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Biomedical subjects

J Colonna

Publications and source records attributed to J Colonna.

At least 19 recordsLinked to original sources
PubMed2000

Use of radiation therapy in posttransplant lymphoproliferative disorder (PTLD) after liver transplantation.

Posttransplant lymphoproliferative disorder (PTLD) is a common and life-threatening complication of immunosuppression used to prevent rejection of solid organ and bone marrow transplants. There is no standardized treatment algorithm, but numerous management strategies are available. We describe a patient who developed a solitary lymphoproliferative lesion in the porta hepatis 9 months after orthotopic liver transplant. Following reduction in immunosuppression with no response, she was treated with involved field radiotherapy utilizing CT-based treatment planning. A partial radiographic response was obtained, and she has not developed disease in the engrafted liver or systemically. Based on the present case report, involved field radiotherapy seems to be a reasonable treatment option for patients with localized PTLD. Int. J. Cancer (Radiat. Oncol. Invest.) 90:104-109, 2000.

Algorithms↗
PubMed1997

The hospital as business. How saving money can help save lives.

As hospitals and clinics merge into integrated delivery networks dependent for patients on health maintenance organizations, it is sometimes hard to remember who's on first. Instead of doctors, nurses, patients and hospitals, the world of health care now contains an alphabet soup of IDNs, HMOs, providers, consumers and payers. The changes extend deeply into the materials management department, where simply bargaining for the best price has been complicated by standardization, capitation, and a host of expense management strategies. Perhaps as a result of this ever-changing identity, most hospitals have yet to fully adopt the style and culture of the businesses they really are. Even purchasing managers, who are closer to the business end of the operation, are caught up in the traditional image. In the following comments, two experts in materials management explore the impact that this ambivalence has on a hospital's relationship with the outside world--including suppliers. Joseph Colonna is corporate vice president of the purchasing program at Shared Services Healthcare, Atlanta. Michael Garvin is an adjunct professor at the University of Iowa, and a researcher in medical supply purchasing practices.

Budgets↗
PubMed1993

Arterial ketone body ratio in pediatric liver transplantation.

Arterial ketone body ratio (AKBR) was measured serially in 49 pediatric orthotopic liver transplantations. The AKBR pattern correlated with hepatic synthetic function, as well as with short-term graft and patient survival. A rapid recovery pattern of AKBR to above 1.0 within 40 hr after reperfusion was associated with 94% graft and patient survival. Pediatric liver grafts were found to have better tolerance to low energy levels when compared with previously published data for adult OLT. The salvage rate of pediatric grafts exhibiting a slow recovery pattern (AKBR 0.7-1.0) was 71%. No recovery pattern (AKBR < 0.7) was seen in all 6 cases of primary nonfunction, and in 3 of 4 cases of early hepatic artery thrombosis (HAT). All these grafts were lost; however, 56% of the children in this group survived retransplantation. Unlike the PNF grafts, the no recovery pattern after HAT was characterized by gradual improvement of the synthetic function, despite the low energy state.

Arterial Occlusive Diseases↗
PubMed1988

The role of liver biopsy in evaluating acute allograft dysfunction following liver transplantation: a clinical histologic correlation of 34 liver transplants.

One hundred six liver biopsy specimens from 34 orthotopic liver transplant (OLT) patients were examined and the histologic findings correlated with the clinical course of the patients to determine if specific morphologic patterns were associated with specific causes of acute allograft dysfunction. The principle causes of allograft injury in these patients appeared to be acute rejection and ischemic injury, with rarer cases of viral infection and biliary obstruction. Graft rejection causing transient liver dysfunction was associated with a mixed inflammatory infiltrate in the portal tracts and involving the interlobular bile ducts. Rejection resulting in severe, persistent dysfunction was associated with destruction and loss of the interlobular bile ducts or portal inflammation, followed by acute centrilobular hepatocyte necrosis. Ischemic liver injury was characterized by hepatocyte ballooning and/or hepatocyte necrosis. Ischemic injury causing transient graft dysfunction demonstrated focal, limited areas of hepatocyte necrosis or transient centrilobular hepatocyte ballooning. Severe ischemic injury resulting in persistent dysfunction caused diffuse hepatocyte necrosis or centrilobular ballooning followed by centrilobular hepatocyte loss and severe cholestasis with evidence of bile duct epithelial injury. The histologic patterns observed were not pathognomonic; radiologic studies, bile cultures, and other laboratory tests were necessary to rule out biliary or vascular obstruction and bacterial cholangitis. However, liver biopsies, especially serial biopsies, were helpful in suggesting the probable cause of liver dysfunction and in predicting subsequent allograft recovery or failure.

Adolescent↗
PubMed1988

[Cardiac Doppler in the selection of patients for aortic valvuloplasty. Comparison with data of phonomecanograms].

