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Biomedical subjects

A C Charters

Publications and source records attributed to A C Charters.

17 recordsLinked to original sources
PubMed1979

Experience with a simplified trauma registry: profile of trauma at a university hospital.

A simplified computer-based trauma registry system with well-defined limits of data capture is presented. This registry was utilized to describe the profile of trauma at a university hospital. In 1 year there were 882 trauma victims hospitalized, with an overall mortality of 3.3%. The majority of the patients had relatively minor injuries, primarily involving soft tissue and bone. Severe multiple trauma was associated with a significant mortality. Intracranial or intra-abdominal injuries occurred in less than 10% of the patients. Transport accidents, falls, and assaults were the cause of injury in 70%. Key access to specific information about the trauma patient population demonstrated the potential of the registry system. The advantages and limitations of the registry are discussed.

Adolescent↗
PubMed1978

Intrahepatic bile duct rupture following blunt abdominal trauma.

The natural history of intrahepatic bile duct rupture secondary to blunt trauma is not known. A unique case of bilateral hepatic lobar duct rupture is presented to demonstrate the clinical features and potential complications of this injury. Operative intervention is not always indicated and treatment should be dictated by the specific lesion.

Abdominal Injuries↗
PubMed1978

The roll-bar hand.

This report describes a new hand injury seen in passengers in dune buggies having rollover accidents. Since these vehicles are usually driven off the road and far from treatment centers the treatment of these injuries is often delayed. As the rollover takes place, the reflex action--usually of the passenger--is to grasp the roll bar. A crush-avulsion injury occurs at the level of the metacarpals, with the thumb frequently spared. Wound contamination, delay in treatment, and the frequency of other serious injuries add to the seriousness of this injury. Redesign of the roll bar, provision of better passenger protection, and an internal grasp support are suggested to reduce its incidence.

Accidents↗
PubMed1978

Off-road vehicle accidents: a new spectrum of trauma.

A survey of off-road vehicle accident injuries indicates a significant incidence of trauma: means of 931 serious injuries and 15 fatalities/year were reported for a three-county region of Southern California. A representative 78-bed community hospital in the desert region saw 542 patients with injuries related to off-road vehicle accidents over 3 years. Characteristic injuries often could be related to the type of accident and vehicle involved. A survey of off-road vehicle enthusiasts showed that 21% had had an accident resulting in injury. Driver immaturity, poor judgment and alcohol were identified as causative factors. Future planning must include attention to the sports enthusiast and medical services planning as well as an appreciation of the characteristic injuries resulting from this sport.

Accidents↗
PubMed1977

Alloxan diabetic neuropathy: electron microscopic studies.

Peripheral nerves of diabetic rats were studied 2 years after alloxan injection. We observed demyelination and remyelination, axonal degeneration and regeneration, reduplication of basal laminae around vessels and Schwann's cells, as well as onion bulb formation by proliferated Schwann's cells. Crystalline deposits composed of aggregates of fibrillary electron dense material often occurred in vessel walls and endoneurium of diabetic animals but rarely were seen in nerves from age-matched control animals. Glycogen accumulated in myelinated and unmyelinated axons within mitochondria. Axoplasmic inclusions resembling Lafora's bodies and the inclusions of glycogenosis type IV were frequent and often were accompanied by deposits of particulate glycogen. The findings suggest that the neuropathy in alloxan diabetes is caused by metabolic impairment of anxons, Schwann's cells, and vessels, leading to segmental demyelination and axonal degeneration.

Animals↗
PubMed1976

Further evidence for an intestinal phase hormone that stimulates gastric acid secretion.

The studies described in this report were directed at isolating the hormone responsible for the intestinal phase of gastric acid secretion. One hundred and ten extracts of hog intestinal mucosa, each representing the yield from about 3,000 hogs, were prepared by a method for isolating small peptides that involved heating, absorption on diethylaminoethylcellulose (DEAE), and acid precipitation. All extracts stimulated gastric acid secretion in acute gastric fistula rats, and 56 were highly active according to stringent criteria that required a greater than 50 percent increase in acid output above basal in at least 60 percent of rats. Increasing doses of extract stimulated increasing acid production according to a regular dose-response relationship. Twelve highly active extracts were tolerated without side effects when infused into dogs with Heidenhain pouches and produced a mean 22 fold increase in acid output above basal. The gastrin content of 73 extracts, measured by radioimmunoassay in two independent laboratories, averaged 5,80 ng. per rat dose of extract, which is approximately 1/500 of the minimal stimulating dose of hog gastrin. No extract contained sufficient gastrin to produce an acid secretory response. Administration of the extract together with a maximal stimulating dose of pentagastrin in rats significantly augmented the maximal acid secretory response. Finally, comparison of the acid secretory response to portal and systemic intravenous infusion of the extract in acute gastric fistula rats demonstrated significant inactivation by passage through the liver, in contrast to the results of similar studies of hog gastrin. It is concluded that the extract had all of the known physiologic properties of the intestinal phase hormone and very likely contained the intestinal phase hormone.

Animals↗
PubMed1975

Long-term exocrine function of the pancreas transplant.

The long-term exocrine function of fifty-nine pancreaticoduodenal isografts was evaluated in rats for up to one year post transplantation. At one, three, six, nine, and twelve months after transplantation the grafts were cannulated and the exocrine secretion was collected. The volume, protein content, pH, amylase and trypsin concentrations, and electrolyte composition of the secretion were compared with those obtained from the host pancreas in nineteen control rats. Twenty-four hour secretion studies demonstrated normal basal function of the pancreas transplant when compared with that of the host. Pancreozymin stimulation caused an increase in volume, trypsin concentration, and amylase concentration of the graft pancreas secretion that was similar to those seen in the host. These studies indicate that there is normal exocrine secretion of pancreas transplants in the absence of rejection and that denervation of the gland has little direct effect on over-all pancreatic function.

