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Biomedical subjects

C D Johnson

Publications and source records attributed to C D Johnson.

At least 253 records · Page 14Linked to original sources
PubMed1989

Attitudes of operating theatre staff to inoculation-risk cases.

In a 12-month period, 177 patients at risk of infection with human immunodeficiency virus (HIV) or hepatitis B were operated on. Sixty-nine had HIV antibodies. The procedures used to identify these patients and minimize the risk of infection of hospital staff in the operating department are described. All staff working in the operating department were surveyed to determine their caseload, feelings of anxiety, and the incidence of high-risk exposure to infection. Anxiety was not related to workload, but was more common in those who had high-risk exposure. All members of staff who sustained a needlestick injury were tested for HIV antibodies at intervals after injury; 33 also volunteered to be tested in a screening session 3 months after the study period. None had HIV antibodies, suggesting that the risk of acquiring HIV infection in the operating department is low.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Computed tomography of the large bowel and appendix.

Computed tomography (CT) of the colon is useful in assessment of patients with colonic disease because the entire bowel wall, extraluminal tissues, and adjacent solid organs can be directly visualized. Patients with advanced stage colorectal carcinoma can be reliably identified with CT. This information can assist in surgical planning for intraoperative irradiation and placement of a hepatic artery infusion catheter. CT is an important imaging modality in the postoperative evaluation for recurrent rectal cancer after abdominoperineal resection. CT-guided biopsy often can provide histologic proof of suspected tumor recurrence or metastasis. Patients with diverticulitis or appendicitis can be identified by CT. The extent of disease and the nature of the inflammatory process--factors potentially affecting patient management--can be directly visualized. Percutaneous aspiration and drainage of abscess collections can be curative in appropriately selected patients.

Appendicitis↗
PubMed1989

Pancreatic exocrine responses to secretin, 2-deoxyglucose, a meal, and ethanol after coeliac ganglionectomy in the conscious dog.

The effects of coeliac ganglionectomy on pancreatic exocrine responses to graded doses of secretin, intravenous 2-deoxyglucose 100 mg/kg, ethanol 0.56 g/kg, and 1 g/kg, and to a meat meal were studied in conscious dogs (weight 11 to 27 kg). Five animals underwent coeliac ganglionectomy and up to seven control animals were studied. Coeliac ganglionectomy increased four-fold the pancreatic fluid response to secretin. The early part of the fluid response to 2-deoxyglucose was reduced, but there was no effect on the protein response to 2-deoxyglucose. In controls, ethanol 0.56 g/kg stimulated pancreatic secretion, to nearly double the basal level, but after coeliac ganglionectomy this dose of ethanol inhibited secretion to one third of basal values. There was no effect of coeliac ganglionectomy on pancreatic response to ethanol 1 g/kg. After coeliac ganglionectomy the early response to a meal was increased by 100% for fluid output and by 50% for protein secretion, but from 10 minutes to two hours after the meal there was no effect on pancreatic response. These data shed further light on the mode of action of ethanol on pancreatic secretion, and they indicate that therapeutic coeliac ganglia ablation in man is unlikely to be detrimental to physiological pancreatic secretion.

Animals↗
PubMed1989

CT-guided biopsy: prospective analysis of 1,000 procedures.

The authors prospectively analyzed 1,000 biopsies guided with computed tomography (CT) and performed in 955 patients over a 30-month period. All patients were followed up from 3 months to 2 years. The biopsies were performed in an average of 22 minutes (range, 3-85 minutes) by 26 different radiologists; five radiologists performed 547 of the procedures. Of the 1,000 biopsies, 722 were performed in areas in the liver, retroperitoneum, pancreas, pelvis, and adrenal glands. Of 69 errors in diagnosis, 67 were falsely negative and two were falsely positive; 747 true-positive and 184 true-negative diagnoses were made. CT-directed biopsy for accurate diagnosis was 91.8% sensitive and 98.9% specific, with a positive predictive value of 99.7% and a negative predictive value of 73.3%. Of 11 patients with complications, seven had hematomas, three had pneumothorax, and one had hematuria. No deaths occurred, and only one patient required surgery.

Adrenal Glands↗
PubMed1989

Is a drain necessary after colonic anastomosis?

