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Biomedical subjects

F V Lorenzo

Publications and source records attributed to F V Lorenzo.

4 recordsLinked to original sources

Experimental retained antrum. Diagnostic technics and histopathologic correlations.

Retained gastric antrum was evaluated in six dogs, and diagnostic methods correlated with histopathology. Secretin and calcium infusion did not significantly alter circulating gastrin levels. 99 mTc scanning was uniformly positive and did not depend on the presence of parietal cells. The failure to consistently develop hypergastrinemia and the absence of gastrin cell hyperplasia suggest that factors other than gastrin may be implicated in the recurrent ulceration seen with retained antrum.

Animals↗

Gastric carcinoma following operation for peptic ulcer disease.

Gastric carcinoma following operation for benign peptic ulcer disease has been considered rare but nine patients have been seen during the past five years. All were male patients, the average time interval from prior ulcer operation to development of cancer was 17 years, but was a short as ten years. The symptoms of cancer are vague and the diagnosis is often delayed. Fiberoptic endoscopy with biopsy of suspicious areas is the most accurate diagnostic approach. Resection of the tumor is indicated if feasible. The poor prognosis of this malignancy is documented. The evidence is reviewed that the creation of achlorhydria with bile reflux increases the risk of development of gastric carcinoma. All patients who undergo peptic ulcer operation require careful long-term follow-up. Vague gastrointestinal symptoms occurring ten years or more after peptic ulcer operation require full evaluation to exclude the presence of gastric cancer.

Achlorhydria↗

The behavior of infected arterial prostheses of expanded polytetrafluoroethylene (Gore-Tex).

In 11 dogs the bacteriologic and morphologic reaction of arterial prostheses made of expanded polytetrafluoroethylene (Gore-Tex) to an induced Staphylococcus aureus septicemia at time of graft implantation was evaluated and compared to that observed with Dacron grafts in 10 dogs. Graft infection developed in all dogs, manifested by positive blood and graft cultures. Grafts, however, could be clearly classified as either histologically infected or uninfected with a marked difference in the pattern of positive blood cultures. Histologically uninfected grafts in general demonstrated the tissue ingrowth and neointima formation which characterize Gore-Tex despite positive graft culture. The appearance of overt histologic infection was correlated with failure of a neointima to develop. Gore-Tex did not loose its structural integrity despite frank injection. The use of the Gore-Tex in the face of overt infection cannot be supported.

Animals↗

Time utilization of a population of general surgeons in community practice.

A time-motion study was performed on a population of general surgeons in suburban community practice whose median weekly operative work load had been previously determined to be 3.1 hernia equivalents (HE). The mean observed 6 day working week of this population of general surgeons was found to be 34.5 hours, of which 28.7 hours were devoted to professional activities for the total work week of 44.3 hours. Thirty-five percent of the mean observed working week was spent in office activities and 50 percent spent in hospital activities. During the mean observed week, 18.5 hours (54 percent) were devoted to patient care, of which 16.5 hours were judged to be devoted to surgical care. Surgeons with above-median operative work loads in the previous study devoted 67 percent more time to professional activities and twice as much time to surgical activities as surgeons with below-median work loads. The findings support the hypothesis that there appears to be an underutilization of costly and highly specialized medical skills in the particular community and suggest that the HE methodology is a valid measure not only of the operative work of surgeons in community practice but of total time devoted to surgical care.

Delivery of Health Care↗