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Biomedical subjects

J W Cook

Publications and source records attributed to J W Cook.

At least 19 recordsLinked to original sources
PubMed1992

Efficacy of an enzyme-linked immunosorbent assay for detection of urinary tract immunoglobulins for diagnosis of urinary tract infections.

Results of the Uristat test (Shield Diagnostics Ltd.), a novel enzyme-linked immunosorbent assay (ELISA) for detection of urine antibodies to seven common bacterial pathogens, were compared with results of urine culture, urinalysis, and clinical history to determine the usefulness of Uristat in the diagnosis of urinary tract infections (UTIs). Midstream, catheterized, and indwelling catheter urine specimens sent to the laboratory for culture were included in the study. Quantitative cultures were performed on both 5% sheep blood agar and eosin-methylene blue agar. Uristat ELISAs were performed according to the manufacturer's instructions. By using a Bacillus subtilis bioassay technique, antibacterial activity was detected in the urine of 236 (22.2%) of 1,061 patients. Probable, possible, or asymptomatic UTIs were diagnosed for 258 (24.3%) of the 1,061 patients. Of those infections, 219 (84.9%) were caused by bacterial species whose antibodies were detectable by Uristat. Uristat's sensitivity and specificity were 76.7 and 56.0%, respectively. Uristat's predictive values of positive and negative results were 31.2 and 90.2%, respectively. Further development of the Uristat test is necessary before it can be of assistance in the diagnosis of UTIs.

Adolescent↗
PubMed1991

"Half and half" woven and knitted Dacron grafts in the aortoiliac and aortofemoral positions: seven and one-half years follow-up.

One-hundred fifty-eight patients received specially manufactured aortoiliac or aortofemoral bifurcated grafts with one limb woven, the other knitted from Dacron. During an observation period ranging from 1,567 to 2,555 days (average 2,130 days) no statistically significant difference was found in either platelet adherence (30 patients studied) or in clinical patency. According to the results of the study, the type of graft (woven or knitted) did not seem to influence either platelet adherence or patency rate in the aortoiliac or aortofemoral positions.

Aged↗
PubMed1989

Traumatic tears of the thoracic aorta: improved results using the Bio-Medicus pump.

Traumatic disruption of the descending thoracic aorta is a relatively rare but dramatic injury. Controversy remains regarding the use of shunts during operative repair. Discouraged by our results using the "no shunt" technique, we adopted the recently reported technique using the Bio-Medicus pump for left atrium-femoral artery bypass without heparin sodium. At Charlotte Memorial Hospital and Medical Center, 39 patients were treated for tears of the descending thoracic aorta between January 1979 and October 1988. Eight patients died before repair could be completed. Four patients underwent repair using femorofemoral bypass with 1 death and no instances of paraplegia. Fifteen patients had repair using the no-shunt technique with 4 deaths and three instances of paraplegia. Since January 1986, 12 patients have been treated using the Bio-Medicus heparinless pump with no deaths and no instances of paraplegia. We present our experience to confirm the reports of others regarding the efficacy of this technique. We believe it reduces the morbidity and mortality associated with this serious injury and aids in the hemodynamic management of the patient during aortic clamping.

Adult↗
PubMed1988

Rapidly growing nontuberculous mycobacteria: a new enemy of the cardiac surgeon.

A review of atypical mycobacterial infections complicating cardiac operations is presented. Proven sources of infections at different institutions include contaminated porcine valves and municipal water supply, but the mode of transmission in the great majority of patients remains unclear. There are two principal clinical forms of atypical mycobacterial infections after cardiac operations--endocarditis and sternal osteomyelitis. The latter has characteristics resembling tuberculotic "cold abscess." Specialized laboratory testing is necessary to confirm the diagnosis, and surgeons may have to take the initiative to request special microbiological investigation in cases where infection is clinically suspected but routine cultures are reported as "negative." The prognosis for patients who have any atypical mycobacterial infection after a heart operation is severe. Those infected with the strain chelonei and those whose cardiac chambers were entered during operation fare worse. This dim clinical prognosis may be improved by appropriate and aggressive antibiotic and surgical therapy. Awareness of the urgency of special bacteriological studies is the key to successful management.

Anti-Bacterial Agents↗
PubMed1987

Cancer in offspring of long-term survivors of childhood and adolescent cancer.

