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Biomedical subjects

D M McCarthy

Publications and source records attributed to D M McCarthy.

At least 127 records · Page 7Linked to original sources
PubMed1982

Effect of isopropamide on response to oral cimetidine in patients with Zollinger--Ellison syndrome.

Patients with Zollinger-Ellison syndrome whose gastric acid secretion or symptoms were not controlled by cimetidine in conventional dosage were selected for studies of responsiveness of their acid secretion to increasing doses of cimetidine, used either alone or in combination with a long-acting anticholinergic agent, isopropamide iodide. Results indicate that in the group as a whole the suppression achieved with a 900-mg dose of cimetidine was not significantly better than that achieved with a 300-mg dose, although in individual cases this did not hold true. In individuals the combination of cimetidine and isopropamide was generally more effective in suppressing acid secretion than cimetidine alone, used either in the same dose as in the combination or in the next highest possible dosage. This was also true in the group as a whole, where combined therapy showed significant advantage over either drug alone in controlling acid secretion, in the third, fourth, and fifth hours following administration of the drugs. The data suggest that in the minority of patients not controlled by cimetidine 300-600 mg q6h per os, addition of isopropamide (20-40 mg/day) may be preferable to further increasing the dose of cimetidine.

Aged↗
PubMed1982

The role of surgery in patients with Zollinger-Ellison syndrome (ZES) managed medically.

From 1975 to 1981, the authors' deliberate intent was to treat all patients with Zollinger-Ellison syndrome (ZES) medically. This allowed the authors to ask the question of the need for surgical intervention in patients managed medically. Twenty-six patients followed for an average of 37 months (range 2 to 147 months) from diagnosis were maintained on cimetidine for a mean of 32 months (2 to 64 months). Six of these patients (23%) were unable to be maintained on cimetidine and required surgery during this period. Four received total gastrectomy, and two had lesser operations. Analysis of survival curves in this small group does not illustrate a difference between outcome based on surgical or medical management. Prospective studies based on aggressive attempts at preoperative localization with staging laparotomy and tumor resection seem justified.

Adult↗
PubMed1982

Incidence of rapid resolution of defects on stress thallium scans.

A prospective study was performed to determine the frequency with which defects on stress thallium images undergo rapid resolution. Analysis of paired views showed that 15% of the defects present in anterior views resolve in less than 30 minutes. This study documents the loss of sensitivity that can occur if imaging does not begin promptly after injection.

Aged↗
PubMed1981

Hyperamylasemia, duodenal duplication, and pleural effusions in hereditary spherocytosis.

A 15-year-old girl with hereditary spherocytosis was admitted for evaluation of recurrent pleural effusions containing amylase in high concentration and was found to have biliary obstruction, pancreatitis, and a congenital duplication of the duodenum attached to an accessory lobe of the pancreas via the duct of Santorini, a unique entity. Successful surgical management of these disorders included common duct clearance and anastomosis of the duplication to the adjacent duodenum.

Adolescent↗
PubMed1981

Healing of peptic ulcers during continuing anti-inflammatory drug therapy in rheumatoid arthritis.

To evaluate the effect of anti-inflammatory drug therapy on ulcer healing, we studied retrospectively patient records listing the dual diagnoses of rheumatoid arthritis and peptic ulcer (1953-1975). Forty-three ulcers (23 gastric and 20 duodenal) occurred in 41 subjects. Evaluation of ulcer healing was possible in 35 patients, 27 of whom had continued on anti-inflammatory drug therapy while being treated for ulcer disease and eight who did not. In 21 of the 27 patients the ulcer healed; in six the ulcer failed to heal, including one who died from gastric carcinoma. Fourteen of the 21 patients whose ulcer healed were taking both aspirin and corticosteroids; in all eight patients who stopped taking anti-inflammatory drugs, the ulcers (eight gastric, one duodenal) healed. In six patients no evaluating was possible because the outcome of ulcer therapy was unknown. The numbers of patients not studied, unlisted or unretrieved are unknown, though probably small, and while no data are available on controls drawn from the same population or on the rates of spontaneous ulcer healing and recurrence in this population, our study nevertheless establishes that ulcer healing does occur in many patients with rheumatoid arthritis despite continued treatment with salicylate, corticosteroid, or other anti-inflammatory drugs.

Anti-Inflammatory Agents↗
PubMed1981

Biochemical studies on cryopreserved granulocytes: possible explanations for the defects induced.

The functional capacity of normal; human granulocytes has been studied after cryopreservation by two different methods with dimethylsulphoxide as cryoprotectant. Both methods resulted in substantial disruption of organelle membranes and impaired cell function. Similar organelle disruption could be induced without cryopreservation following the addition of dimethylsulphoxide to cells, but the extent of this disruption was dependent on the temperature at which the dimethylsulphoxide was diluted out. The loss of cellular function also depended on the temperature and rate of dilution. We suggest that disruption of membrane organization is the mechanism underlying the loss of cell function induced by cryopreservation. Pending development of more successful methods of cryopreserving granulocytes, it is recommended that optimal preservation of functional activity would be obtained if the cryopreserved cells are thawed directly at 37 degrees C and the cryoprotectant diluted carefully and slowly.