Between December 1986 and August 1987, 34 patients referred for aortic valvuloplasty, undergo before catheterization an ultrasonocardiography with continuous and pulsed Doppler study and a phonocardiography for 22 of them. They all present functional and physical signs of aortic stenosis. The cardiac Doppler enables a positive diagnosis in all patients, while the phonocardiography recordings fail to recognize a tight aortic stenosis. On the other hand, the Doppler enables a diagnosis of severity well correlated with the catheterization (r = 0.88 for maximum instantaneous gradients) in 30 patients: in four patients, the correlation could not be calculated because of technical problems related to the catheterization (2 patients) or the ultrasonic examination (2 patients). From this study, it results that the cardiac Doppler may perfectly select patients who are to undergo an aortic valvuloplasty, unlike phonocardiography.

Adult↗
PubMed1980

[Contribution to the study of the phagocytosing ability of broncho-alveolar macrophages in smokers and non-smokers (author's transl)].

Broncho-alveolar macrophages were obtained by bronchial washing from 20 pairs of matched smokers and non-smokers. The following parameters were studied: phagocytosing ability of macrophages on silica in cell culture in the presence or absence of cotinin, a biocompound of nicotin; migration inhibitory factor (MIF), and power and level of alpha 1-antitrypsin in sera of patients. The results are reported as a function of absolute number of macrophages obtained, their viability, the amount of cigarettes smoked, and the action of cotinin. MIF was stronger in the smokers. There was no difference between the groups as far as power and level of alpha 1-antitrypsin are concerned. Cotinin provokes important lesions in the macrophages. The phagocytic power was not significantly different in smokers and non smokers, but the results were better in non-smokers.

Aged↗
PubMed1980

[Dermatoglyphics of subjects with bronchial cancers].

Every high smokers are not able to make a lung carcinoma, on the over hand nonsmokers can be able to develop a bronchial carcinoma. It is possible that genetic factors can be involved in the occurrence of this carcinoma. Dermatoglyphic studies are one of the technics to appreciate this problem. The study was done upon 37 bronchial carcinoma and 51 lung diseases (European origin, only man, same age). There are some big differences upon: --The Cummins index: the right index as well as the left are higher in bronchial carcinoma than in controls, but it is significative only for the right one (p less than 0,05) (28,89 +/- 3,7 to 26,88 +/- 4,55). --The frequency of the ten fingerprints: the differences between lung carcinoma and controls are highly significative (p less than 0,01) for the whorls (22,7 to 34,9) and slightly significative (p less than 0,05) for the ulna loops (65,4 to 57,4), the other fingerprints (arch, radial loops) are quite the same in the two groups. The studies upon the other figures (TFRC and the position of the axial tri-radius) do not show any differences. It seems to us that the dermatoglyphic studies of men with bronchial carcinoma differ from controls (hospitalized for lung diseases). These population have the same dermatoglyphic structure than a control population from blood donors of Marseilles. The dermatoglyphic studies can be an aid to identify high risk people.

Aged↗
PubMed1980

[Respiratory function profile in scleroderma. 20 cases (author's transl)].

This study involved 20 patients, 13 female and 7 male, with a mean age of 49 years, suffering from localized (6 cases) scleroderma or generalized without Raynaud's syndrome (6 cas), with Raynaud's syndrome (6 cas) or acrosclerosis (2 cases). Respiratory function tests included study of volumes, flow rates, CO transfer (TLCO) and blood gases. There were 38% normal chest X-rays, 58% ventilatory disturbances (predominance of restrictive syndrome and decrease in (TLCO) was found in only 25% of cases. The authors emphasize the extent of pulmonary vascular lesions in these patients.

Adult↗
PubMed1979

[Is long term medical follow up of tuberculous patients possible? (author's transl)].

Tuberculosis still remains a current disease, of difficult eradication as shown by numerous studies and epidemiological surveys. The authors studied 180 newly affected tuberculous patients admitted to Pr. Laval's department at Marseille and tried to discover why only 91 (50.6%) were still followed or could be traced 3 years after their first hospitalization. Five parameters were studied: origin, sex and age, living area, socio-economical data (change of address, lack of accomodation, profession), tobacco and alcohol addiction. No significant part was played by nationality, living area, or profession. On the other hand, changing of address, chronic tobacco and alcohol addiction were the factors responsible for loosing sight of the patients. An attempt to define this tuberculous patient, which would not be followed up for long, gave the picture of a 40 to 45 years old man, living in a hotel or with no fixed accomodation, smoking more than 20 cigarettes a day and drinking. Such a profile of a tuberculous patient should increase the watchfulness over likely ones.

Age Factors↗
PubMed1977

[The value of body tomodensitometry for diagnosis in pneumology].

The authors present a preliminary work on 37 pulmonary tomodensitometry performed on 18 bronchial cancers, 7 pleuro-pulmonary metastases, 4 normal lungs and 8 various respiratory diseases. This method presents a double advantage:--first it localizes the affection in relation to pleura, mediastinum or heart; specially interesting in case of a transparietal puncture in carcinology;--secondly, densitometry enables a differentiation between dense tumoral tissue and ventilatory disorders or pleurisy; it is also useful in determining the tumoral target volume. Finally this new technique can show air cavities (emphysema, tuberculous or cancerous caverns) as well as pleurisies of small volume.

Adolescent↗