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Biomedical subjects

J W Pate

Publications and source records attributed to J W Pate.

At least 19 recordsLinked to original sources
PubMed1991

Primary Aspergillus osteomyelitis of the sternum.

We report 2 cases of primary sternal osteomyelitis caused by Aspergillus; previously reported cases have been complications of sternotomy. Both patients were healthy young men with recent intravenous drug abuse. No other focus or predisposing factors were found. Both were treated with partial sternectomy and chondrectomy; 1 received long-term amphotericin B therapy. Both are doing well 2 1/2 years after operation. Drug usage, acquired immunodeficiency syndrome, and medical immunosuppression may lead to other cases.

Adult↗
PubMed1990

Risks of blood exposure to the cardiac surgical team.

The risk of transmission of human immunodeficiency virus from patient to cardiac surgical team is perceived by most people to be very slight, yet the possibility is a valid concern. The feasibility of "barrier protection" in prevention of this risk is dependent on integrity of surgical gloves and absence of splashes of body fluids into eyes and broken skin. These factors were observed and recorded in 50 coronary bypass operations and 17 valve replacements. There was a high risk of glove penetrations (one to two per team member per operation) and of skin punctures, lacerations, or eye splashes (from 0.4 to 1.5 instances per operation). Better gloves and more self-defensive surgical techniques are indicated.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Medical management of acute traumatic rupture of the aorta.

Surgical reconstruction is the treatment for acute traumatic aortic rupture and should be accomplished immediately in most patients. In patients in whom concomitant injuries or the development of life-threatening complications preclude safe and successful aortic reconstruction, pharmacological intervention to reduce the risk of free aortic rupture may be considered. Surgical reconstruction can then be more safely performed under controlled elective circumstances.

Abdominal Injuries↗
PubMed1989

Spontaneous rupture of the esophagus: a 30-year experience.

This retrospective review of 34 patients with spontaneous rupture of the esophagus, which spans a 30-year period, attempts to identify areas in diagnosis and therapy that might alter the dismal prognosis. The diagnosis and definitive surgical repair of Boerhaave's syndrome were frequently delayed. Delay resulted in a significant increase in complication rates. Pain (85%) and vomiting (71%) were the only common historical events suggesting the diagnosis. Physical examination was of aid in the diagnosis in only the 9 patients (27%) who demonstrated cervical or mediastinal emphysema. The initial chest roentgenogram was abnormal in 97% of the patients, but was interpreted as "compatible with perforation of the esophagus" in only 27%. Esophagography was diagnostic in 23 of 24 patients in whom it was used. Thoracentesis was of little diagnostic aid, but pleural fluid pH was measured in only 15% of the patients. Prompt surgical repair, regardless of time after onset, appears to be the indicated therapy.

Adult↗
PubMed1989

Chest wall injuries.

Chest wall injuries range from relatively trivial to fatal flail chest or huge defects. Significant chest wall injury is present in about one third of patients admitted after severe trauma. In management, the principal areas to be considered are pain control, open wounds, pneumothorax, flail chest, and pulmonary contusion.

Fractures, Bone↗
PubMed1989

Tracheobronchial and esophageal injuries.

Tracheobronchial injury was considered rare until the last two decades but is becoming more common (or is being recognized more often). The author reviews diagnosis and the principles of management, among which infection prevention is stressed.

Bronchi↗
PubMed1985

Soft tissue calcium and magnesium content in acute pancreatitis in the dog: calcium accumulation, a mechanism for hypocalcemia in acute pancreatitis.

The mechanism of hypocalcemia in acute pancreatitis remains unknown despite continued investigative work over the past several decades. Because acute pancreatitis is accompanied by multiple systemic manifestations and alterations of plasma membranes, the possibility that an abnormal translocation of calcium from extracellular to intracellular compartments could play a role in hypocalcemia of acute pancreatitis was investigated in dogs. Acute pancreatitis was induced by injecting bile into the pancreatic duct. Plasma calcium, magnesium, and amylase concentrations were determined. Calcium and magnesium contents were also measured in biopsy specimens of pancreas, liver, skeletal muscle, and kidney before and after induction of acute pancreatitis. As expected, hypocalcemia and hyperamylasemia occurred 6 hours after induction of pancreatitis, and persisted throughout the experiment, 13 to 25 hours. Plasma magnesium concentration fell at 6 and 18 hours, and returned to an almost normal level by the end of the study. A significant elevation in calcium content of pancreas (71%), liver (24%), and muscle (112%), and 25% reduction of calcium in kidney were observed in dogs with histologic signs of pancreatitis. However, tissue magnesium concentration fell in pancreas (18%) but remained unchanged in the other tissues investigated. No significant changes in any variables were detected in sham-operated animals. In another group of dogs in which the accessory pancreatic duct was not occluded when bile was injected, the histologic lesions were extremely mild, although the plasma calcium concentration and the pancreatic calcium and magnesium contents were altered just as much as in the severely affected dogs. Data suggest that the hypocalcemia of acute pancreatitis may be the result, at least in part, of accumulation of calcium in soft tissues. The decreased calcium content in kidney could be related to hypocalcemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Amylases↗
PubMed1979

Symptomatic lower esophageal ring: treatment of 24 patients.

