Search PubMed⌕ Search

Biomedical subjects

R L Warpeha

Publications and source records attributed to R L Warpeha.

At least 19 recordsLinked to original sources
PubMed1998

Transplantation of lymph node fragments in a rabbit ear lymphedema model: a new method for restoring the lymphatic pathway.

The treatment of lymphedema by medical or surgical means remains a difficult task, and no technique is presently satisfactory. We established a rabbit ear chronic lymphedema model in which sequential lymph node fragments were transplanted to restore lymphatic pathways. Twenty New Zealand White rabbits were divided into two groups of 10 animals. One group served as the control, and the other was the transplantation group. A 3-cm-wide strip of skin and subcutaneous tissue including all the lymphatics was excised circumferentially from the root part of the right ear in each rabbit. The vascular pedicle in the control group was wrapped with a "bridge" strip of skin from the ventral ear to protect it from drying. In the transplantation group, the auricular lymph node was harvested from the contralateral ear, cut into 1- to 2-mm slices, and implanted next to the vascular pedicle where the lymph vessels had been resected. Water displacement measurements in both groups revealed significant edema (p < 0.001) compared with the contralateral ear at 3 days. Peak swelling was observed at 10 days in both groups. Volumes decreased in both groups postoperatively. The volume measured as percentage change in the lymph node transplantation group was significantly lower than in the control group at 2 months and continuing to the end of the experiment (p < 0.001). Indirect lymphographic examination revealed that the distal lymphatic vessels of the control group were increased in number, dilated, and did not allow proximal passage of dye. Light microscopy revealed the vascular pedicle to be surrounded by dense scar tissue in the "bridge." The transplantation group showed free passage of dye through the bridge. Microscopic examination showed regenerated lymphoid tissue with sinuses along the artery and vein of the "bridge." Many channels with a layer of endothelial cells were also noted. Electron microscopy confirmed these sites to be regenerated lymph vessels. Lymphatic tissue can regenerate after fragment transplantation. This lymph tissue seems to regenerate lymphatic vessels that may function for drainage. The results suggest that this simple technique may be applicable in a clinical situation to prevent or treat obstructive lymphedema.

Animals↗
PubMed1997

Topical application of low molecular weight heparin in a rabbit traumatic anastomosis model.

Low molecular weight heparins (LMWHs) are antithrombotic drugs composed of lower molecular weight components of heparin with an apparent molecular weight in the range of 4.0-8.0 KDA. These agents have been used clinically for several years. They have different mechanisms of action compared to heparin, a longer half-life and much higher bioavailability. Anticoagulant drugs such as heparin have been used topically in our previous studies to avoid bleeding complications observed with systemic administration. In this study, low molecular weight heparin (Certoparin, Sandoz) was topically administered in a rabbit ear arterial crush-avulsion thrombosis model and compared with heparin. The animals were divided into three groups: LMWH, heparin and saline control groups. In the LMWH group, the patency rate was 71% (10 of 14) at both 1 and 7 days. The patency rate in the heparin group was 95% (19 of 20) at 24 hrs and 80% (16 of 20) at 7 days. In the saline control group, the vessel patency rate was 17% at 24 hrs and 13% at 7 days. Clotting times such as ACT, PT and APTT performed on samples drawn one hour after drug administration were within the normal ranges for both the control and the treatment groups. The results suggest that topical administration of LMWH prevents the occurrence of thrombosis at the traumatic anastomosis site to a similar degree as heparin.

Administration, Topical↗
PubMed1984

Prolactin, corticotropin, and gonadotropin concentrations following thermal injury in adults.

The concentration of serum prolactin (PRL), plasma corticotropin (ACTH), serum follicle stimulating (FSH), and luteinizing (LH) hormones were measured in 28 adult burned patients (25 males and three females). Morning and night determinations were performed for each hormone. Serum PRL was elevated in males up to the fourth week after the thermal injury. Plasma ACTH increased significantly on the second day postburn and returned gradually to normal on the fifth; serum FSH and LH increased on day 1, then decreased significantly on day 2 and remained low for about 2 weeks. In females, while PRL increased significantly, the gonadotropins were slightly elevated and the ACTH remained within normal limits for the 3 days during which it was possible to study these patients. In all subjects the circadian rhythm of the four measured hormones showed significant variations from the normal pattern.

