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Biomedical subjects

J A Ryan

Publications and source records attributed to J A Ryan.

At least 91 records · Page 5Linked to original sources
PubMed1986

Pancreatitis in teenagers.

Pancreatitis in teenagers is rare and has not received attention in the medical literature. A retrospective study was conducted to identify unique factors in this age group. Clinical data, cause, radiographic evaluation, operative procedure, and outcome were reviewed in 21 teenagers. Endoscopic retrograde cholangiopancreatography and computerized axial tomography proved to be valuable in determining the etiology and the role and type of operation. Causes of disease were varied but were established in 86 percent of patients; as a group, teenagers were unlike children or adults in their disease characteristics. A high percentage of teenagers required operation (76 percent), with most benefiting from surgery (88 percent).

Adolescent↗
PubMed1986

Colorectal carcinoma evaluation with CT: preoperative staging and detection of postoperative recurrence.

CT was performed prior to surgery in 103 patients with colorectal carcinoma to assess its value in staging the tumor. Preoperative IBD scans had sensitivities and specificities of 72.7% and 98.9% in detection of liver metastases, 25.9% and 96% in detection of lymph node metastases, and 61.2% and 80.6% in detection of local extension. Compared with the Duke's classification, CT correctly staged only 47.5% of patients: 16.6% were upstaged, and 83.3% were downstaged. Recurrent tumors developed in 11 of 67 patients followed for more than 24 months. CT depicted recurrence in six patients scanned prior to 12 months. Routine scans obtained at 12 months depicted unsuspected tumor recurrence in three of four patients with proved recurrent disease (one patient with pulmonary metastases did not undergo CT). This study indicates that because of the poor accuracy of CT in preoperative local staging of colorectal carcinoma, it has virtually no useful clinical role in this regard. However, preoperative CT evaluation of the liver can be useful. Routine postoperative CT, combined with fine-needle aspiration biopsy, is useful for detection of recurrent tumor.

Carcinoembryonic Antigen↗
PubMed1986

When push comes to shove: a comparison between two methods of percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy has supplanted surgical gastrostomy in a number of medical centers. A variety of makeshift or commercially available gastrostomy kits has been used, as have several insertion techniques. Despite widespread use, however, there are conflicting reports regarding the best method of gastrostomy tube insertion. Studying 30 patients, 15 of whom underwent percutaneous endoscopic gastrostomy with the "push" and 15 with the "pull" technique, we found both methods successful, and associated with an acceptable complication rate. In the authors' hands, the "pull" technique was technically easier.

Amyotrophic Lateral Sclerosis↗
PubMed1985

Multiple forms of cyclic nucleotide phosphodiesterase in a murine adrenal cortex cell line (Y-1).

Murine adrenal cortex tumor Y-1 cells contained both soluble and particulate forms of cyclic nucleotide phosphodiesterase (3',5'-cyclic AMP 5'-nucleotide hydrolase, EC 3.1.4.17). The soluble forms of the enzyme comprised 80% of total cellular phosphodiesterase activity. The soluble enzyme(s) hydrolyzed both cyclic AMP and cyclic GMP, with apparent Km values of 125 and 30 microM, respectively. Soluble cyclic AMP phosphodiesterase showed marked inhibition by the calcium chelator, ethylene glycol bis(beta-aminoethyl ether)-N,N'-tetraacetic acid (EGTA), and the anticalmodulin drugs, chlorpromazine, N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7), and calmidazolium. No alteration in soluble cyclic GMP phosphodiesterase activity was observed when cyclic AMP was added to the assay. Resolution of the soluble enzymatic activity by DEAE-cellulose chromatography in the presence of calcium showed two peaks of phosphodiesterase activity. Further purification of one of these peaks on DEAE-cellulose in the presence of EGTA yielded a phosphodiesterase activity peak that was stimulated fivefold by calmodulin. The particulate form of the enzyme hydrolyzed both cyclic AMP anc cyclic GMP; the apparent Km values for these substrates were similar (90 and 100 microM, respectively). Hydrolysis of cyclic GMP by the particulate enzyme was inhibited by cyclic AMP in a concentration-dependent manner with an apparent half-maximal inhibitory concentration of 100 microM. The particulate form of phosphodiesterase was not inhibited by EGTA or anticalmodulin drugs.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗
PubMed1985

Urologic use of gracilis muscle flap for nonhealing perineal wounds and fistulas.

A chronic sinus or urinary fistula in the perineum secondary to surgery and/or radiation therapy for pelvic malignancy may cause serious morbidity and be difficult to treat. The gracilis muscle, either by itself or as a myocutaneous flap, has excellent properties for aiding in healing. Over a six-year period, three nonhealing perineal wounds and three urinary fistulas have healed after the gracilis muscle flap procedure.

Adult↗
PubMed1985

Cecoproctostomy.

A new technique of cecoproctostomy using the side-to-end technique has been documented in 21 patients over 7 years, representing 6 percent of one surgeon's series of colectomies. This procedure was performed in patients requiring removal of all of the colon except the cecum and the rectum. It has advantages over ileoproctostomy because it spares the terminal ileum, ileocecal junction, and cecum. Cecoproctostomy has not resulted in morbidity or mortality and has resulted in good postoperative bowel function with a mean of 2.3 bowel movements per day. With the high incidence of disabling stool frequency after ileoproctostomy, we recommend cecoproctostomy as a beneficial alternative in a select group of patients with extensive or multiple colonic diseases that spare the cecum and rectum.

