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Biomedical subjects

E T Jacob

Publications and source records attributed to E T Jacob.

At least 19 recordsLinked to original sources
PubMed1990

Ileostomy with the EEA stapler.

The EEA instrument was used to perform ileostomy in three patients. Two female patients with complications of Crohn's colitis underwent total colectomy and proctocolectomy, respectively. The first patient was operated upon because of toxic megacolon and the second patient for severe perianal disease. A third male patient underwent total colectomy for severe ulcerative colitis that failed to respond to medical therapy. In all patients, ileocutaneous anastomosis was performed with the EEA stapler (ILS, Ethicon). No serious complications were observed except for slight retraction of the ileostomy in one patient after he had gained 22 pounds.

Colectomy↗
PubMed1990

Calculus in 16-year-old cadaveric kidney transplant: a unique case and literature review.

Calculi are rare in transplanted kidneys with an incidence of 0.1-0.2% of all urological complications. The clinical presentation of an obstructing stone is different from that seen in nontransplant patients and can be easily mistaken for rejection. Ultrasonography and renogram may fail to detect it. Steroid therapy, the treatment of choice for acute rejection, may improve renal functions albeit obstruction. An obstruction ureteral stone in a 16-year-old cadaveric kidney transplant was mistaken for acute rejection. Steroid therapy improved renal function for a short time, but then anuria recurred. Failing treatment, the kidney was considered lost and hemodialysis was started. Spontaneous passage of a stone and improved renal functions clarified the picture. The literature regarding kidney transplant stones is reviewed.

Adolescent↗
PubMed1988

Decompensated ureteropelvic junction obstruction in renal allograft.

We report a case of complete obstruction at the ureteropelvic junction in a renal allograft 6 months after related kidney transplantation. Surgical treatment consisted of a Foley nondismembered Y-V pyeloplasty. Although the donor harbored undetected bilateral, mild, ureteropelvic junction stenosis, as established by review of the excretory urogram that was performed before nephrectomy, the remaining kidney functioned well, as confirmed by renal function and morphological appearance on a repeat excretory urogram. The possible mechanisms of ureteropelvic junction decompensation, the most crucial of which appears to be autonomic denervation of the allograft, are discussed.

Adult↗
PubMed1988

A double ballooned inflatable and collapsible T tube for selective proximal or distal cholangiography.

A double ballooned T tube for common bile duct occlusion and optional collapse of the intra-balloon tube segments was used for improved roentgenologic delineation of the biliary tree intraoperatively and postoperatively. This silicone T tube is effective for intraoperative and completion cholangiograms, and avoids resuturing of the choledocotomy. Furthermore, with increased inflation, each balloon is capable of occluding the proximal or distal, or both, intraductal horizontal limbs. These features have been exploited for optimal imaging and therapeutic purposes. The tube with its deflated balloons is left in the common duct for drainage and further selective proximal or distal cholangiograms. Several extensions of its use can be envisaged.

Catheterization↗
PubMed1979

Angiotensin-converting enzyme inhibitor (SQ 20881) in the diagnosis of renovascular hypertension.

SQ 20881, an angiotensin-converting enzyme inhibitor, was given to 12 patients with renovascular hypertension and to 1 patient with unilateral parenchymatous renal disease in order to evaluate the role of renin-angiotensin systems in their hypertension. Plasma renin activity (PRA) and aldosterone were assayed in systemic blood before and after the injection of SQ 20881. In 5 patients PRA was also measured separately in each renal vein. Blood pressure decreased, PRA increased, and aldosterone level decreased in the 12 renin-dependent patients. When PRA was sampled separately from each renal vein, the increase was larger on the side of the affected kidney. Four patients with a positive test underwent corrective surgery, and in all blood pressure became normal. SQ 20881 is a useful agent in evaluating the contribution of renin in patients with hypertension.

Adolescent↗
PubMed1979

Renal transplantation in the amyloidosis of familial Mediterranean fever. Experience in ten cases.

Ten patients with familial Mediterranean fever (FMF) and histologically confirmed amyloidosis received cadaver kidney transplants for treatment of terminal renal disease. Colchicine, 1 mg daily, was included in the routine postoperative regimen from 1974 for amyloidotic patients. Graft and patient survival were compared with ten nonamyloidotic recipients of renal grafts matched for age, sex, type of allograft, and HLA compatibility. In the FMF group, five of ten grafts have survived from 20 to 64 months; in the control group, six of ten. While only recipients with functioning grafts survived in the FMF group, patient survival in the control group is eight of ten after one year. In all five FMF survivors, graft function is satisfactory, proteinuria is absent, and blood creatinine levels are normal. Amyloid involvement of an allograft was documented 16 months after transplantation in the only patient whose maintenance colchicine dosage had been reduced to 0.5 mg daily.

Adult↗
PubMed1977

Dacron arterio-venous interposition graft: an access to circulation in patients on chronic hemodialysis.

In a small percentage of cases, conventional a-v fistulae of the Brescia-Cimino type fail to provide long-term access facilities for chronic hemodialysis. When homologous venous interposition grafts are not available, the surgeon is forced to seek foreign interposition material. In three instances woven dacron arterio-venous interposition grafts were successfully constructed in the thigh, and uneventful hemodialysis was accomplished in all 3 patients.

Arteriovenous Shunt, Surgical↗
PubMed1977

Acute diaphragmatic hernia caused by blunt trauma.

Traumatic diaphragmatic hernia is being more frequently diagnosed in the acute phase because of a higher degree of alertness. Over a period of eight years the authors treated 16 patients. Associated injuries were present in eight cases and were responsible for the two deaths. The chest roentgenogram was diagnostic in most cases, but serial films and contrast examinations eventually were necessary. In order to attain a low morbidity and mortality rate, early surgery is recommended.

Accidents, Traffic↗