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Biomedical subjects

R M Beazley

Publications and source records attributed to R M Beazley.

At least 37 records · Page 2Linked to original sources
PubMed1978

Antibiotic concentration in human wound fluid after intravenous administration.

Since the wound is the most common focus of infection in the surgical patient, adequate levels of antibiotic within the wound ar essential. This study examines the concentrations of antibiotic achieved in human wounds. Fluid was collected at timed intervals on the first postoperative day from the wounds of 56 patients receiving antibiotics after regional lymph node dissection. Antibiotic concentration was determined by bioassay. Six antibiotics were studied: cephalothin, cefazolin, cephapirin, oxacillin, ampicillin and clindamycin. The cephalosporins and penicillins showed similar patterns of appearance in the wound fluid. The peak level occurred early (1--1 1/2 hours) with subsequent slow decrease. Clindamycin produced nearly constant levels in wound fluid. The concentration of each antibiotic in wound fluid surpassed the serum levels after 2.5 hours. At the dosages studied each antibiotic produced wound fluid concentrations greater than the MIC for most susceptible organisms. Higher doses provided higher wound fluid levels. The rate of appearance and the levels achieved should be considered in the choice of antibiotics in the surgical subject.

Anti-Bacterial Agents↗
PubMed1977

The blood supply of mediastinal parathyroid adenomas.

Arteriography for parathyroid localization following unsuccessful neck surgery should include selective catheterization of the inferior thyroid and internal mammary arteries bilaterally. When the arterial supply to a mediastinal adenoma arises from the internal mammary artery, recovery from the neck may not be possible and an open mediastinal exploration (or embolization) should be considered.

Adenoma↗
PubMed1977

Serum hepatic enzyme and bilirubin elevations during parenteral nutrition.

Serial liver enzyme and bilirubin concentrations were measured in 100 patients undergoing total parenteral nutrition. Between the eighth and tenth days, serum glutamic-pyruvic transaminase levels rose to 5.4 times pretotal parenteral nutrition levels; serum glutamic-oxalacetic transaminase, 2.8 times; bilirubin, 2.3 times, and lactic dehydrogenase, 1.5 times. These elevations were transient, lasting four to ten days. Biopsies of the liver taken during maximal elevations demonstrated marked periportal fatty change. A second elevation of serum glutamic-pyruvic transaminase, serum glutamic-oxalacetic transaminase, alkaline phosphatase and lactic dehydrogenase occurred in one-third to one-half of those patients receiving total parenteral nutrition for longer than a 20 day period. These elevations were more prolonged, and no biopsies were taken. Amino acid solutions contain conversion products of tryptophan, an amino acid that is unstable in the presence of the preservative sodium bisulfite which is added to all commercially available protein solutions. Infusion of these products into rats, either alone or as part of total parenteral nutrition solutions, resulted in periportal fatty change of the livers identical to that seen in our patients receiving total parenteral nutrition. A toxic effect of tryptophan conversion products in total parenteral nutrition solutions is proposed.

Alanine Transaminase↗
PubMed1976

Elevated plasma proglucagon-like component with a glucagon-secreting tumor. Effect of streptozotocin.

To determine the character of the glucagon secretion and its modification by streptozotocin, were studied the plasma of a patient with recurrent pancreatic alpha-cell carcinoma. The plasma immunoreactive glucagon level before treatment of 4.80 ng per milliliter. Biogel column separation of the plasma immunoreactive glucagon revealed four components; the predominant component had a molecular weight of 9000 daltons and was designated as proglucagon-like. This fraction constituted 60 to 90 per cent of the total circulating immunoreactive glucagon, and had a biologic activity of 32 percent of that of an immunoequivalent amount of normal (porcine) pancreatic glucagon. After treatment with streptozocin (1.5 g per square meter) the plasma immunoreactive glucagon level decreased to 0.24 ng per milliliter. Treatment was accompanied by a marked reduction in the proglucagon-like component and the appearance of pancreatic glucagon (molecular weight of 3500 daltons) as the major post-therapy fraction. These findings support the use of streptozotocin in the management of unresectable glucagon-secreting tumors.

Adenoma, Islet Cell↗
PubMed1976

Surgical management of parathyroid disease.

One hundred fifty patients who had operation for hyperparathyroidism at the National Institutes of Health are reviewed. The series is composed of several groups of patients, including 18 with normocalcemic hyperparathyroidism, 13 with hyperparathyroidism associated with MEA II, and 24 patients with a history of previous parathyroid operation. Selective venous catherization and radioimmunoassay of parathormone was carried out in 81 patients and was interpreted as being localizing in 65 cases. Following operation, six patients remained hypercalcemic. There were nine instances of permanent hypocalcemia and four cases in which permanent recurrent nerve injuries were experienced. The operative management of these patients is outlined in detail, stressing an approach which includes the surgeon, the internist and the pathologist. Based upon pathological evidence, the importance of identifying by frozen section four glands is emphasized.

