266 results on '"Malt RA"'
Search Results
2. Accumulation and decay of messenger ribonucleic acid in mouse kidney
- Author
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Ouellett Aj and Malt Ra
- Subjects
Messenger ribonucleic acid ,Male ,Orotic Acid ,Messenger RNA ,Cytoplasm ,Sucrose ,Time Factors ,Polyadenylation ,RNA ,Kidney ,Biochemistry ,Molecular biology ,chemistry.chemical_compound ,Mice ,chemistry ,RNA, Ribosomal ,Animals ,Eukaryotic Small Ribosomal Subunit ,RNA, Messenger ,Sodium dodecyl sulfate ,Poly A - Abstract
The stability of polyadenylated messenger ribonucleic acid(mRNA) from cytoplasmic structures sedimenting faster than 40S was analyzed in normal mouse kidney. Incorporation of radioactivity into poly(A)-containing and poly(A)-lacking cytoplasmic RNAs separated by oligo(dT)-cellulose chromatography was determined after sedimentation of RNA IN SODIUM DODECYL SULFATE CONTAINING SUCROSE DENSITY GRADIENTS. Radioactivity accumulated in poly(A)-containing RNA during the first 6 h and then decayed exponentially. Beginning 8-12h after administering label, two components were evident in the decay curve of poly(A)-containing RNA; the short-lived component (approximately 57% of newly synthesized molecules) had an apparent half-life of 6h, and the second class (approximately 43% of new mRNA) was more stable, decaying with a 24-h half-life. These studies provide the basis for examining the regulation of mRNA stability during compensatory renal hypertrophy.
- Published
- 1976
3. Trisegmentectomy
- Author
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Malt, RA, Starzl, TE, Malt, RA, and Starzl, TE
- Published
- 1985
4. Accretion and turnover of RNA in the renoprival kidney
- Author
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Malt Ra and Lemaitre Da
- Subjects
Male ,Orotic Acid ,Carbon Isotopes ,Time Factors ,Body Weight ,RNA ,Proteins ,Astrophysics ,DNA ,Organ Size ,Biology ,Kidney ,Nephrectomy ,Accretion (finance) ,Mice ,Physiology (medical) ,Animals ,Ribosomes - Published
- 1968
5. Primary liver tumors: diagnosis by MR imaging
- Author
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Rummeny, E, primary, Weissleder, R, additional, Stark, DD, additional, Saini, S, additional, Compton, CC, additional, Bennett, W, additional, Hahn, PF, additional, Wittenberg, J, additional, Malt, RA, additional, and Ferrucci, JT, additional
- Published
- 1989
- Full Text
- View/download PDF
6. Differential labeling with orotic acid and uridine in compensatroy renal hypertrophy
- Author
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Ross, JS, primary, Malamud, D, additional, Caulfield, JA, additional, and Malt, RA, additional
- Published
- 1975
- Full Text
- View/download PDF
7. Colonic cancer induced by 1,2-dimethylhydrazine: promotion by experimental colitis
- Author
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Chester, JF, primary, Gaissert, HA, additional, Ross, JS, additional, Malt, RA, additional, and Weitzman, SA, additional
- Published
- 1989
- Full Text
- View/download PDF
8. Contribution of glomerular and tubular RNA synthesis to compensatory renal growth
- Author
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Vancura, P, primary, Miller, WL, additional, Little, JW, additional, and Malt, RA, additional
- Published
- 1970
- Full Text
- View/download PDF
9. Moore Medals
- Author
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Malt Ra
- Subjects
business.industry ,Medicine ,General Medicine ,business ,Classics - Published
- 1974
10. Surgical management of primary cutaneous melanomas of the hands and feet.
- Author
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Tseng JF, Tanabe KK, Gadd MA, Cosimi AB, Malt RA, Haluska FG, Mihm MC Jr, Sober AJ, and Souba WW
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Melanoma pathology, Middle Aged, Retrospective Studies, Skin Neoplasms pathology, Foot, Hand, Melanoma surgery, Skin Neoplasms surgery
- Abstract
Objective: The purpose of the study was to investigate the surgical management of cutaneous melanomas of the hands and feet., Summary Background Data: Prior studies suggest that patients with melanomes > 1-mm thick should be treated with excision with a 2-cm margin and undergo elective lymphadenectomy in selected circumstances. These recommendations are based primarily on data from melanomas of the trunk and extremities. Melanomas of the hands and feet are less common and less well studied. They pose a surgical challenge because primary wound closure often is difficult, and the incidence and management of regional node metastases are unclear., Methods: Charts of patients with melanomas of the hands or feet treated at the Massachusetts General Hospital between 1980 and 1994 were reviewed retrospectively. Local recurrence rates and the incidence of regional node metastases were analyzed as a function of histology, margin of excision, and microscopic thickness of the melanoma., Results: Data from 116 patients (39 men, 77 women) with melanomas of the hands (n = 26) and feet (n = 90) were evaluated. Pathologic diagnoses were: acral lentiginous melanoma (48 patients); subungual melanoma (13 patients), and skin of dorsum of the hand or foot (n = 55). Digital amputation was required in all 13 patients with subungual melanoma to maintain local control; still, nodal metastases developed in 46% of patients within 1 year. Seventy-one percent of patients with acral lentiginous melanoma presented with lesions > or = 1.5 mm, and nodes or systemic disease or both developed in 56% of patients. Acral lentiginous melanoma lesions < 1.5-mm thick were treated principally by excision with a 1-cm margin; a local recurrence or metastases did not develop in any of the patients. None of the patients with melanomas on the dorsum of the hand or foot < 1.5-mm thick had a local recurrence, but regional or systemic disease developed in > 50%. Local control in patients with lesions > 1.5-mm thick frequently required skin grafting or amputation. The majority of patients with melanomas > or = 1.5 mm in thickness undergoing elective lymph node dissection had histologically positive nodes for melanoma., Conclusions: Melanomas of the hands and feet < 1.5-mm thick have a low incidence of nodal metastases and are treated effectively with wide excision of the primary with a 1-cm margin. Thicker melanomas are associated with a > 50% rate of regional or systemic failure. In the absence of metastatic disease, these individuals should undergo local excision with a 2-cm margin and intraoperative lymphatic mapping followed by lymphadenectomy if the sentinel node is positive.
