PubMed Health⌕ Search

Biomedical subjects

C H Almond

Publications and source records attributed to C H Almond.

At least 19 recordsLinked to original sources
PubMed1995

Pneumococcal clearance function of the intact autotransplanted spleen.

OBJECTIVE: To determine if the venous drainage of the spleen into the portal circulation is essential for its ability to protect against encapsulated bacterial challenge. DESIGN AND INTERVENTIONS: Three groups of dogs were randomly assigned to undergo either sham laparotomy, splenectomy, or splenectomy with autotransplantation of the intact spleen into the pelvis and formation of vascular anastomoses to the iliac vessels. Two weeks post-operatively, the dogs received a sublethal intravenous injection of Streptococcus pneumoniae type 25. OUTCOME MEASURES: Bacterial clearances and inflammatory damage to the liver. Bacterial clearance of the autotransplanted spleen should be no different from that of a sham-operation spleen and significantly different from that of a splenectomized animal. In addition, immunologic function of the autotransplanted spleen should not differ from that of a sham-operation spleen in the degree of inflammatory damage to the liver. RESULTS: No differences in bacterial clearance function were found between the animals that had undergone sham laparotomy or splenic autotransplantation. However, bacterial clearance in the splenectomized animals was significantly impaired. Histologic examination of the liver 2 weeks after the bacterial challenge revealed high-grade inflammatory damage to the livers of splenectomized dogs, intermediate liver damage in dogs that underwent autotransplantation, and essentially no damage in dogs that underwent sham laparotomy. Autotransplanted spleens were essentially nonreactive, lacking actively proliferating germinal centers, whereas splenic tissue from sham-operation animals showed reactivity. CONCLUSION: Although bacterial clearance function is unchanged in autotransplanted spleens, this method still does not fully protect the liver from inflammatory damage.

Analysis of Variance↗
PubMed1993

Two-dimensional echocardiography in the evaluation of penetrating intrapericardial injuries.

Patients with penetrating pericardial trauma whose vital signs stabilize after fluid administration may present a therapeutic dilemma. Two-dimensional echocardiography has emerged as a diagnostic technique to help determine whether surgical intervention may be required. We present 5 patients with penetrating pericardial trauma whose vital signs stabilized after fluid administration and who had minimal clinical findings. In 3 of these patients, a small effusion was seen; in 2 others, no abnormalities were noted. All 5 underwent surgical exploration and had major intrapericardial injuries. We conclude that a normal echocardiographic study does not rule out major intrapericardial injury in patients with penetrating chest trauma. Furthermore, small areas of effusion seen on echocardiography in these patients represent indications for surgical exploration.

Adult↗
PubMed1989

Failure of preoperative staging to assess unresectability in M0 bronchogenic carcinoma.

Despite extensive preoperative staging, unresectability of a bronchogenic carcinoma may not be known until an exploratory thoracotomy is done. Failures in anatomic staging occur because of inability to detect local extent of hilar lesions and inability to detect small deposits of metastatic disease. At the University of South Carolina, nine of 75 patients who underwent thoracotomies were found to be unresectable. Using an extensive staging protocol, the "back out" thoracotomy rate can be reduced to a minimum whereas no patient is denied a chance for surgical cure.

Carcinoma, Bronchogenic↗
PubMed1987

Stair climbing as an indicator of pulmonary function.

Seventy male patients with a mean age of 56.8 years scheduled for pulmonary function testing were subjected to a stair climb in order to determine the relationship, if any, between the number of steps climbed and the results of pulmonary function testing. The number of steps completed was plotted against the different parameters which may be used as predictors of post-thoracotomy outcome. The stair climb acts as a stress test and, although there is a strong relationship to pulmonary function tests, it also is an indicator of many other parameters including cardiovascular status, cooperation, and determination. Based on results of this study, the stair climb can be used as a reliable screening test of pulmonary function. Also, preoperative patients who are unable to perform pulmonary function tests can be evaluated accurately for lung resection by use of the stair climb test.

Adult↗
PubMed1984

Endotracheal granular cell myoblastoma. A failure of laser therapy.

A patient had multicentric endobronchial granular cell myoblastoma. Progression with worsening tracheal obstruction following carbon dioxide laser therapy led to surgical resection. Flow volume loops documented progressive relief of airway obstruction after laser and resectional surgery. Our experience with failure of laser therapy supports previous recommendations for surgical therapy for large (greater than 8 mm) lesions of the trachea.

Adult↗
PubMed1979

Role of surgery in the management of pulmonary sporotrichosis.

Management of four patients with sporotrichosis is summarized; one was treated medically and three were treated surgically. Thirty-seven cases from the literature are reviewed. The role of surgery in the management of pulmonary sporotrichosis is outlined as follows: (1) diagnosis of pulmonary infiltrates and/or pulmonary cavities of undetermined origin, (2) surgical intervention in patients with persistent infiltrates with cavitary lesions resulting from sporotrichosis, following failed medical treatment, and (3) resection of associated pulmonary cavitary lesions in patients in spite of adequte medical control of sporotrichosis. Surgical principles that must be observed in the management of pulmonary sporotrichosis follows:(1) Resection is the procedure of choice. The magnitude ranges from segmental resection to pneumonectomy. Clean resection is necessary. (2) Antifungal drug therapy--preferably with amphotericin B--is advisable preoperatively and postoperatively, since the major cause of late death is progression of the disease when clean resection has not been feasible. (3) Resection combined with drug therapy can be curative without increased risk in physiologically operable and anatomically resectable disease. (4) Thoracoplasty can be a lifesaving procedure for bilateral cavitary lesions with severe hemoptysis in patients with impaired pulmonary functions.

