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Biomedical subjects

G D Dunn

Publications and source records attributed to G D Dunn.

At least 19 recordsLinked to original sources
PubMed1995

Detection of Helicobacter pylori gene expression in human gastric mucosa.

Mucosal and systemic immunologic recognition of cagA by Helicobacter pylori-infected individuals is associated with peptic ulcer disease; however, in the laboratory, expression of cagA is subject to artificial conditions which may not accurately reflect the conditions in host tissues. Gastric antral and body biopsy specimens and serum for anti-H. pylori immunoglobulin G serology were obtained from 42 patients. Biopsy specimens were studied by histology, culture, and reverse transcription PCR (RT-PCR). Oligonucleotide primers specific for H. pylori (16S rRNA, ureA, and cagA) were used to detect bacterial mRNA in gastric biopsy specimens. PCR was performed on DNA from corresponding H. pylori isolates to detect genomic 16S rRNA, ureA, and cagA. Of the 42 patients from whom clinical specimens were obtained, 25 were infected with H. pylori on the basis of both serology and histology or culture (i.e., tissue positive); 13 were negative by serology, histology, and culture; and 4 were positive by serology only. RT-PCR with 16S rRNA primers detected 24 of 25 tissue-positive and 0 of 17 tissue-negative patients (P < 0.001). RT-PCR with ureA primers detected 16 of 25 tissue-positive and 0 of 17 tissue-negative patients (P < 0.001). CagA mRNA was detected by RT-PCR in 14 of 25 gastric biopsy specimens in the tissue-positive group and in 0 of 17 gastric biopsy specimens in the tissue-negative group. PCR of genomic DNA for the presence of the cagA gene in the corresponding bacterial isolates correlated absolutely with cagA gene expression in gastric tissue. These results indicate that RT-PCR is a sensitive and specific method for the detection of the presence of H. pylori and the expression of H. pylori genes in human gastric tissue. Detection of H. pylori gene expression in vivo by this approach may contribute to improving the diagnosis and understanding the pathogenesis of H. pylori infections.

Antigens, Bacterial↗
PubMed1988

Percutaneous endoscopic gastrostomy: clinical experience and follow-up.

To assess our clinical experience with this method of enteral feeding, we conducted a retrospective study and follow-up of 73 patients having percutaneous endoscopic gastrostomy (PEG). In addition, we conducted a telephone survey of 42 persons who cared for the PEG tube. The most common indication was neurologic impairment of deglutition. Early and late complications occurred in 12% and 33% of cases, respectively, and were usually minor. Our 30-day survival was 74%. Most patients (77%) maintained their weight with standard tube feedings. Satisfaction with and acceptance of the PEG was almost universal. Patients should be carefully selected, with attention to long-range benefit.

Adult↗
PubMed1987

Duplex ultrasound in the evaluation of portacaval shunts.

The results of ultrasound imaging combined with Doppler studies of blood flow are presented in two patients with surgical portacaval shunts performed for portal hypertension. Duplex scanning proved a quick and noninvasive method of confirming the patency of the anastomoses. The demonstration of appropriate Doppler flow signals across the shunt is the most convincing ultrasound evidence of patency. Portacaval shunts are more amenable to study by ultrasound than more peripheral shunts because the liver can be used as an acoustic window.

Adult↗
PubMed1986

Functioning middle mediastinal paraganglioma (phaeochromocytoma) associated with intercarotid paragangliomas.

In three patients with phaeochromocytomas, computed tomography or iodobenzylguanidine scanning gave misleading or negative results. These patients were found to have a functioning middle mediastinal paraganglioma in association with one or two intercarotid paragangliomas. The possibility of this association should be considered in patients with functioning extra-adrenal paragangliomas.

3-Iodobenzylguanidine↗
PubMed1986

Enteral-tube feeding as adjunct therapy in malnourished patients with cystic fibrosis: a clinical study and literature review.

