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Biomedical subjects

D M Murphy

Publications and source records attributed to D M Murphy.

At least 109 records · Page 6Linked to original sources
PubMed1982

Polytetrafluoroethylene shunts in congenital heart disease.

Over a 2-year period the authors inserted 22 systemic to pulmonary artery shunts using a polytetrafluoroethylene (PTFE) graft in 19 children. A modified Blalock-Taussig shunt was established in 18 instances and an aorta to pulmonary artery shunt in 3: one patient had an aorta to right ventricle infundibulum shunt. Three children had obstructed grafts and in two others the grafts became stenosed; on of the latter group had successful removal of thrombus. The remaining grafts functioned well. Three other patients are presented. In two an interrupted aortic arch was repaired using a PTFE graft; one of these patients died at later closure of an aortopulmonary window, the other did well following repair of a ventricular septal defect and aortic valvotomy. The third child had a right ventricle to pulmonary artery shunt established for tetralogy of Fallot with pulmonary atresia; this resulted in some growth of the pulmonary arteries. The modified Blalock-Taussig shunt, using a PTFE graft, can be inserted without opening the pericardium, normal flow through the subclavian artery is not interrupted, the PTFE is easy to handle and the shunt can be inserted and taken down more easily than traditional shunts. For these reasons, the authors believe that this procedure, using PTFE, has an important role to play in the surgical management of children with congenital heart disease.

Aorta, Thoracic↗
PubMed1981

Management of high grade transitional cell cancer of the upper urinary tract.

A total of 175 patients was operated on for grade 2, 3 or 4 transitional cell epithelioma of the upper urinary tract. Followup was between 5 and 26 years. The operations involved total nephroureterectomy, simple nephrectomy and local resection. Patient survival correlated well with tumor stage and, particularly, with tumor grade, and, consistently, was inferior to that of an age and sex-matched control group. The correlation of survival and ipsilateral tumor recurrence with the type of operation suggests that patients with grade 2 tumors may benefit from total nephroureterectomy. The incidence of ipsilateral tumor recurrence (28 per cent) was high in this group. The radical procedure seems to be of no benefit to patients with grade 3 or 4 tumors. The incidence of subsequent bladder tumor was 30 per cent in patients with grades 2 and 3 tumors. The latent period ranged from 2 months to 10 years (average 23 months); 82 per cent of the tumors occurred within 3 years of treatment of the upper tract tumor.

Adult↗
PubMed1980

Primary grade 1 transitional cell carcinoma of the renal pelvis and ureter.

During a 22-year period 224 patients were seen for treatment of transitional cell carcinoma of the renal pelvis or ureter. Of these patients 49 (22 per cent) had grade 1 lesions. Followup ranged from 5 to 25 years. The most common symptom was hematuria. In only 54 per cent of the 49 patients was a filling defect noted on excretory urography. Forty-seven patients (96 per cent) had stage I disease. Treatment included total nephroureterectomy, nephrectomy or segmental resection. In 11 patients (23 per cent) evidence of bladder tumor developed 8 months to 12 years (average 4 years) after the diagnosis of tumor of the upper urinary tract and 73 per cent of these recurrences were noted within the first 3 years. In 1 patient a tumor developed in the opposite upper urinary tract. In only 1 of 15 patients who had had partial ureterectomy or local excision tumor developed in the ipsilateral ureter. Patient survival time was identical to that in an age-matched control group. We conclude that the most significant findings are the subsequent high incidence (23 per cent) of bladder tumor and the comparable survival in these pateints and in an age-matched control group. Furthermore, these results suggest that operations preserving the renal parenchyma, that is segmental resection, should be used more frequently.

Carcinoma, Transitional Cell↗
PubMed1980

The Queensland cholera incident of 1977. 2. The epidemiological investigation.

In 1977 the first case of cholera known to be contracted in Australia during the seventh pandemic occurred in southeastern Queensland. Toxigenic isolates of Vibrio cholerae, biotype eltor, serotype Inaba, phage-type 2, were obtained from the index case, a companion of the patient, the reticulated water supply of their place of residence, and a stretch of the neighbouring river that was being used to supplement fully treated water piped from Brisbane. Treatment of the auxiliary supply consisted solely of chlorination. A section of another river was later shown to contain V. cholerae. No source of pollution was identified for either river. From the persistence of the microorganism in the first river over a two-month period, despite increases in river flow following significant rainfall, it seems that the cholera vibrio can not only survive for a long period but can also grow in the river water. This strongly suggests that certain surface, and possibly subsurface, waters may serve as potential silent foci of V. cholerae. Hence the importance of providing bacteriologically safe water supplies, and the possible need to expand the definition of a 'cholera-receptive area'.

