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Biomedical subjects

J M Graham

Publications and source records attributed to J M Graham.

At least 289 records · Page 16Linked to original sources
PubMed1979

Penetrating trauma of the lung.

Records of 373 patients with penetrating wounds of the lung seen at the Ben Taub General Hospital over a 1-year period were reviewed. Intercostal tube thoracostomy was the only therapy required in 282 patients. Thoracotomy was performed in 91 patients with repair of a pulmonary lesion in only 45 patients. Pneumonorrhaphy was performed in 33 patients, segmentectomy in six, and lobectomy in two. Four patients required repair of tracheal injuries. Fourteen patients initially treated with intercostal tube drainage required thoracotomy for complications of clotted hemothorax in eight and empyema in six. There were 29 deaths. Penetrating lung trauma in the majority of patients may be treated conservatively with a low incidence of infection or complication. Of the patients who require thoracotomy, associated injuries will frequently represent the major operative indication. Early thoracotomy for complication of clotted hemothorax or empyema is encouraged.

Adolescent↗
PubMed1979

Improving drug compliance in general practice.

Patients of all ages make serious mistakes with their medicines, especially if several are prescribed at once.Taking medicines involves a great deal of physical and mental work. The best way to help patients take medicines accurately is to reduce this work by packing together all tablets taken at the same time of day. Many elderly patients have relatives who could pack their medicines in this manner.

Adult↗
PubMed1978

Cell surface coat of hamster fibroblasts.

The UHF fraction from NIL 8 hamster embryo fibroblasts contains the LETS protein and several other major proteins. It exhibits three enzymatic activities in significant amounts: 5'-nucleotidase, alkaline phosphatase, and galactosyl transferase. The latter two appear to be different from the membrane-bound enzymes. This fraction is heavily stained with ruthenium red, a dye specific for the cell coat in intact cells. A comparable fraction from hamster sarcoma virus-transformed cells exhibits a similar overall protein composition but lacks at least three major proteins, including the LETS protein. Compared to NIL 8 cells, the distribution of alkaline phosphatase in fractions from these cells is different, and the level of galactosyl transferase in the UHF is much reduced.

Alkaline Phosphatase↗
PubMed1978

Traumatic injuries of the inferior vena cava.

Three hundred and one patients with injury to the inferior vena cava have been treated over the past 30 years. Penetrating injuries predominated, with gunshot injury in 228 patients. The inferior vena cava was injured above the renal veins in 84 patients. One hundred and forty-eight patients had shock, 55 without palpable pulse or blood pressure. Vascular repair was accomplished in 234 patients. Ligation or packing was performed in 32 patients. Thirty-five patients died prior to vascular control or repair. Placement of intravascular shunts or occluding balloons was utilized in 25 patients. Mortality has decreased from a high of 100% in 1955 to 30% during the last six years of this experience. Reduction in mortality probably has resulted from shortened wounding to therapy intervals with more effective resuscitation and vascular control.

Humans↗
PubMed1978

Traumatic injuries of the pancreas.

Traumatic injuries of the pancreas have evolved from an uncommon encounter of even wartime wounds to a relatively common injury of today's civilian strife. A review of 448 patients sustaining pancreatic trauma demonstrated that the pancreatic injury alone contributes little to immediate or late mortality but is frequently a source of postoperative morbidity. Complications of pancreatic injury comprise almost half of those observed after trauma in such patients, but for the most part are self-limited and easily cared for. Survival among patients sustaining pancreatic injury depends mainly upon the degree of success with which the multiple associated injuries can be managed.

Debridement↗
PubMed1978

Sudden sensorineural hearing loss: electrocochleographic findings in 70 patients.

