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Biomedical subjects

J H Thomas

Publications and source records attributed to J H Thomas.

At least 145 records · Page 8Linked to original sources
PubMed1983

Open renal biopsy. Surgical technique and results.

This report describes our experience with a new modified approach for open renal biopsy. The biopsy is performed under general anesthesia through a small anterior incision and extraperitoneal approach. A generous incisional biopsy of the lower pole is obtained, and bleeding is controlled with mattress sutures. Thirty biopsies were obtained in 30 patients. The pathologic diagnoses included glomerulonephropathy (16), necrotizing vasculitis (5), degenerative phase of acute tubular necrosis (4), congenital nephrotic syndrome (2), interstitial nephritis (1), renal invasion by reticulum cell sarcoma (1), and juxtaglomerular cell hyperplasia (1). Ages ranged from 12 months to 75 years. There were no intra- or postoperative complications. There was one late postoperative death secondary to a ventricular arrhythmia. This approach is rapid, safe, and provides more adequate tissue for histologic and electron microscopic examination than does percutaneous needle biopsy.

Adolescent↗
PubMed1983

Computed tomographic mammography directed biopsy of the breast.

Computed tomography of the breast has been demonstrated to identify nonpalpable carcinoma of the breast at an early stage. It has been found possible to do an accurate biopsy of these small tumors using azimuth and distance data provided by the radiologist.

Biopsy↗
PubMed1982

Evaluation of end-to-side v end-to-end proximal anastomosis in aortobifemoral bypass.

The cumulative graft-limb patency rate was significantly higher after aortobifemoral bypass with a proximal end-to-end anastomosis (E-E-AN) than with a proximal end-to-side anastomosis (E-S-AN), 100% v 93%, respectively, after 1.5 years in a consecutive series of 38 E-S-ANs followed by 41 E-E-ANs. The two operations were equally effective in relieving hip claudication, but impotence occurred more frequently after E-E-AN (27%) than after E-S-AN (13%). This difference was not significant, but six of ten patients with E-E-AN who became impotent had arteriographic patterns predicting that graft flow into hypogastric arteries might be compromised. Intraoperative studies demonstrated that acute bilateral occlusion of hypogastric arteries significantly decreases penile BP, but branches of the external iliac arteries also contribute to penile flow and may become the major route of supply in patients with hypogastric occlusive disease.

Aortic Diseases↗
PubMed1982

Insulin binding and degradation by kidney cell membranes of streptozotocin-diabetic rats.

The interaction of insulin with purified rat kidney cell membranes was studied with the use of 125I-insulin. The membranes showed high insulin-degrading activity which was dependent on temperature, time and membrane concentration. Specific binding of insulin was demonstrated in the presence of 0.3 mM bacitracin and was time- and temperature-dependent. 125I-insulin was displaced by native insulin, AI-B29 dodecoyl insulin and proinsulin in proportion to their relative bioactivity. Kidney membranes isolated from streptozotocin-diabetic rats bound more insulin per mg of membrane protein (approx. 65%) than did membranes of control animals. Scatchard analysis indicated that this increase in binding was due to an increased binding capacity rather than an increased affinity for insulin. Injection of diabetic rats with insulin resulted in a decrease of insulin binding when compared with the untreated diabetic animals. Diabetes also resulted in altered kinetics of insulin degradation.

Animals↗
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

Radioimmunoassay of chemically modified insulins.

The reactions between four insulin antisera and eighteen insulin derivatives with modifications at the A1, B1 and B29 positions have been studied using a standard double-antibody radioimmunoassay procedure. The derivatives studied had: a) single modifications at A1, B1 or B29,; b) modifications at two sites with or without a crosslink between them; c) modifications at all three sites with or without a crosslink. Analysis of the results showed a clear difference in the reactivity of the antisera. One antiserum (GP5) was highly sensitive to modifications of the B1 residue and another (Ab1) was sensitive to A1 and B29 modifications. Thus, immunological potencies of insulin analogues derived on the basis of these reactions with the antisera give widely varying results. These antisera were used in discriminatory radioimmunoassays of chemically modified insulins in biological fluids for estimation of in vivo hypoglycaemic potencies by an infusion technique, where the knowledge of the specificity of the antisera was useful in assessing the immunological identity of immunoreactive material in plasma with the analogue infused.

Adipose Tissue↗
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

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↗