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Biomedical subjects

G E Pierce

Publications and source records attributed to G E Pierce.

At least 91 records · Page 5Linked to original sources
PubMed1981

Extrahepatic biliary obstruction secondary to metastatic cancer.

Thirty patients with extrahepatic biliary obstruction secondary to metastatic cancer were reviewed to determine the sites of the primary tumor, diagnostic methods, therapy and success of palliation. Colon carcinoma was the most common primary tumor, and the common bile duct was most often obstructed. Both percutaneous transhepatic and surgical decompression of the biliary tract were employed. Twenty-seven (90 percent) of the patients obtained successful palliation. The length of survival averaged 270 +/- 49 days in patients treated surgically compared with 60 +/- 11 days in patients who underwent decompression by radiologic techniques. Mortality was not increased in patients undergoing operative biliary drainage. Surgical decompression may be the best method for managing patients with biliary obstruction secondary to metastatic cancer.

Adult↗
PubMed1980

Prognosis of nerve injuries incurred during acute trauma to peripheral arteries.

Fifty-nine cases of civilian traumatic injury of peripheral arteries were analyzed to determine the frequency, site and mode of accompanying nerve injury. Fifty-one percent of the patients sustained concomitant injury to one or more peripheral nerves. Nerve injury was more common with trauma in the arm (71 percent of cases) than in the leg (32 percent of cases). LOss of an extremity due to failure of vascular repair occurred in 10 percent of the patients. In contrast, 44 percent of patients had some permanent functional impairment of an extremity because of associated nerve injury. The importance of nerve injury in peripheral vascular trauma is discussed and recommendations for management are presented.

Adolescent↗
PubMed1980

Hickman-Broviac catheters. Indications and results.

The records of 84 patients in whom 98 Hickman-Broviac catheters were inserted were reviewed. The most common indication for catheter insertion was for administration of parenteral nutrition. Forty-four patients (52 percent) had catheters inserted for chemotherapy or combined chemotherapy and parenteranal nutrition. Thirteen patients had Hickman-Broviac catheters inserted for the administration of antibiotics. The majority of the patients (56 percent) had malignant disease. The insertion of Hickman-Broviac catheters was uncomplicated, especially through the external jugular vein. Catheter-related complications occurred in 20 percent of the patients, but none were fatal. The most common complications were thrombotic catheter occlusion and catheter related sepsis. The catheter-related sepsis rate was 8/6,308 catheter-days. These rates compare favorably with those reported by other investigators. Any patient with potential vascular access difficulty or obliterated or thrombosed veins who requires parenteral medication should be considered a candidate for insertion of a Hickman or Broviac catheter.

Adolescent↗
PubMed1980

Effects of adult F1 thymocytes on graft-versus-host splenomegaly and homing of parental normal and cortisone-resistant thymocytes in F1 neonates.

In Simonsen assays parental cortisone-resistant thymocytes (P-CRTs) accounted for all of the thymic graft-versus-host reactivity (GVHR) of 3- to 6-week-old BALB/c males in (C3H X BALB/c) (CBF1) neonatal recipients. In the course of these studies, it was observed that coinjection of P-CRTs with large numbers of normal CBF1 thymocytes (F1 NTs) significantly reduced the GVHR of the P-CRTs as measured in Simonsen splenomegaly and [3H]TdR splenic proliferation assays. Homing experiments indicate that one explanation for the reduction in GVHR was a specific decrease in the homing of P-CRTs to spleens of F1 neonatal hosts when P-CRTs were coinjected with F1 NTs.

Animals↗
PubMed1980

Obstructive lesions of distal mesenteric arteries. A light and electron microscopic study.

Two cases of "nonocclusive" intestinal infarction are reported. No thrombosis or significant atherosclerosis was identified and proximal mesenteric arteries were widely patent. However, distal mesenteric arteries were thickened and had pinpoint lumens. Light microscopic findings suggested that this marked luminal narrowing was due to prominent intimal fibromuscular proliferation, medial hypertrophy and mild structural disarray, focal periarterial fibrosis, and transmural elastosis. Electron microscopic findings indicated that the endothelium was normal but the basal lamina was irregularly thickened. The predominant cellular component of the thickened intima consisted of smooth muscle cells, and smooth muscle cells of the media were seen to migrate through an extensively disrupted and degenerated internal elastic lamina. Deposits of young elastic fibers, collagen, and ground substance were also noted, particularly in the intima. The need for careful sectioning and microscopic examination of small distal mesenteric arteries in cases of so-called nonocclusive intestinal infarction is emphasized.

Aged↗
PubMed1979

Specific and nonspecific cytotoxicity of leukocytes from human renal allograft recipients against donor fibroblasts.

A microcytotoxicity assay was used to search for cell-mediated cytotoxicity, serum-blocking factors, and antibody-dependent cell-mediated cytotoxicity (ADCC) against fibroblasts of donor origin in 19 human renal allograft recipients. Peripheral mononuclear cells (PMC) were frequently cytotoxic when they were obtained within 6 days prior to rejection, following sustained rejections, and within 1 month after removal of rejected grafts, but the toxicity was usually nonspecific. Recipient PMC were noncytotoxic when they were obtained within 6 days after the onset of an acute reversed rejection and during quiescent intervals when there was no evidence of rejection within 6 days before or after the assay. These data suggest that, regardless of its lack of specificity, there is some relationship between cytotoxicity of recipient PMC and allograft rejection. In none of 69 post-transplant serum samples was ADCC against donor target cells detected with the microcytotoxicity assay.

Cytotoxicity Tests, Immunologic↗
PubMed1979

Bilateral pneumothoraces secondary to colonic endoscopy.

Fiberoptic colonoscopy has significantly altered the managment of patients with colonic diseases. Complications of colonoscopy are not common, but most often include hemorrhage and perforation. This report describes an unusual and interesting case of colonic perforation related to fiberoptic colonoscopy in which the perforation presented as bilateral pneumothoraces.

Colon↗
PubMed1977

Tricuspid stenosis secondary to metastatic melanoma.

Cardiac metastases from malignant melanoma are frequent, usually asymptomatic and occur terminally. When responsible for symptoms, close evaluation of the patient is imperative for correct diagnosis and subsequent therapy. Surgical intervention where indicated in combination with chemotherapy and judicious use of irradiation constitutes optimal therapy.

Adult↗
PubMed1977

A transthoracic devascularization procedure for control of bleeding esophageal varices: preliminary report.

A procedure for control of variceal bleeding has been described which involves "devascularization" of the distal one third of the esophagus and upper one half of the stomach combined with a Nissen fundoplication performed through a left lateral thoracotomy and an incision in the left diaphragm. Transection of the truncal vagi is required to effectively de vascularize the distal esophagus and, thus, pyloromyotomy or pyloroplasty is added. Six patients who were moderately high risk candidates underwent this procedure for control for persistent hemorrhage; five of these patients were operated on within 48 hours of admission. There was one postoperative mortality. The five survivors have not rebled, and there has been no evidence of encephalopathy or progressive liver deterioration over a mean follow-up of thirteen months.

Adult↗