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Biomedical subjects

J A Snell

Publications and source records attributed to J A Snell.

16 recordsLinked to original sources
PubMed1995

Cardiac papillary fibroelastoma: an immunohistochemical investigation and unusual clinical manifestations.

Cardiac papillary fibroelastoma (CPF) is a morphologically distinctive, but rare, cardiac lesion that is usually found incidentally at autopsy or during open heart surgery. Because of improved diagnostic imaging techniques, the premortem or preoperative diagnosis of CPF is becoming more frequent. The histogenesis of CPF, however, remains controversial. Herein we report an immunohistochemical investigation of 11 cases of CPF; two cases showed unusual embolization phenomena, including one with histologically documented pulmonary arterial embolism. For comparison, nine cardiac myxomas (CMs) and eight examples of organizing thrombi were also studied. Immunohistochemical markers included keratin, vimentin, collagen type IV, muscle-specific actin, desmin, factor VIII-related antigen, CD34, and S-100 protein. The cells covering the surface of both CPFs and CMs were positive for vimentin, factor VIII-related antigen, and CD34, in keeping with their presumed vascular endothelial origin. Interestingly, the surface lining cells were also positive for S-100 protein in all CPF and in eight of nine CMs. In CPF, collagen type IV showed multilayered linear staining beneath the surface that was virtually identical to the staining pattern for elastic tissue. The major immunophenotypic difference between CPF and CM is the frequent presence of muscle-specific actin in the stellate cells of the stroma in CM but not in CPF. Although this study did not clarify whether CPF is a hamartomatous, neoplastic, or reparative process, it demonstrated active participation of the surface endothelial lining cells with excessive formation of basal membrane material in the formation of CPF.

Adult↗
PubMed1990

Effect of epinephrine on intrathecal fentanyl analgesia in patients undergoing postpartum tubal ligation.

Eighty women receiving spinal anesthesia for postpartum tubal ligation were entered into a double-blind, randomized protocol studying the effects of epinephrine on intrathecal fentanyl-induced postoperative analgesia. All patients received 70 mg hyperbaric lidocaine with either 0.2 mg epinephrine (LE), 10 micrograms fentanyl (LF), epinephrine and fentanyl (LFE), or 0.4 ml saline (L). Onset and regression of anesthesia, degree of intraoperative comfort, incidence of pruritus, and extent of postoperative analgesia were evaluated. The simultaneous administration of epinephrine and fentanyl prolonged the duration of complete analgesia (137 +/- 47 min (LFE); 76 +/- 32 min (LE); 85 +/- 44 min (LF); 65 +/- 36 min (L)) and the duration of effective analgesia (562 +/- 504 min (LFE); 227 +/- 201 min (LE); 203 +/- 178 min (LF); 198 +/- 342 min (L)). Administration of epinephrine decreased the incidence of pruritus associated with intrathecal fentanyl (1/18 (LFE); 1/21 (LE); 8/19 (LF); 2/19 (L)).

Adult↗
PubMed1979

Elastic stockings in the control of hand oedema.

Elastic support and compression in the form of an elastic finger stall or glove seems to be a simple and comfortable way to obviate and reduce oedema of the hand and fingers after surgery or trauma. It may also prove useful in inflammatory conditions such as rheumatoid arthritis, though the authors have not used it as yet for that condition.

Bandages↗
PubMed1975

A method of bloodless circumcision.

A method of circumcision is described which allows accurate removal of the correct amount of tissue. The method is based on the concept of removal of a flat strp of skin rather than a fold. The removal of the correct amount of tissue with the minimal amount of bleeding and minimal risk to the frenal vessels is effected. The treatment after operation is simple and the results are invariably satisfactory. Damage to the urethra and glans is virtually impossible. Delineation of the incisions with ink before beginning is an important step in the procedure.

Circumcision, Male↗