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Biomedical subjects

W J Grant

Publications and source records attributed to W J Grant.

10 recordsLinked to original sources
PubMed2001

Transplantation of ABO group A2 kidneys from living donors into group O and B recipients.

Fifteen blood group O and B recipients have been transplanted with kidneys from subtype A2 living donors since April 1992. ABO red cell grouping was performed by local licensed blood banks with A2 subtype determined using an anti-A1 lectin and, retrospectively, by a polymerase chain reaction (PCR)-based molecular method. All grafts functioned immediately and no patient has required dialysis. Three patients each experienced one reversible rejection episode. With the exception of one cardiac death at 9months and one patient with profound toxicity to calcineurin inhibitors, all allografts continue to function normally. One donor, mistyped as a group A2 using lectin, was by PCR typing an A1O1 nonsecretor; the graft continues to function normally at 30 months. Transplantation of living donor A2 renal allografts into non-A recipients produces excellent long-term allograft survival and expands the potential living donor pool for nonblood group A recipients.

ABO Blood-Group System↗
PubMed1999

Plasmapheresis as an adjunct treatment in toxic epidermal necrolysis.

BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe, progressive disease characterized by the sudden onset of skin necrosis. It is frequently associated with systemic involvement and has a high rate of morbidity and mortality. Standard therapy includes meticulous wound care, fluid replacement, and nutritional support in an intensive care setting. OBJECTIVE: We evaluated the outcomes of patients treated in a burn unit for TEN over a 9-year period and compared the outcomes of a subset of patients treated with plasmapheresis with those managed by conventional means. METHODS: The records of 16 patients with a diagnosis of TEN obtained from a computerized database were reviewed. Parameters recorded included extent of body surface area involvement and number of mucous membranes involved at admission, complications such as sepsis or need for mechanical ventilation, length of stay, and disposition. RESULTS: Sixteen patients were included in this study. Ten were treated with conventional support measures alone. Six were treated with plasmapheresis. The average age was 42.4 years; the male/female ratio was 1:2.2. Sulfamethoxazole/trimethoprim was implicated in causation in 6 patients. The average extent of involvement on admission in all patients was 51.5% total body surface area. The average length of stay in all patients was 14.8 days. Eight patients (50%) were discharged home, 4 (25%) were discharged to a rehabilitation facility, and 4 (25%) died (2 of sepsis, 2 of cardiopulmonary arrest). None of the plasmapheresis-treated patients died. CONCLUSION: Plasmapheresis is a safe intervention in extremely ill TEN patients and may reduce the mortality in this severe disease. Prospective studies are needed to further define its usefulness.

Adolescent↗
PubMed1998

Tracheobronchial injuries after blunt chest trauma in children--hidden pathology.

BACKGROUND: Blunt thoracic injuries in children are unique because the pliability of the chest wall allows transmission of massive external force directly into the mediastinum. Children presenting after blunt chest trauma may have complete disruption of the airway with little external sign of injury. Without prompt diagnosis and appropriate treatment, the risk for progressive respiratory failure is high. METHODS: Four children with tracheobronchial injuries were referred to a pediatric trauma center from 1994 to 1997. All children, age 18 months to 13 years, suffered unusual crush injuries. All diagnoses were based on unresolved pneumothorax or pneumomediastinum. RESULTS: Bronchoscopy identified the location of injury as posterior trachea (n = 1) and right mainstem bronchus (n = 2). A tertiary bronchial injury (n = 1) was missed by initial tracheogram and subsequent bronchoscopy but identified during surgical exploration. All children survived after thoracotomy and primary repair of the injury. CONCLUSIONS: Tracheobronchial disruption is a rare, life-threatening injury. Suspicion should be high when pneumomediastinum and pneumothorax are refractory to adequate pleural drainage. Flexible bronchoscopy with intubation distal to the injury may be necessary to prevent loss of the airway. Advance preparation should include setups for bronchoscopy, thoracotomy, and cardiopulmonary bypass. Patient survival depends on preparation and prompt surgical intervention.

