PubMed Health⌕ Search

Biomedical subjects

E F Cox

Publications and source records attributed to E F Cox.

At least 19 recordsLinked to original sources
PubMed2005

Coral larvae conservation: physiology and reproduction.

Coral species throughout the world's oceans are facing severe environmental pressures. We are interested in conserving coral larvae by means of cryopreservation, but little is known about their cellular physiology or cryobiology. These experiments examined cryoprotectant toxicity, dry weight, water and cryoprotectant permeability using cold and radiolabeled glycerol, spontaneous ice nucleation temperatures, chilling sensitivity, and settlement of coral larvae. Our two test species of coral larvae, Pocillopora damicornis (lace coral), and Fungia scutaria (mushroom coral) demonstrated a wide tolerance to cryoprotectants. Computer-aided morphometry determined that F. scutaria larvae were smaller than P. damicornis larvae. The average dry weight for P. damicornis was 24.5%, while that for F. scutaria was 17%, yielding osmotically inactive volumes (V(b)) of 0.22 and 0.15, respectively. The larvae from both species demonstrated radiolabeled glycerol uptake over time, suggesting they were permeable to the glycerol. Parameter fitting of the F. scutaria larvae data yielded a water permeability 2 microm/min/atm and a cryoprotectant permeability = 2.3 x 10(-4) cm/min while modeling indicated that glycerol reached 90% of final concentration in the larvae within 25 min. The spontaneous ice nucleation temperature for F. scutaria larvae in filtered seawater was -37.8+/-1.4 degrees C. However, when F. scutaria larvae were chilled from room temperature to -11 degrees C at various rates, they exhibited 100% mortality. When instantly cooled from room temperature to test temperatures, they showed damage below 10 degrees C. These data suggest that they are sensitive to both the rate of chilling and the absolute temperature, and indicate that vitrification may be the only means to successfully cryopreserve these organisms. Without prior cryopreservation, both species of coral settled under laboratory conditions.

Animals↗
PubMed1988

Blunt bladder trauma: manifestation of severe injury.

Twenty-nine patients with bladder injuries requiring operative treatment as a result of blunt trauma are presented. Motor vehicle accidents accounted for 86 per cent of the injuries. Hypotension and gross hematuria were the most prevalent clinical features, 68 per cent and 97 per cent, respectively. All patients had multiple associated injuries requiring operative treatment, average 2.9 per patient. Pelvic fractures occurred in 93 per cent and intra-abdominal injuries in 48 per cent of patients. The majority of ruptures (72%) were intraperitoneal. Mortality, related to associated injuries, was high (34%), attesting to the magnitude of injury sustained by the victim.

Abdominal Injuries↗
PubMed1988

Blunt trauma to the liver. Analysis of management and mortality in 323 consecutive patients.

This study represents a 6 year 4 month experience with blunt trauma to the liver of patients from the Maryland Institute for Emergency Medical Services Systems, a major regional trauma center. The significance of this study is that it describes a large, relatively homogeneous population and analyzes what the state of the art for liver trauma has been in a center dedicated solely to trauma that has a full-time staff of trained traumatologists. Three hundred twenty-three consecutive patients with blunt liver trauma are presented, representing 3.5% of 9271 patients admitted to the institute over the period of this study. Ninety per cent had associated traumatic injuries requiring operative intervention. A mortality rate of 31% (101 patients) was noted; 41.5% of the deaths, due primarily to liver injury, occurred intraoperatively during the initial operation following admission. The use of simple suture techniques and resectional debridement to control hemorrhage are advocated. Anatomic lobectomy, intracaval shunting, and hepatic artery ligation were uniformly unsuccessful. The use of drains was associated with a significantly increased incidence of infectious complications (p less than 0.00002).

Adult↗
PubMed1986

Blunt injury to the diaphragm: an analysis of 44 patients.

Forty-four patients sustaining blunt trauma with resultant diaphragmatic rupture during a 5 1/2-year period are presented. In 41 (93%), the diagnosis was established within 6 hours of admission. The correct diagnosis was made preoperatively in 19 patients operated on acutely (42%), in 22 (53%), ruptured diaphragm was an incidental finding at celiotomy or thoracotomy. The admission chest roentgenography, diagnostic peritoneal lavage, UGI contrast studies, and computed tomography were the most useful diagnostic aids. The transabdominal operative approach was utilized in 39 patients (89%). All patients had associated extra-abdominal injuries and 26 patients (59%) had associated intra-abdominal injuries. The mortality rate was 20.4%; early deaths were attributable to hemorrhage and severe head injury, late deaths to sepsis and progressive multiorgan failure.

Accidents, Traffic↗
PubMed1986

Splenic conservation after multiple trauma in adults.

The traditional management of splenic injuries is undergoing serious challenge. During the four year period from 1980 to 1983, 60 of 230 patients with injured spleens operated upon at the Maryland Institute for Emergency Medical Services' Shock Trauma Center have had splenic salvage. Motor vehicle accidents accounted for 57 of the 60 injuries (95 per cent). Fifty-eight patients (97 per cent) had major associated extra-abdominal injuries (average 1.9 injuries per patient) requiring additional operative procedures. Concurrent intra-abdominal injury was present in 37 patients (62 per cent). The mean operating time was 106 minutes; 98 minutes for those patients with isolated splenic injuries and 115 minutes for those with associated minor intra-abdominal injuries. The average amount of blood transfused during celiotomy was 3.5 units of packed red blood cells per patient. As familiarity and confidence with the techniques have accrued, the number of splenic preservation procedures has steadily increased from approximately 10 per cent to more than 50 per cent. Complications related to splenorrhaphy per se were few. The mortality was 10 per cent; all deaths were secondary to associated injuries. Criteria for and contraindications to splenic salvage in patients with multiple trauma are presented and discussed.

