Search PubMed⌕ Search

Biomedical subjects

D Grant

Publications and source records attributed to D Grant.

332 records · Page 19Linked to original sources
PubMedDate not supplied

Percutaneous ethanol injection of unresectable medium-to-large-sized hepatomas using a multipronged needle: efficacy and safety.

Fine needles with an end hole or multiple side holes have traditionally been used for percutaneous ethanol injection (PEI) of hepatomas. This study retrospectively evaluates the safety and efficacy of PEI of unresectable medium-to-large (3.5-9 cm) hepatomas using a multipronged needle and with conscious sedation. Twelve patients, eight men and four women (age 51-77 years; mean: 69) received PEI for hepatomas, mostly subcapsular or exophytic in location with average tumor size of 5.6 cm (range: 3.5-9.0 cm). Patients were consciously sedated and an 18G retractable multipronged needle (Quadrafuse needle; Rex Medical, Philadelphia, PA) was used for injection under real-time ultrasound guidance. By varying the length of the prongs and rotating the needle, the alcohol was widely distributed within the tumor. The progress of ablation was monitored by contrast-enhanced ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) after each weekly injection and within a month after the final (third) injection and 3 months thereafter. An average total of 63 mL (range: 20-154 ml) of alcohol was injected per patient in an average of 2.3 sessions. Contrast-enhanced CT, ultrasound, or MRI was used to determine the degree of necrosis. Complete necrosis was noted in eight patients (67%), near-complete necrosis (90-99%) in two (16.7%), and partial success (50-89%) in two (16.7%). Follow-up in the first 9 months showed local recurrence in two patients and new lesions in another. There was no mortality. One patient developed renal failure, liver failure, and localized perforation of the stomach. He responded to medical treatment and surgery was not required for the perforation. One patient had severe postprocedural abdominal pain and fever, and another had transient hyperbilirubinemia; both recovered with conservative treatment. PEI with a multipronged needle is a new, safe, and efficacious method in treating medium-to-large-sized hepatocellular carcinoma under conscious sedation. Its survival benefits require further investigations.

Administration, Cutaneous↗
PubMedDate not supplied

Smooth muscle cells produce an inhibitor of endothelial cell growth.

A potent inhibitor of endothelial cell growth and neovascularization has previously been isolated from both bovine and human aorta. In an attempt to determine if the major cellular component of that tissue, smooth muscle cells, synthesized molecules with this activity, we studied the effects of serum-free conditioned medium from bovine aortic smooth muscle on the growth of cultured endothelial cells from bovine aorta. The smooth muscle conditioned medium was found to contain both growth inhibitory and stimulating activities that could be distinguished by their heat stability. The inhibitor is precipitable by ammonium sulfate, heat stable (80 degrees C), and inactivated by dithiothreitol, trypsin, and 2-mercaptoethanol. It has an estimated molecular weight of approximately 35,000 to 40,000 daltons (by column chromatography). It therefore appears that smooth muscle cells produce an inhibitor of endothelial cell growth that belongs to a class of natural endothelial cell growth inhibitors derived from avascular tissues we tentatively term "avasculins." Proof of its identity with the inhibitor isolated from intact aorta (or other tissues) must await purification.

Animals↗
PubMedDate not supplied

Wound complications after hip surgery using a tapeless compressive support.

PURPOSE: To compare the incidence of wound complications after hip surgery in patients treated with a compressive spica wrap dressing to those using traditional taping methods. DESIGN: Retrospective, descriptive, comparative, intervention study. SAMPLE: 457 hip surgery patients, including primary arthroplasty, revision surgery and fracture with ORIF. METHOD: A compressive wrap dressing was used on hip surgery patients in the study group while tape was used on patients in the control group. A retrospective chart review was conducted noting postoperative wound complications. FINDINGS: There was a significantly lower incidence of blisters and drainage in the study group using a compressive wrap dressing. There was not a higher incidence of DVT or infection using the wrap dressing when compared to published studies. CONCLUSION: Use of a compressive wrap dressing after hip surgery is recommended to reduce the risk of wound complications. IMPLICATIONS FOR NURSING RESEARCH: A prospective, randomized study with multiple surgeons using both compressive wraps and traditional taping techniques would substantiate the advantage of using a hip spica dressing after hip surgery.

Adhesives↗