- Published
- 1997
- Full Text
- View/download PDF
11. Management of the short gut syndrome.
- Author
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Berger DL and Malt RA
- Subjects
- Gastrointestinal Transit, Humans, Intestinal Absorption, Intestine, Small physiopathology, Intestine, Small surgery, Intestine, Small transplantation, Parenteral Nutrition, Short Bowel Syndrome etiology, Short Bowel Syndrome physiopathology, Short Bowel Syndrome surgery
- Published
- 1996
12. Short-segment intestinal interposition of the distal esophagus.
- Author
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Gaissert HA, Mathisen DJ, Grillo HC, Malt RA, Wain JC, Moncure AC, Kim JH, Mueller PR, DeAngelis R, and Ottinger LW
- Subjects
- Adult, Aged, Anastomosis, Surgical methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Reoperation, Treatment Outcome, Colon transplantation, Esophageal Stenosis surgery, Esophagectomy methods, Gastroesophageal Reflux surgery, Jejunum transplantation
- Abstract
Esophageal replacement remains a challenge. Colon and jejunum provide alternative conduits to replace the lower esophagus when stomach is not suitable. Between 1971 and 1991, 41 patients underwent short-segment interposition of the esophagus with jejunum or colon. Indications were failed antireflux procedures (n = 21), nondilatable stricture (n = 9), achalasia (n = 2), moniliasis (n = 2), Barrett's esophagus with carcinoma in situ (n = 2), hemorrhagic esophagitis after esophagogastrectomy (n = 1), motility disorder (n = 1), instrumental perforation (n = 1), carcinoma (n = 1), and leiomyosarcoma (n = 1). Thirty-one patients (75.6%) had prior surgical procedures. Interposition with colon was performed in 22 patients and with jejunum in 19. Major complications occurred in 45% after colon interposition (10/22) and hospital mortality was 4.5% (1/22). Major complications after jejunal interposition occurred in 31% (6/19) and hospital mortality was 10.5% (2/19). A contained anastomotic leak occurred in 1 patient, perforation of a colon segment in 1, and jejunal graft necrosis in a third. Late functional results in 34 patients with a mean follow-up of 87 months were excellent or good in 26, fair in 5, and poor in 1. Colon interposition failed to improve symptoms in 2 patients with gastrointestinal motility disorders. Six patients underwent manometry and barium food provocation study. Two colon segments and 3 jejunal interpositions were hypoperistaltic or aperistaltic according to manometry. There was 1 case of aperistaltic jejunum with a distended afferent loop. When stomach is not available, successful palliation of swallowing can be accomplished with either jejunum or colon. Surgeons involved in the management of esophageal disease should be familiar with the technical details of both procedures.
- Published
- 1993
13. Complications and survival of multilumen central venous catheters used for total parenteral nutrition.
- Author
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Savage AP, Picard M, Hopkins CC, and Malt RA
- Subjects
- Bacterial Infections etiology, Catheterization, Central Venous mortality, Humans, Prospective Studies, Risk Factors, Time Factors, Catheterization, Central Venous adverse effects, Parenteral Nutrition, Total adverse effects, Parenteral Nutrition, Total mortality
- Abstract
In a prospective study of 879 triple-lumen catheters, 219 pulmonary artery catheters, 31 double-lumen and six single-lumen catheters used for the administration of total parenteral nutrition over a 1-year period, the overall complication rate was 12.5 per cent (14.7 complications per 1000 catheter-days) and the catheter-related sepsis rate 4.4 per cent (5.2 per 1000 catheter-days). The probability of development of catheter-related sepsis did not increase with the duration of catheterization. There were no differences in the rate of complications associated with 427 catheters changed by replacement at a new site compared with 159 lines changed over a guidewire. These data support the use of multilumen central venous catheters for the administration of total parenteral nutrition. They suggest that a routine weekly change of line is unnecessary; catheters should be changed only on the development of a complication. When it is required, a catheter should be changed by replacement over a guidewire.
- Published
- 1993
- Full Text
- View/download PDF
14. Isolation and long-term culture of human hepatocytes.
- Author
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Ryan CM, Carter EA, Jenkins RL, Sterling LM, Yarmush ML, Malt RA, and Tompkins RG
- Subjects
- Albumins metabolism, Cells, Cultured, Collagen, Culture Media, Cytological Techniques, Humans, Liver metabolism, Time Factors, Liver cytology
- Abstract
Pressure-controlled perfusion of specimens of surgical hepatic resection produced improved yields of human hepatocytes for studies of long-term cultures. The effect of an extracellular matrix configuration on albumin secretion was evaluated by culture on a single layer of collagen or between double layers of collagen gel with Dulbecco's modified Eagle and Williams E media. Hepatocytes from 12 patients were maintained for more than 30 days, and in five of 12 experiments cells were cultured beyond 2 months. In the double gels the cells demonstrated typical polygonal liver cell morphology and higher albumin secretion (p < 0.01) up to 65 days; in contrast, in the single gels cells spread horizontally, and albumin secretion declined rapidly within 3 weeks. A comparison of media formulations showed that maximum albumin secretion occurred 5 days later but was maintained significantly longer with Dulbecco's medium (p < 0.01). The simple addition of a second layer of gelled collagen forming a collagen sandwich significantly stabilizes and supports the long-term culture of human hepatocytes.
- Published
- 1993
15. Gallstones: role of surgery.
- Author
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Malt RA
- Subjects
- Anemia, Sickle Cell complications, Biliary Fistula complications, Cholecystitis complications, Cholecystostomy, Cholelithiasis complications, Colic etiology, Female, Gallbladder Diseases etiology, Gallbladder Neoplasms complications, Humans, Intestinal Fistula complications, Male, Postoperative Complications epidemiology, Recurrence, Cholecystectomy, Cholecystectomy, Laparoscopic, Cholelithiasis surgery
- Published
- 1992
- Full Text
- View/download PDF
16. Survival after hepatic resection for malignant tumours.
- Author
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Savage AP and Malt RA
- Subjects
- Adenoma, Bile Duct surgery, Carcinoma, Hepatocellular surgery, Humans, Liver Neoplasms surgery, Prognosis, Retrospective Studies, Risk Factors, Sarcoma mortality, Sarcoma surgery, Time Factors, Adenoma, Bile Duct mortality, Carcinoma, Hepatocellular mortality, Colorectal Neoplasms mortality, Hepatectomy, Liver Neoplasms mortality, Liver Neoplasms secondary
- Abstract
A retrospective analysis of 194 patients who underwent hepatic resection for primary or metastatic malignant disease from January 1962 to December 1988 was undertaken to determine variables that might aid the selection of patients for hepatic resection. Hepatic metastases were the indication for resection in 126 patients. The 5-year survival rate was 17 per cent. For patients with resected metastases from colorectal cancer (n = 104), the survival rate at 5 years was 18 per cent. The 5-year survival rate was 27 per cent when the resection margin was > 5 mm compared with 9 per cent when the margin was < or = 5 mm (P < 0.01). No patient with extrahepatic invasion, lymphatic spread, involvement of the resection margin or gross residual disease survived to 5 years, compared with a 23 per cent 5-year survival rate for patients undergoing curative resection (P < 0.02). The survival rate of patients with poorly differentiated primary tumours was nil at 3 years compared with a 20 per cent 5-year survival rate for patients with well or moderately differentiated tumours (P not significant). The site and Dukes' classification of the primary tumour, the sex and preoperative carcinoembryonic antigen level of the patient, and the number and size of hepatic metastases did not affect the prognosis. The 5-year survival rate for patients with hepatocellular carcinoma (n = 42) was 25 per cent. An improved survival rate was found for patients whose alpha-fetoprotein level was normal (37 per cent at 5 years) compared with those having a raised level (nil at 3 years) (P < 0.01). Involvement of the resection margin, extrahepatic spread and spread to regional lymph nodes were associated with an 8 per cent 5-year survival rate versus 44 per cent for curative resection (P < 0.005). The presence of cirrhosis, the presence of symptoms, and the multiplicity and size of the tumour did not affect the prognosis. The 5-year survival rate of 11 patients with hepatic sarcoma was 25 per cent. No patient with peripheral cholangiocarcinoma survived to 1 year in contrast to patients with hilar cholangiocarcinoma, all four of whom survived for more than 14 months.
