Biomedical subjects

T Rumley

Publications and source records attributed to T Rumley.

6 recordsLinked to original sources

PubMed1986

Haemophilus influenzae meningitis and Waterhouse-Friderichsen syndrome in an adult.

An otherwise healthy 36-year-old man had abdominal pain, vomiting, sepsis, and disseminated intravascular coagulation (DIC). Negative exploratory laparotomy was shortly followed by death. Autopsy showed Haemophilus influenzae (type B) meningitis, multiple organ involvement with DIC, and bilateral adrenal hemorrhagic necrosis (Waterhouse-Friderichsen syndrome). This patient is the fourth reported adult with H influenzae meningitis and hemorrhagic infarction of the adrenals, and the first such patient with an apparent abdominal catastrophe.

Adult↗

PubMed1985

Topical antimicrobial toxicity.

Three topical antibiotics and four antiseptics (1% povidone-iodine, 0.25% acetic acid, 3% hydrogen peroxide, and 0.5% sodium hypochlorite) were directly applied to cultured human fibroblasts to quantitatively assess their cytotoxicity. The four antiseptics were found to be cytotoxic; all of the cytotoxic agents except hydrogen peroxide were subsequently found to adversely affect wound healing in an animal model. Comparison of bactericidal and cytotoxic effects of serial dilutions of these four topical agents indicated the cellular toxicity of hydrogen peroxide and acetic acid exceeded their bactericidal potency. Bactericidal noncytotoxic dilutions of povidone-iodine and sodium hypochlorite were identified. These experiments provide evidence that 1% povidone-iodine, 3% hydrogen peroxide, 0.5% sodium hypochlorite, and 0.25% acetic acid are unsuitable for use in wound care. This sequence of experiments could be used to identify bactericidal, noncytotoxic agents prior to their clinical use.

Acetates↗

PubMed1985

Neutrophil delivery to wounds of the upper and lower extremities.

Clinical observations and experimental evidence indicate that wounds of the lower extremity are more susceptible to infection than are wounds located elsewhere on the body. The details of this regional relative immunoincompetence are not described. In this initial study of regional inflammatory response, neutrophil delivery to standard wounds of the upper and lower extremities was measured in 15 human volunteer subjects using a quantitative skin-window technique. Neutrophil delivery proved to be relatively deficient in the lower extremity. Neutrophil delivery (mean +/- SEM) was significantly lower to the lower-extremity wounds (5,890 +/- 590 cells per cubic millimeter) than to the upper-extremity wounds (16,600 +/- 1,680 cells per cubic millimeter). This lower neutrophil response may be a part of the lower extremity's increased susceptibility to infection. Further functional study of regionally collected neutrophils may provide more details of differences in regional inflammatory response. The mechanisms underlying these differences remain undescribed.

Adult↗

PubMed1985

PIPIDA scan diagnosis of traumatic rupture of the gallbladder.

Eighteen days after injury, a patient was evaluated for bilious ascites with a 99mTc-PIPIDA (paraisopropyliminodiacetic acid) scan. A ruptured gallbladder was shown, and this finding was confirmed at exploration. Radionuclide scanning offers a sensitive, non-invasive approach for delineating disruption of the biliary tract, and should be considered when such a defect is suspected.

Aged↗

PubMed1984

Calcified parathyroid glands detected by computed tomography.

Computed tomographic demonstration of single calcified parathyroid glands in two patients corresponded to operative findings of a calcified carcinoma and a calcified adenoma. The CT demonstration of a calcified parathyroid gland should suggest carcinoma, and the operative approach should be planned to permit an en bloc resection.

Adenoma↗

PubMed1984

Intrahepatic arterial aneurysm: treatment by ligation complicated by hepatic necrosis and biliary-cutaneous fistula.

An intrahepatic hepatic artery aneurysm with massive hemobilia was successfully obliterated by intraoperative ligation of a branch of the right hepatic artery. Subsequent CT studies showed a large area of intrahepatic necrosis that was well tolerated, but was eventually manifested as a biliary-cutaneous fistula. Our patient's benign course argues that management of segmental hepatic necrosis can be tailored to the clinical response.

Aneurysm↗