PubMed Health⌕ Search

Biomedical subjects

J P Kistler

Publications and source records attributed to J P Kistler.

12 recordsLinked to original sources
PubMed1979

Cranioplasty: a review of 1030 cases of penetrating head injury.

A total of 491 cranioplasties performed in a population of 1030 cases of penetrating head injury are reviewed. The morbidity rate was 5.5%, and the mortality rate was 0.2%. The clinical criteria of improving cosmetic defects and restoring craniocerebral protection are established, based on the location and size of the skull defect. Cranioplasty after penetrating head injury should be deferred for a minimum of 1 year to control morbidity. Complication of the original injury and surgical debridement increase the morbidity rate of cranioplasty. Post-traumatic epilepsy is not related to skull defects per se; neither is it affected by cranioplasty. Acrylic is an acceptable cranioplasty material if there is strict adherence to good surgical technique.

Acrylic Resins↗
PubMed1979

Cardiac embolic cerebrovascular disease.

Cerebral emoli may originate in the heart, the carotid arterial system, or the aortic arch. If the source of the embolus can be located, medical or surgical therapy may be able to prevent the occurrence of further strokes.

Aged↗
PubMed1978

The bruit of carotid stenosis versus radiated basal heart murmurs. Differentiation by phonoangiography.

Phonoangiography, quantitative analysis of arterial bruits, has been shown to provide accurate noninvasive diagnosis of uncomplicated carotid arterial stenosis, but had not been tested where cervical bruits from other sources were present. In this study, 27 carotid bruits in 15 consecutive patients with carotid bruits and basal heart murmurs were analyzed by phonoangiography. Tape recordings were made over the base of the heart and along the course of the carotid arteries in the neck; spectral analysis was performed as previously described. The spectral shape of the basal heart murmurs was recognizable and amplitude decreased with distance from the heart, althouth a secondary, lower amplitude, maximum often occurred over the carotid bifurcation. Intrinsic carotid bruits, by contrast, were always maximal over the bifurcation, and although they radiated both proximally and distally, were not detectable over the chest wall. In quantitative terms, the correct diagnosis as to the presence and extent of carotid stenosis was made in 25 of 27 cases (92%) despite the presence of a radiated murmur. Phonoangiography is capable of accurate differentiation of radiated murmurs from intrinsic carotid bruits and of quantitation of the latter even in the presence of radiated sounds.

Carotid Artery Diseases↗
PubMed1978

The Harvard Cooperative Stroke Registry: a prospective registry.

Data from 694 patients hospitalized with stroke were entered in a prospective, computer-based registry. Three hundred and sixty-four patients (53 percent) were diagnosed as having thrombosis, 215 (31 percent)as having cerebral embolism 70 (10 percent) as having intracerebral hematoma, and 45 (6 percent) as having subarachnoid hemorrhage from aneurysm or arteriovenous malformations. The 364 patients diagnosed as having thrombosis were divided into 233 (34 percent of all 694 patients) whose thrombosis was thought to involve a large artery and 131 (19 percent) with lacunar infarction. Many of the findings in this study were comparable to those in previous registries based on postmortem data. New observations include the high incidence of lacunes and cerebral emboli, the absence of an identifiable cardiac origin in 37 percent of all emboli, a nonsudden onset in 21 percent of emboli, and the occurrence of vomiting at onset in 51 percent and the absence of headache at onset in 67 percent of hematomas.

Cerebral Hemorrhage↗
PubMed1977

Mannosidosis. New clinical presentation, enzyme studied, and carbohydrate analysis.

Mannosidosis is a rare inborn error of metabolism characterized by deficiency of the lysosomal enzyme alpha-mannosidase and widespread storage of complex carbohydrate, which is enriched in mannose. Two affected unrelated males, aged 6 and 26 years, are reported. Both had a nonprogressive encephalopathy with moderately severe mental retardation. The older patient showed several unique features, including massive gingival hyperplasia associated with histiocytes containing large amounts of a material with the staining characteristics of glycoprotein. The best determinant of mannose storage proved to be the ratio of mannose to other carbohydrates in urinary polysaccharides. The enzyme deficiency in this disease is most convincingly demonstrated at pH values below 4.0. The ability of zinc to activate the mutant enzyme in vitro offers a possible mode of therapy for this disease. Retarded individuals with a Hurler-like appearance and gum hyperplasia of unknown cause should be screened for alpha-mannosidase deficiency.

