The importance of luminal factors in neomucosal growth.

Growing neomucosa on patched intestinal defects has been investigated as a method of expanding the intestinal absorptive area. The purpose of this study was to determine the effect of luminal factors on the rate of growth and function of neomucosa in rabbit ileum. A 2 X 5-cm distal ileal defect was patched with adjacent colon serosa in 10 New Zealand white male rabbits.

Effect of smoking on human natural killer cell activity.

Natural killer (NK) cells play a central role in immune surveillance against tumors and viral infections. NK activity is depressed in patients who have a wide range of carcinomas, including carcinomas of the lung. Peripheral blood NK activity was measured in 22 nonsmokers, 15 light/moderate smokers, 12 heavy smokers, and 19 patients with carcinoma of the lung.

Increased incidence of pancreas-related complications in patients with postoperative pancreatitis.

The incidence and significance of pancreas-related complications (pseudocysts, abscesses, and fistulas) were evaluated in 100 patients with acute pancreatitis. Alcoholic (40 percent), biliary (20 percent), and postoperative (15 percent) pancreatitis were seen most frequently. Eighteen patients had severe pancreatitis (3 or more Ranson's criteria).

Comparison of techniques for the detection of monocyte specific antigens.

Monocyte specific antigens are relevant in renal and bone marrow transplantation, but a reproducible monocyte-antigen system has not yet been recognized. In order to establish a sensitive test system with reproducible results in monocyte serology, 3 different monocyte cytotoxicity techniques were compared. In our hands the two-colour fluorescence test on post-Ficoll total leukocyte suspensions fulfilled the criteria.

Rehabilitation in a rural setting of a young quadriplegic accident victim. Integrative clinicopathological conference: medical, psychosocial, economic, preventive, and ethical dimensions of a case study.

Problems encountered by a young, unmarried woman who, as a result of a spinal injury in an automobile accident, loses use of all four limbs and requires complex home health care services delivered by a network of health and social service agencies in a rural area of Kentucky. Economic, psychosocial, ethical, preventive, and medical aspects of health care are discussed.

Comparison of needle catheter versus standard tube jejunostomy.

It is commonly stated that needle catheter jejunostomy (NCJ) is associated with fewer complications than standard tube jejunostomy (STJ). We compared the morbidity of NCJ versus STJ performed as adjunctive procedures in 90 patients from 1977 to 1983. NCJ was performed in 55 patients and STJ in 35 patients.

Effect of intestinal location on growth and function of neomucosa.

Growing intestinal neomucosa in patched intestinal defects has been investigated as a means of permanently increasing the absorptive capacity in the short bowel syndrome. Several factors, including luminal contents, appear to affect the growth and function of the neomucosa. The purpose of this study was to compare function and rate of growth of neomucosa in patched defects of the jejunum and ileum.

Surgical therapy for the short bowel syndrome.

The introduction of total parenteral nutrition has resulted in more patients surviving massive intestinal resection. Long-term parenteral nutrition is expensive, has potential complications, and causes inconvenience for the patient. Therefore, interest persists in surgical therapy for the short bowel syndrome.

Intestinal tapering and lengthening for short bowel syndrome.

Intestinal tapering and lengthening were performed in a child with short bowel syndrome to prevent the need for home parenteral nutrition. The intestinal lengthening was not successful, presumably because the vascular anatomy was not favorable. Significant clinical improvement and avoidance of home parenteral nutrition resulted from the tapering procedure.

Rapid microbiochemical method for presumptive identification of gastroenteritis-associated members of the family Enterobacteriaceae.

A method for rapid screening of isolates of pathogenic members of the family Enterobacteriaceae is described. Flow charts are used in conjunction with triple sugar iron agar, o-nitrophenyl-beta-D-galactopyranoside-phenylalanine-motility sulfate screening media, oxidase test, and six rapid biochemical tests, namely, lysine decarboxylase, urease, indole, esculin hydrolysis, malonate, and xylose. This scheme is used to provide an inexpensive but rapid presumptive identification of Salmonella, Shigella, Edwardsiella, Aeromonas, Plesiomonas, Vibrio, and Yersinia isolates from stool cultures.

Colistin-oxolinic acid blood agar: a selective medium for the isolation of Gardnerella vaginalis.

Colistin-oxolinic acid medium is proposed as a selective isolation medium for Gardnerella vaginalis. The medium is effective in inhibiting staphylococci and gram-negative bacteria while allowing growth of G. vaginalis.

Plasmacytoma of the parotid gland.

Extramedullary plasmacytoma of the parotid gland is an extremely rare lesion of which there have been only four other reported cases. The importance of these lesions rests in the possibility of their being a harbinger of multiple myeloma or their subsequent transformation to multiple myeloma. Because of its extreme rarity, the proper management remains unclear.

gamma-Aminobutyric acid plasma levels and brain binding in Eck fistula dogs.

It has been hypothesized that gamma-aminobutyric acid (GABA), the principle inhibitory neurotransmitter of the mammalian brain, contributes to the neural inhibition of hepatic encephalopathy. Eck fistulae were created in seven dogs and celiotomy alone performed in five dogs to determine plasma GABA levels, brain GABA binding, and synaptic membrane changes in dogs after creation of Eck fistulae. Eck fistula dogs lost 19 +/- 9% body weight, lost hair, ate poorly, and developed atrophic livers with classic hepatic histological changes.

Familial IgA nephropathy. Evidence of an inherited mechanism of disease.

The evaluation of familial glomerulonephritis in patients with IgA nephropathy who were from central and eastern Kentucky resulted in the discovery of potentially related pedigrees containing 14 patients. An additional 17 members of the pedigrees had clinical glomerulonephritis, and 6 had "chronic nephritis" noted on their death certificates. Six patients with IgA nephropathy had a common ancestor.

Prospective DR matching for first cadaver donor renal allografts and retransplantation.

From January 1981 through 1983 80 cadaver donor renal allografts were transplanted at a single center utilizing prospective HLA-DR matching. All patients received at least two blood transfusions prior to transplantation. One year actual allograft survival of 77% for initial grafts and 57% for retransplantation was observed.

Insertion of Hickman catheters. A comparison of cutdown and percutaneous techniques.

The insertion of Hickman catheters is useful in providing long-term vascular access in patients with a variety of conditions. Recently, enthusiasm has developed for the percutaneous insertion of the catheter because of the speed and ease of insertion. The insertion of 82 Hickman catheters in adults was reviewed.

Operative management of incidental cholelithiasis.

Incidental cholelithiasis was encountered at the time of celiotomy in 56 patients. Thirty-three of the patients underwent concomitant cholecystectomy. The overall morbidity and mortality were 27 and 3 percent, respectively, but only one complication (3 percent) was clearly related to the cholecystectomy.