Blood Preservation↗
PubMed1981

Gastroesophageal reflux disease in the Zollinger-Ellison syndrome.

Gastroesophageal reflux has rarely been reported in the Zollinger-Ellison syndrome, presumably due to elevation in the lower esophageal sphincter pressure. We have evaluated 15 patients with the Zollinger-Ellison syndrome for evidence of esophageal disease. Five presented initially with esophageal disease: one, reflux symptoms; two, severe esophagitis; and two, strictures. Six of 15 had heartburn and nine of 15, objective evidence for reflux disease. Mean lower esophageal sphincter pressure was higher in the Zollinger-Ellison syndrome than in controls but was unrelated to serum gastrin levels. Zollinger-Ellison syndrome patients without heartburn had a higher mean sphincter pressure than did patients with heartburn (who had a mean sphincter pressure similar to that of controls but greater than that in patients with idiopathic gastroesophageal reflux). Four patients had biopsy evidence of esophagitis, one in association with Barrett's epithelium. Gastroesophageal reflux and its complications appear to be common in the Zollinger-Ellison syndrome.

Adult↗
PubMed1981

Comparison of two radionuclide techniques for detecting disease of right and left coronary arteries.

Radionuclide angiography and thallium-201 myocardial perfusion scintigraphy were compared in 31 patients with coronary artery disease studied at rest and during exercise. Seventeen of the 31 patients had perfusion defects on thallium-201 redistribution scans (61%); 16 of these had prior transmural infarction. Six other patients with prior inferior infarction had no defects on thallium-201 redistribution scans. During treadmill exercise, 28 of 31 patients (90%) developed new or larger thallium-201 perfusion defects, a significantly higher percentage of patients than those that developed ST segment abnormalities during exercise (74%). During bicycle exercise left ventricular ejection fraction decreased in 27 of the 31 patients (87%); the average change in left ventricular ejection fraction was from 54 +/- 16+ to 48 +/- 14% (p less than 0.1). Twenty-three of the 31 patients had abnormalities of regional ejection fraction at rest (74%), while 30 of the 31 had abnormalities during exercise (97%). The number of patients who developed new regional ejection fraction abnormalities during exercise (28 of 31) was not significantly different from the number of patients who developed new or larger thallium-201 myocardial perfusion defects during exercise. In order to compare the two radionuclide techniques with respect to identification of vessel involvement, the patients were separated into those with disease of the right coronary system, disease of the left coronary system, or both. Thallium-201 scintigraphy correctly identified ten of 14 patients with involvement of only the right or left system; radionuclide angiography correctly identified six of 14. However, radionuclide angiography identified more patients with right and left system involvement (15/17) than did thallium-201 scintigraphy (6/17), p less than .01. These data suggest radionuclide angiography is more useful for identifying patients with disease of both the right and left coronary arteries.

Adult↗
PubMed1980

Computed tomographic detection of nonbeta pancreatic islet cell tumors.

Twenty-five patients with nonbeta pancreatic islet cell tumors were examined by computed tomography (CT). In eight patients (32%), the primary pancreatic tumor was identified, and in ten patients (40%), hepatic metastases were seen. Only one of the eight tumors seen on CT was loager tha 10 cm; the other seven ranged from 4 to 9 cm in diameter. Tumors in ectopic locations or possible cellular hyperplasia rather than a discrete tumor may account for the relative insensitivity of CT visualization, particularly among patients with Zollinger-Ellison syndrome.

Adenoma, Islet Cell↗
PubMed1980

False aneurysm formation following arteriographic intimal dissection: serial studies in 2 patients.

Two patients with metastatic islet-cell carcinoma underwent multiple hepatic artery catheterizations for streptozotocin infusion. An intimal flap was raised during one of the initial arteriographic procedures and a false aneurysm developed. The progression of the aneurysm was documented on sequential studies. False aneurysm formation appears to be a relatively unappreciated complication of intimal dissection, and these 2 cases permitted observation of their natural history.

Adenoma, Islet Cell↗
PubMed1980

Intestinal enzyme adaptation to normal diets of different composition.

Groups of rats were fed isocaloric amounts of diets rich in starch, protein, or fat. After 7 days, activities of sucrase, maltase, lactase, alkaline phosphatase, L-phenylalanylglycine hydrolase, and L-leucyl-L-alanyl hydrolase were measured in the duodenal, jejunal, and ileal mucosa of fed rats. Peptide hydrolase and alkaline phosphatase activities were significantly higher in rats fed high-protein diets, particularly in the ileum. Disaccharidases were highest in rats fed high-starch diets, especially in jejunum; the lowest activities of peptide hydrolase were seen with this diet. The high-fat diet was generally associated with intermediate activities of most enzymes, except disaccharidases, which were lowest on this diet. The different macromolecular nutrients were associated with adaptive differences in intestinal enzyme activities, which were biologically appropriate and coordinated with similar known changes in pancreatic and other enzyme activities concerned with assimilation of the particular food. However, other less interpretable changes occurred, which may have been due to effects on pancreatic secretion or on the metabolism, growth, and differentiation of intestinal cells.

Alkaline Phosphatase↗