Adolescent↗
PubMed1981

Estradiol receptor-binding protein in head and neck neoplastic and normal tissue.

Estradiol (E2) receptor-binding protein was measured in 42 neoplasms and normal tissues from the head and neck region. Tissues with high E2 receptor protein content included normal skin and normal mucosa of the nose and the floor of the mouth and of the parotid and submandibular salivary glands. Two of four papillary carcinomas of the thyroid, three of five pleomorphic adenomas of the parotid, four of six squamous cell carcinomas of the oral cavity, one of angiofibroma of the nose, and an eye (sclera) melanoma also had a high content of E2-binding protein. The demonstration of estrogen receptors in these neoplasms may indicate that these tumors also, as many breast lesions, may be hormone-dependent. If this is correct, an appropriate hormonal treatment may influence their biological evolution.

Adenoma↗
PubMed1981

Resurfacing the burned face.

Facial burns cause deformities through the permanent effects of wound contracture and scar hypertrophy; they are related to the depth of the burn. The depth of an acute burn can be accurately ascertained only by observation over a period of time. Facial skin burns that do not heal by three weeks are subject to increasingly permanent deformity with the passage of time. The best defense against wound contraction and hypertrophic scar is early and complete wound closure. Early and late grafting must be completely successful in "take" to avoid unsightly irregular scarring; therefore, the receptor bed must be meticulously prepared for optimal take. Both early and late grafts are patches that flatten normal contour. However, if the skin graft conforms to a position in the facial mosaic (aesthetic unit of the face), or some subunit that is harmonious with normal facial lines, the patch of proper color can give a more aesthetic result. Nonreproducible anatomical structures such as the margins of the lids, lips, and nostrils should be preserved whenever found to be normal or only partially destroyed. To minimize the distorting effects of wound contracture, pressure therapy of the face and neck, as well as the positional splinting of the neck, must be maintained for many months following grafting and epithelialization until the deleterious wound forces abate. Burns of mobile structures, such as lids and lips, do not lend themselves to control by pressure, and frequently must be managed secondarily by first totally removing scarred tissues and then applying thick skin grafts of the best color match.

Burns↗
PubMed1979

Computed tomography of the larynx.

The normal computed tomographic anatomy of the larynx and surrounding structures is illustrated and discussed. An attempt is made to distinguish various types of tissues in cross-sectional display. The advantages of computed tomography over other modalities used for imaging the laryngeal region include the capacity to depict structural relationships in cross-section, to better define cartilaginous involvement by adjacent neoplasms, and to identify vascular components with contrast enhancement. The clinical application of computed tomography with respect to radiation therapy treatment planning of laryngeal tumors in an important feature of this imaging technique.

Humans↗
PubMedDate not supplied

Angiotensin-1-converting enzyme activity as index of pulmonary damage in thermal injury with or without smoke inhalation.

Serum angiotensin-converting enzyme (ACE) activity, plasma renin activity (PRA), and serum aldosterone levels were measured up to four weeks in a population of adults exposed to thermal injury, with or without concomitant exposure to smoke inhalation. In 10 patients, plasma levels of angiotensin-2 and ACE activity in bronchial lavage were also evaluated. Patients with severe burn injury had a significant decline of serum ACE activity while the concentrations of aldosterone and PRA were markedly elevated. Smoke inhalation seemed to counterbalance the decline of serum ACE activity, and, in the last group of patients, ACE concentrations were higher than those recorded in patients suffering only from cutaneous burn. The ACE activity was evidenced in bronchial lavage of patients exposed to smoke inhalation with the highest values present in the first day after the injury. The same patients had also very elevated levels of plasma angiotensin 2. In conclusion, serum ACE activity decreases in burn patients according to the severity of the cutaneous burn; smoke inhalation influences serum levels of the enzyme with concentration values opposite to the low ones present in cutaneous burn. Finally, the enzyme activity has an independent pattern from that of the other components of the renin angiotensin aldosterone system. The evaluation of ACE activity may be a marker of pulmonary damage in smoke inhalation.

Adolescent↗