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Biomedical subjects

J A Caprini

Publications and source records attributed to J A Caprini.

At least 73 records · Page 4Linked to original sources
PubMed1980

Adjuvant chemotherapy for stage II and III breast carcinoma.

Stage II or III breast carcinoma patients were assigned to one of three adjuvant chemotherapy groups after mastectomy. The efficacy of melphalan, vs cyclophosphamide, fluorouracil, and prednisone (CFP), vs CFP plus BCG vaccine was compared in 173 patients treated for five days every six weeks for the first postoperative year. Tumor size, unfavorable local signs, extent of axillary nodal involvement, menopausal status, and participating hospital were considered in assigning patients to treatment groups. The median follow-up time was 26 months; 24.2% of the patients were studied for more than three years. Recurrent disease occurred in 31.6% of the patients in the melphalan group and in 13.4% and 13.2% in the other two groups. Six patients died of metastatic tumor; three others died of other causes. A favorable significant difference exists for polychemotherapy in prolonging disease-free interval in our series.

Antineoplastic Agents↗
PubMed1980

Results of nonsurgical treatment of retained biliary calculi.

During the past six years, 100 patients with retained biliary tract calculi underwent stone extraction, consisting of manipulation of the ductal system through the sinus tract using a variety of flexible catheters, stone baskets and a specially designed forceps and fiberoptic scope. Thirty-one of the patients were referred from outside the Chicago area and 19 of the total group had previously been operated upon at medical school hospitals. Stone extraction was successful in 96 of the total group. Eighty-five of these extractions were accomplished in one to three sessions, while eight of the patients required four to nine sessions before all of the stones were removed. Forty-five patients had multiple stones; 25, single stones; eight, sludge, fragments, mucus or debris, and no stones could be found in 12. Four patients required reoperation following unsuccessful percutaneous duct manipulation. One of these patients died along with two others who had successful extraction procedures. In two additional patients, duct obstruction recurred requiring reoperation three months and one year after manipulation. A high percentage of patients with retained biliary calculi can be successfully treated without reoperation using these methods. Failures are related to poorly placed T tubes, tortuous sinus tracts or dislodged tubes. Major morbidity and mortality are related to biliary obstruction and sepsis. An aggressive approach to infection with urgent nonoperative or operative measures to decompress completely the biliary tree is mandatory to reduce the incidence of major complications in these patients.

Adult↗
PubMed1979

Symptomatology as an indicator of recurrent or metastatic breast cancer.

Eighty-seven patients with recurrent breast cancer after mastectomy were analyzed for patterns of recurrence and methods of detection. After an average disease-free interval of 30 months, 38% developed osseous metastases, 16% recurred locally, 10% had local plus systemic disease, 10% showed pulmonary metastases and the remainder were distributed among liver, brain, and remaining breast disease. In 79 patients recurrence was heralded by symptoms. Physical examination in five asymptomatic patients revealed local or supraclavicular recurrence. In only three asymptomatic patients was recurrence documented by "routine" chest x-rays (in two), or liver enzymes/liver scan (in one). No asymptomatic disease was found by bone scan. It is concluded that periodic history, physical examination, and chest x-rays are the most important components in the follow-up of breast cancer patients. Radioisotope scans and other radiographs are valuable in confirming symptomatic disease and detecting additional diseases, but cannot be recommended routinely in the asymptomatic patient because of low yield and cost.

Bone Neoplasms↗
PubMed1978

Disseminated intravascular multiple systems activation (DIMSA) following thermal injury.

Seventy-seven major thermal injury victims were studied with a number of hematologic and immunologic tests initially and sequentially during the first postburn month. The patients were grouped by initial prognostic index as well as by ultimate survival. Pairs were grouped by initial prognostic index as well as by ultimate survival. Pairs of test data from subjects studied at successive time intervals were compared with prognostic index and ultimate survival. Statistically significant changes in coagulation, fibrinolytic, complement, and kinin tests all occurred within these groups. These findings strongly suggest that intravascular contamination occurs following thermal injury in proportion to the extent of the burn, because of the occurrence and persistence of statistically significant multiple system changes. Regrouping all of the blood data according to ultimate death or survival reinforced the concept of intravascular contamination and provided the basis by which one can compute laboratory prognostic indices. The combination of plasminogen, C'3 complement, C'H50, one-minute kinin, and TEG index discriminated between death and survival with 91% accuracy by the end of the first postburn week. These data offer the potential for select blood measurements in refining current prognostic indicators. This may provide an objective data base for the analysis of new treatment programs in thermal injury victims.

Blood Cell Count↗
PubMed1978

Computerization of three-channel thrombelastograph.

A small-size and low-cost microcomputer using an Intel 8080 micro-processer is employed to provide real-time data collection and reduction of a three-channel electronic-readout thrombelastograph (TEG). Computed values of significant clotting parameters are obtained instantly allowing for rapid analysis and monitoring of many patients. Computer hardware was designed to optimize signal sampling rates, processing time and storage.

Analog-Digital Conversion↗
PubMed1978

Use of progressive pneumoperitoneum in the treatment of giant abdominal hernias.

The preoperative use of progressive pneumoperitoneum in the treatment of large or complicated ventral hernias is established to be safe and useful. Indications for use of this technique include massive hernias, hernias that are repaired in a contaminated field, hernias in patients considered poor operative risks, and recurrent hernias. Five patients are described in whom this technique was used; all five hernias were closed primarily without tension, mesh, or postoperative complications. follow-up reveals no evidence of recurrence.

Aged↗
PubMed1978

Effect of platelet count and hematocrit on the coagulability of heparinized blood.

The coagulability of heparinized blood is shown to be a function of platelet and red cell concentrations. Thrombelastrographic tests were conducted on celite-activated fabricated whole blood samples with heparin concentrations ranging from zero to 1.46 units per ml of plasma, hematocrits from zero to 50% and platelet counts from zero to 300,000/mm3. The thrombelastograph provides three useful parameters of coagulability in native and heparinized blood: clot time, rate of clot stiffening and final clot stiffness. Of these, only the clot time is determined with the common clotting tests, while the rate and final clot stiffness are measures of clot quality that are found to be particularly sensitive to thrombocytopenia. The test results indicate (i) increases of platelet concentration produce the expected decrease in clot time, increase in rate of stiffening, and increase in final stiffness; (ii) increases of the red cell concentration from zero to 20% hematocrit, produce nonlinear increases in clotability, while further increases beyond 20% hematocrit produce no additional effects if the heparin concentration is less than 1.2 units/ml. Quantative relations are derived between the thrombelastographic variables, heparin concentration, and platelet concentration for those samples with hematocrits greater than 20%. These data indicate further experiments for the study of possible interaction between cellular blood elements and heparin.

Animals↗
PubMed1977

Percutaneous forceps extraction of retained biliary tract calculi.

The experience of the authors with postoperative extraction of retained biliary calculi in 35 cases is presented. Successful removal of the stones was achieved in all patients without any significant complication. The advantage of the Mazzariello-type metal forceps as compared to the Burhenne method is emphasized and illustrative examples are presented. Specific guidelines for a successful application of various techniques of stone extraction are provided.

Adult↗