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Biomedical subjects

J Barkin

Publications and source records attributed to J Barkin.

33 records · Page 2Linked to original sources
PubMed1988

Effect of nifedipine on sphincter of Oddi motor activity: studies in healthy volunteers and patients with biliary dyskinesia.

The effect of nifedipine on sphincter of Oddi (SO) motor activity was determined by endoscopic manometry. Sphincter of Oddi pressures and motor function were compared in 21 healthy volunteers and in 9 patients with SO dyskinesia. The effects of sublingual doses of 10 or 20 mg of nifedipine were compared with placebo. Neither placebo nor 10 mg of nifedipine produced any effect on SO motor activity. In healthy volunteers 20 mg of nifedipine produced a moderate but significant decrease in basal SO pressure from 12.0 to 6.7 mmHg as well as in the amplitude, duration, and frequency of phasic contractions. In patients with SO dyskinesia 20 mg of nifedipine also resulted in a significant but more profound decrease of the basal SO pressure from 47.1 to 17.3 mmHg as well as in a decrease of amplitude, duration, and frequency of the phasic contractions. Neither placebo nor 10 or 20 mg of nifedipine has any effect on the sequence of phasic contractions. In summary, nifedipine may have a possible therapeutic role in the treatment of SO dyskinesia.

Adult↗
PubMed1985

Pancreatic cancer. Assessment of prognosis by clinical presentation.

Three hundred ninety-three patients who were entered into pancreatic carcinoma treatment protocols of the Gastrointestinal Tumor Study Group (GITSG) were analyzed as to significant differences in clinical presentation and factors influencing survival. Patients were grouped according to the stage of the disease. Group I (21 cases) included those patients who had a potentially curative resection. Group II (182 cases) patients had a locally unresectable tumor less then 400 cm2 (surgically proven) and no distant metastases, and Group III (190 cases) had advanced disease. Group I patients had the smallest lesions (median area, 9 cm2), located in head of the gland in 90% and painless jaundice was the most frequent clinical presentation (52%). In Group II, 83% were located in the head of the gland but the median area was much larger (36 cm2). Pain was present in 80% of cases, and jaundice in 62% with 48% having jaundice and pain. In Group III patients, lesions of body and tail were over four-fold as frequent as in Group I and almost three-fold greater than in Group II. The median area of the lesion was large (30 cm2). Pain was present in 85% and jaundice in only 31%. Median survival in Group I patients was longer than Group III (73 versus 10 weeks; P less than 0.001). Ambulatory status, sex, race, abdominal pain, and histologic type influenced survival in one or more groups whereas age, jaundice, location of the tumor, degree of cellular differentiation, back pain, and nutritional status did not influence survival in any group. In all groups, those with a good performance status (Eastern Cooperative Oncology Group [ECOG] 0 and 1) survived longer than those with poor status (ECOG 2 and 3; P less than 0.05). The best potential prognosis is in those who are fully productive and present with painless jaundice, and who have resection of the tumor.

Adenocarcinoma↗
PubMed1985

Bone mineral content in idiopathic calcium nephrolithiasis.

The calcium content of the central one third of the skeleton was measured using neutron activation analysis in 109 patients with idiopathic calcium nephrolithiasis. The bone mineral content (calcium bone index or CaBI, corrected for body size) was significantly decreased by 5.2% in 20- to 60-year-old patients with calcium nephrolithiasis (p less than 0.01). Under age 50 the decrease was more marked in 64 males (7.1%; p less than 0.02) than in 21 females (4.1%; p = NS). There was a significant negative correlation of CaBI with fasting urine calcium/creatinine ratio (r = 0.39; p less than 0.01), but no correlation with age or indices of parathyroid function. The decrease in bone mineral content did not appear to be progressive. The decrease in CaBI indicates negative calcium balance, either in the past or at present, in patients with calcium nephrolithiasis and does not favour increased intestinal absorption as a primary cause. The lack of correlation of CaBI with parameters of parathyroid function does not support a primary renal loss of calcium. The results suggest that increased bone turnover may be an important component of disordered calcium metabolism in patients with calcium nephrolithiasis.

Adult↗
PubMed1984

Hypercalcemia associated with cancer of prostate without bony metastases.

Although hypercalcemia is sometimes found in carcinoma of the prostate with osseous metastases, it is rarely seen as a paraneoplastic manifestation of this neoplasm. We present a patient with such a tumor in whom severe hypercalcemia developed in the absence of detectable osseous metastases.

Adenocarcinoma↗
PubMed1983

Psoas abscess after operation on lumbar spine.

A case of pyogenic psoas abscess is reported. It was found many years after lumbar spine operation, although the patient had confusing symptoms during the whole period. The last presenting symptoms were fever, chills, back pain, and hematuria. Ultrasonography provided conclusive information about the abscess.

Abscess↗
PubMed1983

The role of percutaneous aspiration in the diagnosis of pancreatic abscess.

Percutaneous aspiration should be performed on pancreatic/peripancreatic fluid collections when an abscess is suspected. Thirty-one percutaneous aspirations were performed on 21 such patients and seven (33%) proved to have an abscess. A Gram stain after the aspiration is important, as it can make an immediate diagnosis of an abscess. By helping make an early diagnosis, percutaneous aspiration might reduce the high mortality rate associated with a pancreatic abscess while avoiding surgery in those who have sterile fluid collections. Two complications (6%) occurred: superinfection of a pseudocyst and a hemoperitoneum.

