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Biomedical subjects

D Alderson

Publications and source records attributed to D Alderson.

90 records · Page 5Linked to original sources
PubMed1986

Comparison of harvesting methods for islet transplantation.

One problem preventing islet transplantation becoming a clinical reality in the treatment of insulin-dependent diabetes is the unsatisfactory, low yield processes for harvesting islets. This study was designed to find the most effective harvesting process and to examine the feasibility of obtaining more than one graft from a single pancreas. After confirming that normoglycaemia at one month could be achieved in dogs using 50 per cent of an autograft prepared by a previously established method, novel techniques were assessed using 33 per cent of the tissue obtained. An isolation process involving perfusion of the duct by enzymes allowed normoglycaemia using only one-third of the graft preparation and these animals exhibited significantly improved glucose handling and insulin output when compared with recipients of grafts prepared by the established method. A significant improvement in harvesting technique has, therefore, been demonstrated and this will exploit the potential of multiple donor grafts in islet transplantation and the method may be worthy of trial in the human gland.

Animals↗
PubMed1985

Demonstration of pancreatic parenchyma by digital subtraction techniques during endoscopic retrograde cholangiopancreatography.

This paper reports the feasibility of using digital subtraction angiography techniques during endoscopic retrograde cholangiopancreatography to obtain greater detail of pancreatic structure. The pancreatic duct was filled in 23 of 27 cases attempted and in 17 cases parenchymal detail was obtained. Filling defects due to neoplasm were clearly defined and the changes of chronic pancreatitis visualised. The technique seems valuable for small lesions but may carry a higher risk of producing pancreatitis.

Acute Disease↗
PubMed1984

Islet cell transplantation in diabetic dogs: studies of graft function and storage.

Islet cell transplantation is a potential treatment for insulin-dependent diabetes (IDD), assuming that physiological hormone release results in biochemical normality which, in turn, reduces the incidence of long-term diabetic complications. These experiments sought to create a metabolic model of IDD in a large animal and investigate the effects of insulin therapy and islet transplantation. After demonstrating the success of transplantation, further studies examined the feasibility of creating multiple grafts from a single donor and their long-term preservation. The totally pancreatectomized dog, treated with suboptimal insulin therapy was biochemically identical to human IDD and, when more appropriate doses of insulin were administered, metabolic improvements occurred without restoring normality. Islet cell autotransplants rendered such animals metabolically normal apart from persisting impairment of glucose tolerance. The isolation technique permitted the production of at least two recipient grafts and some success was achieved after graft cryopreservation. The experiments confirm the theoretical background to islet transplantation and demonstrate its applicability in a large animal model before allotransplantation.

Animals↗
PubMed1981

Endoscopic sphincterotomy before pancreaticoduodenectomy for ampullary carcinoma.

Pancreaticoduodenectomy remains the operation of choice for carcinoma of the ampulla of Vater, but the presence of severe jaundice in almost all patients with ampullary neoplasia is a major contributory factor to the high incidence of complications and hospital mortality after the operation. To achieve biliary decompression in five patients endoscopic sphincterectomy was performed at the time of endoscopic retrograde cholangiopancreatography. The procedure was successful in achieving biliary drainage in all cases and was without appreciable morbidity. All five patients subsequently underwent identical resections, the interval to operation being decided by the speed of resolution of the jaundice; minor pancreatic leaks in two patients were the only complications. None of the patients died. These results suggest, therefore, that endoscopic sphincterotomy should be performed at the time of duodenoscopy if an obstructive ampullary tumour is found.

Adenocarcinoma↗
PubMed1981

Fifteen-year review of the mortality of brain abscess.

Ninety consecutive cases of brain abscess admitted to this center between 1964 and 1978 have been reviewed. The overall mortality has fallen in three consecutive 5-year periods from 42 to 21 to 9.7%. A number of factors seem to be responsible for this. Early surgical intervention was associated with the reduction in mortality between the first and second 5-year periods. Recognition of the significance and extent of cerebral edema, confirmed since computed tomographic (CT) scans have been available, led to a greater use of steroids during the last 5-year period, but the number of patients thus treated was too small to permit an assessment of any effect on mortality. There is no evidence to suggest a change in the natural history of the disease, and surgical management has not altered significantly. Experience with CT scanning in this center in the diagnosis of brain abscess is limited. It is therefore not possible no assess whether any improvement in mortality may have arisen from the early and accurate diagnosis obtainable with this technique. Improvement in culture technique has been of major importance, leading to a better understanding of the bacteriology of brain abscesses. This has allowed a more rational antibiotic program to be instituted, in particular the use of agents active against obligate anaerobes.

Anti-Bacterial Agents↗
PubMedDate not supplied

The role of preoperative TIPSS to facilitate curative gastric surgery.

The use of TIPSS to facilitate radical curative upper gastrointestinal surgery has not been reported. We describe a case in which curative gastric resection was performed for carcinoma of the stomach after a preoperative TIPSS and embolization of a large gastric varix in a patient with portal hypertension.

Adenocarcinoma↗