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Biomedical subjects

S S Mattingly

Publications and source records attributed to S S Mattingly.

8 recordsLinked to original sources
PubMed1988

Massive upper extremity edema following vascular access surgery.

We recently treated three patients with chronic renal failure who required subclavian vein cannulation with Uldall catheters following thrombosis of their arteriovenous fistulae. New arteriovenous fistulae were created in each patient following removal of the Uldall catheters. The patients were seen subsequently with massive, painful edema in the ipsilateral upper extremities from one to 10 weeks following creation of the arteriovenous fistulae. Radiographic studies documented stenosis or occlusion of the ipsilateral proximal subclavian vein. The arteriovenous fistula was ultimately ligated in each patient, which promptly resolved the pain and edema. Because subclavian vein thrombosis following temporary hemodialysis through an indwelling catheter is frequently asymptomatic until an arteriovenous fistula is constructed, venography should be considered in patients requiring upper extremity vascular access procedures. Demonstration of subclavian vein stenosis or occlusion would either preclude use of the upper extremity for an arteriovenous fistula or would require a concomitant procedure to relieve the venous obstruction.

Adult↗
PubMed1987

Long-term results with autogenous tissue repair of traumatic extremity vascular injuries.

With extensive vascular injuries in which a vascular conduit is required, there is controversy as to whether an autogenous or prosthetic graft is preferable. The authors reviewed their experience with 91 extremity arterial injuries in which autogenous tissue was used to repair vascular injuries of the extremities. Twenty-two patients also had concomitant repair of associated venous injuries with autogenous vein grafts. Ten patients required amputations, despite patent grafts in five patients, because of severe muscle necrosis. Two patients had thrombosis of their vein grafts develop in the early postoperative period but did not require amputation. The authors identified only one late vein graft failure in a patient in whom an infected pseudoaneurysm developed. Three patients with extensive soft tissue injuries had infection develop in vein grafts, with subsequent massive bleeding that ultimately required arterial ligation. Among the 22 patients with repair of their venous injuries, occlusion of popliteal vein repairs was documented in two patients and suspected in three others. The remainder of patients had satisfactory results. The excellent results obtained in the vast majority of the authors' patients with extremity vascular injuries reinforces their preference for using autogenous tissue whenever a vascular conduit is required. Exceptions include patients with extensive soft tissue loss precluding adequate graft coverage, the repair of large vessels, and life-threatening emergencies when there is insufficient time to harvest and prepare a vein.

Adolescent↗
PubMed1987

Fibroadenomas: histopathologic and MR imaging features.

Twelve fibroadenomas were studied in vivo using magnetic resonance (MR) imaging with a cylindrical surface coil and at 0.15 T. On T1-weighted images, most fibroadenomas had an intensity similar to that of normal fibroglandular tissue; areas of inhomogeneity were seen in six. On five of the T2-weighted images, the fibroadenomas gave a signal equal to or slightly greater than that of normal fibroglandular tissue; five showed a marked increase in intensity, and two gave a low signal intensity. Four fibroadenomas were inhomogeneous on both T1- and T2-weighted images, and two additional lesions became inhomogeneous on T2-weighted images. No consistent correlations were found between MR appearances and histopathologic findings in the fibroadenomas. It is concluded that the appearance of fibroadenomas on MR images is sufficiently variable that it would be difficult to differentiate benign from malignant circumscribed tumors on the basis of MR imaging alone.

Adenofibroma↗
PubMed1986

Nonpalpable breast lesions: wire localization and excisional biopsy.

From January, 1984, through July, 1984, 53 women with 56 nonpalpable suspicious mammographic breast lesions underwent breast biopsy directed by pre-operative needlewire localization. All of the suspicious lesions were removed at the first operation, and, although in 10 patients, the localization wire was greater than 2 cm from the lesion, this did not increase the number of attempts required to excise the lesion. Once the specimen and wire were removed, a radiograph was taken to assure removal of the suspicious area. Also, once the blocks were cut, they were x-rayed to pinpoint further which histopathologic sections would include the area in question. Six of the 56 suspicious mammographic lesions removed were intraductal breast carcinomas. All were Stage I tumors. The remainder of the lesions were benign including 24 with nonproliferative fibrocystic changes, 31 with proliferative fibrocystic changes and only one demonstrating proliferative changes with atypical hyperplasia. This procedure can be performed effectively on outpatients utilizing local anesthesia. Excellent communication among surgeon, radiologist, and surgical pathologist is imperative.

Adult↗
PubMed1985

Prototype coil for magnetic resonance imaging of the female breast. Work in progress.

Magnetic resonance imaging (MRI) of the breast was performed in 35 women using a prototype breast coil at 0.15 T. The distribution of fibroglandular and fatty tissues was demonstrated sufficiently well to permit correlation with the mammographic patterns of Wolfe, and it was possible to identify 1-cm cysts. The signal intensity of the cysts varied from low to high as repetition time (TR) and echo time (TE) using the spin echo technique (TR/TE) were prolonged from 250/30 to 1,000/120. In two women, fibroadenomas were seen as low-intensity, smoothly marginated lesions surrounded by fat. A range of in vivo observed T1 values is summarized for normal and pathologic tissues. It is concluded that MRI of the female breast, currently in the developmental phase, is feasible and further evaluation is indicated.

Adipose Tissue↗
PubMed1985

Failure of antiplatelet therapy with ibuprofen (Motrin) to prevent neointimal fibrous hyperplasia.

To evaluate the effect of ibuprofen (Motrin) on the development of neointimal fibrous hyperplasia (NFH), 4 cm segments of expanded polytetrafluoroethylene (ePTFE) grafts with an internal diameter of 4 mm were implanted in the femoral arteries of 28 dogs. Three dogs served as controls and these grafts were removed at 7 to 14 days. The remaining 25 dogs were medicated with either intravenous (IV) or oral (PO) ibuprofen. The medicated dogs were grouped according to whether the ibuprofen was administered prior to or after graft implantation. The orally medicated dogs were also grouped according to whether the grafts were removed from 30 to 60 days after graft implantation. The grafts were analyzed for the amount of anastomotic initimal hyperplasia, pannus extension, thrombus deposition, and patency. Analysis of the data demonstrated no statistically significant differences among any of the treatment groups or the control group for the variables analyzed. We conclude that ibuprofen neither prevents nor retards the development of NFH. There was a trend toward less thrombus deposition in the animals that received oral ibuprofen preoperatively. There was also a trend toward higher patency in the animals that received ibuprofen prior to graft implantation, which most likely resulted from decreased thrombus and fibrin deposition.

Animals↗