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Biomedical subjects

S Mitchell

Publications and source records attributed to S Mitchell.

At least 181 records · Page 10Linked to original sources
PubMed1987

Percutaneous management of benign ureteral strictures and fistulas.

The percutaneous methods of management of benign ureteral strictures or fistulas have developed as a natural evolution of percutaneous nephrostomy and angiographic techniques. We review our 5-year experience, which includes 18 patients with 19 benign ureteral strictures and 12 patients with ureteral fistulas. In the majority of the patients the ureteral strictures occurred at sites of surgical reconstruction or endoscopic manipulation. All fistulas resulted from surgical injury. In 10 of the 12 patients (82 per cent) the fistulas healed without development of a stricture or need for further intervention. Patients with short ureteral strictures had a high incidence of success and they usually were the best candidates for percutaneous manipulation. The long strictures usually were of longer duration and they were less likely to be managed successfully percutaneously. Failure of percutaneous dilation did not impede subsequent surgical management. Percutaneous management often is a reasonable initial step in the treatment of ureteral strictures and fistulas.

Dilatation↗
PubMed1987

Changes in treatment-related concepts of illicit drug abusers related to time in treatment in two residential treatment programs.

This research investigated the effects of two residential drug treatment programs on changing the attitudes the residents had toward three treatment-related concepts over a 10-month time period. The semantic differential evaluative and potency scales of the concepts Therapeutic Community, Counselor, and Group Therapy were administered to the residents of these programs after they were residents for set periods of time. The results of this research showed that the residents rated the evaluative and potency scales of Group Therapy and Counselor higher the longer they remained in the program.

Adult↗
PubMed1987

Kidney transplantation in Pittsburgh: experience and innovations.

1. The introduction of combined CsA and steroid treatment as the baseline immunosuppressive medication significantly enhanced the results of kidney transplantation in our series. But various other preexisting recipient or donor conditions may still have an important effect on kidney transplant survival and should not go unrecognized. 2. Living-related kidney transplants were almost totally abandoned at our institution. Reasons for this approach are the increased availability of cadaveric donor organs, the improved results with cadaveric transplants under CsA and the possible risks to the living donors. 3. Combined liver/kidney transplants have been shown to offer a favorable treatment modality for patients with endstage liver and renal failure. 4. A newly developed center-oriented Transplant Information Management System (TIMY) significantly facilitates the clinical and research tasks in our department. 5. An integrated, computerized scoring system for equitable allocation of donor organs has proven to be highly effective during routine clinical use.

Adolescent↗
PubMed1986

Subpopulations of common acute lymphoblastic leukemia antigen-positive lymphoid cells in normal bone marrow identified by hematopoietic differentiation antigens.

Bone marrow samples from normal adults and children with nonhematologic malignancies not involving the marrow, acute lymphoblastic leukemia (ALL) in continued remission, and immune cytopenias were studied by two-color immunofluorescence (IF) and flow cytometry to characterize common acute lymphoblastic leukemia antigen (CALLA)-positive marrow lymphoid cells. Marrow was separated by Ficoll/Hypaque centrifugation followed by passage over a monoclonal antibody affinity column to remove myeloid cells prior to IF staining. A higher proportion of CALLA-positive cells was found in the pediatric marrows (mean, 33.7% +/- 6.3% SEM) than in the adult marrows (mean, 4.5% +/- 1.6% SEM). Two subpopulations of CALLA-positive cells identified by cell sorting to be of lymphoid morphology were found in both adult and pediatric marrows. A small subpopulation comprising 12.3% of the total CALLA-positive cells was characterized by a high intensity of CALLA, terminal deoxynucleotidyl transferase (TdT), and MY10 expression, but low B1, common leukocyte antigen, and peanut agglutinin receptor expression. The remainder of the CALLA-positive cells displayed low intensity of CALLA expression, positivity for the common leukocyte antigen, B1 and peanut agglutinin, and negative reaction with TdT and MY10. Both CALLA-positive subpopulations were positive for HLA-DR and the pan-B cell marker B4, but negative for cytoplasmic immunoglobulin, B2 and Leu 1. BrdU labelling studies showed that a similar proportion of cells in each subpopulation was in S phase. A slightly higher proportion of the strongly CALLA-positive cells possessed the morphologic features of high nuclear/cytoplasmic (N/C) ratio and prominent nucleoli. These studies suggest that a discrete maturation step occurs among CALLA-positive marrow lymphoid cells, resulting in the loss of TdT and MY10 expression, but gradual acquisition of the B cell marker B1 and the common leukocyte antigen. The presence of B4 antigen in nearly all CALLA-positive cells suggests that both subpopulations of normal CALLA-positive marrow cells are committed to the B cell lineage.

Adult↗
PubMed1985

Abbreviated surveillance of nosocomial urinary tract infections: a new approach.