- Published
- 1992
- Full Text
- View/download PDF
17. Elective and emergency hepatic resection. Determinants of operative mortality and morbidity.
- Author
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Savage AP and Malt RA
- Subjects
- Chi-Square Distribution, Emergencies, Hepatectomy methods, Hepatectomy statistics & numerical data, Humans, Length of Stay, Liver Neoplasms mortality, Liver Neoplasms pathology, Liver Neoplasms surgery, Morbidity, Neoplasm Metastasis, Postoperative Complications mortality, Postoperative Period, Retrospective Studies, Survival Rate, Time Factors, Hepatectomy mortality
- Abstract
To determine the reasons for improved mortality and morbidity rates after major hepatic resection, five variables were analyzed retrospectively in 300 patients operated on over a 27-year period: (1) the indication for surgery, (2) the surgical approach, (3) the urgency with which surgery was performed, (4) the nature of the surgical procedure, and (5) the experience of the surgeon. The operative mortality rate decreased from 19% between 1962 and 1979 to 9.7% between 1980 and 1988 (p less than 0.05). The operative mortality rates for patients undergoing resection for benign hepatic neoplasms was 3.4%; for metastatic tumors, 6.3%; for primary hepatic malignancies, 19%; and for trauma, 33%. Fifty-seven percent of operations before 1980 were performed through a thoracoabdominal exposure as compared with 19% after 1980. Overall a thoracoabdominal exposure of the liver was associated with a 20% mortality rate as compared with 8.6% for operations with abdominal exposure of the liver (p less than 0.02). Elective operations accounted for 65% of hepatic resections before 1980, as compared with 90% after 1980, and were associated with an 8.8% mortality rate as compared with 30.7% for urgent and emergency operations (p less than 0.001). Segmental and wedge resections were associated with a 5.3% mortality rate as compared with 14.7% for major hepatic resections (p less than 0.05), but this difference did not affect overall operative mortality rates because there was no change in the proportion of major hepatic resections after 1980. Surgical experience was not a determinant of operative mortality or morbidity rates in elective operations. Although there was no reduction in the complication rate after 1980, there was a reduction in postoperative stay from 26 days before 1980 to 16 days after 1980 (p less than 0.001). A reduction in the incidence of postoperative sepsis and a change in its management was associated with improved operative mortality rates.
- Published
- 1991
- Full Text
- View/download PDF
18. Renal angiomyolipoma with sarcomatous transformation and pulmonary metastases.
- Author
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Ferry JA, Malt RA, and Young RH
- Subjects
- Biopsy, Needle, Female, Humans, Hyperplasia pathology, Liver pathology, Lung pathology, Middle Aged, Hemangioma pathology, Kidney Neoplasms pathology, Lipoma pathology, Lung Neoplasms secondary, Sarcoma pathology
- Abstract
We report the case of a 49-year-old woman with a large renal angiomyolipoma that invaded the liver. In some areas, the tumor had the appearance of a typical angiomyolipoma; however, it also had foci where the spindle cells of the lesion showed marked cytologic atypia and mitotic activity, giving it the appearance of a high-grade sarcoma. Immunohistochemical studies demonstrated expression of vimentin, desmin, and muscle-specific actin by the sarcoma cells; these findings were consistent with leiomyosarcoma. A second, small typical angiomyolipoma was also present in the kidney. In addition, the liver exhibited focal nodular hyperplasia. Three weeks after resection of the primary renal tumor, pulmonary metastases were diagnosed by fine-needle aspiration biopsy. This is the first report of a case of angiomyolipoma with sarcomatous transformation and biopsy-proven metastatic disease.
- Published
- 1991
- Full Text
- View/download PDF
19. MR demonstration of edema adjacent to a liver metastasis: pathologic correlation.
- Author
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Lee MJ, Saini S, Compton CC, and Malt RA
- Subjects
- Humans, Male, Middle Aged, Rectal Neoplasms pathology, Edema diagnosis, Edema pathology, Liver Diseases diagnosis, Liver Diseases pathology, Liver Neoplasms secondary, Magnetic Resonance Imaging
- Published
- 1991
- Full Text
- View/download PDF
20. Practical surgeons doing basic research.
- Author
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Malt RA
- Subjects
- Career Choice, General Surgery, Research
- Published
- 1991
21. Prediction of risk in noncardiac operations after cardiac operations.
- Author
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Michel LA, Jamart J, Bradpiece HA, and Malt RA
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Male, Middle Aged, Postoperative Complications mortality, Prognosis, Prospective Studies, Reoperation, Reproducibility of Results, Retrospective Studies, Risk, Survival Rate, Cardiac Surgical Procedures, Postoperative Complications epidemiology
- Abstract
To determine the preoperative variables affecting the mortality rate and the development of severe complications in patients who have had myocardial revascularization or a valve replacement and who then undergo a noncardiac operation, we retrospectively studied data from 120 such patients over the 5 years from 1982 through 1986. Thirty-six percent of patients had a noncardiac operation during the first month after the cardiac operation. The mortality rate was 11%, and the morbidity rate was 56%. The statistical comparison of the predictive accuracy of postoperative complications of three simple, widely used classifications (American Society of Anesthesiologists physical status, New York Heart Association classification, Massachusetts General Hospital cardiac risk index) demonstrated the superiority of the simplified three-class cardiac risk index (Massachusetts General Hospital-cardiac risk index; predictive accuracy of 84%). In a multivariate discriminant analysis of 21 variables in this population, five variables (myocardial infarction in previous 6 months, S3 gallop or jugular vein distention, arrhythmia on last preoperative electrocardiogram, emergency operation, delay between cardiac and noncardiac operation) were identified as being the most predictive of a postoperative complication. When these variables were used in the function (DF3) obtained by linear discriminant analysis, the prediction accuracy of a postoperative complication reached 83%. Performance of the new models in a prospective validation population remained satisfactory (75% for Massachusetts General Hospital-cardiac risk index three-class index and 72% for DF3). Extensive statistical analysis of our data tested by a validation study provided simple predictive models based on clinical variables easily available even in emergency situations.