Adult↗
PubMed1984

Colorimetric determination of gentamicin, kanamycin, tobramycin, and amikacin aminoglycosides with 2,4-dinitrofluorobenzene.

The reaction of 2,4-dinitrofluorobenzene (Sanger's reagent) is used to form colored products with aminoglycoside antibiotics. Stopping the progress of the reaction with acid after a fixed time allows aqueous solubility to be maintained while discharging any color due to excess reactant. The choice of an appropriate analytical wavelength results in adherence to Beer's law. Although this colorimetric method is not expected to be stability-indicating, it is convenient and should be useful in content uniformity determinations for pharmaceutical dosage forms (e.g., ointments).

Amikacin↗
PubMed1984

Localization of abnormal parathyroid glands using thallium-201.

Ectopically located parathyroid adenomas may be difficult to find during initial neck exploration. They account for over 70 percent of missed adenomas found at reexploration. Preoperative localization of parathyroid adenomas would reduce unnecessary dissection and possibly reduce the number of negative results of initial neck exploration. Before reoperative parathyroid surgery is performed, some means of localization is mandatory to detect ectopic adenomas in the neck and mediastinum. Computed tomography and ultrasonography cannot effectively evaluate the mediastinum. Angiography and venous parathyroid hormone sampling are invasive, costly, and tedious to perform. We have shown that thallium-201 will accurately localize ectopic parathyroid adenomas. All 10 adenomas found in positions not immediately adjacent to the thyroid gland were detected by thallium-201 scintigraphy. One was a mediastinal adenoma resected with a median sternotomy. Our results suggest that thallium-201 scintigraphy should be the initial localization procedure of choice before all reexplorations. Its use before initial explorations, as well, will enable the surgeon to immediately direct attention to the area of the localized adenoma. If mediastinal uptake is found to be present, then median sternotomy may be performed during initial surgery provided a thorough neck exploration is performed first.

Adenoma↗
PubMed1984

Gracilis muscle flap for the persistent perineal sinus of inflammatory bowel disease.

A persistent perineal sinus may develop in patients undergoing proctocolectomy for inflammatory bowel disease. Healing may resist the traditional methods of wound management. Wide excision including coccygectomy, transposition of the vascularized gracilis muscle flap into the rigid cavity, and wound closure have led to healing in 12 of 15 patients and vast improvement in two others. There has been only one failure. Aggressive reoperation can achieve success after initial failure. Women may present a more difficult challenge than men. A primary wound healing deficit may be present.

Adolescent↗
PubMed1984

Outpatient inguinal herniorrhaphy with both regional and local anesthesia.

Fifty-three patients who were undergoing outpatient inguinal herniorrhaphy with short-acting regional anesthetic agents and local infiltration of a long-acting anesthetic were retrospectively compared with a matched population of 53 hospitalized patients who were undergoing herniorrhaphy with a long-acting regional anesthetic. There was a significantly greater incidence of urinary retention in the hospitalized patients who received long-acting regional anesthetic agents. Otherwise, complications in the two groups were similar. Inguinal herniorrhaphy can be accomplished as an outpatient procedure without increased morbidity. This can result in significant savings in hospital bills. We suggest that anesthesia for inguinal herniorrhaphy is most satisfactorily provided by the combination of a short-acting regional anesthetic agent and a long-acting local one.

Adolescent↗
PubMed1984

Mycotic aneurysm of the external iliac artery caused by migration of a total hip prosthesis.

A 77-year-old patient had a mycotic aneurysm of the left external iliac artery secondary to migration of a total hip prosthesis. Symptoms included pain, numbness, decreased hip motion, and a temperature of 38.5 degrees. The left leg was shortened, externally rotated, and swollen. There was anterior thigh hypoesthesia and quadriceps paralysis. A pulsatile mass in the lower left quadrant of the abdomen emitted a thrill and a loud bruit. A preoperative arteriogram facilitated diagnosis and planning of surgery. A transpubic femorofemoral bypass graft was used to reroute blood to the left lower limb, avoiding vascular reconstruction in the area of the aneurysm, a suspected site of infection. A false aneurysm was determined and was then isolated. The prosthesis was removed. During this operation, the acetabular component was found freely mobile within the false aneurysm. Cultures of the removed vascular tissue grew Staphylococcus epidermidis. An arteriogram should be obtained prior to operation for any medial intrapelvic displacement of a total hip prosthesis to diagnose the extent of vascular involvement. Physical examination may not reveal the aneurysm, but signs of neuropathy or venous thrombosis may suggest this diagnosis.

Acetabulum↗
PubMed1983

The structure of the capsular polysaccharide obtained from a new serogroup (L) of Neisseria meningitidis.

A newly isolated serogroup of Neisseria meningitidis (serogroup L), obtained from contacts of a patient with meningococcal meningitis, elaborates a structurally unique, capsular polysaccharide. The polysaccharide contains only 2-acetamido-2-deoxy-D-glucosyl and phosphate constituents in the molar ratio of 3:1, and is composed of the following repeating unit.

Carbohydrate Conformation↗
PubMed1983

Prognostic significance of hormone receptors in early recurrence of breast cancer.

A retrospective analysis of 155 patients with primary infiltrating breast cancer was carried out to determine the prognostic significance of hormone receptor values and analyze the effect of adjuvant chemotherapy. Estrogen receptor-negative patients were found to have a significantly higher recurrence rate than estrogen receptor-positive patients (p less than 0.005). No difference was found based on the progesterone receptor value. The data strongly suggest a favorable response to adjuvant chemotherapy administered on the basis of the estrogen receptor value alone.

Adenocarcinoma↗