Search PubMed⌕ Search

Biomedical subjects

B Jones

Publications and source records attributed to B Jones.

At least 415 records · Page 23Linked to original sources
PubMed1989

Pylorus-preserving Whipple pancreaticoduodenectomy: postoperative evaluation.

The pylorus-preserving Whipple pancreaticoduodenectomy is becoming a popular alternative to the standard Whipple operation. Fluoroscopy plays an important role in postoperative assessment. The authors evaluated images of 50 consecutive patients who had undergone the newer procedure. Thirty-one complications were identified. Two normal variants that could be confused with abnormalities were noted: (a) the featureless appearance of the duodenal bulb may be mistaken for extravasation, and (b) contrastmaterial filling of the proximal jejunal loop at an end-to-end anastomosis with retained invaginated pancreas may be mistaken for intussusception. Another pitfall was failure to evaluate the pancreaticojejunostomy anastomosis fully, resulting in false-negative radiologic interpretations when leaks were present. The approach to postoperative examination of patients who have undergone the pylorus-preserving Whipple procedure is different from that of patients who have undergone the standard procedure. Radiologists should be familiar with this approach, the normal postoperative anatomy, and pitfalls in imaging so that complications can be diagnosed and treated.

Adult↗
PubMed1989

CT of the small bowel and mesentery.

The detection and definition of small bowel pathology is a frequent clinical and radiologic problem. Although contrast radiography and enteroclysis are the primary means of evaluating the small bowel, computed tomography (CT) has become increasingly important as a complementary examination. Initial diagnoses proffered by barium studies may be further characterized by CT and this additional information may have significant impact on patient management.

Humans↗
PubMed1989

CT of the gut in the immunocompromised host.

The spread of the acquired immunodeficiency syndrome, the increasing popularity of bone marrow, renal, and other organ transplants, and the development of potent immunosuppressive drugs have produced a large population of immunocompromised hosts. These patients are at great risk for developing both opportunistic infections and neoplasms such as Kaposi's sarcoma and lymphoma. The gastrointestinal complications and computed tomographic manifestations of these previously rare disorders are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Incidence and management of complications after injection sclerotherapy: a ten-year prospective evaluation.

The incidence and management of complications of injection sclerotherapy are reviewed in 304 consecutive patients with esophageal varices followed up prospectively for a 10-year period. The 304 patients were injected on 1336 occasions. Three hundred eleven local esophageal complications occurred in 140 patients (complication rate, 23% per injection and 46% per patient). Esophageal mucosal slough, which was diagnosed by endoscopy, occurred on 250 occasions in 126 patients but did not require specific treatment. An injection site leak occurred in 25 patients, was managed conservatively, and was associated with a mortality rate of 28%. Stenosis of the esophagus was found in 32 patients, but only five patients required dilatation for relief of symptoms. Rupture of the esophagus occurred in four patients, three of whom had surgical treatment, and was associated with a mortality rate of 50%. Serious complications were more frequent with the rigid esophagoscope. An injection site leak occurred more frequently after acute sclerotherapy via the rigid esophagoscope. All four patients with rupture of the esophagus were injected electively via the rigid esophagoscope. Although the incidence of serious complications after injection sclerotherapy in this series appears acceptable, complications have been noted to be cumulative with time.

Adolescent↗
PubMed1989

Comparison of myocardial temperatures with multidose cardioplegia versus single-dose cardioplegia and myocardial surface cooling during coronary artery bypass grafting.

Myocardial hypothermia with multidose cardioplegia has not been compared with single-dose cardioplegia and myocardial surface cooling with a cooling jacket in patients having coronary artery bypass grafting. In this study, 20 patients with three-vessel disease undergoing coronary bypass at 28 degrees C with bicaval cannulation, caval tapes, and pulmonary artery venting (4.9 +/- 0.7 grafts per patient) were prospectively randomized equally into group I (multidose cardioplegia) and group II (single-dose cardioplegia with a cooling jacket). The initial dose of cardioplegic solution was 1000 ml. Group I then received 500 ml of cardioplegic solution every 20 minutes, delivered into the aortic root and available grafts. In group II, after the cardioplegic solution had been administered, a cooling jacket covering the right and left ventricles was applied. In both groups temperatures were recorded every 30 seconds at five ventricular sites: (1) right ventricular epicardium; (2) right ventricular myocardium or cavity, 7 mm; (3) left ventricular epicardium; (4) left ventricular myocardium or cavity, 15 mm; and (5) septum, 20 mm. Group mean temperatures at each site at various times were compared within each group and between the two groups by analysis of variance. Aortic crossclamp time was 60.3 +/- 12.1 minutes in group I and 52.8 +/- 7.3 minutes in group II (p = 0.12); cardiopulmonary bypass time was 103.7 +/- 11.1 minutes in group I versus 87.7 +/- 12.7 minutes in group II (p less than 0.01). One minute after the cardioplegic solution was initially given, temperatures between groups at each site were not statistically different, but left ventricular epicardial temperatures within both groups were significantly higher than in the other four sites. Nineteen minutes after administration of the cardioplegic solution, temperatures in group I at all sites were higher than in group II. Similarly, throughout the entire period of aortic crossclamping, mean temperatures (except left ventricular myocardial site), maximum temperatures, and percentage of time all temperatures were 15 degrees C or higher were greater in group I than in group II. The following conclusions can be reached: 1. Initial myocardial cooling with 1000 ml of cardioplegic solution is not significantly limited by coronary artery disease but is suboptimal (16 degrees or 17 degrees C) in the inferior left ventricular epicardium because of continual warming from the aorta and subdiaphragmatic viscera. 2. Without myocardial surface cooling, excessive external myocardial rewarming to 18 degrees to 22 degrees C occurs within 20 minutes at all sites after delivery of the cardioplegic solution.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1989

Analysis of benefit of anticoagulation after placement of Kimray-Greenfield filter.

