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Biomedical subjects

D E Fry

Publications and source records attributed to D E Fry.

At least 163 records · Page 9Linked to original sources
PubMed1981

A prospective study of carotid endarterectomy with and without shunt.

The extent of cerebral protection necessary during carotid endarterectomy for ischemia is controversial. In 147 carotid endarterectomies, carotid backflow was estimated and, in later years, these clinical impressions were correlated with stump pressure. These estimates or values, modified particularly in early years by the extent of contralateral disease and (inversely) of ipsilateral occlusion, were used to determine the need for a shunt at the time of carotid clamping. Only 32 shunts were used, 12 because of poor back bleeding and 20 because of stump pressure below 50 mmHg. The patients who received shunts had no mortality or neurologic deficits. In 30 patients excluded by adequate stump pressure there was only a single minor and temporary monoparesis. In 85 patients excluded by apparently good back bleeding, there were two deaths (one due to stroke), a permanent 10 per cent neurologic deficit, and two postoperative thromboses salvageable by reoperation. Routine shunting would probably have prevented only the temporary monoparesis and the 10 per cent neurologic deficit. Meticulous technique and selective use of a shunt should give satisfactory results.

Adult↗
PubMed1980

Multiple system organ failure. The role of uncontrolled infection.

Multiple system organ failure (MSOF) remains a principal cause of death after major operative procedures and/or severe trauma. We studied multiple parameters in 553 consecutive emergency surgical patients to determine the incidence of MSOF, the predisposing factors to MSOF, and the sequelae of MSOF. Thirty-eight patients had MSOF; mortality was 74% for these patients. Evaluation of multiple factors demonstrated that (1) MSOF is primarily due to infection, (2) the temporal sequence of organ failure is lung, liver, gastric mucosa, and kidney, and (3) MSOF is the most common fatal expression of uncontrolled infection.

Acute Kidney Injury↗
PubMed1980

Breast carcinoma in the elderly patient: an assessment of operative risk, morbidity and mortality.

Of 711 patients with histologically proven carcinoma of the breast, 94 patients aged 65 years or older were treated primarily by operation. The long-term survival was comparable to that in the general population with breast cancer despite a high percentage of noncancer death from intercurrent disease. Surgical therapy appropriate for the stage of disease can be performed with acceptable morbidity and mortality. Elderly patients often present with advanced disease but should not be denied the benefits of surgical palliation strictly on the basis of age.

Aged↗
PubMed1980

Radical peritoneal debridement for established peritonitis. The results of a prospective randomized clinical trial.

A randomized, prospective comparison of radical peritoneal debridement and standard surgical management of peritonitis disclosed no differences in terms of hospital mortality for the frequency of reoperation for abscess. Adjunctive measures such as antibiotic therapy and peritoneal irrigation were identical between the groups. The groups were demographically and clinically similar but had a much lower incidence of intestinal obstruction than in the patients originally reported by Hudspeth.

Bacterial Infections↗
PubMed1980

Clinical considerations in unusual colonic obstructions.

Colonic obstructions of uncommon cause may present challenging diagnostic problems that require prompt and correct treatment. Fifty such patients were studied and illustrate the problems that may be encountered. Clinical observations of importance include the need to distinguish a prostatic cancer obstructing the rectum, the mimicking of inoperable cancer by various benign processes, the need to decompress an enlarging cecum even in paralytic ileus, and the occasional inadequacy of sigmoidectomy as the elective treatment of sigmoid volvulus.

Adenocarcinoma↗
PubMed1980

Pseudoaneurysms and related complications of aortic bypass grafts.

During a recent five-year period 14 patients had pseudoaneurysms as late complications of aortic bifurcation grafts. Severe atherosclerosis had been present at the time of the aortic grafts, and subsequent progression of arterial disease appeared to be the usual cause of the pseudoaneurysms which occurred from two to 14 years later. Nineteen of the 23 pseudoaneurysms in the 14 patients were in the groin. Excision and interposition graft usually worked well. Eleven patients had early benefit. Two early failures were due to infection. The long-term results correlated with success in obtaining adequate arterial outflow. Rupture of pseudoaneurysms, concomitant thrombosis, other complications, and diagnostic errors also caused operative problems and influenced results.

Adult↗
PubMed1980

Populations of infectious virus produced during avian adenovirus-associated virus infection.

Multiple rounds of infection in vitro or in vivo with avian adenovirus-associated virus (AvA-AV) and avian adenovirus (AvAV) result in production of both heavy (H) and light (L) infectious forms. In this study, the infectious AvA-AV progeny produced at different hours during recombined dual infection of cells with either H or L AvA-AV and AvAV was determined by equilibrium CSCl centrifugation and infectivity assay. In both types of infection, H virions were found early, both intra- and extracellularly, whereas L virions were found late. The data iondicate an H to L particle density shift during infection. Virus-specified cell-dependent factors mediated the process extracellularly, as activity was detected in infected cell-conditioned medium and in lysates of infected cells but not in medium or components of uninfected cells. The shift in density was accompanied by a conversion in particle type. H and L virions differed in size and conformation as evidenced by differences in serological cross-reactivity and physical-chemical stability during heat inactivation, ultrasonic disruption and DNA extraction.

