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Biomedical subjects

C J Simpson

Publications and source records attributed to C J Simpson.

26 records · Page 2Linked to original sources
PubMed1984

The early diagnosis of acute gall-bladder disease: the accuracy of overnight eight-hour infusion cholangiography.

The reliability of overnight 8-hour infusion cholangiography in confirming the diagnosis of acute cholecystitis or biliary colic was assessed by a prospective study in 100 patients. 55 positive infusion cholangiograms were subsequently confirmed at operation in 45 patients and by cholecystogram in 10 patients who did not have surgical treatment. The absence of false positive examinations is of fundamental importance if early cholecystectomy is to be performed without the risk of an unnecessary laparotomy. Infusion cholangiography proved to be a safe, simple and reliable investigation in the confirmation of acute gall-bladder disease.

Acute Disease↗
PubMed1984

Microcirculatory norepinephrine constrictor response in hemorrhagic shock.

Hemorrhagic shock is characterized by a phase of compensation that preserves central blood flow and intravascular pressure through an integrated vasoconstrictor response mediated by catecholamines, particularly norepinephrine (NE). The skeletal muscle microcirculation is important in this response. Decompensation occurs when arteriolar vasodilation occurs despite continued hypovolemia and high circulatory levels of NE. Using an isolated decerebrate rat cremaster muscle, we measured constrictor response to NE (10(-7)M tissue concentration) in compensated and decompensated shock. Our data indicate that larger arterioles (143 to 152 microns) show persistent constrictor response with lowered sensitivity to NE. Smaller arterioles (11 to 22 microns) and all venules dilate late in shock but retain constrictor responses to NE. Dilator responses contribute to decompensation in small arterioles and venules but not because of altered NE constrictor response.

Animals↗
PubMed1983

Guidelines for prevention of surgical wound infection.

Despite the widespread use of antibiotics, surgical wound infections continue to cause patient discomfort and drain on health care finances. More serious local complications often develop concomitantly (eg, cellulitis) or later (eg, incisional hernia). Inadequate treatment of an illness or poor host defenses may lead to serious systemic complications (septicemic shock, multiple organ failure). Therefore, it is essential that every effort be made to minimize the likelihood of infection. The Centers for Disease Control in Atlanta convened a group of physicians and surgeons knowledgeable in the practice of infection control. This group developed a set of guidelines that is thought to reflect the state of the art in 1982. The trials, which were objective and preferably randomized or even blinded, determined present options for surgical infection control.

Anti-Bacterial Agents↗
PubMed1983

Effect of bile salt perfusion and intraduct pressure on ionic flux and mucosal ultrastructure in the pancreatic duct of the cat.

Net ionic flux and mucosal ultrastructure were examined following perfusion of the cat pancreatic duct with bicarbonate or sodium taurocholate solutions (5-40 mM). Taurocholate perfusion increased net Cl- gain, net HCO3- loss and net K+ gain and was associated with significant widening of lateral intercellular spaces and increased complexity of intercellular labyrinths. Increased perfusion pressure (30 mm Hg) did not affect flux or ultrastructure during perfusion with bicarbonate but increased net ion flux significantly during perfusion with 40 mM sodium taurocholate. Ultrastructural changes during perfusion of 40 mM taurocholate at increased pressure were not consistent but focal epithelial disruption and cell shedding were seen occasionally. The hypothesis is advanced that taurocholate perfusion triggers physiological transport mechanisms and may make the duct mucosa more vulnerable to other potentially harmful agents. The significance of these changes in the pathogenesis of acute pancreatitis in man remains uncertain and care must be exercised before extrapolating from observed net ion flux data in this animal model.

Animals↗
PubMed1983

Metronidazole prophylaxis in colorectal surgery: the need for additional aminoglycoside?

A randomized double-blind trial was conducted in two phases to compare the efficacy of prophylactic oral and intravenous administration of kanamycin and metronidazole in preventing wound infection and other complications in patients undergoing colorectal surgery, and also to assess the need for inclusion of an aminoglycoside in the prophylactic regimen. Adequate prophylaxis did not depend on the route of antimicrobial administration, but wound infection rates were increased following exclusion of kanamycin.

Aged↗
PubMedDate not supplied

The phlebotome in the management of incompetent perforating veins and venous ulceration.

A shearing operation using a phlebotome has been used on 26 limbs of 24 patients with venous ulceration to deal with incompetent perforating veins. Only one ulcer has failed to heal or remain healed at mean operative follow-up of 24 months. Numbness, usually transient, and haematoma formation have been the only recorded complications. This procedure is recommended in the management of incompetent perforating veins associated with venous ulceration.

Adult↗
PubMedDate not supplied

Infrapopliteal bypass grafts for severe ischaemia of the lower limb.

A retrospective survey of 27 infrapopliteal bypass grafts performed for rest pain revealed a cumulative limb salvage rate of 65.3% with an overall operative mortality of 8%. When pre-operative angiography demonstrates a patent infrapopliteal artery, reversed saphenous vein bypass grafting offers a realistic alternative to primary amputation when femoropopliteal occlusion threatens limb viability.

Adult↗