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Biomedical subjects

E J Harris

Publications and source records attributed to E J Harris.

At least 55 records · Page 3Linked to original sources
PubMed1988

A comparative study of the clinical presentation of tarsal coalitions.

Twenty patients have received the radiographic diagnosis of tarsal coalition. Seven were talocalcaneal (35 per cent), seven were calcaneonavicular (35 per cent), and six were talonavicular (30 per cent). The average age at time of diagnosis was 19.3 years for talocalcaneal coalition, 14.7 years for calcaneonavicular coalition, and 15.2 years for talonavicular coalition. Bilateral involvement was seen in more than half of the talocalcaneal and talonavicular coalitions. Symptoms were more severe in talocalcaneal and calcaneonavicular coalitions. All patients in these two groups had pain. Talonavicular coalitions either were asymptomatic (picked up on radiographs taken for other complaints) or were associated with painful medial navicular masses. In our study, five of the six patients (81 per cent) had this mass. We report a surprisingly high number of talonavicular coalitions for such a small group. In studies based on the investigation of peroneal spastic flatfoot, this form of coalition is not as frequently encountered. This suggests that talonavicular coalitions may be much more common than the literature to date has suggested.

Adolescent↗
PubMed1986

The cell-saver and autologous transfusion: an underutilized resource in vascular surgery.

The vascular surgeon's best resource for blood transfusion is the patient's own blood. It is readily available for recycling, already precisely typed and crossmatched, and without the risk of transfusion-related diseases such as hepatitis and AIDS. The relative ease, safety, and cost-effectiveness of autologous blood transfusions, intraoperative autotransfusions, and postoperative autotransfusions has been shown in our hospital experience with 320 cases and in the literature. We predict that autologous donor blood and autotransfusion will soon be widely accepted and utilized as the best and safest method of blood replacement.

Blood Transfusion, Autologous↗
PubMed1985

Arterial thromboembolism. A 20-year perspective.

Our experience with 739 patients with lower extremity thromboembolism since the advent of the balloon catheter has led us to several important observations: As the etiology has shifted from rheumatic to atherosclerotic, we treat a more complex group of patients, one fourth of whom have severe, preexisting peripheral occlusive disease. Early diagnosis and treatment is essential to decrease the mortality and morbidity, which has ranged about 25% +/- 10%. Anticoagulation must be continued in the postoperative period, accepting wound hematomas as a fair "trade-off" to prevent recurrent embolus and distal thrombosis in areas inaccessible to the catheter. Postoperative use of heparin "buys time" to further assess marginal results of embolectomy allowing arteriography and careful planning of secondary operations to assure not only a viable but a functional limb. There is little mention in the literature to emphasize this approach, which we think is essential for long-term salvage. Early in the series, patients were treated with heparin or embolectomy alone. There were 161 secondary operations in 135 patients following embolectomy consisting of repeated thromboembolectomy, popliteal exploration, sympathectomy, bypass graft(s), angioplasty, and endarterectomy. Additionally, 44 patients had a direct attack correcting the cardiac source of their embolism. Our overall mortality (12%) and limb salvage (95%) shows marked improvement compared with earlier reports. Therefore, we recommend combined embolectomy and heparin as the primary choice of therapy.

Adult↗
PubMed1984

Inhibition of lipid peroxidation in muscle homogenates by phospholipase A2 inhibitors.

Chloropromazine, mepacrine, tetracaine, dibucaine, chloroquine, and procaine have been shown to inhibit the iron- and ascorbate-induced lipid peroxidation of skeletal-muscle homogenates in vitro. These compounds are known to be inhibitors of phospholipase activity, but they were also found to be effective in blocking free-radical-mediated damage to lipids in denatured homogenates, to linoleate suspensions, and to glutamic acid solutions where phospholipase activity was not a relevant factor. The inhibitory action did not appear to be related to any iron-binding activity of the compounds.

Animals↗
PubMed1983

Value of postoperative heparin therapy in peripheral arterial thromboembolism.

The experience with 359 patients with arterial thromboembolism from 1963 to 1982 has been reported. Combined operative and anticoagulant therapy appears the most beneficial form of treatment. Treatment with heparin after catheter embolectomy was associated with a decrease in mortality (7.6 percent), number of amputations (5 percent), and recurrent emboli (6 percent). Serious wound complications occurred less frequently than anticipated (8 percent). We advocate prompt arteriography and revascularization procedures to ensure long-term limb function after initial embolectomy for salvage, if the result is less than optimal or expected. Postoperative heparin seems to buy time in marginal cases, enabling secondary operations to ensure a satisfactory outcome in most patients.

Adult↗
PubMed1983

Polytetrafluoroethylene vein composite grafts across the knee.

Fifteen Gore-tex vein composite femoral-popliteal artery bypass procedures were performed during the four year period of December 1975 to December 1979. Nine were performed for salvage of the limb and six, for incapacitating claudication. Preoperatively, all patients had an arteriographic evaluation of the outflow tract. CPR by the life-table method was 63 per cent at six years. Early failures were three occlusions within two months in patients with poor outflow. One late occlusion occurred at 16 months, and the limb was salvaged with a femoral tibial bypass graft. Another late occlusion was treated by thrombectomy at 24 months with continued patency. Late revision was carried out in one patient at seven months. This consisted of repair of a stenosis of the distal popliteal artery with salvage of the graft. Only two of ten grafts available for evaluation beyond one year have become occluded. All patients operated upon for claudication or with good runoff have patent grafts. On the contrary, none of the grafts to an isolated popliteal segment remained patent. When there is not sufficient autogenous saphenous vein available for femoral-popliteal bypass, the ready availability of a synthetic graft makes it an attractive choice. Nevertheless, our 63 per cent CPR at six years strongly suggests that the composite graft is a durable option.