- Published
- 1990
22. Expression of two "immediate early" genes, Egr-1 and c-fos, in response to renal ischemia and during compensatory renal hypertrophy in mice.
- Author
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Ouellette AJ, Malt RA, Sukhatme VP, and Bonventre JV
- Subjects
- Animals, Hypertrophy, Kidney pathology, Kidney physiology, Male, Mice, Proto-Oncogene Proteins c-fos, RNA, Messenger analysis, DNA-Binding Proteins genetics, Gene Expression Regulation, Ischemia genetics, Kidney blood supply, Metalloproteins genetics, Proto-Oncogene Proteins genetics, Proto-Oncogenes
- Abstract
To identify specific genetic regulatory mechanisms associated with renal ischemia, we measured the accumulation of Egr-1 and c-fos mRNAs in the mouse kidney after occlusion of the renal artery and reperfusion. At 1 h after right nephrectomy and arterial occlusion of the contralateral kidney for 10 or 30 min, Egr-1 mRNA levels were three to five times greater in these kidneys as compared with those in control animals that had sustained unilateral nephrectomy alone and were much greater than levels in the normal organ. Whether ischemia was imposed for 10 or for 30 min, renal Egr-1 mRNA contents were equivalent and remained elevated after 24 h of reperfusion subsequent to 30 min of ischemia. Although c-fos mRNA also accumulated in response to ischemia and reperfusion, the pattern differed from that of Egr-1 in that c-fos mRNA content varied with the duration of ischemia and was undetectable 24 h after injury. Contralateral nephrectomy was not necessary to see the marked accumulation of Egr-1 and c-fos mRNAs with unilateral ischemia. Reflow was necessary, however, since only minimal sequence accumulation occurred by the end of the ischemic period. After left uninephrectomy alone, Egr-1 mRNA levels in the remaining kidney were maximal 30 min after surgery, but were not detectable thereafter; c-fos mRNA levels did not change after unilateral nephrectomy. Differential expression of early growth-related genes implicated in transcriptional activation may influence tissue recovery after renal ischemia.
- Published
- 1990
- Full Text
- View/download PDF
23. Simulation of gallstone fragments by cavitation bubbles during extracorporeal shock wave lithotripsy: physical basis and in vitro demonstration.
- Author
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Brink JA, Simeone JF, Saini S, Mueller PR, de Correia-Kamat MR, Malt RA, Staritz M, Delius M, and Ferrucci JT
- Subjects
- Bile, Gases, Humans, Models, Structural, Cholelithiasis therapy, Lithotripsy, Ultrasonography
- Abstract
During extracorporeal shock wave lithotripsy of gallstones, sonography often shows a swirling pattern of echogenic foci shortly after the application of shock waves. This effect has been thought to represent gallstone fragments in suspension. However, evidence suggests that this finding is in part due to cavitation, a physical phenomenon associated with the formation or movement of gas bubbles in the fluid-filled gallbladder. Condoms filled with degassed water and five human bile specimens were positioned in the focus of an MPL 9000 lithotriptor (Dornier Medical Systems, Munich). A solitary nonradiopaque gallstone was then added to a bile-filled condom, and the sonographic pattern was observed before and after fragmentation. The mean clearance time of the cavitation bubbles was 4 seconds for degassed water and 22 seconds for human bile. Gallstone fragments were distinguished from cavitation bubbles by their prolonged settling time (up to 30 minutes) along the dependent gallbladder wall.
- Published
- 1990
- Full Text
- View/download PDF
24. Jejunal mucosal DNA content and maturation. Inverse relation to serum gastrin levels in suckling and weanling rats.
- Author
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De Vries JE, Ford WD, Boelhouwer RU, King WW, Oscarson JE, Ross JS, Thorell J, and Malt RA
- Subjects
- Animals, Colon analysis, Colon growth & development, Gastrectomy, Gastric Fundus physiology, Gastrins physiology, Intestinal Mucosa growth & development, Jejunum growth & development, Male, Pyloric Antrum physiology, Rats, Rats, Inbred Strains, Sucrase analysis, Weaning, Animals, Newborn growth & development, DNA analysis, Gastrins blood, Intestinal Mucosa metabolism, Jejunum metabolism
- Abstract
Although pentagastrin has a tropic action on intestinal mucosa in suckling rat pups, and at weaning a rise in gastrin levels coincides with maturation of the intestinal mucosa, direct correlations of serum gastrin levels and intestinal maturation have yet to be made. Ten-day-old rats were subjected either to antrectomy to produce a 43% decrease in serum gastrin levels or to fundectomy to produce a 319% increase over gastrin levels in rumenectomized or normal animals. These changes were not associated with tropic or adaptive changes in jejunal or colonic mucosa as determined by jejunal and colonic DNA content, jejunal sucrase activity, jejunal villous height, or crypt depths in jejunum and colon at the beginning (day 15), middle (day 21), or end (day 27) of the weaning period. To the contrary, an inverse relation was found between serum gastrin levels and both jejunal mucosal DNA content and sucrase activity as an index of maturation.
- Published
- 1985
- Full Text
- View/download PDF
25. [21-year-old woman with apparent hepatic mass after treatment of amenorrhea].
- Author
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Malt RA and Compton CC
- Subjects
- Adult, Amenorrhea drug therapy, Carcinoma, Hepatocellular chemically induced, Carcinoma, Hepatocellular surgery, Diagnosis, Differential, Female, Gonadal Steroid Hormones adverse effects, Humans, Liver pathology, Liver Neoplasms chemically induced, Liver Neoplasms surgery, Liver Transplantation, Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology
- Published
- 1988
26. Dimethylhydrazine-induced colonic neoplasia: dissociation from endogenous gastrin levels.
- Author
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Oscarson JE, Veen HF, Ross JS, and Malt RA
- Subjects
- 1,2-Dimethylhydrazine, Animals, Colonic Neoplasms chemically induced, Dimethylhydrazines, Gastric Fundus surgery, Male, Neoplasms, Experimental blood, Neoplasms, Experimental chemically induced, Pyloric Antrum surgery, Rats, Colonic Neoplasms blood, Gastrins blood
- Abstract
The potential tropic effect of gastrin in promoting colonic carcinogenesis was tested in rats (n = 133) with 6- to 16-fold variations in endogenous gastrin resulting from antrectomy or fundectomy, followed by 12 injections of 1,2-dimethylhydrazine (10 mg/kg). The incidence and grade of differentiation of resulting tumors, as well as the thickness, content of nucleic acids, and specific activity of DNA in colonic mucosa, were similar in both high-gastrin and low-gastrin animals and were unchanged from data in unoperated control animals receiving only the carcinogen. Long-term changes in endogenous gastrin concentration are not followed by colonic mucosal tropic effects, and gastrin does not act as a cofactor in dimethylhydrazine-induced carcinogenesis at this dosage.
