Search PubMed⌕ Search

Biomedical subjects

R Zeppa

Publications and source records attributed to R Zeppa.

At least 73 records · Page 4Linked to original sources
PubMed1978

Cystadenocarcinoma and carcinoembryonic antigen (CEA).

A 40-year-old woman with back pain, an abdominal and a serum CEA level of 200 ng/ml was found to have at laparotomy, a large but resectable mucinous retroperitoneal mass. Pathologic diagnosis revealed cystadenocarcinoma, probably of pancreatic origin. It is remarkable that the cyst fluid contained a CEA level 100,000-fold normal. Serum CEA fell to normal levels in the postoperative period. This suggests that the CEA was of cyst epithelial origin.

Adult↗
PubMed1978

The comparative survivals of alcoholics versus nonalcoholics after distal splenorenal shunt.

Survival after distal splenorenal shunt in appreciably better in nonalcoholic patients than in alcoholics. This increase in survival does not appear to be dependent upon the state of biochemical liver function or the severity of changes in liver histology since these latter were similar for both groups. We suggest that the poorer survival of alcoholics may be related to continuing alcohol toxicity, and that a possible reason for the failure to demonstrate this difference in survival after portacaval shunts may be due to the harmful effects of total portal diversion on the liver.

Adolescent↗
PubMed1978

Tryptophan and hepatic coma.

To clarify the involvement of tryptophan in the pathogenesis of hepatic coma, plasma and cerebrospinal fluid (CSF) tryptophan was studied in three patient groups (hepatic coma, stable cirrhosis, and control). An assessment of free fatty acids, some of the amino acids reported to compete with tryptophan for brain uptake, and albumin was also made. The data demonstrated that, whereas the elevated CSF tryptophan levels in cirrhotic patients compared to controls may have been attributable to decreased plasma branched chain amino acids, the elevated CSF tryptophan levels in hepatic coma compared to stable cirrhotic patients were probably attributable to increased plasma free tryptophan concentrations. Associated with the elevated plasma free tryptophan in coma patients was an increase in plasma free fatty acids and a marked decrease in serum albumin levels. Of all the amino acids investigated in the CSF, only tryptophan was significantly increased in patients in hepatic coma compared to cirrhotic patients not in coma.

Amino Acids↗
PubMed1977

Noncirrhotic portal hypertension in Felty's syndrome.

A case of Felty's syndrome with nodular regenerative hyperplasia of the liver, presinusoidal portal hypertension, and bleeding esophageal varices is reported. Increased splenic blood flow may be a contributing factor to the development of the regenerative nodules. The portal hypertension is postulated to be a result of intrahepatic vascular compression.

Esophageal and Gastric Varices↗
PubMed1977

The effect of the distal splenorenal shunt on hypersplenism.

Twenty-four patients with leukopenia and/or thrombocytopenia improved these deficiencies after distal splenorenal shunts. The average white blood cell count for 23 neutropenic patients increased by an average 1000 cells/cu.mm p less than .01. The average platelet count for 13 thrombocytopenic patients increased by more than 40,000, p less than .02. Analysis of the data showed that patients older than 50 years, with a history of alcoholic liver disease and sinusoidal hypertension greater than 15mm Hg were most likely to correct leukocyte and platelet defects after distal splenorenal shunts.

Adult↗
PubMed1977

Survival after distal splenorenal shunt.

These data support the conclusions that the distal splenorenal shunt is attended by the highest post-shunt survival as yet reported for patients with non-alcoholic cirrhosis, portal hypertension and bleeding varices; the procedure is safe, and in this series, the mortality has been nil for 66 consecutive operations. An analysis of the causes of death suggests that continued alcohol abuse plays an important part in the late mortality among those in the post-shunt alcoholic cirrhosis group.

Adult↗
PubMed1976

The fate of esophageal varices following selective distal splenorenal shunt.

Esophagographic evaluation of the fate of esophageal varices after distal splenorenal shunt was obtained. The radiologist-observer was blinded as to the surgical status of the films under study. The results indicate that varices are likely to persist after surgery. However, the sizes of the varices are clearly diminished following selective distal splenorenal shunt. The incidence of postoperative bleeding has been low, 3.7% (2/54) or one episode for each 441 months of postoperative survival.

Esophageal and Gastric Varices↗
PubMed1976

Predicted survival in peptic ulcer patients based on computer analysis of preoperative variables.

A prospective study designed to emphasize and quantitate the operative risk of patients preparing to undergo surgery for the treatment of complicated peptic ulcer disease is presented. Data were gathered from 347 consecutive patients operated on with benign gastric and/or duodenal ulcers in a Veterans Hospital over an 8-year period. Resident surgeons performed all operations and for the most part decided on the operative procedure used, with advice from attending faculty. Preoperative factors influencing the operative mortality in 34 patients were compared with those in surviving patients and subjected to a multivariant discriminant function analysis by computer. Ten variables were identified as being significantly different (P less than 0.05-P less than 0.01) between the survivor and non-survivor groups. Using the discriminant weights of these variables, a computer program was written to calculate the 30-day operative mortality of any preoperative patient based on this past experience. The accuracy of the program is excellent in good risk patients; i.e., a predicted greater than 90% chance of survival was correct 98.9% of the time with 3 deaths in 279 patients. Patients at the low end of the scale (less than 10%) were predicted with 85% accuracy. In the last 8 months, 29 patients have undergone surgery after prospective computer assessment of their operativ risk. All have survived with a predicted chance of greater than 50%. Four patients died with survival chances predicted at 4, 2, 1, and 1%. The computer may be used as an educational vehicle for sharpening our preoperative assessment of a patient with ulcer disease, particularly regarding operative risk.

Adult↗
PubMed1976

Sphincteroplasty in selected cases of acute recurrent pancreatitis.

Although most patients with acute pancreatitis can be treated sucessfully by non-operative therapy and progress to oral alimentation without difficulty, an occasional patient may require exploration during the acute or subacute phase. This is justified principally by the recurrence of pain following attempts at oral alimentation in the hospital.

Acute Disease↗