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Biomedical subjects

C J Davis

Publications and source records attributed to C J Davis.

At least 55 records · Page 3Linked to original sources
PubMed1992

Laparoscopic cholecystectomy: the St. Vincent experience.

Laparoscopic cholecystectomy has rapidly become the procedure of choice for the management of patients with symptomatic gallbladder disease. Since December 1989, a total of 622 patients have undergone laparoscopic gallbladder surgery. The operative technique we employ requires the insertion of only three laparoscopic cannulas and uses monopolar electrocautery to dissect the gallbladder from the liver bed. Average operating room time was 90.5 min. Twenty-six (4.2%) of the 622 patients required conversion to open laparotomy. A total of 24 (3.8%) operative complications occurred, including one common bile duct injury. Eight patients required readmission to the hospital. Eighteen percent of patients were discharged on the same day as the operative procedure, and overall average hospital stay was 1.8 days (range, 0 to 59 days).

Adolescent↗
PubMed1992

Carcinoma of the male and female urethra.

About 600 cases of urethral carcinoma have been reported. Such tumors may arise from the surface epithelium or any of the glands, and four histologic patterns--squamous, transitional, glandular, and undifferentiated--have been recognized. Metastases from other sites are possible, as are melanomas and various types of sarcoma.

Carcinoma↗
PubMed1991

MM 55266 and MM 55268, glycopeptide antibiotics produced by a new strain of Amycolatopsis. Isolation, purification and structure determination.

Two novel glycopeptide antibiotics MM 55266 and MM 55268 containing fatty acid acyl functions, and of molecular formula C86H89N8O35Cl5 and C87H91N8O35Cl5, respectively, have been isolated and identified from a complex produced by Amycolatopsis sp. NCIB 40089. Fermentation conditions for their production, and methods for their isolation are described. Structures have been deduced by use of COSY and NOE NMR techniques and supported by chemical degradation studies. Both glycopeptides possessed good antibacterial activity against Gram-positive organisms.

Actinomycetales↗
PubMed1991

In selected patients outpatient laparoscopic cholecystectomy is safe and significantly reduces hospitalization charges.

The safety of laparoscopic cholecystectomy has been demonstrated through its increased use, and we have performed 114 of these operations as outpatient procedures. These patients have done well and hospitalization charges have been reduced substantially. Of 622 laparoscopic cholecystectomies performed from November 1989 to March 1991, 114 were done on an outpatient basis if the patients were generally healthy, lived nearby, and the operative procedure was uneventful. Other patients were admitted as 23-h observation or as inpatients. Records of 106 outpatients were reviewed and hospital charges obtained. These charges were then compared with those of 337 patients who underwent standard open cholecystectomy as morning admissions and who had no comorbid conditions nor complications. Comparisons are also made with 23-h observation and inpatient laparoscopic cholecystectomies as well as with all standard open cholecystectomy patients. The technique employed is with three punctures using electrocautery and a minimum of disposable products. Of the 106 outpatients, one required admission for postoperative ileus and pain control; 21 (19.8%) experienced nausea and 14 (13.2%) experienced vomiting but were treated successfully with antiemetics; none required admission. One patient required outpatient catheterization for urinary retention. Of the last 100 laparoscopic cholecystectomies performed by three surgeons (M.E.A., C.J.D., A.A.), 43 were performed as outpatients using the above selection criteria. 44 were held for 23-h observation, and 13 were inpatients. The average hospital charge for 377 uncomplicated morning-admitted inpatient standard cholecystectomy patients was $4,250.00, compared with $2,293.02 for 106 outpatient laparoscopic cholecystectomy patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Neurilemmoma of the intrathoracic vagus nerve.

A neurilemmoma (Schwannoma) of the left intrathoracic vagus nerve was discovered on a chest radiograph of a 28 yr old woman and was removed via a left thoracotomy. Although neurogenic tumours are the most common tumours of the mediastinum, they rarely involve the intrathoracic vagus nerve.

