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Biomedical subjects

M E Vincent

Publications and source records attributed to M E Vincent.

31 records · Page 2Linked to original sources
PubMed1982

The anatomy and complications of "T" versus vertical closure of the hypopharynx after laryngectomy.

The early postoperative hypopharyngeal anatomy of 37 consecutive patients undergoing total laryngectomy at the Boston Veteran's Administration Hospital between July 1977 and April 1980 was studied by barium swallow radiographs and correlated with the technique of closure. The "pseudoepiglottis," a structure radiographically resembling a normal epiglottis, was seen arising from the anterior hypopharynx near the base of the tongue in 21 of 28 evaluable patients. It occurred in all patients with vertical closures vs. 67% of patients with a "T" shaped closure. The average length in the "T" closure group was 9.6 mm (range 0-35) vs. 18.4 mm (6-40) in the vertical group, a statistically significant difference (p less than 0.05). Radiologic strictures occurred in 39% of all patients, dysphagia in 29%, fistulae in 18%, and sinus tracts in 14%. All complications occurred more frequently in the vertical closure group. Patients who received preoperative cis-platinum bleomycin chemotherapy and postoperative irradiation had 50% dysphagia and 67% stricture rates. The average ratio of the width of the retropharyngeal space to that of C4 was 0.48 in stricture patients vs. 0.29 in non-stricture patients (statistically significant at the p less than 0.01 level). This ratio taken in the early postoperative period may help predict which patients will develop strictures.

Bleomycin↗
PubMed1979

Ceruletide-assisted cholecystography: a clinical assessment.

The cholecystokinetic effect of ceruletide, a synthetic decapeptide similar in action to cholecystokinin, was examined in both a randomized and nonrandomized study in 81 patients scheduled for routine oral cholecystograms. Intramuscular injection of ceruletide in a dose of 0.3 microgram/kg resulted in a mean maximum contraction of the gallbladder of 68% and a mean time until maximum contraction of 28 minutes. Visualization of the cystic duct occurred in 57 patients (70%); the common duct was seen in 67 (83%). Ceruletide demonstrated superior gallbladder contraction when compared to fatty meals and demonstrated no interference with a subsequent upper gastrointestinal series.

Adult↗
PubMed1979

Percutaneous catheter drainage of abdominal abscesses guided by ultrasound and computed tomography.

Ultrasonography and computed tomography were used to diagnose, localize, and guide the percutaneous drainage of 24 intraabdominal and retroperitoneal abscesses in 23 surgical and medical inpatients 16 of whom had abscess formation as a postoperative complication. On the basis of anatomic detail from sectional imaging, safe percutaneous drainage routes similar to surgical approaches were defined. After confirmation by needle aspiration, one of two methods of percutaneous catheter introduction were used: (1) a modified Seldinger technique for placement of an 8 French pigtail catheter and (2) a trocar catheter technique for placement of a 12 or 16 French catheter. Once in position, the catheters were managed as a surgically placed drain. In 22 of 24 cases, percutaneous catheter drainage was curative with no surgery required. There were no deaths or recurrences with an average follow-up period of 12 months ranging from 1 week to 3 years. Percutaneous aspiration and drainage should be considered as an alternative to surgery in the treatment of intraabdominal or retroperitoneal abscess.

Abdomen↗
PubMed1978

Revised radiologic concepts of the Barrett esophagus.

The radiologic findings in 39 cases of histologically proven Barrett esophagus are reviewed. Esophageal strictures were not found in 18% of the cases, and when present were more often distally located. Esophageal ulcers were found in only 46% of the patients. In 13% of the cases neither ulcer nor stricture was found. The majority (72%) of these cases did not fit the classic stereotype of high esophageal stricture and/or ulcer.

Epithelium↗
PubMed1977

Benign transient eosinophilia following intravenous urography.

Eosinophilia, a component of the allergic response, may occur after the use of iodinated radiographic contrast media for intravenous urography. A benign transient elevation in differential eosinophil count was seen in 21 of 101 patients following the injection of iodinated contrast agents for that purpose.