Adenoma↗
PubMed1976

Cryosurgery of the ureter in dogs.

The effect of cryosurgery on the ureter has been studied in dogs. A single 1- or 2-min cryosurgical exposure produced stricture in two of eight animals. A tumoricidal cryosrugical dose consisting of three, 2-min exposures caused stricture in six of eight dogs. Histopathologic examination of the ureter after repetitive cryosurgery showed progressive, persistent loss of smooth muscle, fibrosis of the lamina propria, and early loss with subsequent regeneration of the transitional epithelium. Although there was no loss of ureteral integrity, the possibility of permanent ureteral damage should be considered with the use of cryosurgery.

Animals↗
PubMed1975

Intrathyroidal parathyroid adenoma or hyperplasia. An occasionally overlooked cause of surgical failure in primary hyperparathyroidism.

In six surgically proved intrathyroidal parathyroid tumors, neither thyroid scan nor gross appearance of the thyroid at surgery allowed reliable detection of parathyroid glands wholly within the thyroid. Preoperative selective catheterization of thyroid veins with radioimmunoassay for parathyroid hormone facilitated successful removal of hyperfunctioning intrathyroidal parathyroid tissue in all five cases in which it was performed.

Adenoma↗
PubMed1975

Malignant lymphoma of the jejunum in a patient with Wiskott-Aldrich syndrome. Surgical treatment.

An 8-year-old boy with Wiskott-Aldrich syndrome underwent laparotomy and resection of a stage 1E malignant lymphoma of the jejunum. Although preoperative platelet counts were less than 10,000/cu mm, intraoperative bleeding was minimal, and postoperative bleeding from the wound was easily controlled with platelet infusions and local application of epinephrine. Six weeks later, he underwent reoperation for small intestinal obstruction and no residual tumor could be identified. The patient died 4 1/2 months following the initial surgery from an intracerebral hemorrhage. Postmortem examiniation did not reveal residual lymphoma.

Blood Platelets↗
PubMed1975

Reoperative parathyroid surgery.

Reoperative parathyroid surgery is associated with a high mortality and morbidity. Morbidity consists of uncorrected hypercalcemia, hypoparathyroidism, and recurrent nerve injury. Initial operative failure is most frequently a result of not identifying four parathyroid glands. On reoperation, parathyroid glands are most often found in the neck and are usually hyperplastic. It is recommended that before attempting rexploration for parathyroid disease, all the patient's records especially the operative note and the previous pathology material should be reviewed. Preoperative localization by selective venous catheterization is of great use in the management of this type of patient.

Adenoma↗
PubMed1975

Mesenteric leaf repair of pelvic defects following exenterative operations.

Perineal enterocutaneous fistula and hernia are unique complications of radical pelvic exenterative operations. A technique for management of these complications is presented. A vascularized segment of small bowel mesentery is interposed as a peritoneum covered pelvic "lid" to separate the abdominal contents from the pelvic defect.

Adult↗
PubMed1975

In vitro demonstration of cryosurgical augmentation of tumor immunity.

C57B1 mice bearing methylcholanthrene-induced fibrosarcomas (MCA-10) and receiving a single cryosurgical treatment to those tumors showed significantly greater humoral and lymphocyte-mediated cytotoxicity to MCA-10 target cells than did untreated tumor-bearing animals or mice which had undergone tumor amputation. Sera and lymphocytes from normal animals receiving crycosurgery demonstrated no immunity to the MCA-10 target cells. Specific immunity to the MCA-10 line following tumor cryosurgery was demonstrated since lymphocytes and sera from cryosurgically treated tumor-bearing mice were not cytotoxic to a different methylcholanthrene-induced sarcoma (MCAP) in C57 mice or a malignant melanoma (S91) being transferred in Balb/C mice. It can be concluded that cryosurgical treatment of the MCA-10 sarcoma does not produce heightened immunity to H-2 transplantation antigens, nor does it nonspecifically stimulate the immune system. Instead, the result of tumor cryosurgery appears to be a boosting of the immune response to the tumor-specific antigens of the sarcoma.

Animals↗
PubMed1975

Mechanism of heightened tumor immunity induced by cryosurgery.

Sarcoma-bearing mice treated with cryosurgery demonstrated significantly greater tumor immunity (as measured by lymphocytoxicity assays) than untreated tumor-bearing mice (p less than .001). However, cryosurgically treated mice did not show greater cytotoxicity than tumor-bearing and tumor-amputated mice which were treated with frozen exogenous tumor antigen. These results suggested that the mechanism by which cryosurgery stimulates systemic tumor immunity is through the release of antigen from the neoplasm. Thus, tumor-bearing mice treated with cryosurgery in these experiments underwent definitive ablative therapy while at the same time they received active tumor immunotherapy.

Animals↗