Adult↗
PubMed1990

Duodenal villous tumors.

The treatment of 36 patients with duodenal villous tumors was reviewed to determine the long-term outcome of various surgical treatment options for specific adenoma histopathology. Duodenal villous tumors were typically solitary and periampullary in location. Villous adenomas contained epithelial atypia in 30% of patients, in situ carcinoma in 14%, and invasive carcinoma in 33%. Treatment consisted of transduodenal submucosal excision in 19 patients and radical pancreaticoduodenectomy in 15. There was no perioperative mortality. Perioperative morbidity for transduodenal excision and pancreaticoduodenectomy was 16% and 47%, respectively. Benign adenomas recurred more than 5 years postoperatively in 17% of patients undergoing transduodenal excision. Five-year survival following radical resection for invasive cancers was 45%. Overall median follow-up was 5.8 years. We conclude that duodenal villous tumors without invasive cancer can be managed successfully by local submucosal excision, but invasive carcinoma requires radical resection.

Adenoma↗
PubMed1990

Evidence for presynaptic 5-hydroxytryptamine3 recognition sites on vagal afferent terminals in the brainstem of the ferret.

Antagonists acting at the 5-hydroxytryptamine3 receptor are potent anti-emetic agents in cases of cytotoxic- and radiation-induced vomiting, and binding sites for these compounds have been described in brainstem areas known to be involved in mediation of nausea and vomiting. We have used autoradiography to examine the distribution of one of these antagonists, [3H]granisetron in the caudal brainstem of the ferret, a commonly used animal model for physiological investigations of emesis. The highest density of binding sites was found to be in the dorsomedial region of the nucleus of the solitary tract, the principal terminus for gastric vagal afferent fibres. Lower levels of binding were observed in the area postrema and the dorsal motor nucleus of the vagus. Following unilateral nodose ganglion excision, displaceable binding of [3H]granisetron in the nucleus of the solitary tract was attenuated on the ipsilateral side by 65%. Bilateral subdiaphragmatic vagotomy abolished binding of [3H]granisetron in the entire dorsal vagal complex. These results provide strong circumstantial evidence that 5-hydroxytryptamine3 receptors are located on vagal afferent terminals in the ferret brainstem.

Afferent Pathways↗
PubMed1990

Current understanding of pathology of bladder cancer and attendant problems.

Urinary bladder is an easily accessible organ and its histology is simple, but there exists considerable controversy in the interpretation of pathological findings; in fact, even in the criteria for diagnosis of malignancy. These controversies must be resolved to provide us with proper management of patients with cancer of the bladder.

Carcinoma, Papillary↗
PubMed1990

The abdominal visceral innervation and the emetic reflex: pathways, pharmacology, and plasticity.

In recent years the role of the area postrema in the emetic reflex has been predominant and the involvement of the abdominal visceral innervation has tended to be overlooked. This paper attempts to redress the balance reflex by reviewing aspects of the existing literature and complementing this with original studies from the ferret. In view of the widespread use of the ferret in studies of emesis and particularly in the characterization of the antiemetic actions of 5-HT3 receptor antagonist, the opportunity is taken to assess the suitability of this species for studies of emesis. It is concluded that the ferret is sensitive to a wide range of emetic stimuli including intragastric irritants, opiate and dopamine receptor agonists, many cytotoxic drugs, and radiation. For several stimuli it is more sensitive than other species and for radiation on the basis of its ED100 it appears to be the most sensitive of the laboratory animals studied. Using electrical stimulation of the central end of the dorsal vagal trunk in the abdomen in conscious and anaesthetized animals, the vagal afferents were shown to be capable of eliciting emesis. Using lesioning studies an involvement of the vagus in the emetic response to a number of cytotoxic drugs (e.g., cisplatinum, cyclophosphamide, mustine) and radiation was demonstrated, although the magnitude of the effect varied with the different stimuli. An attempt is made to reconcile these observations with previous studies of area postrema ablation. The problems of interpreting the effects of nerve lesions are critically discussed in light of preliminary evidence presented here that there may be a degree of plasticity in the emetic pathway following such lesions. The range of antiemetic effects of 5-HT3 receptor antagonists is reviewed and an attempt is made to identify the site(s) at which these agents act. Results are presented that suggest a link between the vagus and 5-HT3 receptor antagonism. These studies are discussed together with others and lead us to propose that (in the ferret) 5-HT3 receptor antagonists have their main antiemetic effect by acting on vagal afferent terminals in the wall of the upper gut with an additional minor site either in the nucleus tractus solitarius or presynaptically on the vagal afferent terminals in the medulla where binding sites for 5-HT3 receptor ligands have recently been demonstrated in this species.

