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Biomedical subjects

J S Thompson

Publications and source records attributed to J S Thompson.

At least 325 records · Page 18Linked to original sources
PubMed1982

Nuclear magnetic resonance imaging and evaluation of human breast tissue: preliminary clinical trials.

In vivo clinical evaluations of human mammary tissue, including normal, dysplastic, and neoplastic breasts, were initiated using the FONAR method of nuclear magnetic resonance (NMR) imaging. Spin-lattice relaxation times (T1) were determined and correlated with other diagnostic modalities including mammography, xeroradiography, and sonography. Normal breasts and breasts with extensive fatty replacement were found to have the lowest T1 values, whereas T1 values of malignant tissue were elevated. T1 values for mammary dysplasia extended over a wide range, and NMR images exhibited lower proton density than normal tissue. In several patients with severely dysplastic breasts, T1 values overlapped those from patients with documented breast neoplasms. Markedly elevated T1 values were obtained from fluid-filled cysts that were well beyond the range of malignancy.

Breast↗
PubMed1982

Jejunal rupture caused by a Sengstaken-Blakemore tube.

In a patient with cirrhosis and bleeding esophageal varices who had previously undergone a partial gastric resection, the gastric balloon of a Sengstaken-Blakemore tube was inadvertently placed into the efferent jejunal limb of the gastrojejunostomy. Inflation of the balloon to the standard volume of 150 ml resulted in rupture of the jejunum. Precautions in the use of the Sengstaken-Blakemore tube that might prevent this complication are described.

Esophageal and Gastric Varices↗
PubMed1981

Human suppressor cells: evidence of functionally distinct subsets.

Human suppressor cells (SC) differing in both kinetic characteristics and degree of specificity were induced in vitro either by Concanavalin A (CON A) (10 microgram/ml) or by repeated stimulation with allogeneic cells. CON A SC caused a characteristic early peak in blastogenesis (Day 2) when cocultured with fresh autologous cells in the presence of either CON A or augmented response fell rapidly to values 50--90% below positive controls by the usual optimal day for the particular stimulus. Treatment with 5-bromodeoxyuridine and light during rapid proliferation ablated the early responses but increased the later responses (i.e., reduced the suppression). The cells mediating both the early rise and late suppression were found to belong to a subset of T cells that lost their ability to form SRBC rosettes (theophylline sensitive) in the presence of the phosphodiesterase inhibitor, theophylline, and were inactivated by mitomycin C. In contrast, SC induced by repeated allogenic stimulation were suppressive in MLC but not CON A cultures, did not initiate early blastogenesis in the presence of naive cells and were partially mitomycin resistant. The mitomycin resistant SC induced by allogeneic stimulation are found in the theophylline resistant T-cell subset. These data are consistent with a model of human SC differentiation in which at least two subsets may be present: (1) a mitomycin sensitive, nonspecific cell that participates in an obligatory early autologous recognition event (induction?) and (2) a later occurring, more mitomycin resistant effector cell that appears to acquire specificity for the response that it affects.

Bromodeoxyuridine↗
PubMed1981

Comparison of penetrating injuries of the right and left colon.

Controversy still exists whether penetrating injuries of the right colon have more favorably than those to the left. The importance of the issue rests in the operative management. This is a review of 50 cases of penetrating injuries of the right colon and 55 of the left treated at our institution from 1975 to 1980. The two patient groups were similar with respect to mechanism of injury, presence of shock at admission, degree of fecal contamination, severity of injury, and the percentage of cases with associated intra-abdominal injuries. The number of patients managed by primary repair or resection (52 vs. 45%), repair or resection with exteriorization (20 vs. 22%), and colostomy (28 vs. 33%) were also comparable in right versus left injuries. The treatment of right colon injuries resulted in 32% morbidity rate and 2% mortality rate, and that of left sided injuries 33% morbidity and rate of 4% mortality rate. These findings indicate that, despite known anatomic and physiologic differences, penetrating trauma to the right and left colon should be managed similarly.

Adolescent↗
PubMed1981

A 2-year trial of prospective HLA-DR matching: effects on renal allograft survival and rate of transplantation.

