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Biomedical subjects

G L Griffith

Publications and source records attributed to G L Griffith.

16 recordsLinked to original sources
PubMed1998

Endoscopic versus traditional saphenous vein harvesting: a prospective, randomized trial.

BACKGROUND: Saphenous vein harvested with a traditional longitudinal technique often results in leg wound complications. An alternative endoscopic harvest technique may decrease these complications. METHODS: One hundred twelve patients scheduled for elective coronary artery bypass grafting were prospectively randomized to have vein harvested using either an endoscopic (group A, n = 54) or traditional technique (group B, n = 58). Groups A and B, respectively, were similar with regard to length of vein harvested (41 +/- 8 cm versus 40 +/- 14 cm), bypasses done (4.1 +/- 1.1 versus 4.2 +/- 1.4), age, preoperative risk stratification, and risks for wound complication (diabetes, sex, obesity, preoperative anemia, hypoalbuminemia, and peripheral vascular disease). RESULTS: Leg wound complications were significantly (p < or = 0.02) reduced in group A (4% [2 of 51] versus 19% [11 of 58]). Univariate analysis identified traditional incision (p < or = 0.02) and diabetes (p < or = 0.05) as wound complication risk factors. Multiple logistic regression analysis identified only the traditional harvest technique as a risk factor for leg wound complications with no significant interaction between harvest technique and any preoperative risk factor (p < or = 0.03). Harvest rate (0.9 +/- 0.4 cm/min versus 1.2 +/- 0.5 cm/min) was slower for group A (p < or = 0.02) and conversion from endoscopic to a traditional harvest occurred in 5.6% (3 of 54) of patients. CONCLUSIONS: In a prospective, randomized trial, saphenous vein harvested endoscopically was associated with fewer wound complications than the traditional longitudinal method.

Age Factors↗
PubMed1994

2H NMR studies of isomeric omega 3 and omega 6 polyunsaturated phospholipid membranes.

The properties of aqueous multilamellar dispersions of [2H31]16:0-alpha 18:3 PC (1-[2H31]palmitoyl-2-cis,cis,cis-octa-9,12,15- trienoylphosphatidylcholine) and of [2H31]16:0-gamma 18:3 PC (1-[2H31]palmitoyl-2-cis,cis,cis-octa-6,9,12-trienoylphosphatid ylcholine) were compared by broadline 2H NMR spectroscopy. These isomeric phospholipids differ only in the location of the unsaturations in the sn-2 chain. The alpha 18:3 chain has double bonds at delta 9, 12, and 15 positions whereas in the gamma 18:3 chain they are at positions delta 6, 9, and 12. Moment analysis of spectra recorded as a function of temperature reveals dramatically distinct phase behavior for the two isomers. The gel to liquid crystalline transition for [2H31]16:0-alpha 18:3 PC membranes exhibits broad hysteresis which is characterized by a mid point temperature of -9 degrees C and -20 degrees C on heating and cooling, respectively. In contrast, the phase transition of [2H31]16:0-gamma 18:3 PC membranes does not exhibit hysteresis and occurs over a lower temperature range centred on -27 degrees C. Appreciably different molecular ordering also exists within the membranes in the liquid crystalline state. Average order parameters SCD are smaller in [2H31] 16:0-alpha 18:3 PC than in [2H31]16:0-gamma 18:3 PC by 10% at the same temperature and by 20% at equal reduced temperature. Smoothed order parameter profiles generated from depaked spectra clarify the nature of the difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Deuterium↗
PubMed1985

Acute aortic dissection.

Disease processes affecting the aorta are gaining increasing attention as average longevity of the population in this country increases and as awareness of conditions such as hypertension and atherosclerotic cardiovascular disease improves. Aortic dissection is commonly seen as a manifestation of these processes in the aging population and is the most common catastrophic illness affecting the aorta. Familiarity with its pathogenesis, diagnosis, and therapy is mandatory to prevent almost certain death if left untreated.

Acute Disease↗
PubMed1984

Right atrial rupture due to blunt chest trauma.