- Published
- 1982
27. Growth and metabolic alterations after submandibular sialadenectomy in male mice.
- Author
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Li AK, Schattenkerk ME, De Vries JE, Ford WD, and Malt RA
- Subjects
- Aging, Animals, Body Weight, Epidermal Growth Factor physiology, Male, Mice, Nerve Growth Factors physiology, Fertility, Growth, Oxygen Consumption, Submandibular Gland physiology
- Abstract
Because the submandibular salivary glands of male mice are rich in growth factors such as epidermal growth factor and nerve growth factor, and because there are sporadic reports of sialadenectomized mice showing growth retardation and endocrine abnormalities, we studied oxidative metabolism and fertility after submandibular sialadenectomy. Despite similar intake of food, male mice (n = 60) deprived of submandibular saliva, either by duct ligation or gland excision, initially weighed 12-13% less than the sham controls and had a slower rate of growth (P less than 0.001). After 5 mo, mice with duct ligation caught up with the sham-operated mice, but the differences compared with submandibular-sialadenectomized mice were still apparent at 32 wk (P less than 0.001). The mean respiratory quotient of submandibular-sialadenectomized and duct-ligated mice was 0.71 instead of 0.88 as in the shams at 10, 20, and 30 wk after operation (P less than 0.01). No effect on fecundity was observed in either male or female mice following submandibular sialadenectomy.
- Published
- 1983
- Full Text
- View/download PDF
28. Surgery of the stomach, duodenum, gallbladder, and bile ducts.
- Author
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Welch CE and Malt RA
- Subjects
- Biliary Tract Diseases surgery, Gastrointestinal Diseases surgery, Gastrointestinal Neoplasms surgery, Humans, Bile Ducts surgery, Duodenum surgery, Gallbladder surgery, Stomach surgery
- Published
- 1987
- Full Text
- View/download PDF
29. Abdominal surgery (third of three parts).
- Author
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Welch CE and Malt RA
- Subjects
- Abdominal Muscles surgery, Abscess surgery, Cholelithiasis complications, Humans, Pancreas surgery, Pancreas Transplantation, Pancreatic Neoplasms surgery, Pancreatitis surgery, Postoperative Complications, Preoperative Care, Radiography, Abdominal, Spherocytosis, Hereditary therapy, Spleen surgery, Splenectomy, Abdomen surgery, Digestive System Diseases surgery
- Published
- 1983
- Full Text
- View/download PDF
30. Skin lesions suspected to be melanoma should be photographed. Gross morphological features of primary melanoma associated with metastases.
- Author
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Day CL Jr, Mihm MC Jr, Sober AJ, Fitzpatrick TB, Malt RA, Kopf AW, Lew RA, and Harrist TJ
- Subjects
- Biopsy, Color, Humans, Pigmentation, Prognosis, Risk, Melanoma pathology, Neoplasm Metastasis pathology, Photography, Skin Neoplasms pathology
- Abstract
We reviewed photographs of 256 primary cutaneous melanomas to determine the gross morphological correlates of metastases. Seven and a half years after diagnosis, the melanomas with ulceration occupying at least 80% of their surface had the highest rate of metastases (85%), and melanomas without a nodule had the lowest metastatic rate (11%). Melanomas with nodules had a metastatic rate of 62%, and this rate increased in direct proportion to nodule diameter. Even after adjusting for nodule diameter and ulceration, melanomas with single nodules located completely within the confines of an associated plaque had half of the metastatic rate of melanomas with nodules located at the periphery (abutting normal skin). These data suggest that (1) carefully recorded gross pathological data can augment the microscopic pathological data in the determination of prognosis; (2) skin lesions suspected to be melanoma should be photographed; (3) the photograph, if followed by surgical removal of the lesion, should be attached to the pathology report in the patient's permanent medical record; (4) nodule diameter is better correlated with metastases than the total lesion diameter (as traditionally held); and (5) the cytologically malignant melanocytes that constitute the less-raised portion of most melanomas may not be biologically malignant, thus enlarging the precursor concept for malignant melanoma. The TNM staging system for malignant melanoma could be modified to incorporate these data.
- Published
- 1982
31. Potentiation of 1,2-dimethylhydrazine-induced anal carcinoma by epidermal growth factor in mice.
- Author
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Kingsnorth AN, Abu-Khalaf M, Ross JS, and Malt RA
- Subjects
- 1,2-Dimethylhydrazine, Adenoma chemically induced, Animals, Anus Neoplasms metabolism, Anus Neoplasms pathology, Body Weight, Carcinoma, Squamous Cell chemically induced, DNA, Neoplasm metabolism, Male, Mice, RNA, Neoplasm metabolism, Anus Neoplasms chemically induced, Dimethylhydrazines pharmacology, Epidermal Growth Factor pharmacology, Methylhydrazines pharmacology
- Abstract
Because epidermal growth factor (EGF) can modify cell proliferation in the gastrointestinal tract, effects of EGF were studied on the development of colonic, rectal, and anal neoplasms in male mice treated with 1,2-dimethylhydrazine (DMH) (20 mg/kg/wk for 20 weeks). DMH treatment caused a 13% increase in colonic RNA content, a 16% increase in DNA content, and 28% greater crypt depth. EGF (5 micrograms on alternate days during weeks 20 to 22) administered to DMH-treated mice produced no additional changes in colonic mucosa. At 30 weeks colorectal tumors were present in 13 of 20 mice treated with DMH (mean number of tumors per mouse 2.3 +/- 0.5) and 18 of 24 mice (mean 2.6 +/- 0.7) treated with DMH and EGF. Anal tumors were present in two of 20 DMH-treated mice (mean 0.1 +/- 0.07) but in eight of 24 DMH-EGF-treated mice (mean 0.33 +/- 0.1) (X2 = 4.84; p less than 0.05 for prevalence). Although EGF in this dose has no effect on the frequency of colorectal adenocarcinomas, the frequency of anal squamous cell carcinomas is increased more than three fold.
- Published
- 1985
32. A prognostic model for clinical stage I melanoma of the upper extremity. The importance of anatomic subsites in predicting recurrent disease.
