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Biomedical subjects

W O Griffen

Publications and source records attributed to W O Griffen.

At least 55 records · Page 3Linked to original sources
PubMed1985

The evaluation of postoperative function of the adrenal gland.

The cosyntropin (Cortrosyn) stimulation test has been adapted for use in the postoperative period. The normal adrenal gland response to 200 micrograms of cosyntropin given intravenously has been quantified at six, 12, 24, 48 and 72 hours after extensive general surgical procedures. The value of the test in quickly and accurately diagnosing postoperative acute insufficiency of the adrenal gland remains to be established.

Adrenal Gland Diseases↗
PubMed1985

Failure of antiplatelet therapy with ibuprofen (Motrin) to prevent neointimal fibrous hyperplasia.

To evaluate the effect of ibuprofen (Motrin) on the development of neointimal fibrous hyperplasia (NFH), 4 cm segments of expanded polytetrafluoroethylene (ePTFE) grafts with an internal diameter of 4 mm were implanted in the femoral arteries of 28 dogs. Three dogs served as controls and these grafts were removed at 7 to 14 days. The remaining 25 dogs were medicated with either intravenous (IV) or oral (PO) ibuprofen. The medicated dogs were grouped according to whether the ibuprofen was administered prior to or after graft implantation. The orally medicated dogs were also grouped according to whether the grafts were removed from 30 to 60 days after graft implantation. The grafts were analyzed for the amount of anastomotic initimal hyperplasia, pannus extension, thrombus deposition, and patency. Analysis of the data demonstrated no statistically significant differences among any of the treatment groups or the control group for the variables analyzed. We conclude that ibuprofen neither prevents nor retards the development of NFH. There was a trend toward less thrombus deposition in the animals that received oral ibuprofen preoperatively. There was also a trend toward higher patency in the animals that received ibuprofen prior to graft implantation, which most likely resulted from decreased thrombus and fibrin deposition.

Animals↗
PubMed1985

Recurrent appendiceal colic.

From 1962 through 1983, 1,869 appendectomies were performed at our institution. Careful review disclosed 11 patients (0.6 per cent) who had an appendectomy for recurrent pain in the right lower abdominal quadrant not associated with other classical symptoms of appendicitis. Seven patients had an urgent diagnostic barium enema during the course of the episode of pain for which they had an appendectomy and six of the seven were abnormal. All of the patients exhibited gross abnormality of the appendix, such as fecalith (four), torsion or kinking of the appendix (three), narrowed lumen (three) and purulent material in the lumen (one). However, three specimens were thought to be histologically normal. In a follow-up study of ten of 11 patients for two weeks to 20 years, there has been no recurrence of the abdominal pain in all but one patient.

Adolescent↗
PubMed1985

The serum and urinary cortisol response to operative trauma.

Serum and urinary cortisol levels were monitored throughout the perioperative period in eight patients who underwent elective extensive general surgical procedures. Significant elevations of serum cortisol levels occurred four and eight hours after anesthetic induction and were reflected by elevated urinary cortisol production on the day of operation. Cortisol serum levels and urinary production rapidly returned toward normal as all subsequent measurements were insignificantly different from preoperative values. Adrenal gland stimulation resulting from general surgical procedures is intense but short-lived.

Adrenal Glands↗
PubMed1984

Stapling in gastroesophageal surgery.

This article gives a brief history of stapling equipment used in gastroesophageal surgery. A variety of surgical procedures, which can be performed on the gastrointestinal tract easily and safely with present-day stapling devices, are then described.

Esophagus↗
PubMed1984

Capillary blood flow: videodensitometry in the atherosclerotic patient.

Recently the noninvasive technique of videomicroscopy has demonstrated qualitative morphologic changes in the nutritional skin capillaries in atherosclerotic (ATS) patients. The purpose of this study is to quantitatively examine the ATS microcirculation and effects induced by reconstructive surgery. Capillary blood flow velocity (CBV) of single vessels within the nail fold of the large toe was measured by dual-sensor videodensitometry in 14 ATS patients (age 45 to 80 years) and 11 age-matched controls. In addition to CBV, capillary diameter (CD) and the number of flow-active capillaries (FC) were also measured at constant temperature. Of the 14 patients, eight had measurements repeated 1 week after reconstructive surgery. The measurements were obtained at rest and then periodically after a 45-second period of pedal inflow occlusion. Respective group averages at rest for CBV, CD, and FC for the 14 ATS patients were as follows: 0.16 mm/sec, 10.5 micron, and 6.8 capillaries per field. Corresponding values for the control subjects were 0.10 mm/sec, 8.7 micron, and 5.3 capillaries per field. Combining CBV, CD, and FC into a measurement of volume capillary flow yielded a value of 281 pl/sec/mm2 for the patients and only 85 pl/sec/mm2 for the controls (p less than 0.02). Peak postocclusion CBV significantly increased, whereas FC significantly decreased relative to rest in the control group; however, the only patient group that responded to occlusion-induced ischemia was the postoperative group. In these patients there was a decrease in CBV and an increase in FC relative to rest. These responses are exactly opposite to those in the age-matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1984

Atherosclerosis in the young: a virulent disease.

