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Biomedical subjects

D J Patterson

Publications and source records attributed to D J Patterson.

At least 73 records · Page 4Linked to original sources
PubMed1989

Colorectal neodymium-YAG photoablative therapy. Comparing applications and complications on both sides of the peritoneal reflection.

Laser photoablative therapy has seen wide application in the esophagus, stomach, and rectum. Its use in the supraperitoneal colon has been less extensive because of fear of complications. One hundred fifteen patients who presented during a four-year period and underwent neodymium-YAG laser treatment on both sides of the peritoneal reflection (rectum, 47 patients; colon, 68 patients) were reviewed. The various lesions treated with laser therapy included 32 malignant tumors that presented with bleeding or obstruction, 44 large broad-based villous adenomas, six carcinoid tumors, and 33 patients with arteriovenous malformations or radiation proctitis who presented with acute hemorrhage or chronic blood loss. Overall treatment efficiency was 83% in the rectal group vs 87% in the colonic group. There was no significant difference in complication frequency or severity between the two groups, even though 45% of the colonic lesions were located in the thin-walled cecum. There was no laser-related mortality in this series. Laser photoablative therapy is safe and effective treatment for a wide variety of colorectal lesions. In experienced hands, it can be used on either side of the peritoneal reflection with equal efficiency and no increased risk of complications.

Adenoma↗
PubMed1989

Endoscopic placement of pancreatic stents and drains in the management of pancreatitis.

Although widely used in the biliary tree, little data is available on endoscopic placement of stents or drains within the pancreas. This report describes 17 patients, nine with acute relapsing pancreatitis and eight with chronic pancreatitis, who had drain or stent placement for hypertensive pancreatic duct (PD) sphincter, dominant ductal stenosis, duct disruption, or pseudocyst. Two patients have subsequently undergone surgery, and six other patients continue long-term stent placement with marked reduction of chronic pain or attacks of recurrent pancreatitis. All six pseudocysts resolved, although one recurred and required surgery. It is concluded that pancreatic drains or stents may obviate the need for surgery, temporize before definitive therapy, or direct a subsequent surgical procedure.

Acute Disease↗
PubMed1989

Conception rate in Bos taurus and Bos indicus crossbred heifers after postweaning energy manipulation and synchronization of estrus with melengestrol acetate and fenprostalene.

Conception rate in heifers after synchronization of estrus with melengestrol acetate (MGA) and fenprostalene (a prostaglandin F2 alpha analogue; PGF) was determined in pubertal Bos taurus and Bos indicus crossbred yearling heifers. Angus x Hereford (AH, n = 137) and Brahman x Hereford (BH, n = 97) heifers were sorted by body weight after weaning into light (LW) and heavy (HW) weight blocks. Heifers were assigned by age to diets to reach a target weight of 55% (LE) or 65% (HE) of their projected mature weight by the start of breeding. Heifers that exhibited estrus and had serum progesterone greater than or equal to 1 ng/ml (0 or 10 d before estrous synchronization treatment) were assigned randomly within breed and nutritional groups to either an estrous synchronization (S) or control (C) group. Heifers in the S group were fed .5 mg of MGA for 7 d and injected s.c. with 2 mg PGF on d 7 of MGA. All heifers were inseminated 12 h after first detected estrus. A greater proportion of AH (P less than .01) than of BH heifers were in estrus within 6 d after PGF, and more S heifers than C heifers (P less than .01) were in estrus. Conception rate at first service was proportionately higher (P less than .001) in AH than in BH heifers and lower (P less than .02) in S than in C heifers. There was a breed x energy level interaction (P less than .01) for conception rate at first service. Stage of the estrous cycle at the time treatment with MGA was initiated influenced (P less than .05) conception rate at first service in the S, AH heifers, with lower conception rates among heifers beginning treatment late in their estrous cycles (greater than or equal to d 12). Pregnancy rates after 21 d were higher (P less than .01) in AH than in BH heifers and higher (P less than .01) in HW than in LW heifers. More HE than LE heifers (P less than .02), and more AH than BH heifers were pregnant after 45 d. Pregnancy rates at the end of 21 d were higher among HE, BH heifers than among LE contemporaries. A higher (P less than .02) percentage of HE, HW, BH heifers were pregnant at the end of 45 d compared with other BH groups. Results indicated that a 7-d MGA-PGF treatment reduced conception rates at first service in pubertal yearling heifers. Pregnancy rate was affected by prebreeding nutrition in BH yearling heifers at the end of 45 d.