- Author
-
Day CL Jr, Sober AJ, Kopf AW, Lew RA, Mihm MC Jr, Hennessey P, Golomb FM, Harris MN, Gumport SL, Raker JW, Malt RA, Cosimi AB, Wood WC, Roses DF, Gorstein F, Postel A, Grier WR, Mintzis MN, and Fitzpatrick TB
- Subjects
- Forearm, Hand, Humans, Melanoma pathology, Neoplasm Staging, Prognosis, Prospective Studies, Skin pathology, Skin Neoplasms pathology, Time Factors, Arm, Melanoma mortality, Models, Biological, Neoplasm Recurrence, Local epidemiology, Skin Neoplasms mortality
- Abstract
Thirteen variables were studied for their relative usefulness in predicting recurrent disease in 107 patients with clinical Stage I melanoma of the upper extremity. After a mean follow-up period of 54 months, the only patents who have had recurrent disease to date are those who primary lesions were located either on the hand or posterior upper arm. The five-year disease-free survival role for 44 patients with melanoma at these sites was 68%. None of 63 patients with melanoma located on the forearm of anterior upper arm have had recurrent disease (i.e., the five-year, disease-free survival rate was 100% (p = 0.00004), compared with the hand or posterior arm group). A Cox proportional hazards (multivariate) analysis demonstrated that two primary tumor histologic variable, thickness in millimeters and ulceration, interacted to produce the best prognostic model for those 44 patients with melanoma of the hand or posterior upper arm. Twenty-one patients with primary lesions at these sites had primary tumors less than 2.25 mm in thickness and no evidence of ulceration histologically. Their five-year, disease-free survival role was 95%. For the remaining 23 patients with primary tumors on the hand or posterior upper arm who had either histologic evidence of ulceration or primary tumors greater than or equal to 2.25 mm, the five-year disease-free survival rate was 37% (p = 0.002, compared with group nonulcerated, thin lesions). The excellent survival rate for patients with melanomas on the forearm or anterior upper arm was not completely explained by pathologic stage, by primary tumor thickness, or by histologic ulceration of the primary tumor.
- Published
- 1981
- Full Text
- View/download PDF
33. Adenocarcinoma and lymphoma of the small intestine. Distribution and etiologic associations.
- Author
-
Williamson RC, Welch CE, and Malt RA
- Subjects
- Adult, Aged, Carcinoid Tumor etiology, Duodenal Neoplasms etiology, Female, Humans, Ileal Neoplasms etiology, Immunity, Innate, Intestinal Mucosa immunology, Jejunal Neoplasms etiology, Leiomyosarcoma etiology, Lymphoma, Large B-Cell, Diffuse etiology, Male, Middle Aged, Neoplasms, Multiple Primary etiology, Adenocarcinoma etiology, Intestinal Neoplasms etiology, Lymphoma etiology
- Abstract
Malignant small-bowel tumors in 171 patients over 64 years included 68 with adenocarcinomas, 41 with primary lymphomas, 50 with carcinoids, and 12 with sarcomas. The distribution of the carcinomas showed approximately 80% preponderance in the duodenum and proximal jejunum. A similar distribution in the upper small bowel in small-bowel carcinomas induced in Fischer and Sprague-Dawley rats by azoxymethane (90-160 mg/kg) suggests defense mechanisms within ileal mucosa. The clinical series from 1958 to 1976 included two Crohn's carcinomas (jejunum, defunctioned ileum), two jejunal cancers (lymphoma, carcinoma) associated with celiac disease, two duodenal carcinomas arising in villous adenomas, and one jejunal lymphoma following exposure to irradiation. Multiple primary malignancies were found in 20 to 25% of enteric cancers. Hemorrhage was more common with carcinoma than lymphoma, but lymphomas predominated considering perforation or a palpable mass. Both carcinoma and lymphoma had 75 to 80% resectability rates and 14 to 15% five-year postoperative survival rates. The prognosis was least poor for carcinoma of the jejunum, one third of patients with "curative" resections surviving five years.
- Published
- 1983
- Full Text
- View/download PDF
34. Abdominal surgery (first of three parts).
- Author
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Welch CE and Malt RA
- Subjects
- Anti-Bacterial Agents therapeutic use, Appendectomy, Crohn Disease surgery, Duodenal Ulcer surgery, Duodenum surgery, Esophageal Stenosis surgery, Esophagus surgery, Gastritis surgery, Gastroesophageal Reflux surgery, Hernia, Hiatal surgery, Humans, Ileostomy, Intestinal Obstruction surgery, Intestine, Small surgery, Stomach surgery, Stomach Neoplasms surgery, Stomach Ulcer surgery, Zollinger-Ellison Syndrome surgery, Abdomen surgery, Gastrointestinal Diseases surgery
- Published
- 1983
- Full Text
- View/download PDF
35. Transmission of infectious agents by inadequately sterilized ENT instruments.
- Author
-
Malt RA
- Subjects
- Disinfection, Equipment Contamination, Humans, Infections transmission, Otolaryngology instrumentation
- Published
- 1989
36. Total parenteral nutrition inhibits intestinal adaptive hyperplasia in young rats: reversal by feeding.
- Author
-
Ford WD, Boelhouwer RU, King WW, de Vries JE, Ross JS, and Malt RA
- Subjects
- Adaptation, Physiological, Animals, Body Weight, DNA analysis, Hyperplasia, Intestinal Mucosa analysis, Intestinal Mucosa pathology, Intestine, Small physiopathology, Intestine, Small surgery, Male, RNA analysis, Rats, Rats, Inbred Strains, Sucrase analysis, Time Factors, Food, Intestine, Small pathology, Parenteral Nutrition adverse effects, Parenteral Nutrition, Total adverse effects
- Abstract
To determine whether the inhibition of intestinal adaptation by total parenteral nutrition (TPN) in young growing animals is reversible, 130 7-week-old rats with 70% resection of the midportion of the small bowel were given an amino acid and glucose TPN solution parenterally or orally or a chow diet for 10 days. After TPN administration, villous height, crypt depth, DNA and RNA content, RNA:DNA ratio, and sucrase activity were decreased. After returning to 4 weeks of chow feeding, rats given TPN achieved similar body weight and 15% greater intestinal length as compared with rats fed chow from the start, although their jejunal villous height, ileal crypt depth, and RNA:DNA were decreased. Therefore, the inhibition by TPN of intestinal adaptation after intestinal resection in young growing rats is largely reversible. Furthermore, oral feeding of a high-calorie, high-protein liquid diet before feeding of a normal diet appears to promote adaptation after intestinal resection in immature, growing rats.
- Published
- 1984
37. Left intrahepatic cholangiojejunostomy for proximal obstruction of the biliary tract.
- Author
-
Malt RA, Warshaw AL, Jamieson CG, and Hawk JC 3rd
- Subjects
- Adult, Aged, Biliary Tract Neoplasms complications, Cholestasis, Intrahepatic etiology, Female, Humans, Male, Methods, Middle Aged, Bile Ducts, Intrahepatic surgery, Cholestasis, Intrahepatic surgery, Jejunum surgery
- Abstract
Good palliation from high neoplastic obstruction of the biliary system was achieved by direct anastomosis of the duct draining hepatic segment III to a Roux-en-Y loop of jejunum in six patients. Roentgenologically guided transcutaneous drainage of intrahepatic ducts may be desirable as a preliminary to surgical drainage in severely icteric patients. With improvements in methods of transcutaneous intubation, the selection of proper patients for surgical drainage will be a fine point of judgment.
