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Biomedical subjects

J M Ham

Publications and source records attributed to J M Ham.

At least 73 records · Page 4Linked to original sources
PubMed1979

Partial and complete atrophy affecting hepatic segments and lobes.

Thirty-four patients with atrophic lesions of liver segments or lobes are described. The primary diagnoses included alcoholic liver disease, various forms of cirrhosis, hydatid disease, tumours and sclerosing cholangitis. Seventeen patients had complete atrophy of the segment or lobe and the other 17 patients had partial atrophy (i.e. a reduction of at least 50 per cent in the size of the affected area). Complete atrophy affected the left lobe more frequently than the right. The condition is important, first, because it is more common than is generally recognized, and second, because it may create considerable diagnostic and therapeutic problems.

Adult↗
PubMed1979

The biliary excretion of sulfbromophthalein in the pig.

The characteristics of the hepatic metabolism of Sulfbromophthalein (BSP) have not been described previously for the pig. This is an important deficiency, since the pig is particularly suitable for studies of hepatic physiology and pharmacology which might apply to man. The aim of these experiments was to establish the pattern of serum clearance and biliary excretion of BSP and to determine that dose which would produce a maximal concentration in bile. A dose response and pattern of biliary excretion of BSP was studied at three dose levels administered either as a single bolus of a continuous infusion. All experiments were performed in conscious, conditioned pigs. The patterns of serum clearance and biliary excretion were found to be similar to other laboratory animals and to man. Maximary biliary concentration of BSP was achieved by a single bolus of 5-9 mumol/kg or a constant infusion of 0-59 mumol/kg/min. At these dose levels no significant alteration in bile flow was demonstrated nor was there any correlation between bile flow and BSP excretion. Supra-maximal doses produced a significant increase in bile flow and with these doses there was a significant positive correlation between bile flow and BSP excretion.

Animals↗
PubMed1979

Work loads of a sample of general surgeons in N.S.W.

The work loads of 34 general surgeons in New South Wales during a six week period in 1977 have been determined. Data was obtained on the number of elective, emergency and supervised procedures, and of elective and emergency first consultations. The operative work loads were assessed by a simple grading system, and also by the "hernia-equivalent" method which relates the work involved in a given operation to that for an adult unilateral inguinal herniorrhaphy. The latter is arbitrarily given a score of one. The hernia-equivalent scores for academics, country and city surgeons were similar. The mean hernia-equivalent rating for the 2,321 operations assessed was 1.1; thus, the "typical" operation was equivalent to a herniorrhaphy. The mean number of operations per week was 11.4, or 12.6 hernia-equivalents. Assuming a 48-week working year, these figures represent an annual work load of 547 operations, or 605 hernia-equivalents. Comparison of these results with those obtained in the U.S.A. (the "SOSSUS" report) indicates that these work loads are almost three times those found for board-certified general surgeons in the U.S.A.

Australia↗
PubMed1978

Heparin prophylaxis of deep vein thrombosis in patients with a fractured neck of the femur.

A double-blind controlled clinical trial of the efficacy of the prophylactic subcutaneous administration of calcium heparin in preventing deep vein thrombosis has been conducted in 50 patients with a fractured neck of the femur. Heparin was given every eight hours in a dose of 100 international units per kilogram of body weight and was commenced as soon as possible after the patient's admission to hospital. Treatment was continued for two weeks. In the placebo group, 12 of 25 patients developed a deep venous thrombosis and in five of these patients the thrombosis propagated to the thigh. There were no deep venous thromboses in the heparin-treated group during the two weeks of treatment, but four patients developed a deep venous thrombosis within a week of stopping the heparin. The heparin regime was safe; operative blood loss was not increased, nor was there an increased incidence of wound complications as compared to the placebo group.

Aged↗
PubMed1978

The diagnosis and treatment of functional disorders of the biliary tract.

An approach to the diagnosis and treatment of patients with presumed functional disorders of the biliary tract (biliary dyskinesia) is described. The current diagnostic criteria are pain compatible with biliary pain in the absence of gallstones and other organic gastrointestinal disease, or other disorders which might produce abdominal pain, together with reproduction of the patient's symptoms by cholecystokinin, or morphine, or both. Other diagnostic methods are described together with their limitations. The results of operation in 38 of 45 patients seen in this Unit during the past six years are presented. The results were poor in 20% of patients, but two-thirds of the group have had good results in the short term.