Abdomen↗
PubMed1989

Body-image disturbances in bulimia nervosa: influences of actual body size.

This study evaluated body-image distortion and ideal body-size preferences in 423 nonbulimic women and 108 bulimics. Analyses of covariance were utilized to compare the bulimic and nonbulimic groups on measures of current and ideal body size. Weight was used as a covariate to evaluate the influence of actual body size on perception of current body size and selection of ideal body size. Bulimics chose current body sizes that were significantly larger than those picked by nonbulimics regardless of actual body size. Bulimics also chose thinner ideal body sizes than did nonbulimics, regardless of actual body size. These results suggest that body-image distortion and extreme preference for thinness are a fundamental characteristic of bulimia nervosa. These results were discussed in terms of how perception of a large body size and preference for a very thin body size might interact to produce a high degree of dissatisfaction and overconcern with body size in bulimia nervosa.

Adult↗
PubMed1989

An uncontrolled evaluation of inpatient and outpatient cognitive-behavior therapy for bulimia nervosa.

Inpatient (n = 27) and outpatient (n = 22) cognitive-behavior therapy programs for bulimia nervosa were evaluated in an uncontrolled experiment. Both treatment conditions included exposure with response prevention and cognitive restructuring. Inpatient treatment had a mean length of stay of 5 weeks. Outpatient treatment lasted 15 weeks. Both groups were followed after the end of treatment. The results showed that both programs were effective in reducing problems associated with bulimia nervosa. The inpatient program led to very rapid progress, whereas the outpatient program led to more gradual improvement. There was, however, a trend toward relapse for inpatients. Other psychological disturbances, (e.g., depression) were improved after inpatient, but not outpatient, treatment. These data were discussed in terms of their implications for treatment planning for cases of bulimia nervosa.

Adult↗
PubMed1988

Differential patterns of local cerebral glucose utilization in response to 5-hydroxytryptamine agonists.

Local cerebral glucose utilization was measured in parallel groups of conscious rats following intravenous injection of either 1 mg/kg 8-hydroxy-2-(di-N-propylamino)tetralin (a 5-hydroxytryptamine 1A binding site agonist), 3 mg/kg 5-methoxy 3-(1,2,3,6-tetrahydro-4-pyridinyl)1H indole, succinate (a 5-hydroxytryptamine1B agonist), or saline alone, using the 2-deoxyglucose quantitative autoradiographic techniques (n = 5 in each of the three groups). Following both drugs, local rates of glucose use in the majority of the 72 brain areas analysed remained unaltered, but in some other regions either increases or decreases were observed. In keeping with the observed behavioural response to 8-hydroxy-2-(di-N-propylamino)tetralin there were marked increases in cerebellum (+56%) and motor cortex where a columnar arrangement of increased metabolism (+34%) contrasted with adjacent columns of decrease (-26%). Hippocampal areas showed moderate decreases in glucose use (-13 to -21%). All areas which increased following 8-hydroxy-2-(di-N-propylamino)tetralin also increased following 5-methoxy 3-(1,2,3,6-tetrahydro-4-pyridinyl)1H indole, succinate, but in the latter case all elements of the basal ganglia were also increased, including globus pallidus (+105%) and the striatum where the changes (+54%) were limited to a discrete dorsal region of the nucleus. In the hippocampus only dorsal dentate gyrus was decreased (-24%) whilst a moderate increase (+16%) was observed in dorsal subiculum. The complexity of these results contrasts with previous 2-deoxyglucose investigations where less specific 5-hydroxytryptamine receptor ligands were used, and suggests that certain aspects of brain function may be selectively targeted by systemic pharmacological manipulation of endogenous serotonergic systems.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1988

