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Biomedical subjects

J A Wolfe

Publications and source records attributed to J A Wolfe.

34 records · Page 2Linked to original sources
PubMed1986

Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomy.

This prospective study attempted to determine if nonreversible occlusive vascular changes in the skin contribute to skin slough after rhytidectomy. The dermal microvasculature from 83 consecutive rhytidectomies was evaluated for intimal proliferation and/or hyalin sclerosis. Occlusive vascular disease increased progressively with age in all patients, but smokers and ex-smokers had significantly greater involvement than nonsmokers at any given age (p = 0.03). Severe occlusive vascular disease and skin slough were associated (p = 0.02), and there was a strong trend toward an association between active smoking and skin slough (p = 0.06). Among smokers, there was a significant relationship between skin slough and failure to abstain from smoking postoperatively (p = 0.006). We conclude that with aging, nonreversible occlusive changes develop in the dermal microvasculature. These changes appear to be accelerated by cigarette smoking. Our data, however, show that these nonreversible occlusive vascular changes by themselves do not completely account for the occurrence of skin slough after rhytidectomy.

Adult↗
PubMed1986

The influence of manual chest compression rate on hemodynamic support during cardiac arrest: high-impulse cardiopulmonary resuscitation.

Considerable effort has been expended in recent years by a number of laboratories to improve methods of cardiopulmonary resuscitation. This article briefly summarizes 5 years of investigation by our group on hemodynamic support during external cardiac massage. In most studies, long-term canine preparations were used, and implanted transducers allowed precise hemodynamic measurements. Although cardiac output was depressed with all CPR methods, manual chest compressions of high velocity, moderate force, and brief duration at a rate of 120/min seemed to optimize systemic and coronary blood flow. This method was termed high-impulse CPR. High-impulse techniques now have been applied extensively in the clinical setting, and preliminary observations also support their efficacy in man. Based on this experience, it is suggested that the American Heart Association guidelines be changed to recommend a manual chest compression rate of 120/min during closed-chest cardiac massage.

Animals↗
PubMed1985

Laser induced thermal injury of rabbit cornea and treatment with anti-inflammatory agents.

A moderately severe thermal injury of the central cornea of 48 Dutch-belted rabbit eyes was produced with a carbon (CO2) laser. The lesions were photographed with a slit lamp (SL) camera immediately following the injury and at 1, 2, 4, 7, 14, 21, 30 and 60 days after the exposure. Lesion size, opaqueness, and depth were graded clinically by SL biomicroscopy at the same intervals. No significant differences were found (p less than or equal to 0.05) between groups of eyes treated with flurbiprofen (0.03%), prednisolone acetate (1%), and vehicle control four-times-a-day for three weeks following injury. Additionally, eyes were studied histopathologically at 3 and 60 days following injury by light and transmission electron microscopy, and clinically at 30 and 60 days by endothelial specular microscopy. Important clinical and histopathological findings included coagulative necrosis of the corneal epithelium, epithelial sloughing, fusion of stromal collagen, stromal edema and inflammatory cell infiltration, stromal scar formation, corneal thinning, endothelial hyperplasia and metaplasia, fibrinous anterior chamber reaction with hypopyon, and retrocorneal fibrous membrane formation.

Administration, Topical↗
PubMed1985

Laser accidents.

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Accidents, Occupational↗
PubMed1985

Safety with lasers.

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Eye Protective Devices↗
PubMed1984

Composite lymphoma: a unique case with two immunologically distinct B-cell neoplasms.

The authors recently have encountered a unique case of composite lymphoma arising in a 69-year-old man with severe long-standing rheumatoid arthritis. The neoplasm was composed of two B-cell lymphomas occurring within a single axillary lymph node: nodules of IgG-kappa nodular poorly differentiated lymphocytic lymphoma were surrounded by a diffuse growth of IgM-lambda well-differentiated lymphocytic lymphoma. It was the immunohistologic studies performed in this case that demonstrated the simultaneous occurrence of two separate monoclonal lymphocyte proliferations. Without the immunohistologic procedures, this composite lymphoma easily may have been overlooked. This unusual malignancy arose in the background of a long-standing autoimmune disease that may have played a role in its genesis.

Aged↗
PubMed1983

Management of patients with concurrent primary tumors of bladder and prostate.

The clinical course of 33 male patients presenting with concurrent primary tumors of the bladder and prostate was reviewed. Twenty-four of 33 patients were treated by radical cystoprostatectomy. The remaining 9 patients were treated by more conservative means. Seventy-four per cent of the patients survived five years. A rationale for management of concurrent primary tumors of the bladder and prostate is presented.

Adult↗
PubMed1980

Ethanol in intracerebral clot. Report of two homicidal cases with prolonged survival after injury.

Two homicidal cases are reported with prolonged survival after injury. In one case there was a 33-hour survival and the other had a 9-hour survival before death. In both cases there was severe injury to the brain: in one by blunt force and in the other by penetrating injury by firearm. Blood and urine alcohol levels in these cases were low or negative. The blood clot is another potential resource for information in an unnatural death investigation where intoxication is suspected or indicated by the behavior of the victim.

