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Biomedical subjects

C D Johnson

Publications and source records attributed to C D Johnson.

423 records · Page 24Linked to original sources
PubMedDate not supplied

Neuroendocrine tumors of the pancreas.

Neuroendocrine tumors of the pancreas (NETP) are rare. We report our surgical experience of 11 patients with NETP. These included 5 patients with benign insulinomas. Raised serum insulin and C-peptide levels with hypoglycemia were always diagnostic. Ultrasonography, CT, visceral angiography, arterial stimulation and venous sampling, and intraoperative ultrasound localized the tumor in 0/5, 1/5, 3/4, 2/2, 3/3 cases, respectively. The 6 other malignant NETP (one gastrinoma, 2 carcinoids, 3 non-functioning) were managed by pancreatic resection (Whipple's operation = 3, distal pancreatectomy with total gastrectomy = 1, total pancreatectomy = 1, distal pancreatectomy with left nephrectomy and proximal gastrectomy = 1). Two patients died postoperatively. We had 5 major and 2 minor postoperative complications, with 2 deaths. During follow up from 1 to 7 years, one patient with malignant carcinoid tumor died at two and half years, of local recurrence. The other 8 patients are disease-free with good quality of life.

Aged↗
PubMedDate not supplied

"Research" and "science" in the first half of the chiropractic century.

In the first 50 years of the chiropractic profession, a variety of unorthodox meanings for the terms "research," "science" and related words were in evidence. In harmony with popular conceptions of the day, science was constructed as a relatively static body of knowledge and was thought to reflect the will of God. Research was an ill-defined activity, and acquisition of new knowledge did not involve the experimental methodology that increasingly took hold in biology and medicine in the twentieth century. Chiropractors often viewed science and research as marketing strategies. Clinical data collection, when it occurred at all, was not described in sufficient detail to permit replication. Results were enthusiastically interpreted as indisputable proof of investigators' a priori assumptions about the effectiveness of chiropractic methods. A few in the profession recognized the general lack of understanding of the scientific method and sought reform from within. However, the colleges were unwilling to introduce coursework in research methods. At the end of World War II, the broad-scope national association of chiropractors in the United States established a nonprofit foundation for the purpose of raising funds for chiropractic research and education. Research plans were poorly conceived and grandiose: the first major initiative of the Chiropractic Research Foundation involved a nationwide publicity and fund-raising campaign modeled after the March of Dimes. When these efforts failed and the possibility of establishing free-standing research centers collapsed, the Foundation sought to shift responsibility for research to the schools. The poverty-stricken chiropractic colleges lacked the research sophistication for this task. Several more decades would pass before a sustained research effort and interest in clinical experimentation would become evident in chiropractic.

Chiropractic↗
PubMedDate not supplied

Heartburn, oesophagitis and Barrett's oesophagus in self-medicating patients in general practice.

A postal questionnaire on heartburn sent to 6760 randomly selected subjects yielded 3971 replies suitable for analysis. Heartburn had never been experienced by 1665 (42%) respondents. Significant symptoms of more than three months' duration that had occurred at least once a month in the preceding 12 months were reported by 1337 (34%) respondents. Of these, 875 had not consulted their general practitioner and were invited to attend for a structured interview with questionnaire and upper gastrointestinal endoscopy. A total of 177 were interviewed, and 143 underwent upper gastrointestinal endoscopy. Of those endoscoped, 106 (74%) experienced symptoms at least once a week. These were relieved by alginate consumption in 97 (68% of) cases. Just nine (6%) patients had been taking H2-receptor antagonists. Macroscopic appearances of oesophagitis were seen in 46 cases [13 (6%) grade 1, 24 (11%) grade 2, five (2%) grade 3, two (1%) grade 4, and two (1%) grade 5]. Three patients had mild strictures and six patients had Barrett's oesophagus. There were no appearances suggestive of malignancy. Biopsies were taken in 122 cases, including all those in which abnormalities had been seen. Histological evidence of oesophagitis was seen in 47 cases. Gastric metaplasia was found in six cases and dysplasia seen in three. Patients who self-medicate for reflux symptoms have a low prevalence of pre-neoplastic and neoplastic pathology. A substantial proportion, however, have histological evidence of oesophagitis and a small number have metaplasia.

Adult↗
PubMedDate not supplied

Atrial parasystole.

A case of the relatively rare atrial parasystole is reported, and this interesting cardiac arrhythmia is reviewed. Atypical deviations from classical parasystole are reviewed, and modern concepts of parasystole as they differ from traditional, classical parasystole are addressed.

Diagnosis, Differential↗
PubMedDate not supplied

Acute spinal cord and head injury: case report and discussion of cardiac, respiratory and endocrine abnormalities.

We report a male patient who after a fall suffered high cervical spinal cord and head (cerebral) injuries. These injuries led to spinal shock, marked sinus bradycardia and asystolic cardiac and respiratory arrests, recalcitrant central traumatic diabetes insipidus, and death within approximately seven weeks. Temporary transvenous cardiac pacing proved useful in the management of this patient.

Accidental Falls↗