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Biomedical subjects

K Simmons

Publications and source records attributed to K Simmons.

At least 37 records · Page 2Linked to original sources
PubMed1986

Percutaneous transluminal angioplasty for severe lower extremity ischaemia.

Percutaneous transluminal angioplasty (PTA) was attempted on 70 occasions in 63 consecutive patients presenting with advanced ischaemia. The procedure was technically successful in 64 (91%) with haemodynamic improvement in 39 (56%) and clinical improvement maintained at 6 months in 51 (73%). Follow-up ranged from 6 months to 4 years and life-table analysis showed 60% success at 1 year and 58% success at 2 years. Overall limb salvage was 76%. Complications occurred in 6 (9%) and in one case this lead to amputation. The relationship of a number of associated factors to outcome was assessed. The presence of cardiac disease requiring treatment for failure or angina was a highly significant adverse factor (P less than 0.001). Decreasing age and greater extent of disease were also significant adverse factors (P less than 0.05). Therefore, because of its low morbidity and cost, PTA can be seen as a useful procedure in patients presenting with advanced peripheral vascular disease.

Adult↗
PubMed1986

Percutaneous transhepatic dilatation in the management of bile duct strictures.

Despite improvements in surgical techniques, some complex bile duct strictures continue to present difficult management problems. Strictures recurring after previous biliary-enteric bypass, those associated with established biliary cirrhosis or coexistent malignancy, and those that follow hepatic resection may pose almost insuperable technical and physiological problems. Percutaneous transhepatic balloon dilatation will not solve all problems, but can help in some instances. Six patients are presented in whom this technique has been used in attempts to overcome particular problems. The strengths and weaknesses of the method are discussed.

Adult↗
PubMed1985

The postnatal development of norepinephrine-stimulated cyclic AMP accumulation in rat spinal cord.

Norepinephrine (NE) stimulated cyclic adenosine 3',5'-monophosphate (cyclic AMP) accumulation in regional spinal cord and cortical tissue slices from postnatal rats demonstrated distinct developmental patterns. NE-concentration-response studies using a 10-min incubation period demonstrated minimal NE-stimulated cyclic AMP accumulation in whole spinal cord at PD 1-5 with maximal sensitivity on PD 12. Thereafter, sensitivity decreased to adult values at PD 30. Sensitivity changes were reflected in alterations in maximal response only since NE EC50s all averaged 10(-6) M. This agrees with no change in calculated Kd for NE with increased Vmax to PD 12 and a reduction thereafter. Studies on regional spinal cord and cerebral cortical cyclic AMP accumulation indicated peak NE sensitivity in cervical and thoracic cord occurred at PD 10, in lumbar cord at PD 15, and in cerebral cortex at PD 20. The fact that inhibition of phosphodiesterase (PPDE) produced the same percentage alteration in peak accumulation in spinal cord slices regardless of postnatal age suggests that PPDE is not the primary determinant of the ontogenic changes. The results indicate that the postnatal development of spinal NE receptors may be reflected in an increase in the responsiveness of the cyclic AMP system to NE.

1-Methyl-3-isobutylxanthine↗
PubMed1985

Hepatic haemobilia: non-operative management in eight cases.

Eight cases of major haemobilia have been seen by the Surgical Hepatobiliary service at Westmead Hospital between 1979 and 1984. Two occurred following blunt abdominal trauma, three after percutaneous biliary drainage or liver biopsy, two in association with postoperative haemorrhagic pancreatitis and one because of an abscess complicating hepatic hydatid disease. Coeliac and superior mesenteric angiography were carried out in all patients, and false aneurysms were demonstrated in seven of the eight. A marked coagulopathy was present in the remaining patient, in whom bleeding stopped without intervention when the coagulopathy was reversed. Those with false aneurysms were treated by radiologically controlled transarterial embolization with gelfoam, acrylate or Gianturco coils, and bleeding was controlled in all. There was one death from overwhelming sepsis in the patient with the hepatic abscess. It is concluded that percutaneous radiologically controlled embolization is the treatment of choice for most cases of haemobilia, except when there is major hepatic sepsis.

Acute Disease↗
PubMed1985

Use of a T tube as an endoprosthesis for internal biliary drainage.

A technique is described for the percutaneous transhepatic placement of a T tube into the bile ducts. The short limbs are placed in the right and left hepatic ducts, and the long limb is passed through the malignant obstruction into the duodenum, creating an endoprosthesis for internal drainage.

Cholestasis, Intrahepatic↗