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Biomedical subjects

C M Radford

Publications and source records attributed to C M Radford.

4 recordsLinked to original sources

Endoscopic laser therapy for watermelon stomach.

Thirteen patients (9 women, 4 men) with anemia from acute and chronic gastrointestinal bleeding were found to have antral vascular disease consistent with watermelon stomach. The median age was 73 yr, with a range of 54-88 yr. Eight of the patients were transfusion-dependent, requiring a median of 5.5 U within the 12 mo before treatment. All were treated with endoscopic neodymium:yttrium-aluminum-garnet laser coagulation. Endoscopic and hematologic improvement were evident in 12 patients available for follow-up after a median period of 6 mo. There was a median increase of 4 g/dl in hemoglobin concentration; thus, the need for transfusion was eliminated. No major complications were encountered. Laser coagulation for watermelon stomach appears to be safe and efficacious and may be a therapeutic alternative for this disorder.

Aged↗

Aortic regurgitation in scleroderma.

Two cases of scleroderma with isolated aortic regurgitation are described. Other known causes of aortic regurgitation were not apparent. None of the patients gave a history of rheumatic fever. It appears likely that aortic regurgitation is related to scleroderma in these two patients. Aortic regurgitation in scleroderma is, however, rare.

Adult↗

Prospective comparison of contact with noncontact Nd:Yag laser therapy for palliation of esophageal carcinoma.

Twenty patients with dysphagia due to inoperable esophageal cancer were randomized to receive either contact or noncontact endoscopic laser treatment. Treatment groups were similar with respect to age, dysphagia score, and tumor dimensions. The median number of initial treatment sessions was two in both groups, and the median treatment times per session were 23 min (range, 12 to 55 min) in the contact group and 19 min (range, 5 to 28 min) in the noncontact group. Median dysphagia scores were also similar in both groups 1 month after laser treatment, and no difference was apparent in the duration of palliation. There were no patient complications attributable to laser therapy, but damage to the laser wave guide occurred in three contact sessions and two noncontact sessions. These data suggest no advantage for the contact method of endoscopic Nd:YAG laser palliation of esophageal carcinoma with respect to number of treatment sessions, relief of dysphagia, or occurrence of complications.

Adenocarcinoma↗

Endoscopic gastric vagotomy: a feasibility study using laser in dogs.

The aim of this study was to explore the feasibility of an endoscopic approach to gastric vagotomy using the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in dogs. Based on gross and histologic measurements, target zones for endoscopic vagotomy were defined with reference to mucosal side landmarks. Target zones containing the unbranched segments of the major intramural vagal branches were linear and symmetrically located anterior and posterior to the midline of the lesser curvature extending from the level of the esophagogastric junction to the proximal antral border. Because of minimal variability between dogs, this zone could be accessed endoscopically and reliably injured. Unfortunately, it was necessary to produce a nearly full thickness burn to interrupt the deep intramural vagal branches. Despite efforts to control dosimetry, delayed perforations occurred in three of four dogs. We conclude that endoscopic gastric vagotomy using the Nd:YAG laser is not feasible in the dog model because of difficulty controlling the depth of thermal injury. An endoscopic approach to vagotomy remains conceptually appealing because of the predictable location of and accessibility to a target zone.

Animals↗