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Biomedical subjects

P Mucha

Publications and source records attributed to P Mucha.

67 records · Page 4Linked to original sources
PubMed1982

Two-dimensional echocardiographic findings in cardiac trauma.

Cardiac contusion is a potentially fatal complication of blunt chest trauma. The diagnosis is obscured because cardiac contusion usually occurs in a setting of multisystem trauma. Furthermore, the electrocardiographic changes are nonspecific. Experience with 2-dimensional echocardiography in evaluating cardiac trauma has not previously been emphasized. This report examines the results of 2-dimensional echocardiographic examinations in 7 patients after significant blunt chest trauma. Generalized right ventricular dilatation was identified in 4 cases; superimposed segmental areas of right ventricular dilatation occurred in 3. Three patients had localized myocardial thinning, and segmental wall motion abnormalities occurred in 2. Additional abnormalities identified included ventricular thrombi (4 right and 1 left ventricular), fibrinous pericardial effusion (1), ruptured tricuspid chordae with flail leaflet (1), and a small aneurysm of the sinus of Valsalva (1). It is concluded that 2-dimensional echocardiography is useful for diagnosing cardiac contusion, for estimating the extent of myocardial damage, and for identifying accompanying cardiac lesions such as thrombi, pericardial effusion, and valvular disruption.

Adolescent↗
PubMed1980

Surgical management of inflammatory bowel disease.

Indications for operation in patients with inflammatory bowel disease are now standardized as a result of the vast surgicaL experience that has been accumulated during the past 40 years. The surgical indications in Crohn's disease and chronic ulcerative colitis vary minimally with the anatomic distribution of either disease, and can be recognized easily in a particular patient. Consequently, decision or judgment regarding the need for operation is rarely difficult. Delaying operation on the basis of fear of recurrence of Crohn's disease is unrealistic because (1) indications for operation are complications of the disease that have not responded or cannot be expected to respond to medical treatment, (2) conservative resection primarily removes diseased bowel that will never return to normal, (3) many patients, perhaps 50%, will never have recurrence of disease, and (4) those who have recurrence will have experienced varying periods when they were free of disease and relieved of the serious complications for which their operations were performed. The value of surgery in the treatment of patients with chronic ulcerative colitis can be stated even more positively, because recurrence of disease is never a concern after proctocolectomy.

Adult↗
PubMed1980

Aortic graft-enteric fistula.

Fifteen years' experience with 20 patients undergoing 24 operations for intestinal bleeding from aortic graft-enteric fistula at the Mayo Clinic has been reviewed. A review of the English language literature permits analysis of an additional 127 patients who underwent surgical intervention for this condition. Associated operative mortality in our experience and in that of others has been high--55% and 46%, respectively. Long-term survival in both groups remains low--approximately 15%. Consideration has therefore been given to aspects of prophylaxis, diagnosis, and intervention which may minimize future morbidity and mortality.

Aged↗
PubMed1980

Subclavian vein. A golden route.

Percutaneous access to the subclavian vein provides a route for the insertion of a variety of devices necessary in the management of severely ill patients. As described in this article, the technique can be easily and safely performed. Special emphasis is given to the more recent applications of the technique in the placement of Swan-Ganz catheters, cardiac pacemakers, and hemodialysis cannulas. With familiarity of the anatomy, careful attention to details, and an awareness of the potential complications, this technique can become a useful tool for the practicing physician in various disciplines.

Cardiac Catheterization↗
PubMed1980

[Liver injuries].

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

Mechanism of the activation of proteinase inhibitor synthesis by systemin involves beta-sheet structure, a specific DNA-binding protein domain.

We analyzed a tertiary structure of systemin, the first identified polypeptide plant hormone, using two-dimensional NMR spectroscopy. From these data and molecular dynamics calculations we concluded that the peptide can adopt a Z-like-beta-sheet structure, which has previously been found in many specific DNA-binding proteins. Using DNA-cellulose affinity chromatography, we showed that systemin binds strongly to DNA. We suggest that the specific systemin-DNA interaction, particularly in a promoter region of the proteinase inhibitors, could effect gene expression and thus explain the biological activity of systemin.

Amino Acid Sequence↗
PubMedDate not supplied

Long-term outcome of cholecystoenterostomy as a definitive biliary drainage procedure for benign disease.

Our aim was to examine the long-term success of cholecystoenterostomy performed for the relief of benign extrahepatic biliary obstruction. Concern about the ability of cholecystoenterostomy to provide reliable long-term biliary decompression has led many to abandon its use for benign biliary obstruction. Thirty-four patients who underwent cholecystoenterostomy for benign biliary obstruction over a 17-year period were reviewed. Patients were followed until cholecystoenterostomy failure, death, or to date. Failure was defined as recurrent biliary obstruction or cholangitis requiring therapeutic intervention. Mean follow-up was 8.0 years. Early postoperative morbidity occurred in 11 patients (32%), but only one early complication (cholangitis) was related directly to the cholecystoenteric anastomosis. Five patients (15%) experienced late biliary tract complications related directly to the cholecystoenterostomy including recurrent biliary stones with biliary obstruction in four and anastomotic stricture in one. All required reoperation and conversion to choledochoenterostomy at a mean of 112 months. Cholecystoenterostomy can provide reasonably effective long-term biliary decompression in selected patients with benign biliary obstruction.

Adolescent↗
PubMedDate not supplied

The diagnostic challenge of postoperative acute appendicitis.

During the period 1979 to 1989, 0.1% of all cases of acute appendicitis at our institution occurred soon after another operative procedure. The interval between primary operation and appendectomy was 5 to 31 days (mean, 14 days). Signs and symptoms did not differ from those of classical acute appendicitis. Duration of symptoms ranged from 12 hours to 8 days (mean, 2.4 days). Perforation was present in 3 patients, suppurative appendicitis in 1 patient, and acute inflammation in 4 patients. Two of the perforations were associated with abscess formation. Morbidity related to the appendiceal condition included hepatic abscesses, septic shock, and prolonged ileus. There was no mortality. Hospitalization ranged from 6 to 80 days (mean, 12.5 days).

Acute Disease↗
PubMedDate not supplied

Physical and psychological outcome after burns.

The relationship between compliance of moderately or severely burned patients with suggested plans of treatment and outcome was examined retrospectively by reviewing medical records. This review was limited to patients admitted to our facilities between 1977 and 1982 with burns in the moderate or major burn category and admitted within seven days of their injuries. The outcome measures included the following: limitation in range of motion (ROM), hypertrophic scar formation, total days of care required, quality of life, and impact of event. Noncompliance was related to the outcome as measured by limitation in ROM (P less than 0.01) and total days of care required (P less than 0.0001). A trend for diminished quality of life was related to noncompliance (P less than 0.08). Extent of injury (measured by total body surface area involved) was not related to ROM, quality of life, or impact of event but was related to total days of care required (P less than 0.01); there was also a trend toward scarring (P less than 0.06).

Activities of Daily Living↗