In a 2-year trial at a single center, prospective HLA-DR matching for cadaver renal transplantation exerted a stronger effect than either HLA-A and B matching or blood transfusion. One-year cumulative graft survivals for two-DR-matched organs was 92%. Grafts matched for one DR antigen had a cumulative 1-year graft survival of 65% whereas grafts matched for zero DR antigens had a cumulative 1-year survival of 41%. When all cadavers with less than two identifiable DR antigens were excluded from this analysis, however, the graft survivals of the groups known to be mismatched for one or two DR antigens were similar (61% versus 59%). Grafts matched for three or four HLA-A and B antigens did somewhat better than those matched for only zero, one, or two HLA A and B antigens (74% versus 59%, 1-year survival). This effect was only demonstrable in the zero- and one-DR-matched group. Similarly, prior blood transfusion exerted a modest effect (transfused versus nontransfused, 71% versus 56% 1-year graft survival) that was also most evident in the zero- and one-DR-matched groups. The institution of this trial was also associated with a 35% annual increase in the rate of transplantation and a 50% reduction in median patient waiting time. DR typing of cadaveric donors is feasible and highly desirable. Multicenter pooling of DR-typed donors is thus predicted to lead to optimal matching for a high proportion of renal transplant candidates.

Graft Survival↗
PubMed1981

Functional cell mediated lympholysis I. Description of the assay.

The anamnestic response by human bi-directional (BD) mixed lymphocyte cultures (MLC) to restimulation by cells of the original stimulating type is generally strikingly reduced as compared to that of standard one-way cultures. This difference was shown not to be related to a change in kinetics nor was it due to exhaustion of the media or soluble factors since fresh media did not ameliorate the effect nor were supernatants from BD cultures found to be suppressive. The relative inhibition was also not reversed by removal of the allogeneic cells by phenotype specific antiserum. Cytotoxic tests with donor and responder specific antisera revealed that the cells bearing that phenotype were dramatically reduced in BD as compared to one-way cultures. Thus, the diminished secondary response appears to be due to cytotoxic elimination of the responder cells. This allogeneic cytotoxicity is dependent on non-T, phagocytic, adherent cells. The phenomenon is called Functional Cell Mediated Lympholysis (F-CML).

Cell Adhesion↗
PubMed1981

Functional cell mediated lympholysis: II. Genetics.

The diminished response to secondary stimulation of human lymphocytes primed in bi-directional (BD) mixed lymphocyte culture (MLC) has been demonstrated to be due to cytotoxic destruction of the responder cells by the numerically superior allogeneic stimulating cell population. This phenomenon is called Functional Cell Mediated Lympholysis (F-CML). Matching for HLA-A and B, HLA-DR or for MLC non-responsiveness (HLA-D) in unrelated pairs does not ablate F-CML, indicating that none of these loci serve as the exclusive target for this activity. One locus appears to be centromeric from HLA-A in an A/B recombinant family and a B/D recombinant family demonstrates a target centromeric from HLA-B. A special family with homozygous for HLA-A, B and D provided evidence for an additional locus other than HLA-A, B or D. Thus, genetic studies indicate that at least one target antigen of F-CML may be coded for by a locus that is centromeric from HLA-B and which may be distinct from HLA-D or DR.

Antigens, Surface↗
PubMed1981

Penetrating abdominal trauma index.

A method of quantifying the risk of complication following penetrating abdominal trauma is described. A trauma index score was calculated by assigning a risk factor (1-5) to each organ injured and then multiplying this by a severity of injury estimate (1-5). The sum of the individual organ scores comprised the final penetrating trauma index (P.A.T.I.). A consecutive series from 1975 to 1979 of 108 isolated stab wounds and 114 gunshot wounds to the abdomen requiring laparotomy were analyzed by this scheme. Only patients surviving 24 hours postoperatively were evaluated. Gunshot wounds resulted in P.A.T.I. scores greater than 25 in 39 (34%) of the patients. This was associated with a 46% complication rate and contrasted to a 7% incidence when the P.A.T.I. was equal to or less than 25. Following abdominal stab wounds six (6%) of the patients had P.A.T.I. scores exceeding 25. Complications developed in 50% of this group compared to 5% when the P.A.T.I. was less than 25. Using the P.A.T.I., we conclude that gunshot victims are more likely to need trauma center treatment than those with stab wounds. The P.A.T.I. also might facilitate cost analysis of trauma care. The ability to assess effects of patient age, sex, amount of blood loss, duration of hemodynamic shock, and metabolic response to injury might further enhance the therapeutic implications in both penetrating and blunt abdominal trauma.

Abdominal Injuries↗
PubMed1981

Peritoneal lavage in the evaluation of penetrating abdominal trauma.