Violent injury currently accounts for the majority of deaths among young people. Cardiac trauma is responsible for 15% of deaths from thoracic injury, and the incidence of cardiac injury in blunt chest trauma is as high as 76% in some clinical series. Many of these cardiac injuries consist of myocardial contusions. Recently, however, there has been increasing recognition of chamber disruption caused by blunt chest trauma. Cardiac injury is usually the result of direct compression of the heart between the sternum and the dorsal spine. These patients are frequently in extremis, with signs of pericardial tamponade, hypotension, and/or massive hemothorax. Successful management is dependent upon prompt diagnosis and surgical repair. To date there have been only 28 survivors (including the three patients in this report) of this catastrophic and frequently unrecognized injury.

Accidents, Traffic↗
PubMed1979

Umbilical anomalies.

During intrauterine development the primordia of the developing gastrointestinal and urinary tract come into close proximity in the umbilicus where the communication of these structures with the external environment is usually obliterated. In a small percentage of patients the omphalomesenteric duct and/or urachus may remain completely or partially patent. When complete patency is present, drainage of mucus, stool, or urine may occur. Partial patency may be manifest by an abdominal mass or by no symptoms at all. Definitive treatment includes total excision of the omphalomesenteric duct and/or urachus, lest recanalization of remnant tissue or carcinoma in later life occur.

Diagnosis, Differential↗
PubMed1978

Acute traumatic hemothorax.

Over the past 5 years, 107 patients have been evaluated for acute traumatic hemothorax at the University of Kentucky Medical Center. Immediate tube thoracostomy was performed on 90 patients for evacuation of blood and air. Only 2 patients died. Thoracotomy was performed as part of the initial therapy in 9 patients. Thoracotomy for continued hemorrhage from a pulmonary parenchymal injury was required in 3 patients from the entire group. Thoracentesis or observation was the initial therapy for limited hemothorax in 8 stable patients. Three of these patients subsequently required tube thoracostomy 2 to 23 days following injury due to expanding effusions, and 1 patient required multiple thoracotomies for sepsis, fibrothorax, and empyema. These observations indicate that early evacuation of blood by means of a tube thoracostomy is essential to minimize morbidity in acute traumatic hemothorax. If continuing hemorrhage after tube thoracostomy occurs, there is a higher association of injury to additional vital structures.

Abdominal Injuries↗
PubMed1978

Massive skin necrosis in Rocky Mountain spotted fever.

The occurrence of massive skin necrosis of approximately 50% of the body surface area in an 8-year-old girl with Rocky Mountain spotted fever is reported. Although the surgeon will not often be confronted with the management of Rocky Mountain spotted fever or its complications, certain therapeutic corollaries can be outlined, based upon the observed similarity between this particular complication of severe skin loss and the syndrome of purpura fulminans: (1) heparinization for the consumptive coagulopathy and disseminated intravascular clotting; (2) correction of hypovolemia and hypoproteinemia; (3) decompression by escharotomy and/or fasciotomy if indicated; (4) topical chemotherapeutic coverage of necrotic skin; (5) full-thickness eschar excision combined with biologic dressings directed toward autograft wound closure; and (6) appropriate extremity splinting and physiotherapy.

Child↗
PubMed1977

Septic pulmonary embolization.

Septic pulmonary embolization occurs when an infected thrombus lodges in the pulmonary arterial tree. Pulmonary abscess, empyema, bronchopleural fistula, shock and death may follow. During the preantibiotic era, septic pulmonary embolization was a dread complication of septic thrombophlebitis occurring in the pelvis and after infections of the head and neck. More recently, the multiplicity of long term indwelling catheters has changed the epidemiologic aspect of this disease, pointing toward iatrogenic causes in many instances. The drug addict, however, remains the person at greatest risk of having septic pulmonary embolization develop. A clinical evaluation seeking drug abuse and related stigmata is extremely helpful in suggesting the proper cause, establishing the presence of right-sided endocarditis and directing appropriate therapy. Staphylococcus aureus is the most common offending organism in all patient populations except for the patient with thermal injury in which gram-negative organisms predominate. Early diagnosis and proper therapy, which includes high doses of parenteral antibiotics and control of the inciting septic focus in all instances, are prerequisites for a favorable outcome.

Animals↗