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Biomedical subjects

J Doran

Publications and source records attributed to J Doran.

At least 55 records · Page 3Linked to original sources
PubMed1983

A modified Gritti-Stokes amputation: its place in the management of peripheral vascular disease.

A modified technique for performing the Gritti-Stokes amputation is described and the results obtained in 247 cases are presented. The mortality rate was 9.3% and healing occurred in 87% of survivors. Using this modified technique the frequently cited criticisms of non-union of the patella and painful stumps were not found to be major problems. The prosthetic problems of amputation at this level are discussed in relation to recent developments in the design of artificial limbs.

Adult↗
PubMed1982

Enzyme inhibition and the toxic action of moniliformin and other vinylogous alpha-ketoacids.

The inhibition of two thiamine-requiring enzymes by the potent mycotoxin, moniliformin (1-hydroxycyclobutene-3,4-dione), was investigated. Rat brain transketolase and pyruvate dehydrogenase were inhibited 25 percent by 10-9 M moniliformin. Studies carried out to determine if moniliformin causes enzyme inhibition by reaction with thiamine were negative. Varying the hydroxycyclobutenedione structure by substitution or ring expansion resulted in loss of toxicity and inhibition.

Animals↗
PubMed1982

Bleeding patterns in colorectal cancer: the effect of aspirin and the implications for faecal occult blood testing.

Faecal occult blood testing for 3 consecutive days is recommended for the detection of colorectal cancer. Is this adequate? Haemoccult tests were performed for 6 days on the faeces of 50 patients with colorectal cancer. Enteric-coated aspirin was given during the final 3 days to see if its systemic effect on coagulation would increase tumour bleeding. In 25 patients blood loss was quantified by radiochromium assay. Bleeding was slight and intermittent with large daily fluctuations in individual patients. Median daily loss before aspirin was 1.2 ml and after aspirin 2.5 ml. Thirty per cent of the tumours were Haemoccult negative using the standard 3-day regimen and 18 per cent were negative after aspirin. Over the 6-day period, 10 per cent were persistently negative. We conclude that new methods are required to improve the diagnostic yield from faecal occult blood tests.

Aspirin↗
PubMed1982

Glucagon and infusion cholangiography.

It has been previously suggested that glucagon improves the bile duct and gall-bladder opacification obtained by infusion cholangiography. One hundred and ninety consecutive patients referred for intravenous cholangiography were entered into a double-blind study designed to see if glucagon would in fact significantly improve bile duct opacification. All patients received a one hour intravenous infusion of iotroxamide at a rate of 3.15 mg/kg body weight/min. Glucagon did not enhance bile duct opacification, the mean post-injection scores for the two groups being 2.47 +/- 1.11 and 2.29 +/- 1.15 respectively. On the basis of the present study we cannot recommend the routine use of glucagon following infusion cholangiography.

Bile Ducts↗
PubMed1981

Clinical and economic consequences of wound sepsis after appendicectomy and their modification by metronidazole or povidone iodine.

The effects of intrarectal metronidazole and intraincisional povidone iodine on sepsis after emergency appendicectomy were compared in a double-blind randomised controlled trial in 496 patients. Wound sepsis occurred in 12.3% of metronidazole-treated patients compared with 24% in the povidone-iodine group and 23.5% in an untreated control group. The metronidazole-treated patients left hospital approximately 2 days earlier than patients in the other two groups. They returned to work sooner and receiver fewer visits from the district nursing service. A short six-dose course of metronidazole significantly reduces the wound-infection rate in patients over the age of 12 undergoing emergency appendicectomy. If the clinical and economic benefits of metronidazole shown by this study are confirmed, the drug should be considered for routine use in emergency appendicectomy.

Appendectomy↗
PubMed1981

A controlled trial of colostomy management by natural evacuation, irrigation and foam enema.

Twenty patients entered a prospective controlled trial of colostomy management by three techniques--natural evacuation, colostomy irrigation and foam enema. Every patient spent 2 months using each technique. The mean number of colostomy actions weekly was 17 during natural evacuation, 6 during irrigation and 10 with the enema. There was no significant difference in the time taken to manage the colostomy by each technique. Eighteen patients considered that both irrigation and the foam enema improved the quality of their life, and opted to continue with irrigation on completion of the study. There were no major complications during the trial but leakage of foam and an increase in flatus were problems with the foam enema. It is concluded that patients should be made aware of the alternative methods available for colostomy management and be encouraged to use the method of their choice.

Aged↗
PubMed1980

Iotroxamide studies in man--biliary iodine levels following bolus injection and slow infusion. Comparison with ioglycamide.