Eight children (aged 8 mo to 13 yr) with cystic fibrosis (CF) and growth failure were given home nocturnal nasogastric feeding of an elemental diet for 3 mo and re-evaluated 3 mo after cessation of tube feeding. An increase in energy intake (p less than 0.05) resulted in increased serum transferrin (p less than 0.005), retinol-binding protein (p less than 0.05), and clinical scores (p less than 0.05) during the study. Height and growth velocity increased by 60% (p less than 0.05), and weight growth velocity increased by 63%. Arm-muscle circumference, triceps skinfolds, serum albumin, vitamin A, vitamin E, zinc, and copper did not change significantly during tube feeding. Nocturnal feeding were safe and effective in promoting growth; however, most children with severe lung disease did not sustain the gains after cessation of tube feeding. Our findings indicate that continued nutritional support is needed to maintain the growth in malnourished children with severe lung disease.

Adolescent↗
PubMed1986

Occult gastric cancer manifested by progressive shortness of breath in a young adult.

We have reported a case of occult, diffuse gastric cancer in a young adult with progressive shortness of breath and bilateral pulmonary interstitial infiltrates. Progressive shortness of breath may be the first or only manifestation of occult gastric cancer caused by either lymphangitic carcinomatosis or microscopic tumor emboli to the lungs. Widespread recognition of this syndrome, a high index of suspicion, and prompt lung biopsy are necessary to make the correct diagnosis. With progress in chemotherapy for malignant diseases, early diagnosis and specific treatment may improve the prognosis of this condition.

Adenocarcinoma, Mucinous↗
PubMed1986

The left-sided pancreas.

Ultrasonography (US) performed in nine patients (two with pancreatic carcinoma, one with hepatomegaly, six with no relevant abdominal disease) showed the pancreas to lie wholly to the left of the aorta. This not uncommon location may give rise to difficulty in demonstrating the pancreas on real-time US scans. The superior mesenteric vessels and splenic vein remain useful landmarks for locating the head of the pancreas in this position.

Aged↗
PubMed1986

Large hypopharyngeal polyp producing intermittent dysphagia and acute airway obstruction.

A 65-yr-old man who developed sudden respiratory arrest was found to have a long, smooth, esophageal filling defect on esophagogram. Endoscopy eventually proved this to be a large esophageal polypoid lesion that had arisen in the hypopharynx and extended to the midesophagus. He was successfully treated with a lateral pharyngotomy and excision of the hypopharyngeal polyp.

Aged↗
PubMed1986

Intramucosal gastric carcinoma in a patient with familial polyposis coli.

Upper gastrointestinal polyps commonly occur in patients with familial polyposis coli; but the occurrence of gastric carcinoma is very rare in this disorder. We report a case of intramucosal gastric carcinoma in a patient with familial polyposis coli and multiple gastrointestinal adenomatous polyps.

Adenocarcinoma↗
PubMed1986

Primary sclerosing cholangitis associated with massive intraabdominal lymphadenopathy.

A 40-year-old man with a history of insulin-dependent diabetes mellitus was admitted to the hospital because of jaundice and pruritus. During his evaluation the diagnosis of primary sclerosing cholangitis and "microscopic" ulcerative colitis were established. Massive intraabdominal lymphadenopathy was discovered on CT scan and histological examination eventually proved this to be follicular hyperplasia. The case herein reported documents the association of primary sclerosing cholangitis with diabetes mellitus and ulcerative colitis as well as reporting the occurrence of massive intraabdominal lymphadenopathy.

Abdomen↗
PubMed1985

Malignant fibrous histiocytoma of the liver.

A 59-yr-old man was admitted to the hospital for evaluation of right upper quadrant pain, anorexia, weight loss, and low-grade fever of 2-mo duration. During his evaluation, an abnormal liver ultrasound and computed tomography scan demonstrated what proved to be an avascular hepatic lesion. At surgery, the diagnosis of malignant fibrous histiocytoma was established. We present herein our findings of what we believe to be the first reported study of malignant fibrous histiocytoma of the liver.

Histiocytoma, Benign Fibrous↗