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Biomedical subjects

T G Peters

Publications and source records attributed to T G Peters.

At least 37 records · Page 2Linked to original sources
PubMed1989

Amputation of the distal portion of the foot.

For 101 patients, initial amputation of 124 extremities involved some distal portion of the foot. Amputations done for atherosclerosis healed in eight of 21 cases (38%), compared with 40 of 77 extremities (52%) in diabetic patients. Presence of cellulitis (44 cases) and absence of a popliteal pulse (44 cases) had no significant effect on success of amputation, but a palpable foot pulse was significantly associated with a successful outcome (29/35 cases, or 83%) (P less than .005). Serial amputations to preserve the foot were successful for 18 of 31 extremities (58%), a success rate equal to that of the entire series, 72 of 124 (58%). Attempts to preserve viability in the distal portion of the foot were not associated with mortality. Cellulitis and absence of a distal pulse are not contraindications to attempting preservation of the extremity, although the best results occur when distal extremity pulses are palpable. In nearly six of every ten cases, amputation of the distal portion of the foot resulted in a successful outcome.

Adult↗
PubMed1989

Splenectomy and the sick asplenic patient.

The sick asplenic patient bears risk to infectious complications and mortality. That risk is not widely accepted since no specific syndrome is applicable to all asplenic patients who are ill. In order to determine outcome following splenectomy, 624 patients having simple splenic injury, splenic plus multisystem trauma, elective splenectomy, incidental or accidental splenectomy, or splenectomy associated with transplantation were studied. Nonfatal complications specifically related to splenectomy occurred in 23 per cent of patients with multiorgan injury and 18 per cent with incidental-accidental splenic removal; splenectomy associated with transplantation had the highest mortality. The classic postsplenectomy sepsis syndrome was encountered late only twice. In the already sick patient rendered asplenic, conditions heralding susceptibility to progressive and sometimes fatal infection must be considered at all times. Sound indications for splenectomy must prevail before splenic removal since morbidity and mortality follow splenectomy, especially in the sick asplenic patient.

Adult↗
PubMed1988

Suppurative pylephlebitis caused by toothpick perforation.

We have reported a case of suppurative pylephlebitis in an elderly, debilitated patient. The infection was caused by toothpick perforation of and migration from the gastrointestinal tract. The patient had risk factors for foreign body ingestion, including poor dentition, aphasia caused by a previous cerebrovascular accident, and alcohol abuse. Investigation for the otherwise obscure cause of suppurative hepatic disease should take into account the possible, yet difficult to define, source related to an ingested foreign body.

Aged↗
PubMed1988

Conventional immunosuppressive therapy in modern renal transplantation.

Conventional immunosuppression has been replaced by cyclosporine protocols for renal transplantation in most centers. Some centers have continued using conventional immunosuppression in certain instances. In our series, 104 patients received 105 kidney allografts (58 cadaver, 47 living donor) in 1983 and 1984. No patients was treated with cyclosporine. Patient survival was 95% and 92% at six months and one year, respectively. Eight deaths were caused by sudden cardiorespiratory events (four), liver failure (one), and suicide (one); fatal infection occurred after regrafting in two asplenic patients. Actuarial graft functional survival was 80% at 12 months; living related donor graft survival of 94% at one year was comparatively better than the 66% with cadaveric grafts. Death from excessive pharmacologic immunosuppression did not occur. Graft survival was excellent with living donor and acceptable with cadaveric grafts, especially with good tissue matching. Conventional immunosuppression may remain applicable in renal transplantation under conditions of low risk for graft loss.

Adolescent↗
PubMed1988

Investigation of passive venovenous shunts during the anhepatic period of canine hepatic transplantation.

The anhepatic period of canine orthotopic hepatic transplantation is usually accompanied by cardiovascular instability due to occlusion of both the portal and inferior systemic venous systems. The present study was undertaken in order to determine some of the hemodynamic and renal alterations that occur during a 2 hour anhepatic period in the dog and to investigate the use of a passive endoportal, endocaval venovenous shunt that places both the portal and infrahepatic vena caval limbs of the shunt directly into the divided ends of these vessels. Three groups of experimental animals were studied. One group had hepatectomy without a shunt and was compared with two other groups which had hepatectomy with some form of venovenous shunting. Systemic arterial blood pressure, portal and inferior vena caval pressure, urinary output, and renal histology were all better maintained when a shunt was used.

Animals↗
PubMed1988

Lumbar hernia.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1988

Effect of pretransplant graft irradiation on canine intestinal transplantation.

This study was done to define the tolerance of ex vivo administered irradiation to intestinal allograft and to assess the effect of irradiation on the incidence and severity of rejection and graft versus host disease after intestinal transplantation in dogs. Excessive intestinal damage was produced by 2,500 rads, but 750 and 1,500 rads produced no detectable acute or chronic damage in dogs observed from 100 days to two years. Using cyclosporine for postoperative immunosuppression, 1,500 rads reduced the incidence of acute (p = 0.05) and chronic rejection (p = 0.08), yet did not impair intestinal absorption of cyclosporine. The greatest improvement in survival occurred with 750 rads (p = 0.02). Histologic evidence of graft versus host disease appeared in the native small intestine in two of four long term surviving dogs receiving a nonirradiated graft but in none of the dogs receiving irradiated grafts. Irradiation of the graft may be a promising adjunct in the search for a clinically applicable method of intestinal transplantation.

Animals↗