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Biomedical subjects

J M Griffin

Publications and source records attributed to J M Griffin.

10 recordsLinked to original sources
PubMed1991

Esophageal insufflation and videofluoroscopy for evaluation of esophageal speech in laryngectomy patients: clinical implications.

Esophageal speech proficiency in 75 laryngectomy patients was rated on a seven-point scale by a speech therapist. Radiologic evaluation of the reconstructed pharyngoesophageal (PE) region during swallowing, attempted phonation, and phonation, by means of esophageal insufflation and barium-enhanced videofluoroscopy and spot radiography revealed the PE segment to be normal in 13 patients and hypotonic in 21. Hypertonicity or spasm of the PE segment was detected in 28 patients. Three patients had a postoperative stricture. Speech in 24 patients was fluent at the time of assessment; the remainder had negligible speech. Correlation between esophageal speech fluency and response at insufflation was highly positive. Esophageal insufflation, when combined with radiologic assessment, provides a reproducible method for accurate evaluation of the PE transition zone. Videofluoroscopy allowed good visualization of tracheoesophageal dynamics. Results indicated anatomic factors in the reconstructed PE region to profoundly affect the acquisition of esophageal speech.

Adult↗
PubMed1991

Clinical pharmacokinetics of contraceptive steroids. An update.

The present article should be read in conjunction with the original review published in the Journal in 1983. There is no new information of major significance about the pharmacokinetics of levonorgestrel, norethisterone (norethindrone) or ethinylestradiol, although it has been shown that the concentrations of these hormones secreted in breast milk are small and mothers taking combined oral contraceptive steroids may breast-feed safely. Both levonorgestrel and ethinylestradiol can be successfully administered from appropriate vaginal formulations, but no clear advantages over oral administration have been demonstrated. Several new progestogens have been investigated. Desogestrel is a prodrug for its active metabolite 3-keto-desogestrel, gestodene is itself an active progestogen and norgestimate is a prodrug acting by conversion to norgestrel and its metabolites. All 3 compounds have good bioavailability with wide intersubject variation. The newer progestogens, like norethisterone and levonorgestrel, are bound to sex hormone binding globulin (SHBG). This causes their plasma concentrations to increase with time, since SHBG is induced by ethinylestradiol even in doses of 30 micrograms daily. The binding capacity and affinity of SHBG do not increase in direct proportion to its concentration. Further drug interactions with oral contraceptive steroids have been described. Contraceptive steroids may inhibit hepatic microsomal enzyme metabolism and increase the plasma concentration and effect of some tricyclic antidepressants, the hydroxylated benzodiazepines, some beta-blocking drugs, methylxanthines, prednisolone and cyclosporin. There are no significant effects on vitamins. Oral contraceptive steroids induce glucuronidation and hence decrease plasma concentrations of some benzodiazepines, clofibric acid, paracetamol (acetaminophen) and possibly morphine. The plasma concentration of ethinylestradiol may be increased by competitive sulphation with paracetamol. Plasma concentrations of contraceptive steroids are decreased by griseofulvin, which induces their hepatic metabolism. The role of other antibiotics remains controversial but there is probably a group of susceptible women who have lower plasma contraceptive hormone concentrations and experience breakthrough bleeding or pregnancy when given broad spectrum antibiotics. This may relate to interruption of the enterohepatic recirculation of ethinylestradiol. Anticonvulsants, other than valproic acid, all induce contraceptive steroid metabolism and therefore lower plasma hormone concentrations, thus reducing contraceptive effectiveness.

Contraceptives, Oral, Hormonal↗
PubMed1978

Congenital arteriovenous malformations of the upper extremity.

The embryology and the clinical management of congenital AV fistulas of the upper extremity are discussed. Early excisional surgery of asymptomatic lesions should be confined to ones of a very limited extent. Excisional surgery on extensive lesions should be limited to those which are symptomatic and have decreasing hand function. Possibly of limited effectiveness in some lesions may be the selective occlusion of vascular feeders by injecting cyanoacrylate glue through a catheter.

