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Biomedical subjects

M Towers

Publications and source records attributed to M Towers.

At least 19 recordsLinked to original sources
PubMed1992

Role of intraoperative ultrasonography in hepatic surgery: a preliminary report.

Twenty-four patients who underwent ultrasonography during hepatic surgery in the 22 months from October 1989 to July 1991 were studied prospectively to determine the value, if any, of intraoperative ultrasonography. For 6 (25%) of the 24 patients the operative plan was altered because of the ultrasonographic findings. In one of them resection was extended from a left lateral segmentectomy or sectorectomy to a left hemihepatectomy. In the other five patients the planned liver procedure was abandoned. Two of these five patients were cirrhotic--in one of them an additional metastasis was seen, and in the other there was tumour invasion of the portal vein. Of the three noncirrhotic patients, one had tumour invasion of the right hepatic vein, and the other two patients had additional metastases in the caudate lobe (Couinaud segment 1). Ultrasonography was found to be useful in 25% of patients who underwent this investigation during hepatic surgery--it avoided liver resections that would have failed because of advanced malignant disease.

Humans↗
PubMed1986

Prospective randomized double-blind trial of nabilone versus domperidone in the treatment of cytotoxic-induced emesis.

A prospective randomized double-blind trial comparing the butyrophenone analogue domperidone (D) and the synthetic cannabinoid nabilone (N) in the treatment of cytotoxic-induced emesis was conducted in 38 patients receiving highly emetogenic chemotherapy regimens (70% containing cisplatin). Patients received 20 mg D or 1 mg N the night before chemotherapy and 8-hourly on each chemotherapy day for two consecutive cycles of treatment. Three of 19 patients randomized to N completed only one cycle because of disease progression or subjectively adverse effects. Four of 19 patients completed only one cycle of D because of lack of efficacy or chemotherapy toxicity. In all, 32 cycles of N and 33 cycles of D were evaluable for efficacy. The mean number of vomiting episodes in cycle 1 was 4.76 for N and 12.95 for D (P less than 0.02). The corresponding values for cycle 2 were 4.27 and 7.69 (P greater than 0.10), and for cycles 1 and 2 combined, 4.53 for N and 10.81 for D (P less than 0.01). Nausea and food intake scores did not differ significantly, although there was a trend towards less nausea and an increased food intake with N. Subjectively adverse effects were more frequent with N and included drowsiness, dizziness, dry mouth, and postural hypotension. N is superior to D for the control of cytotoxic-induced emesis.

Adult↗
PubMed1979

Influence of preoperative left ventricular function on results of homograft replacement of the aortic valve for aortic stenosis.

The effect of preoperative left ventricular function on early and late prognosis was assessed in 103 patients with aortic stenosis who underwent left ventricular cineangiography before homograft replacement of the aortic valve. The patients were separated into two groups: Group A (58 patients) with an ejection fraction of 0.46 or more and Group B (45 patients) with an ejection fraction of 0.45 or less. The two groups were compared with respect to clinical and hemodynamic data as well as operative result. There was poor correlation between clinical data and left ventricular function. In Group A there were three early deaths (5.2 percent) and three late deaths (5.2 percent) compared with no early and six late deaths (13.3 percent) in Group B during the follow-up period of 12 to 102 months (mean 43 months). Most patients in Group B showed considerable symptomatic improvement but less than that observed in Group A. Forty-two patients (13 in Group A and 29 in Group B) underwent repeat cardiac catheterization and coronary angiography. Improvement in left ventricular function as assessed by radial analysis of segmental wall motion and ejection fraction was observed in 20 of the 29 patients in Group B. Failure of left ventricular function to improve was associated with additional coronary artery disease in the majority of patients. It is concluded that poor left ventricular function does not increase the risk of aortic valve replacement for aortic stenosis and that improvement in left ventricular function can be expected in the majority of patients.

Adolescent↗
PubMed1979

Influence of preoperative left ventricular function on results of homograft replacement of the aortic valve for aortic regurgitation.

The effect of preoperative left ventricular function on eraly and late prognosis was assessed in 69 patients with aortic regurgitation who underwent homograft replacement of the aortic valve. Patients were divided into two groups: Group A (38 patients) had an ejection fraction of 0.46 or more and Group B (31 patients) had an ejection fraction of 0.45 or less. Clinical data, hemodynamic data, and operative results were compared in the two groups. In Group A there was one early death (2.6%) and there were two late deaths (5.3%) compared to two early deaths (6.5%) and seven late deaths (22.6%) in Group B during a follow-up period of 13 to 98 months (mean, 49 months). Actuarial analysis showed a 94% survival at 6 years in Group A compared to 80% in Group B. Twenty-four patients were reinvestigated by repeat cardiac catheterization and coronary angiography at a mean time of 38 months following valve replacement. Left ventricular function was assessed by computerized quantitative radial analysis of segmental wall motion. Improvement in left ventricular function occurred in eight of the 14 patients reinvestigated in Group B, and appeared to be closely related to the etiology of the initial valve lesion. Despite the higher mortality rate in patients with poor left ventricular function, most derived considerable benefit from operation.

Adolescent↗
PubMed1977

The use of "fresh" unstented homograft valves for replacement of the aortic valve: analysis of 6 1/2 years experience.

Between August 1969 and January 1976, 561 patients underwent homograft replacement of the aortic valve (AVR). Isolated AVR was performed in 339 patients, ranging in age between 18 months and 74 years. The valves were sterilized in antibiotic solution and preserved at 4 degrees C in tissue culture medium. There were 11 early deaths (3.2%) and 23 late deaths (6.8%). Actuarial analysis showed 88% survival at 5 years and 85% at 6 years. Valve failure occurred in 13 patients (3.8%) due to prolapse of one cusp in five patients (1.5%), infective endocarditis in three and degeneration of the graft in five (1.5%). Degenerative valve failure was encountered after the fourth year with an incidence of 3.5% of patients at risk, and occurred only in grafts from donors over the age of 70 years. Diastolic murmurs were present in 22% of patients followed up for more than one month and increased very slightly with time. The clinical result was judged to be good or excellent in approximately 90% of the surviving patients.

Adolescent↗
PubMed1975

Combined gas endarterectomy and coronary artery bypass graft. A follow-up study.

One hundred and four patients who underwent combined gas endarterectomy and bypass grafting were followed for periods up to 4 1/2 years (mean, 15 months). The early mortality was 2.9% and the late mortality 3.8%; all of these deaths occurred in patients operated on for heart failure. The survival rate, presented in an actuarial manner, was 91% for the whole group at 3 years. Perioperative infarction occurred in 5.8%, was usually accompanied by patent grafts, and produced left ventricular dysfunction in only 1 of 5 patients investigated. Symptomatic improvement was observed in 96% of the patients. There was fairly good correlation between symptomatic improvement and graft patency. Repeat graft and coronary angiography showed that of 65 grafts to endartectomized arteries, 56 were patent (a patency rate of 87%); there was no evidence of decrease of patency rate with time, and no significant difference between patency rates of grafts to different arteries. The runoff of patent grafts was judged to be good in 75% of patients, moderate in 15% and poor in 10%.

Adult↗