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Biomedical subjects

I E Fortuny

Publications and source records attributed to I E Fortuny.

At least 19 recordsLinked to original sources
PubMed1990

Gastroduodenal artery-duodenal fistula: a complication of continuous floxuridine (FUDR) infusion into the gastroduodenal artery.

This case report describes a patient who for 31 months has received regional intrahepatic chemotherapy from a continuous infusion pump and who developed a gastroduodenal artery-duodenal fistula, a previously unreported complication of regional infusion therapy. The patient presented with signs and symptoms of upper gastrointestinal bleeding. The clinical evaluation and management are described. An angiogram was performed through the auxillary septum to identify the source of bleeding. The possible etiologic factors in this case are discussed. We believe that this complication will continue to be rare, but health care providers should be aware of its presentation and its preferred method of evaluation and management.

Adenocarcinoma↗
PubMed1977

Hypereosinophilic syndrome with biventricular involvement.

In a 45-year-old man with hypereosinophilic syndrome, cardiac disease, mainly endocardial thickening and extensive mural thrombosis of both ventricles, was confirmed at autopsy. Early in the course of the disease, right ventricular endocardial biopsy had demonstrated the basic process. Restriction in filling and contraction of the right ventricle were demonstrated by functional studies. By echocardiographic study, progressive reduction in size of the right ventricular cavity and premature opening of the pulmonary valve were demonstrated, while this method was less adequate in identifying the process in the left ventricle.

Autopsy↗
PubMed1976

Neutrophil leukocyte reserves in lymphoreticular malignancies.

The marginal neutrophil leukocyte pool and the bone marrow neutrophil reserves were assessed in 43 patients with lymphoreticular malignancies, using epinephrine and steroid stimulation. Thirty-three patients were studied before staging, following splenectomy, before and after nodal irradiation and during remission induction chemotherapy. Ten patients in partial remission were studied after 12 month or more of chemotherapy. A neutrophil count of 1,500-2,500 cells/mm3 is not a sufficient guide for midifying the chemotherapy. The response to steroid stimulation may be a more dependable guide to evaluate the patient's potential risk for infection.

Adult↗
PubMed1976

The role of continuous flow centrifuge leucapheresis in the management of chronic lymphocytic leukaemia.

Continuous flow centrifuge leucapheresis (CFCL) provides a simple, mechanical technique for removing large numbers of circulating lymphocytes without cytotoxicity. Seven sequences of CFCL were performed on six patients with chronic lymphocytic leukaemia (CLL). In six, the median course consisted of six procedures in 10 days. A median total of 27.7 X 10(11) leucocytes were removed and a 70% drop in leucocyte counts (from 433 X 10(9)/l. to 130 X 10(9)/l.) was observed with little fall in haemoglobin and platelet counts. Tissue massess decreased in two patients. A similar effect was seen in one patient managed less intensively with 21 procedures being performed over 73 days, removing a total of 87.6 X 10(11) leucocytes. The peripheral leucocyte count decreased from 760 X 10(9)/l. to 114 X 10(9)/l. and hepatomegaly diminished markedly. One patient has survived for over 9 months since CFCL but stayed in control only briefly after each of two courses. Short courses of daily CFCL can produce short-term benefit in the management of advanced CLL but at present its main value is as an investigational form of therapy which provides a unique opportunity to study the cytokinetics of advanced CLL without the complications of superimposed cytotoxic therapy.

Aged↗
PubMed1976

The Rebuck skin window as a guide in cancer chemotherapy.

The skin-window inflammatory cell response was studied in 64 adult patients with various malignant neoplasms before initiation of chemotherapy and was repeated when a neutrophil level of 2500 cells/mm3 or less occurred. Of the 21 neutropenic patients, 15 had an abnormal neutrophil cell response and nine had an abnormal mononuclear cell response. Of the nine patients who had infection, eight had an abnormal mononuclear cell response and seven of the eight had a concomitant abnormal neutrophil response. The Rebuck skin window may be a practical clinical test to evaluate the risk for infection in neutropenic patients receiving cancer chemotherapy.

Agranulocytosis↗
PubMed1976

In vitro function and post-transfusion survival of granulocytes collected by continuous-flow centrifugation and by filtration leukapheresis.

The function of granulocytes collected by continuous-flow centrifugation (CFC) and by filtration leukapheresis (FL) was studied in vitro, and the post-transfusion recovery and intravascular survival of these cells was studied by autologous transfusion in normal donors. Granulocytes collected by both FL and CFC leukapheresis (CFCL) functioned normally in the quantitative nitroblue tetrazolium, oxygen consumption, and chemotaxis assays. Bacterial killing was slightly but consistently decreased in FL but not CFCL granulocytes. The post-transfusion recovery of control granulocytes collected by ordinary phlebotomy averaged 52% in eight transfusions, compared with 34% for six CFCL granulocyte concentrates and 16% for six FL concentrates. The intravascular half-times were 3.8 hr for phlebotomy and 3.0 hr for CFCL granulocytes. FL granulocytes had survival curves which were nonlinear and a single half-life could not be calculated. The average half-time 30 min after transfusion was 1.3 hr, and 3 hr after transfusion it was 2.6 hr. Granulocytes collected by FL had a mild impairment of bacterial killing, decreased post-transfusion recovery, and altered intravascular kinetics. None of these abnormalities was found in granulocytes collected by CFCL.

Blood Bactericidal Activity↗
PubMed1975

Continuous flow centrifuge leucapheresis in the management of chronic myelogenous leukaemia.

Six patients with chronic myelogenous leukaemia (CML) were treated by repeated continuous flow centrifuge (CFC) leucapheresis. In six of seven courses of leucapheresis there was no improvement in splenomegaly. In no instance was the leucocyte count reduced to the normal range. The immediate changes in peripheral leucocytosis produced by each CFC leucapheresis procedure were quite variable. There was no correlation between the intensity of a series of CFC leucapheresis procedures and the total clinical effectiveness of the therapy. Balancing potential benefits against definite costs to the patient, CFC leucapheresis seems justified in only a minority of CML patients. Untreated CML patients who have cyclic leucocytosis may be the best candidates for this therapy. Currently this form of therapy for CML remains experimental.

Cell Separation↗