Adolescent↗
PubMed1976

Acute toxicity of ammonia-base neutral sulfite pulp mill waste liquor to rainbow trout.

The acute toxicity to rainbow trout of untreated ammonia-base neutral sulfite pulp mill waste liquor was demonstrated in these experimants. A mean LC50 of 0.82% and 95% confidence interval of 0.08 - 1.56% was obtained in four static bioassays. Lignin, sulfur dioxide, and ammonia were implicated as toxic components. The latter two were probably the most toxic.

Animals↗
PubMed1976

Diabetes insipidus caused by craniofacial trauma.

A patient is presented with diabetes insipidus secondary to craniofacial trauma. Diabetes insipidus can occur in any patient within ten days of craniofacial trauma. Even the masked disease in the unconscious patient can be diagnosed by observation of intake and output, urinary specific gravities, and appropriate chemical studies. The disease can recur following operative reduction of facial fractures. Diabetes insipidus can be successfully treated by intramuscular Pitressin and appropriate fluid intake.

Accidents, Traffic↗
PubMed1976

Survey of aflatoxicosis in farm animals.

Over a 22-month period, 278 submissions of farm animals were made to the North Carolina Diagnostic Laboratory for suspected aflatoxicosis, and 94 cases were confirmed on the basis of finding aflatoxin in the feed and the occurrence of bile ductule proliferation. There was an annual variation in the incidence of aflatoxicosis, as well as a seasonal variation: the peak incidence occurred in the winter, and the minimum incidence occurred during the summer. The annual increase coincided with the corn harvest. All confirmed cases occurred on farms that raised and stored their own corn, and 88% were in swine. The cases were geographically localized in the eastern section of North Carolina (94% of the total cases) where 82% of the swine and 79% of the corn are produced. Mean concentration of aflatoxin in feed samples from the confirmed cases was 3,890 mug/kg, and the mean value for corn used in making the feed was 5,180 mug/kg. Only aflatoxin B1 was found in the samples. These data were interpreted to mean that the incidence and severity of aflatoxicosis is greater than previously suspected, that poor on-farm storage of corn is a primary contributing factor, that aflatoxin formation continues during and after the milling process, and that mycotoxicoses other than aflatoxicosis may cause equal or greater problems.

Aflatoxins↗
PubMed1975

Further experience with lateral wedge resection mammaplasties.

The lateral wedge resection method of reduction mammaplasty results in breasts with a single oblique radial scar in the outer quadrant, good contour, the nipples with sensation, erectile capacity and forward projection. It is suitable for cases of moderate enlargement and for ptotic breasts.

Breast↗
PubMed1975

American Indian sign: a gestural communication system for the speechless.

American Indian sign, used as a gestural communication system for the speechless, served the daily life needs of patients with a variety of deficits, many with unfavorable prognosis for oral speech rehabilitation. The project included total glassectomees, laryngectomees, dysphonics, dysarthrics and apraxics. Many of the last named were hemiplegics. The sign was effectively interpreted by hospital personnel, patients and visitors, none of whom had received any instruction in interpreting the sign. This system may be a desirable new tool from an old culture for the professional repertoire of the speech clinician. An illustrated manual and instructional videotapes are in preparation.

Apraxias↗
PubMed1975

Subcutaneous mastectomy. The excess skin problem.

Subcantaneous mastectomy through a lateral approach, with preservation of the nipple and areola on a dermal pedicle, removing the excess skin at the time of aubautaneous mastectomy, is a safe procedure which results in esthetically acceptable breasts. The surgical approach greatly facilitates the removal of the entire glandular portion of the breast. The need for a second surgical procedure is eliminated. Lateral biopsy scars can be reinforced by the dermal sling support, thereby decreasing the chances of exposure of the implant. The implant is also successfully and easily held in position by the use of the dermal-fat sling support. The nipple and areola survive quite well on the dermal pedicle, with preservation of contractility and sensation, as well as of blood supply.

Dermatologic Surgical Procedures↗