Biliary Tract Diseases↗
PubMed1978

Operative liver biopsy abnormalities in patients with functional disorders of the biliary tract.

The group of conditions variously termed biliary dyskinesia, acalculous cholecystitis, biliary pain without stones, or functional disorders of the biliary tract, is poorly defined clinically, and no consistent pathological abnormalities have been previously described in patients with this diagnosis. In this paper we report histological abnormalities encountered in operative live biopsies in such patients. The criteria for the diagnosis of a functional biliary tract disorders were: pain typical of biliary pain, negative results of investigations for organic biliary tract or other gastrointestinal disease, and reproduction of the patient's symptoms by cholecystokinin, or morphine, or both. Twenty of 45 patients with a presumptive diagnosis satisfied these criteria, and had a wedge liver biopsy at the time of operation. The 20 liver biopsy specimens were compared in a blind fashion with similar ones taken from patients having diagnostic laparotomies; patients with stones confined to the gallbladder; patients with gallstone pancreatitis; and patients with proven common bile duct stones. The biopsy findings were found to be similar to those in the latter two groups. Thus the abnormalities were similar to those found in partial or intermittent biliary obstruction, and it is suggested that they may be due to intermittent increases in biliary pressure.

Adult↗
PubMed1978

Traumatic haemobilia treated by hepatic artery ligation.

A 22-year-old woman developed haemobilia following suture of an apparently superficial liver injury. The diagnosis was made on the basis of the clinical features, duodenoscopy, and liver function test. Selective hepatic angiography and liver scintiscan demonstrated a cavity in the right lobe on the liver, with the bleeding arising from a branch of the right hepatic artery. She was treated by cholescystectomy, exploration of the common bile duct with removal of clots, and ligation of the right hepatic artery. Subsequent T tube cholangiography and liver scintiscans demonstrated complete resolution of the cavity, and there was no further bleeding. Experience with this patient suggests that contrary to previous recommendations, haemobilia associated with an intrahepatic cavity may be successfully treated by hepatic artery ligation.

Accidents, Traffic↗
PubMed1977

Seasonal variation in the incidence of deep vein thrombosis.

Two double-blind controlled clinical trials of the effectiveness of prophylactic low dose subcutaneous calcium heparin (dose based on body weight) in the prevention of deep vein thrombosis (DVT) have been completed. The first was concerned with upper abdominal operations in 242 patients over 21 years of age, and the second with 50 patients presenting with a fracture of the neck of the femur. There was no increase in the incidence of bleeding or wound complications in the patients given heparin. In each trial, the incidence of DVT as diagnosed by 125I-labelled fibrinogen was significantly reduced in the treated group. The incidence of DVT in the control groups varied significantly during the period of the trials. The incidence was much higher in the cold half of the year than in the hot months. In the first trial, this variation in incidence was directly correlated with the average temperature and the diurnal variation in temperature in the perioperative period. These results may help to explain the considerable variation in the incidence of postoperative DVT reported from various parts of the world, and also from within Australia.

Adult↗
PubMed1977

Heparin, heparin-activated enzymes and platelets.

This review summarises evidence supporting the view that the therapeutic anticoagulant properties of heparin are related to its physiological function in the organism, especially its activation of lipoprotein lipase and lecithinase. The conflicting results obtained from studies of the effect of heparin on platelet function are discussed, together with reasons for these differences of opinion. Finally, a hypothesis which links heparin, heparin-activated enzymes and platelet function is proposed, this hypothesis being complementary to the current views concerning the activation by heparin of the inhibitor of activated factor X.

Blood Platelets↗
PubMed1976

Operative pancreatography.

The results of operative pancreatography in 32 patients with pancreatitis are reported. The main pancreatic duct was successfully and adequately demonstrated in 30 patients: in 29 by cannulation of the major ampulla, and in one by direct needle puncture of the duct. No films were obtained in one patient, and in another only the accessory duct could be demonstrated. There was thus a high rate of technical success, but the frequency of gross abnormalities of the major pancreatic duct was low, except in those patients with traumatic pancreatitis. These results are relevant to the assessment of the value of endoscopic retrograde cholangiopancreatography in pancreatic disease.

Adenocarcinoma↗