The Kimray-Greenfield venal caval filter is widely accepted as a means of preventing pulmonary embolism when medical anticoagulation has failed or complications have developed. When indicated, anticoagulants are usually resumed after placement of the filter. A retrospective study was performed comparing the thromboembolic and postphlebitic complications in patients who continued to receive anticoagulants after placement of the filter versus those who did not. Sixty-eight Kimray-Greenfield filters were placed in 68 patients (43 men and 25 women) during a four year period. After placement of the filter, 26 patients received anticoagulants and 42 did not. Three of those receiving anticoagulants and six of those who did not had significant swelling of the leg; two of those receiving anticoagulants and two of those who did not had a recurrent deep venous thrombosis. There were no instances of recurrent pulmonary embolism. There were no significant differences in the results of these two groups of patients. These results are consistent with those reported in the literature in that no correlation has been found between the use of anticoagulants after placement of the filter and recurrent thromboembolism or stasis sequelae. In view of the complications associated with medical anticoagulation, we recommend its discontinuation in all patients after placement of the Kimray-Greenfield filter.

Anticoagulants↗
PubMed1988

Olfactory deficits in schizophrenia.

Olfactory discrimination was measured in patients with schizophrenia who were on neuroleptic medication and was compared with other psychiatric patients receiving neuroleptics and normal controls. The performance of the patients with schizophrenia was significantly lower than the psychiatric and normal controls. The latter two groups performed at equivalent levels. The findings are discussed with respect to olfactory deficits found in patients with cerebral lesions and with abnormalities of specific neurotransmitter systems.

Adolescent↗
PubMed1988

Molecular analysis of T cell receptor gamma gene expression in allo-activated splenic T cells of adult mice.

Northern analysis, hybridization in situ and cDNA sequence analysis have been used to demonstrate that the induction of T cell gamma-gene expression is a general occurrence when primary splenic T cells of adult mice are cultured in short-term mixed lymphocyte reactions (MLR). Splenic T cells from nine strains of mice examined in eleven different MLR all showed significant induction of gamma-RNA, even when the primary T cell response was to only a three amino acid mismatch in a major histocompatibility complex class I antigen. In MLR examined in detail, the expression is highly enriched for in CD3+ "double-negative" T cells (lacking both CD4 and CD8 expression). A cDNA sequence analysis, constituting the first such analysis of any size of gamma-gene transcripts from circulating, peripheral cells of adult mice, revealed transcription to be frequently of productively rearranged genes. These genes display extensive junctional diversity.

Animals↗
PubMed1988

Peritoneal eosinophilia in patients on continuous ambulatory peritoneal dialysis: a prospective study.

A prospective study on peritoneal eosinophilia was conducted in 23 continuous ambulatory peritoneal dialysis (CAPD) patients for a mean period of 7.9 months. Peritoneal eosinophilia as defined by peritoneal eosinophil count exceeding 100/mm3 was found in 60.8% of patients. Most developed peritoneal eosinophilia within 3 months of the initiation of dialysis, although the phenomenon could occur as early as one day or as late as 6 months after dialysis. Fifty-seven percent of those with peritoneal eosinophilia also had peripheral blood eosinophilia. Although most peritoneal eosinophilic episodes subsided in a month, in one patient the process grumbled on for 150 days. The number of peritonitis episodes was not significantly different between patients with peritoneal eosinophilia and those without. The only distinction between the two groups of patients was that those who developed peritoneal eosinophilia had a significantly (P = .002) higher serum IgE concentration initially as well as throughout the period of observation.

Adolescent↗
PubMed1988

Characterization of a bovine thymic differentiation antigen analogous to CD1 in the human.

Three monoclonal antibodies (MoAb), TH97A, CC13, and CC14, define a thymic differentiation antigen in cattle. The antigen is expressed on 50-60% of bovine thymocytes, located mainly in the cortical areas, but is not expressed on peripheral blood mononuclear cells (PBMC). In cryostat sections of lymph node, the antibodies react with large dendritic-like cells in the paracortical regions. They also react with a proportion of the large 'frilly' cells in afferent lymph and with dendritic-like cells in the dermis. The antibodies apparently do not react with cells in the epidermis. Biochemical analysis of the antigen recognized by MoAb TH97A reveals two bands of 44 kDa and 12 kDa under reducing conditions. These polypeptides are distinct from bovine class I major histocompatibility complex molecules reactive with the MoAb w6/32. The tissue distribution of positive cells together with results of biochemical analyses indicate that the antigen recognized by these MoAb is the bovine analogue of the human CD1.

Animals↗
PubMed1988

Examination of the patient with dysphagia.

Difficulty in swallowing is not an uncommon symptom. Approximately 10,000 persons choke to death every year in the United States, and at least 50% of patients in nursing homes have some difficulty eating or drinking. Dysphagia will become an increasing problem as the population continues to age, as more intensive resuscitative measures are applied, and as more aggressive head and neck surgery is performed. The practicing radiologist should be familiar with the examination technique and interpretation of swallowing studies.

Barium Sulfate↗