Technetium was carried out in 29 patients suspected of having myocardial contusion. Of 13 patients in whom contusion was confirmed electrocardiographically, scan was positive in only two. Use of the technique in diagnosis of myocardial contusion is not recommended.

Adolescent↗
PubMed1978

The continuing challenge of duodenal injuries.

Thirty-four cases of duodenal trauma, 23 caused by gunshot wounds, are reviewed. All but three patients had associated major organ injuries, a total of 97 injuries. Postoperative mortality was 14% for injuries into the duodenal lumen. Techniques for operative repair included simple primary closure, use of omental or serosal patches, controlled fistula with a duodenostomy tube, decompressive and feeding ostomies, "diverticulization", segmental duodenal resection and anastomosis, and total duodenectomy and pancreatectomy. It is emphasized that the surgeon finding duodenal injury must be familiar with all of these techniques, each of which has its indications. Treatment of duodenal injuries perhaps more than any other bowel trauma must be individualized.

Adult↗
PubMed1977

Surfing injuries At waikiki.

A 56-month survey of 36 hospitalized patients injured while surfing off Oahu, Hawaii, indicated that 34% of the injuries involved the head and spine. Bodysurfing involves a considerable risk of craniospinal injury if the head is driven into the sand. The most frequent injury in surfboarding is being hit by a loose board. Risk of injury in surfboarding is approximately one per 17,500 surfing days--an incidence far below most sports.

Athletic Injuries↗
PubMed1977

Clinical indications and accuracy of gray scale ultrasonography in the patient with suspected biliary tract disease.

One hundred patients with suspected biliary tract disease underwent gray scale cholecystosonography (GSCS) and had diagnostic confirmation by oral cholecystogram (OCG) and/or operation. Ultrasonography demonstrated the gallbladder in 94 of the 100 patients; 2 patients had had previous cholecystectomy and 3 of the 4 remaining patients had documented stones with no confirmation of a nonvisualizing OCG in the other patient. Among the 88 patients with OCG, GSCS findings correlated in 91 per cent (2 per cent false-positive; 7 per cent false-negative). Among the 43 operative patients, GSCS was proven correct in 91 per cent (no false positive; 9 per cent false-negative). Of 12 patients with jaundice GSCS correlated with operative findings in 75 per cent (no false-positive; 25 per cent false-negative). Diagnostic errors occurred in patients with very small biliary calculi, particularly when a single stone was impacted in the cystic duct. Failure to identify the gallbladder with ultrasound signifies probable cholelithiasis in the patient without previous cholecystectomy. On the basis of this experience, we conclude that (1) GSCS is most useful when jaundice or acute illness precludes conventional studies; (2) GSCS provides an inexpensive, quick, accurate means of diagnosing cholelithiasis with a very high specificity (97 per cent) and moderate sensitivity (88 per cent); and (3) GSCS is the optimal diagnostic procedure for evaluating the biliary tract in the acutely ill, jaundiced, vomiting, allergic, and/or pregnant patient.

Biliary Tract Diseases↗
PubMed1977

Pedestrian injuries near disabled vehicles.

Six cases of pedestrians injured near disabled vehicles and treated at Denver General Hospital are reviewed, with special attention paid to their cause. All occurred next to disabled or stopped vehicles. The serious injuries sustained could be avoided with public education.

Accidents, Traffic↗
PubMed1977

[New methods of managing massive upper gastrointestinal bleedings (author's transl)].

A four year experience in the management of 585 patients with massive upper gastrointestinal tract bleeding (U. G. I. B.)has been reviewed. The effect of routine fiberoptic gastroscopy, selective angiography, and selective pitressin arterial infusion has been analyzed as it effects the more accurate diagnosis and better non-operative therapy of these dangerously ill patients. Duodenal and gastric ulcer, which comprise one-half of such patients, are best treated by early operation. Mallory-Weiss-syndrome is more frequent than previously appreciated. Pitressin infusion is worthy of trial in diffuse gastritis, varicose- and stress ulcer bleeding. Stress bleeding is usually one manifestation of multiple organ failure due to bacterial sepsis.

Duodenal Neoplasms↗
PubMed1977

Multiple organ failure.

Forty-two postoperative patients, each with demonstrable failure of two or more vital organ systems, have been studied as they define a syndrome of multiple organ failure. They typify the emerging clinical entity of patients kept alive solely by reason of specific mechanical and pharmacologic support. Trauma initiated hospitalization in 40 per cent and major bleeding, in 11 per cent. Sepsis was judged to be of etiologic significance in 69 per cent. Complications in clinical management were, in retrospect, thought to be of contributory etiologic significance in 57 per cent. Twenty-nine of 42 patients died; a mortality of 69 per cent. Mean duration of multiple organ failure was 30.5 days. Hospital cost, omitting the physician's fees, was conservatively estimated at $700 per day. Scientific, social, moral, ethical and legal factors emphasize the need to establish a statistically valid large data base concerning this new man-made syndrome which has both important scientific and social implications. This study is a first step in this direction.

Abdomen, Acute↗
PubMed1977

Erythrocytes cultured from bone marrow.

The long-range objective of this study is in vitro tissue culture of bone marrow stem cells to produce erythroid cells of sufficient volume for clinical transfusion. Bone marrow from dogs and patients was cultured in 29 experiments lasting up to 15 weeks. Peripheral erythroid cells from dogs were cultured in three control experiments. Optimal tissue culture media was NCTC 109 augmented with vitamin B12, erythropoietin (EP), folic acid, and 9% fetal protein in 60 mm glass Petri dishes. Additional media and Step III EP was added at 2 to 4 day intervals. Peripheral erythroid cells in culture all were dead within 4 weeks. Marrow erythroic cells in culture proliferated as demonstrated by (1) Fe59 incorporation into cells during culture, (2) H3 thymidine uptake into cultured cells, (3) microscopic evidence of mitoses, and (4) total erythrocyte concentration in cultures far exceeding that of peripheral culture controls. For as yet unexplained reasons the total mature red blood cell concentration in the culture media remained essentially constant throughout the studies. This is a first step in achieving the ultimate goal of bulk erythrocyte production from tissue culture.

Animals↗
PubMed1977

Hepatic support with hepatocyte suspensions in a permeable membrane dialyzer.

Hepatic support by whole liver, liver slice, or hepatocyte perfusion is unsatisfactory. A new concept of support with circulating hepatocytes on one side of a cuprophan membrane and blood from an anhepatic pig on the other was evaluated in 19 dialysis experiments. Levels of pyruvate metabolism and oxygen utilization were similar to those obtained when liver cells in a centrifuge are perfused with oxygenated plasma. Of six anhepatic pigs given late hepatic support, five showed neurologic improvement. One had concomitant improvement in electroencephalographic results. A membrane hemodiolysis unit in which hepatocytes circulate against blood from an anhepatic animal is the most suitable extracorporeal liver support unit described so far. Its simplicity allows repeated and prolonged use.

Animals↗
PubMed1976

The continuing challenge of acute and perforated appendicitis.

A two year review of 216 patients with a preoperative diagnosis of appendicitis is used to help clarify the continuing points of controversy concerning appendicitis. Morbidity of perforated appendicitis by far exceeds that of nonperforated cases. Twenty-nine per cent of patients had perforation with a postoperative complication rate of 33 per cent. Rate of wound infection after perforation was 15 per cent despite antibiotics and delayed wound closure. Pediatric patients in this study did not experience a higher incidence of perforation or complication. A decision tree for management of acute appendicitis is presented.

Abscess↗