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Biomedical subjects

R Reiss

Publications and source records attributed to R Reiss.

At least 19 recordsLinked to original sources
PubMed1992

The risk of cholecystectomy for acute cholecystitis in diabetic patients.

In order to evaluate the risk of acute cholecystitis in diabetic patients, we analyzed 2,700 consecutive cholecystectomies, 566 of which were performed in the presence of acute cholecystitis. Of these patients 123 had diabetes mellitus (DM) and 433 had no diabetes (ND). The aim of this study was to establish the comparative risks in the two groups. We found that diabetics are more likely to be operated on in the acute stage of their disease (22% vs. 12%). The DM group had a higher rate of septic bile, gangrenous changes and perforations of the gallbladder wall. The morbidity rate was higher in the DM group (21% vs. 9%), and mortality was slightly higher in the DM group. The degree of additional operative risk does not in our view justify recommending cholecystectomy in diabetic patients with asymptomatic gallstones. Early surgery however, is highly recommended in diabetics with symptomatic gallstones and acute cholecystitis.

Acute Disease↗
PubMed1991

Choledochoduodenostomy an important surgical tool in the management of common bile duct stones. A review of 126 cases.

Of 2,000 patients who underwent cholecystectomy between 1965-1984, 457 had their common bile ducts explored and of these 126 had choledochoduodenostomies. There were 70 women and 56 men and a third were over 70 years old. Forty-three also had acute cholecystitis or pancreatitis, and 73 had an increased serum concentration of bilirubin. Of the 126, 103 had stones in the common duct, and 16 had benign strictures of the sphincter of Oddi. Morbidity included wound infections in 18 (14%) and bile discharge from the drain for over 14 days in four (3%). Five patients died (4%), and they were all over 70 years old. Ninety-seven of 103 patients followed-up over 1-19 years were symptom free (94%). Two patients required re-operation for a narrow anastomosis. Three patients developed a "sump" syndrome; two were treated with antibiotics, and the third responded to endoscopic sphincterotomy. Choledochoduodenostomies should be considered during operation for benign biliary disease, when stones or a stricture in the common bile duct are anticipated.

Adult↗
PubMed1991

Hemosuccus pancreaticus and intraperitoneal bleeding secondary to spontaneous rupture of the splenic artery.

Hemosuccus pancreaticus is a rare condition where bleeding occurs through the pancreatic duct, usually due to a pseudoaneurysm of the splenic artery. We describe a patient with spontaneous rupture of the splenic artery that caused hemosuccus pancreaticus and later massive hemoperitoneum. The pathological process had lasted at least 10 days before the diagnosis was established. The patient underwent an emergency operation during which splenectomy and distal pancreatectomy were successfully performed.

Hemoperitoneum↗
PubMed1990

Clinical experience with fetal echocardiography.

Current ultrasound technology allows for accurate evaluation of the fetal heart. To evaluate the importance and accuracy of the routine clinical use of fetal echocardiography at our center, a consecutive series of 338 fetal cardiac studies of 323 patients was reviewed. Average gestational age was 24 weeks (range, 17 to 39 weeks). Forty-seven (15%) patients with abnormal conditions were detected. The most common indication for fetal cardiac scan was a family history of congenital heart disease (28%). Other indications were maternal diabetes mellitus (25%), fetal dysrhythmia (14%), other major defect (10%), drug exposure (10%), and obstetrician suspicion of fetal congenital heart disease on routine scan (10%). The highest yield of significant abnormal findings was among those referred for dysrhythmia (31%) and obstetrician suspicion of congenital heart disease (29%). Five fetuses with sustained supraventricular tachycardia and hydrops were successfully treated. The combination of fetal bradycardia and structural heart disease was the most ominous finding. Fifteen (4.6%) patients had clear changes in management based on the fetal echocardiogram. Our experience suggests that the routine use of fetal echocardiography is accurate and an important part of the overall management of the pregnancy considered at risk for producing an infant with congenital heart disease.

Diagnostic Errors↗
PubMed1990

Achievements of physical therapy in patients after modified radical mastectomy compared with quadrantectomy, axillary dissection, and radiation for carcinoma of the breast.

Flexion of the shoulder, abduction, and external rotation in 90 degrees abduction are impaired after operations for breast cancer. We compared postoperative range of motion in 27 patients who underwent modified radical mastectomy and 21 patients who underwent quadrantectomy with axillary dissection and radiation therapy. The patients in the quadrantectomy group demonstrated a significantly higher range of flexion on postoperative day 1 and the day of suture removal. After 3 months, all patients had regained their preoperative range of flexion, with no difference between the groups. The better compliance of the quadrantectomy group to physical therapy may indicate that they suffer less pain and require a briefer or less intensive course of physical therapy.

Adult↗
PubMed1990

Transient induction of vinculin gene expression in 3T3 fibroblasts stimulated by serum-growth factors.

