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Biomedical subjects

J F Pohl

Publications and source records attributed to J F Pohl.

9 recordsLinked to original sources
PubMed2001

Plasminogen deficiency leads to impaired lobular reorganization and matrix accumulation after chronic liver injury.

To determine the regulatory role of plasminogen in hepatic repair following a chronic liver injury, we injected carbon tetrachloride (CCl(4)) biweekly into mice lacking plasminogen (Plg(0)) and plasminogen-sufficient littermates (Plg(+)). On gross examination, we found that Plg(0) livers became enlarged and pale with foci of red nodules as early as 4 weeks after CCl(4) injection, while Plg(+) livers appeared minimally affected by 6 weeks. Microscopically, Plg(0) livers had a pronounced pericentral linking, with accumulation of centrilobular eosinophilic material in injured areas, which resulted in a significant increase in liver mass and total protein. Immunohistochemistry revealed that fibrin accumulated progressively in injured regions. However, the combined genetic loss of plasminogen and fibrinogen did not correct the abnormal phenotype. Mason's trichrome staining revealed intense signal in centrilobular regions and electron microscopy showed a marked increase in fibrillary material demonstrating an excessive accumulation of extracellular matrix in Plg(0) mice. The zone-specific increase in matrix components was associated with an increase in the number of activated hepatic stellate cells within injured sites of Plg(0) livers. Taken together, these data suggest that the progressive accumulation of fibrin-unrelated matrix substrates in Plg(0) livers after a chronic injury results from the combined effects of impaired proteolysis and increased matrix production.

Afibrinogenemia↗
PubMed1999

A cluster of microvillous inclusion disease in the Navajo population.

We report 4 unrelated patients with characteristic microscopic findings of microvillous inclusion disease (MID) with early-onset phenotype. All 4 patients came from the Navajo reservation in northern Arizona. A literature search revealed a fifth unrelated Navajo child with MID. The unusually high incidence in this population indicates that a founder effect might be responsible for an increased frequency of this rare genetic disorder in the Navajo. It is recommended that all Navajo infants presenting with severe diarrhea during early infancy undergo investigation for MID.

Arizona↗
PubMed1997

Abdominovaginal fistula complicating a needle urethropexy.

The author reports a case of an abdominovaginal fistula caused by a Dacron buttress needle urethropexy. In one case this occurred 12 years after the original procedure. Inadequate identification and removal of the Dacron buttress 9 and 10 years after the original needle urethropexy may have predisposed to the development of the abdominovaginal fistula.

Abdomen↗
PubMed1997

Bilateral transvaginal sacrospinous colpopexy: preliminary experience.

OBJECTIVE: Our goal was to determine how often a transvaginal sacrospinous colpopexy procedure can be done bilaterally. STUDY DESIGN: Between August 1993 and July 1996, 66 patients were prospectively evaluated for uterine prolapse (19 patients) and posthysterectomy vaginal vault prolapse (47 patients). Twenty-six patients (25 with posthysterectomy vaginal vault prolapse) underwent an abdominal sacral colpopexy. The remaining 40 patients (18 with uterine prolapse, 22 with posthysterectomy vaginal vault prolapse) were preoperatively and intraoperatively assessed for a bilateral sacrospinous colpopexy. All patients with uterine prolapse underwent hysterectomy. RESULTS: In 10 of the 18 (56%) patients with uterine prolapse and in 16 of the 22 (73%) patients with posthysterectomy vaginal vault prolapse, bilateral suspension to the sacrospinous ligament was carried out. Follow-up has ranged from 6 to 40 months, and no recurrent vaginal cuff prolapses have been detected in any patients. In 3 patients, however, all in the bilateral fixation categories, distention cystoceles have developed; one patient has undergone a successful anterior colporrhaphy. CONCLUSIONS: The bilateral suspension is different from the unilateral suspension in that the former requires significant intraoperative judgment in its feasibility and in maintaining the width of the vaginal cuff to allow a bilateral suspension without tension. A bilateral fixation appears more attainable in a patient with posthysterectomy vaginal vault prolapse than in one with uterine prolapse.

Adult↗
PubMed1997

Blood cultures in febrile patients after hysterectomy. Cost-effectiveness.

OBJECTIVE: To determine the impact and cost-effectiveness of blood cultures in patients with febrile morbidity following vaginal or abdominal hysterectomy. STUDY DESIGN: The charts of 192 abdominal and 150 vaginal hysterectomy cases performed at Walter Reed Army Medical Center for benign disease between June 1992 and June 1995 were retrospectively analyzed for postoperative febrile morbidity, fever evaluation, blood culture results, management and clinical course. RESULTS: Of the 342 hysterectomy cases reviewed, 46 (24%) abdominal and 16 (10.7%) vaginal hysterectomies had fever evaluations that included aerobic and anaerobic blood cultures. There were no blood cultures documenting bacteremia in the abdominal or vaginal hysterectomy patients evaluated for postoperative febrile morbidity. Two patients with positive blood cultures had preoperative infections and were eliminated from statistical analysis. Adherence to the definition of febrile morbidity eliminated another 19 (30.6%) of the 62 febrile patients phlebotomized for blood cultures. CONCLUSION: Blood cultures in the routine patient following vaginal or abdominal hysterectomy did not alter management and were not cost-effective. Blood cultures may be appropriate for febrile patients with preoperative, intraoperative and postoperative risk factors for bacteremia.

Bacteremia↗
PubMed1981

Influence of cimetidine on pharmacokinetics of propranolol.

Whole-blood propranolol concentrations were estimated for 12 hours after a single 80 mg oral dose was given in six patients taking cimetidine and two weeks after they had stopped the drug. Mean blood propranolol concentrations were higher throughout the sampling period when the patients were taking cimetidine than when they were not, and the difference was statistically significant between one and four hours (p less than 0.05). The mean relative bioavailability of propranolol, measured as the area under the concentration time curve, was significantly higher when the patients were taking cimetidine (p less than 0.025). The mean increase in bioavailability was 136.5 +/- 57.6%, and the results were consistent in each subject. It is concluded from these results that cimetidine reduces the hepatic first-pass extraction of propranolol.

Adult↗