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Biomedical subjects

N B Ackerman

Publications and source records attributed to N B Ackerman.

At least 19 recordsLinked to original sources
PubMed1990

High-frequency oscillation during simulated altitude exposure.

Ventilatory requirements using high-frequency oscillation (HFO) during simulated altitude exposure were investigated in control dogs and animals with oleic acid-induced lung injury. FIO2 values of 0.21 and 1.0 were supplied by bias flow to the normal and injured dogs, respectively. After a control period, animals were exposed to a simulated altitude of 8,000 ft (barometric pressure 564 torr), followed by a second control period at ground level. Both experimental groups had similar values of PaCO2 at ground level and during exposure to reduced barometric pressure. The tidal volume necessary to maintain eucapnia was higher in oleic acid-injured animals compared with the control group; cardiac output and functional residual capacity were lower. The alveolar-arterial oxygen difference was substantially larger in the oleic acid group. Adequate gas exchange can be maintained with HFO during exposure to altitude provided that ventilation and inspired PO2 are not reduced below normobaric levels.

Altitude↗
PubMed1979

Perforated appendicitis in an incarcerated inguinal hernia.

Although perforated appendicitis in an incarcerated hernia is an uncommon condition, the clinical manifestations vary from relatively benign to much more serious, depending on whether the septic process is limited to the hernial canal and sac or if there is intraperitoneal contamination. The patient described in this report had minimal symptoms other than a slightly tender, irreducible inguinal hernia. He easily tolerated resection of the appendix and contiguous inguinal tissues, with a primary repair of the inguinal hernia.

Acute Disease↗
PubMed1979

Comparison of changes in intestinal length and circumference after 90 per cent bypass and 90 per cent resection.

Compensatory hypertrophy was compared in rats that had undergone 90 per cent small intestinal resection and rats that had undergone 90 per cent small intestinal bypass. Increases in intestinal length and circumference occurred rapidly in both groups and were virtually identical. Lengthening was more pronounced in the jejunum; increase in circumference was greater in the ileum. Increases in length and circumference of the appendix were seen in both experimental groups. These studies suggest that compensatory hypertrophy can occur in patients after either intestinal bypass or resection, and that patients with bypasses have a less difficult postoperative course because of their preexisting obesity.

Animals↗
PubMed1979

Improved exposure for excision of rectal carcinomas: initial experiences with a pubic resection technique.

Preliminary experiences with a transpubic approach for carcinoma of the rectum are described. By excising a wedge of pubic bone and freeing the left lateral attachments of the bladder, the entire length of rectum can be exposed, down to the level of the levator muscles. Dissection of the tumor can be performed under direct vision, even in unfavorable anatomic and pathologic situations. Low rectal anastomoses, at levels of 1--2 cm above the anus, may be performed with greater ease. It is felt that urinary problems should be uncommon and that orthopedic complications should not occur since sacroiliac articulations are not disturbed by retraction.

Aged↗
PubMed1979

Obstructive, pseudo-obstructive and enteropathic syndromes after jejunoileal bypass.

We have encountered two patients with volvulus of the small intestine at the ileocolic anastomosis, occurring after jejunoileal bypass. This uncommon complication is generally seen many months after bypass and may be difficult to diagnose. Barium enema examination was helpful in one patient. If there are acute, severe abdominal symptoms, mechanical obstruction and early operation should be considered. Attention has been called to other intestinal syndromes with obstructive features developing after jejunoileal bypass, and these have been compared.

Adult↗
PubMed1979

Poor prognosis of patients with intra-abdominal sepsis and hypouricemia.

With uric acid levels of 0.4 to 3.0 milligrams per cent, hypouricemia was noted in 17 patients with intra-abdominal sepsis. This was associated with a fivefold to sixteenfold increase in the urate clearance and uric acid to creatinine clearance ratios. The number of deaths in the 17 patients with hypouricemia is 14 versus 20 for the overall group of 111 patients studied. Two patients had a reversal of the serum uric acid, 24 hour urine uric acid output and uric acid to creatinine clearance ratio, with drainage of the intra-abdominal sepsis. Hypouricemia seems to indicate a poor prognosis in patients with intra-abdominal sepsis.

Abdomen↗
PubMed1979

Protein supplementation in the management of degenerating liver function after jejunoileal bypass.

Five patients who began to have signs of degenerating liver function develop after jejunoileal bypass were treated with protein supplementation, either on an outpatient or inpatient basis, making use of preparations orally and intravenously. Subjective as well as objective evidence of improving liver function was obtained, and all patients have survived. It is important to maintain a high protein intake postoperatively. The most useful tests for assessing the status of liver function in these patients have been serum albumin, serum bilirubin and prothrombin time.

Adult↗
PubMed1978

The significance of serratia as an infectious organism.

