Biomedical subjects

J Saxe

Publications and source records attributed to J Saxe.

6 recordsLinked to original sources

PubMed1992

Antibiotic-primed fibrin gel improves outcome in contaminated splenic injury.

Fibrin gel (FG) has recently been shown to be bactericidal in the management of contaminated hepatic injury; antibiotic loading of fibrin gel (AFG) may augment this effect. We evaluated the antimicrobial properties of FG and AFG in a rat model of contaminated splenic injury. Fibrin gel was made from centrifuged plasma of separate donor rats and bovine thrombin. Antibiotic fibrin gel was similarly produced following intravenous injection of 70 mg/kg ticarcillin. Male Holtzman rats (250-300 g) were anesthetized and a laparotomy done. The abdomen was contaminated with 1 x 10(7) Bacteroides fragilis and the spleen transected in the midportion. Treatment consisted of splenorrhaphy (S) (n = 7), FG application (n = 7), or AFG (n = 7). The animals were autopsied at 1 week to evaluate abscess formation and abdominal adhesions (grade I = none, grade II = mild, grade III = severe). Antibiotic/fibrin gel significantly decreased abscess formation following splenic injury when compared with S (2 of 7 vs. 7 of 7; p less than 0.05 by ANOVA) without an increase in adhesions. Fibrin gel also decreased abscess formation but not significantly (4 of 7 vs. 7 of 7). Histologic analysis confirmed the beneficial effect of FG and AFG on wound healing. The bactericidal effect of FG is improved by antibiotic loading in contaminated intraabdominal injury.

Animals↗

PubMed1992

Effect of increased intra-abdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow.

The effects of increased intra-abdominal pressure (IAP) on hepatic perfusion were studied in five anesthetized pigs. Doppler flow probes were used to measure hepatic artery blood flow (HABF) and portal venous blood flow (PVBF), and laser Doppler flowmetry was used to assess changes in hepatic microvascular blood flow (HMVBF). Hepatic blood flow responses to 10, 20, 30 and 40 mm Hg increases in IAP were assessed while the mean arterial BP (MAP) was maintained at baseline levels with IV crystalloid infusions. Although cardiac output and MAP were normal, HABF and HMVBF fell significantly with 10 mm IAP, and at 20 mm Hg IAP, HABF was 45% of the control value, PVBF was 65% of the control value, and HMVBF was 71% of the control value (p less than 0.05). At 30 and 40 mm Hg, hepatic blood flow was reduced even more. Thus, modest increases in IAP can cause significant impairment of hepatic perfusion despite a normal BP and cardiac output.

Abdomen↗

PubMed1992

Effect of intra-abdominal pressure on abdominal wall blood flow.

Adverse effects of increased intra-abdominal pressure (IAP) on cardiac, pulmonary, and renal function have been well described. Abdominal wound healing complications seen in the massively injured patient may also be associated with IAP. The effects of IAP on abdominal wall blood flow, however, have not been documented. This study examines rectus sheath (RS) blood flow in a porcine model of increased IAP. Seven domestic swine were anesthetized with pentobarbital and maintained with isoflurane. Swan-Ganz and femoral arterial catheters were placed for measurement of mean arterial pressure (MAP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP). A midline incision was performed for placement of laser flow probe on the RS and for placement of catheters to raise and measure IAP. Intra-abdominal pressure was then increased by installation of lactated ringers (LRs) into the peritoneum. Mean arterial pressure was maintained throughout the procedure with intravenous LR. Hemodynamics and RS blood flow data were obtained at baseline, 10, 20, 30, and 40 mm Hg IAP. Analysis of data was done by paired t-test with level of significance at P less than 0.05 and linear regression. Rectus sheath blood flow was significantly reduced at all pressure levels when compared to baseline and negatively correlated (r = -0.82) with increasing IAP. Since indices of systemic perfusion were maintained with increasing IAP, the decreased RS blood flow is most likely due to increased compartmental pressure within the abdomen.

Abdomen↗

PubMed1992

MRE enteropathy.

Explore the source record for details and available documents.

Adult↗

PubMed1988

Villous adenoma of the common bile duct.

A patient with villous adenoma of the common bile duct presented with obstructive jaundice, weight loss, and icterus. Results of preoperative evaluation suggested cancer of the pancreas or common bile duct. Despite normal findings of intraoperative needle biopsies, a duodenopancreatectomy was performed. Three years after operation the patient is without significant problems. We present the surgical challenge of treating this unique entity.

Adenoma↗

PubMed1984

Profile analysis of a referral sample.

This investigation demonstrates the use of Skinner's Modal Profile Analysis technique to uncover the underlying classification structure in a group of children (n = 235) referred for psychological evaluations by their public school teachers. Data were acquired on children's intellectual development, academic achievement, and social adjustment. The profile solution identifies three profiles of children with each profile containing two distinct types. Thus, six types (groups) were identified. This three-profile (six-group) solution is able to classify 81% of the referral sample. However, the statistical solution to the classification question did not correspond to the system by which the children were classified in their respective schools. While a discriminant analysis using profile elevation, scatter, and shape scores as the predictor variables and the child's classification in the school as the criterion of interest indicates a statistically significant ability to predict the child's school label, for all practical purposes the predictive ability is not useful.

Affective Symptoms↗