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Biomedical subjects

R P Jacobs

Publications and source records attributed to R P Jacobs.

At least 37 records · Page 2Linked to original sources
PubMed1981

Renal vein thrombosis: occurrence in membranous glomerulonephropathy and lupus nephritis.

Renal vein thrombosis developed in 11 of 280 patients having either biopsy-proved membranous glomerulonephropathy or systemic lupus erythematosus with nephritis. All 11 also were found to have nephrotic syndrome. In nine, nephrotic syndrome developed before renal vein thrombosis; the diagnoses of nephrotic syndrome and renal vein thrombosis were made simultaneously in the other two. Ten of the 11 patients also had pulmonary emboli at or near the time of renal vein thrombosis.

Adolescent↗
PubMed1979

Hepatocellular carcinoma: clinical and angiographic findings and predictability for surgical resection.

Demographic, clinical, and angiographic data were reviewed for 63 consecutive patients with hepatocellular carcinoma. Angiography remains the critical examination in determining extent of disease and potential surgical cure. Angiographic findings were correlated with surgical or autopsy findings for 26 of the patients. The absence of venous invasion and lack of involvement of at least one hepatic segment favor resectability. Selective hepatic injections and oblique views accurately answered these questions in more than 80% of our patients. Pitfalls to angiographic accuracy include vascular invasion by very small tumor masses, hypovascular or diffuse hepatocellular carcinomas, metastatic disease, and involvement of the left lobe.

Adult↗
PubMed1978

Mechanisms of hemopoietic and immunological dysfunction induced by lymphocytic choriomeningitis virus.

Sublethal irradiation (500 R) of C3H mice is followed by a gradual replacement of radiosensitive cells in their spleens by surviving stem cells originating in bone marrow. This compensatory hemopoiesis was quantitated by counting the numbers of stem cell-derived colonies appearing on spleen surfaces, as well as those which grew in vitro after marrow cells, suspended in soft agar, were overlaid onto syngenic mouse embryo fibroblast feeder layers. Compensatory colony formation, both in vivo and in vitro, was severely depressed when mice were infected with lymphocytic choriomeningitis virus (LCMV) 1 day before irradiation, although the induction of virus-specific cytotoxic T cells in their spleens was unimpaired. Without irradiation, mice, acutely infected with LCMV, showed a dramatic reduction in the numbers of specific antibody-forming cells generated in their spleens after priming with sheep erythrocytes during week 1 post-infection, yet the ability of their marrow cells to form colonies in vitro remained normal. Therefore, the basis of immunodepression is distinct from that of defective hemopoiesis since the latter is apparent only when LCMV infection is accompanied by irradiation. However, as discussed, both phenomena may be related to alterations induced within the splenic environment by LCMV.

Animals↗
PubMed1978

Bleeding simulated by the distal internal pudendal artery stain.

A capillary and venous phase blush in the region of the distal branches of the internal pudendal artery that simulates bleeding can sometimes be seen on arteriograms of male patients who are not bleeding. We describe five such cases. Correct identification of this pooling of contrast material is important to avoid unnecessary treatment by transcatheter embolization or by infusion of vasoactive drugs.

Adult↗
PubMed1978

Diminished radiopacity of contrast material: a urographic sign of ureteral calculus.

Eleven patients with unilateral ureteral calculus had excretory urography which showed the radiopacity of excreted contrast material to be diminished on the side of the calculus. This finding was of diagnostic importance in nine patients who demonstrated little or no dilatation of the urinary tract proximal to the calculus. Other forms of unilateral renal disease, such as acute pyelonephritis, can produce the same urographic finding.

Contrast Media↗
PubMed1977

Value of ultrasonography in the detection of retroperitoneal inflammatory masses.

The ultrasonographic and radiologic findings for 7 patients with retroperitoneal inflammatory processes are presented. Ultrasonographic findings were critical to the diagnosis in 6 of the 7 patients and allowed for rapid evaluation and the institution of successful therapy. The relative sensitivity and specificity of ultrasonography is compared with conventional radiologic modalities. The application of diagnostic ultrasound to the problem of retroperitoneal inflammation is advocated.

Adult↗
PubMed1977

Transpleural abdominal systemic artery-pulmonary artery anastomosis in patients with chronic pulmonary infection.

Systemic-pulmonary artery anastomoses commonly occur in lung diseases characterized by inflammation and decreased pulmonary artery perfusion. Three cases are reported in which anastomotic branches arose within the abdomen and crossed the pleural space. Arteriography differentiated acquired abdominal systemic artery supply from that seen in sequestration. In each case an inferior phrenic artery was involved, and a tangle of anastomotic branches was present at the pleural surface. Intensive medical therapy prior to lobectomy may be indicated in such patients.