The hospital records of 48 patients with infections due to Serratia marcescens were reviewed. Isolates from these patients had been cultured during the period from August 1973 through July 1975, at which time an increase in frequency of infections due to Serratia had been noted. Most of these patients were elderly males with chronic debilitating diseases. All patients had received antimicrobial therapy prior to the time Serratia was first isolated. The majority had had indwelling urinary catheters inserted during some period of their hospitalization. Isolates were obtained predominantly from the urinary tract. In six of the 11 patients who died, Serratia appeared to play a role in the outcome, and all three patients with Serratia septicemia died. Serratia marcescens can be a virulent pathogen with a high degree of resistance to antibacterial agents. Attention must be given to the use of a sterile technique for insertion of urinary catheters, frequent care and cleansing of the catheter-meatal junction and use of a closed drainage system.

Adult↗
PubMed1978

Studies on the capillary permeability of experimental liver metastases.

By using a quantitative Evans blue technique, vascular permeability of Walker carcinosarcomas implanted in the liver was compared with that of the host liver tissue. Rats were sacrificed at intervals from one minute to 96 hours after the intravenous injection of the dye. Permeability activity curves were significantly different for tumors and normal liver. Permeability activity was lower in the tumor at one and five minutes, approximately the same in the tumor and liver from 15 minutes to one hour but, from two hours to 48 hours, the permeability activity was significantly higher in the tumor. The peak tumor-liver permeability activity ratio of 1.87 occurred at six hours, and the highest tumor permeability activity values were seen at 18 hours. Liver permeability activity, in contrast, increased gradually after dye injection, reading peak levels at 24 to 72 hours. At 96 hours, both tumor and liver permeability activity were lower and equal. The differences in permeability activity may be explainable on the basis of structural differences in normal and tumor vessels or may be due to chemical substances released as a result of the presence of the tumor. The differences in permeability activity of tumors and normal tissues may be an important factor in determining the effectiveness of diagnostic and therapeutic techniques.

Animals↗
PubMed1977

Primary arterial ligation in resection of cancer of the colon. Rational and technic.

The dynamics of arterial, venous, and lymphatic flow in the mesentery were studied in dogs, using an electromagnetic flowmeter for the blood and cannulation and gravimetric measurement for the lymph. Ligation of veins caused an increased venous outflow in adjacent veins and a marked increase in lymph flow. When marginal vessels were ligated, eliminating the major collateral flow, venous flow decreased, but elevated lymph flow persisted. Simultaneous ligation of arteries and veins resulted in increases of both arterial and venous flow in adjacent vessels. Lymph flow decreased unless excessive arterial collateral flow persisted. When collateral marginal vessel flow was occluded, adjacent venous and arterial blood flow decreased to control levels. With arterial ligation, collateral arterial blood flow increased slightly, but venous and lymph flow decreased sharply. When collateral marginal vessels were eliminated, adjacent arterial blood flow decreased to control levels and venous flow virtually stopped. As a result of these studies, the technic of early primary arterial ligation followed by marginal vessel ligation appears to be the most satisfactory procedure for decreasing venous and lymphatic outflow and hopefully avoiding dissemination of cancer cells during the operation. This technic is now being used as a modification of the "no touch" technic for cancer of the colon.

Animals↗
PubMed1976

Hyperparathyroidism with coexisting hyperthyroidism.

Diagnosis of parathyroid disease in patients with hyperthyroidism may be difficult on clinical findings alone. Radiologic examination of the bones suggested the possibility of parathyroid disease in this patient. Confirmation of the diagnosis was made when serum calcium levels remained elevated in spite of adequate antithyroid medication. Measurement of serum parathyroid hormone levels may prove to be of greatest value. Of additional interest is the fact that the patient, before her symptoms became apparent, delivered an infant with congenital hypoparathyroidism.

Adult↗
PubMed1976

Problems in differentiating between pancreatic lymphoma and anaplastic carcinoma and their management.

A group of 6 patients with malignancies involving the pancreas is presented, with a range of diagnosis from primary reticulum cell sarcoma to probable anaplastic carcinoma. Even with adequate biopsy and autopsy material, it may be difficult to provide a definitive tissue diagnosis in these patients. Although this entire spectrum of tumors is uncommon, it is important to try to establish a diagnosis whenever possible. Biopsy of the tumor should be performed, even from the pancreas itself, if necessary, particularly when the initial presentation of the disease is unusual or if the pattern of metastasis is different from that usually seen with carcinoma of the pancreas. It is suggested that a therapeutic trial of appropriate radiotherapy and chemotherapy be instituted in patients of this type even if a diagnosis of lymphoma is not firmly established. The possibility exists of survival of some of these patients for periods of one year or more as a result of successive therapy.

Adult↗