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Biomedical subjects

D Y Graham

Publications and source records attributed to D Y Graham.

At least 577 records · Page 32Linked to original sources
PubMed1979

Simian rotavirus SA11 replication in cell cultures.

Understanding the basic virology of rotavirus infections has been hampered by the fastidiousness of most isolates and by the lack of a rapid quantitative assay method. The growth characteristics of the simian rotavirus SA11 were studied because it grows to high titers in tissue culture and infectivity can be quantitated by plaque assay. SA11 replication was analyzed in a variety of primary cell cultures or continuous cell lines derived from both homologous and heterologous hosts. Viral replication was observed in each of the cell cultured examined. The individual cell cultures demonstrated marked variability in their susceptibility to rotavirus infection. The highest titers were obtained with MA104, BSC-1, CV-1, and BGM cells. Observable cytopathic effect was found to correlate with the percentage of infected cells in the culture. This study presents growth curves of the simian rotavirus in a variety of cell cultures.

Animals↗
PubMed1978

Bougienage is effective therapy for most benign esophageal strictures.

Esophageal stricture is the most frequent serious complication of reflux esophagitis. Bougienage was used as the primary therapy of benign esophageal stricture in 92 patients, followed by institution of a medical antireflux program. Response to treatment was excellent, and 78% of patients required two or fewer subsequent dilations. Twenty patients were followed up for two years or longer, and 75% did not require more than one dilation annually. Primary therapy for most patients with peptic stenosis of the esophagus is recommended to be dilation; operative therapy should be reserved for those patients in whom a malignant neoplasm is suspected or those in whom frequent and rapid stricture recurrence makes medical therapy impractical.

Adult↗
PubMed1978

Acute upper-gastrointestinal hemorrhage. New observations on an old problem.

In a two-year period, 289 patients with acute upper-gastrointestinal hemorrhage were evaluated. The site of hemorrhage was proven by endoscopy in more than 90% of cases. The frequency of any particular bleeding site was characterized for several subgroups and was found to correlate with: (1) the severity of the bleeding episode; (2) the iatrotropic stimulus of hemorrhage, and (3) the history of ethanol consumption. No difference was found in the frequency of ulcer and acute mucosal lesions as sites of hemorrhage between patients who consumed aspirin and those who did not. A history of symptoms of peptic ulcer correlated with the presence of an ulcer as the bleeding site. It is possible that failure to identify important patient subgroups may be partially responsible for the disagreement between previous reports.

Alcohol Drinking↗
PubMed1978

The spectrum of the Mallory-Weiss tear.

A Mallory-Weiss tear is a mucosal laceration occurrring at or near the esophagogastric junction and is most often associated with vomiting. This is a common cause of upper gastrointestinal bleeding; in our series, 14% of patients presenting to the hospital because of upper gastrointestinal bleeding had Mallory-Weiss tears. Massive hemorrhage is not characteristic and 37% of the patients required no blood transufsions. A classical history of nonbloody emesis followed by hematemesis was found in only 29% of patients. The most common story was the appearance of blood with the first vomiting. In 35% of our patients with Mallory-Weiss tear, an additional potential bleeding site was identified, and, in approximately half of these patients, it was actually bleeding. Most Mallory-Weiss tears stop bleeding spontaneously and supportive treatment is all that is required. If bleeding continues, infusion of vasoactive substances into the celiac artery or into the left gastric artery often obviates the need for operation.

Adolescent↗
PubMed1978

Hypertensive lower esophageal sphincter: a reappraisal.

The hypertensive lower esophageal sphincter (LES) is defined as one with normal relaxation and an average LES-intragastric pressure gradient greater than or equal to 40 mm Hg. Case histories of two patients with hypertensive LES and normal peristalsis in the body of the esophagus are contrasted to that of a patient with a hypertensive LES and diffuse esophageal spasm. In one patient, the postdeglutitive contractions were excessively prolonged due primarily to a slower return to baseline pressure. It is suggested that the hypertensive LES may be a separate disease entitly, and that it should be separated from diffuse esophageal spasm so that its pathophysiology and natural history can be elucidated.

Adult↗
PubMed1978

Value of fiberoptic gastrointestinal endoscopy in infants and children.

Fiberoptic gastrointestinal endoscopy was performed on 52 patients between the ages of 2 months and 16 years. The procedures were safely and easily done with premedications consisting of meperidine, promethazine, and chlorpromazine, and atropine, with diazepam given at the time of the procedure. Fiberoptic endoscopy was particularly helpful in localizing the site of upper gastrointestinal hemorrhage, in retrieving foreign objects, and in removing colonic polyps. In contrast, endoscopy added little to the clinical history and roentgenographic studies in children with recurrent abdominal pain or vomiting, in whom we believe fiberoptic endoscopy is not indicated unless the symptoms or history appear inconsistent with the diagnosis of functional bowel disease.

Abdomen↗
PubMed1978

Circulating anticoagulant associated with chronic active hepatitis.

