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W J Dodds

Publications and source records attributed to W J Dodds.

At least 379 records · Page 21Linked to original sources
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Pain on common bile duct injection during ERCP: does it indicate sphincter of Oddi dysfunction?

The reproduction of a patient's biliary-type pain upon initial injection of contrast material into the common bile duct during diagnostic ERCP is a dramatic experience for both patient and physician. The significance of this phenomenon is not clear, but it is touted by some to be a provocative test for sphincter of Oddi dysfunction. Sphincter of Oddi manometry was performed on 224 consecutive patients referred over a 2-year period for evaluation of post-cholecystectomy syndrome and suspected sphincter of Oddi dysfunction. All patients received only intravenous diazepam as premedication for ERCP. Delayed drainage time (greater than 45 min), bile duct dilation (greater than or equal to 12 mm), and a basal sphincter of Oddi pressure of greater than 40 mm Hg (mean +/- 3 SD) were considered elevated. We observed a reproduction of pain in 15 of 224 patients (6.7%) immediately following contrast injection. There was no correlation between pain on contrast injection and elevated basal sphincter of Oddi pressure, delayed common bile duct drainage, bile duct dilation, or abnormal liver enzymes. Therefore, we feel that reproduction of the patient's biliary-type pain associated with contrast injection of ERCP is not a provocative test for sphincter of Oddi dysfunction.

Adult↗
PubMedDate not supplied

Evaluation of platelet cryopreservation techniques by isolated kidney perfusion.

The isolated perfused rabbit kidney, a model system used previously to assess platelet function, was adapted for evaluation of human platelet cryopreservation techniques. A new, simple, efficient device for controlling cooling rates before, during, and after freezing was used. Platelet concentrates frozen with 5 per cent dimethyl sulfoxide (DMSO) under different conditions were the most effective of those tried in maintaining the hemostatic function and vascular integrity of perfused kidneys. Our studies indicate that the isolated, perfused rabbit kidney can be used to evaluate platelet cryopreservation techniques and is potentially adaptable for studies of organ cryopreservation.

Animals↗
PubMedDate not supplied

Rectal balloons: complications, causes, and recommendations.

Nine previously unreported rectal injuries caused by barium-enema examinations have been reviewed. In each case, the injury occurred in conjunction with inflation of a rectal balloon. Analysis of the clinical material suggested that certain mechanical properties of balloon catheter tips might transfer mechanical stress to the rectal wall and contribute to the observed injuries. Careful manometric evaluation of in vivo rectal balloons suggest that significant anatomic differences in patients may be clinically important. Further experimental bench studies revealed undesirable mechanical properties in many commercially available rectal balloon catheters. These mechanical problems include low compliance, asymmetrical inflation, strong lateral and anterior displacement of a firm catheter tip into the restraining wall, and self-obstruction of the balloon deflation outlet by the inflated baloon. Many of these problems were clinically confirmed by careful in vivo observations and by evidence collected from the nine cases of rectal injury. A series of practical prophylactic procedures are recommended.

Aged↗