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Biomedical subjects

J D Reid

Publications and source records attributed to J D Reid.

At least 55 records · Page 3Linked to original sources
PubMed1991

Total occlusion of the common carotid artery with patent internal carotid artery. Identification with color flow Doppler imaging.

With common carotid artery occlusion there is usually no flow in the distal vessels. However, flow to the ipsilateral internal common carotid artery may be maintained by collateral vessels. Nine of 1100 patients referred for carotid duplex sonography were found to have occluded common carotid arteries. Five of these patients had collateral circulation with reconstitution of flow via the external carotid artery. The color Doppler sonograms of three representative patients are presented. There was antegrade flow in the internal carotid artery with retrograde flow in the external carotid artery.

Adult↗
PubMed1989

Color flow duplex screening of infrainguinal grafts combining low- and high-velocity criteria.

The aim of this prospective study was to evaluate the ability of duplex ultrasonography to identify infrainguinal grafts at high risk for failure. The criteria used identified low flow by low peak systolic velocity (less than 45 cm/s) and stenosis by high velocity (greater than 300 cm/s) or by velocity at the stenosis three times the velocity in the adjacent normal graft. A total of 114 patent grafts were scanned and compared with concurrent angiograms. Duplex scanning correctly identified 18 high-risk grafts by low-flow criteria and an additional 21 by stenosis criteria. There was one false-negative finding (sensitivity 98 percent). The velocity ratio of the stenosis to the adjacent graft was useful in estimating the degree of stenosis. Color flow duplex imaging reduced examination time through visual feedback by highlighting the graft and areas of high velocity. These results indicate that color flow duplex scanning, combining low- and high-peak systolic criteria, is a very sensitive screening test in the early detection of failing grafts.

Blood Vessel Prosthesis↗
PubMed1989

A profile of urban adult pedestrian trauma.

The interaction between the pedestrians, drivers, and vehicles involved in pedestrian trauma often receives less attention than motor vehicle occupant accidents. To better define these factors, records of 161 pedestrians admitted to two urban university hospitals were reviewed. There were 87 females and 74 males. Females were older, with a median age of 62 years, compared to 43 years for males. Alcohol was a factor in 39 (52%) males and ten (12%) females. The mean Injury Severity Score (ISS) was 14.6, with injuries most commonly to the extremities in 135 (84%), external surfaces in 103 (64%), and the head and neck in 71 (44%). There were 18 deaths (11.2%) with a mean ISS of 40.3. Of the 143 survivors, 18 (12.5%) with a mean age of 68.4 years required placement in long-term care facilities. Elderly survivors also had longer hospital stays, consuming 51% of all hospital days. Driver information from the governmental universal automobile insurance agency was available for 134 accidents. Drivers failed to yield the right of way in 31 instances (23%). Fifteen (11%) were driving without due care and five (4%) at an unsafe speed. Nine (7%) had documented alcohol involvement. Forty drivers (30%) incurred a total of 50 traffic charges. Previous driving records were available for 109. Forty-six (42%) had been involved in two or more previous accidents and 40 (37%) had five or more previous citations for moving violations. Pedestrian action at road intersections was recorded in 75 accidents.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗
PubMed1988

Assessment of proximity of a wound to major vascular structures as an indication for arteriography.

The use of angiography to evaluate penetrating extremity wounds with proximity to major vascular structures remains controversial. Arteriography in the asymptomatic patient with a penetrating extremity wound is reported to identify arterial injuries in 6% to 21% of patients; however, some injuries may have little clinical importance. This study attempted to determine the value of proximity as an indication for angiography. Five hundred seven asymptomatic patients with 534 penetrating extremity injuries underwent arteriography due to proximity to major vascular structures. Thirty-six arteriograms (6.7%) were positive. Seven patients did not undergo operative exploration, 19 patients (3.6%) had arteriograms, and ten (1.9%) had false-positive arteriograms. The remaining 498 patients had true-negative examination results. Arteriography was associated with 13 complications (2.6%). Proved vascular injury in the clinically asymptomatic patients in our series was extremely low (3.6%). These data make it difficult to justify arteriography due to proximity of injury to major vascular structures. However, it is difficult to abandon exclusion arteriography based on these retrospective data. These observations do suggest that better criteria to define proximity need to be identified.

Adult↗
PubMed1988

Calcium oxalate in sarcoid granulomas. With particular reference to the small ovoid body and a note on the finding of dolomite.