Accidents, Traffic↗
PubMed1985

Acute posttraumatic acalculous cholecystitis.

A series of 18 patients who had acute posttraumatic acalculous cholecystitis over a 12 year period was presented. An attempt was made to determine the etiologic factors involved in the pathogenesis of the disease. Large amounts of parenteral narcotics administered over a prolonged period were evident in all patients. Narcotic-induced biliary stasis appeared to be the prime factor involved in the genesis of acalculous cholecystitis after trauma. Other factors such as the presence of shock, respiratory failure, acute renal failure, parenteral hyperalimentation, and multiple transfusions were less prevalent and were not temporally related to the onset of the disease.

Acute Disease↗
PubMed1985

Blunt intestinal trauma. A modern-day review.

During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accidents and therefore commonly had multisystem injuries. Sixty of these patients suffered 83 major injuries in the form of perforation or mesenteric injury resulting in ischemic bowel. This group accounted for 6.9% of the 870 patients who had celiotomy for blunt trauma during this period. Several significant observations were made. All injuries, except one, were diagnosed by peritoneal lavage. Only two duodenal injuries were present. Perforations involving the jejunum and ileum were distributed throughout the entire length of the small bowel. Colon injuries comprised one-fourth of the major injuries, with most occurring in the ascending and sigmoid colon. There were 16 deaths, 6 of which occurred as a result of complications from the bowel injury.

Abdominal Injuries↗
PubMed1985

Non-left sided diaphragmatic rupture due to blunt trauma.

An analysis of the clinical, diagnostic and therapeutic features of non-left sided diaphragmatic rupture due to blunt trauma to the torso was performed in ten patients. All patients had multiple systems involved. False-positive peritoneal lavage occurred in three patients (37.5 per cent). The correct diagnosis was made only once preoperatively; diaphragmatic rupture usually being an incidental finding at celiotomy or thoracotomy. Mortality is high and is a manifestation of associated injuries.

Adolescent↗
PubMed1984

Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy.

This study represents the experience with blunt trauma to the abdomen of patients from a major regional trauma center. Eight hundred and seventy patients with blunt abdominal trauma are reviewed, representing 12.89% of the total admissions over a 5-year period. The motor vehicle continues to be the major cause (89.5%) of injury to these patients. Thirty per cent had positive blood alcohol. Intra-abdominal injuries in this group necessitating operative intervention were based on the use of peritoneal lavage. Negative celiotomies occurred in 10.2% of these patients. Of the injuries incurred, the spleen was involved 42%, the liver 35.6%, the serosa, diaphragm, bowel, and blood vessels were involved to a lesser extent. Only 0.4% of the patients suffered direct injury to the stomach, duodenum, and pancreas, data which should preclude routine exploration of retroperitoneal structures unless by obvious retroperitoneal injury is noted. Additional surgical intervention for associated injuries was seen in 50.54% of this patient group.

Abdomen↗
PubMed1983

Cholangiocarcinoma. A place for brachytherapy.

Carcinoma arising from the common hepatic duct is unique in its clinical course and is difficult to manage due to its dismal prognosis. The case reported and the treatment reflected not only the highly selective process but also the innovation of the intracatheter brachytherapy technique available to date. Exploratory laparotomy appears essential to identify the extent of the tumor and localize the area for brachytherapy. Percutaneous transhepatic cholangiography and placements of the indwelling catheter should be reserved for non-surgical candidates whose long-term survival is limited. Review of pertinent literature also shows various roles of irradiation in the management of this disease. The potentials of intraoperative therapy, brachytherapy, external beam therapy and their combinations were examined to implement the future recommendation of the treatment.

Adenocarcinoma↗
PubMed1983

Traumatic hemipelvectomy: report of two survivors and review.

Two surviving patients with traumatic hemipelvectomy are presented. Rapid transport, aggressive initial resuscitation, and attention to detail in the rehabilitation phase are necessary for the successful management of these patients. The viability of the psoas muscle should be assessed, because of the high possibility of avulsion. Associated nerve injury and complicating meningitis can be serious problems in the management of such patients. There is need to include this entity in the existing classifications of pelvic fractures. Hemipelvectomy is proposed as an alternative in the management of the severe unilateral open pelvic fracture with uncontrollable bleeding.

Accidents, Traffic↗
PubMed1982

Failure of cross clamping the thoracic aorta to control intra-abdominal bleeding.

The efficiency of cross clamping the thoracic aorta for cases of massive hemorrhage and impending cardiac arrest is questionable. We present two cases of major intra-abdominal aortic injury in which the bleeding could not be controlled by cross clamping the thoracic aorta. Multiple collateral pathways around the clamped aorta may have rendered this procedure almost ineffective. In cases of major intra-abdominal arterial disruption, emergency department laparotomy may be necessary.

Adult↗
PubMed1982

MAS trousers improperly applied causing a compartment syndrome in lower-extremity trauma.

A case is presented in which the leg segments of MAS trousers were deflated without deflating the abdominal segment, causing the trousers to act as a venous tourniquet. As a result bleeding and edema secondary to a pertrochanteric hip fracture were aggravated, causing a compartment syndrome in the thigh; fasciotomy became necessary. MAS trousers must be inflated in proper sequence, the leg segments first and then the abdominal portion. In deflation, the order is reversed. Only if this sequence is followed can MAS trousers be used safely.

Adult↗