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Biomedical subjects

T F Nealon

Publications and source records attributed to T F Nealon.

At least 37 records · Page 2Linked to original sources
PubMed1979

The absence of protein--sparing effects utilizing crystalline amino acids in stressed patients.

The protein-sparing effects of the peripheral infusion of crystalline amino acids (PAA) was studied metabolically in selected surgical patients subjected to various degrees of stress. Twenty-one patients (sixteen cancer patients receiving chemotherapy and/or radiotherapy, three with major abdominal traumatic injuries and four with paralytic ileus) were infused with 2 1/24 hours of a solution of 4.2% Travasol amino acids with only 5% glucose as a source of nonprotein calories. One-half of the cancer patients were also allowed ad libitum oral intake of a regular hospital diet or Vivonex-HN. The nutritional status was evaluated by measuring changes in body weight, serum albumin levels and nitrogen balance. Body weight decreased in only the trauma patients. When these solutions were the sole source of nutrients all patients were in negative nitrogen balance and had significant decreases in their serum albumin levels. Serum albumin levels were preserved only when extra sources of calories were provided. The infusion of the crystalline amino acids without adequate levels of nonprotein energy did not conserve protein in these stressed patients.

Abdominal Injuries↗
PubMed1979

Nutritional deficiencies and nutritional support therapy in geriatric cancer patients.

Nutritional deficits and their correction were studied in 45 cancer patients (age range, 60--86 years) who were undergoing various modalities of cancer therapy. Their nutritional status was maintained with a variety of commercially available special diets, and serum albumin concentrations were sequentially determined in order to gauge the efficacy of the nutritional support. Serum albumin levels were preserved when nutritional support was employed in surgical therapy. However, patients undergoing palliative chemotherapy or radiotherapy responded only to adequate levels of the standard hospital diet with or without supplements of special enteral diets. In the survivors, albumin levels were maintained; in the nonsurvivors, albumin levels decreased. This group of older patients tolerated nutritional support therapy, especially when it was carefully monitored. Satisfactory nutritional therapy can be achieved by use of appropriate enteral formulas. The method lends itself to adequate management in the outpatient or nursing-home situation during certain phases of cancer.

Adult↗
PubMed1978

Transcatheter arterial embolization of a traumatic lumbar artery false aneurysm.

The case of a false aneurysm of a lumbar artery secondary to penetrating trauma is presented. Problems of diagnosis are outlined, emphasizing the value of ultrasound, computerized tomography, and angiography. The early use of angiography is strongly advocated in cases of suspected post-traumatic bleeding. The use and value of therapeutic transcatheter embolization is discussed.

Abdominal Muscles↗
PubMed1978

Yoshi 864 (1-propanol, 3,3'-iminodi-, dimethanesulfonate [ester], hydrochloride): a phase II study in solid tumors.

Two hundred and eight acceptable patients were treated with Yoshi 864 (2 mg/kg/day by iv push X 5 days repeated once every 6 weeks). Toxicity was minimal. There was an overall response rate of 11%. Cross resistance with other alkylating agents may not be present. Because of its lack of toxicity, Yoshi 864 should be further evaluated in chronic myelocytic leukemia, lymphomas, and carcinomas of the ovary and bladder where significant responses were seen. It should also be evaluated in combinations as a replacement for other alkylating agents which cause more nausea and vomiting.

Alkylating Agents↗
PubMed1977

Autologous blood in the treatment of intraoperative hemorrhage.

Severe hemorrhage associated with major trauma and vascular procedures is seen frequently in our operating rooms. Immediate autotransfusion has enabled us to safely and adquately correct blood losses without placing overwhelming demands on our blood bank. Since October 1973, a device capable of retrieving, filtering and reinfusing blood lost during operation has been used on 51 patients (major trauma, 20; ectopic pregnancy, 2; portacaval shunt, 9; peripheral vascular surgery, 20). From 700 to 20,000 cc's of blood were reinfused. Platelets, hematocrit, fibrinogen, free plasma hemoglobin, bilirubin, and creatinine showed no significant changes as compared to preoperative values in 39 survivors. There were 12 deaths. Eight died postoperatively as a result of their injuries, 3 of uncontrollable bleeding and one of renal failure. This study shows that autotransfusion, when used with proper operating technique, is a most satisfactory technique for restoring blood volume in severe trauma cases and elective vascular operations. This method provides a rapid, simple way of reinfusing fresh blood, free of hepatitis contamination with minimal derangement in cellular and plasma coagulation parameters.

Adult↗
PubMed1976

Massive bleeding from a ruptured superior mesenteric artery aneurysm duodenum.

