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Biomedical subjects

B F Rush

Publications and source records attributed to B F Rush.

At least 91 records · Page 5Linked to original sources

A comparative study of breast cancer in the black and white populations of two inner-city hospitals.

A comparative study of breast cancer was made among black and white populations admitted to two inner-city hospitals from 1971 through 1976, inclusive. There were 306 patients in the study group of which 162 were black and 144 were white. Age, sex, color, duration of illness, different quadrants of breast involved, staging of cancer, histological diagnosis, treatment given, and incidence of recurrence were studied in each group. A statistically higher incidence of cancer of the breast was found among the black patients in the groups aged 30--50 years and 70--80 years, as compared to the white population. All other parametes studied showed no statistical differences.

Adolescent↗

The hemodynamic effects of prostaglandin E1 (PGE1) in acute hypoxic respiratory failure.

The hemodynamic effect of prostaglandin E1 (PGE1) on acute respiratory failure is investigated. Eight adult mongrel dogs were subjected to oleic acid-induced acute respiratory failure. Four dogs received PGE1 intravenously one hour after oleic acid injection, and four received an equal volume of saline. Cardiac output, arterial PO2 and alveolar-arterial oxygen difference decreased significantly in the saline-treated animals, and systemic vascular resistance increased. These parameters were maintained in the PGE1 group, and stroke volume and arterial-venous oxygen difference were improved. Pulmonary vascular resistance increased in both groups. This beneficial effect of PGE1 in acute respiratory failure may be related to maintenance of hemodynamics and pulmonary gas exchange and to improved tissue oxygenation.

Acute Disease↗

Construction of a neolarynx after radiation and laryngectomy.

We have developed a technique for forming a new larynx from a cervical "bucket handle" flap to replace the larynx after laryngectomy in patients who have had radiation of the neck. Experience with the technique in six patients suggests that it is more successful than previous procedures used in such patients and may offer some advantages as a general technique of laryngeal construction. The procedure is designed to preserve speech and swallowing without aspiration, but translaryngeal breathing is sacrificed and respiration requires a permanent tracheostomy tube.

Humans↗

Comparison of corticosteroids and prostaglandins in treatment of hemorrhagic shock.

The hemodynamic and microcirculatory effects of prostaglandin E1 and methylprednisolone sodium succinate were compared in a standard canine shock model. Prostaglandin significantly increased cardiac output and decreased total peripheral resistance when compared to control animals while steroids did not. There was no significant effect upon heart rate or arterial pressure by either drug. Methylprednisolone sodium succinate significantly increased arterial pH at the conclusion of the experiment and showed directional improvement in venous lactate and proteolytic activity. Prostaglandin significantly increased length of survival compared to both steroid and control infusion. It is concluded that prostaglandin and steroid have different hemodynamic effects in shock, that steroid protects microcirculatory flow more efficiently and that the prolongation of survival seen with prostaglandin infusion is not entirely due to its hemodynamic or lysosomal stabilizing effects.

Animals↗

Traumatic hematocele of the gallbladder with hemobilia.

An unusual case of traumatic hemobilia in which blood reached the bile duct through transhepatic penetration of the gallbladder is reported. The salient features of this variant of traumatic hemobilia are described: antecedent subcapsular liver injury; variant time interval to GI hemorrhage and episodic hemorrhage; and necrosis or hematoma at the bleeding site.

Adult↗

The effect of hemorrhagic shock on plasma amino acids and tissue energy substrates in the primate.

Levels of plasma amino acids and muscle concentrations of energy substrates and metabolites after shock in the Macaca mulatta Rhesus monkey were investigated. The hemodynamic response to shock is similar to that of previously reported studies of primates in shock. Plasma glucose and ASAT increased significantly, while levels of ALAT and pyruvic acid did not change. Lactic acid was elevated. Muscle glycogen and concentrations of lactic acid were increased, and levels of pyruvic acid, creatine phosphate, and malate fell during shock. Levels of ATP in muscle were unchanged. Nine of the 23 arterial plasma amino acids analyzed decreased significantly. Aspartic acid was increased during shock. The increased levels of tissue carbohydrates and decreased concentrations of plasma amino acids observed in this study differ from results previously reported for other animal shock models. Changes in amino acid levels are similar to the results of some clinical studies.