To date, there have been no clinical investigations of the usefulness of drains following colonic anastomosis in elective operations. We report a prospective study in which 49 patients were randomized to have a corrugated silastic drain (Portex) placed next to the colonic anastomosis. These patients were compared with a control group of 57 patients who had no drain. The two groups were similar in age, sex, diagnosis and site of anastomosis. There was no difference in outcome between the two groups. Anastomotic leakage occurred in six patients in each group. Wound infections were noted in 10 patients in each group. Two patients with a drain and one patient without a drain died from leakage at the anastomosis. This study provides no evidence to support the use of a corrugated drain after anastomosis of the colon.

Aged↗
PubMed1989

Pregnant women eligible under Medicaid expansion of maternity services. Implications for outreach.

Recent reforms in federal legislation have made Medicaid-financed prenatal care available to pregnant women from households at nearly twice the poverty level. Census and birth certificate data provide little information about the newly eligible group beyond estimates of their size. This article reports on efforts to compare the Medicaid expansion group to traditional Medicaid prenatal care patients in terms of demographics, access problems, and prenatal care adequacy by employing a short-term, hospital-based survey of postpartum women in Michigan. Differences between pregnant women eligible under the expansions and traditionally eligible pregnant women suggested that major changes in outreach and enrollment activities of state Medicaid agencies may be necessary to fulfill the opportunity represented by the Medicaid expansions.

Aid to Families with Dependent Children↗
PubMed1989

The popliteus tendon.

The posterior aspect of forty cadaver knees was dissected to determine the proximal insertion of the popliteus tendon, particularly its relationship to the lateral meniscus. Thirty-three (82.5 per cent) of the specimens demonstrated no major attachment of the popliteus tendon to the lateral meniscus. Eight specimens were from bilateral dissections and revealed no major asymmetry. On the basis of these dissections, we found no evidence that the popliteus tendon has a role in the retraction and protection of the lateral meniscus.

Humans↗
PubMed1989

The Wolff-Parkinson-White syndrome associated with Marfan's syndrome.

This article documents the rare, possibly coincidental, association of the Marfan and the Wolff-Parkinson-White syndromes. However, an as yet unproven, hypothetical link of a connective tissue, mesenchymal and embryologic, developmental dysplasia, offers a provocative nosological connection.

Adult↗
PubMed1988

Blunt injuries of the diaphragm.

Rupture of the diaphragm is a potentially serious complication of blunt trauma which can easily be overlooked at the time of presentation. This review examines the incidence and pathogenesis of the injury and discusses diagnosis and management.

Diaphragm↗
PubMed1988

Colonic metaplasia with colonic-type polyps on an ileostomy stoma in polyposis coli. Report of a case.

A unique case is reported in which chronic physical and chemical irritation of an ileostomy stoma (after proctocolectomy for polyposis coli) was associated with colonic metaplasia and formation of colonic-type tubular adenomas on the external surface of the ileostomy. The remainder of the terminal ileum and the upper gastrointestinal tract were normal, with no evidence of Gardner's syndrome. This case demonstrates that even metaplastic colonic epithelium is susceptible to the formation of adenomas in polyposis coli patients.

Adenomatous Polyposis Coli↗
PubMed1988

The acetylcholinesterase genes of C. elegans: identification of a third gene (ace-3) and mosaic mapping of a synthetic lethal phenotype.

In C. elegans, the newly identified ace-3 is the third gene affecting acetylcholinesterase (AChE) activity. ace-3 II specifically affects class C AChE and is unlinked to ace-1 X or ace-2 I, which affect the other two AChE classes (A and B, respectively). Strains homozygous for an ace-3 mutation have no apparent behavioral or developmental defect; ace-1 ace-3 and ace-2 ace-3 double mutants are also nearly wild type. In contrast, ace-1 ace-2 ace-3 triple mutant animals are paralyzed and developmentally arrested; their embryonic development is relatively unimpaired, but they are unable to grow beyond the hatching stage. Based on the analysis of genetic mosaics, we conclude that in the absence of ace-2 and ace-3 function, the expression of ace-1(+) in muscle cells, but not in neurons, is essential for postembryonic viability.

Acetylcholinesterase↗