Administration, Oral↗
PubMed1989

Control of the bovine estrous cycle with melengestrol acetate (MGA): a review.

Expanded use of artificial insemination in the beef cattle industry depends on successful application of treatments designed to synchronize estrus. Regulation of estrous cycles is associated with control of the corpus luteum (CL), whose life span and secretory activity are subject to trophic and lytic mechanisms. The advantages of melengestrol acetate (MGA) in estrous synchronization incorporate ease of administration, lower cost relative to other estrous synchronization products, and potential for use to induce estrus in prepubertal heifers. Treatments first designed to synchronize estrous cycles of normally cycling heifers by feeding MGA were imposed daily for 14 to 18 d at levels of .5 to 1 mg. The minimal daily effective dose required to inhibit ovulation was .42 mg. Longer feeding periods of MGA were associated with low fertility at the first synchronized estrus, but at the second estrus, conception was normal. Low fertility at the synchronized estrus resulted in development of alternative treatment practices, which combined feeding of MGA with injections or implants of estradiol-17 beta, estradiol cypionate, luteinizing hormone, human chorionic gonadotropin, pregnant mare serum gonadotropin, or oxytocin. Estrus was synchronized after MGA and estradiol-17 beta or estradiol cypionate treatments, but fertility was low. Short-term feeding of MGA (5 to 7 d) combined with prostaglandin F2 alpha or its analogs (PGF) on the last day of MGA reduced fertility at the synchronized estrus. The reduced conception at first service occurred in animals that began treatment after d 12 of the estrous cycle. However, feeding MGA for 14 d and then injecting PGF 17 d later avoided problems with reduced conception. Fertility of animals after this treatment was similar to that of contemporaries synchronized with Syncro-Mate-B. However, the length of the treatment period creates a need for increased management and may extend management beyond practical limits. Further research is warranted to address problems associated with reduced fertility after short-term treatment with MGA.

Animals↗
PubMed1988

Complete esophageal obstruction secondary to dissecting intramural hematoma after endoscopic variceal sclerotherapy.

Endoscopic variceal sclerotherapy (EVS) is an accepted alternative to surgery in many patients with bleeding esophageal varices. Esophageal ulceration is a common sequelae of EVS with chest pain, stricture, and perforation occurring less frequently. We present a patient with Laennec's cirrhosis and coagulopathy who developed an obstructing esophageal hematoma caused by submucosal dissection after two EVS treatments.

Adult↗
PubMed1987

Occurrence of neonatal and postnatal mortality in range beef cattle. I. Calf loss incidence from birth to weaning, backward and breech presentations and effects of calf loss on subsequent pregnancy rate of dams.

Data from 13,296 calvings collected over a 15-yr period indicated 893 calves died from birth to weaning for an average loss of 6.7%. Calves lost from birth through Day 3 postcalving accounted for a 4.6% loss with an additional 2.1% loss from Day 4 through weaning. Calf deaths from primiparous 2- and 3-yr-old dams accounted for 41.0% of total mortality. Losses within groups were primiparous 2-yr-olds, 10.9%; primiparous 3-yr-olds, 8.7%; second-calf 3-yr-olds, 4.1%; second-calf 4-yr-olds, 8.3%; multiparous 4-yr-olds, 4.8%; and dams 5 yr and older, 5.3%. The majority of calf deaths (57.4%) occurred within the first 24 h postpartum with 75% of the total occurring Days 0 through 7. This loss was similar among all dam age and parity groups. Calf death due to dystocia accounted for the single largest loss category through the first 96 h postpartum, resulting in 69.6, 39.6, 30.8 and 33.3% of the loss incidence for Day 0, 1, 2 and 3 postpartum, respectively. More (P < 0.01) male calves (510, 57.6%) died than females (376, 42.4%). Backward presentations occurred more frequently (P < 0.01) than breech (1.6 vs 0.6% of all births, respectively). Incidence of backward presentation was 2.3%, 5.6% and 0.9% for primiparous 2-yr-old, 3-yr-old and multiparous dams, respectively (P < 0.01); 64.2% of the backward calves were males and 35.8% females (P < 0.01). Survival of calves in backward presentation exceeded (P < 0.01) that of breech calves (70.7 vs 32.9%). Fall pregnancy rate of dams that lost calves and reentered the breeding herd that same year was 72.4% compared to 79.4% (P < 0.01) for contemporary females that did not lose calves. The depression in pregnancy rate was not specifically due to dystocia but apparently to some general effect of calf loss.