Abdomen↗
PubMed1976

An experience with a LeVeen ascites shunt.

A patient with intractable ascites was treated by placement of the LeVeen peritoneovenous shunt. Shunt failure was caused by malpositioning of the venous limb in the inferior vena cava. This was demonstrated by injection of water-soluble contrast material into the venous limb. Revision of the shunt led to diuresis, weight loss, and reduction of ascites. The physiologic process of the LeVeen shunt is reviewed and we suggest placement of a radiopaque marker into the tubing.

Arteriovenous Shunt, Surgical↗
PubMed1976

The role of emergency excretory urography in evaluation of blunt, abdominal trauma.

In our hospital, patients seen for blunt, abdominal trauma have an "emergency" urogram. The results of our review of 209 such patients with complete urographic evaluations indicate that (1) the clinical examination, urinalysis, and plain abdominal roentgenogram do not reliably allow one to predict which patients would show urographic abnormalities and (2) the clinical management of these patients is rarely altered by the knowledge of the results of the urogram.

Abdominal Injuries↗
PubMed1976

Cell-mediated immune response to herpes simplex virus: type-specific lymphoproliferative responses in lymph nodes draining the site of primary infection.

Cell-mediated immune responses to type 1 and type 2 HSV were studied in rabbits using an in vitro lymphocyte transformation assay. The footpad route of inoculation was used to allow us to study the specificity and degree of localization of the responses. Rabbits inoculated in the hind footpads with infectious HSV-I or HSV-II mount type-specific lymphocyte transformation responses that are localized to draining lymphoid organs. Type-specificity requires careful control of all in vitro culture conditions and reflects the extensive cross-reactivity demonstrated by serologic techniques. While lymphocyte transformation responses can be detected with immune SL and PBL, presumably the result of early escape of antigen into the systemic circulation, responses by draining LNL are significantly greater in magnitude. Distant LNL have not been shown to respond. It is postulated that the augmented local immune response to HSV plays a significant role in controlling recurrent HSV infections.

Animals↗
PubMed1976

Lymphocytic choriomeningitis virus-induced immunosuppression: a virus-induced macrophage defect.

Primary immunizing infections with LCM virus result in a transient depression of the in vitro proliferative responses of splenic lymphocytes to mitogens specifically reactive with T cells or B cells. This depression of lymphocyte function is the result of a virus-induced defect in an adherent, phagocytic cell population required for in vitro lymphocyte activation. Depressed responses persist for about 1 week after virus clearance and can be corrected by the addition of normal PEM or 2-ME to infected spleen cell cultures. Although the precise nature of this defect remains unclear, it is postulated that it is due to a productive infection of macrophages and their precursors that renders them dysfunctional. Secondary LCM virus infections do not result in depressed in vitro responses to mitogens, presumably because of rapid virus clearance and limited numbers of infected cells. Primary infections of immunologically immature mice, mice rendered functionally athymic, or mice treated with nonspecific immunosuppressive agents result in LCM virus persistence. Shortly after infection, these animals show a similar depression of immunologic reactivity that returns to normal as the virus carrier state becomes established. Despite virus persistence, few PEM from established LCM virus carrier mice contain viral antigens and these cells function normally. Thus, LCM virus-induced immunosuppression appears to reflect a subtle cytopathic effect of LCM virus replication that is not mediated by the virus-specific cell-mediated immune mechanisms responsible for acute LCM virus disease.

Animals↗
PubMed1975

Submucosal hemorrhage of the renal collecting system.

Two cases of submucosal hemorrhage in the renal pelvis and ureter are presented. The roentgenographic appearance was identical to that of pyeloureteritis cystica but without evidence of urinary tract infection and, in 1 case, the submucosal impression resolved rapidly. When nodular, submucosal filling defects are demonstrated in the renal collecting system in the clinical setting of anticoagulant therapy or trauma, a diagnosis of submucosal hemorrhage should be considered.

Adult↗
PubMed1975

Vascular manifestations of von Recklinghausen's disease.

A casual relationship between von Recklinghausen's disease, or neurofibromatosis, and arteriolar abnormalities has been reported in the European literature. A patient was seen who had biopsy-proved neurofibromatosis and renovascular hypertension and retroperitoneal bleeding. An arteriographic study showed multiple small aneurysms throughout the coeliac axis, the superior mesenteric artery and in several small intrarenal vessels. Renal vein renin levels were elevated particularly in the right renal vein, supporting the diagnosis of renovascular hypertension. Both the aneurysms seen in angiographic studies and the retroperitoneal hemorrhage are probably vascular manifestations of von Recklinghausen's disease. Support for this conclusion is enhanced by the absence of clinical, laboratory or histologic data supporting the only tenable differential diagnosis, periarteritis nodosa.

Adult↗