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Biomedical subjects

J Crass

Publications and source records attributed to J Crass.

6 recordsLinked to original sources
PubMed1994

Transbronchial biopsy in patients with pulmonary eosinophilic granuloma. Comparison with findings on open lung biopsy.

We evaluated the findings on transbronchial biopsy specimens in reference to open lung biopsy specimens from 12 patients with pulmonary eosinophilic granuloma. Features in transbronchial biopsy specimens were further contrasted to those of patients with interstitial fibrosis and nondiagnostic biopsy specimens for localized lesions. Transbronchial biopsy specimens were randomized and graded for histologic features and cellularity. Patients with eosinophilic granuloma had more macrophages (P < .05) but equivalent numbers of eosinophils, neutrophils, and Langerhans' cells compared with those of the other two groups. Only two endoscopic biopsy specimens were histologically diagnostic or highly consistent with eosinophilic granuloma. We conclude that the diagnosis of eosinophilic granuloma is possible on transbronchial biopsy but requires a high index of suspicion. The demonstration of Langerhans' cells by immunohistochemical staining for S100 protein is a useful adjunct. The low diagnostic yield for eosinophilic granuloma on transbronchial biopsy results from inadequate sampling and from the nonspecific appearance of discrete lesions in small tissue samples.

Adult↗
PubMed1993

Fulfilling referring clinicians' needs.

We have come to expect autonomy and accountability only to ourselves. This is a false paradigm. Poor service encourages a do-it-yourself spirit or a search for an alternate provider. We must recognize, however, that addressing quality does not begin with fixing an individual problem. This process must begin with redefining quality. This will require better communication and teamwork.

Consumer Behavior↗
PubMed1984

Percutaneous aspiration and drainage for suspected abdominal infection.

Percutaneous drainage (PCD) of abdominal infection is a therapeutic modality whose role is not well defined. Surgical literature on abdominal infection cites a cumulative mortality rate in the range of 20% to 30%, markedly dissimilar from the 80% to 90% cure rates reported in the literature on PCD. We reviewed the PCD experience at a tertiary teaching hospital from 1981 to 1983. Fifty-five patients were suspected to have localized abdominal infection and underwent 66 procedures. PCD was attempted after percutaneous needle aspiration produced drainable fluid. Cure is defined by complete resolution of the abdominal process without any surgical intervention. Palliation is defined as acute decompression of the abdominal process permitting an elective corrective procedure to be performed. Failure is defined as false diagnosis, unsuccessful drainage requiring operation, or recurrence of infection. Diagnosis of the abdominal process was successfully made by aspiration in 59/66 (89%) attempts. PCD was curative in 31/66 (47%) attempts and failed or was palliative in 35/66 (53%). Simple nonfungal, nonfistulous abdominal abscesses were cured with PCD in 25/26 attempts (96%). PCD failure was encountered in 10 infected organized hematomas or thick phlegmons, nine fungal infections, nine abscesses with enteric communication, and five infected necrotic tumors. Abscesses with an underlying enteric communication were cured in 28%, were palliated in 32% and failed in 32% of PCD attempts. Abscesses with yeast as a major component or with necrotic tumor were never cured with PCD. PCD is a valuable diagnostic and therapeutic tool that is curative in simple abdominal abscesses. Its therapeutic role in complex abdominal infections seems to be limited.

Abdomen↗
PubMed1980

Changerless peripheral angiography: a new concept.

The authors describe a new technique using the principle of rotational scanography, in which the x-ray tube is rotated through the center of the focal spot and scans the field of interest. A single primary and secondary slot system in conjunction with an 8:1 grid is used for efficient scatter removal. If the speed of blood flow is increased by reactive hyperemia and a large amount of contrast medium is injected, the abdomen to the toes can be scanned with one injection. The advantages of this technique are that a 127-cm field can be covered with a 6 degree or 12 degree target tube and without an especially high ceiling, and the film changer is eliminated. The angiograms are markedly improved because virtually all scatter is eliminated, and exposure is reduced since only one radiograph is necessary.

Angiography↗
PubMedDate not supplied

Probable neutropenic enterocolitis in patients with AIDS.

Neutropenic enterocolitis is well documented in patients with leukemia or lymphoma who are recovering from the adverse effects of chemotherapy. We report two cases of probable neutropenic enterocolitis in two patients with AIDS who developed the syndrome during an episode of moderate neutropenia. To the best of our knowledge, this syndrome has not been reported previously in a patient with AIDS. Both of our patients manifested a mild form of enterocolitis that was characterized by fever, abdominal pain, and evidence of colonic edema easily recognized by computed tomography of the abdomen. Both patients were managed successfully with use of conservative measures including discontinuation of use of marrow-suppressive drugs and therapy with broad-spectrum antimicrobial agents. Neutropenic enterocolitis should be considered as a treatable cause of fever and abdominal pain in patients with AIDS.

Acquired Immunodeficiency Syndrome↗