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Biomedical subjects

D H Dunn

Publications and source records attributed to D H Dunn.

14 recordsLinked to original sources

Computed tomography for evaluation of puerperal infections.

Pelvic computed tomography was used to evaluate 74 women with persistent puerperal infection. There was at least one abnormal roentgenographic finding in 57, and these are correlated with clinical and surgical findings. In 16 women, a palpable pelvic mass was seen on tomography, however, masses not appreciated clinically were visualized in another 29 women, and in five, a clinically palpable mass was not visualized by tomography. In 12 women who had a normal pelvic examination, septic pelvic thrombophlebitis was diagnosed by tomography. Over-all, there was poor correlation with roentgenographic findings and uterine incisional necrosis and dehiscence. We conclude that pelvic tomography is useful to evaluate some women with persistent puerperal infection, but that these studies must be correlated with clinical findings.

Adolescent↗

Surgical treatment of duodenal ulcer: a prospective randomized study.

From 1960 to 1980, 344 patients were included in a prospective randomized study for elective surgical treatment of duodenal ulcer disease. Results of vagotomy and pyloroplasty were compared with vagotomy and hemigastrectomy. There were no postoperative deaths, the postoperative complication rates were similar for both groups. Ulcerations recurred in 12% of the vagotomy-pyloroplasty group and in 3% of the vagotomy-hemigastrectomy group (P less than .05). Independent analyses of recurrence were performed for young patients, for alcoholics, and for patients who had obstructions or were bleeding preoperatively. Recurrence rates in these special populations were not found to be significantly different. Eight percent of the vagotomy-pyloroplasty group required reoperations for recurrent ulceration; only 2% of the vagotomy-hemigastrectomy group required reoperation. Postoperative dumping symptoms were significantly more frequent in the vagotomy hemigastrectomy group. Postoperative diarrhea was also more frequent and more severe in the vagotomy-hemigastrectomy group.

Adult↗

Gastric outlet obstruction in peptic ulcer disease: an indication for surgery.

Eighty-seven patients with duodenal peptic ulcer disease and gastric outlet obstruction were reviewed retrospectively. All patients were initially treated with standard medical regimens. Gastric outlet obstruction persisted in 49 patients (56 percent) for more than 5 days, necessitating operative intervention. Obstruction relented in the other 38 patients (44 percent), and they were discharged from the hospital. However, late follow-up on the entire cohort revealed that 98 percent of patients with chronic ulcer disease and 64 percent of patients with acute disease ultimately required an operation.

Gastric Emptying↗

Gastrin cell populations after highly selective vagotomy in the dog.

Highly selective vagotomy was performed on five dogs. Postoperatively, gastrin cell (G cell) hyperplasia occurred in all dogs. Mean preoperative G cell numbers increased from 350 to 530/cm mucosal length (p less than 0.02). Antral tissue gastrin also increased by 100 per cent (6.7 x 10(6) to 13.7 x 10(6) pg/gm tissue, p less than 0.05). Basal and stimulated serum gastrin were unchanged following highly selective vagotomy. The cause for G cell hyperplasia is not clear, but is probably multifactorial.

Animals↗

Adrenal corticosteroids cause gastrin cell hyperplasia.

Chronic exogenous high dose adrenal cortical steroid administration to dogs resulted in a 137% increase in G-cell mass with an associated enhancement of peak serum gastrin levels. Adrenalectomy caused a halving of G-cell numbers without significant changes in serum gastrin levels. Adrenal cortical steroids appear to have an important trophic role for the G-cell.

Adrenal Cortex Hormones↗

Intermittent hydroephrosis. A cause of abdominal pain.

Intermittent hydronephrosis may appear as acute abdominal pain. Between episodes of pain, the patient may be asymptomatic, and the intravenous urogram usually will be normal. The condition is diagnosed from intravenous urograms taken either during an episode of pain or after hydronephrosis has been precipitated by hydration. There are many causes of intermittent hydronephrosis; however, the closed renal pelvis and nondistensible ureteropelvic junction are important factors in nearly all cases. Pyeloplasty is the best treatment and is usually curative.

Abdomen↗

The treatment of hemorrhagic gastritis with cimetidine.

Thirteen patients in whom bleeding from hemorrhagic gastritis was not controlled by a variety of therapeutic modalities were treated with cimetidine. Twelve of the 13 patients stopped bleeding. Three subsequently rebled, two of whom required an operation to control the bleeding. The average amount of blood transfused per patient before treatment with cimetidine was 16 units and after cimetidine, 1.6 units. Nine of the 13 patients died, but only one of them died of hemorrhage. The remaining eight patients died of a combination of sepsis and multiple organ failure. We observed no adverse side-effects after the administration of cimetidine. Cimetidine is a safe and reliable means to control bleeding from hemorrhagic gastritis. Once the diagnosis of hemorrhagic gastritis is established, treatment with cimetidine should be begun and continued until the underlying stress which initiated the bleeding is controlled.

Cimetidine↗