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Biomedical subjects

S N Joffe

Publications and source records attributed to S N Joffe.

At least 19 recordsLinked to original sources
PubMed1992

Nd:YAG laser bipolar dissector--preliminary results.

We have developed a laser bipolar dissector (LBD) which uses the 1,064 nm Nd:YAG wavelength. The laser emits from the inner surface of the distal 7 mm of each probe made of synthetic sapphire. With low laser power (15-25 W), the bipolar provides hemostatic cutting of larger blood vessels. Animal experiments were carried out using New Zealand white rabbits. The LBD hemostatically cut through veins up to 5 mm and arteries up to 2 mm in diameter. Rebleeding did not occur. Transection of parenchymal organs such as liver and lung was easily performed with complete hemostasis. In chronic experiments a partial hepatectomy with splenectomy and left nephrectomy was performed using the LBD alone without any ligation. Up to 3 weeks postoperatively there were no direct complications related to using the LBD. In conclusion the LBD could perform a hemostatic transection of large vessels and might have clinical application in the dissection of vascular parenchymal organs.

Animals↗
PubMed1992

Clinical application of the Nd:YAG laser bipolar dissector in intra-abdominal surgery.

A laser bipolar dissector (LBD) using a 1064 nm Nd:YAG laser energy source that provides hemostatic dissection using low-powered laser energy (15-25 W) has been developed. Clinical applications have included a partial hepatectomy (n = 5), a cholecystectomy (n = 4), an appendectomy, lymphnode dissection, and division of adhesions. The LBD was effective in resection of noncirrhotic liver and reduced the number of ligations required. There were no direct complications related to using the LBD. Operative time and blood loss were difficult to compare to conventional methods. The LBD may have applications for partial hepatectomies and other intra-abdominal operations.

Abscess↗
PubMed1979

Aspiration cytology and outpatient excision of breast lumps.

Fine-needle aspiration biopsy was performed in 30 consecutive women with clinically non-malignant breast lumps. All aspirates were shown to be benign on cytology and the lumps were excised under local anaesthetic at the outpatient department. Frozen section and paraffin section histology of the excised lump confirmed the diagnosis. Follow-up at the outpatient department and a postal questionnaire revealed the following wound complications: redness (70%), bruising (55%), and discharge (35%). Outpatient excision of solid breast lumps is a safe, rapid, and economical method of treating non-malignant breast lumps, if it is preceded by an accurate cytological interpretation of a technically satisfactory aspirate.

Adolescent↗
PubMed1979

The temporary effect of proximal gastric vagotomy on experimental duodenal ulcers and gastric secretion.

A proximal gastric vagotomy (PGV) prevented experimental duodenal ulcers in rats for only 5 days and thereafter all rats developed duodenal ulceration. In sham-operated rats the mean stimulated gastric acid output was 186 mumol/60 min. Immediately following a PGV there was a significant decrease in gastric juice volume and acidity (P less than 0.001) with a fall in the mean stimulated acid output to 12 mumol/60 min. On the seventh day after vagotomy the stimulated acid output (volume and concentration) significantly increased to 88 mumol/60 min (P less than 0.001). When the dose of gastric secretagogues was reduced by 50 per cent, a PGV on day 0 prevented any changes occurring in the duodenal mucosa, but when repeated at 4 weeks after a PGV the severity of duodenal ulcers in vagotomized rats was greater than in those having had a sham operation (P less than 0.05). This transient effect of a PGV on duodenal ulcerogenesis and gastric secretion may be due to recovery of the parietal cell mass.

Animals↗
PubMed1979

Amylase activity in human bile.

The mean amylase level in 42 human bile samples was 154 IU/l and there was no significant difference in the amylase activity of 32 paired serum and bile samples. Estimation of the amylase thermolability of bile showed it to be similar to that of serum. This suggests that the amylase activity in bile may have filtered through the liver from the hepatic circulation rather than refluxed from the pancreatic duct. The presence of amylase in human bile provides further evidence that the liver might have a role in the regulation of serum amylase.

Amylases↗
PubMed1979

Serial serum amylase levels in patients with pancreatic pseudocysts.

The incidence of hyperamylasaemia in serial serum amylase levels from patients with pancreatic pseudocysts is not well documented in the literature. Accordingly serial amylase levels were estimated in 5 patients with proven pancreatic pseudocysts. The majority of the values were normal or only minimally elevated. In contrast the amylase thermolability was persistently elevated and appeared to be a more sensitive measurement than serum amylase activity for indicating the presence of pancreatic pseudocysts.

Amylases↗
PubMed1979

Response to starvation before and after a jejuno-ileal bypass operation for morbid obesity.

A greater metabolic response developed during a seven day starvation in two morbidly obese patients three months after a 90 per cent jejuno-ileal bypass operation when compared with a similar fast before operation. There was a greater degree of ketosis, a decreased urinary urea excretion and an earlier utilization of ketone bodies. These changes suggest a metabolic adaptation of the body to the semistarvation state caused by the operation with a more rapid utilization of adipose tissue as a fuel and a sparing of lean body mass.

Adult↗
PubMed1979

The endoscopic and histological features of peptic duodenitis.

