Biomedical subjects

E Massac

Publications and source records attributed to E Massac.

7 recordsLinked to original sources

PubMed1994

Improvement of sickle cell anemia by iron-limited erythropoiesis.

We report the hematologic and clinical features of four adult patients (Pts.) with sickle cell anemia and iron-limited erythropoiesis. Two of the Pts. had spontaneous iron deficiency (chronic GI bleeding, low-grade hemoglobinuria). In the other two Pts. iron restriction was induced by periodic RBC aphereses as part of a pilot protocol designed to decrease intracellular HbS polymerization by MCHC reduction. Iron-limited erythropoiesis was defined by reduction in red cell indices (MCV range 60.4-67 fl) in the presence of low serum ferritin (range < 10-20 ng/ml). In these Pts. iron restriction did not cause clinically significant worsening of the anemia (Hb 7.8-9.0 g/dl). In two Pts. the anemia actually improved. Other hematologic effects of iron restriction were: decreased MCHC, reticulocyte count, RDW, and dense cells. A reduced hemolytic rate was suggested by a lowering of serum bilirubin and LDH. In one of the Pts. the 51Cr RBC T1/2 survival increased from 12 to 16 days. The intracellular HbS polymer fractions (fp) were determined at 25% O2 by Csat and with the use of the conservation of mass equation. The baseline fp values ranged from 0.48-0.53. After iron restriction they ranged from 0.33-0.48. The fp decreased even though iron-limited erythropoiesis also lowered the Hb F concentration in three of our Pts. In one of the two Pts. with induced iron depletion, hospitalization days for pain crises decreased from an average of 4.5 days/month (2 year baseline period) to an average of 0.5 days/month in the 3 year follow-up after iron depletion. The second patient with induced iron restriction experienced the rapid healing of a leg ulcer. Controlled iron restriction should be explored as a therapeutic strategy in selected SS patients.

Adult↗

PubMed1989

Model for phase III autografts of epidermal cells cultured on a collagen-proteoglycan biomatrix.

The primary aim of this study was to develop a model system that uses epidermal cells (keratinocytes and accessory pigmented cells) cultured on a reconstituted basement membrane biomatrix for use in conjunction with type I collagen as a replacement dermis-epidermis in the treatment of recurrent ulcerative lesions. Type I collagen sponges (Collistat) have been shown to promote rapid healing of leg ulcers but with extensive scarring (Reindorf et al, 1989). Dermatome sections from patients undergoing elective plastic surgery were treated with dispase to dissociate epidermis from dermis, the inner epidermal cells were then dissociated with trypsin-EDTA and plated on the biomatrix. A 4 cm2 skin specimen yielded approximately 10 to 12 million inner epidermal cells. These cells were plated at a density of 500,000 cells/cm2, thereby covering an area of 20 to 24 cm2. At 24 hours attached cells were dispersed primarily in monolayers, and by day 3 most of the epidermal cells reassociated into bi- or multilayered aggregates. Cells containing melanin granules were distributed in the basal to middle layers of the aggregates and persisted throughout the culture period (up to 14 days).

Cells, Cultured↗

PubMed1986

The use of the signal averaging computer for evaluation of peripheral nerve problems.

Utilization of signal averaging computers to analyze evoked nerve potentials generated by an electrical stimulus is a useful adjunct to clinical evaluation. Currently, somatosensory evoked responses are useful for the evaluation of the peripheral nerve with suspected compression syndromes, neuropathies of unknown etiologies, post-traumatic injuries, neuromas-in-continuity, and brachial plexus injuries. Further refinements in the system will result in increased clinical application of this useful modality. Present data indicate that neuromas with a conduction velocity of less than 10 meters per second or an amplitude of less than one fourth of normal should be considered unfavorable neuromas, and if clinically correlated, resection and repair anticipated. Conduction velocity slowing of greater than 20 meters per second across a potential site of compression neuropathy at the wrist using short-segment study should also be viewed as undesirable and will usually correlate with clinical findings on an abnormal von Frey test. The somatosensory response in compression neuropathy usually correlates better with the clinical finding than with an EMG.

Adult↗

PubMed1985

Reduction suction mammoplasty and suction lipectomy as an adjunct to breast surgery.

Suction lipectomy has become an accepted procedure and its full use is still being elucidated. The author herein describes the use of suction lipectomy as an adjunct in refining the results of established surgical procedures on the breast. The authors also explain the use of suction lipectomy in doing "suction reduction" mammoplasty. The advantages of the use of suction lipectomy as an adjunct to breast surgery and for reduction mammoplasty are explained.

Adipose Tissue↗

PubMed1983

Penetrating neck wounds.

Over a 15 year period 120 patients with neck injuries that penetrated the platysma were studied. Appropriate treatment was initiated in the emergency room. Sixty-one patients underwent exploration and 59 were observed. Two of the observed patients later required delayed operation. In 9.2 percent of the patients, two or more injuries were present within the neck, whereas in 30 percent the neck injury was only one of many bodily injuries. Length of hospital stay for the operative group of patients was 9 days and for the nonoperative group 5 days. There was one death. The complication rates in the operative and nonoperative groups were 2.5 and 1.7 percent, respectively. The major structures injured were within the venous system. The neck injuries were classified according to three zones defined by Saletta and Jones and their co-workers [4,5]. The majority were Zone II injuries. Our morbidity and mortality rates are slightly lower than those reported in most series. This review supports the concept that therapy for penetrating injuries to the neck should be individualized.

Adolescent↗

PubMed1982

Segmental ulcerative colitis: a case report and review of the literature.

Ulceractive colitis, a chronic diffuse inflammatory disease affecting the mucosa of the colon and rectum, is characterized by ulcerations with bleeding, mucosal crypt abscesses, and inflammatory pseudopolyps. Classically, it begins in the rectosigmoid but often extends to involve the entire colon. It is uncommon to find segmental involvement sparing the rectosigmoid.A case of segmental ulcerative colitis is presented with a brief comparison of segmental ulcerative colitis and segmental Crohn's colitis.

Aged↗

PubMed1982

Mediastinal hyperfunctioning parathyroid adenoma.

A patient presented with peptic ulcer disease and nephrolithiasis. Laboratory investigation disclosed hyperparathyroidism and following neck exploration, hypercalcemia persisted. After two years' follow-up, a retroesophageal mass that proved to be a parathyroid adenoma was discovered. This case is presented to illustrate the unusual occurrence of a posterior mediastinal tumor and the difficulty in managing ectopic parathyroid adenomas.

Adenoma↗