Amylases↗
PubMed1975

Simplified technic for orthotopic liver transplantation in the rat.

A new surgical procedure has been developed to simplify the difficult, complex technic of orthotopic liver transplantation in the rat that we previously described. This procedure eliminates the hepatic artery anastomosis and specifically changes the sequence of anastomoses of the vena cava and portal vein to minimize splanchnic congestion and hepatic ischemia. This has simplified and shortened the operation and has eliminated the need for an extracorporeal portosystemic shunt. Seventy-two per cent operative survival was achieved in fifty-seven orthotopic liver transplantations. This simplified technic of orthotopic liver transplantation in the rat can be applied widely to studies of liver physiology, immunologic rejection, and liver preservation.

Animals↗
PubMed1975

Long term studies of pancreas transplantation in experimental diabetes mellitus.

Alloxan diabetes was induced in inbred rats that then were divided into four groups consisting of unoperated diabetic controls, sham-operated diabetic controls, rats given pancreaticoduodenal isografts, and rats given duct-ligated pancreas isografts. The animals were studied for from 18 months (controls) to two years (transplants) and the following important results were obtained: 1) In striking contrast to the diabetic controls, pancreas transplants of both types produced immediate and permanent relief of hyperglycemia, immediate and lasting elevation of serum insulin levels, a normal weight and growth curve, and good health for two years. Removal of the graft was followed by recurrence of severe diabetes. 2) Pancreas transplants of both types prevented the widespread and severe renal, ophthalmic and neural lesions of diabetes that were found in the diabetic controls. 3) The duct-ligated pancreas graft and pancreaticoduodenal transplant were equally effective in controlling diabetes. Ligation of the pancreatic duct was not followed by significant morphologic or clinical evidence of pancreatitis or by loss of endocrine function. 4) Portal venous drainage of the pancreas transplant was unnecessary for good endocrine function.

Animals↗
PubMed1975

Liver regeneration after portacaval transportation in rats.

General recognition of the presence of a specific hepatotrophic factor in portal blood that is necessary for liver regeneration was delayed by two major problems. First, there was a long period of confusion regarding liver atrophy, liver hypertrophy, and cellular hyperplasia. Second, because only exposure to other liver tissue destroys the hepatotrophic activity, all of the studies that were based on bypassing the portal blood into the systemic circulation merely diluted the active substance, which still was available to the hepatocytes by recirculation through the hepatic artery. These problems have been resolved by the development of more sophisticated methods by which to assay liver regeneration and by the introduction of the double liver model to study regeneration. During the time when liver weight alone was used to assess regeneration, the regenerative capacity of the liver was reported to be much greater after portacaval transposition than after end-to-side portacaval shunt, a finding that is inconsistent with current knowledge of the hepatotrophic portal blood factor. To re-evaluate the effect on liver regeneration of providing a compensatory systemic venous inflow after complete portal diversion, 40 partially hepatectomized inbred rats which had previously undergone either a sham operation and end-to-side portacaval shunt or a portacaval transposition were compared on the basis of six separate criteria of regeneration. All of the livers actively regenerated and no significant advantage of providing a substitute systemic venous inflow to the liver could be detected by any of the criteria.

Animals↗
PubMed1975

Portacaval shunt as emergency procedure in unselected patients with alcoholic cirrhosis.

A prospective evaluation of emergency portacaval shunt has been conducted during a 12 year period in 138 unselected, consecutive patients with alcoholic cirrhosis and bleeding esophageal varies. An extensive diagnostic evaluation was completed within seven hours of hospital admission, and the shunt operation was undertaken within a mean of 8.5 hours. Follow-up study was conducted in a special clinic, and the current status of 97.1 per cent of the patients had jaundice, ascites or encephalopathy alone or in combination on admission. Systemic intravenous administration of posterior pituitary extract temporarily controlled the hemorrhage in 94 per cent of the patients, and the emergency portacaval shunt promptly and permanently controlled the varix bleeding in 96 per cent of the patients. Contrary to recent proposals, patients with the highest portal perfusion pressure and, presumably, the largest hepatopetal portal flow had the highest survival rate and those who were presumed from pressure measurements to sustain the smallest portal flow diversion from the shunt had the lowest survival rate. The operative survival rate was 51 per cent, the predicted seven year survival rate for those operated upon seven or more years ago was 42.5 per cent. Encephalopathy requiring dietary protein restriction developed at some time in 17 per cent of the survivors. Sixty per cent of the survivors abstained from alcohol, and 53 per cent resumed gainful employment or full time housekeeping. Preoperative factors that adversely influenced survial rate were ingestion of alcohol within one month of bleeding, ascites, severe muscle-wasting and a small liver. Postoperatively, the single most important factor that compromised long term survival was resumption of alcoholism. In comparisons with our previous prospective studies, emergency portacaval shunt resulted in a significantly greater long term survival rate than did either emergency medical therapy or emergency varix ligation, followed by elective shunt. It is concluded that emergency portacaval shunt is the most effective treatment of bleeding esophageal varices in patients with alcoholic cirrhosis. Criteria for exclusion of those patients who are unlikely to derive long term benefits from portacaval shunt remain to be defined by further studies.

Adult↗