The results of transtympanic ECochG in 70 patients with sudden sensorineural deafness are presented. ECochG was compared with traditional methods of audiometry as a means of deciding whether the deafness was mainly cochlear or retrocochlear. It was found to make a useful and sometimes unique contribution. ECochG gave a definite localization of the deafness in 22 out of 23 patients in whom conventional methods of audiometry had produced equivocal results and was also found to be extremely valuable in 17 patients with "dead" ears. Electrical stimulation of the cochlea may have a prognostic value in cases of sudden retrocochlear deafness. A rational approach to the treatment of sudden deafness depends on precise knowledge of the aetiology and pathology: accurate localization of the site of the lesion is a convenient first step.

Adolescent↗
PubMed1978

Portal venous system injuries.

Traumatic injuries of the portal venous circulation occur infrequently but often pose management problems. During the past 13 years, 94 patients have been treated at the Ben Taub General Hospital for traumatic injury to the portal venous system, including 37 portal, 45 superior mesenteric, seven splenic, and nine inferior mesenteric venous injuries. Injury resulted from penetrating wounds in all but 17 patients. Associated vascular injuries were present in 80 patients. Twenty-six patients died from failure to control hemorrhage. Six deaths resulted from postoperative complications. Operative approach necessitated lateral venorrhaphy in 66 patients, ligation in 23, end-to-end anastomosis in one, saphenous vein mesocaval shunt in two, end-to-side portacaval shunt in one, and clamping and packing in five. In spite of numerous associated vascular and visceral injuries, portal venous injuries can be successfully managed utilizing generally available vascular reconstructive techniques.

Adolescent↗
PubMed1978

Chronic active hepatitis, haemolytic anaemia and Listeria monocytogenes bacteraemia.

The association of chronic active hepatitis with haemolytic anaemia is well known. Both conditions may respond to steroid therapy which, in common with other causes of suppressed T-lymphocyte function, predispose to many types of infection. A case is described in which transient Listeria monocytogenes bacteraemia occurred and the patient recovered without antimicrobial therapy.

Anemia, Hemolytic↗
PubMed1978

Injuries to the visceral arteries.

Injuries of the major visceral arteries are among the more difficult to manage and rarely occur without serious associated injuries. Sixty-six patients are presented with injuries to the celiac, superior, and inferior mesenteric arteries. Fifty-three injuries resulted from gunshot wounds, nine from stab wounds, and four from blunt trauma. Operative management included vessel ligation in 11 patients, arteriorrhaphy in 43, resection and end-to-end anastomosis in six, Dacron graft interposition in four, and aortic reimplantation in two. Twenty-three patients died, 16 from failure to control hemorrhage. In two patients failure to restore adequate visceral circulation resulted in bowel ischemia and infarction. The successful management of patients with visceral arterial injuries is dependent upon rapid and adequate exposure followed by primary repair or revascularization utilizing available surgical techniques.

Adolescent↗
PubMed1977

Left testicular and groin pain: an unusual presentation for perforated appendicitis.

A 12 yr old black male presented with a 3 day history of left inguinal and testicular pain associated with nausea, vomiting, and fever. Left groin exploration demonstrated a markedly inflammed patent process vaginalis containing purulent exudate. Concomitant abdominal exploration demonstrated a perforated gangrenous appendix with diffuse peritonitis.

Appendectomy↗
PubMed1977

Systemic air embolism following penetrating trauma to the lung.

Systemic air embolism following penetrating injuries of the lung has not been widely recognized clinically. Experimental studies designed to reproduce the phenomenon in dogs have been at variance, although none has taken into consideration the often high intrabronchial pressures created during resuscitative efforts in such patients. Twelve patients with systemic air embolism following penetrating traumatic injuries to the lung have been seen at our hospital. Ventilatory pressures created during resuscitative thoracotomy in traumatized patients were monitored and found to be as high as 100 mm Hg. Penetrating injuries of the lung were created in mongrel dogs, and the animals were ventilated with pressures reaching 90 mm Hg. All dogs unequivocally developed systemic air embolism, with air visualized in the coronary arteries. It would appear that systemic air embolism following penetrating injury to the lung may result when increased intrabronchial pressure, such as found during manual ventilatory assistance, forces air through traumatic bronchovenous fistulae into the systemic circulation.

Adolescent↗