Peritoneal lavage has become widely accepted in the management of blunt abdominal trauma, but its role has not been clearly established in the evaluation of penetrating abdominal injuries. The interpretation of lavage effluent analysis and the criterion for laparotomy are also unclear. A review of our recent experience and that of other indicates that peritoneal lavage has a significant role in detecting intra-abdominal injury from abdominal stab wounds and penetrating injuries of the lower part of the chest. Peritoneal lavage has a limited role in the evaluation of abdominal gunshot wounds, that is, when penetration of the peritoneum is equivocal. It is of negligible value in the evaluation of penetrating trauma to the back and flank. Quantitation of erythrocytes in the lavage effluent is the most reliable indication of intra-abdominal injury, and the level of significance varies according to the mechanism and location of the injury. The usefulness of other analysis of the effluent remains undetermined.

Abdominal Injuries↗
PubMed1980

Transfusion and renal allograft survival: beneficial effect of transfusions given on day of transplantation.

To determine if the beneficial effect of blood transfusion on renal allograft survival can be obtained without risk of presensitization, we examined the effect of transfusions given on the day of transplant surgery in a series of 180 primary cadaveric renal allografts. Three-month graft survival of those transfused only on the day of transplant was significantly better than the graft survival of those never transfused, and was not significantly different from graft survival of those transfused during the dialysis waiting period. Maximal beneficial effect was achieved by administration of as few as two to three units. We conclude that the benefits of transfusion can be obtained while minimizing the risks of presensitization if transfusion is minimized during the dialysis waiting period and patients are electively transfused at the time of transplant.

Adolescent↗
PubMed1980

Mechanisms of levamisole-induced granulocytopenia in breast cancer patients.

Five of 39 (13%) women treated with adjuvant combination chemotherapy plus levamisole immunotherapy after mastectomy for Stage II or III breast cancer developed levamisole-induced granulocytopenia. This complication occurred in each of the women between six and ten weeks after the completion of six months of combination chemoimmunotherapy when they were taking levamisole alone. Although none of the patients had an HLA B-27 locus and leukoagglutinins could not be demonstrated, complement-dependent, IgM mediated, peripheral destruction of granulocytes was documented using a microgranulocytotoxicity assay. In addition, a factor(s) present in serum from patients developing levamisole-induced granulocytopenia caused suppression of bone marrow granulocyte progenitor cells (CFU-C). The possible relationships between levamisole-induced peripheral granulocyte destruction and bone marrow CFU-C suppression are discussed.

Acute Disease↗
PubMed1980

Abdominal injuries associated with penetrating trauma in the lower chest.

A 5 year experience of 248 patients with isolated penetrating lower chest injury was reviewed. Twenty-two (15 percent) of the stab wounds and 46 (46 percent) of the gunshot wounds caused associated intraabdominal injury. Among those taken to the operating room for laparotomy, physical examination proved misleading in 40 percent of the patients with stab wounds and 30 percent of those with gunshot wounds. The diagnostic accuracy of peritoneal lavage, used selectively, was 93 per cent for the patients with stab wounds and 90 percent for those with gunshot wounds. The morbidity was high in patients with combined injuries, with major complications occurring in 27 percent of those with stab wounds and 43 percent of those with gunshot wounds. Two thirds or more of these complications were thoracic. There was one death (4 percent) among the patients with thoracoabdominal stab wounds and six (13 percent) among those with gunshot wounds.

Abdominal Injuries↗
PubMed1980

Mandatory laparotomy for gunshot wounds penetrating the abdomen.

A 4 year experience with 245 patients with isolated lower thoracic or anterior abdominal gunshot wounds was reviewed. Twenty-three (16 percent) of the 144 abdominal injuries were clinically superficial and all were managed successfully nonoperatively. Of the remaining 121 patients, 115 were confirmed to have peritoneal violation at laparotomy and 111 (96 percent) of these had significant visceral injuries. Of the 101 patients with lower chest wounds, 47 had peritoneal violation and 45 (96 percent) had intraabdominal injuries. Twenty-six (17 percent) of the 156 patients with intraperitoneal trauma had unimpressive physical signs on admission. these findings support a policy of routine exploration for gunshot wounds violating the peritoneum. When depth of penetration is uncertain, diagnostic peritoneal lavage should be used. Only those patients with unequivocally superficial injuries warrant observation.

Abdominal Injuries↗