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Biomedical subjects

E Barker

Publications and source records attributed to E Barker.

88 records · Page 5Linked to original sources
PubMed1982

Left-sided portal hypertension from pancreatic pseudotumor.

Involvement of the splenic venous outflow tract by pancreatic disease can cause localized splenic venous hypertension and esophageal varices. Resolution of this problem resides in splenectomy and distal pancreatectomy or perhaps splenectomy alone. Although this phenomenon most commonly arises from thrombosis of the splenic vein by adjacent pancreatitis, we report a case arising from nonocclusive obstruction of the splenic vein by an adjacent pancreatic pseudotumor.

Adult↗
PubMed1980

High prevalence of cervical dysplasia in STD clinic patients warrants routine cytologic screening.

The results of routine cervical cytology screening at a Planned Parenthood Center (PPC) clinic were compared to those at a nearby sexually transmitted diseases (STD) clinic in Seattle. Cervical cytologic findings were consistent with cervical intraepithelial neoplasia (CIN), grades 1 (mild dysplasia), 2 (moderate dysplasia), or 3 (severe dysplasia to carcinoma in situ) in 502 (5.9 per cent) of 8,504 PPC patients and 87 (11.4 per cent) of 764 STD patients (p = .001). This rate for STD patients is five times that reported for the general population. Sixty-three PPC patients and 31 STD patients with screening smears consistent with CIN 1 or 2 underwent further prospective study by us, including repeated cytologic and colposcopic examinations. Thirty-seven (59 per cent) of 63 PPC patients and 26 (84 per cent) of 31 STD patients (p = .02) had at least on additional smear or colposcopy consistent with CIN and were advised to undergo cervical biopsy. Among those who underwent recommended biopsy, CIN was confirmed histologically in 15 (50 per cent) of 30 PPC patients and 11 (61 per cent) of 18 STD patients. Thus, the proportion of patients who had screening cytologic findings consistent with CIN, the proportion with persistent cytologic or colposcopic findings consistent with CIN on retesting, and the proportion of those biopsied who had histologically confirmed CIN, all were higher for STD than for PPC patients. There is a serious need for cytologic screening in STD clinics throughout the nation.

Adolescent↗
PubMed1975

Effect of suture materials on healing skin wounds.

A systematic comparison has been made of six suture materials used as subcuticular closure of abdominal incisions in dogs. The effect on wound healing was measured by mechanical, biochemical, and histologic methods. No difference was demonstrated in wound breading strength among wounds closed with different suture materials up to 28 days postoperatively. At 70 days, wounds sutured with nonabsorbable sutures were weaker than those closed with absorbable sutures, but this difference probably was due to a much higher incidence of infection in wounds closed with nonabsorbable sutures. It was our observation that monofilament sutures were superior to multifilament sutures with regard to the incidence of wound infection. By five days, the rate of collagen synthesis in wounds was increased over that of normal skin and remained elevated throughout the 120 day observation period. Suture material had no effect on collagen synthesis. The rate of noncollagenous protein synthesis in the wound was not altered throughout the entire observation period and did not differ from that measured in normal skin. Catgut, both plain and chromic, produced only a mild cellular reaction in dogs after 21 days as contrasted with the intense inflammatory reaction reported by others in rats and rabbits. We observed neither plain nor chromic catgut was absorbed rapidly in dogs; intact sutures were frequently observed at 120 days. Polyglactin, a synthetic absorbable suture, produced a moderate tissue reaction and uniformly disappeared between the twenty-eighth and seventieth days. Silk and Mersilene showed the highest rate of wound infection and the most intense and prolonged tissue reaction. Prolene, a monofilament suture, produced only a mild to moderate tissue reaction. These results taken in conjunction with those of other investigators suggest a marked species difference in the reaction to suture materials, particularly catgut, and suggest caution in transferring these observations to human beings.

Animals↗
PubMed1975

The effect of suture materials on healing wounds of the bladder.