Forbidden Food Survey: measure of bulimic's anticipated emotional reactions to specific foods.

The Forbidden Food Survey is an instrument that was designed for use with eating disordered individuals. The first experiment in this study includes a description of the Forbidden Food Survey and the reliability and internal consistency of its scales. The second investigation examined the discriminant validity of the Forbidden Food Survey by comparing the responses of three groups: bulimic binge-purgers, bulimic binge-eaters, and normals. The Forbidden Food Survey was found to differentiate the two bulimic groups on two scales, high caloric foods, medium calorie foods, and milk. As predicted from the anxiety model of bulimia, binge-purgers consistently reported stronger negative emotional responses to these foods than did the other groups. In the third experiment, bulimic binge-purgers were compared on Forbidden Food Survey responses to obese and normal subjects. Again, binge purgers were found to respond with stronger negative responses than obese and normals. These studies support the reliability and discriminant validity of the Forbidden Food Survey with eating disordered individuals.

Adolescent↗
PubMed1988

Influence of splenectomy on survival rate of patients with colorectal cancer.

Between 1966 and 1980, 68 patients were identified who had a splenectomy before or concurrent with resection of a colorectal adenocarcinoma. Control subjects with concurrent disease were then matched with each study patient for age, sex, stage of disease, and date of operation. Follow-up was complete. Between splenectomy patients and control subjects, there was no difference in the site of primary disease (rectum versus colon), the number of patients receiving adjuvant therapy, the technique of resection (cure versus palliation), or the extent of regional disease. Overwhelming sepsis occurred in only one splenectomy patient. Splenectomy was associated with a significant decrease in survival at 5 years in patients with regional (stage C) disease but not in patients with localized (stage B) disease. More splenectomy patients received blood transfusions than control subjects, but an independent effect on survival could not be demonstrated. The mechanism responsible for this adverse impact of splenectomy is undefined. However, splenectomy should be considered a possible factor in the survival of patients operated on for regional colorectal cancer.

Adenocarcinoma↗
PubMed1988

Infiltrative renal lesions: CT-sonographic-pathologic correlation.

The CT and sonographic findings in 23 cases of renal lesions in which the abnormality was infiltrative, as opposed to expansile, were analyzed (invasive transitional cell carcinoma [seven], renal lymphoma [six], metastasis to the kidney [three], acute bacterial nephritis [three], mesoblastic nephroma [two], squamous cell carcinoma of the renal pelvis [one], and renal cell carcinoma [one]). CT scans were evaluated for shape and density of the mass, pelvocaliceal displacement, effect on the renal sinus fat, and the presence of perirenal involvement. Sonograms were evaluated for the shape and echogenicity of the mass and for the effect on the renal sinus echoes. Findings of infiltrative growth included poorly defined margins of the mass; trapped, nondisplaced infundibulae; and calices with occasional calicectasis, diminished contrast enhancement, occasional nephrographic striations, replacement of central sinus fat, loss of central sinus echoes, and variable renal parenchymal echogenicity. The reniform shape was usually preserved and was present in 19 of 20 cases with CT and 13 of 15 cases with sonograms. These observations indicate that analyses of the margins, architecture, and effects on the collecting system and renal sinus by the mass are helpful in the diagnosis of those diseases that characteristically infiltrate the kidney.

Acute Disease↗