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Biomedical subjects

W O Griffen

Publications and source records attributed to W O Griffen.

At least 109 records · Page 6Linked to original sources
PubMed1980

Cholecystokinin cholecystography in the diagnosis of gallbladder disease.

Twenty-six patients who had typical symptoms of biliary tract disease, e.g. postprandial right upper quadrant pain, nausea and vomiting, fatty food intolerance and flatulence and who had had two or more normal oral cholecystograms were subjected to cholecytokinin cholescystography. Ten patients showed a normal response to the intravenous administration of cholecystokinin, namely prompt and complete emptying of the gallbladder without producing any adverse reaction or symptoms. Sixteen patients demonstrated either no contraction or incomplete contraction of the gallbladder in response to cholecystokinin; several patients had moderate contraction of the gallbladder accompanied by symptoms of biliary colic. This latter group underwent cholecystectomy and operative cholangiography. Fifteen of the 16 patients are asymptomatic or improved, and only one patient continues to have symptoms. All removed gallbladders had histologic evidence of chronic cholecystitis. It is concluded that in some individuals with continuing symptoms suggesting gallbladder disease but normal oral cholecystograms, cholecystokinin cholecystography may be helpful in identifying physiologic dysfunction of the gallbladder.

Adult↗
PubMed1980

Splenectomy.

Explore the source record for details and available documents.

Anemia, Hemolytic, Autoimmune↗
PubMed1980

Thyroidography as a technique for localization of parathyroid adenomas.

Thyroidography was performed in seven patients with hyperparathyroidism. The technique accurately localized parathyroid adenomas in six patients. It was not useful in the patient with hyperplasia of the glands due to secondary hyperparathyroidism. There were no recognizable complications. Thyroidography is a simple technique, and we feel that it is useful in preoperative evaluation of patients with hyperparathyroidism.

Adenoma↗
PubMed1980

Factors influencing morbidity and mortality in perforated duodenal ulcer.

The overall mortality and morbidity rates in 124 patients with perforated duodenal ulcer from 1968 to 1978 were 9.6 per cent and 28 per cent. The only factors which directly affected the patient's outcome were 1) age of the patient (high mortality in older patients) and 2) the time interval from onset of symptoms caused by perforation to the time of the operation (the longer the interval, the more likely the complications). No improvement in mortality and morbidity figures was seen in the past decade.

Adult↗
PubMed1980

Amikacin pharmacokinetics in morbidly obese patients.

The pharmacokinetics of single-dose amikacin sulfate was studied in seven morbidly obese patients to determine the fraction of fat weight (FW) that, when added to ideal body weight (IBW), will normalize the volume of distribution. Seven patients (mean total body weight of 166.5 kg) were each given a 1,250-g intravenous injection of amikacin. Amikacin serum levels over eight hours were measured by radioimmunoassay. A correction factor (CF) of 0.38 was found to normalize the patients' volume of distribution (Varea) to 0.26 liters/kg, when added to the patients' IBW. There was no significant difference between peak amikacin levels predicted using the actual Varea and using the Varea plus the CF. Predictions using the actual Varea and those using Varea estimated by ideal body weight were significantly different. In morbidly obese patients, peak amikacin serum levels can be predicted best when a volume of distribution based on IBW plus a correction factor of 38% of FW is used.

Adult↗
PubMed1979

Diagnostic errors with peritoneal lavage in patients with pelvic fractures.

Diagnostic peritoneal lavage, considered to be a highly accurate, technique for detecting intraperitoneal blood in the trauma patient, may be less reliable in the presence of a pelvic fracture. In a retrospective review of 222 patients with pelvic fractures, 61 patients were found who had had a diagnostic peritoneal lavage performed as part of the initial evaluation of their condition. Twenty-six of these patients had had a negative lavage result negative lavage result. There had been no false-negative results in this group, although six patients required operations for extraperitoneal injuries. Of the 35 patients with a positive lavage results, 10 (29%) were found to have false-positive lavage results with no intraperitoneal source of bleeding. The only deaths in this series occurred in the group requiring operations, eight of 41 (20%). Four of the eight detahs were due to uncontrollable bleeding that resulted from exploration of the retroperitoneal hematoma. These data suggest that a negative lavage result is highly reliable in the patient with a pelvic fracture and should allow management with confidence that there is no severe intraperitoneal injury. Positive lavage results, however, must be interpreted with caution.

Abdominal Injuries↗
PubMed1979

Tobramycin pharmacokinetics in morbidly obese patients.

Tobramycin kinetics were examined in 9 morbidly obese women following a single intravenous (120 mg) bolus. After the injection, serum elimination conformed to a 2-compartment open model with alpha and beta t1/2s of 0.285 and 2.1 hr. The volume of distribution (Varea) was determined to be 0.44 1/kg ideal body weight (IBW) and 0.20 1/kg total body weight (TBW). To normalize Varea to 0.26 1/kg, 58% of the patients' adipose weight (TBW -- IBW) must also be taken into account.

Anti-Bacterial Agents↗
PubMed1979

Gastric bypass for morbid obesity.

