Biomedical subjects
Publications and source records attributed to L R Del Guercio.
Twenty patients with hepatobiliary disorders were prospectively studied by means of minilaparotomy. The study included cytologic evaluation of intra-hepatic bile obtained at trans-hepatic cholangiography. The yield of malignancy identified was increased one third by the cytologic studies.
An instrument has been developed to record contrast dilution curves by a noninvasive technique. Transthoracic roentgen density alterations are recorded by use of a solid state radiation detector array. A small amount of injected nonradioactive, radiopaque contrast material is distrubuted throughout the central circulation. The detector array positioned over the cardiopulmonary silhouette, records changes in density during the passage of the contrast material, and typical indicator dilution curves are transcribed. These curves reflect changes in blood flow distribution, vascular volume, cardiac function, and intrathoracic vascular shunts; and define the hemodynamic status of the circulatory system.
A simple means of evaluating the immune function of critically ill patients has been designed. This system uses 22 input data that are derived from an assessment of humoral and cellular immunity and of the various factors known to influence the immune status. The profile allows quantification of the degree of immune depression as well as follow-up of the progression of the immune status.
Clinical monitoring of isolated parameters may lead to erroneous conclusions or conflicting speculations about the patient's general physiological status. Data derived from two or three primary parameters may provide a better understanding of the patient's overall status. Four automated profiles have been designed to aid in the management of critically ill patients. Data obtained from simple blood and urinary tests are used to compute parameters for various physiologic, renal, respiratory, and metabolic functions. The derived data are plotted in hard-copy form. A sequential series of each profile assists the physician in making intelligent and rapid therapeutic decisions and in evaluating the effectiveness of this therapy.
A relatively simple and inexpensive data management system is described with which comprehensive physiologic and cardiovascular profiles are produced. The system is comprised of a desk-top programmable calculator interfaced with an acoustic digitizer input, and an X-Y plotter, with alphanumeric printing output capability. Numerical clinical data such as intracardiac pressures and blood gas values are entered into the calculator via the keyboard, and graphical data such as dye-dilution curves or ventricular contours are digitized with a pen stylus on the acoustic tablet. The data are processed in the calculator and the results charted in familiar and readily interpreted bar-graph format on preprinted charts on the X-Y plotter. The entire system is inexpensive and compact enough to be applicable to small- and medium-size community hospitals.
Measurements of hemodynamic, oxygen transport, and tissue utilization functions were incorporated into a physiologic profile assessment system in order to evaluate patients who are candidates for mechanical support of the failing heart. Circulatory function was assessed in patients with acute myocardial infarction associated with diminished peripheral perfusion and compared to an age-matched, normal patient group. Serial studies performed prior to and during intra-aortic balloon counterpulsation provide a means to assess circulatory status accurately and document the efficacy of therapeutic interventions.