Adolescent↗
PubMed1991

Stapedius tendon ossification: a rare cause of congenital conductive hearing loss.

Two cases are presented of bilateral conductive deafness in siblings. An initial presumptive diagnosis of otosclerosis was made in the first case, that of a nine-year-old girl with a bilateral hearing loss of 45 dB. Exploratory tympanotomy revealed normal ossicles but the stapedius 'tendon' was found to be a solid bony bar fixing the stapes. Division of the 'tendon' resulted in normal ossicular mobility and return of hearing with closure of the air-bone gap. Identical ossification was found in her other ear, and some years later in both ears of one of her brothers. Similar surgery restored hearing successfully in each case. An acquired aetiology has been proposed in one of the three previously reported cases; this report, however, suggests the congenital nature of the anomaly. No previous cases have been described occurring in siblings.

Adult↗
PubMed1985

Photosynthetic and stomatal responses of spinach leaves to salt stress.

The gas exchange of spinach plants, salt-stressed by adding NaCl to the nutrient solution in increments of 25 millimolar per day to a final concentration of 200 millimolar, was studied 3 weeks after starting NaCl treatment. Photosynthesis became light saturated at 1100 to 1400 micromoles per square meter per second in salt-treated plants and at approximately 2000 micromoles per square meter per second in control plants. Photosynthetic capacity of the mesophyll measured as a function of intercellular partial pressure of CO(2) at the light intensity prevailing during growth and at light saturation were both decreased in the salttreated plants. The CO(2) compensation points and relative enhancements of photosynthesis at low O(2) were not affected by salinity. The lower photosynthetic rates in salt-treated leaves at 450 micromoles per square meter per second were associated with a 70% reduction in stomatal conductance and low intercellular CO(2) (219 microbars; cf. 285 microbars for controls). Increasing photon flux density to light saturation extended the linear portions of the CO(2) response curves, increased stomatal conductances, increased intercellular CO(2) in the salt-treated plants, but lowered it in controls, and accentuated differences in photosynthetic rate (area basis) between the treatments.Leaves from salt-treated plants were thicker but contained about 73% of the chlorophyll per unit area of control plants. When photosynthetic rates were expressed on a chlorophyll basis there was no difference in initial slope of assimilation versus intercellular CO(2) between treatments. Photosynthetic rates (chlorophyll basis) at light saturation differed only by 20% which was also observed earlier with isolated, intact chloroplasts (Robinson et al. 1983 Plant Physiol 73: 238-242).Measurement of carbon isotope ratio revealed less discrimination against (13)C with salt treatment and confirmed the persistence of low intercellular partial pressures of CO(2) during plant growth. The development of a thicker leaf with less chlorophyll per unit area during salt treatment permitted stomatal conductance and intercellular partial pressure of CO(2) to decline without restricting photosynthesis and had the benefit of greatly increasing water use efficiency.

Journal Article↗
PubMed1966

Lactic acidosis.

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Acidosis↗
PubMedDate not supplied

Clinical experience with a multi-element ultrasonic hyperthermia system: analysis of treatment temperatures.

A summary of tumour temperature data obtained from 31 patients who underwent 147 hyperthermia treatments with the Sonotherm 1000 ultrasonic system is presented. The treatment goal was to achieve a minimum of 42.0 degrees C in tumour for 60 min duration with normal tissues remaining below 43.0 degrees C. In 83% of treatments at least one measured tumour temperature reached or exceeded 42.0 degrees C at some time during the treatment. Nineteen per cent of these treatments had a time- and spatial-averaged temperature (measured in tumour) greater than or equal to 42.0 degrees C. A variety of anatomical sites were treated and these were grouped into four categories: groin/trunk, axilla, breast/chest wall and head/neck. Measured temperatures in tumours located in the groin and trunk sites were significantly higher (22% greater than or equal to 42 degrees C) than other locations. The head and neck treatment temperatures were significantly lower (8% of measured points greater than or equal to 42 degrees C.

Body Temperature↗