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Biomedical subjects

M Cremer

Publications and source records attributed to M Cremer.

At least 199 records · Page 11Linked to original sources
PubMed1965

Mechanism of Polykaryocytosis Associated with Noncytopathic Infection by Measles Virus.

Atherton, John G. (University of Southern California, Los Angeles), Sotiros G. Chaparas, Martha Cremer, and Irving Gordon. Mechanism of polykaryocytosis associated with noncytopathic infection by measles virus. J. Bacteriol. 90:213-219. 1965.-Infection with a measles virus variant resulted not only in formation of polykaryocytes (PK) but also in formation of multicellular immunofluorescent foci (IFF) in which no cytopathic effect could be detected. The ratio of IFF to PK changed from 27 to 4 during the first passage and remained 4 after a second passage. PK were plaques. Plaque assay was linear in the presence of IFF. To investigate the mechanism of PK formation, radioautography was done on cells pulse-labeled with tritiated thymidine before virus multiplication began. The results showed that PK were formed by fusion; there were no PK whose nuclei contained no label, and the proportion of labeled nuclei (32%) and distribution of grain counts was the same in PK as in uninvolved cells, ruling out nuclear replication without concomitant cytoplasmic membrane formation as the mechanism of formation of these PK. Early in PK development, neutral red uptake was markedly increased ("red" plaques). As PK matured, hyperchromicity disappeared ("white" plaques). This sequence provided an index of rate of evolution of PK. Rate of PK maturation was more rapid at 37 than at 32 C.

Journal Article↗
PubMedDate not supplied

Endoscopic approach to malignant biliary obstruction.

A consensus is growing among units that have experience in both endoscopic and percutaneous stenting techniques that the endoscopic approach to malignant biliary strictures is more comfortable for the patient and has fewer complications. This article describes endoscopic biliary drainage in malignant stenoses of the bile ducts and delineates the respective indications for percutaneous and endoscopic techniques. New materials have become available for endoscopic and percutaneous biliary drainage, particularly metallic stents which may provide better palliation.

Cholestasis, Intrahepatic↗
PubMedDate not supplied

Long-term follow-up of patients with hilar malignant stricture treated by endoscopic internal biliary drainage.

Seventy patients with biliary obstruction secondary to hilar tumors underwent attempted endoscopic internal biliary drainage using large transpapillary stents between December 1981 and March 1986. Placement of one or more stents was successful in 68. The type of stricture and mode of treatment were more important in determining subsequent survival than the type of tumor. In type II and III malignant strictures of the bifurcation of the common hepatic duct and the main hepatic duct, use of two or more stents to achieve complete drainage of the biliary system improves survival compared to incomplete drainage (176 vs. 119 days) and reduces procedure-related mortality and the incidence of early and late cholangitis. Patients with hilar tumors causing type II and III strictures treated with placement of multiple stents have at least as good a prognosis as patients with tumor involving only the common hepatic duct treated with use of a single stent. Once ERCP is performed and palliative endoscopic management of bifurcation tumors is begun, it must completed as soon as possible.

Adenoma, Bile Duct↗
PubMedDate not supplied

Endoscopic management of cysts and pseudocysts in chronic pancreatitis: long-term follow-up after 7 years of experience.

Endoscopic cystoenterostomy was performed in 33 patients with chronic pancreatitis. Endoscopic cystoduodenostomy (ECD) was done in 22 cases of symptomatic paraduodenal cysts and endoscopic cystogastrostomy (ECG) in 11 cases of retrogastric pseudocysts. The success rates were 96% for ECD and 100% for ECG. The relapse rate was 9% after ECD and 19% after ECG. No significant complications were observed after successful ECD and clinical relief of pain was achieved in 20 patients. ECD was an effective and definitive treatment for 19 of the 22 cases. Two complications of ECG were gastric hemorrhage and iatrogenic pseudocyst infection. In two ECG patients, percutaneous drainage was required. ECG alone was a definitive treatment for 8 of the 11 cases. When restricted to the precise morphological indication (paraintestinal cyst bulging into the duodenal or gastric lumen), ECD is the first choice for treatment of paraduodenal cysts, whereas ECG is an alternative procedure for the drainage of retrogastric pseudocysts, offering at least results as good as percutaneous drainage.