This study attempts to compare the endoscopic features of duodenitis with the histological characteristics. During a 12 month period, 98 patients undergoing fibreoptic oesophago-gastro-duodenoscopy had the endoscopic appearances of the duodenum classified on a three point scale of increasing severity of duodenitis. Multiple duodenal biopsies were then taken and the histological features of the severity of duodenitis graded from 0 to 4 plus by an independent observer. The histological criteria included an assessment of neutrophil infiltration, villous bluting, gastric metaplasia and chronic inflammation. Routine endoscopic assessment alone was unsatisfactory for diagnosing and grading the severity of duodenitis and multiple target biopsies are required for histological examinations.

Duodenitis↗
PubMed1979

A preliminary study of scanning electron microscopic changes of the duodenum during healing of duodenal ulcers.

Using the scanning electron microscope, changes in the rat duodenum have been studied during the healing of gastric secretagogue-induced duodenal ulcers on the 1st, 3rd, 7th and 10th days post-infustion. A montage technique with fine resolution has allowed both the entire area of the duodenum and the cellular organization in individual villi in proximity to the ulcers to be investigated. There was a considerable range of appearances noted at any one time point due to the variations in the size and depth of the original area of ulceration. On day 1, there was acute destruction of the mucosal surface with distortion of the villi at the ulcer margin. By the 3rd day, some specimens already showed full epithelialization over the defects whereas others up to day 10 revealed persistent areas of ulceration. Occasional specimens showed areas suggestive of gastric surface metaplasia on the villous surface adjacent to these ulcers.

Animals↗
PubMed1979

The effect of ethanol ingestion on plasma biochemistry and the pancreas in the rat.

Intra-gastric ethanol given daily for 4 weeks caused transient elevations in plasma amylase and total protein with a fall in total calcium. Light microscopic examination of the pancreas at 4 weeks showed areas of acinar cell degranulation and necrosis without an inflammatory cell infiltrate. The pancreatic changes are unlikely to be an artefact, but rather a direct toxic effect of the alcohol as confirmed by the biochemical changes.

Amylases↗
PubMed1979

Histological grading and sequential morphological changes during the production of acute duodenal ulcers.

A method of grading histological changes in the duodenum and the sequential morphological appearances during the development of acute duodenal ulceration is described. After s.c. infusion of ulcerogenic doses of gastric secretagogues, rats were killed hourly and the duodenal lesions were graded from 1, which was the earliest change seen consisting of focal necrosis of the tips of villi to 6, which showed perforation of duodenal ulcer. For the first 4 h the duodenum was normal but after this there was progressive necrosis of the mucosa and submucosa, and inflammatory-cell infiltration. From 18 h rats were shown to have duodenal ulcers with or without perforation.

Acute Disease↗
PubMed1978

Natural history of perforated duodenal ulcers treated by suture closure.

Of 50 patients with a perforated duodenal ulcer treated with simple suture closure, 36 (72%) had symptoms before the perforation for a mean period of 9.9 years. 24 of the 36 (66.6%) acquired further symptoms or complications at 1--48 months (mean 11 months) after the operation, whereas only 2 of the 14 patients (14%) who were symptom-free preoperatively had further complications. At follow-up 48% of the patients were still free of symptoms. Simple suture closure with a "wait and see" policy remains the treatment of choice, and a prospective clinical study to evaluate definitive emergency surgery for duodenal ulcer has been cancelled.

Adult↗
PubMed1978

Clinically silent gross hypergastrinaemia from a multiple hormone-secreting pancreatic apudoma.

A patient is described who had a malignant pancreatic islet cell apudoma secreting corticotrophin (ACTH) and melanocyte-stimulating hormone (MSH), both of which were clinically active, and very large quantities of immunoreactive gastrins, which were biologically active but clinically silent (normal gastric acid secretion and no peptic ulceration). The presence of parietal cell antibodies, with no increase in the plasma concentrations of hormones which can inhibit gastric acid secretion (secretin, GIP and VIP), suggests that many of the of the parietal cells may have been blocked by the autoantibodies.

Adenoma, Islet Cell↗
PubMed1978

A prospective study of the clinical value and accuracy of grey scale ultrasound in detecting gallstones.

The accuracy and possible clinical value of grey scale ultrasonography in the detection of gallstones has been prospectively studied in 100 unselected patients presenting with recurrent biliary colic, acute cholecystitis or acute pancreatitis. Adequate visualization of the gallbladder was obtained in 79 cases, with 3 false positive and no false negative reports. Oral cholecystography remains the initial investigation of choice in patients presenting with recurrent biliary colic, but grey scale ultrasound has been shown in this study to be a reliable means of detecting gallstones in the 'acute' situation, when conventional contrast radiology is of limited value.

Acute Disease↗
PubMed1978

Amylase thermolability as a screening test for pancreatic pseudocysts.

Amylase thermolability was determined by heating sera from control patients and patients with acute pancreatitis and pancreatic pseudocysts at 65 degrees C for 15 min. Normal serum amylase was 44 per cent thermolabile, but increased to 84 per cent thermolability during the hyperamylasaemia of acute pancreatitis, and returned to normal on resolution of the pancreatitis. In 9 patients with a pancreatic pseudocyst, although the total amylase level had almost returned to normal limits, 79 per cent of the amylase remained thermolabile. Amylase thermolability appears to be a simple screening test for pancreatic pseudocyst formation secondary to acute pancreatitis.

Acute Disease↗