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Biomedical subjects

R E May

Publications and source records attributed to R E May.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of peptide and nonpeptide receptor-mediated responses in rat tail artery.

Chronic uremia and metabolic acidosis impair vascular responses to norepinephrine (NE) and also cause multiple metabolic defects in skeletal muscle. These studies were conducted to determine whether decreased vascular responsiveness resulted from putative second messenger metabolism. Tail arteries were used from rats with metabolic acidosis or nonacidotic uremia and from normal controls. In normal arteries, the maximal responses were the same for arginine vasopressin (AVP), NE, and mixtures of the two agonists, suggesting that the two receptor types use the same transduction mechanism. Nonetheless, qualitative differences exist between AVP- and NE-induced responses: (a) Concentration-response curves are steeper for AVP than for NE, (b) EC50 values are similar for AVP between inositol phosphates (IP assays) and contraction, but not for NE, and (c) arteries from rats with metabolic acidosis or uremia show selective blunting of biochemical and contractile responses to NE but not to AVP. We conclude that these metabolic derangements selectively affect alpha-adrenergic receptors, but not AVP receptors or the transduction mechanism leading to contraction.

Acidosis↗
PubMed1989

Conservative surgery for early breast cancer results from a district hospital.

Wide local excision followed by radiotherapy was offered as an alternative to mastectomy to 93 women on 96 occasions. Complications attributable to the surgery occurred in 4 per cent whilst 37.5 per cent developed complications secondary to the radiotherapy. The complications were generally of a mild nature. Nine patients (9.3%) have developed regional recurrence and seventeen (17.7%) distant metastases with a mean follow up of 53.4 months.

Adult↗
PubMed1987

Polydioxanone suture in the gastrointestinal tract.

A randomized prospective trial was undertaken of polydioxanone suture (PDS) versus conventional suture material in 98 patients undergoing anastomoses in the gastrointestinal tract. Nine patients died within 6 months of surgery, one of these being related to an anastomotic leak. All other patients were followed up for between one and three and a half years. In 57 colonic anastomoses, 30 were randomized to a single layer of 2/0 (BPC) interrupted PDS and 27 to a single of 2/0 (BPC) interrupted silk. Follow up sigmoidoscopy and barium enemas were used to confirm the clinical suspicion of 6 benign anastomotic strictures, 5 of which occurred in the PDS group. At this stage, the colonic arm of the trial was discontinued because the 19% stricture rate with PDS was deemed unacceptable. In a second limb of the study, patients were randomized to two layers of 2/0 (BPC) continuous PDS or 2/0 (BPC) continuous chromic catgut. There were no significant differences in 32 gastric or small bowel anastomoses and in particular, no anastomotic strictures were apparent. The reasons for the high rate of stricture formation when using PDS for large bowel anastomoses are unclear. However, it would seem to be a suitable alternative to chromic catgut when confined to the stomach and small intestine.

Adult↗
PubMed1985

Abdominal wound closure: a controlled trial of polyamide (nylon) and polydioxanone suture (PDS).

Two hundred and thirty three patients with major laparotomy wounds, either midline or transverse, were randomly allocated to mass closure using No 1 (BPC) polyamide (Nylon) or polydioxanone suture (PDS). Wounds were assessed during the hospital stay and postoperatively in outpatients, at six weeks and six months, for evidence of wound failure or wound infection. Two wound failures occurred in the PDS group (one burst abdomen and one incisional hernia) although neither was directly attributable to suture failure. The overall wound infection rate was 13.3%; 2.9% being major infections and the majority (two thirds) occurring in the PDS group. There were no reported wound sinuses or wound pain in either group at six months. Polydioxanone suture may be an alternative to polyamide for laparotomy closure but is associated with a higher, though not statistically significant, incidence of wound failure and infection.

Adult↗
PubMed1985

An assessment of operative choledochoscopy--a worthwhile procedure or not?

The results of a nine year survey of biliary surgery are reported. The incidence of retained common bile duct stones prior to choledochoscopy was 4%. When choledochoscopy became available, the incidence of retained stones rose to 9%. This disappointing rise is probably due to inexperience with the technique and post-exploratory cholangiography is still considered mandatory.

Adult↗
PubMed1985

Complications of T-tube drainage of the common bile duct.

The complications associated with T-tube drainage of the common bile duct following biliary surgery were studied prospectively. A high rate of complications especially associated with T-tube removal was found. Biliary leakage and bacteraemia were the two main problems though in most cases caused minimal clinical upset. Alternatives to T-tube drainage are discussed. It is suggested that if T-tubes are to be used broad spectrum antibiotic cover should be employed at the time of removal.

Common Bile Duct↗
PubMed1982

Absent vas deferens in association with renal abnormalities.

Absence of the vas deferens, especially if unilateral, should alert the clinician to an underlying renal anomaly, and further urological investigation is mandatory. If the vas is shown to be bilaterally absent in an infant, cystic fibrosis should be excluded. In the context of vasectomy, exploration of the palpably absent side should be unnecessary if intravenous urography detects a combined anomaly, although post-operative seminal analysis will still need to be performed.

Adult↗
PubMed1981

Intussusception in the adult.

Intussusception in the adult is an uncommon cause of intestinal obstruction. Seventeen cases were seen at two teaching hospitals over a twenty-year period. A local causative lesion was present in all cases; a malignant tumour was present in two out of seven intussusceptions arising in the small intestine and in seven out of ten arising in the large intestine. More than half the cases had a protracted clinical course prior to diagnosis.

Adolescent↗
PubMed1981

Hepatic artery aneurysm following cholecystectomy.

A rare case is reported of an hepatic artery aneurysm developing 5 months after cholecystectomy. This presented as massive haemobilia as a result of the aneurysm communicating with the cystic duct stump. The diagnosis was delayed owing to the complicating features of Waldenström's macroglobulinaemia and jejunal diverticulosis.

Aged↗