Adult↗
PubMed1977

Influence of etiology of atrial fibrillation on incidence of systemic embolism.

Atrial fibrillation is well known to increase greatly the risk of systemic arterial embolism in patients with mitral valve disease. In light of the clinical frequency of embolism in patients with atrial fibrillation due to other types of heart disease, a study was made of embolic occurrences in 333 autopsy patients with atrial fibrillation associated with various kinds of heart disease. Considering only symptomatic emboli with pathologic or surgical confirmation, embolism occurred in 41% of patients with mitral valve disease, 35% of those with ischemic heart disease, 35% of those with coexisting mitral and ischemic heart disease and 17% of those with "other" types of heart disease. Embolism was found in only 7% of a control group of 58 autopsy patients with ischemic heart disease without atrial fibrillation. These findings suggest a high risk of embolism from atrial fibrillation of any origin, but particularly from that caused by ischemic heart disease and mitral valve disease.

Adult↗
PubMed1977

Computed tomography of cerebral infarction: hemorrhagic, contrast enhancement, and time of appearance.

Large confluent petechial hemorrhages and/or hemorrhage within infarct may be seen on CT scan. Small petechial hemorrhages are not resolved by current equipment and techniques. Elevation of absorption values of an infarct following contrast media primarily occurs in the first month after onset, and may be occasionally confused with a tumor. Sequential CT changes in infarcts correlate well with established pathologic changes. Cerebral infarction may be seen on CT scan in some cases as early as 24--48 hr after its onset.

Cerebral Hemorrhage↗
PubMed1975

Computerized axial tomography: clinicopathologic correlation.

Between August 1973 and April 1974 more than 750 patients had computerized axial tomography (CT) scans at the Massachusetts General Hospital. Ten brains from previously CT-scanned patients in this group were sectioned in the plane of the scan. Nearly exact correlation was found between the anatomic location and extent of intracranial lesions demonstrated by CT scan and the findings on gross and microscopic pathologic examination in cases of primary intracranial tumors, obstructive hydrocephalus, intracerebral hemorrhage, ischemic and hemorrhagic infarctions, pineal tumor, and thermal-burn encephalopathy. Determination of absorption values (mu) of 47 pathologically verified processes showed that high-absorption intracerebral hemorrhage and calcium-containing tumors are readily separable from other processes on the basis of mu values alone. However, the abnormal mu values of primary brain tumor, edema, and infarction are difficult to distinguish from those of normal spinal fluid and white matter.

Autopsy↗
PubMed1975

A study of B and T cells in multiple sclerosis.

Peripheral blood T and B lymphocytes were enumerated using E and EAC red blood cell rosetting techniques. The percentage of EAC-binding cells in peripheral blood of multiple sclerosis patients is elevated (31.7 plus or minus 2.4S.E.M.) when compared with the percentage in healthy controls (18.5 plus or minus 1.1 S.E.M.). The total T cell percentage is not significantly lower in multiple sclerosis than in controls, but fewer T cells in patients with multiple sclerosis are able to bind 10 or more red blood cells.

B-Lymphocytes↗
PubMedDate not supplied

Intravenous nitroglycerin in experimental cerebral vasospasm. A preliminary report.

Cerebral arteriospasm is a common complication of subarachnoid hemorrhage and is responsible for much of the brain damage which accompanies it. No pharmacologic agent has been found which regularly alleviates arteriospasm. We have evaluated the effect of continuous intravenous nitroglycerin infusion on the diameter of the basilar artery in dogs with cerebral vasospasm experimentally induced by subarachnoid blood injection. In 6 consecutive dogs, 10 minutes after beginning intravenous nitroglycerin at 100 microgram/min and at other times during 120 minutes of infusion, the diameter of the basilar artery had increased from 75 +/- 2% of control value to 114 +/- 2% of control value (p less than 0.001). In all 6 dogs, the basilar artery diameter during infusion was greater than the control value prior to creating subarachnoid hemorrhage. Intravenous nitroglycerin caused only a moderate (8%) decrease in blood pressure. Further investigation of the effects of nitroglycerin on cerebral vasospasm is warranted.

Animals↗