Journal Article↗
PubMed1987

Occurrence of neonatal and postnatal mortality in range beef cattle. II. Factors contributing to calf death.

Results are summarized of necropsy findings from 798 calves lost from birth to weaning over a 15-yr period. Autopsies determined cause of death and ascertained anatomical normalcy of the skeletal, musculature and organ systems and functinal status of the lungs. Of the 798 calves, 77.7% were anatomically normal and 22.3% were abnormal (P < 0.01) and 75.0% of the total deaths of abnormal calves occurred by Day 2 postpartum. Birth weights of normal calves averaged 4.2 kg heavier (P < 0.05) than that of abnormal calves. Internal hydrocephalus was identified and confirmed heritable as a lethal recessive trait. The number of calves lost from dystocia (406 calves, 50.9%) exceeded losses from all other causes (392 calves, 49.1%). Lung status was determined for 492 calves dying at birth, with 39.6 and 60.4% having functional and nonfunctional lungs, respectively (P < 0.01). Diseases, mainly scours and pneumonia, ranked second in importance as cause of death (12.8%), followed by exposure-chilling (5.6%) due to cold and wet conditions. Abnormalities observed included heart anomalies (24 calves), hydrocephalus (38 calves) and a missing segment of the caudal gut (8 calves). Multiple congenital malformations were found in 15 calves with findings similar to those resulting from maternal consumption of toxins from poison hemlock (Conium maculatum) during gestation. Twelve calves died from peritonitis resulting from a perforated abomasal ulcer caused by accumulated hair. Of the 373 dystocia deaths in anatomically normal calves, 121 (32.4%) involved abnormal presentation, with calves involved in backward or breech presentation accounting for 62.0% of the losses from abnormal presentation. Calves experiencing hiplock or retained forelimb were heavier (P < 0.05) than calves presented in normal, back-ward or breech positions. Dystocia scores were assigned to 253 calves dying at parturition. Percentage losses within score were 52.6, 6.7, 30.8 and 9.9 (P < 0.05) and birth weights were 33.9, 36.1, 39.2 and 37.4 kg (P < 0.05) for scores of 1, 2, 3 and 4, respectively.

Journal Article↗
PubMed1987

Product line management: organization makes the difference.

Three dominant models of product line management are emerging in the healthcare industry today--market management, distribution management, and strategic business unit management. These models offer unique benefits for the healthcare organization. It is important to use the model that best fits the needs of the institution. Therefore, an analytical framework has been developed to help the organization evaluate and implement the proper model to ensure successful organizational change. This article is the second in a three-past series on product line management in health care. The first article dealt with the question of whether product line management will work in the healthcare industry.

Financial Management↗
PubMed1984

Effects of information about specific nutrient content on ratings of "goodness" and "pleasantness" of common foods.

In a study of the effects of information concerning nutrient content on ratings of foods, subjects (247 male and female school students aged 13-14 years) rated a list of 21 common foods on two scales "good for you" and "pleasant", either without prior information (control group) or after being shown, and asked to memorize, a classification of the foods as "high" "medium" and "low" in terms of a specified nutrient. There were five experimental groups, each receiving classificatory information about a different nutrient (iron, protein, carbohydrate, calorie or fat). Compared with controls, experimental subjects rated the value of the foods in a way corresponding more closely with the specific classification presented to them. Ratings of pleasantness, however, showed no such consistent effects. These findings are interpreted in terms of models of attitudinal judgement concerned with factors influencing the salience to individuals of different stimulus attributes. Implications for the effects of selective information on judgements are discussed, with specific reference to advertising and nutrition education.

Adolescent↗
PubMed1983

Double-blind comparison of liquid antacid and placebo in the treatment of symptomatic reflux esophagitis.

Although antacids have been the mainstay of pharmacologic therapy for reflux esophagitis, their effectiveness has not been tested in a placebo-controlled double-blind trial. We report a double-blind comparison of liquid antacid vs placebo in the treatment of reflux esophagitis in 32 patients with chronic heartburn. Entry criteria included the presence of symptomatic gastroesophageal reflux confirmed by both an acid perfusion (Bernstein) test and by intraesophageal pH probe. Drug treatment consisted of 15 ml (80 mEq) doses of antacid (Maalox Therapeutic Concentration, William H. Rorer) or placebo taken 7 times daily, ie, 1 and 3 hr after meals and at bedtime. Both groups showed significant improvement (P less than 0.05) in both frequency and severity of heartburn. The time to reproduce heartburn with the timed Bernstein test was increased with both active drug and placebo therapy. The mean increase was 402% (41 +/- 20 sec to 169 +/- 66 sec) for the placebo group and 286% (42 +/- 16 to 120 +/- 57 sec) in the antacid group. Both the antacid and placebo groups showed improvement in the degree of esophagitis as assessed endoscopically. The current study asked: does regular antacid therapy have a favorable influence on the natural history of symptomatic reflux esophagitis, ie, does therapy heal or otherwise change esophagitis so that painful episodes are either less frequent, less severe, or both? We found that the natural history of symptomatic reflux esophagitis was to improve with either antacid or placebo. There was no significant difference in antacid or placebo on the (short-term) natural history of the disease.