The healing pattern of bladder tissue and its response to various suture materials were studied and compared with data reported previously on skin, stomach and colon wounds. Tensile strength, biochemical data and histologic reactions were used as parameters of wound healing measurement. The healing pattern of urinary bladder wounds resembles that observed for stomach and colon. However, wounds of the urinary bladder wall regain strength equal to unwounded bladder wall within 21 days, whereas wounds of stomach and colon do not achieve more than 70 per cent of unwounded tissue strength after 120 days. The rate of collagen synthesis in bladder wounds reaches a peak at five days and returns to that of normal unwounded tissue by 70 days. Colon and stomach wounds, on the other hand, showed elevated rates of collagen synthesis even at 120 days. As with colon and stomach, absorbable sutures appear to lower the strength of both the wound and unwounded tissue. However, in stomach and colon this effect is only observed during the first 21 days of healing; in the bladder it persists throughout the 120 day observation period. No histologic evidence of smooth muscle regeneration was seen in bladder wounds. Noncollagenous protein synthesis was not increased in the wound, also suggesting smooth muscle regeneration does not occur. Silk and Mersilene sutures produced the greatest tissue reaction; if the sutures were exposed in the lumen of the bladder, stone formation was observed. This was not observed with monofilament polypropylene sutures. Plain catgut produced the least tissue reaction, but both plain aions comparable with chromic catgut but were regularly absorbed between 28 and 70 days. Since the bladder is well healed by 21 days, polyglactin-910 may be an ideal suture for use in the bladder.

Absorption↗
PubMed1975

Effect of suture materials on healing wounds of the stomach and colon.

Wound healing in the stomach and colon of mongrel dogs was studied using physical, histologic and chemical techniques to evaluate effects of various suture materials on the healing pattern and to compare visceral wounds with skin wounds. The general pattern of healing for stomach and colon wounds is the same in rats, rabbits and dogs. However, the extent of healing, the percentage of strength of normal tissue attained by the wound, is less in the dog than in the rat or rabbit. Prolene and plain and chromic catgut produce the least and silk produces the greatest cellular reaction in the stomach and colon. We believe the effect of absorbable sutures on strength of stomach and colon wounds, while statistically significant, is not of any great clinical significance except perhaps in severely debilitated patients. A trial of Prolene sutures for anastomotic closure would seem indicated. The healing of stomach and colon wounds differs from the pattern observed for skin wounds. Breaking strength increases rapidly for 14 to 21 days postwounding and then does not change significantly. The wounds are metabolically more active than skin wounds since the rate of collagen synthesis is markedly elevated even after 120 days and the rate of noncollagenous protein synthesis is twice as great in the wound as it is in normal tissue. Colon and stomach wounds closed with absorbable sutures are weaker at 14 through 28 days than similar wounds closed with nonabsorbable sutures. Yet, when strength of wound is expressed as a percentage of strength of unwounded tissue, there is no difference between wounds blosed with absorbable or nonabsorbable sutures. Thus, it would appear that there is a general diminution of the strength of normal stomach and colon wall up to 6 centimeters from wounds which have been closed with absorbable sutures.

Animals↗
PubMed1973

Reactions to tetanus toxoid.

In a factory population the occurrence of reactions to tetanus toxoid was recorded after 6740 injections. The incidence of general reactions was 0.3% and of local reactions 2.6%. The local reaction rate to the first injection of the basic immunization course was 0.9%, to the second injection 2.7%, and to the third injection 7.4%. To booster injections the rate was 1.6%. The local reaction rate was appreciably higher in women than in men - 14.4% and 5.7% respectively in the case of the third injection - and the incidence among women increased with age.Tetanus vaccine containing 10 Lf of toxoid caused fewer reactions than one containing 20 Lf, but a reduction in the content of aluminium adjuvant did not affect the reaction rate.Almost all reactors were found to have a satisfactory serum antitoxin concentration at the time of the reaction or developed a satisfactory immunity within 1-6 months.Skin tests were made in 32 hypersensitive patients. Neither the diluent, thiomersal preservative, nor the culture medium appeared to be responsible for hypersensitivity. The degree of hypersensitivity elicited by a special highly purified toxoid was only very slightly less than that elicited by the commercially pure toxoid. It is suggested that reactions are largely due to the toxoid antigen itself rather than to impurities or other components of the vaccine.

Adjuvants, Immunologic↗