When stimulated with serum, quiescent Balb/C-3T3 fibroblasts were found to induce vinculin transcription transiently within 30 min, followed by accumulation of vinculin mRNA and protein synthesis between 2 and 4 h after stimulation and a decrease to the basal level by 6-8 h. Platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), and 12-O-tetradecanoylphorbol-13-acetate (TPA) each could elicit a similar response, albeit to a lesser extent, whereas epidermal growth factor (EGF) was inefficient in inducing vinculin expression. In cells stimulated with serum and cycloheximide, vinculin expression was superinduced and vinculin mRNA levels persisted longer than in cells stimulated with serum alone. Cells arrested in the presence of serum by anchorage denial in methyl cellulose suspension culture also induced vinculin expression and formed large vinculin positive plaques when reattaching and spreading on the substrate in the presence of serum. Cells replated from suspension culture in the absence of serum on either plastic or extracellular matrix (ECM) components were capable of extensive spreading, but failed to elevate vinculin expression and displayed diffuse vinculin staining. The results indicate that the changes in vinculin organization and expression in response to growth factor stimulation may reflect either a necessary step in the progression through the cell cycle or a response related to complex cellular processes such as wound repair and embryogenesis.

Amino Acid Sequence↗
PubMed1989

Involvement of chromosome 22 in a Merkel cell carcinoma in a patient with a previous meningioma.

The relatively simple cytogenetic findings in an aggressive metastatic Merkel cell carcinoma are reported. Deletion 2p was found in 100% of the cells. Nevertheless, this was considered a secondary (metastatic?) change because the same aberration has been found in several other kinds of malignancy. The involvement of chromosome 22 [del(22q) and -22] in 85% of the cells seemed more intriguing, considering the fact that the Merkel cell carcinoma followed a previous meningioma.

Carcinoma, Merkel Cell↗
PubMed1989

Small bowel obstruction: a review of 264 cases and suggestions for management.

Two hundred and sixty-four cases of acute small bowel obstruction were retrospectively reviewed for the purpose of defining factors which could point to the presence of strangulated bowel. History, physical signs and investigations, including body temperature, X-rays, white blood count, and serum amylase, were not significantly different in the simple and strangulated groups. Although an elevated urinary white blood count and a palpable mass were more common in the strangulated group, they were not sufficiently reliable for early diagnosis of strangulation. In reviewing the literature, it is clear that all hernias with obstruction must undergo emergency surgery. Cases with intra-abdominal complete intestinal obstruction should also undergo emergency surgery. A more conservative attitude can only be taken when there is incomplete obstruction.

Adolescent↗
PubMed1989

Clinical experience treating varicose veins in the aged.

Patients over 70 years of age suffering from varicose veins or complications of venous insufficiency formed 6.7 per cent of the population treated in our phlebologic clinic in 10 years. This group of patients is unable to perform intensive walking exercises and fails to use high-pressure elastic stockings; thus, most of the so-called "conservative armamentarium" is nonapplicable. This challenged us to find alternative or modified ways of treatment for this high-risk-for-surgery group. An isolated Trendelenburg procedure under local anesthesia, with sclerotherapy and/or transfixion sutures as an outpatient procedure, was used. In the case of stasis ulceration, patients were treated with sequential intermittent pneumatic compression including local hyperbaric oxygen and teaching the use of elastic support as an inhospital procedure. Both methods proved successful, thereby offering a more acceptable solution to one of the chronic problems of the older age group.

Aged↗
PubMed1988

Biochemical tissue markers of human colorectal carcinoma.

The potential therapeutic effects of differentiating agents on leukemic and solid tumor cells are being evaluated worldwide. These effects can be followed by morphologic as well as biochemical parameters. The enzymatic profile of four enzymes and the level of carcinoembryonic antigen were studied in 24 human colorectal carcinoma specimens and their adjacent uninvolved mucosa. The enzymes studied were thymidine kinase and 6-phosphogluconate dehydrogenase as markers of proliferation, and alkaline phosphatase and gamma-glutamyl transpeptidase as markers of differentiation. A consistent finding was a marked increase in the activities of thymidine kinase and 6-phosphogluconate dehydrogenase in the tumor cells as compared with the adjacent normal mucosa. The activity of gamma-glutamyl transpeptidase was not significantly different between tumor and uninvolved colon tissue. Alkaline phosphatase activity was markedly reduced in the tumor specimens. A relationship between the degree of differentiation and the degree of penetration and CEA expression was demonstrated in the tumor specimens as well as in their surrounding uninvolved mucosa.

Alkaline Phosphatase↗
PubMed1988

Familial fragile 8q22 involved as a cancer breakpoint in cells of a large bowel tumor.

A familial fragile 8q22 and an interferon-induced fragile 16q22 were found in two sisters. Eight years previously, both sisters developed an endometrial adenocarcinoma and now one of them presented with an adenocarcinoma of the colon. An 8q22 deletion was found in all the cells of the colonic tumor and seemed to be the primary initiating change. Other nonrandom and possibly promoting aberrations were also present, among others, a 16q22 deletion. The possibility exists that a familial fragile 8q22 may predispose to cancer and a fragile 16q22 may have promoting capacities.

Adenocarcinoma↗