To learn more about the prognosis of young patients with atherosclerotic cardiovascular disease we reviewed our experience with patients 40 years of age or younger who required surgical intervention for cardiovascular occlusive disease. We identified 47 patients, 25 of whom required peripheral vascular reconstruction and 22 of whom underwent coronary artery bypass grafting. All but one patient were extremely heavy cigarette smokers. Of the 11 women with peripheral vascular disease, eight required operations for limb salvage and three for renovascular hypertension. Four of the 11 women required a total of 11 subsequent operations because of recurrent or progressive disease. Of the 14 men, 13 required intervention for limb salvage and one for renovascular hypertension. Forty-five additional operations, including 15 amputations, were required in these 14 male patients because of recurrent or progressive disease. Of the 22 patients (21 men and one woman) who underwent coronary artery bypass operations, there was one postoperative death. Five patients (23.8%) required a second bypass operation and one patient (4.8%) required a third procedure bypass because of recurrent symptoms and occluded grafts. One patient has occluded grafts and inoperable disease. Atherosclerotic cardiovascular disease in young patients appears to be a virulent disease process and is associated with a high rate of recurrent or progressive disease. There is a striking association between the premature development of atherosclerotic cardiovascular disease and cigarette smoking.

Adult↗
PubMed1984

Gastric bypass.

This article describes the gastric bypass as performed by the author and his associate since 1979. The Roux-en-Y gastric bypass by this technique has been used in more than 1000 patients. The author uses the additional 3-0 prolene suture on the gastrojejunostomy, but his associate does not. Additionally the author has discontinued the nasogastric tube in the postoperative period, whereas his associate uses it for 24 hours postoperatively.

Humans↗
PubMed1984

Characterization of a common antigen of colorectal and mucinous ovarian tumors, COTA.

A new colon cancer antigen is reported. It is designated as COTA, Colon-Ovarian Tumor Antigen, because it is found in mucins produced by both tissues during malignancy. The new antigen was identified by making antibodies against human colon cancer tissue in goats. The antisera were exhaustively absorbed with lyophilized extracts of normal colon, lung, liver, spleen, kidney, plasma, and the well-known colon tumor antigen, carcinoembryonic antigen (CEA). The new antigen was identified by immunodiffusion. Studies of 28 malignant tissue extracts, 10 ovarian adenocarcinoma cyst fluids, 43 normal tissues, and 5 plasma samples revealed that this antigen is found only in colon tumors and mucinous ovarian adenocarcinomas. The antigen was not detected in serous adenocarcinoma of the ovaries, extracts of adenocarcinoma of lung, breast, kidney or stomach nor in the extracts of normal tissues. Other tests show that this antigen is not CEA, Ca 19-9, or CSAp. It is stable to heating at 65 degrees for 5 minutes; it elutes from an ion exchange matrix (DEAE) with 0.3-0.5M NaCl; it migrates to the alpha-2 region on immunoelectrophoresis; and its size, by exclusion chromatography on Sepharose 4B, is 3-15 million daltons. Anti-COTA stains colon cancer tissue sections indicating that COTA is present in goblet-cell mucin.

Adenocarcinoma↗
PubMed1984

Acalculous cholecystitis.

During a two year period, 1981 to 1982, 21 of 262 patients undergoing cholecystectomy had acalculous cholecystitis. The majority of these patients had chronic disease, and more than 50 per cent of them were in the older age group and had other chronic medical problems. The signs and symptoms are similar to that of calculous cholecystitis, although the cause is unclear. However, the patient with these complaints deserves thorough evaluation in order to rule out other disorders of the upper part of the gastrointestinal tract, because cholecystectomy for chronic acalculous cholecystitis will relieve the symptoms in more than 80 per cent of the patients. Acalculous cholecystitis is a true organic problem which, if diagnosed accurately, can be effectively treated with cholecystectomy.

Cholangiography↗
PubMed1983

Preoperative and postoperative assessment of nutrient intakes in patients who have undergone gastric bypass surgery.

