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Biomedical subjects

J R Starling

Publications and source records attributed to J R Starling.

At least 73 records · Page 4Linked to original sources
PubMed1982

Providing sexual information to ostomy patients.

Forty patients with a permanent colostomy, ileostomy, or ileal conduit were interviewed. Besides changes in sexual performance postoperatively, the authors specifically attempted to determine answers to other sexual variables such as attractiveness, appliance problems, and partner reactions. The extent of information provided to patients on sexuality prior to the permanent ostomy was also examined. There was a significant but predictable incidence of male impotence and female dyspareunia after surgery. Despite innumerable sexual variables, other than performance, which these patients faced postoperatively, 42 per cent received no information regarding sexuality at the time of ostomy surgery. most patients (97.5 per cent) stated that sexuality, including variables other than performance, should be discussed primarily by the surgeon prior to permanent ostomy surgery. The enterostomal therapist has an important role in the total patient adjustment in the long-term postoperative period.

Adaptation, Psychological↗
PubMed1982

Surveillance colonoscopy after ureterosigmoidostomy.

Fourteen patients had surveillance colonoscopy 2 to 48 years after ureterosigmoidostomy urinary diversion. Five patients (37 per cent) had benign polyps distal to the implant sites that were removed but no colon carcinomas were found. We discuss the rationale for surveillance colonoscopy at regular intervals. This procedure may allow greater usage of ureterosigmoidostomy as a means of urinary diversion.

Adenocarcinoma↗
PubMed1982

Treatment of symptomatic gastroesophageal reflux using the Angelchik prosthesis.

During the past 20 months, 28 patients with symptomatic gastroesophageal reflux were treated with the Angelchik anti-reflux prosthesis. The patients ranged in age from 12 to 75 years, with symptoms present from one to 24 years. Vigorous medical management had failed with all patients prior to surgery. Before operation, 28 of 28 patients had upper GI x-rays, 27 of 28 fiberoptic esophagogastroscopy, 26 of 27 esophageal biopsy, eight of 28 Bernstein testing, and 24 of 28 lower esophageal sphincter pressure and motility. Eight patients had strictures requiring preoperative or postoperative dilatation. In four of 28 patients, a Nissen procedure had been previously done. In addition, two patients had metaplastic epithelium, and a single patient a previous Heller myotomy. Twenty-five of the 28 patients are completely asymptomatic eight to 20 months after Angelchik insertion. Fifteen patients had surgery more than one year previously. There are no recurrent hiatal hernias. Endoscopy and biopsy reveal resolution or marked improvement in the esophagitis. Seven patients complained of transient dysphagia lasting up to three months. One patient has persistent "gas bloat" syndrome. There were no technical or perioperative complications. Trouble with the prosthesis occurred in two patients; in one, the prosthesis disrupted and fell into the pelvis, and in the other the prosthesis migrated into the mediastinum. LES pressures preoperatively were 6.17 +/- 0.9 and 16.95 +/- 1.76 mmHg for the 19 patients studied after operation. The limited sample of patients who were studied with preoperative and postoperative acid-reflux tests have all shown improvement in their score. The Angelchik prosthesis in this series has been safe, simple, and reproducible, and can eliminate the symptoms and signs of gastroesophageal reflux.

Adolescent↗
PubMed1981

Enzymatic and ultrastructural study of lysosomes in rats bearing radiation-induced thyroid follicular carcinoma.

Radiation-induced well-differentiated and poorly differentiated follicular thyroid cancers were transplanted into the intrascapular fat pads of male Fisher 144 rats. The tumors grew in the recipient rats and after a time interval were removed and studied along with normal rat thyroids for lysosomal activity and ultrastructural characteristics. Plasma from experimental and control rats was also studied for lysosomal activity. Rats with radiation-induced thyroid carcinoma had a decrease in growth rate compared with normal rats. There was no significant increase in plasma lysosomal enzymes in the experimental rats. Well-differentiated thyroid carcinomatous tissue showed increased total activities of lysosomal enzymes as well as a difference in subcellular distribution compared with normal and poorly differentiated carcinomatous tissue. Electron microscopy of normal and carcinomatous tissue demonstrated the greatest number of lysosomes in the well-differentiated carcinoma and the fewest in the poorly differentiated carcinoma.

Adenocarcinoma↗
PubMed1981

Lysosomal enzyme activity in pulmonary alveolar macrophages from conventional, germfree, monoassociated, and conventionalized rats.

Pulmonary alveolar macrophages (PAM) were harvested from conventional (CONV), germfree (GF), conventionalized, and monoassociated (MA) rats. Germfree rats had significantly fewer PAM than did their CONV, conventionalized or MA counterparts. The bronchopulmonary wash from the CONV and conventionalized rats contained higher lysosomal specific activity for beta-glucuronidase and cathepsin D than did similar washes from GF rats. Cellular and subcellular PAM fractions from GF rats also showed decreased enzyme activity in comparison with similar fractions from the PAM or CONV rats. Colonization of GF rats with one (MA) or more bacterial species (conventionalized) increased the beta-glucuronidase and cathepsin D activity of their PAM as well as total PAM. These data suggest that the intestinal flora not only enhances PAM proliferation but also is associated with an increase in their lysosomal enzyme activity.

Animals↗
PubMed1980

Benign mechanical obstruction of the common hepatic duct (Mirizzi syndrome).

Common hepatic duct obstruction that results from a gallstone impacted in the cystic duct or fundus of the gallbladder is an uncommon cause of obstructive jaundice and cholangitis. In the literature, the Mirizzi syndrome frequently is used to describe a rare entity consisting of an anatomic variation of the cystic duct or neck of the gallbladder, an impacted gallstone in the cystic duct, and a benign mechanical obstruction of the hepatic duct which causes jaundice and cholangitis. Recently, we saw two patients who had this syndrome. Their case reports, operative management, and a review of the Mirizzi syndrome are discussed in this article.

Cholangiography↗
PubMed1979

Hemosuccus pancreaticus secondary to ruptured splenic artery aneurysm.

A case is presented of a ruptured splenic artery aneurysm communicating with the main pancreatic duct which resulted in obscure upper gastrointestinal bleeding. Bipolar ligation of the splenic artery and excision of the pseudoaneurysm was curative. The location of the splenic artery makes it especially vulnerable to aneurysmal formation in patients with pancreatitis. It is recommended that early arteriography be obtained in patients with obscure upper gastrointestinal bleeding. If the splenic artery aneurysm is located in the mid-portion of the vessel, partial pancreatectomy and splenectomy are not necessary to effect a cure.

Aneurysm↗