An abbreviated method for the surveillance of nosocomial urinary tract infection is described. Combining desirable features of both active and passive surveillance, this new method involves concurrent review of microbiology reports. Compared to traditional active surveillance methods which require review of individual patient charts, the abbreviated method requires only one-fifth the time commitment while maintaining a 98% sensitivity. Although some degree of overestimation is inherent in this method, the primary goals of surveillance--monitoring infection rates and identifying clusters of infection--should be preserved.

Cross Infection↗
PubMed1985

Storing summary patient data as a microcomputer file.

The time taken to summarize 1000 patient records and store this data as a hard disc file on a microcomputer was evaluated in a health centre with about 7300 patients. On average it took 25 minutes to prepare or update summary sheets for each patient and between three to five minutes to input the data to the computer. About one in 10 of the records were long and complicated and took considerably more time to summarize. An error rate of 9% over six months was determined for the age-sex register, mostly owing to patients who had left the practice. In about 5% of cases important information was missing from the A4 folders and was only obtainable from the health visitor records.

Computers↗
PubMed1984

Prevalence of antibodies to lymphadenopathy-associated retrovirus in African patients with AIDS.

The presence of antibodies to lymphadenopathy-associated retrovirus (LAV) was determined by a radioimmunoprecipitation assay and by an enzyme-linked immunosorbent solid assay of sera from Zairian patients with the acquired immune deficiency syndrome (AIDS) in 1983. Thirty-five of 37 patients (94 percent) and 32 of 36 patients (88 percent), respectively, were seropositive by the two tests. In a control group of 26 patients, six (23 percent) showed positive results in these tests. Of these six control patients, five had clinically demonstrable infectious diseases and a low ratio of T4 to T8 lymphocytes. In addition, sera collected from a control group of Zairian mothers in 1980 were positive for LAV in 5 of 100 cases. Other serologic data suggest that LAV was present as early as 1977 in Zaire.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Effects of female urine on growth and sexual maturation in male rabbits.

Urine of adult males or adult females, or distilled water (control), was applied to the oro-nasal grooves of Dutch-belted male rabbits after weaning. The body and testicular weights of males treated with urine of females were significantly less than those of controls between 88 and 125, and 96 and 109 days, respectively. Sperm counts and the pattern of androgen-dependent production of gel-plugs in semen also differed significantly between treatments during the critical maturation period. These suppressant effects of urine of females on male development in rabbits may represent a mechanism by which females may manipulate the reproductive success of neighbouring conspecifics in free-living colonies.

Animals↗
PubMed1982

The role of surgery in the management of gastric lymphoma.

With the development of more effective combination chemotherapy and radiation, the role of surgical resection in the management of gastric lymphoma is reappraised. A retrospective review of 32 patients with gastric lymphoma, diagnosed and treated during the period between 1966-1979, is presented in an attempt to evaluate the relative effectiveness of the various modalities of diagnosis and treatment. Preoperative gastric barium x-ray studies were abnormal in 28 patients but were infrequently diagnostic of lymphoma. Endoscopy was employed in 15 patients with washings and biopsy. The biopsies were reported: four nondiagnostic; three suspicious of tumor; three carcinomas; and in only five patients was a clear diagnosis of lymphoma established. Fifteen patients were treated on the basis of biopsy via gastroscopy, or were explored and not resected and were treated with chemotherapy and/or radiation therapy. Fourteen of the nonresected patients have died with disease; one patient is surviving with disease at 20 months. Surgical resection was accomplished in 17 of the 32 cases, with seven patients (41%) surviving from 2-12 years. Aggressive primary chemotherapy with four-drug combination (CAOP) without surgical resection has resulted in massive upper gastrointestinal hemorrhage in four of five patients thus treated. This required emergency surgery for patients with depressed leukocyte and platelet counts. No perforation of the stomach was seen with primary chemotherapy as reported by other authors. In this series surgical exploration was necessary to establish a definite histologic diagnosis in 27 of the 32 patients. Exploration was an essential step in establishing the extent of disease to plan therapy. The only long-term survivors free of tumor were those which had been surgically resected. Resection of the gastric lymphoma prevented the complication of hemorrhage and perforation associated with chemotherapy and radiation therapy.

Adolescent↗
PubMed1982

Balloon embolization of a mycotic pulmonary artery aneurysm.

A patient presented to the hospital with mild hemoptysis of 1 day's duration and an infiltrate on chest roentgenogram. Shortly after admission, she developed shock, massive hemoptysis, and a bloody pleural effusion that yielded Streptococcus viridans. Pulmonary arteriography revealed a peripheral pulmonary artery aneurysm, which was embolized with a detachable silicone balloon, resulting in immediate cessation of hemoptysis. An acute pneumonia associated with moderate to massive hemoptysis raises the possibility of mycotic aneurysm; pulmonary arteriography is indicated, which allows for diagnosis and treatment during the same study. Successful embolization may obviate the need for surgery or convert an emergency thoracotomy to an elective procedure.

Aneurysm, Infected↗