The study of 25 morbidly obese patients who had undergone gastric bypass surgery was undertaken to determine the fat, carbohydrate (CHO), protein, and total caloric intake before and at 1, 3, 6, and 12 months postoperatively. No postoperative complications occurred, and all patients lost weight appropriately. The nutrient intakes were estimated from dietary recall. Dramatic decreases occurred in average total caloric intake from a preoperative value of 3979.4 to 351.6 kcal at 1 month, 471.3 kcal at 3 months, 932.7 kcal at 6 months, and 1091 kcal at 12 months. Fat, CHO, and protein intake decreased equally until 12 months when fat intake had reached a plateau while CHO and protein intake continued to rise. Weight reduction after gastric bypass surgery is related to decreased caloric intake, predominantly in the fat component.

Adult↗
PubMed1983

Technical complications of Roux-en-Y gastrojejunostomy.

The Roux-en-Y gastrojejunostomy has become an increasingly popular technique for gastrointestinal tract reconstruction since it is purported to obviate many of the classic complications of the Billroth II gastrojejunostomy. In a review of over 900 Roux-en-Y gastrojejunostomies, seven patients with complications mimicking those seen with Billroth II reconstruction were identified. These complications included duodenal stump blowout, proximal blind loop or afferent loop syndrome, and bile-reflux gastritis. These complications resulted from technical problems in construction of the Roux-en-Y. Once the complications were diagnosed, they were amenable to operative correction. Recognition of the potential for these complications following Roux-en-Y gastrojejunostomy should aid in early diagnosis and treatment.

Adult↗
PubMed1983

Properties of anticancer agents relevant to in vitro determinations of human tumor cell sensitivity.

The physical properties of 59 anticancer agents have been examined with respect to solubility in tissue culture media, binding to ultrafiltration materials, and molecular absorbance and fluorescence behavior. Methods for dissolving these agents, which are compatible with in vitro sensitivity testing of human tumor cells to anticancer agents, are reported in this paper. The potential for anticancer agent binding to cellulose nitrate/cellulose acetate and teflon membrane ultrafilters was documented, and quantitation of these anticancer agents based upon absorbance and fluorescence spectroscopy was performed. Post-filtration quantitation of anticancer agents was found to be a reliable method for determining the actual drug concentrations available in tumor cell sensitivity testing in vitro. The properties documented herein are pharmacologically relevant parameters related to in vitro determinations of human tumor cell sensitivity to anticancer agents.

Antineoplastic Agents↗
PubMed1983

The prophylactic use of antimicrobials in surgery.

During the period August 1976 to June 1982, there were 98 reports of antimicrobial prophylaxis in human surgery that were judged unevaluable. Our review, coupled with that of Chodak and Plaut, identified studies of 126 antibiotic regimens that were considered evaluable and a total of 205 studies considered unevaluable. A decrease in infection rate in antibiotic-treated patients compared to non-antibiotic-treated patients was seen in 120 (95%) of the evaluable regimens. Ninety-nine (79%) of these 120 regimens produced statistically significant reductions in the infection rate (P less than .05, chi 2 analysis). The majority of the antibiotic regimens were tested in procedures that were classified as clean-contaminated. Of the regimens that yielded a statistically significant reduction in infection rate with antimicrobial therapy, in 66 (67%) the agents were used for 24 hours or less. Five regimens were identified in which a higher infection rate occurred in specific patient groups when prophylactic antibiotics were used, but the differences were not statistically significant. In the overwhelming majority of evaluable studies, antibiotics decreased the incidence of surgical infection compared with non-antibiotic groups. The available data also support the effectiveness of short prophylactic antibiotic courses of 24 hours' duration or less. The duration necessary for antibiotic prophylaxis was specifically tested in nine regimens. In all nine, a short course (less than 24 hours) of antibiotic prophylaxis was as effective as longer periods of therapy (24 hours to 5 days) in preventing infection.

Anti-Bacterial Agents↗
PubMed1983

Serum alpha 1-acid glycoprotein and the binding of drugs in obesity.

Although clinically relevant, drug-protein interactions in the morbidly obese population have not been studied thoroughly. The objective of this study was to evaluate serum chemistry profiles and the degree of serum protein binding of propranolol, diazepam and phenytoin in the serum of four female, morbidly obese (greater than 190% of ideal body weight) and eight control female subjects. Serum triglyceride concentrations were higher and high-density lipoproteins were lower in the obese subjects than in the control group. Serum albumin and total protein concentrations in the obese were not different from controls. Unexpectedly, alpha 1-acid glycoprotein concentrations were doubled in the obese subjects (mean obese value 121 mg/100 ml vs 62.9 mg/100 ml for the control subjects). Obese subjects had a mean fraction unbound (fu) for propranolol of 0.086, which was significantly different from the controls (fu = 0.123). The binding of diazepam was decreased slightly in the obese subjects. The binding of phenytoin was similar in both groups. The altered serum chemistry of obesity may play a significant role in the drug management of the obese patient by altering drug-protein interactions.

Adult↗