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Biomedical subjects

C C Patterson

Publications and source records attributed to C C Patterson.

144 records · Page 8Linked to original sources
PubMed1985

Results of middle ear reconstruction: do patients and surgeons agree?

The usual methods of measuring the therapeutic effects of middle ear reconstruction in tympanoplasty and stapedectomy take into account only changes occurring in the operated ear. These do not necessarily reflect the final state of the patient's auditory capacity, because normal speech perception is a bilateral function. Minor temporary interaural differences due, for example, to ear canal occlusion by cerumen can cause considerable distress. To determine what might be the final audiometric situations that would be worthwhile for patients having unilateral operations aimed only at improving auditory status, 203 patients' personal assessments of their final hearing ability were correlated with the audiometric data from both ears. The results indicated that the most relevant factor in predicting assessment was the postoperative hearing level.

Adolescent↗
PubMed1984

Late mortality after vagotomy and drainage for duodenal ulcer.

Seven hundred and thirty five patients who underwent elective vagotomy and drainage procedures in one hospital during 1957-67 were followed up until 1 September 1982. At this time 281 were dead compared with an expected 184. This gives a ratio of observed to expected deaths of 1.53 (p less than 0.0001). The most important cause of increased mortality was lung cancer, which accounted for 33 of the excess deaths (observed to expected ratio 3.53). Gastric cancer yielded an observed to expected ratio of 3.3. Other causes of death that were significantly more common than expected were cerebrovascular accident, bronchopneumonia, and colorectal cancer. It is concluded that although gastric cancer occurs more commonly after vagotomy and drainage than in the general population, it is not as important a cause of death as diseases related to smoking.

Adolescent↗
PubMed1984

Relationship between histology and gastric juice pH and nitrite in the stomach after operation for duodenal ulcer.

One hundred patients who had undergone operation for duodenal ulcer (68 vagotomy and gastroenterostomy; seven vagotomy and pyloroplasty; 22 gastrectomy and three gastroenterostomy) 10 or more years previously each underwent endoscopy. Biopsies were taken and gastric juice aspirated for measurement of pH and nitrite concentration. Patients were divided into five histological grades; chronic superficial gastritis (+/- minimal atrophic gastritis) (35), atrophic gastritis/intestinal metaplasia (30), mild dysplasia (21), moderate/severe dysplasia (13) and carcinoma (one). A wide spectrum of pH values was found with 35 patients having a fasting intragastric pH below 4.0 and 65 above 4.0. A strong relationship was found between histological grade and pH. Patients with chronic superficial gastritis had a fasting intragastric pH below 4.0 more frequently than those with moderate/severe dysplasia (p less than 0.001). Gastric juice nitrite concentrations were higher in the moderate/severe dysplasia group than in the chronic superficial gastritis group (p = 0.02). The strong correlation between pH and nitrite concentration, previously documented, was confirmed. The implications of these findings in the pathogenesis of carcinogenesis in the postoperative stomach are discussed.

Adult↗
PubMed1983

Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968-1976: evidence of an increasing incidence.

A computer file of all Scottish hospital admissions in the period 1968-1976 was searched to identify the 2,505 children (aged less than 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged less than 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10-14 years and the lowest 7.1 per 100,000 in those aged less than 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis.

Adolescent↗
PubMed1983

Effect of reconstructive vascular surgery on red cell deformability--preliminary results.

Using a simple filtration method, red cell deformability was measured in healthy control subjects and in patients with peripheral vascular disease. Impaired red cell deformability was demonstrated in patients with rest pain or gangrene and in patients with intermittent claudication. An improvement in red cell deformability was demonstrated after successful reconstructive vascular surgery in both patient groups. An improvement in red cell deformability was demonstrated in patients undergoing major limb amputation.

Aged↗
PubMed1983

Serum copper and zinc levels in the preterm infant. A longitudinal study of the first year of life.

