Biomedical subjects

J R Derrick

Publications and source records attributed to J R Derrick.

At least 19 recordsLinked to original sources

PubMed1981

Use of cold cardioplegic solution for vein graft distention and preservation: a light and scanning electron microscopic study.

To evaluate the effect of a cardioplegic solution on the endothelium of the saphenous vein, portions of this vein were harvested from each of 5 patients undergoing coronary artery bypass operation. Each sample was divided into five segments. One segment was distended with heparinized saline solution, one with heparinized blood, and one with heparinized cardioplegic solution (25 mEq of potassium per liter). All of the distending solutions were kept at 10 degrees C, and pressure was carefully limited to 200 mm Hg. The fourth segment of vein was distended with heparinized saline solution but no effort was made to limit distending pressure, and the fifth segment was not distended. All samples were then examined with light and scanning electron microscopy. There were no great morphological differences in the endothelium of veins distended to 200 mm Hg with saline solution, blood, or cardioplegic solution. The morphology of these samples compared favorably with the control vein endothelium although scattered areas of endothelial disruption were present in every sample. Veins distended without pressure control showed massive endothelial disruption. The particular solution used to distend the sephenous veins is not as important as limiting the distending pressure.

Blood↗

PubMed1980

Recent experience with tuberculous pericarditis.

Twelve patients with tuberculous pericarditis were found among 1,194 patients with tuberculosis treated at the University of Texas Medical Branch over a 10-year period, an incidence of 1%. Surgical treatment was undertaken in 4 patients, and the rest were treated medically. The surgically treated patients had no major complications, and none of them died. In the medically treated group, however, 1 patient died, 1 had an anaerobic empyema, and 1 experienced respiratory arrest. In addition, the average hospital stay was 33 days less in the surgically treated group. Early surgical intervention should be carried out in patients with tuberculous pericarditis who do not respond promptly to adequate antituberculosis chemotherapy.

Adult↗

PubMed1980

Mediastinoscopic removal of a superior mediastinal foreign body.

A metallic mediastinal foreign body, which eroded into the esophagus and resulted in a mediastinal abscess, was removed through the mediastinoscope. Tubes for drainage and irrigation were easily inserted after the pus had been entirely drained. Satisfactory low-risk treatment was accomplished without the need for major surgical intervention.

Abscess↗

PubMed1979

Intrapleural instillation of quinacrine for treatment of recurrent spontaneous pneumothorax.

We used intrapleural instillation of quinacrine hydrochloride in 20 patients (Group A) with recurrent spontaneous pneumothorax (one bilateral) and compared their clinical course with 19 patients who underwent thoracotomy and scarification or pleurectomy (Group B) and 63 patients treated by tube thoracostomy alone (Group C). In Group A, there was one complication of treatment, a pneumothorax immediately following tube removal, which necessitated repeat tube thoracostomy, and there was one late ipsilateral recurrence 2 years after treatment. These 20 patients with 21 recurrent spontaneous pneumothoraces treated with intrapleurally administered quinacrine have been followed for from 6 months to more than 4 years with only one late recurrence on the treated side. Eight patients in Group B had postoperative complications: 2 patients who had had pleurectomy required reoperation for postoperative bleeding; lobar pneumonia developed in 3; 1 had lack of total expansion of the lung; an intrathoracic hematoma developed in 1; and an ipsilateral pneumothorax necessitating tube thoracostomy developed in 1. In Group C, the rate of recurrence of pneumothorax was 23% during the first year following treatment. Intrapleural instillation of quinacrine is a simple, low-risk, reliable, and effective treatment for recurrent spontaneous pneumothorax, and is equally as effective as thoracotomy and scarification.

Adolescent↗

PubMed1979

Subclavian steal syndrome: an update.

The clinical findings in this series of 22 cases of subclavian steal syndrome showed a predominance of men (13:9), a mean age of 51 years, and a predominance of left subclavian artery obstruction. There was a blood pressure differential of more than 20 mm Hg and diminished pulses ipsilaterally in most. Main indications for surgical repair were transient neurologic symptoms. Twenty-one of our patients had surgical repair of the subclavian steal syndrome; six had concomitant carotid artery surgery. The most common surgical procedure performed consisted of a carotid subclavian bypass graft. One patient had only carotid revascularization; 19 patients have had good long-term results. One patient, with tetralogy, died and three had complications. The asymptomatic or mildly symptomatic patient may be given a trial of medical treatment. Symptomatic patients can have extrathoracic bypass with a very low risk. Surgery is indicated if significant associated carotid lesions are present.

Adult↗

PubMed1976

Hospital electrical safety.

Electrocution is an environmental hazard for hospital personnel and patients. The source is low-level alternating current, accidentally applied through indwelling electrodes which invade the normally protective high resistance of the body. Probably the greatest offender is the combination of electronic monitoring and the electrically operated bed. Preventive measures include education of medical personnel and the establishment of guidelines on leakage, coupled with periodic maintenance and inspection by trained technicians.

Electric Injuries↗

PubMed1974