The concentration of iodine in the bile of patients with indwelling T-tubes has been measured following administration of the new cholangiographic agent Iotroxamide. Studies have been performed after administration of the contrast agent by both 10 min bolus injection and 1 h drip infusion techniques. Comparison has been made with the iodine concentrations obtained after administration of equimolar amounts of Ioglycamide. There was no significant difference in the biliary iodine levels obtained with the two methods of administration when Iotroxamide was the contrast agent employed. However, with Ioglycamide the slow infusion technique produced higher iodine levels than the bolus injection method (P less than 0.05). Comparison between the two agents reveals that, whichever administration technique is used, Iotroxamide provides higher iodine levels than Ioglycamide. After bolus injection the superiority for Iotroxamide is in the region of 20% and after slow infusion is of the order of 10--15%. It is concluded that Iotroxamide is likely to prove superior to Ioglycamide as a cholangiographic agent. In terms of opacification of the biliary tree there is little to choose between bolus injection and slow infusion techniques when using Iotroxamide and the relative toxicity of the two techniques should be the major factor in determining which method is employed in clinical practice.

Bile↗
PubMed1980

Iotroxamide--a new cholangiographic agent. Relation between plasma concentration and biliary excretion in man.

The relationship between infusion rates, plasma concentration and biliary excretion of iotroxamide were studied in 24 patients with a T-tube in situ. Plasma iotroxamide concentration was linearly related to the rate of infusion over a dose range of 0.525 to 6.3 mg/kg/min. Peak biliary concentrations and excretory rates of iotroxamide were seen when the plasma concentration was of the order of 1500 microgram/ml. The results suggest that when using a one hour infusion of iotroxamide near optimal concentrations of iodine in the bile duct can be achieved with an infusion rate of around 4 mg/kg/minute. No toxic effects were noticed from the use of this new cholangiographic agent.

Bile↗
PubMed1980

Drip infusion cholangiography using iotroxamide. Double blind comparison with ioglycamide.

A double blind clinical trial was carried out in 200 unselected patients to compare the efficacy and tolerance of ioglycamide and iotroxamide as contrast media for intravenous cholangiography. The two agents were administered by slow infusion at a rate of 2.6 mumoles/kg bodyweight/minute for one hour. Radiological opacification of the bile duct was assessed independently by two radiologists. In patients with serum bilirubin levels of less than 34 mumoles/litre visualization of the bile duct was significantly better with iotroxamide than with ioglycamide (P < 0.001). Toxic side effects were observed in 8% of patients receiving ioglycamide and in only 3% of the patients given iotroxamide.

Adult↗
PubMed1980

Recurrent meningococcal infections associated with a functional deficiency of the C8 component of human complement.

A patient is described who had a functional deficiency of the C8 complement component. His serum contained abnormal C8 which lacked some of the antigenic determinants of normal C8. The defect was associated with recurrent meningococcal infections due at different times to at least two strains. The patient's serum contained antibodies to meningococci and could induce phagocytosis and intracellular killing of the cocci by polymorphs. However, the serum was bactericidal only after the addition of C8-containing serum. As the patient did not give a history of susceptibility to other pyogenic organisms and has normal polymorph function, the circumstances of meningococcal infection must be unusual in that the plasma bactericidal activity critically determines the outcome: it may be that if large numbers of meningococci are not killed in the plasma, the polymorphs are overwhelmed.

Adolescent↗
PubMed1979

Rowachol--a possible treatment for cholesterol gallstones.

It has been claimed that Rowachol, a proprietary choleretic, is occasionally successful in the treatment of gallstones. In gallstone patients we have examined its effect on the lipid composition of (1) samples of fasting gall bladder bile obtained at the time of cholecystectomy, and (2) T-tube bile on the tenth post-operative day. In a dose of two capsules, three times a day for only 48 hours, Rowachol significantly lowered the cholesterol solubility of both gall bladder (P less than 0.001) and T-tube bile (P less than 0.05). Rowachol in a dose of one capsule three times a day for 48 hours did not alter bile composition, while four capsules four times a day for a similar period caused a significant (P less than 0.05) deterioration in biliary lipid composition. The possible mechanisms of action of Rowachol and their therapeutic implications are discussed.

Adult↗
PubMed1979

Control by stimulus features during fading.

Sixteen children were given four successive circle-size discrimination problems with luminance as the fading stimulus. Children who were first presented with a difficult size discrimination failed to acquire this discrimination. Those who first received an easy discrimination learned the difficult discrimination. At the end of each 10-trial block, two probe stimuli were presented to monitor any shift in control from luminance to size. One probe was the same size as the positive stimulus but of different luminance; the other was the same luminance but of different size. If, in the course of fading, size and luminance both controlled responding, fading was successful. If luminance alone controlled responding until the end of fading, the size discrimination was not established. Dual control, and thus successful fading, resulted when the target stimuli were very discriminable, or when the target stimuli were subtly different provided that previous fading series had first established less subtle discriminations.

Child↗
PubMed1978

The Gritti-Stokes amputation in ischaemia: a review of 134 cases.

The results of 134 Gritti-Stokes amputations for ischaemia are presented. The mortality rate was 11% and healing occurred in 88%, reaffirming the good results already reported for this operation. The long term results are reviewed in an attempt to decide whether the most frequently cited criticisms of this procedure are justified. Stump pain and mobility of the patella were not major problems. The difficulties in fitting a suitable prosthesis are discussed and attention is drawn to the advantages of a new prosthesis that has been developed for this amputation.

Adult↗