A traumatic false aneurysm of the superior mesenteric artery resulting from a gunshot wound five years previously, caused massive hemorrhage into the second portion of the duodenum. Dissection, resection, and end-to-end anastomosis was successful in controlling bleeding into the gastrointestinal tract, but immediate postoperative angiography showed a reappearance of the aneurysm, and three months later, it bled into the retroperitoneum. The patient underwent further resection and two subsequent reconstructions of the superior mesenteric artery, the first with a Dacron graft, which clotted, and the second with autologous saphenous vein, which was successful. Three years later, the patient is well. The case shows that adequate reconstruction of an arterial injury is best performed immediately after it is diagnosed.

Abdominal Injuries↗
PubMed1976

Hepatic artery flow improvement after portacaval shunt: a single hemodynamic clinical correlate.

We have documented a highly significant increment in hepatic arterial flow following a portacaval shunt in patients with cirrhosis of the liver and portal hypertension. In contrast with other hemodynamic variables, the increment in arterial flow was directly related to morbidity, hospital mortality, and long term survival. Patients with increments smaller than 100 ml/min had the worst clinical results. They accounted for all of the hospital mortality, the largest incidence of encephalopathy, and the worst long term cumulative survival rates. The extent of the increment was not related directly to the type of shunt but, rather, to some intrinsic capability of the cirrhotic liver to increase its arterial flow in response to the relief of sinusoidal hypertension produced by the shunt. This capablilty appears related to the degree of entrapment of the hepatic arterioles by the fibrous tissues of cirrhosis. This encasement of arterioles should change the elastic properties of the hepatic arterial bed and we propose to measure these properties by determining the characteristic input impedance of the arterial bed.

Brain Diseases↗
PubMed1976

Perforations and foreign bodies of the rectum: report of 28 cases.

A series comprised of 28 patients (five with perforations of the recto-sigmoid colon and 23 with lodged rectal foreign bodies) is presented. The symptomatology, physical, laboratory and x-ray findings are described. Methods of management are discussed, with emphasis on the operative management of perforations and the conservative approach to retained foreign bodies. It is felt that these protocols will be useful to physicians who see this practice less frequently. X-rays of two more unusual cases are depicted. A thorough review of the literature is also presented. This is the largest reported series of patients with retained rectal foreign bodies and/or perforations. The series includes two female patients, a heretofore unreported occurrence.

Abdomen, Acute↗
PubMed1976

Use of elemental diets in surgical cases.

Over the past five years elemental diets have assumed an important role in the pre- and postoperative nutrition of patients on the Surgical Service at the St. Vincent's Hospital and Medical Center of New York City. The purpose of this paper is to give the history of this development and the results of our experience with the elemental diet.

Adult↗
PubMed1975

Primary amyloidosis of the respiratory tract.

Two patients with solitary amyloidosis of the respiratory tract are discussed. Bronchial obstruction caused by amyloid deposits led to the death of our first patient. Diagnosis in the second patient was made after removal of a localized amyloid deposit within the lung parenchyma.

Adult↗
PubMed1975

Four hundred consecutive patients with permanent transvenous pacemakers.

Between April 1, 1965, and May 1, 1973, we inserted permanent transvenous pacemakers in 400 consecutive patients. Patients considered for this type of pacing were those with any episode of heart block and those with other types of bradyarnhythmias who had unexplained vertigo or syncope. There was one operative death and one instance in which the primary unit became infected. Problems with catheter dislocation, electrode fracture, and exit block were few and were easily corrected. We believe transvenous permanent pacing to be the best method of cardiac pacmaking in these patients. It is well tolerated by largely avoidable and easy to correct.

Adolescent↗
PubMed1975

The hemodynamics of portal hypertension revisited: determinants and significance of occluded portal pressures.

We bring up to date our series of direct measurements of portal flow and pressure in patients with cirrhosis of the liver. In 153 patients the portal flow averaged 447 plus or minus 350 ml. Hg per minute and the portal pressure 28.5 plus or minus 4 mm. Hg (approximately 387 mm. H2O). Both quantities compare favorably with our previous measurements in smaller groups of patients. In 80 of our patients we had also measurements of pressure on the hepatic and splanchnic sides of a clamp occluding the portal vein. Nine of these patients had an hepatic occluded portal pressure higher than either or both the free portal pressure and the splanchnic occluded portal pressure. Of these nine patients with reversed pressure differences, two had stagnant portal flow and the remaining seven had forward flow into the liver measuring from 80 to 1,116 ml. Hg per minute.

Blood Flow Velocity↗