Adenoviridae↗
PubMed1980

Patterns of morbidity and mortality in splenic trauma.

The cases of 337 consecutive patients undergoing splenectomy for trauma have been reviewed. The combination of physical examination and peritoneal lavage is effective and safe in establishing the need for operation. Associated injuries are the major determinants of mortality. Exsanguination, infection, and neurologic injuries are the major causes of death.

Female↗
PubMed1980

Measurement of anticonvulsants in serum by reversed-phase ion-pair liquid chromatography.

We describe a method for the simultaneous liquid-chromatographic determination of ethosuximide, ethylphenacemide, primidone, phenobarbital, carbamazepine, and phenytoin in serum. The drugs, together with an internal standard, are extracted into ethyl acetate at pH 7.0. The extract is analyzed isocratically at ambient temperature on a reversed-phase column of "SAS Hypersil" with a mobile phase of acetonitrile/tetrabutyl ammonium phosphate solution (2/8 by volume). The eluted drugs are detected by their absorption at 200 nm, and quantitated from their peak heights as compared with those of extracted standards. The day-to-day CV of the method varied between 5.1 and 9.6% for concentrations ranging from less than therapeutic to toxic. The results, when compared with those by gas chromatography, gave correlation coefficients of 0.936 for phenytoin, 0.977 for phenobarbital, and 0.939 for primidone. No drug interference was found except that amobarbital and ethylphenacemide co-chromatographed.

Anticonvulsants↗
PubMed1980

The effects of acidosis on canine hepatic and renal oxidative phosphorylation.

The intracellular effects of acidosis remain poorly defined. To examine the effects of acidosis on oxidative phosphorylation, liver biopsies and weight nephrectomies were performed on 10 adult German shepherd dogs. The mitochondria were isolated from each tissue and their respiratory activity was studied by the polarographic technique with the pH of the reaction media varied from 5.5 to 8.0. Glutamate and succinate substrates were employed. Results showed a dramatic reduction in the efficiency of oxygen utilization by mitochondria with glutamate as the reaction medium became more acidic. The efficiency of succinate oxidation was significantly (P less than 0.01) preserved. These findings were confirmed by both the respiratory control indices and by ADP:O ratios. Acidosis appears to result in severe inhibition of NAD-linked energy substrate oxidation.

Acidosis↗
PubMed1980

Determinants of death in patients with intraabdominal abscess.

To better define determinants of death in patients with intraabdominal abscess, 143 patients from a 5-year hospital experience were reviewed. Abscesses were most commonly results of trauma, spontaneous gastrointestinal perforations, and technical errors. Clinical presentation of abscess was quite variable as were criteria to justify reoperation for drainage. Abscesses occurred most commonly in the subphrenic space, pelvis, or subhepatic space. Complete abdominal exploration was employed most frequently for drainage. Those factors that were associated with a fatal outcome were: organ failure (P < 0.001), lesser sac abscess (P < 0.001), positive blood culture (P < 0.01), recurrent and/or persistent abscess (P < 0.01), multiple abscesses (P pE 0.01), age > 50 years (P < 0.03), and subhepatic abscess (P < 0.03). These data suggest that deaths from abdominal abscess are consequences of ineffective surgical drainage and failure of host defense mechanisms.

Abdomen↗
PubMed1979

Recurrence of volvulus after sigmoidectomy.

Three patients had recurrences of left-sided colonic volvulus after allegedly total resections of redundant sigmoid loops. All three patients had chronic, acquired megacolon. Other instances of late recurrence of volvulus after sigmoidectomy are documented in the literature. Sigmoidectomy may be an inadequate operation for sigmoid volvulus in younger patients and/or in patients with severe chronic megacolon. The decision to perform an interval operation and the selection of the type of operation must take this into account.

Colon, Sigmoid↗
PubMed1979

Inhibition and enhancement of avian adenovirus plaque production by heavy and light avian adenovirus-associated viral particles.

The effect of heavy and light avian adenovirus-associated viral (A-AV) particles on the replication of several adenovirus serotypes was studied in chicken embryo kidney cells. There was a significant decrease (P less than 0.05) in the number and size of adenovirus-induced plaques at A-AV multiplicities of infection greater than 40. Enhancement of plaque production was observed when A-AV multiplicities of infection were 1 to 40. There was a significant increase in the number and size of infective centers. Analysis of cellular yields indicated an increase in the number of adenoviruses produced per cell. Heavy A-AV particles of buoyant density 1.42 g/cm3 in CsCl were found to enhance plaque production more than light particles (1.38 g/cm3). Conversely, light particles showed greater inhibition of plaque production. Adenovirus serotypes varied in their response to enhancement or inhibition by A-AV particles of different density.

Adenoviridae↗