The gastric bypass operation is designed to decrease the size of the food receptacle so that a limited number of calories can be ingested. All food ingested is absorbed normally, thus eliminating problems that mey be associated with metabolic derangements. Although it is possible to overeat the gastric pouch, the overall result of gastric bypass, in terms of weight loss, is quite satisfactory, and the mortality rate of less than 2 per cent and the morbidity rate of less than 20 per cent are also acceptable. Late complications following gastric bypass are low: specifically, nephrolithiasis is eight to 10 times less frequent than after jejunoileal bypass. Liver disease has not been seen following gastric bypass.

Eating↗
PubMed1979

The problem of the cystic duct remnant.

Symptoms persisting after cholecystectomy for gallbladder disease are often attributed to a long residual cystic duct. Of 30 patients who underwent excision of their cystic duct remnant, 15 were found to have common duct stones which accounted for their symptoms, while an additional four patients had had previous episodes of jaundice which suggested passage of a common duct stone. Those patients with common duct disease in addition to the cystic duct remnant were completely relieved of their symptoms by operation while only eight of the patients without common duct stones obtained relief. A cystic duct remnant infrequently causes symptoms in the absence of pathologic conditions in the common duct.

Adult↗
PubMed1979

Final inline filtration: a means of decreasing the incidence of infusion phlebitis.

Infusion phlebitis is the most common complication of intravenous therapy. Six methods of reducing the incidence of infusion phlebitis including inline final filtration, buffers, heparin, hydrocortisone, heparin-hydrocortisone combinations, and frequent set changes were tested in a two part randomized prospective double-blind study of 266 surgical patients. Patients who received filtered fluids had a significantly decreased incidence of infusion phlebitis as compared with that of controls (P = 0.0000001). Of the other methods tested, only the heparin-hydrocortisone combinations achieved any significant decrease in phlebitis (P less than 0.5). Therefore, inline filtration is a highly effective means of decreasing the incidence of infusion phlebitis and should be considered as a routine part of intravenous therapy.

Buffers↗
PubMed1979

Incidence of ischemic colitis following abdominal aortic reconstruction.

The incidence of ischemic colitis following abdominal aortic reconstruction was determined by postoperative colonoscopy during a three year period. The over-all incidence of colitis was 11 of 163 patients who underwent elective or urgent reconstruction of the abdominal aorta for aneurysmal and occlusive diseases. The incidence of ischemic colitis for patients who survived resection of ruptured abdominal aortic aneurysms was higher, although the colonoscopy rate was lower. The incidence might have been even higher if all patients surviving resection of ruptured abdominal aneurysms had undergone colonoscopy.

Aorta, Abdominal↗
PubMed1978

Dopamine-phenytoin interaction. A cause of hypotension in the critically ill.

Five critically ill patients received dopamine hydrochloride intravenously to support their blood pressure. When seizures developed, intravenous phenytoin sodium therapy was begun. Coincident with the infusion of phenytoin, the blood pressure, which was stable on the dopamine infusion, declined rapidly. Analysis of these cases led to a hypothesis that the interaction of dopamine and phenytoin produced the hypotension. When this hypothesis was tested in the normovolemic dog, intravenous dopamine produced no change in the blood pressure, and the addition of a phenytoin infusion had little effect. In animals rendered hypovolemic and hypotensive by bleeding, intravenous dopamine returned the blood pressure to the prebleeding level. At this point, an infusion of phenytoin produced a sustained decrease in the blood pressure. The mechanism of this action may be related to a combination of catecholamine depletion and myocardial depression.

Adult↗
PubMed1978

Proximal hepatic duct reconstruction. Repair using sutureless mucosal graft hepaticojejunostomy.

Six patients who had hepatic duct lesions, five who had strictures, and one who had a right hepatic duct transection underwent repair by sutureless mucosal graft hepaticojejunostomy. All patients had initial improvement, and five have maintained excellent biliary-intestinal continuity after an average 25-month follow-up. In one patient, recurrent symptoms developed and she died of cholangiocarcinoma. This technique is simple and fulfills the criteria for successful high hepatic duct reconstruction. The promising early results in these patients suggest that this procedure may provide a superior approach to this difficult problem.

Biliary Tract Diseases↗
PubMed1978

Systemic anaphylaxis secondary to the use of 5 per cent plasma protein fractions.

A severe anaphylactic reaction developed in a twenty-six year old female after the administration of only 40 ml of 5 per cent plasma protein fractions (Plasmanate). The reaction was characterized by generalized tingling, chest pain, sudden severe hypotension, and urticaria. The patient responded to intravenous fluid, epinephrine, diphenylhydramine, and steroid administration.

Adult↗
PubMed1978

Acute traumatic hemothorax.

Over the past 5 years, 107 patients have been evaluated for acute traumatic hemothorax at the University of Kentucky Medical Center. Immediate tube thoracostomy was performed on 90 patients for evacuation of blood and air. Only 2 patients died. Thoracotomy was performed as part of the initial therapy in 9 patients. Thoracotomy for continued hemorrhage from a pulmonary parenchymal injury was required in 3 patients from the entire group. Thoracentesis or observation was the initial therapy for limited hemothorax in 8 stable patients. Three of these patients subsequently required tube thoracostomy 2 to 23 days following injury due to expanding effusions, and 1 patient required multiple thoracotomies for sepsis, fibrothorax, and empyema. These observations indicate that early evacuation of blood by means of a tube thoracostomy is essential to minimize morbidity in acute traumatic hemothorax. If continuing hemorrhage after tube thoracostomy occurs, there is a higher association of injury to additional vital structures.

Abdominal Injuries↗