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Biomedical subjects

J C Patel

Publications and source records attributed to J C Patel.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Percutaneous transthoracic needle biopsy of the lung: review of 612 lesions.

PURPOSE: The results and complications of 651 pulmonary fine-needle aspiration biopsies (FNABs) were reviewed. The number of needle passes and needle size were correlated to pneumothorax and chest tube placement rates. MATERIALS AND METHODS: FNAB of the lung was performed on 651 occasions in 612 patients with 18- to 22-gauge Franseen needles. Diagnostic rates were calculated. The number of needle passes performed and needle size used were evaluated for their association with pneumothorax and subsequent chest tube placement. RESULTS: Diagnostic accuracy was 94% with sensitivity for malignancy of 95%. Positive and negative predictive values were 99.5% and 90%, respectively. Pneumothorax occurred in 26.9% of patients with 9.2% requiring chest tube placement. Increasing numbers of needle passes and larger needle sizes did not increase the rates of pneumothorax or chest tube placement. CONCLUSIONS: FNAB of the lung has excellent diagnostic rates and remains the procedure of choice for diagnosing pulmonary lesions. This large study contradicts perceptions that pneumothorax and chest tube placement rates decrease with thinner needles and fewer passes.

Adult↗
PubMedDate not supplied

New thrombolytic brush catheter in thrombosed polytetrafluoroethylene dialysis grafts: preclinical animal study.

PURPOSE: To assess the safety, efficacy, endothelial changes, and risks of pulmonary embolic events after the use of a new thrombolytic brush catheter in mature thrombosed polytetrafluoroethylene (PTFE) dialysis grafts in an animal model. MATERIALS AND METHODS: Loop configuration PTFE grafts were implanted in the femoral vessels of 12 canines 4 weeks before mechanical thrombosis was performed. The thrombus was allowed to consolidate for 24 hours in 10 animals, 72 hours in one animal, and 7 days in one animal. Standard percutaneous criss-cross catheter access was performed, and a soft, low-speed, brush (6 mm in diameter), aided by 250,000 U of periprocedural urokinase, was utilized for thrombolysis. The native vessels, just distal to the anastomosis, and lungs were evaluated macro- and microscopically. RESULTS: Thrombolysis was complete in all grafts with the exception of a small segment between the crossing of the access vascular sheaths. The total thrombolysis time ranged from 8 to 12 minutes; this included 5 minutes of pulse-spray lacing. No difference in thrombolysis time was found with regard to the age or amount of thrombus. Minimal endothelial changes were noted and no evidence of acute pulmonary embolus was found on necropsy or histologic studies. CONCLUSION: This method offers a simple, safe, and efficient means of recanalization of thrombosed PTFE dialysis grafts in this canine model.

Animals↗
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[Peritonitis by ruptured pyonephrosis (author's transl)].

The authors have observed one case of peritonitis by ruptured lithiasis pyonephrosis. The elective treatment of this unusual (13th case in the literature) complication of the urinary lithiasis is the nephrectomy.

Adult↗
PubMedDate not supplied

[Arterial substitutes used in peripheral vascular surgery].

Peripheral vascular surgery frequently requires the implantation of substitute arteries for the re-establishment of blood flow. Biological grafts, either authentic (autograft or venous homograft) or processed (bovine heterograft, human umbilical vein) comproise the first group. The venous autograft possesses a real capacity of healing and remains the established standard for small and medium bore conduits. The other biological models lead to unpredictable outcomes. The second group of substitutes is composed of synthetic prostheses made from Teflon R or DacronR. Although of lesser healing capacity, their durability is excellent. Finally, numerous prostheses are under development. Before proceeding to human implantation, it is advisable to evaluate them without prejudice.

Biocompatible Materials↗
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[Post-haemorrhagic encephalopathy in cirrhosis. Prevention by digestive irrigation with 100 mg/l mannitol (author's transl)].

Rapid digestive irrigation makes it possible to remove all the blood contained in the intestine of the cirrhotic suffering from a gastrointestinal haemorrhage. With this procedure, used 62 times during 110 haemorrhages occurring in 57 patients with portal hypertension due to cirrhosis, there was statistically significant prevention (p is less than 0.001) against complications of post-haemorrhagic encephalopathy, but there was no action where neurological and psychiatric problems had already developed. The excellent tolerance of mannitol in a concentration of 100 mg/l, and in particular the absence of any untoward effects on water and electrolyte balance, made it possible to reduce fluid intake to 2000 ml in 2 hours without diminishing its effectiveness, the technique thus being simple and easy to apply.

Adult↗