PubMed Health⌕ Search

Biomedical subjects

D L Carr-Locke

Publications and source records attributed to D L Carr-Locke.

144 records · Page 8Linked to original sources
PubMed1979

Gilbert's syndrome: evidence of morphological heterogeneity.

Hepatic ultrastructure was examined by electron microscopy in 25 patients with Gilbert's syndrome and the changes in the smooth endoplasmic reticulum quantified by grid technique. Thirteen patients showed gross hypertrophy of the smooth endoplasmic reticulum (SER). These were designated Gilbert's EM Positive. The remaining 12, designated Gilbert's EM Negative, did not differ significantly from normal controls. The EM Positive group showed a significantly greater percentage response to caloric restriction (P less than 0.01) and an exaggerated response to nicotinic acid stimulation when compared with the EM Negative group and normal controls. These results suggest that SER hypertrophy is not, as previously suggested, a constant feature of Gilbert's syndrome but rather a characteristic of a distinct subpopulation.

Adolescent↗
PubMed1978

Psittacosis.

Explore the source record for details and available documents.

Animals↗
PubMed1978

Disinfection of upper gastrointestinal fibreoptic endoscopy equipment: an evaluation of a cetrimide chlorhexidine solution and glutaraldehyde.

There is little information available on the bacteriological contamination of upper gastrointestinal fibreoptic endoscopes during routine use and the effects of 'disinfecting solutions'. A bacteriological evaluation was therefore made of cleaning an endoscope and its ancillary equipment with (1) water, (2) an aqueous solution of 1% cetrimide with 0.1% chlorhexidine, and (3) activated aqueous 2% glutaraldehyde. All equipment, but particularly the endoscope itself, was found to be heavily contaminated after use with a wide variety of organisms of which 53% were Gram positive. Cleaning the endoscope and ancillary equipment with water and the cetrimide/chlorhexidine solution alone or in combination was inadequate to produce disinfection but immersion in glutaraldehyde for two minutes consistently produced sterile cultures with our sampling technique. A rapid and simple method for disinfection of endoscopic equipment is therefore recommended and we think this is especially suitable for busy endoscopy units.

Aldehydes↗
PubMedDate not supplied

Management of bile leaks following laparoscopic cholecystectomy.

In a series of 650 consecutive laparoscopic cholecystectomies, nine bile leaks were identified (1.4%). Patients with bile leaks presented clinically at a mean of 4.9 days (range: 3-8 days) after surgery complaining of diffuse abdominal pain, ileus, and nausea. Laboratory values for complete blood counts and liver function tests were all mildly elevated. Definitive diagnosis was made on the basis of abnormal hepatobiliary scintigraphy. Management strategies included laparotomy and drain placement (n = 1), laparoscopy and drain placement (n = 3), ERCP and drainage (n = 4), and CT-guided percutaneous drainage (n = 1). When the etiology of the leakage was identified, it was most commonly either dysfunction of the cystic duct clips (n = 3) or leakage from a disrupted duct of Luschka (n = 2). The source of the remaining leaks (n = 4) was never determined. We conclude that bile leaks are an uncommon cause of morbidity following laparoscopic cholecystectomy. Diagnosis can usually be made with nuclear medicine biliary tract scans and a variety of managements alternatives are successful in treating this complication.

Bile↗
PubMedDate not supplied

Bacteremia after endoscopic band ligation of esophageal varices.

In a 6-month period, 17 consecutive unselected patients undergoing emergency or elective endoscopic variceal band ligation were evaluated prospectively for clinical and bacteriological signs of bacteremia after each treatment session. None had signs of sepsis, fever, or chills; however, in one patient, a coagulase-negative Staphylococcus epidermidis was cultured from peripheral blood at 5 but not 30 min after the procedure. These data indicate that, in contrast to sclerotherapy, endoscopic variceal ligation rarely induces bacteremia.

Adult↗
PubMedDate not supplied

Brush cytology during ERCP for the diagnosis of biliary and pancreatic malignancies.

Endoscopic retrograde cholangiopancreatography is a valuable tool in the diagnosis and management of pancreaticobiliary diseases. The diagnostic sensitivity of brush cytology is reported as between 18% and 70% for malignant bile duct or pancreatic duct strictures. We report our findings in 74 patients with pancreaticobiliary strictures who underwent ERCP. Brush cytology was performed on 55 bile duct specimens and 19 pancreatic duct specimens. No complications related to the procedure occurred; 4 specimens (5.4%) were unsatisfactory for interpretation. Strictures were benign in 22 patients (12 pancreatitis, 5 sclerosing cholangitis, 3 Mirizzi syndrome, and 2 papillitis) and malignant in 52 patients (29 pancreatic carcinoma, 10 cholangiocarcinoma, 6 metastatic disease, 4 pancreatic mucinous ductal ectasia, 1 ampullary carcinoma, and 2 non-functioning islet cell tumors). The nature of the stricture was confirmed by surgery, surgical biopsy, necropsy, or follow-up. The overall results for brush cytology were sensitivity 56.2%, specificity 100%, positive predictive value 100%, negative predictive value 51.2%, and accuracy 70%. Our results confirm the value, safety, and utility of obtaining cytologic specimens at the time of ERCP; confirmation was obtained in 65.5% of pancreatic carcinoma cases. Although a negative result does not exclude pancreaticobiliary malignancy, a positive result confirms this diagnosis.

Bile Duct Neoplasms↗
PubMedDate not supplied

Colonic tumors.

Explore the source record for details and available documents.

Adenoma↗
PubMedDate not supplied

Endoscopic treatment of acute biliary pancreatitis.

The successes of supportive management of patients with severe acute pancreatitis in recent years has evolved from our improved understanding of some of the serious consequences of pancreatic necrosis on other organ systems. When gallstone disease is identified as the cause in such patients, there has been an expectation that biliary intervention will lead to a more rapid resolution of the index attack and prevention of future pancreatitis. There is now convincing evidence, in the setting of severe gallstone-associated pancreatitis using prognostic scoring, that not only is emergency or early elective biliary surgery associated with an unacceptable morbidity and mortality but that appropriate endoscopic therapy is safe and highly effective. In populations where concomitant cholangitis is common, emergency biliary endoscopic management provides optimal therapy for all grades of pancreatitis.

APACHE↗
PubMedDate not supplied

[Esophageal squamous cell papilloma. Report of 3 cases. Diagnostic aspects].

UNLABELLED: Dysphagia is not always present in patients with esophageal squamous cell papilloma, and it can be an incidental finding during gastrointestinal endoscopy of an asymptomatic patient. PURPOSE: Three cases of squamous cell papilloma of the esophagus and aspects regarding diagnosis and association with human papillomavirus are presented. CASUISTIC: Two cases are male and one female what is consistent with a higher incidence showed in the literature in males. The three patients were submitted to upper gastrointestinal endoscopy: in one case the tumor was unusually large and in all patients it was located in the mid and lower esophagus. Chromoscopy was performed in one case and the lesion was not stained. We were unable to identify human papillomavirus using DNA-hybridization techniques. Our results are similar to those reported in the review of the literature. RESULTS: There is no other case published in the Brazilian literature and this is the first report on the use of chromoscopy. CONCLUSION: We were not able to show an association between esophageal squamous papilloma and human papillomavirus.

Adult↗