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Biomedical subjects

D W McCullough

Publications and source records attributed to D W McCullough.

7 recordsLinked to original sources
PubMed1991

Laryngeal carcinoma associated with human papillomavirus type 16.

The advent of molecular hybridization technology has provided evidence supporting human papillomavirus as an etiologic agent of laryngeal carcinoma. Using Southern blot analysis, we identified human papillomavirus type 16 DNA associated with an invasive laryngeal carcinoma. The virus genome did not appear to be integrated into the host genome, as is often the case with anogenital tumors. Laryngeal carcinoma usually arises on the true vocal cords of individuals who demonstrate demographic and lifestyle risk factors for this cancer. The patient, an adult male, has no identifiable risk factors for laryngeal carcinoma other than papillomavirus infection. Our finding suggests that the application of hybridization analysis to all cases of laryngeal cancer would promote understanding of the association between human papillomavirus and laryngeal carcinoma.

Adult↗
PubMed1979

Preservation of auditory-evoked brainstem responses in anaesthetized children.

In a series of six anaesthetized children we have been unable to demonstrate any effect of anaesthetic concentrations of halothane or thiopentone on the brainstem auditory-evoked response. The results imply preservation of brain stem function during anaesthesia with these drugs and suggest future application of anaesthesia to the testing of hearing disabilities in children, as well as application of evoked response audiometry to neurological critical care.

Anesthesia, General↗
PubMed1979

Clinical experience with brain stem audiometry performed under general anesthesia.

Hearing tests were given to 22 difficult-to-test children using brain stem audiometry performed under general anesthesia. The effect of halothane and sodium thiopental on the brain stem response was assessed as well as the feasibility of using this technique with a difficult-to-test population. No effect on brain stem responses was observed to various levels of anesthesia. Successful hearing tests were carried out on all the children and results were helpful in their management. Brain stem audiometry perfromed under general anesthesia appears to be an effective and helpful technique for testing challenging diagnostic cases.

Adolescent↗
PubMed1978

Granulocytopenia in hospitalized patients. II. A prospective comparison of two antibiotic regimens in the empiric therapy of febrile patients.

The results of empiric antibiotic therapy in 126 hospitalized patients with fever during 192 episodes of granulocytopenia were studied. Febrile granulocytopenic patients were randomly allocated to receive either carbenicillin, methicillin and gentamicin, or carbenicillin and cephalothin. The response rate for the two antibiotic regimens was similar, 49 (60 per cent) of 81 responded to the former and 42 (54 per cent) of 78 to the latter. The response rate in patients receiving other antibiotics because of specific indications or counterindications was 19 (58 per cent) of 33. Thirty-nine (35 per cent) of 110 patients who responded to initial antibiotic therapy had an increase in circulating granulocytes of one log10 or more compared to only 10 (12 per cent) of 79 nonresponders with such an increase. The mortality rate in adult patients receiving carbenicillin, methicillin and gentamicin was eight (16 per cent) of 51, compared to 18 (37 per cent) of 49 in those receiving cephalothin and carbenicillin (P less than 0.05). The significance of this difference in the initial response rate or mortality rate between patients treated with the two antibiotic regimens when only patients with documented bacterial infection were considered. Patients who responded to their initial antibiotic regimen, and patients for whose fever no explanation was found, had the best prognosis.

Adolescent↗
PubMed1976

Clinical evaluation of amikacin in treatment of infections due to gram-negative aerobic bacilli.

The efficacy and safety of amikacin were evaluated in 42 patients with infections presumed to be due to gram-negative rods. The dosage of 7.5 mg of amikacin/kg every 12 hr was administered intramuscularly to 32 patients and intravenously to seven patients; three patients with renal impairment were given a modified regimen. The duration of treatment was three to 51 days (mean, 9.6 days). Of 19 patients with acute pyelonephritis, five had positive blood culture results. Ten patients had chronic urinary infection, and isolates of Pseudomonas aeruginosa from four of these patients acquired resistance to amikacin during therapy. Of seven patients with gram-negative bacteremia from sources other than the urinary tract, four showed satisfactory and three had less than optimal responses to therapy with amikacin. Two patients with chronic osteomyelitis or soft tissue infection improved but subsequently relapsed. Two patients with acute febrile illness, in whom the etiologic agent was unidentified, recovered. Serial audiograms revealed no change in 26 of 27 patients; one had a significant deterioration in hearing. A transient rise in the level of serum creatinine was noted in three patients. Serial tests of liver function revealed no abnormalities.

Adolescent↗
PubMed1976

Tracheal stenosis.

Tracheal stenosis following assisted ventilation is becoming recognized as a major complication of tracheostomy, and the use of cuffed tracheostomy tubes. The possible causes and surgical management of this condition are discussed together with recommendations to minimize the possibility of post-tracheostomy tracheal stenosis.

Bacterial Infections↗