Biomedical subjects
W B Long
Publications and source records attributed to W B Long.
"Hypochondriacal" and/or resistive patients.
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Effect of water and fat on gastric emptying of solid meals.
Gastric emptying of solid egg meals tagged with 99mtechnetium sulfur colloid was studied in 10 normal subjects and in 6 patients after truncal vagotomy, antrectomy, and gastrojejunostomy (Billroth II) for peptic ulcer disease. Technetium sulfur colloid was found to bind more firmly to cooked egg whites than did the water soluble marker DTPA. Water accelerated gastric emptying in Billroth II patients to a greater degree than in normal subjects, in whom the effect of water was minimal and transient. Fat inhibited solid emptying both in normals and in Billroth II patients. These findings suggest that in humans there are jejunal receptors for fat that may inhibit gastric emptying even following truncal vagotomy.
Effect of sugar and monoglyceride on fatty acid esterification.
The effect of hexose and monoolein on fatty acid esterification was studied in everted rings of rat jejunum. By use of [3H]oleic acid and [U-14C]glucose, esterification via both phosphatidic acid and monoglyceride pathways was quantified. Our results showed that 1) metabolizable sugars stimulate fatty acids esterification regardless of their mode of transport; 2) in the presence of glucose alone, in vitro fatty acid esterification is mediated entirely by the phosphatidic acid pathway; 3) glucose stimulates both esterification pathways in the presence of monoolein; 4) monoolein stimulates only the monoglyceride pathway and has no effect on the phosphatidic acid pathway; and 5) the rate-limiting factor in the presence of monoolein alone is the formation of acyl-CoA, whereas in the presence of glucose alone, the rate-limiting factor is the formation of alpha-glycerophosphate.
Steroid hypothermia.
A retrospective study of 17 episodes of septic shock was made. In most patients, intravenous treatment involving a 2 gram bolus of Solu-Medrol produced a precipitous fall in temperature within four hours. Accompanying the temperature change was an improvement in their general physical condition. The hypothermic effect usually lasted approximately 30 hours, after which the temperature would reach a level below the presteroid temperature or would return to the presteroid level. If the sepsis was overwhelming and the patient did not survive, thetemperature response was not as dramatic and lasted approximately eight to ten hours, with no clinical improvement.
Can OR nurses reverse role erosion?
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Bilateral recurrent parotid gland swelling after endoscopy.
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Marlex mesh in gas gangrene.
Clostridial gas gangrene is a well recognized complication of traumatic and surgical wounds, and is associated with an overall mortality rate of 25% (5, 22). Gas gangrene of a limb results in a mortality rate approximately half that of gas gangrene of the trunk (4, 7, 8, 9, 11, 12, 13, 15, 16, 19, 24). Radical debridement and antibiotic therapy or high amputation of involved limbs are accepted traditional approaches to the problem. The role and value of hyperbaric oxygenation (OHP) remains controversial despite intense study over the past few decades. Patients with gas gangrene involving all layers of the abdominal wall as well as an extremity pose major resuscitative, operative, supportive, and rehabilitative problems. A report is presented of two such patients with comments on the therapeutic modalities employed.
Amylase isoenzyme clearances in normal subjects and in patients with acute pancreatitis.
Renal clearances of amylase isoenzymes, expressed as percentages of creatinine clearances, were determined in 20 normal subjects and in 8 patients with acute pancreatitis. The isoenzyme assay employed thin layer isoelectric focusing, starch iodine staining, and densitometry. Normal clearance of pancreatic-like amylase (mean +/- SE: 3.00 +/- 0.40%) was greater than the clearance of salivary-like amylase (0.51 +/- 0.06%) in ea ch individual (P less than 0.001). However, the amount of pancreatic amylase in the serum was not the major determinant of amylase clearance. Normal clearance of pancreatic-like amylase was significantly (P less than 0.001) less than the clearance of total serum amylase in acute pancreatitis (6.49 +/- 1.07%). In pancreatitis the clearance of pancreatic-like amylase (7.29 +/- 1.19%) and the clearance of salivary-like amylase (4.55 +/- 1.02%) were both elevated compared to normal (P less than 0.001). These findings indicate that the increased clearance of amylase in pancreatitis results from a change in renal function rather than a change in serum amylase. Renal changes not reflected by increased serum creatinine or more than mild proteinuria may be manifestations of the systemic toxicity of acute pancreatitis.
Zinc and wound healing.
A review of the literature on zinc and wound healing shows the many gaps of knowledge which still exist. This study of the histologic appearance of wound healing in rats fed various diets demonstrates the serum zinc levels achieved by such diets. No significant improvement was observed in the rate of healing for any one group, but a number of histologic differences were observed.
Alcohol intoxication and serum osmolality.
The relation between serum osmolality and blood-alcohol was studied prospectively in 565 acute trauma patients. The two measurements were closely correlated. It is therefore possible to estimate the blood-alcohol from serum osmolality to assist in the clinical management of acutely injured patients.
Abdominal lavage in blunt trauma.
A technique for abdominal lavage is described and was used to evaluate the abdomen of 671 multiple trauma victims. In 44 per cent (299 cases) there was a bloodstained return and these were regarded as positive. Patients with a positive result underwent exploratory laparotomy which revealed that 89 per cent had significant intra-abdominal trauma requiring a surgical procedure, 8 per cent had trauma which did not require any active surgical correction and 3 per cent had no abdnormal findings. Of all the lavages performed, there were 0-11 per cent false positive and 0-03 per cent false negative results. The value of the test in the context of multiple trauma is emphasized.
Volume resuscitation in critical major trauma.
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Controversial aspects of abdominal trauma.
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