Adult↗
PubMed1978

Surgical repair of right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum.

Five cases of right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum, with or without Kommerell's diverticulum, are presented. Either right or left thoracotomy with divesion of the aberrant retroesophageal left subclavian artery can be accomplished with good results. However, a right thoracotomy is recommended in the presence of a large Kommerell diverticulum because such a diverticulum should be excised. The development of a subclavian steal syndrome later in life may be prevented by reimplantation of the divided left subclavian artery into the aorta or the left common carotid artery.

Adolescent↗
PubMed1978

Cyanosis in a patient with combined ostium primum and secundum atial septal defects and anomalous inferior vena cava with azygos continuation. Case report and surgical considerations.

A case is described of combined ostium primum and ostium secundum atrial septal defects and azygos connection of the inferior vena cava plus cyanosis. Emphasis is made to recognize the functional mechanism of cyanosis and to demonstrate the anatomic site of hepatic venous drainage so that an appropriate corrective operative procedure can be planned. A gratifying result was achieved in this case after closure of the atrial septal defects.

Adult↗
PubMed1977

True and false aneurysms of the left ventricle following myocardial infarction.

Anterolateral myocardial infarction resulted in the formation of both true and false aneurysms in a 75 year old man in whom severe congestive heart failure subsequently developed as the false aneurysm became progressively larger. Left ventriculography detected and quantified both aneurysms, and demonstrated reasonable function of the remaining volume-overloaded left ventricle. Resection of both aneurysms was accomplished with marked relief of symptoms. The literature on false aneurysm is reviewed, and the dilemma posed by the need to recognize false aneurysms before they become symptomatic or rupture is discussed.

Aged↗
PubMed1977

Retention of pacemaker electrode complicated by Serratia marcescens septicemia. Removal with total cardiopulmonary bypass.

A case in which Serratia marcescens septicemia complicated the insertion of a transvernous pacemaker unit is reported. Appropriate antibiotic therapy and removal of the pacemaker electrode are two essential steps to achieve a complete cure in this stimulation. Open cardiotomy with total cardiopulmonary bypass provides a safe approach for withdrawal of an incarcerated electrode and is justified because of the lethal potential of systemic Serratia infections, particularly those superimposed on intracardiac prostheses.

Anti-Bacterial Agents↗
PubMed1977

The role of surgery in the management of pulmonary monosporosis. A collective review.

Nine cases of pulmonary monosporosis treated in the Missouri State Chest Hospital over a period of 19 years (1956 to 1975) were reviewed. Nine other cases from the literature are summarized. Ten of these 18 patients underwent resectional operations with two operative deaths, one from respiratory insufficiency and the other from a bronchopleural fistula and massive hemorrhage. The rest of the patients had an uneventful recovery. The indications for resectional surgery are re-established for suitable cases. The underlying disease is the major determinant of the outcome of the surgery. Other modes of treatment are also discussed. Based on the analysis of these 18 cases, a guideline for the management of pulmonary monosporosis is proposed.

Aged↗
PubMed1977

Sclerosing mediastinitis with occlusion of pulmonary veins. Manifestations and management.

A case of mediastinal fibrosis with occlusion of the right inferior and middle lobe pulmonary veins is described. The patient had severe hemoptysis, and the diagnosis was established with thoracotomy. Review of the literature emphasizes the lethal nature of this syndrome if untreated. Resection of the involved bronchopulmonary tissue, when feasible, offers good palliation, although the long-term prognosis is unpredictable.

Adult↗
PubMed1976

Solitary peripheral pulmonary artery aneurysms. Pathogenesis and surgical treatment.

The case of a solitary peripheral pulmonary artery aneurysm in a patient with congenital heart disease and secondary pulmonary hypertension is presented. The aneurysm appeared following an episode of bacterial endocarditis and was probably mycotic in origin. Resection was prompted by a recent increase in size. A successful aneurysmectomy was performed. Lobectomy was the procedure employed in seven other reported cases treated surgically. A brief review of the literature emphasizes the necessity for resection whenever the diagnosis is made to prevent a fatal outcome due to rupture. A classification of pulmonary artery aneurysms based on their etiology is proposed, together with a possible explanation for the pathogenesis of peripheral aneurysms of nonspecific etiology.

Adult↗
PubMed1976

Total correction of double-outlet ventricle with concordant atrioventricular relation, dextrocardia, pulmonary stenosis, and situs inversus.

A case of successful surgical correction of double-outlet right ventricle with concordant atrioventricular relation, pulmonic stenosis, and situs inversus is described. Transposition of the great vessels was not present. Intracardiac repair with a Teflon tunnel conduit gave an excellent result. Proper resection of the subpulmonic obstructing fibromuscular band required no patch reconstruction of the outflow tract.

Cardiopulmonary Bypass↗