Abscess↗
PubMed1983

The role of hepatobiliary scintigraphy in differentiating acute cholecystitis from acute nonbiliary pancreatitis.

Thirty-five patients with acute nonbiliary pancreatitis were studied with 99m-Technetium para isoproply iminodiacetic acid in order to determine its ability to differentiate acute nonbiliary pancreatitis from acute cholecystitis. Of acute nonbiliary pancreatitis patients 90.3% (28/31) visualized their gallbladder in 1 h, 9.7% (3/31) had delayed visualization of gallbladder, and no patient in this category failed to visualize their gallbladder. Two of four patients with acute episodes of pancreatitis superimposed on chronic pancreatitis visualized their gallbladder. Biliary scintigraphy remains to be a valuable tool in differentiating acute nonbiliary pancreatitis from acute cholecystitis.

Acute Disease↗
PubMed1982

Acute pancreatitis: clinical vs. CT findings.

In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptoms. This was especially true of phlegmonous pancreatitis, where the CT findings could persist for months.

Abscess↗
PubMed1981

Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil: The Gastrointestinal Tumor Study Group.

One-hundred-ninety-four eligible and evaluable patients with histologically confirmed locally unresectable adenocarcinoma of the pancreas were randomly assigned to therapy with high-dose (6000 rads) radiation therapy alone, to moderate-dose (4000 rads) radiation + 5-fluorouracil (5-FU), and to high-dose radiation plus 5-FU. Median survival with radiation alone was only 51/2 months from date of diagnosis. Both 5-FU-containing treatment regimens produced a highly significant survival improvement when compared with radiation alone. Forty percent of patients treated with the combined regimens were still living at one year compared with 10% of patients treated with radiation only. Survival differences between 4000 rads plus 5-FU and 6000 rads plus 5-FU were not significant with an overall median survival of ten months. Significant prognostic variables, in addition to treatment, were pretreatment performance status and pretreatment CEA level.

Adenocarcinoma↗
PubMed1981

The clinical significance of acute pancreatic hemorrhage.

Computed tomography (CT) has the ability to demonstrate acute hemorrhage both within the pancreatic parenchyma and the adjacent retroperitoneal spaces. It was found that during the acute phase of pancreatic hemorrhage (about 1-7 days) the CT number of hemorrhage is significantly greater than that of the gland. At the present time the true incidence of pancreatic hemorrhage and the relation of the CT demonstration of hemorrhage to the clinical entity of hemorrhagic pancreatitis is unclear. The CT, laboratory, and clinical findings in eight patients with acute pancreatitis were analyzed to help answer these questions. This limited experience suggests pancreatic hemorrhage is more frequent than hemorrhagic pancreatitis as currently defined clinically.

Acute Disease↗
PubMed1981

Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography.

A prospective study using sonography and computed tomography (CT) was performed on 102 patients consecutively identified as having acute pancreatitis to see which method provided the most information. Each examination was graded for visualization of the pancreas, extent of disease, and the detection of complications. CT was found to be of significantly greater value than sonography due to the high percentage (38%) of nondiagnostic studies with the latter method. Of the 102 patients, 70% had abnormal CT studies, including 18% with extrapancreatic phlegmons, 10% with pseudocysts, 5% with acute hemorrhage, and 3% with pancreatic abscesses.

Acute Disease↗
PubMed1978

Randomized phase II clinical trial of adriamycin, methotrexate, and actinomycin-D in advanced measurable pancreatic carcinoma: a Gastrointestinal Tumor Study Group Report.

Sixty-six patients with advanced pancreatic carcinoma were randomized to receive single agent chemotherapy with either adriamycin, methotrexate, or actinomycin-D using conventional dose, route and schedule of administration. All patients had measurable lesions which were used to objective assessment of response. For adriamycin, 2 of 25 patients (8%) evidenced a partial response (2 of 15 (13%) previously untreated patients). One of 25 patients treated with methotrexate and one of 28 received actinomycin-D responded. The duration of responses ranged from 43-64 days for those patients with no chemotherapy prior to study entry. The median survival of patients who received adriamycin as initial treatment was 12 weeks compared to 8 weeks for methotrexate and 6 weeks for actinomycin-D therapy.

Adult↗
PubMed1977

Computerized tomography, diagnostic ultrasound, and radionuclide scanning. Comparison of efficacy in diagnosis of pancreatic carcinoma.

Forty-six patients, including 33 with proved pancreatic carcinoma, were studied with computerized tomography (CT), ultrasound (US), and radionuclide (RN) scanning. The results of each scanning procedure were compared with the surgical and clinical findings. The detection rate was 82% for CT, and 92% with US. A mass is the most important finding in the diagnosis of pancreatic carcinoma. Measurements of the pancreas with CT and US were similar, with visualization of all parts of the pancreas routinely better with CT scans. Radionuclide scans were abnormal in 96% of the patients with pancreatic carcinoma as well as in 75% of patients without pancreatic disease. A rational approach to examination of a patient with suspected pancreatic carcinoma should begin with US scan with available, because the detection rate with this method is equal to that with CT and its cost per procedure and for equipment is substantially less.

Humans↗