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Biomedical subjects

W J Hodgson

Publications and source records attributed to W J Hodgson.

At least 37 records · Page 2Linked to original sources
PubMed1984

Preliminary experience in liver surgery using the ultrasonic scalpel.

We will describe the development of new resectional techniques with the use of the ultrasonic scalpel in 33 patients with liver disease. Our experience is presented in the performance of anatomic and nonanatomic liver resections by use of this device. Its saline-cooled tip vibrated at ultrasonic frequencies and selectively fragmented target tissue, then suspended and aspirated the fragments, thus removing the mesenchyma from the blood vessels. Tactile feedback enhanced this dissection so that all but the smallest blood vessels could be divided between clamps or clips. This resulted in improved control and hemostasis in hepatic resections. Only six patients had complications and there was only one operative death. We now use this technique routinely as we believe it is a major advance over existing methods.

Hemorrhage↗
PubMed1982

Ultrasonic partial splenectomy.

We describe use of the ultrasonic scalpel to perform three partial splenectomies expeditiously, with control, and with excellent hemostasis. This new powered instrument has a tip that vibrates at ultrasonic frequencies and cuts through mesenchymal tissue, sparing blood vessels. On the basis of experience in the laboratory and the cases presented, we believe that the technique of ultrasonic partial splenectomy may overcome problems inherent in methods now used.

Adult↗
PubMed1981

A comparative study between Z-plasty and incision and drainage or excision with marsupialization for pilonidal sinuses.

Pilonidal sinuses are acquired in the natal cleft as a result of dead hairs being pushed into skin abrasions by the movements of the buttock. Traditional surgical approaches have resulted in high recurrence rates. To avoid this, plastic procedures, such as the Z-plasty, have been advocated but have not been generally accepted. In a randomized trial, we compared Z-plasty with incision and drainage or marsupialization and found that no further surgical treatment was required in the Z-plasty group; in the control group, 40 per cent had repeated surgical treatment. We support Z-plasty for pilonidal sinuses.

Drainage↗
PubMed1980

Ultrasonic surgery.

Animal and clinical studies of a new approach in general surgery using an ultrasonic aspiration device have been encouraging. On 31 patients 11 liver procedures, 12 extensive head and neck dissections, 5 ultrasonic fulgurations for rectal cancer, and excision of 2 local oral lesions, 1 para-aortic mass, 1 pancreatic cancer, 1 giant subfascial lipoma, and 1 rectal villous adenoma have been carried out.

Humans↗
PubMed1979

Continent anal ileostomy with mucosal proctectomy: a bloodless technique using a surgical ultrasonic aspirator in dogs.

At present, mucosal proctectomy with ileo-anal anastomosis is a difficult, time-consuming operation involving much blood loss, often associated with impaired postoperative continence. A new operation has been devised in our department in which a surgical ultrasonic aspiratory, the CUSATM System (Cavitron Corporation) was used to fragment directly and strip bloodlessly mucosa from the rectal wall in 20 dogs as part of a simple ileo-anal sleeve anastomosis. All dogs were closely followed for up to 10 months. The only operative mortality occurred in the first dog where the upper rectum sloughed because the superior haemorrhoidal artery was divided. Preoperative weight was regained within the first 2 months. Initially stools were loose and frequent. Within 2 weeks the daily stool count was 5-6 with gradual thickening to semisolid consistency by 6 weeks. Finally 3-4 normal stools were passed daily. Postoperatively, all dogs remained contingent.

Animals↗
PubMed1979

Transverse taeniamyotomy in localized acute diverticulitis.

Transverse taeniamyotomy has been in use for over four years in the surgical correction of the muscle abnormality of diverticular disease. Essentially, the technic is to carefully transversely incise the two antimesenteric taeniae coli at 2 cm. intervals, in a stepwise manner, from the rectosigmoid junction proximally up to normal colon. This causes the cut ends of the taeniae coli to pull apart into separate 2 cm. blocks of longitudinal muscle. Thus elongation and widening of the colon occurs, resulting in dilatation of the necks and free drainage of the diverticula obstructed by inflammation. Four patients are presented with localized diverticulitis who had simple transverse taeniamyotomy from which they quickly recovered. This operation justifies continuing study as it may increase the surgeon's range of response over one end of the spectrum of acute diverticulitis.

Acute Disease↗
PubMed1977

The placebo effect. Is it important in diverticular disease?

Thirty patients with diverticular disease confirmed by barium enema examination were entered into a three-month double-blind trial of two tablets of methylcellulose (Celevac) daily or two placebo tablets daily. As these tablets were indistinguishable it was possible to cross over nine of the patients and follow them for a further three-month period. The placebo effect was sufficient for 11 patients who completed the trial on placebo to show a small mean improvement. A greater mean clinical improvement was shown, however, by the 16 patients who completed the trial on methylcellulose and in those who were crossed over, most of the improvement occurred during the time the patients were on methylcellulose.

Aged↗
PubMed1972

An interim report on the production of colonic diverticula in the rabbit.