Chronic active hepatitis is frequently associated with a variety of serologic abnormalities. A patient with chronic active hepatitis and a circulating anticoagulant to factors XI and XII is described. Circulating anticoagulants should be suspected in patients with chronic active hepatitis and a prolonged partial thromboplastin time. This risk of liver biopsy in these patients is unknown, but this possible hazard should be considered in all patients with chronic active hepatitis.

Adult↗
PubMed1978

Cimetidine, antacid, and hospitalization in the treatment of benign gastric ulcer: a multicenter double blind study.

Two hundred forty patients with benign gastric ulcer were treated in a controlled clinical trial to assess the effect on healing of cimetidine, antacids, and hospitalization. Inpatients and and outpatients were randomly assigned to one of three treatments: cimetidine plus antacid, cimetidine plus dummy antacid, or placebo tablet plus antacid. In 206 patients who met criteria for analysis, ulcer healing as shown by endoscopy occurred by 12 days in 11 to 26 percent and by 42 days in 58 to 76 percent. There were no significant differences in healing between hospitalized and nonhospitalized patients or between treatment subgroups. Symptomatic response was equivalent in all groups. The median antacid consumption was 328 mEq of in vitro buffering capacity per day. Patients taking antacids experienced significant diarrhea compared with those taking no antacid. This investigation suggests that the effect of cimetidine is equivalent to that of large amounts of antacid, but because a true placebo group was not studied it is not possible to conclude from this study alone whether either agent influenced healing. In contrast to widespread belief, initiation of treatment in the hospital did not enhance healing, but because patients were not randomly assigned to inpatient and outpatient status no final conclusion about the effect of hospitalization on healing can be drawn.

Adult↗
PubMed1977

Enzyme replacement therapy of exocrine pancreatic insufficiency in man. Relations between in vitro enzyme activities and in vivo potency in commercial pancreatic extracts.

I assayed 16 commercially available pancreatic extracts (representing capsules, tablets and enteric-coated tablets) for enzyme activities and the relation between the in vitro activities and in vivo potency evaluated in man. Lipase activity ranged from 10 to 3600 units per unit, with 11 preparations containing less than 600 units per unit. The preparations with the highest lipase activities were llozyme, 3600, Kuzyme HP, 2330, Festal, 2073, Cotazym, 2014, and Viokase, 1636 units. Lipase activity in vitro correlated with potency in vivo for tablets and capsules, with tablets and capsules being effective in reducing steatorrhea by 56.1 +/- 9 per cent and 48.6 +/- 10 per cent (mean +/- S.E.M.) respectively, P less than 0.001. Enteric-coated tablets were less effective (20 +/- 13 per cent reduction, P greater than 0.02). The longer the gastric pH remained greater than or equal to 4 (r = 0.915, P less than 0.01) and the higher the average duodenal pH (r = 0.966, P less than 0.01), the more marked the reduction in steatorrhea.

Administration, Oral↗
PubMed1977

The use of pyloric exclusion in the management of severe duodenal injuries.

Repair of severe duodenal injuries often constitutes a technical challenge, and a variety of special technics have been described. For the past seven years we have utilized temporary pyloric exclusion and gastrojejunostomy to produce "diverticulization" of the duodenum. This procedure was utilized in seventy-five patients selected from 175 consecutive patients presenting with duodenal trauma. The mortality was 19 per cent and the rate of fistula formation was 5 per cent in this series and 14 per cent and 2 per cent, respectively, in the overall series. Follow-up studies of gastric physiology and functional anatomy show no evidence of alteration of these parameters. We thus believe that patients presenting with severe duodenal trauma and often multiple devastating associated organ injuries can be adequately treated with this procedure with a significant decrease in mortality and with marked improvement of postoperative morbidity.

Adult↗
PubMed1977

Toothpick perforation of the intestines.

Toothpicks have been used since antiquity as instruments for mouth cleansing and as eating utensils. Toothpick injury to the gastrointestinal tract is often suspected only at the time of operation because patients rarely relate a history of swallowing toothpicks and most toothpicks are not radiopaque. The spectrum of toothpick injury to the gastrointestinal tract is illustrated by 5 patients who developed toothpick perforation of the gastrointestinal tract. Two patients died as a result of complications of toothpick injury, one of these presenting with recurrent gram negative sepsis with multiple organisms due to a duodenal-inferior vena caval toothpick fistula. In two instances the toothpicks were removed at operation and one that was penetrating the duodenum was removed with a fiberoptic duodenoscope.

Adult↗
PubMed1977

The columnar-cell-lined (Barrett's) esophagus: a premalignant condition?

A 65-year-old man developed adenocarcinoma arising in Barrett's epithelium of the esophagus. He died three months after unsuccessful surgery to remove the tumor. The columnar-cell-lined esophagus may represent a premalignant condition, and it is suggested that patients with this condition undergo regular follow-up examination.

Adenocarcinoma↗