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Biomedical subjects

H B Devlin

Publications and source records attributed to H B Devlin.

At least 73 records · Page 4Linked to original sources
PubMed1978

Cholecystectomy and a simple technique of operative cholangiography.

A simple, easily reproducible technique of operative cholangiography is described. The technique has three advantages: (a) there is no need to divide or ligate the cystic duct; (b) it demonstrates the cystic duct anatomy clearly and is particularly useful in demonstrating stones in that duct thus eliminating the hazard of the retained stone in the cystic duct stump; (c) it is possible to eliminate the problem of false positives due to air bubbles. A consecutive series of 442 cholecystectomy patients is reviewed. The overall operative mortality was 1.6 per cent; no death could be attributed to operative cholangiography. Thirty-five of 324 patients (10.8 per cent) with gallstones and no history of jaundice were shown to have unexpected abnormalities in the common bile duct.

Aged↗
PubMed1977

Day-case surgery for hernias and haemorrhoids. A clinical, social, and economic evaluation.

Patients with inguinal hernia or haemorrhoids were randomly allocated to an experimental group expected to stay in hospital for only eight hours after surgery or a control group scheduled for discharge on the fifth or sixth day. There was no difference in clinical outcome between the two groups of hernia patients. However, complications were twice as common in haemorrhoid day-patients as in long-stay haemorhoid patients. The standard postoperative regimen for haemorrhoids has since been changed and the change has been accompanied by a fall in the complication-rate. Day-case surgery appears to have similar social effects on the patient and his family as traditional hospital care. There was no significant difference in either the additional expenditure incurred or patients' perceptions of the disruption associated with their operation and convalescence. In the hospital under study, day-case surgery was saving between 20 pounds and 29 pounds per patient. However, this conclusion should not be extrapolated to the N.H.S. as a whole without taking into account the use to which the resources released by day-case surgery will be put.

Adolescent↗
PubMed1977

Short-stay surgery for inguinal hernia. Clinical outcome of the Shouldice operation.

In 1970 a general surgical team on Teesside adopted the Shouldice operation for inguinal hernia together with a policy of short-stay surgery. Careful follow-up has established that repairs using the suture material of choice--stainless-steel wire--have an estimated 6-year recurrence-rate of 0.8%, statistically indistinguishable from that achieved by the highly specialised Shouldice Clinic. However, the recurrence-rate 2 years after suturing with an alternative polyester-based material is estimated at 8.1%--a figure much more in keeping with rates reported by general surgeons using traditional methods.

Adult↗
PubMed1977

Experimental pneumonia due to Pseudomonas aeruginosa in leukopenic dogs: prolongation of survival by combined treatment with passive antibody to Pseudomonas and granulocyte transfusions.

Treatment with type-specific IgG antibody to Pseudomonas aeruginosa significantly increased rates of survival after experimental induction of pseudomonas pneumonia in leukopenic dogs. Longer survival times were correlated with higher titers of circulating antibody in serum; however, no animals treated with antibody alone were long-term survivors. Subsequent development of sepsis or the recovery of Pseudomonas from infected lung tissue was not altered by treatment with antibody. Therapy with granulocyte transfusions plus gentamicin was associated with a 27% rate of long-term survival. Passive immunization with IgG (reciprocal mean hemagglutination titer, 52) in addition to granulocyte transfusions and treatment with gentamicin resulted in a rate of long-term survival of 67% (P less than 0.05). Dogs that died while receiving this combination therapy still had a survival time significantly longer than those of controls or animals treated only with granulocytes and antibiotic.

Animals↗
PubMed1974

Colostomy care.

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Adaptation, Psychological↗
PubMed1974

Development of cellular and humoral immunity in the respiratory tract of rabbits to Pseudomonas lipopolysaccharide.

Immunization with Pseudomonas lipopolysaccharide induced both cellular and humoral immunity in rabbits, particularly in the respiratory tract after intranasal immunization. Either parenteral (i.m.) or intranasal immunization elicited an IgG antibody response in respiratory secretions, but only intranasal immunization produced secretory IgA antibody. Immunization by both routes stimulated serum IgM and IgG agglutinative antibodies. Because both methods of immunization produced skin test reactivity which had components of both Arthus and tuberculin-like reactions, cellular immunity was more readily assessed by the measurement of migration inhibitory factor (MIF) released from immune lymphocytes in respiratory and spleen cell suspensions after challenge with the lipopolysaccharide antigen. After intranasal vaccination, MIF activity was detected in the respiratory tract by direct assay; in contrast, i.m. immunized rabbits did not produce respiratory MIF. Both modes of immunization resulted in splenic MIF activity. However, lymphocytes were only capable of producing MIF for short periods after primary immunization had ended, apparently losing this function in about 2-3 wk. Therefore, it was concluded that cellular immunity by in vitro assay was transient after primary immunization with this Pseudomonas antigen in contrast to the more persistent humoral immunity. The biological significance of immune lymphocytes as part of the coordinated host defense of the lung needs further evaluation.

Animals↗