Aged↗
PubMed1982

The effect of superoxide generation on the ability of mitochondria to take up and retain Ca2+.

When heart or liver mitochondria are exposed to superoxide radicals generated from xanthine + xanthine oxidase their ability to take up and to retain Ca2+ is impaired. The rate of oxidation of pyruvate + malate as substrates is diminished and the appearance of thiol groups when the mitochondria are supplied with these substrates is abolished. These inhibitory effects are offset if respiration is supported by succinate in presence of rotenone provided that a substrate (beta-hydroxybutyrate) is provided to maintain the reduction of NADH. The data agree with the thesis that a generation of thiol groups is essential to maintain membrane integrity and that the generation depends on provision of reduced NAD(P)H.

Animals↗
PubMed1982

Management of deep venous thrombosis and pulmonary embolism during pregnancy.

Despite venous stasis and a hypercoagulable state during pregnancy, the reported incidences of deep venous thrombosis and pulmonary embolism are remarkably low, about 1 in 2,000 and 1 in 10,000 cases, respectively. Mortality from antepartum thromboembolism has been reported in about 15 percent of untreated patients and less than 1 percent of treated patients. Adequate anticoagulant therapy significantly reduces maternal mortality and decreases postpartum morbidity. The proper anticoagulant agent for use during pregnancy has been widely debated. Coumarin compounds pass through the placenta and into the fetus. Hemorrhagic complications in the fetus are uncommon if prothrombin times are carefully controlled and if the drug is discontinued before delivery. However, coumarin during the first trimester has the teratogenic hazard of producing chondrodysplasia punctata. Heparin, in contrast, does not cross the placental barrier and is considered more effective treatment for deep venous thrombosis; however, long-term intravenous administration during pregnancy has been considered both impractical and possibly hazardous due to the risk of osteoporosis after 6 months of therapy. In our study, a combined regimen of intravenous and subcutaneous heparin was used successfully in four women with deep venous thrombosis. One patient who had recurrent embolization while on adequate intravenous heparin underwent vena caval clipping and had an uneventful Cesarian section at term with a normal infant. Another patient also underwent Caesarian section with a normal infant, while the other two women had normal vaginal deliveries at term. Miniheparin therapy was continued for 3 months postpartum, followed by long-term aspirin and Ascriptin therapy. Carefully controlled heparin therapy in a pregnant woman with deep venous thrombosis both safe and beneficial for mother and fetus.

Adolescent↗
PubMed1982

Monoamine oxidase activity of mitochondria prepared from rat liver and rat heart.

The effect of agents that change the respiratory state of the mitochondrion on tyramine oxidation was investigated. Neither uncoupler nor ADP and P1 in the presence of substrate produced any change in the rate of tyramine oxidation, as judged by direct measurement of tyramine oxidation or by H2O2 production. We conclude that previously reported depression of monoamine oxidase activity by stimulated respiration was due to oxygen depletion.

Animals↗
PubMed1981

Stimulation of calcium-ion efflux from liver mitochondria by sodium ions and its response to ADP and energy state.

The Ruthenium Red-insensitive efflux of Ca2+ from previously loaded rat liver mitochondria was studied as a function of the added Na+ concentration and ADP present. Stimulation of Ca2+ efflux is sigmoidally dependent on the Na+ concentration; maximal stimulation of efflux was observed with 12--15 mM-NaCl. Na+-stimulated Ca2+ efflux from liver mitochondria is about one-tenth that from cardiac mitochondria. No synergistic effect of K+ on the Na+-stimulated efflux was found. The alkali-metal cations other than Na+ did not stimulate efflux and did not prevent stimulation by Na+. In the absence of Na+, Ca2+ efflux was diminished by added ADP, but the Na+-stimulated efflux was made correspondingly greater as ADP concentration was increased to 16 microM. The Na+-stimulated Ca2+ efflux was inhibited by 70% by oligomycin and was not observed in the presence of antimycin. It is suggested that failure to observe Na+-stimulation of Ca2+ efflux from liver mitochondria by some investigators is attributable to a high basal efflux existing before addition of the Na+ salt.

Adenosine Diphosphate↗
PubMed1981

Coagulopathy associated with peritoneovenous shunting.

Le Veen shunts successfully alleviated ascites in 19 of 24 patients (79 percent). Clinical clotting typical of disseminated intravenous coagulation occurred in nine of these patients (37 percent) and was fatal in seven (78 percent). Laboratory findings suggesting disseminated intravenous clotting were present in five other patients (21 percent) but were not associated with troublesome bleeding. Coagulopathy was reversed in 7 of 14 patients (50 percent), if the shunt was ligated and supportive measures were taken early in the postoperative course. Failure to recognize or take immediate action resulted in progressive disseminated intravenous clotting associated with a mortality of 50 percent (7 of 14 patients).

Adult↗