Adult↗
PubMedDate not supplied

Endoscopic biliary drainage in chronic pancreatitis.

Between April 1982 and March 1988, 25 patients with chronic pancreatitis presented with biliary stenosis and significant cholestasis. They were treated by endoprosthesis placement. Nineteen patients had jaundice, and, initially, seven had cholangitis (including three with hepatic abscesses). ERCP was successful in all 25 patients. Cholangitis, cholestasis, and jaundice resolved in all cases after stent placement. Two patients died in the 2 months after treatment. Complete follow-up (mean duration, 14 months, range 7 to 42 months) was available for 19 of the 23 remaining patients. Migration of the stent occurred in 10 patients and stent blockage in 8 patients, with relapsing cholestasis (N = 12), cholangitis (N = 4), or without symptoms (N = 2). Only three of these patients are now asymptomatic without a stent in place after 12 to 72 months. In all of the other cases, stents have been replaced or patients have been treated by surgery. We conclude that endoscopic biliary drainage is an effective treatment for resolving cholangitis or jaundice in patients with chronic pancreatitis and biliary stenosis, but that the results of definitive endoscopic drainage for these patients are less satisfactory because resolution of the stricture after removal of the stent is rarely obtained.

Adult↗
PubMedDate not supplied

Endoscopic palliative intubation of the esophagus invaded by lung cancer.

Thirty-two patients with esophageal involvement by lung cancer were managed by endoscopic intubation. In 22 patients with extrinsic esophageal strictures, the success rate of intubation was 91%, and 82% were discharged with their dysphagia relieved and esophageal patency restored. The mean survival rate was 4.4 months. In 10 patients with esophago-bronchial fistulas, 3 had the fistulous tract obliterated and lived a mean of 5 months. This low success rate of closing fistulas is due to failure to seal off the space between the stent and the fistula because of absence of tumor-associated stenosis. The overall morbidity rate was 28.1% (18.8% perforation, 6.3% hemorrhage, and 3.1% tracheal obstruction). The overall mortality rate was 18.8%. Although complications were more frequent than in primary esophageal tumors, endoscopic intubation was the only way to palliate this desperate condition and provided 66.6% of patients with relief of symptoms, nutritional improvement, and a mean survival time of 4.5 months.

Bronchial Fistula↗
PubMedDate not supplied

Expandable biliary metal stents for malignancies: endoscopic insertion and diathermic cleaning for tumor ingrowth.

Seventeen patients with malignant biliary strictures have been treated by endoscopic insertion of self-expandable metallic prostheses. Two patients received two prostheses inserted simultaneously in both the left and right hepatic ducts for Klatskin tumor type III. Immediate results were satisfactory despite an operative mortality of 18%, and neither early nor late clogging was observed even in patients who presented previously with sludge above plastic stents that were removed. However, among five patients followed for more than 4 months, two presented with obstruction due to tumor ingrowth into the stent through the metallic mesh. Accordingly, initial enthusiasm concerning long-term patency of these stents has decreased. However, we describe a technique of "diathermic cleaning" of tumor ingrowth which can easily restore the stent patency. The advantages of these wire mesh 30 F stents are their easier insertion, better immediate drainage, and absence of dislocation or perforation.

Aged↗
PubMedDate not supplied

Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current.

The complications related to 1485 colonic snare polypectomies were analyzed according to the type of current which was used for resection. From January 1982 to August 1986 (period 1), blended current was used in 758 snare polypectomies, while continuous coagulation current was applied in 727 polypectomies from September 1986 to October 1989 (period 2). The incidence of complications observed in the entire series was low, consisting of 0.26% perforations and 0.9% major hemorrhages. There were no deaths in this series. Twelve of 14 hemorrhages occurred after resection of polyps larger than 1 cm. Although the incidence of complications was not statistically different in the two groups, there was a significant difference in the timing of hemorrhages. All of the major hemorrhages were immediate (eight) when the blended current was used, but delayed (six; from 2 to 8 days after polyp resection), when pure coagulation current was applied.

Colonic Polyps↗