Serial determinations were carried out on 27 male and 21 female preterm infants (gestational age 28-36 weeks) throughout the first year of life. Serum copper at birth was 0.33 +/- 0.20 micrograms/ml (n equal 8); at 9 weeks, 0.77 +/- 0.19 micrograms/ml (n = 22); at 24 weeks, 1.00 +/- 0.27 micrograms/ml (n = 31), and at 52 weeks 1.21 +/- 0.27 micrograms/ml (n = 40). Serum zinc at birth was 1.03 +/- 0.16 micrograms/ml (n = 9); at 9 weeks, 0.71 +/- 0.11 micrograms/ml (n = 17); at 24 weeks, 1.02 +/- 0.20 micrograms/ml (n = 20), and at 52 weeks, 1.19 +/- 0.34 micrograms/ml (n = 33). The results of this study compare well with values previously reported for infants studied at selected age points.

Copper↗
PubMed1983

Post-thoracotomy pain relief: combined use of cryoprobe and morphine infusion techniques.

In a reported study we found that freezing of the intercostal nerves under direct vision at thoracotomy provided better postoperative analgesia than im morphine on demand. Infusions of morphine were also more effective than when used by the intramuscular route. The benefit on the eighth postoperative day was greatest following the use of the cryoprobe. Further studies were carried out to evaluate the benefit of combining 'cryoprobe' analgesia with infusions of morphine. The combined use of morphine infusion and a cryoprobe did not produce greater postoperative pain relief than the use of the cryoprobe alone with im morphine on demand.

Adult↗
PubMed1980

Lead in albacore: guide to lead pollution in Americans.

Lead contamination in canned tuna, exceeding natural concentrations 10,000-fold, went undiscovered for decades because of analytical error. The magnitude of this pollution effect helps explain the difference between the lead concentration in the diets of present-day Americans (0.2 part per million) and inthe diets of prehistoric peoples (estimated to be less than 0.002 part per million). It also explains how skeletal concentrations of lead in typical Americans became elevated 500-fold above the natural concentrations measured in bones of Peruvians who lived in an unpolluted environment 1800 years ago. It has been tacitly assumed that natural biochemical effects of lead in human cells have been studied, but this is not so because reagents, nutrients, and controls used in laboratory and field studies have been unknowingly contaminated with lead far in excess of naturally occurring levels. An unrecognized form of poisoning caused by this escessive exposure to lead may affect most Americans because magnitudes of biochemical dysfunctions are proportional to degrees of exposure.

Animals↗
PubMed1980

"ULtra-clean" isotope diultion/mass spectrometic analyses for lead in human blood plasma indicated that most reported values are artificially high.

We measured lead concentrations in venous blood plasma from two subjects, one having a typical exposure and the other a high exposure to lead. Our preliminary data, obtained by isotope dilution/mass spectrometric techniques in an ultra-clean laboratory, show lead concentrations of 0.02 mug/L and 2 mug/L, respectively, in their blood plasma, and 110 mug/L and 800 mug/L, respectively, in samples of whole blood. These results indicate that plasma lead concentrations previously reported have been overestimated by a large factor, and that further improvements in analytical procedures are needed in most laboratories before data on lead concentratios in blood plasma can be properly interpreted. Our preliminary data indicate a positive correlation between lead intake and lead concentrations in blood plasma.

Adult↗
PubMed1979

Skeletal concentrations of lead in ancient Peruvians.

The level of biologic lead (expressed as the ratio of atomic lead to atomic calcium) in bones of Peruvians buried 1600 years ago was found to be 3 x 10(-8), as compared to 2100 to 3500 x 10(-8) in the bones of present-day residents of England and the United States. The ratio of barium to calcium was 2 to 3 x 10(-6) in bones of ancient Peruvians and present-day Americans. Barium and lead have similar morphologic distributions in organisms, so this discrepancy for lead must result from overexposure of present-day people to industrial lead and not from natural variations. The magnitude of this discrepancy has been confirmed by two different lines of investigation not reported in this article. This new evidence suggests that natural interactions of lead in human cells have not yet been determined because reagents, nutrients and controls used in laboratory and field studies have been contaminated with lead far in excess of naturally occurring levels.

Adult↗
PubMed1974

Lead aerosol pollution in the High Sierra overrides natural mechanism which exclude lead from a food chain.

