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Biomedical subjects

W O Griffen

Publications and source records attributed to W O Griffen.

At least 145 records · Page 8Linked to original sources
PubMed1976

Analysis of the causes of mortality from appendicitis.

An analysis of 944 cases of acute appendicitis treated at the University of Kentucky Medical Center from 1966 to 1973 is presented. There were 12 deaths in this series, a mortality rate of 1.3 per cent, and the clinical presentation, operative and autopsy findings are discussed. It is significant that seven of the 12 patients had other serious illnesses that influenced the decision for operation and that operation was delayed over 48 hours in 50 percent. It is stressed that the need for early exploration in the patient suspected of having appendicitis is even more imperative in the individual with concomitant disease. Adequate but immediate preoperative preparation with fluids and electrolytes antibiotics and stabilization of renal, pulmonary and cardiac status is mandatory.

Acute Disease↗
PubMed1975

Transsacral repair of rectal prolapse.

Whatever the basic pathogenesis of rectal prolapse, the structural alterations invariably include a defect in the pelvic floor fascia, a deep pouch anterior to the rectum, a patulous anus, loose fixation of the rectum to the pelvic structures, and a long sigmoid colon. A variety of corrective procedures have been described for rectal prolapse, but all suffer from various disadvantages. The transsacral approach to the rectum has several advantages: (1) it is simple and safe even for the elderly, (2) it avoids an abdominal incision with its concomitant postoperative complications, (3) it will allow complete correction of all abnormalities, and (4) it has been performed with a low recurrence rate.

Age Factors↗
PubMed1975

Use and abuse of gastric function tests by British and American gastric surgeons.

The use of gastric function tests by American and British gastroenterologic surgeons in different clinical situations has been studied by questionnaire. Clinical practice on both sides of the Atlantic is generally similar. The major difference in the type of test employed is that pentagastrin cannot be used in clinical practice in the United States. Surgeons in the USA were much more liberal in their indications for gastric secretory tests than were their British counterparts. Significantly more tests were used by American surgeons, if x-ray evidence of duodenal or gastric ulcer existed, and to evaluate a post-gastrectomy patient, whether symptomatic or not. The British surgeonswere much less likely to allow the results of secretory tests to influence their surgical approach. The authors discuss indications for and the clinical value of gastric secretion tests and conclude that in most instances far too many tests are being employed.

Cross-Cultural Comparison↗
PubMed1975

Hereditary polypoid diseases of the gastrointestinal tract: a working classification.

Almost all published cases of hereditary intestinal polypoid diseases can be meaningfully classified into a relatively few distinct syndromes including familial polyposis of the colon, Peutz-Jeghers syndrome, and juvenile polyposis. Familial polyposis is characterized by the development of numerous adenomatous polyps of the colon and subsequent development of colorectal carcinoma in nearly all patients. Extracolonic manifestations are common but do not influence the premalignant nature of this syndrome. Peutz-Jeghers syndrome is identifiable by a combination of circumoral melanin pigmentation and hamartomatous polyps. These polypoid lesions have an unusually wide distribution and may occur in the respiratory, gastrointestinal, or genitourinary tract. There is a small but definite increased incidence of gastrointestinal cancer in these patients. Juvenile polyposis presents a more variable spectrum. In one form there is extensive intestinal involvement leading to diarrhea, inanition, and increased susceptibility to infection. Another form is limited to the colon and easily confused with familial polyposis. With the third form, there is involvement of the stomach, intestines, and colon, which makes it easily mistaken for the Peutz-Jeghers syndrome.

Adult↗
PubMed1975

Carcinoma in situ of the gallbladder: A dilemma.

The prognosis for advanced carcinoma of the gallbladder is grave, but a reappraisal of the histologic and gross presentation of the disease may uncover a group of patients with significantly better prognosis. During any cholecystedtomy, the gallbladder should be opened by the surgeon and frozen sections should be obtained for suspicious lesions. Carcinoma in situ appears to be well treated by cholecstectomy alone. Microinvasive carcinomas of the gallbladder require wider surgical excision

Adult↗
PubMed1975

Filtration and infusion phlebitis: a double-blind prospective clinical study.

The effect of final filtration on the incidence of infusion phlebitis was studied in a prospective, double-blind investigation involving 146 postoperative patients. The incidence of infusion phlebitis was found to be significantly reduced when an inline, 0.45-mum membrane filter was used. The greatest reduction of infusion phlebitis was in the filter groups receiving unbuffered solutions and no set change over the 72 hours of therapy. Buffering the infusion fluid or 24-hour change of the administration set did not have any effect on reducing the incidence of phlebitis. Antibiotic therapy appeared to have a slightly beneficial effect only when inline filters were employed. A significant rise in white blood cell count and an increase in sedimentation rate were observed in the patients receiving unfiltered fluids. It is recommended that inline final filters should be a part of routine intravenous therapy.

Adolescent↗
PubMed1975

Importance of histologic classification of carcinoma of the gallbladder.

In summary, we have reviewed 914 patients who underwent primary biliary procedures at the University of Kentucky between 1962-1970. Twenty-one (2.5%) of these patients were found to have carcinoma of the gallbladder. There were differences in histological evidence of invasion and in survival between invasive, microinvasive and in situ carcinomas. The changing age of the population and the increasing incidence of cholelithiasis make it likely that the incidence of carcinoma of the gallbladder will also increase. Today, aggressive surgical therapy will probably not change the prognosis for invasive carcinoma.

Adult↗