The lower esophageal ring, or Schatzki's ring, consists of a thin, submucosal, circumferential scar which forms a thin incomplete diaphragm in the lower esophageal lumen. The symptoms may be either episodic aphagia or progressive dysphagia, and the severity of symptoms is related to the diameter of the ring. Between 1970 and 1978, we saw 24 patients with lower esophageal rings and complaints of episodic aphagia or progressive dysphagia. Symptoms of esophagitis were present in 20 of the 24. Twenty were treated surgically by interrupting the rings and repairing the sliding hiatal hernias. Two were treated by dilatation and two received no treatment to the ring. Hiatal hernias have recurred in two patients. In one, there is a recurrent ring and in the other, an acid peptic stricture. The ring has responded to dilatation and the peptic stricture to dilatation and repair of the recurrent hernia. Two patients without symptoms of esophagitis, treated by dilatation, are doing well but the follow-up period is so far too short to draw any conclusion.

Aged↗
PubMed1979

Peripheral pulmonary embolization from central pulmonary aneurysm.

A 59-year-old man underwent successful repair of a pulmonary arterial aneurysm because of peripheral pulmonary embolization. These lesions are relatively rare; and, to out knowledge, peripheral embolization from such an aneurysm has not been previously reported.

Aneurysm↗
PubMed1977

Present status of coronary artery surgery.

Postinfarction ventricular septal defects are best repaired surgically several weeks after occurrence; however, deterioration of the patient's condition may require emergyncy operation. Ventricular aneurysms are resected when associated with low cardiac output, emboli occur or when present in a patient who is otherwise a candidate for aortocoronary grafting. Mitral valve replacement may be required when coronary disease produces severe malfunction of a papillary muscle or rupture of a chorade tendineae. Acute infarctectomy alone is not recommended at this time. The balloon assist device may result in some patients who are candidates for infarctectomy with aortocoronary bypass graft. Preinfarction angina which is not controlled by medical therapy should be treated by immediate aortocornary bypass. Tachyarrhythmias are not an absolute contraindication to surgery. Stable angina that is unacceptable to the patient under optimal medical therapy and is associated with operable anatomical lesions is the prime indication for coronary artery surgery. Relief of pain and increased exercise tolerance are usual after surgery. Sometimes life may be prolonged.

Angina Pectoris↗
PubMed1977

Cyanoacrylate sealing of pancreatic biopsy sites in dogs.

The ability of ethyl cyanocrylate monomer adhesive in preventing leaks following pancreatic surgery dogs was evaluated. Seventeen of 18 dogs in the control group had evidence of pancreatic leak following biopsy. There was no evidence of leak in 17 of 18 dogs on which the adhesive was used to seal the cut surface of the pancreas. Similar successful use of ethyl cyanoacrylate in patients would provide a safe method of taking a specimen from a mass for biopsy in the pancreas.

Animals↗
PubMed1976

Esophageal obstruction due to intermuscular hematoma following pneumatic dilatation.

A case of incomplete esophageal perforation with an intermuscular hematoma is presented. Unlike previously described submucosal or intramural perforations, this case involved mucosa, submucosa, and the inner circular muscle layer but was limited by the outer longitudinal layer. Nonsurgical treatment was followed when the clinical picture of an incomplete perforation without mediastinal soilage was considered. Surgery was done when evidence of impending extension of the process outside the esophagus developed.

Adult↗
PubMed1976

Aspergilloma within a malignant pulmonary cavity.

The simultaneous appearance of both bronchogenic carcinoma and aspergilloma with the typical radiographic appearance of a mycetoma emphasizes the importance of consistent suspicion for malignancy in any pulmonary lesion. This is apparently the first reported case in which allergic phenomena (asthma-like symptoms and eosinophilia) are associated with an aspergilloma occurring within a cavitary bronchogenic carcinoma.

Aged↗
PubMed1976

Follow-up of patients with saphenous vein bypass grafts for angina pectoris.

These studies are in agreement with others that aortocoronary vein grafts done for severe angina pectoris are associated with a low operative and late mortality rate. Most patients were significantly improved in regard to pain and exercise tolerance. "Optimal" graft site is associated with a graft patency rate of about 90 per cent. There is clear evidence that left ventricular function, particularly with exercise, is improved in some patients. When a graft is placed in an obstructed coronary artery supplying a segment of abnormally contracting myocardium, there frequently is significant improvement of contraction when the graft remains patent.

Adult↗