Adult↗
PubMed1978

Relation between sound intensity and the latency and amplitude of the brainstem auditory evoked response.

This study investigated the relation of peak amplitude and latency to signal intensity for the brainstem auditory evoked response (BSAER). One thousand clicks were presented to obtain each averaged response. Responses were obtained to clicks presented at sensation levels of 15, 20, 30, 40, 50, 60, and 70 dB. Five adult males who demonstrated normal hearing served as subjects. Latency and amplitude for various wavelets were plotted against signal intensity. A consistent trend of decreased peak latency occurred with increased signal intensity. Contrary to previous reports, the amplitude of Wavelet V showed a linear growth with increased signal intensity.

Brain Stem↗
PubMed1976

Gastritis, duodenitis, and bleeding duodenal ulcer following mefenamic acid therapy.

A 46-year-old woman developed hematemesis and melena two weeks after starting mefenamic acid therapy for osteoarthritis of the spine. Esophagogastroduodenoscopy, arteriography, and a laparotomy revealed antral gastritis, duodenitis, and an acute bleeding ulcer in the third portion of the duodenum. Although mefenamic acid has many of the pharmacologic and physicochemical properties of aspirin and produces gastrointestinal ulceration in animals when administered in large doses, the English literature reveals only one case of gastric ulceration and a single instance of upper-gastrointestinal tract hemorrhage associated with its use. This case warns that mefenamic acid may cause serious gastric and duodenal inflammation and ulceration more commonly than is presently suspected.

Duodenal Diseases↗
PubMedDate not supplied

Value of radionucleotide scanning in the staging of head and neck carcinoma.

The presence or absence of distant metastases in squamous cell carcinoma of the head and neck is critical in making rational therapeutic decisions. Radionucleotide bone and liver scans are frequently utilized in the initial evaluation of these patients for possible distant metastases. The true value of routine bone and liver scans in the initial staging of primary squamous cell carcinoma of the head and neck is unknown. One hundred eighteen patients with primary squamous cell carcinoma of the head and neck, evaluated during a five-year period, were retrospectively reviewed. Eight percent were stage I, 18% stage II, 21% stage III, 53% stage IV. Because metastatic carcinoma of the head and neck is primarily regional or pulmonary, the low prevalence of liver and bone metastases limits the usefulness limits the usefulness of these radionucleotide scans. We conclude that routine bone and liver scanning is not a valuable diagnostic technique in the initial staging of head and neck carcinoma when clinical or biochemical evidence of distant metastases is not present.

Adult↗
PubMedDate not supplied

Tracheotomy for infant botulism.

Botulism is a serious intoxication caused by ingestion of food containing preformed botulinus toxin and characterized by rapidly progressive bulbar paralysis, generalized weakness, and respiratory insufficiency. In 1976 a distinct clinical entity of infant botulism was recognized. The disease apparently results from intraintestinal toxin production which produces a defect in neuromuscular transmission by interfering with release of acetylcholine at cholinergic synapses. Five cases of infant botulism were identified at the Children's Hospital of Philadelphia between 1975 and 1977. Initial symptoms included constipation, slow feeding, lethargy and weak cry. Four of the patients progressed to respiratory insufficiency requiring nasotracheal intubation. Three of the infants with respiratory failure required tracheotomy. Because infants with respiratory failure may require support for months, we recommend that a tracheotomy be performed early in the management to avoid the complications associated with prolonged intubation. The effectiveness of antitoxin or antibiotics to treat infant botulism remains questionable and therefore prolonged respiratory supportive care is the mainstay of therapy. In addition, we offer guidelines for decannulation in cases of infant botulism. None of the patients in our series could be decannulated prior to initial discharge from the hospital.

Botulism↗
PubMedDate not supplied

Upper airway obstruction in infectious mononucleosis.

Life-threatening upper respiratory obstruction is an unusual complication of infectious mononucleosis. Although the majority of fatalities result from progressive bulbar paralysis or the Guillain-Barré syndrome, airway impairment primarily occurs as a result of pharyngeal lymphoid hyperplasia and associated faucial arch edema. Recent experience in a young child with infectious mononucleosis who exhibited progressive hypersomnolence, sleep apnea, and stridor during sleep is presented. In addition, a retrospective analysis of 72 cases of respiratory complications of infectious mononucleosis provides guidelines for specific airway management. Mild upper respiratory obstruction with persistent fever, severe odynophagia, and malaise is treated with parenteral corticosteroids. Immediate tonsillectomy using a halothane and oxygen induction technique is recommended for severe airway occlusion. Tracheotomy is currently reserved for those patients with progressive alveolar hypoventilation, hypercarbia, atelectasis, and bulbar paralysis. In general, tonsillectomy is well-tolerated, eliminating airway obstruction, improving swallowing function, and rapidly resolving pharyngeal discomfort.

Adrenal Cortex Hormones↗