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Biomedical subjects

W Browder

Publications and source records attributed to W Browder.

45 records · Page 3Linked to original sources

Protective effect of nonspecific immunostimulation in postsplenectomy sepsis.

The enhanced risk of severe sepsis following splenectomy is now well recognized in both adult and pediatric patients. Prophylactic antibiotics and bacterial vaccines have been utilized with limited success to inhibit the high morbidity and mortality. This study reports the use of glucan, a beta-1,3-polyglucose, as a nonspecific immunostimulant for postsplenectomy pneumococcal sepsis. ICR mice were treated with glucan or glucose (5% w/v) following splenectomy or sham operation. Mice were then challenged with 1 X 10(9) Streptococcus pneumoniae intranasally. Glucan significantly increased survival in the splenectomy group (75%) compared to controls (27%). Phagocytic function, as measured by the clearance of 131I-triolein-labeled reticuloendothelial test lipid emulsion, was increased in the glucan group when compared to control glucose animals, both in the presence and absence of pneumococcal infection. Splenectomy alone did not significantly decrease phagocytic function. An increased leukocytosis in response to pneumococcal infection was observed in splenectomized glucan-treated animals. Nonspecific immunostimulation appears to have significant potential as a treatment strategy against postsplenectomy infection.

Animals↗

Successful management of acute traumatic duodenocaval fistula.

Acute traumatic duodenocaval fistula is a devastating injury, usually resulting in early exsanguination and death due to lack of retroperitoneal tamponade of vena caval bleeding. Early recognition of possible entericvascular communication and rapid transport to the operating room are prerequisites for successful management of this rare injury.

Adult↗

Excision of mediastinal parathyroid gland by mediastinoscopy.

Mediastinal parathyroid tissue continues to be a significant problem in patients with recurrent or persistent hypercalcemia after parathyroid surgery. In two such cases, we used mediastinoscopy to locate and remove mediastinal parathyroid glands, thus avoiding the morbidity of median sternotomy.

Humans↗

Arteriovenous fistulas for long-term dialysis. Factors that influence fistula survival.

We reviewed our total experience with arteriovenous (AV) fistulas for long-term hemodialysis. We are unable to show any significant difference in the survival of AV fistulas based either on the type of material used to create the fistulas or on their location. Complications encountered early in this experience largely were due to technical or judgmental errors. Thrombosis of radiocephalic fistulas resulted from failure to use a vein of adequate caliber. Failure of bovine artery heterograft AV fistulas resulted either from wound infection or from the use of a diseased artery that was incapable of delivering sufficient blood to keep the fistula open. Infection around a heterograft fistula frequently was associated with a lymphocele. The meticulous division, between clips or ligatures, of all tissues deep to the skin prevented lymphocele formation.

Adolescent↗

Malignant cystosarcoma phylloides. Treatment and prognosis.

Twenty-six cases of malignant cystosarcoma phylloides treated at The Charity Hospital of Louisiana were reviewed. No metastases to axillary lymph nodes was observed. The lesion appears to metastasize seldom, if ever, to lymphatics, and axillary dissection is seldom required. Local recurrence was common, however, and justifies wide resection of the primary. Mortality was related more to the size of the lesion than to other findings such as skin or muscle involvement. No lesion with less than three mitoses per ten high power fields and minimal stromal atypia proved fatal. Associated neoplasia was common, particularly in the opposite breast.

Adult↗