A multicentre retrospective cohort study of long-term survivors of childhood and adolescent cancer identified 7 cases of cancer among 2308 offspring (0.30%) of 2283 case-survivors and 11 cases among 4719 offspring (0.23%) of 3604 controls. Overall, the observed numbers of cases were not significantly different from those expected in the general population. Among offspring of case-survivors observed for the first 5 years of life, the group with the most person-years of follow-up, 5 cancers were reported (3 confirmed), compared with 1.7 expected, a significant excess due mostly to boys whose mothers survived cancer. Some offspring with cancer had known single-gene traits; others resembled previously recognised patterns of family cancer. The remainder may represent chance occurrences or new cancer family syndromes, such as an association with malignant melanoma. The study had an overall 79% power to detect a 3-fold excess of cancer among offspring of case-survivors, but no excess was observed. The number person-years of follow-up in the second decade of life, when most cases of cancer developed, was small.

Adolescent↗
PubMed1987

Indium 111-labeled platelet deposition in woven and knitted Dacron bifurcated aortic grafts with the same patient as a clinical model.

A study was designed to compare platelet deposition between knitted and woven Dacron grafts in the same patient. Twenty patients received aortoiliac or aortofemoral bifurcated Dacron grafts, each composed of one woven and one double-velour knitted limb. External nuclear graft imaging was carried out after injection of autologous platelets labeled with indium 111. The patients were studied postoperatively in time periods ranging from 6 days to 42 months. Platelet accumulation was almost identical in knitted and woven limbs in all patients. This study appears to indicate that there is no difference in thrombogenicity between knitted and woven bifurcated Dacron grafts in the aortoiliac or aortofemoral positions measured by platelet accumulation.

Aorta, Abdominal↗
PubMed1985

The impact of successful laboratory system on the teaching of nursing skills.

The laboratory guided practice approach has been found an effective strategy for teaching nursing skills to large numbers of students. It provides flexibility in meeting individualized needs and serves to decrease stress levels of both students and faculty. At the School of Nursing, University of N.C. at Chapel Hill, it has served to establish more uniform clinical expectations of students and greater correlation between skills level and clinical site placement, as well as integration of skill components into clinical courses. These outcomes and the positive evaluations discussed above help to validate this strategy as a practical and effective way to approach the teaching of clinical nursing skills.

Clinical Competence↗
PubMed1979

Thoracoabdominal aortic aneurysms. A review and current status.

Surgical management of the thoracoabdominal aortic aneurysm is a formidable undertaking. Presently two fairly distinct operative methods are available. The conventional technique, pioneered by Etheredge, involves replacement of the aneurysm with a synthetic graft and then, step by step, revascularization of the abdominal organs with prosthetic side limbs taken from the primary graft. Individual organ ischemic time is limited to that time required for the performance of each distal side limb anastomosis. The second operative method, first described by Crawford, consists of proximal and distal control of the aneurysm, followed by its incision to simultaneously expose the origin of all four major intra-abdominal arteries. Replacement is then rapidly performed with a tubular Dacron graft including anastomosis of these major intra-abdominal arteries to four elliptical graft incisions, from within the aneurysm. Total operating time is reduced at the expense of prolonged organ ischemia. The conventional method allows for step-by-step intraoperative planning and action, and this technique is accordingly recommended to most surgeons, who have had little experience with this unusual lesion. Our recent successful experience with two cases of extensive thoracoabdominal aortic aneurysms is described as well as a discussion of additional measures which may become useful in certain cases to favor a successful outcome. Finally the problem of potential resultant paraplegia is discussed.

Angiography↗
PubMed1979

Pectus carinatum.

In the mirror of the pertinent literature, we present our experiences gained in 161 operations for pectus carinatum. The Type I (keel chest) deformity is corrected by bilateral resection of the costal cartilages, transverse osteotomy of the sternum, detachment of the xiphoid process, and resection of the lower end of the body of the sternum. The sternum is maintained in its corrected position by utilizing the pulling force of the rectus muscles through the reattached xiphoid and by tacking the pectoralis muscles together in front of the breast bone. Type II (pouter pigeon breast) is handled by double transverse osteotomy, chiseling off the protuberant portion of the strernomanuberial junction, and by supporting the lower sternal body with either the suspended xiphoid process or with Marlex mesh. Limited forms of Type III (asymmetrical or lateral pectus carinatum) are managed with simple resection of the involved cartilages only. If the anomaly is more extensive, bilateral resection of the cartilages and correction of the sternal axis is carried out.

Adolescent↗
PubMed1979

Sinus venosus type of atrial septal defect with partial anomalous pulmonary venous return.

This report describes our method of repairing the sinus venosus type of atrial septal defects. The superior vena cava is compartmentatlized by means of a single double-armed suture. Caval catheters are used as temporary internal shunts, and a vertical U-shaped patch is incorporated into the atriotomy suture line. The experiences with 27 cases are presented.

Adolescent↗
PubMed1979

Pectus carinatum.

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Adolescent↗