Most of the lead contained in sedge and voles (mountain meadow mice) within one of the most pristine, remote valleys in the United States is not natural but came from smelter fumes and gasoline exhausts. In a food chain, natural mechanisms do not allow lead to accompany the bulk of the nutritive metals as they proceed to higher trophic levels. This exclusion can be expressed quantitatively by a comparison of lead/calcium ratios at successive trophic levels. This ratio decreased by an overall factor of 200 in proceeding from rock, to soil moisture, to sedge, to vole. This factor would have been 1200 if lead aerosols had not collected on sedge leaves and circtumvented the tendency by sedge to exclude lead from the nutritive metals it absorbed from soil moisture.

Air Pollution↗
PubMedDate not supplied

Acute asthma exacerbations and air pollutants in children living in Belfast, Northern Ireland.

The incidence of childhood asthma, a common condition, is on the rise worldwide. Despite reductions in the emission of urban smoke, traffic pollution is now a major worldwide problem. Belfast, Northern Ireland, is an old industrial city with major pollution problems. In this study, the authors investigated the rates of acute asthma admissions to Belfast's major children's emergency department. The admissions were studied, relative to day-to-day fluctuations in thoracic particulate matter, sulfur dioxide, nitrogen dioxide, nitric oxide, oxides of nitrogen, ozone, carbon monoxide, benzene, temperature, and rainfall. Daily admissions for acute asthma at the emergency department of the Royal Belfast Hospital and average daily pollution were recorded for the 3-yr period between January 1, 1993, and December 31, 1995. The authors used Poisson regression to assess independent association(s). Individually, small associations were seen for thoracic particulate matter (relative risk = 1.10), sulfur dioxide (relative risk = 1.09), nitrogen dioxide (relative risk = 1.11), nitric oxide (relative risk = 1.07), oxides of nitrogen (relative risk = 1.10), carbon monoxide (relative risk = 1.07), and benzene (1.14); no associations were noted between meteorological factors (temperature and rainfall) or ozone and asthma emergency-department admissions. The authors adjusted for the aforementioned parameters, and benzene level was the only variable associated independently with asthma emergency-department admissions in children. Benzene may be a more reliable method of measuring exposure to vehicle exhaust emissions than measurements of other pollutants.

Acute Disease↗
PubMedDate not supplied

Tympanostomy tubes: do they significantly benefit the patient?

To gain more information about the role of tympanostomy tubes in the treatment of chronic middle ear effusion, the authors conducted a randomized trial that clearly indicated the short-term advantages of combining the insertion of an Armstrong ventilator tube with paracentesis and fluid aspiration over paracentesis and aspiration alone. A retrospective study of the success rate with three types of tympanostomy tubes (Shepard, Armstrong, and Paparella) was also carried out. The Armstrong tube had the highest success rate.

Child↗
PubMedDate not supplied

Evaluation of routine ultrasound in the prenatal diagnosis of structural anomalies of the fetus.

The objective of this study was to evaluate routine obstetric ultrasound in detecting fetal structural anomalies and the impact of changing clinical practice on success rates. A retrospective study of routine ultrasound in a population of 6,869 pregnancies was performed during 1985-86 (phase 1) to establish efficacy of ultrasound in the detection of fetal anomalies. Changes in ultrasound practice comprised timing, personnel and technique of fetal examination. After alterations in practice, a prospective study of 6,969 pregnancies during 1987-89 (phase 2) was performed. All abnormal fetuses (cases) were assessed in both studies. Random samples of normal infants (controls) were chosen from both populations to establish specificity. In 83 cases in phase 1,116 anomalies were diagnosed postnatally of which 11 were suspected by routine prenatal ultrasound at < 24 weeks (sensitivity 9%, 95% C.I. 4-15). In 72 cases in phase 2, 89 anomalies were identified postnatally of which 27 were suspected by routine prenatal ultrasound at < 24 weeks (sensitivity 30%, 95% C.I. 21-41). The change in sensitivity was statistically significant (p = 0.0003). Of the 382 control infants randomly selected in phase 1, false abnormal scans were not identified (specificity 100%, 95% C.I. 99-100). Of the 367 control infants in phase 2, 12 false abnormal scans were identified (specificity 96.7%, 95% C.I. 95-99). The decrease in specificity was statistically significant (p = 0.0013). The detection of urorenal and to a lesser degree central nervous system anomalies showed most improvement between the two phases. The alterations to routine ultrasound practice in timing, personnel and technique have significantly improved the detection of all fetal structural anomalies but at the cost of a small but significant loss of specificity.

Adult↗