Search PubMed⌕ Search

Biomedical subjects

K S Scher

Publications and source records attributed to K S Scher.

At least 55 records · Page 3Linked to original sources
PubMed1984

The fate of the left kidney after division of its vein.

The effect of dividing the left renal vein was studied in Sprague-Dawley rats. Immediately after the left renal vein is divided near the renal hilum, the left kidney becomes markedly edematous and dusky. Twenty-four hours later, the kidney remains edematous and boggy. In contrast, the edema that immediately follows division of the left renal vein adjacent to the inferior vena cava is much less dramatic and virtually resolves within 24 hours. When the left renal vein was divided near the hilum simultaneously with right nephrectomy, all animals died within 48 hours. When the vein was divided adjacent to the vena cava with simultaneous nephrectomy, all animals survived. The effect of dividing the renal vein on perfusion of the left kidney was studied in Sprague-Dawley rats using intra-arterial injection of copper pigment. Division of the left renal vein reduced perfusion of that kidney to 68.9 per cent of control levels. This reduction was demonstrated to be totally reversible within 10 days.

Animals↗
PubMed1983

Traumatic diaphragmatic rupture involving the pericardium.

We have described a case of severe blunt injury to the thorax and abdomen causing an 8 cm laceration of the central tendon of the diaphragm, with extension into the pericardium. Herniation of the apex of the heart through this defect produced hypotension that was unresponsive to fluid resuscitation. Replacement of the heart into the mediastinum promptly restored the blood pressure to satisfactory levels.

Accidents, Occupational↗
PubMed1983

Protection from postsplenectomy sepsis: Effect of prophylactic penicillin and pneumococcal vaccine on clearance of type 3 Pneumococcus.

The intravascular clearance of type 3 Streptococcus pneumoniae was studied in Sprague-Dawley rats. One hundred animals were divided into the following five equal groups: I--splenic mobilization, II--splenectomy, III--splenectomy plus pneumococcal vaccine, IV--splenectomy plus 50,000 U of penicillin prophylaxis, V--splenectomy plus 300,000 U of penicillin prophylaxis. Bacteremia was induced by intraperitoneal injection of 10(6) type 3 S. pneumoniae. Serial cultures of peripheral blood were obtained. Splenectomy produced significant impairment of intravascular clearance of Pneumonococcus compared to clearance in control animals (P less than 0.01). Neither dose of penicillin, administered prophylactically prior to induction of bacteremia, significantly altered pneumococcal clearance of asplenic animals. Administration of polyvalent pneumococcal vaccine to splenectomized rats resulted in measurable antibody titers. More importantly, such immunization of asplenic animals significantly improved pneumococcal clearance compared to clearance in asplenic, nonimmunized rats (P less than 0.03). Although in both groups I and III animals S. pneumoniae organisms were effectively removed from the peripheral blood, the clearance curves are significantly different (P less than 0.01). This represents the difference between phagocytosis by the reticuloendothelial cells of the liver and those of the spleen.

Animals↗
PubMed1982

The effect of splenectomy on gram-negative bacteremia.

Both clinical and laboratory studies have demonstrated an increased risk of fatal sepsis after splenectomy. The importance of the spleen in clearing a bacterial challenge from pneumococci or other encapsulated organisms is now well accepted. The role of the spleen in handling a bacteremia due to nonencapsulated (Gram negative) organisms is not well established. Rats were subjected to either sham operation or splenectomy. Two weeks after surgery, all animals received 10(6) E. coli by intraperitoneal injection. Tail vein blood samples for quantitative culture were obtained at multiple time intervals after the bacterial challenge. All animals developed a bacteremia. Initially, the mean bloodstream bacterial counts were comparable in the sham and splenectomy groups. Sham-operated rats cleared all bacteria from the bloodstream within 240 minutes. In contrast, 240 minutes after bacterial injection, E. coli could still be recovered from the blood of asplenic rats at levels comparable to those noted at the start of the experiment. The present study shows that splenectomy does impair the animal's ability to clear a Gram-negative bacteremia.

Animals↗
PubMed1982

A comparison of stapled and sutured anastomoses in colonic operations.

Stapled colonic anastomoses can be performed both above and below the peritoneal reflection with complication rates that are comparable with those achieved when these anastomoses are sutured by hand. The new circular stapling instrument may facilitate the performance of a lower colorectal anastomosis than can be done by hand. Operative time, return of intestinal activity and postoperative hospital stay are not significantly affected by the anastomotic technique used.

Adenocarcinoma↗
PubMed1982

Effects of oxidized cellulose and microfibrillar collagen on infection.

Topical hemostatic agents may be used to control bleeding from a variety of surgical sites. Oxidized cellulose (Surgicel), gelatin sponge (Gelfoam), and microfibrillar collagen (Avitene) are the hemostatic agents in widest use. Oxidized cellulose has previously been shown to be superior to gelatin sponge with respect to infection. Microfibrillar collagen has not been studied in this regard. Contamination of experimental wounds with an inoculum of 3.2 to 3.6 X 10(4) colony-forming units of Staphylococcus aureus did not produce any infection. The addition of 20 mg of oxidized cellulose to wounds that received the same level of bacterial contamination resulted in nine infected wounds of 20 (45%). When the wounds were treated with 20 mg of microfibrillar collagen prior to contamination, 18 of 20 (90%) developed infection. The observed difference between the two hemostatic agents was significant (P less than 0.008). When 5 and 10 mg of oxidized cellulose was added to experimentally contaminated wounds, infection did not ensue. The incidence of infection increased strikingly when the amount of oxidized cellulose employed was increased to 20 and 30 mg. No such dose effect was observed for microfibrillar collagen. Infection developed even when very small quantities of the agent were used. Both oxidized cellulose and microfibrillar collagen may promote infection. The present study, in which a subcutaneous wound model was used, suggests an advantage of oxidized cellulose as compared with microfibrillar collagen from the standpoint of infection. Further studies with these agents in other body sites seem warranted.