Australia↗
PubMed1980

Behavioral training for parents of mentally retarded children: one-year follow-up.

Ninety-five families who had completed a 20-week behavioral-training program for parents of retarded children (Heifetz, 1977) were re-contacted 14 months later. An in-home interview and several questionnaires assessed maintenance of child gains and parents' knowledge of programming principles, as well as the extent and quality of continued and new programming, perceived obstacles to home teaching, and perceived effects of the training program. Parents had retained their knowledge of programming principles, and the children had retained their original skill gains. Many families had initiated some teaching of new skills, although few parents carried out regular formal teaching sessions. Almost one-half of the families were classified as having continued to employ useful or very useful teaching. The main perceived obstacles to home-teaching were limitations in time, in the child's learning ability, in the parent's teaching ability, and in professional support. The implications of these follow-up results for future training programs were discussed.

Adolescent↗
PubMed1979

Cholinesterase in the atherosclerotic intima and in fibroblast cultures.

Cholinesterase activity was present in the atheromatous plaque of the rabbit's atherosclerotic aorta. Cholinesterase activity was significantly increased in rat fibroblast cultures grown in the presence of hypercholesterolemic serum. Cholesterol ester synthesis in these cultures was inhibited by neostigmine, a cholinesterase inhibitor.

Animals↗
PubMed1979

Mechanism of inhibition of alanine absorption by Na ricinoleate.

The mechanism of inhibition of alanine absorption by Na ricinoleate has been examined in the rabbit intestine. This fatty acid in a concentration of 2--5 mM inhibits alanine absorption in vivo and in vitro. The inhibition is more evident in the jejunum than in the ileum. Strips of ileal mucosa treated with Na ricinoleate gain Na. Sodium ricinoleate inhibits alanine influx across rabbit ileum, even in the presence of a sodium gradient across these cells. The results suggest that the main action of Na ricinoleate is on the alanine-transport system at the brush-border membrane. The fatty acid may also inhibit amino acid absorption by increasing intestinal cell Na concentration, which results in a decreased Na gradient across the brush-border membrane.

Alanine↗
PubMed1976

Severe airway disease due to inhalation of fumes from cleansing agents.

A subject had severe airway obstruction and evidence of small-airway disease resulting from inhalation of "fumes" liberated during the course of mixing several drain-cleansing agents. The evidence in favor of the airways as the predominant site of damage was severe reduction of maximal expiratory flow in the presence of normal lung-recoil pressure in a nonsmoker who had no other known industrial exposures or predisposing respiratory conditions.

Acids↗
PubMed1975

Anaesthetic considerations in bronchial adenoma.

The patient with bronchial adenoma can present a puzzling diagnostic dilemma as well as challenging problems in anaesthetic management. Several aspects are reviewed in this report. Diagnostically these include chest roentgenographic findings and unique pulmonary function test. Problems in anaesthetic management include possible development of acute carcinoid syndrome, as this tumour is usually of the carcinoid variety. In addition, the tumour may act as a ball valve, causing uneven ventilation of affected lung with expiratory air trapping. Several factors may necessitate prolonged bronchial blockage during anaesthesia. These include a friable mass which may bleed profusely upon manipulation, infected and atelectatic parenchymal tissue beyond the obstruction, copious volumes of purulent secretions, and one lung ventilation during resection.

Adenoma↗
PubMedDate not supplied

Increasing children's responsibility for diabetes self-care: the In Control study.

The purpose of this pilot study was to test the hypothesis that children can learn to become more independent in their own diabetes self-management without compromising their metabolic control. Twenty-four children (ages 8 to 12 years) with insulin-dependent diabetes mellitus (IDDM) were matched by age and race, then randomly assigned either to a 6-week, self-management education program (experimental) or to receive usual care (control). A questionnaire was administered to the parents to determine the frequency with which 35 diabetes management behaviors were performed and the degree to which children assumed responsibility for these behaviors. Glycohemoglobin levels were monitored at baseline and at posttreatment, 12 weeks after baseline. At the posttreatment, children in the experimental group were found to be assuming significantly more responsibility for their diabetes self-care than were children in the control group. No decrease in the frequency with which self-care behaviors were performed was observed, and metabolic control was maintained. The results suggest that a diabetes self-management education program for children ages 8 to 12 years can be effective in facilitating children becoming more responsible for their own diabetes management.

Child↗