- Published
- 1980
38. Pseudotumor at the confluence of the hepatic ducts as a pitfall of percutaneous transhepatic cholangiography.
- Author
-
Li AK, Warshaw AL, and Malt RA
- Subjects
- Aged, Cholestasis etiology, Cholestasis, Extrahepatic diagnostic imaging, Diagnosis, Differential, Diagnostic Errors, Female, Hepatic Duct, Common diagnostic imaging, Humans, Male, Middle Aged, Necrosis, Pancreas pathology, Bile Duct Neoplasms diagnostic imaging, Biliary Tract Neoplasms diagnostic imaging, Cholangiography, Cholelithiasis diagnostic imaging, Cholestasis diagnostic imaging, Pancreatic Diseases diagnostic imaging
- Abstract
Four patients with jaundice who had misleading diagnoses as a result of percutaneous transhepatic cholangiography are reported upon. Three of these patients actually had calculous disease and the fourth had pancreatic disease. The levels of obstruction were also roentgenographically inaccurate in three of the four patients. The primary cause of the error appears to be poor mixing of the contrast material with viscid stagnant bile, resulting in blurred definition and failure of the contrast material to traverse the common bile duct.
- Published
- 1981
39. Occasional notes. Portal hypertension, 1979.
- Author
-
Malt RA, Nabseth DC, Orloff MJ, and Stipa S
- Subjects
- Budd-Chiari Syndrome surgery, Child, Congresses as Topic, Esophageal and Gastric Varices surgery, Esophageal and Gastric Varices therapy, Hepatic Encephalopathy therapy, Humans, Italy, Methods, Portacaval Shunt, Surgical, Postoperative Complications, Prognosis, Renal Veins, Risk, Schistosomiasis surgery, Splenectomy, Splenic Vein surgery, Hypertension, Portal surgery
- Published
- 1979
- Full Text
- View/download PDF
40. Effects of alpha-difluoromethylornithine and 5-fluorouracil on the proliferation of a human colon adenocarcinoma cell line.
- Author
-
Kingsnorth AN, Russell WE, McCann PP, Diekema KA, and Malt RA
- Subjects
- Cell Cycle drug effects, Cell Line, Cell Survival drug effects, Eflornithine, Humans, Kinetics, Ornithine toxicity, Putrescine metabolism, Spermidine metabolism, Adenocarcinoma physiopathology, Antineoplastic Agents toxicity, Fluorouracil toxicity, Ornithine analogs & derivatives
- Abstract
Because alpha-difluoromethylornithine (DFMO) reduces the incidence of experimental colon cancers, inhibits the growth of human lung cancer cells and human leukemia cells in culture, and in combination with methylglyoxal (bis)guanylhydrazone induces remission in children with leukemia, its effectiveness against a human colon adenocarcinoma cell line (Colo 205) was tested alone and in combination with 5-fluorouracil (5-FU). Both DFMO (2 X 10(-4) M) and 5-FU (10(-6) M) inhibited Colo 205 cell proliferation. Above 5 X 10(-4) M DFMO (p less than 0.001) and at 10(-4) M 5-FU (p less than 0.001), Colo 205 growth was completely inhibited. Although DFMO did not sensitize Colo 205 cells to a noninhibitory concentration of 5-FU, the effectiveness of inhibitory concentrations of 5-FU and DFMO in reducing Colo 205 cell growth was additive. DFMO (2 X 10(-4) M) caused 89 to 93% inhibition of ornithine decarboxylase activity (p less than 0.001) and reduced levels of putrescine (93%; p less than 0.01) and spermidine (57%; p less than 0.02). Growth rate and the intracellular putrescine and spermidine contents were restored by 10(-6) M putrescine. DFMO could be an effective chemotherapeutic agent against human colonic cancer because of its effects at such unusually low concentrations in vitro.
- Published
- 1983
41. Narrower margins for clinical stage I malignant melanoma.
- Author
-
Day CL Jr, Mihm MC Jr, Sober AJ, Fitzpatrick TB, and Malt RA
- Subjects
- Humans, Melanoma mortality, Melanoma pathology, Methods, Neoplasm Metastasis, Skin Neoplasms mortality, Skin Neoplasms pathology, Melanoma surgery, Skin Neoplasms surgery
- Published
- 1982
- Full Text
- View/download PDF
42. Side-to-side portacaval shunt versus nonsurgical treatment of Budd-Chiari syndrome.
- Author
-
Malt RA, Dalton JC, Johnson RE, and Gurewich V
- Subjects
- Adult, Ascites surgery, Budd-Chiari Syndrome surgery, Female, Hepatic Veins diagnostic imaging, Hepatomegaly, Humans, Middle Aged, Radiography, Vena Cava, Inferior diagnostic imaging, Budd-Chiari Syndrome therapy, Portacaval Shunt, Surgical
- Abstract
Although a side-to-side portacaval shunt will relieve some patients with Budd-Chiari syndrome, distinction between relief as a result of operation and spontaneous recovery may be inexact. A nonshunting operation relieved one of two patients as much as a side-to-side portacaval shunt did. In these two patients and one additional patient, streptokinase therapy may have been beneficial.
- Published
- 1978
- Full Text
- View/download PDF
43. Rapid reversal of compensatory renal hypertrophy after withdrawal of the stimulus.
- Author
-
Dijkhuis CM, van Urk H, Malamud D, and Malt RA
- Subjects
- Animals, Body Weight, DNA metabolism, Hypertrophy, Kidney anatomy & histology, Kidney metabolism, Male, Nephrectomy, Organ Size, Parabiosis, RNA metabolism, Rats, Time Factors, Kidney physiology
- Abstract
The permanence of the early phases of compensatory renal hypertrophy was tested by interrupting vascular parabiosis between an anephric rat and a normal rat after 48 hours. At the time of interruption, the weights and the ratio of ribonucleic acid (RNA) content to deoxyribonucleic acid (DNA) content of the kidneys were the same as those of the remaining kidney in a single rat subjected to unilateral nephrectomy, previously reported. Within 12 hours after parabiosis was stopped, renal mass and nucleic acid concentrations returned to normal. Compensatory hypertrophy could be produced again by unilateral nephrectomy. Regression of the early phase of compensatory hypertrophy appears to be faster than muscular atrophy produced by disuse or denervation. Compensatory hypertrophy can be activated at least twice.