Animals↗
PubMed1982

A comparison of stapled and sutured anastomoses in gastric operations.

To compare the results of sutured and stapled anastomoses in the performance of gastric operations, 112 consecutive patients, operated upon by the same group of surgeons, were reviewed. Of 80 gastric resections, 44 were done with conventionally sutured anastomoses, while 36 had stapled anastomoses. Of 42 gastrojejunostomies without resection, 18 were sutured and 24 stapled. The incidence of leaks, bleeding and stasis was similar for stapled and sutured procedures. This was true for both gastric resections and gastrojejunal anastomoses without resection. No significant differences were noted between the stapled and sutured procedures with regard to operative time and length of postoperative stay. Patients in the sutured gastrectomy group regained intestinal function more rapidly than when the staples were used, 3.9 compared with 5.1 days. Stapling devices can be safely used to perform gastric operations. Complication rates with these devices are the same as those noted for more conventional suture techniques. Data from this study do not substantiate claims that stapling instruments reduce operative time or speed recovery of intestinal function.

Adult↗
PubMed1982

Prevention of wound infection: the comparative effectiveness of topical and systemic cefazolin and povidone-iodine.

From studies in mice, the irrigation of a contaminated surgical wound saline alone proved of little benefit. The addition of cefazolin to the irrigating solution favorably influenced the rate of infection. The most effective way to administer antibiotics topically was by the application of the antibiotic powder to the wound. Topical cefazolin administered in this way was equally as effective as systemic administration in preventing wound sepsis. Irrigation of a contamined wound with a solution of povidone-iodine was no more effective than the use of cefazolin powder but may be associated with significant toxicity.

Administration, Topical↗
PubMed1981

Malignant melanoma in West Virginia.

In West Virginia from 1959 to 1975 there were 279 deaths caused by malignant melanoma. From 1959 to 1967 there were 8.4 such deaths per year and from 1968 to 1975, 25.4 per year (2P < .0005). This trend was observed throughout the state. The population-adjusted melanoma mortality of 1.45 per 100,000 from 1968 to 1975 contrasts with a rate of only 0.48 per 100,000 during the earlier period from 1959 to 1967. The rate of increase was greater in the southern portion of the state. The highest melanoma mortality was seen in the state's major agricultural area, while the lowest rate was seen in its most densely populated urban region. In our community, 102 new melanoma cases were diagnosed from 1969 to 1978. From 1969 to 1973, there were 33 new cases, 6.6 per year, and from 1974 to 1978, 13.8 per year (2P < .01). Men tended to be older at the time of diagnosis. The most common locations of the primary tumors were the lower extremity in women and the trunk and head and neck in men.

Adolescent↗
PubMed1980

Selective approach to outpatient breast biopsy.

Despite several studies advocating the routine use of outpatient breast biopsy, most surgeons have been reluctant to adopt this practice. Selection of patients with low-risk lesions for outpatient biopsy is, therefore, proposed. Eighty-eight patients were divided into high-risk and low-risk groups using simple clinical criteria, including the size, consistency, and mobility of the breast mass, mammographic findings, history of previous breast cancer, and strong family history of breast cancer. The incidence of malignancy was 30.7% in the high-risk group and 2.6% in the low-risk group (P < .0005). A program of outpatient biopsy for patients with low risk for cancer might represent a compromise acceptable to both those who advocate outpatient biopsy for all lesions and those who follow a more traditional approach. This study shows that clinical criteria can be established to provide the basis for such a selective approach to the woman with a breast mass.

Ambulatory Care↗
PubMed1980

The continuing challenge of perforating appendicitis.

A series of 335 consecutive patients treated for acute appendicitis is presented. The incidence of perforation in the series was 32.2 per cent. The mortality was 0.3 per cent for the total series and 0.9 per cent for those patients with perforating appendicitis. When perforation occurs, a twofold increase in the hospital stay and a threefold increase in hospital costs result. A complication rate of 47.2 per cent in instances of perforation was significantly greater than that noted in instances of nonperforation. A 40 per cent incidence of perforation was noted during the first decade of life, after which the frequency of perforation declines. Beginning with the fifth decade, a progressive increase in the incidence of perforation was noted. Prior to hospital admission, a significant delay was noted among patients with perforation. In addition, those with perforating appendicitis were far more likely to have been seen previously by a physician who failed to advise hospital admission. Finally, a significant inhospital delay, from admission to operation, was noted in patients with perforating appendicitis. While geographic access to health care did influence the incidence of perforation, insurance status and possession of a telephone did not.

Adolescent↗
PubMed1980

Appendicitis: factors that influence the frequency of perforation.

The mortality from perforating appendicitis has decreased, but the incidence of perforation has not changed in 30 years. We found that among 335 consecutive patients treated for acute appendicitis, 108 (32%) had evidence of perforation. No significant differences between the groups were noted with respect to race, sex, educational level, family income, health insurance coverage, availability of transportation, and possession of a telephone. Perforation was more likely in patients who lived more than 20 miles from the hospital and in patients under age 10 years or over age 60. Patients with perforation were ill for a mean of 2.5 days before seeking medical attention, compared to a mean of 1.5 days for those without perforation (P < .001). Yet, approximately 75% of patients in each group stated that they had a "family doctor." Patients with perforation had significantly more physician visits before hospital admission (mean 1.61 vs 1.33, P < .005); 54.3% of patients with perforation had previous contact with a physician who failed to make the correct diagnosis.

Adolescent↗