The nature, prevalence, and specificity of birefringent calcific particles in granulomas of sarcoidosis have been examined, including histochemical reactions, single particle, and microchemical analyses. Particular attention was paid to small ovoid forms of which most were calcium oxalate monohydrate. Larger crystals, those within giant cells, and the birefringent component of a Schaumann complex were also calcium oxalate. Small ovoids appeared to originate in macrophages and to be precursors of other forms; they were found in 86% of lymph nodes and 73% of surgical lung specimens. They were not specific for sarcoidosis. Organisms could not be certainly identified in them. Their origin is discussed in relation to activated macrophages, calcium, and oxalate metabolism, and the role of calcium oxalate in granulomas is considered. Four particles from two cases were dolomite and two were a calcium-sulphur compound. The biologic origin of dolomite is reviewed.

Birefringence↗
PubMed1988

Forty-three cases of vertebral artery trauma.

Forty-three cases of injury to the vertebral artery are reviewed. Trauma to these cervical vessels requires deep tissue penetration, most often as a result of gunshot or stabwounds. The majority of patients are hemodynamically stable, although serious hemorrhage and death may result from injury to this artery alone. Injury to the vertebral artery was frequently associated with cervical spine fracture and local neural damage. However, no patient presented with or developed neurologic sequelae attributable to vertebral-basilar ischemia. Arteriography accurately identified the site of injury, but the specific arteriographic diagnosis can be unreliable. Two of 13 patients (15%) treated by proximal vascular control alone had postoperative vascular complications. While direct surgical intervention with proximal and distal arterial ligation is the appropriate treatment of acute injuries, in some cases there may be a role for conservative treatment of minimal injuries. In this series, mortality related to a vertebral artery injury was low (4.7%), likely as a result of accurate diagnosis and prompt operative intervention.

Adult↗
PubMed1988

Wounds of the extremities in proximity to major arteries: value of angiography in the detection of arterial injury.

The place of angiography in the diagnosis of arterial injuries in cases of penetrating wounds of the extremities has been a source of controversy, especially when the injury is in proximity to the artery but there is no clinical evidence of arterial injury. The positive yield of angiography has been reported to be between 6% and 20%, but most angiographers suspect the yield to be lower. The cost of angiography continues to increase. A retrospective analysis was performed in 507 patients with 534 possible arterial injuries associated with wounds near vessels. Thirty-one arteries were considered by the radiologist to have surgically significant injury. Seven patients did not have surgery. On the basis of surgical findings in 24 patients, there was a true-positive angiographic yield of 3.6% as well as five false-positive angiograms. Angiographic sensitivity was 100%, specificity 99%, accuracy 99%, positive predictive value 85%, and negative predictive value 100%. Ten (2.0%) minor angiographic complications and two (0.4%) major complications occurred. There were three surgical complications in negative surgeries. False-positive angiograms can probably be reduced by more circumspect evaluation of minor abnormalities. However, the 3.6% true-positive yield must be balanced against the complications of surgery and angiography and the associated costs. Although delayed diagnosis and therapy of arterial injury are less satisfactory than early repair, angiography of wounds in proximity to major extremity arteries should be reserved for situations in which exclusion of injury is critical to overall management of the patient.

Adult↗
PubMed1987

Calcium oxalate crystals in the thyroid. Their identification, prevalence, origin, and possible significance.

Calcium oxalate crystals are not encountered in normal animal tissues, except for the human thyroid, where they were found in 79 of 100 routine consecutive autopsies. They appear during childhood, and numbers of crystals increase with age. In diffuse hyperplasia, prevalence was higher, but crystals were fewer than expected. In adenomas and carcinomas, crystals were decreased except for three cases with a striking focal increase. None was found in 22 adult primate thyroids. After Clorox digestion of human thyroids, calcium oxalate dihydrate was identified by x-ray diffraction and infrared spectroscopy. Origin, tissue and species localization are discussed in relation to ascorbate metabolism, thyroperoxidase, and calcitonin. Possible metabolic roles are suggested. Calcium oxalate crystals injected in animals and humans initiate a foreign body reaction with giant cells. In Hashimoto's thyroiditis, crystals disappear but occasionally remain with giant cell reaction. In subacute thyroiditis, granulomas are related more to colloid than to crystals.

Adolescent↗
PubMed1986

Arteriography and histopathology in experimentally produced atherosclerosis in rhesus and fascicularis monkeys.