- Published
- 1975
44. Transhepatic embolization of varices: a surgeon's view.
- Author
-
Malt RA
- Subjects
- Catheterization, Esophageal and Gastric Varices mortality, Esophageal and Gastric Varices surgery, Gastrointestinal Hemorrhage therapy, Humans, Embolization, Therapeutic methods, Esophageal and Gastric Varices therapy
- Published
- 1980
- Full Text
- View/download PDF
45. Extracorporeal shock-wave lithotripsy of gallstones: Boston experience with the Dornier MPL 9000 lithotripter.
- Author
-
Malt RA, Rothschild JG, Holbrook RF, Mueller PR, Simeone JF, Latta WB, Kimball WR, and Reinhold RB
- Subjects
- Boston, Cholelithiasis pathology, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Cholelithiasis therapy, Lithotripsy instrumentation
- Abstract
After the success of shock-wave therapy for fragmentation of renal stones, machines for shock-wave therapy of gallbladder stones were quick to follow. In Munich, gallstones were successfully treated in 174 of 175 patients who were also taking ursodiol to help solubilize the calculous rubble left after treatment. In Boston, of the initial 87 patients accepted, 58 were treated for a single stone (mean diameter 15.7 mm), 16 were treated for 2 stones, and 13 for 3 stones. Although reporting of exact results is not possible before the Food and Drug Administration issues a clearance, it is fair to say that both patients and physicians are generally pleased with the results.
- Published
- 1989
- Full Text
- View/download PDF
46. Abnormal sex-steroid milieu in young adults with hepatocellular carcinoma.
- Author
-
Malt RA, Galdabini JJ, and Jeppsson BW
- Subjects
- Adult, Carcinoma, Hepatocellular therapy, Female, Humans, Liver Neoplasms therapy, Male, Carcinoma, Hepatocellular etiology, Contraceptives, Oral adverse effects, Liver Neoplasms etiology, Methyltestosterone adverse effects
- Published
- 1983
- Full Text
- View/download PDF
47. Student's test and the kangaroo curve.
- Author
-
Malt RA
- Subjects
- History, 19th Century, History, 20th Century, Mathematics history, United Kingdom, Wit and Humor as Topic, Writing, Famous Persons, Statistics as Topic
- Published
- 1977
- Full Text
- View/download PDF
48. Fat-based (Intralipid 20%) versus carbohydrate-based total parenteral nutrition: effects on hepatic structure and function in rats.
- Author
-
Boelhouwer RU, King WW, Kingsnorth AN, Weening JJ, Young VR, and Malt RA
- Subjects
- Alkaline Phosphatase blood, Animals, Body Weight, Cholesterol blood, Energy Intake, Fatty Liver etiology, Muscles metabolism, Nitrogen metabolism, Rats, Dietary Carbohydrates administration & dosage, Fat Emulsions, Intravenous, Liver physiopathology, Parenteral Nutrition, Parenteral Nutrition, Total adverse effects
- Abstract
The role of fat-based total parenteral nutrition (TPN) in preventing or ameliorating hepatic dysfunction during TPN was investigated. Adult ACI-N rats were given fat-free carbohydrate-based TPN or isocaloric, isonitrogenous fat-based TPN (50% cal from 20% Intralipid, 50% cal from carbohydrate) for 7 days with Purina Chow-fed and fasting rats as controls. After fat-based TPN as compared with Chow or carbohydrate-based TPN, serum alkaline phosphatase activity and cholesterol levels doubled. Fatty infiltration and periportal inflammation in the liver were more marked. Both the TPN regimens were equally effective in maintaining body weight, positive nitrogen balance, muscle and hepatic protein content. Hepatic dysfunction in rats during TPN was not prevented by using a fat emulsion to provide 50% of the caloric requirement; the optimal proportion of fat as energy substrate in this system is less than 50%.
- Published
- 1983
- Full Text
- View/download PDF
49. Colostomy closure promotes cell proliferation and dimethylhydrazine-induced carcinogenesis in rat distal colon.
- Author
-
Terpstra OT, Dahl EP, Williamson RC, Ross JS, and Malt RA
- Subjects
- Animals, Cell Division drug effects, Colon cytology, Colon metabolism, DNA metabolism, Male, Proteins metabolism, RNA metabolism, Rats, Colonic Neoplasms chemically induced, Colostomy, Dimethylhydrazines adverse effects, Methylhydrazines adverse effects
- Abstract
The influence of adaptive cell proliferation on colonic carcinogenesis was studied in male Fischer rats with a defunctioning transverse colostomy that was closed 4 wk later. Control observations were made in other rats after colonic transection, repeated at 4 wk, after laparotomy alone, or after permanent colostomy. Tumors were induced by 1,2-dimethylhydrazine (total dose, 300 mg/kg) over 11 wk, starting 2 days after the second operation. After creation of the colostomy, amounts of protein, RNA, and DNA in the distal colon halved in 4 wk (p less than 0.001), but returned to normal 7 days after restoration of colonic continuity. This reactive hyperplasia promoted the development of distal colonic carcinomas, as compared with rats having repeated transection of the bowel (incidence 32% vs. 6%; p less than 0.03). Although the amounts of protein and nucleic acid in the proximal colon were unchanged by transverse colostomy, values increased by 18%-59% 4 wk after colostomy closure (p = 0.05-0.002); nonetheless, the yield of tumors in this segment was unaltered. Suture-line cancers were commoner after repeat transection than after colostomy closure (76% vs. 39%; p less than 0.01). These data confirm the promotional effect of increased cell proliferation on intestinal carcinogenesis.
- Published
- 1981
50. Appendicitis near its centenary.
- Author
-
Berry J Jr and Malt RA
- Subjects
- Anti-Bacterial Agents therapeutic use, Appendectomy, Appendicitis diagnosis, Appendicitis epidemiology, Appendicitis surgery, Demography, Drainage, Female, History, 19th Century, History, 20th Century, Humans, Intestinal Perforation diagnosis, Intestinal Perforation surgery, Leukocyte Count, Male, Seasons, Surgical Wound Infection drug therapy, Appendicitis history
- Abstract
In an analysis of the first 72 cases treated after the formulation of the appendicitis syndrome in 1886 compared with the experience from 1929-1959 and with 307 randomly selected recent cases, the major therapeutic trend has been an emphasis on appendectomy before perforation and abscess formation occur. The rate of infection nonetheless remains approximately 17%. Although the overall mortality rate has declined from 26% overall (40% for surgery) to 0.8%, the current rate of perforation is 28%, with a diagnostic accuracy of 82%. Among 13,848 patients from several reports the perforation rate increases linearly with diagnostic accuracy; therefore, a balance must be sought. Delay awaiting a diagnosis is a major determinant of perforation, but diagnostic aids are of limited help. Clinical acuity and prudent decisiveness are the keys to proper action.
- Published
- 1984
- Full Text
- View/download PDF
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