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Biomedical subjects

J Manny

Publications and source records attributed to J Manny.

At least 55 records · Page 3Linked to original sources
PubMed1978

Humorally mediated alterations in cardiac performance as a consequence of positive end-expiratory pressure.

Two experimental designs were used to study the mechanism of the decreased cardiac output associated with the use of positive end-expiratory pressure (PEEP). In the first study of nine dogs the application of 15 cm H2O PEEP led to a decrease in cardiac output (CO) from 2.68 +/- 1.05 to 2.01 +/- 1.26 liters/min (+/- SD) (p less than 0.05) concomitant with an increase in transmural central venous pressure of 5.2 +/- 0.9 to 8.4 +/- 2.7 mm Hg (p less than 0.05) and a slight increase in transmural left atrial pressure of 6.8 +/- 3.3 to 7.3 +/- 3.6 mm Hg (p less than 0.1). These data are consistent with altered ventricular performance. In a second study nine pairs of dogs were cross-circulated. Application of 15 cm H2O PEEP to one member of the experimental pair led to a decrease in the CO of the other member from 2.71 +/- 0.98 to 2.21 +/- 0.81 liters/min (p less than 0.001). This decrease returned toward baseline with the removal of PEEP (p less than 0.02). Results indicate that one mechanism whereby PEEP reduces the cardiac output is through the action of a humoral agent.

Animals↗
PubMed1978

Acute superior mesenteric arterial occlusion: a plea for early diagnosis.

Acute mesenteric arterial occlusion is a curable disease, provided it is diagnosed and treated before irreversible changes occur in the ischemic bowel. Forty patients treated for proven mesenteric arterial occlusion were evaluated retrospectively in an effort to broaden the existing criteria for early diagnosis. Twenty-three patients suffered from mesenteric thrombosis and 17 sustained embolic occlusion of the superior mesenteric artery. The overall mortality rate was 77.5% (31 of 40 patients). Three patients survived without bowel resection. The appearance of acute abdominal pain accompanied by profuse cold sweating in a cardiac patient with apparently normal abdomen, hyperactive bowel sounds, and a history of embolic events should always raise the suspicion of acute mesenteric ischemia and should be verified immediately by mesenteric angiography. A high index of suspicion, aggressive measures for early diagnosis, and early operative treatment are presently the only possibilities to provide a better outcome.

Acute Disease↗
PubMed1977

The effect of furosemide on the flow and composition of bile in the dog.

The effect of furosemide, a potent inhibitor of active sodium transport, on the amount and composition of bile was studied in the dog. Ten milligrams per kilogram of body weight of furosemide were injected intravenously to anesthetized dogs with a previously constructed fistula of the common bile duct. In all dogs, a 2.5 times increase in bile flow was observed concomitant with a 15 times increase in urinary output. The amount of bile flow decreased gradually and returned to control levels 60 to 75 minutes after furosemide injection. The choleretic effect was associated with a high increase in sodium, chloride and bicarbonate anions and with a smaller increase in potassium, phosphorus and calcium. The total amount of bilirubin alkaline phosphatase and cholesterol was not significantly affected, while the calculated output of inorganic salts increased. The results indicate that inhibition of sodium reabsorption by furosemide simultaneously affects the liver and kidney and that the increase in electrolyte solution is most likely caused by the inhibition of sodium reabsorption in the ductuli. Furosemide also may interfere with the sodium mediated secretory fraction at the canalicular level, but the predominant factor determining the increase in bile flow and electrolytes is inhibition of sodium reabsorption in the biliary ducts and ductuli.

Alkaline Phosphatase↗
PubMed1977

Traumatic hemolysis after aortofemoral bypass. A study of 25 cases.

The prevalance of traumatic intravascular hemolysis was estimated in 25 patients following aortofemoral bypass. Stigmata of mild red cell fragmentation were noted in approximately one third of the patients, but in only one of them was hemolysis of sufficient severity to be of clinical significance. The case history and laboratory findings in this patient are described in detail. This study indicates that traumatic hemolysis should be considered as a possible cause of anemia developing after aortofemoral bypass.

Aged↗
PubMed1977

Pneumoperitoneum associated with pneumothorax: a surgical dilemma in the post-traumatic patient.

Two patients with pneumoperitoneum associated with post-traumatic pneumothorax are described. The role of artificial respiration in the production of pneumoperitoneum is descussed. This association presents a curious diagnostic dilemma. If the diagnosis of perforated hollow viscus can be eliminated with considerable certainty, then conservative management with careful observation and monitoring may avoid unnecessary surgery, so long as other causes of pneumoperitoneum have been ruled out.

Adult↗
PubMed1977

Parietal cell vagotomy and omentopexy as definitive surgery for perforated duodenal ulcer.

We recommend a definitive procedure as initial management for acute perforated duodenal ulcer. In the two patients herein reported, the parietal cell vagotomy with omentopexy and without drainage was performed as a definitive procedure for perforated duodenal ulcer. No wound infection, dumping symptoms or diarrhea occurred in the early postoperative period. Gastrointestinal follow-up study in one patient showed normal passage. These early favorable results with minimal morbidity encourage us to broaden the indications for definitive operation for acute perforation.

Adult↗
PubMed1976

Vesicocolic fistula due to "collision" between adenocarcinoma of the colon and transitional cell carcinoma of the urinary bladder.

A patient with sigmoidocystic fistula due to "collision" between mucoid adenocarcinoma of the colon and transitional cell carcinoma of the urinary bladder is presented. A wide resection of the colonic tumor, along with the involved bladder segment, and a decompressive colostomy with bladder drainage by catheter, were performed. The clinical symptoms, diagnostic procedures, operative treatment, and prognosis are discussed. Although fistular formation is an indication of advanced carcinoma, wide resection of the tumor and the associated fistular along with the node-bearing area will result in a reasonable percentage of 5-year survivals.

Adenocarcinoma, Mucinous↗
PubMed1976

Pulmonary varices. Report of two cases and review of the literature.

Two cases of pulmonary varices are presented. The lesion is rare, and only 32 cases have been reported in the literature. Although the lesion is benign in nature, complications are possible, and death has occurred from rupture of the varix intrapleurally or into the bronchial tree.

Adolescent↗
PubMed1976

A safe method of thoracentesis.

A simple and safe method for therapeutic and diagnostic thoracentesis is described. The application of this technique of thoracentesis may decrease the chance of injury to the lung during the procedure. The complete evacuation of the pleural cavity may reduce the chance of development of adhesions. Repeated aspirations and instillation of medications with the same system left in the thoracic cavity may also be possible.

Catheterization↗