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Biomedical subjects

W O Griffen

Publications and source records attributed to W O Griffen.

At least 91 records · Page 5Linked to original sources
PubMed1981

Experiences with conversion of jejunoileal bypass to gastric bypass: its use for maintenance of weight loss.

Jejunoileal bypass for morbid obesity has been associated with a variety of long-term adverse sequelae, including excess diarrhea, electrolyte imbalance, kidney dysfunction, liver abnormalities, and polyarthropathy. Takedown of the bypass without providing a means of maintenance of weight reduction will lead to recurrence of morbid obesity. We studied 32 patients who underwent conversion of jejunoileal bypass to gastric bypass either in one procedure (27 patients) or more than one procedure (five patients). There were no operative deaths, but significant morbidity. Nevertheless, the conversion has maintained weight reduction and reversed the adverse effects of the small-bowel bypass. We concluded that conversion of the jejunoileal bypass to the gastric bypass, particularly with a Roux-en-Y anastomosis, in a single procedure is relatively safe, simple, and effective.

Adolescent↗
PubMed1981

Evaluation of biliary disease by scintigraphy.

The value of biliary scintigraphy was studied in 180 patients with suspected biliary tract disease. Scintigraphy was performed after intravenous injection of technetium-99m labelled (1) N-substituted iminodiacetic acid derivative (HIDA) in 91 patients, and (2) butyl derivative of iminodiacetic acid (BIDA) in 89 patients. Most of the patients were investigated additionally by conventional techniques such as cholecystography, cholangiography and ultrasonography. It is concluded that biliary scintigraphy is a simple and safe technique for visualization of the biliary tract. It is particularly useful in the evaluation of acute cholecystitis, in patients with iodine sensitivity requiring imaging of biliary tract, and in the differentiation of obstructive from nonobstructive jaundice. Its value in kinetic disturbances of the gallbladder and in quantitative evaluation of hepatobiliary function needs further study.

Adolescent↗
PubMed1981

Gastric operation for the morbidly obese.

The surgical approach to the morbidly obese patient has been changing over the years because of complications of the procedure. Evolution of gastric surgical techniques has resulted in a decrease in the radiologically evident complications such as anastomotic leaks, abscess, and marginal ulceration. Knowledge of the pertinent surgical and radiographic anatomy is important to the radiologist in evaluating the patient who has undergone a gastric bypass or gastroplasty for morbid obesity.

Abscess↗
PubMed1981

Estimating creatinine clearance in morbidity obese patients.

Estimates of creatinine clearance (Clcr), using five methods, were compared to measured Clcr in morbidity obese patients. Patients whose total body weight (TBW) was greater than or equal to 195% of their ideal body weight (IBW) and who had urinary Clcr measured with 24-hour urine collections were studied. The 12 men weighed an average of 180 kg; the 31 women averaged 138 kg. The methods studied considered a combination of the following factors: weight, age, sex, and serum creatinine. One method was a nomogram; TBW could not be used because of limitations of the nomogram. Both TBW and IBW were used in two methods that considered weight as a variable. Measured Clcr averaged 105.7 ml/min/1.73 sq m body surface area. All estimating methods using IBW significantly underestimated Clcr; all methods using TBW significantly overestimated Clcr. Two methods that did not include body weight as a variable predicted Clcr more accurately than did other methods, but there was still a significant difference between estimated and measured Clcr. None of the Clcr estimation methods is accurate in morbidly obese patients.

Adult↗
PubMed1981

Management of gastrocolic fistula.

The authors present 13 patients with gastrocolic, gastrojejunocolic, or duodenocolic fistula, the majority of which were complications of peptic ulcer disease or its treatment. In contrast to previous reports, these patients were not severely anemic, dehydrated, or malnourished at time of presentation. Pain, fecal emesis, and diarrhea were the most common presenting symptoms. Half of the patients waited more than two weeks before seeking treatment. Barium enema and upper gastrointestinal series were equally useful in making the diagnosis in this study. When the patient was adequately prepared, one-stage operations could be performed safely in most situations. Operation may not be necessary or advisable in patients with metastatic malignant disease with minimal symptoms relating to fistulization.

Adult↗
PubMed1980

Morbid implications of above-knee amputations. Report of a series and review of the literature.