In order to attempt to characterize atheromatous plaque dynamics, and to develop standardized techniques of observation of this behavior, 91 arteriographies were performed on 47 subhuman primates (40 Rhesus and 7 Fascicularis) over a 10-year experimental project. Histopathologic examination was performed at biopsy on the majority of animals and at autopsy on all animals. Selected representative arteriograms and histopathologic cross-sections are presented as well as detailed analyses of the various animals' response to atherogenic regimen. Arteriographic stenosis was site specific for 4 sites virtually exclusively: right internal carotid, inferior mesenteric, lumbar, and presacral arteries. There was no distinction within each grade of stenosis (on a 1-4 grade scale) for all arteriograms, and precision reproducibility of arteriographic technique was achieved without regard to age, size, weight, or type of animal. The consistency and exclusivity of arteriographic 4-site pattern of stenosis, together with non-correlation between it and the histopathologic or surgical observations, suggests that the stenosis observed by all of these methods may be partially or completely a function of artefact attributable to technique. At the very minimum, arteriographic and histopathologic methods are demonstrably dissociative and, therefore, the findings of these 2 cannot be compared in grading atherosclerotic plaque advancement or regression.

Angiography↗
PubMed1984

Pelvic recurrence after anterior resection and EEA stapling anastomosis for potentially curable carcinoma of the rectum.

Rectal carcinoma can be treated by anterior resection with EEA anastomosis in order to preserve rectal continuity in those patients in whom anastomosis may be technically difficult. In our initial local experience however, the pelvic recurrence rate has been approximately three times as high as would be expected. The surgical results were good in those patients with Dukes' B lesions. The majority of failures occurred in those with Dukes' C lesions. When the preoperative assessment indicates the strong likelihood of a Dukes' C lesion, consideration of abdominoperineal resection must be given if cure is anticipated. Most surgeons will obtain a more complete pararectal tissue clearance with this procedure than with anterior resection. Those who wish to preserve rectal continuity with curative procedures for rectal carcinoma must become proficient at pararectal tissue clearance if a low rate of pelvic recurrence is to be achieved. The EEA stapler can enable safe anastomosis when these other factors have been accomplished. When cure is anticipated, it can only be provided for the majority of patients at initial surgical resection. The EEA stapler has a unique value in patients who have resectable rectal carcinoma, and yet have distal metastasis by the time initial surgery is performed. The preservation of rectal continuity in such patients is an excellent method of palliation.

Female↗
PubMed1983

The black thyroid associated with minocycline therapy. A local manifestation of a drug-induced lysosome/substrate disorder.

Two cases of black discoloration of the thyroid are reported, each in a young woman treated for acne; the first with minocycline alone, the second with tetracycline and minocycline. Light microscopy showed numerous brown granules in the cytoplasm of the follicular epithelium, with large brown deposits in the colloid, including, in Case 2, numerous crystalline forms. The association between drug therapy and pigment accumulation (in conjunction with animal experiments) was taken to indicate some form of causal relationship, and minocycline residues were anticipated. Histochemical studies indicated that the granules were lipofuscin and electron microscopy showed an increase in phagolysosomes but no novel structures. There was no evidence for persisting minocycline, or its derivatives, although these could not be excluded. The black thyroid appears to be a disorder at lysosome/substrate level, induced by drug action, particularly by minocycline, and manifested by an accumulation of heterogeneous intracellular material with the histochemical and electron microscopic appearances of lipofuscin.

Acne Vulgaris↗
PubMed1982

Ductuloinsular tumors of the pancreas: a light, electron microscopic and immunohistochemical study.

Most pancreatic tumors are of a single cell type and are identified delta as duct, acinar, or islet cell neoplasms. The authors report on three examples with both duct and endocrine characteristics as seen by light microscopy; two with further confirmation of endocrine differentiation by electron microscopy; and one by immunocytochemistry. Mixed differentiation of this sort can be understood by reference to the embryonic pancreas, which develops from the small intestine and forms ducts, intercalated ducts, acini, and islets, with their different cell types. The merging and intermingling of different cell prevents the identification of one specific cell of origin. It also suggests that the neoplastic process here may not be a clonal proliferation from a single cell mutation as this is generally understood. Alternative explanations are briefly mentioned.

Adenoma, Islet Cell↗
PubMed1982

Efficient transformation of Serratia marcescens with pBR322 plasmid DNA.

Eight Serratia marcescens strains tested could be transformed with the plasmid pBR322. Transformants were selected on the basis of resistance to high levels of ampicillin (400 to 500 micrograms/ml). For six of the strains, the CaCl2- mediated transformation procedure developed for Escherichia coli was successful. For the other two strains, no transformants were obtained with the CaCl2-mediated transformation procedure unless the cells first received a heat treatment. Transformation frequency was dependent on DNA concentration, and no transformation was detected with linear pBR322 DNA. The stability and copy number of pBR322 were similar in S. marcescens and E. coli. As in E. coli, the pBR322 DNA was amplified in S. marcescens after inhibition of proteins synthesis. Based on these results, cloning in S. marcescens should be possible and pBR322 should be a useful cloning vehicle.

Ampicillin↗