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Biomedical subjects

I B Simon

Publications and source records attributed to I B Simon.

At least 19 recordsLinked to original sources
PubMed1997

Standardizing laparoscopic procedure time and determining the effect of patient age/gender and presence or absence of surgical residents during operation. A prospective multicenter trial.

BACKGROUND: Most of the expense of laparoscopic cholecystectomy (LC) is incurred while the patient is in the operating room (OR). Half of this operating room cost is equipment and the other half is personnel. What is an acceptable LC procedure time and how much variation is there? What are the effects of age, gender, and expertise on the mean LC procedure time? METHODS: A prospective, multicenter gathering of LC procedure times and task component times was performed through the cooperative effort of members of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) at 11 hospitals. The effect of LC time of age, gender, and surgical resident was recorded. RESULTS: The mean LC time for 359 cases was 73 +/- 28 min. The percent of this LC time for the following component tasks included: to place and remove trocars, 34%; total dissection time, 40%; intraoperative cholangiogram, 15%; and removing the gallbladder, 7%. Age and gender did not change LC time, but the presence of a surgical resident prolonged LC time from 53 to 79 min due to an increase in all LC component task times. CONCLUSIONS: LC time was globally calibrated in 11 North American hospitals and was found to be affected by expertise but not by gender or age. The mean and standard deviation of LC time can be used for purposes of self-assessing quality performance.

Age Factors↗
PubMed1994

Endoscopy for the year 2000.

With the rapid advancement in technology, there is a revolutionary paradigm shift in the delivery of health care: physicians are now interacting with their patients via an "electronic interface." This interface will make possible the future of endoscopy and endoscopic surgery by taking advantage of the emerging technologies in robotics, micro-robotics, telepresence, and virtual reality.

Colonoscopy↗
PubMed1993

Teleoperation, telerobotics, and telepresence in surgery.

The concepts of teleoperation, telerobotics, and telepresence are presented and defined. Current surgical systems, some in clinical practice and others in prototype demonstration, are used to illustrate each of these principles. The importance and impact of these technologies and their relation to other advanced technologies are illustrated to project a framework for the future of surgery.

Animals↗
PubMed1991

Tract formation following percutaneous endoscopic gastrostomy in an animal model.

Complications of percutaneous endoscopic gastrostomy (PEG) have often been related to the application of excessive traction to the gastrostomy tube in an attempt to achieve immediate juxtaposition of the gastric and abdominal walls. Recent clinical reviews have suggested that complication rates can be reduced by avoiding such traction and leaving a longer tract between these structures. Laboratory evaluation of tract development has been lacking. The present study was designed to evaluate tract formation in an animal model. Eight mongrel dogs underwent PEG placement using silastic (n = 4) or latex (n = 4) catheters. Two animals from each group were subsequently sacrificed at 1 week and the remaining animals, at 2 weeks. In each animal, 6 cm catheter length was left between the gastric and the abdominal walls. This distance was assured by crossbar and suture fixation of the catheter at the skin entry site. Complete tract formation was evident in all animals at the time they were sacrificed, with no significant gross or histologic differences being noted between the silastic and the latex groups. Increased collagen deposition was noted at 2 weeks in comparison with that observed at 1 week. In an additional three animals, the same procedure was performed, but the catheter was not secured to the abdominal wall at the site of skin penetration. In these animals, tract formation was incomplete as late as at 2 weeks, but there were no associated complications. We conclude that early PEG tract formation is not dependent on the immediate proximity of the gastric and abdominal walls. The type of catheter used does not dictate the time course of early tract development.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Muscles↗
PubMed1991

A safe method for sedating and monitoring patients for upper and lower gastrointestinal endoscopy.

Although the incidence of significant complications occurring during endoscopic procedures that require sedation are low, it has been demonstrated that they are usually related to cardiovascular system dysfunction. Such complications are a manifestation of cardiac hypoxia and are a function of the arterial oxygen desaturation. A practical method of monitoring such patients includes continuous oxygen saturation measurements and EKG monitoring. From October, 1987 to July, 1989, a total of 730 endoscopic examinations were performed using a combination of meperidine and midazolam as an intravenous (IV) bolus for sedation. Supplemental nasal oxygen was routinely given at 2 L per minute and real-time monitoring was performed with electrocardiograph and continuous pulse oximeter. There were no deaths and only four untoward events related to medication that altered the course of the examination. Transient hypoxemia that responds to gentle stimulation and bradycardia resolving with cessation of endoscope advancement are viewed as physiologic responses and not complications. All occurrences were immediately identified and corrected appropriately, and no morbidity resulted. With proper monitoring of oxygen saturation, pulse, and cardiac rhythm in a patient with nasal oxygen, IV bolus administration of meperidine and midazolam is a safe and adequate sedation even in the elderly and debilitated patient.

Procedural Sedation↗
PubMed1976

[Effect of ethyl ether of p-chlorphenoxyisobutyric acid on the glucocorticoid function of the adrenal cortex of guinea pigs].

In administration to quinea pigs of ethyl-p-chlorophenoxyisobutyrate daily in a dose of 0.2 g/kg per os for 15-26 days decreased the 17-OHCS concentration in the peripheral blood plasma. A fall of the urinary excretion of individual 17-OHCS occurred chiefly at the expense of free unchanged cortisol, tetrahydrocortisol and tetrahydro-11-desoxycortisol. The zona fasciculate displays the abundance of the sudanophilic material. A test with ACTH demonstrated that the present functional reserves of the adrenal cortex failed to change under the effect of the preparation. The content of NEFA decreased in the blood serum; as to cholesterol level - it reamined unchanged. Possible mechanisms of the action of the preparation and prospects of its use for the treatment of hypercorticism are discussed.

17-Hydroxycorticosteroids↗
PubMed1976

[Anti-arrhythmic activity of the beta2-adrenoblockader alpheprol].

Experiments were conducted on dogs, cats and rats in which various disturbances of the cardiac rhythm were induced. Beta2-adrenoblocker alpheprol proved to produce a marked antiarrhythmic action. The preparation arrested the auricular arrhythmias caused by electric stimulation of the auricles or by aconitine application, eliminated the auricular arrhythmias resulting from occlusion of a branch of the coronary artery or oubaine intoxication, prevented lethal auricular fibrillation in rats after the calcium chloride intoxication. It is supposed that along with the beta-adrenoreceptor block the antiarrhythmic effect of alpheprol was also caused by quinidine-like action of the preparation.

Alprenolol↗
PubMed1975

[The nature of differences in beta-adrenergic receptors].

Results of investigation of the affinity between teranol (practalol), alpheprol (alprenolol), propranolol to beta-adrenoreceptors of various organs confirmed the division of these receptors into two subtypes. The action of isadrin on beta1-adrenoreceptors of the myocardium and smooth muscles of the gastrointestinal tract was accompanied by changes in Ca2+ entrance into the cells. With the action of isadrin on beta2-adrenoreceptors of the trachea and the vessels there was seen an intensification of the Ca2+ ions from the cells and a reduction of the smooth muscle tone.

Alprenolol↗