In a retrospective review of 100 consecutive patients requiring above-knee amputation for arterial occlusive disease, the operative mortality was 15%. An additional 26% mortality occurred during a two-year follow-up period. Principal causes of death were sepsis in 54%, heart disease in 16%, and stroke in 11%. The poor prognosis of patients requiring amputation was related to progression of systemic diseases and to generalized debility among these patients.

Aged↗
PubMed1980

Thyroidography in evaluation of thyroid disease.

Thyroidography was performed in 53 patients with various thyroid disorders. In ten patients with hyperthyroidism, the procedure showed the size of the gland and the presence of nodules not suspected clinically or by scanning. It also demonstrated noticeable lymphadenopathy and lymphovenous communications. In nine patients with malignant disease of the thyroid, the pattern of contrast distribution within the gland was distinct from normal and was diagnostic. In addition, involvement of the regional lymph nodes by tumor was identified in three patients. The technique was useful in exclusion of malignant disease in two patients suspected of having cancer of the thyroid. In 26 patients with single thyroid nodules or with multinodular glands studied by this method, 19 were found to have cystic lesions and the other seven solid lesions. These results were compared with scintiscanning and ultrasonography. Based on this data, the technique seems to be useful in evaluation of thyroid disease.

Adenocarcinoma↗
PubMed1980

Colonic tumorigenesis in rats with 1,2-dimethylhydrazine.

Subcutaneous injections of the carcinogen dimethylhydrazine in inbred Fischer 344 male rats induced squamous-cell carcinomas in the ear canal, adenocarcinomas in the small bowel and duodenum, and adenomas and adenocarcinomas in the large bowel. The incidences of the tumors induced in the large bowel and ear canal were dose-related. As for tumors of the large bowel, the average size of adenomas was less than that of adenocarcinomas with massive infiltration beyond the muscularis mucosa. The average size of early adenocarcinomas was greater than that of adenomas but less than that of adenocarcinomas with massive infiltration beyond the muscularis mucosa.

Adenocarcinoma↗
PubMed1980

Palliation for esophageal carcinoma.

Fifty-three patients with carcinoma of the esophagus treated since 1972 are reviewed. Eighteen unresectable patients with distant metastases or pulmonary insufficiency were treated with irradiation or with esophageal or gastrostomy tubes plus irradiation. There were 5 early deaths, and only 3 patients survived more than three months. Six patients underwent bypass. Three died in the hospital, and 1 lived three months. None compled a course of irradiation or gained weight. The remaining 29 patients, who did not differ clinically from the bypass group, underwent resection for palliation or cure. There were 5 hospital deaths. Twenty patients lived more than three months and 7 of these more than one year. Two of them apparently were cured. These data indicate that the only effective means of increasing the duration of survival for esophageal carcinoma is resection with immediate reconstruction.

Adenocarcinoma↗
PubMed1980

Parenteral safflower oil emulsion (Liposyn 10%): safety and effectiveness in treating or preventing essential fatty acid deficiency in surgical patients.

The safety and effectiveness of a 10% safflower oil emulsion in treating or preventing essential fatty acid deficiency was tested in a prospective study of 15 surgical patients requiring total parenteral nutrition for two to four weeks. Three dosage regimens were evaluated including: Group I: 4% of calories as linoleate daily (five patients), Group II: 4% of calories as linoleate every other day (two patients), and Group III: 8% of calories every other day (eight patients). Patients were monitored for laboratory changes from baseline specifically in those areas where previous fat emulsions have caused serious deviations. No significant changes were noted in hematologic parameters, coagulation studies, cholesterol and triglyceride serum levels. Although there were sporadic mild deviations in liver function changes in several patients, no clinically significant adverse effects could be directly attributed to infusion of the fat emulsion. Three patients had baseline triene/tetraene ratios of 0.4 or greater, indicative of essential fatty/acid deficiency, and these ratios dropped to less than 0.4 within eight days of beginning therapy with the parenteral fat emulsion. The remaining 12 patients maintained a normal triene/tetraene ratio of less than 0.4 throughout the 28 day study period. All three dosage regimens were considered effective for treatment and prevention of essential fatty acid deficiency.

Cholesterol↗