Adenosine Triphosphate↗

Glucagon treatment of hemorrhagic shock: improved survival and metabolic parameters in a murine shock model.

One hundred-twenty Sprague-Dawley rats were shocked at 60 torr for 60 minutes and at the end of this period shed blood was reinfused. The animals were divided into three groups at random. These groups were either treated by N saline or glucose in N saline or glucagon in N saline. Glucagon treatment resulted in increased liver and muscle glucose-glycogen stores in the late period following shock. This was associated with a decrease in liver pyruvate and lactate and improved survival. It appears that glucagon more favorably affects the response to shock in this model than does treatment with glucose or saline.

Animals↗

Effect of prostaglandin E1 and steroid combination in the treatment of hemorrhagic shock.

Prostaglandin E1 and methylprednisolone sodium succinate were administered simultaneously after shock in an intact canine hemorrhagic shock model and compared to treatment with each agent singly and with a 60 cc saline infusion. A detrimental effect of the prostaglandin E1/steroid combination was evidenced by decreased heart rate, mean arterial and central venous pressures, cardiac output, and arterial pH, and increased venous lactate. Survival was poor after the combined regimen. These changes may be related to vasodilation in the peripheral vascular system, causing pooling of blood. Lysosomal membranes were stabilized in spite of prolonged hypoperfusion.

Animals↗

Pyogenic liver abscess.

A review of 20 cases of pyogenic liver abscesses seen from 1971 through 1976 is presented. In this five-year interval, no amebic liver abscesses were found. The primary inflammatory processes were evenly divided among those patients with biliary, urinary, and intraperitoneal disease. Intensive antibiotic therapy was less efficient in sterilizing the abscess than the blood stream. The nebulous histories, clinical findings, and routine laboratory studies emphasize the difficulty in establishing an early diagnosis of liver abscess. Radioisotopic scanning of the liver proved to be the most reliable tool not only for the diagnosis but also for monitoring the postoperative course of the drained cavities. The overall mortality of pyogenic liver abscesses was 45% and the greatest mortality occurred in those patients over 40. Closed needle aspiration of pyogenic liver abscess in the elderly poor-risk patient in conjunction with the appropriate antibiotics may offer an acceptable alternative.

Adolescent↗

Changing attitudes in the management of cancer of the breast.

Opportunity to assess changes in the management of cancer of the breast over the past 7 years was afforded by analysis of responses to questionnaires that were part of an annual questionnaire course. Comparison of responses to questionnaires conducted in 1971 and 1977 identified important features of approaches to this disease and indicated the way in which changes have occurred. Diagnostic needle aspiration increased from 24% (1971) to 54% (1977). In both surveys surgeons reported employing mammography infrequently. Use of modified radical mastectomy increased from 15% (1971) to 60% (1977). Employment of classical radical mastectomy decreased from 83% (1971) to 37% (1977). Surgeons considering biopsy of the contralateral breast to be unnecessary decreased from 47% (1971) to 14% (1977). Skin grafting, after a mastectomy, decreased from 40% (1971) to 24% (1977). Though oophorectomy is still the preferred initial treatment for premenopausal patients with advanced disease, preference for chemotherapy in postmenopausal patients increased from 5% (1971) to 23% (1977). Surgeons approving of reconstruction with implants after mastectomy for carcinoma increased from 30% (1971) to 49% (1977). Following mastectomy in patients with positive axillary nodes, 58% of our respondents employ chemotherapy with several drugs and 34% prefer irradiation.

Breast Neoplasms↗

Assessment of student experiences in technical procedures in surgical clerkship.

To determine the amount of exposure to technical procedures received by students at the New Jersey Medical School, Newark, NJ, during their first surgical clerkship, a prospective study was carried out over a 3-year period. Students completing each 12-week clerkship filled in a questionnaire to indicate whether they had received exposure to a series of technical procedures. The study showed that students received relatively little experience in some important, though less commonly employed, techniques. It is therefore recommended that: (a) the instruction in technical procedures be carried out on a planned basis; (b) performance of some routine laboratory tests by students be curtailed to permit more time for technical experience in other areas; and (c) the dog laboratory be utilized for the teaching and practice of surgical procedures.

Diagnostic Techniques, Surgical↗