Aluminum Hydroxide↗
PubMed1983

The effects of taxol on microtubular arrays: in vivo effects on heliozoan axonemes.

The effects of the antitumor drug taxol on the microtubular axonemes of the heliozoon Actinophrys sol have been investigated. The drug induces polymerization of microtubules as shown by a large increase in the length and number of microtubular arrays. The interaction between microtubules and microtubule-associated proteins is also affected, with the result that the normal geometric patterning within the microtubular arrays is disturbed. This is due to the loss or inactivation of long intermicrotubule links. As a result, arms lose their rigidity. Because the drug stabilizes polymerized microtubules, C-shaped profiles and other signs of poor microtubule preservation are absent in taxol-treated cells.

Alkaloids↗
PubMed1983

Niacin hepatitis.

We report a case of severe liver injury occurring on two occasions in a patient ingesting large doses of nicotinic acid. The liver architecture was markedly distorted, with both massive and submassive lobular collapse and marked cholestasis. Complete resolution of biochemical and histologic abnormalities occurred after withdrawal of these drugs.

Adult↗
PubMed1983

Why do apparently healthy people use antacid tablets?

Proprietary antacids represent a multimillion dollar business in this country. Marketing surveys have shown that approximately one-half of American adults have used antacids. Twenty-seven percent of adults take 2 or more doses per month. Seventy-five percent of total antacid consumption is by heavy users, defined as greater than 6 doses per week (less than 5% of adults). We investigated why apparently healthy people are heavy antacid users. Thirty-seven heavy users were evaluated. The median duration of antacid use was 20 years, and most took antacids 2-6 times per day, concentrated through the work week. The primary diagnosis was reflux esophagitis in 31 (84%), peptic ulcer disease in one, and nonulcer dyspepsia in five. Ninety-five percent had symptoms consistent with reflux esophagitis. Thirty-three completed a 1 month double-blind, randomized cross-over trial of antacid tablets (14 mEq neutralizing capacity per tablet) versus placebo. Twenty-nine correctly identified the antacid product (p less than 0.0001). Twenty-three subjects underwent Bernstein tests and endoscopy; 21 had positive Bernstein tests, 13 had definite esophagitis as determined endoscopically. We conclude 1) heavy proprietary antacid tablet use in the adult male is not an expression of functional disease but is due to reflux esophagitis, 2) tablet use can be effective symptomatic treatment, and 3) history is an adequate evaluation for most heavy antacid tablet users.

Antacids↗
PubMed1983

Natural history of benign esophageal stricture treated by dilatation.

Although bougienage is widely used to treat benign esophageal stricture, the rate of stricture recurrence and the long-term effectiveness of bougienage are unknown. We studied the natural history of esophageal stricture in 154 patients in whom bougienage was used as primary therapy. Dilatations were considered successful in terms of relief or major improvement of dysphagia in 84.5% of 103 patients followed 6 mo or longer (median, 26 mo). The risk of requiring esophageal dilatation after the initial episode was greatest in the first year of follow-up; thereafter, a smaller fraction of patients required dilatation each year. Forty-three percent of patients required no further dilatations, and a life-table analysis showed that 36% of patients would require no further dilatation during a projected 4-yr follow-up. The median frequency of subsequent dilatation was less than once a year. We were unable to identify any significant factors, such as initial severity of stricture, cause of stricture, presence of active esophagitis, or initial caliber of dilatation, that could predict the need for subsequent dilatation. Our results suggest that patients with benign strictures fall into two groups. In one group, the natural history was to improve or become asymptomatic after an initial series of dilatations, and only a small proportion eventually developed recurrent symptoms. The second group (46% of patients) required further dilatations to treat dysphagia during the first year of follow-up. Two-thirds of these patients needed regular dilatations in subsequent years. We conclude that bougienage is effective treatment for benign esophageal strictures, and should be utilized as primary therapy for most strictures.

Adult↗