Six New Zealand white rabbits were given gas induction anaesthetics and maintained on glucochloralose (Merck) 60 mg/kg given intravenously. Intracolonic pressures were measured after a standard dose of prostigmine, 0.05 mg/kg, using fluid-filled, open-tipped, narrow-bore polythene tubes. Then the rabbits were put on a diet of white bread, butter, milk, and sugar supplemented by vitamins for four months. All six rabbits had put on weight but their general condition deteriorated; they had become constipated and the colon contracted. After stimulation with prostigmine 0.05 mg/kg scattered intertaenial wide-necked diverticula appeared which were thinner than the normal haustra and looked like a blackcurrant in colour, size, and shape. Repeat pressure measurements showed that the colonic motility index was increased up to 10 times from predietary levels with a highly significant mean increase from 5299 to 33151 (p < 0.0005).

Animals↗
PubMedDate not supplied

A bloodless technique for tongue surgery.

The Cavitron Ultrasonic Surgical Aspirator (CUSA System) has been used at our institution in the resection of carcinoma of the tongue in 10 patients. This device is an ultrasonically powered aspirator that selectively fragments and aspirates tissue within a 1- to 2-mm radius of its tip. The technique used in our unit in tongue surgery was to incise the touch mucosal capsule of the tongue with electrocautery, and then to divide muscle and skeletonize blood vessels using the CUSA System. Smaller vessels, up to 2 mm in size, were cauterized directly by the friction created at the tip of the instrument. In this way, excellent control was available at all times and blood loss was consequently minimal. As our experience in the use of the CUSA System increased, blood loss was virtually eliminated, anatomic landmarks were more easily defined, and at no stage did any tongue necrosis occur in any of the patients of the series.

Animals↗
PubMedDate not supplied

Developmental expression of cytochrome P450S within intrasplenically transplanted fetal hepatocytes.

Fetal hepatocytes were harvested at day 20 of gestation from spontaneously hypertensive rats (SHR) and then transplanted into recipient adult SHR spleens. Morphological examination of the recipient spleens revealed that, after 4 and 10 wk, large masses of hepatocytes were present in the red pulp with apparent cord-like structures. Larger batches of hepatocytes were observed in the spleens at 10 wk after than at 4 wk after transplantation. Of major significance was the fact that hepatocyte transplanted spleens were able to express several families of cytochrome P450 (cyto P450) proteins 2-10 wk after transplantation. Immunochemical determinations revealed that cytos P450 IA1, P450 IIB1, P450 p, P450 HLp, and P450 LA omega could be detected without any prior induction. All were intensely expressed 6 wk after transplantation; however, P450 IA1 and P450 IIB1 did not appear to be expressed by 2 wk after transplantation. Although cytos P450 p and P450 HLp did not appear to be expressed by 10 wk after transplantation, they were induced with dexamethasone at that time. Cyto P450 LA omega and peroxisomal acyl CoA oxidase were expressed 6 wk after transplantation in a 70% hepatectomized host. These results demonstrate that fetal hepatocytes can be successfully transplanted into the spleens of recipients and that the fetal hepatocytes appear to grow and develop cyto P450 metabolizing systems.

Animals↗
PubMedDate not supplied

Developmental expression of cytochrome P450s within intrasplenically transplanted fetal hepatocytes from spontaneously hypertensive rats.

Fetal hepatocytes were harvested at 20 days of gestation from spontaneously hypertensive rats (SHR) and then transplanted into recipient adult SHR spleens. Morphological examination of the recipient spleens revealed that after 4 wk, large masses of hepatocytes were present in the red pulp with apparent cord-like structures. Of major significance was the fact that hepatocyte transplanted spleens were able to express several families of cytochrome P450 (cyto P450) proteins 2-6 wk after transplantation. Thus, the transplanted hepatocyte tissue appeared to grow and develop a cyto P450 metabolic system. Immunochemical determinations revealed that cytos P450 IA1, P450 IIB1, P450 p, P450 HLp, and P450 LA omega were over detected without any prior induction. None of the cyto P450s could be detected in control nontransplanted spleens, however, all were detected in fetal hepatocyte microsomes before transplantation. All were intensely expressed 6 wk after transplantation, however P450 IA1 and P450 IIB1 did not appear to be expressed by 2 wk after transplantation. These results demonstrate that fetal hepatocytes can be successfully transplanted to the spleens of recipient hosts, and that the fetal hepatocytes appear to grow and develop functional cyto P450 metabolizing systems. Therefore, transplantation of fetal hepatocytes to splenic tissue represents a unique in vivo system of extra hepatic metabolizing tissue.

Animals↗
PubMedDate not supplied

Expression and inducibility of cytochrome P450 IIIA family within intrasplenically transplanted fetal hepatocytes.

With the development of transplantation of hepatocytes into the spleen, interest has focused on the metabolic changes associated with hepatocyte proliferation. As these changes are important for drug metabolism in hepatocytes, we examined the expression and inducibility of the cytochrome P450 IIIA family within transplanted hepatocytes. Fetal hepatocytes were harvested at 20 days of gestation from spontaneously hypertensive rats (SHRs) and transplanted into recipient adult SHR spleens. Microscopic examination of the recipient spleens 4 and 10 wk after transplantation revealed masses of hepatocytes with cord-like structures in the red pulp. Proliferating hepatocytes were detected with a bromodeoxyuridine (BrdU) immunohistochemical stain. Immunochemical studies detected cytochromes (cytos) P450 p and P450 HLp in fetal hepatocytes before transplantation without prior induction. And although these cytos were not detected by 10 wk after transplantation, they were induced with dexamethasone. These results demonstrated that fetal hepatocytes can be transplanted successfully into recipient spleens and suggested that fetal hepatocytes grow in the spleen, similar to the adult hepatocyte response.

Animals↗