PubMed Health⌕ Search

Biomedical subjects

J T Mullen

Publications and source records attributed to J T Mullen.

At least 19 recordsLinked to original sources
PubMed1990

Potassium effects on blood pressure: is the conjugate anion important?

Potassium salts, often in the form of KCl, have had variable hypotensive effects in experimental animals and man. The chloride anion has recently been implicated as the hypertensive agent in salt-sensitive hypertension. We therefore hypothesized that non-chloride salts of potassium would have superior hypotensive effects to KCl. In randomized, double-blind fashion, we administered placebo, KCl (75 mmol/day) or potassium citrate (75 mmol/day) to 24 normotensive adult males. In these subjects, neither KCl nor potassium citrate affected blood pressure, despite urinary verification of potassium supplement intake. Thus, in these experimental circumstances, neither potassium nor its conjugate anion were of importance in lowering blood pressure.

Adult↗
PubMed1990

Prospective evaluation of the role of fine-needle aspiration biopsy in the diagnosis and management of patients with palpable solid breast lesions.

To evaluate the role of fine-needle aspiration biopsy (FNAB) in the diagnosis and management of patients with palpable, solid and suspicious breast lesions, a total of 107 FNABs were performed on 98 patients under the prospective FNAB protocol. Eight-four FNABs were positive for breast carcinomas; of these 84 positive FNABs, 80 underwent mastectomy without open biopsy or frozen section. Our data showed a sensitivity of 95 per cent and a specificity of 100 per cent for diagnosis of breast malignancies on these patients. We concluded that FNAB is a simple, reliable, and cost-effective diagnostic procedure for patients with palpable breast carcinomas.

Algorithms↗
PubMed1978

Squamous cell carcinoma of the foot.

The need for considering squamous cell carcinoma when diagnosing foot lesions is stressed in these two cases. Early diagnosis and treatment are the hallmarks of proper patient management.

Adult↗
PubMed1977

Bowel perforation with candidiasis.

Spontaneous multiple jejunal perforations developed in a relatively normal patient. Candida albicans was cultured from a biopsy specimen of an area of perforation and from peritoneal fluid. Yeasts and pseudohyphae were seen deep within the necrotic mucosa. Serial determinations of precipitating and agglutinating antibodies support the diagnosis of invasive candidiasis causing this unusual presentation.

Adult↗
PubMed1977

Routine upper gastrointestinal examinational examination in preoperative cholecystectomy patients.

The charts of 663 patients who had cholecystectomy were reviewed to determine the usefulness of preoperative radiologic examination of the upper gastrointestinal tract. In 14% of the patients a positive finding was reported. However, slightly less than half of these findings were confirmed at surgery. Only 2.9% of the patients had a procedure in addition to cholecystectomy. It is felt that routine examination of the upper GI tract is not indicated in the preoperative evaluation of patients with gallbladder disease unless the clinical history is equivocal and one suspects coincidental disease.

Adolescent↗
PubMed1977

Preoperative diagnosis of rectal bleeding in an adult using a radioisotope scan.

A 22-year-old man with burning pain in the lower abdomen and rectal bleeding had a sodium pertechnetate Tc 99m scan. The scan showed an area of uptake in the right lower quadrant which at operation was found to be a Meckel's diverticulum. The ability of ectopic gastric mucosa within a Meckel's diverticulum to concentrate sodium pertechnetate Tc 99 m allows for this noninvasive diagnosis of some types of rectal bleeding, especially when the cause has escaped detection by conventional endoscopic and barium contrast examinations.

Adult↗
PubMed1976

Triage for the breast biopsy.

A plan is advocated for the management of the dominant breast mass with use of local anesthesia in the outpatient setting as the primary diagnostic tool, but with selection of certain patients for immediate general anesthesia biopsy in the "conventional" manner. Experience with this plan in 2,492 patients during a period of 114 months shows local anesthesia biopsy to be efficient and accurate. Five year survival for all mastectomy-treated patients whose cancers were diagnosed under local anesthesia is 72 per cent. Use of a triage method for selecting biopsy procedures has resulted in a thirteen-fold decrease in the number of patients subjected to general anesthesia.

Adult↗
PubMed1976

Pancreatic ascites.

Two patients with pancreatic ascites secondary to acute pancreatitis are presented. Successful drainage was carried out in one patient with distal pancreatectomy and Roux-en-Y pancreaticojejunostomy and in the other by cystoduodenostomy. Most cases of pancreatic ascites are due to a mild peritoneal reaction casued by inactivated pancreatic enzymes liberated after ductal or pseudocyst disruption. A majority of cases are successfully treated by surgical correction of the underlying pathology.

Acute Disease↗
PubMed1976

Barrett's esophagus: a multifaceted condition.

Five patients with Barrett's esophagus, each with a differing presentation, serve as the basis of this report. Hiatal hernia is noted to be frequently present in Barrett's esophagus, and the incidence of adenocarcinoma is thought to be distinctly increased. The condition is easily diagnosed by fiberoptic endoscopy and verified by direct biopsy. The increasing use of fiberoptic panendoscopy may lead to an increased frequency of diagnosis of the columnar cell-lined lower esophagus and its complications.

Adenocarcinoma↗
PubMed1976

Patient acceptance of local anesthesia for breast biopsy.

Three out of every four patients undergoing breast biopsy found the outpatient local-anesthesia method acceptable in this study. Patient acceptance was greater among those who experienced less pain and anxiety. This suggests that acceptance could be increased by more complete preoperative explanation to the patient, adequate premedication, properly administered local anesthesia and gentle technique. Acceptance would also probably be far greater in a private practice setting than in the instititutional and sometimes impersonal setting of a large federal hospital. Breast biopsy under local anesthesia has not compromised survival rates or increased local recurrence. When it is done on an outpatient basis, hospital costs have been reduced at least threefold. It is apparent, then, that patient objection is not a deterrent to the use of breast biopsy under local anesthesia on an outpatient basis. For patients with dominant breast masses, this modality can be added to any plan of management which seeks to reduce patient risk and inconvencience, diminish hospital costs and alleviate bed demand all without impairing diagnostic accuracy or long-term survival.

Adolescent↗
PubMed1976

Clinical evalation of the the of local anesthesia for repair of inguinal hernia.

Three hundred sixty-six patients undergoing elective inguinal hernioplasty were randomized to receive either local anesthesia or traditional spinal or general anesthesia. Overall operative complication rates were nearly the same, but wound complication predominated in the local anesthesia group while problems related to anesthesia were more common with spinal or general technique. Patients who had local anesthesia had significantly fewer postoperative symptoms than did the others.

Adult↗