Diatrizoate↗
PubMed1976

Double-blind comparison of meglumine lodoxamate (Cholovue) and meglumine iodipamide (Cholografin).

A double-blind comparison of two intravenous cholangiocholecystographic agents of similar molecular structure, meglumine iodoxamate and meglumine iodipamide, was carried out in 90 patients. Each produced a comparably high percentage of satisfactory examinations. A similar pattern of excretion speed and intensity was noted for each, though meglumine iodoxamate appeared to be slightly more effective in patients with elevated serum bilirubin. Less evidence of hepatic toxicity and fewer and less serious adverse side effects were observed in patients given the newer agent, meglumine iodoxamate.

Adult↗
PubMedDate not supplied

Renal electrolyte excretion pattern in response to bumetanide in healthy volunteers.

Renal electrolyte excretion patterns were determined in nonedematous healthy volunteers following bumetanide and furosemide in two separate clinical studies. In study 1, intravenous bumetanide was administered to 24 subjects at four dose levels. In study 2, bumetanide (1 or 2 mg) or furosemide (40 or 80 mg) was administered in a single oral dose to 32 subjects assigned at random to one of the four treatment groups. In study 1, there was a significant dose-related increase in urine volume and sodium, potassium, and chloride excretion, with chloride exceeding sodium at all dose levels, and the Na+/K+ ratios after bumetanide were greater than 3:1. In study 2, the Na+/K+ ratio increased significantly after treatment in all four treatment groups. The relative Na+/K+ ratios showed higher natriuretic potency and lower kaliuretic potency for bumetanide than for furosemide, but the differences were not statistically significant. Additionally, all four treatment groups demonstrated elevation in titratable acidity, ammonia formation, and total acid excretion. There was a significant degree of positive correlation in the bumetanide-treated groups between Na+/K+ and the three variables. In the furosemide-treated groups, this positive correlation was statistically significant between the Na+/K+ ratio and ammonia and total acid secretion but not for titratable acidity. The results support the view that increased H+ formation after the administration of loop diuretics has a relative potassium-sparing effect.

Adult↗
PubMedDate not supplied

Clinical use of diuretics in congestive heart failure.

Loop diuretics have become indispensable in the management of patients with cardiac decompensation and severe edema. To evaluate the relative potency of these agents, bumetanide and furosemide were compared in 20 patients with edema associated with congestive heart failure in a double-blind, parallel study design. The dosage of the drugs administered daily for three days was 1 to 2 mg bumetanide or 80 mg furosemide. Both agents were highly effective in reducing the edema and relieving the symptoms of heart failure. Muscle cramps and abdominal pain as side effects were deemed not severe. Laboratory values indicative of mild hypochloremic alkalosis and hyponatremia were observed in two patients. Hypokalemia and reversible eighth-nerve involvement were not apparent in this study.

Bumetanide↗
PubMedDate not supplied

Pharmacology, clinical uses, and adverse effects of ceruletide, a cholecystokinetic agent.

Ceruletide, a decapeptide, is a potent cholecystokinetic agent with a direct spasmogenic effect on the gallbladder muscle and bile ducts in humans and animals. It was recently approved by the Food and Drug Administration for use as an adjunct in x-ray examination of the gallbladder and small bowel. The drug causes a coordinated propulsive activity from the duodenum to the ileum and segmenting activity in the colon. Because of this stimulatory effect, ceruletide is useful not only diagnostically as an aid in x-ray examination of the small bowel, but also therapeutically for treatment of postoperative ileus, intestinal atonia, and chronic fecal statis. Because of its pancreatic stimulatory action, it is useful in evaluation of exocrine pancreatic function. In therapeutic doses the adverse effects noted are mild, transient extensions of the drug's pharmacologic actions and are manifest as nausea, vomiting, abdominal pain, and rarely hypotension and tachycardia. On the basis of current evidence, ceruletide is a safe and effective cholecystokinetic agent and small bowel and exocrine pancreatic stimulant.

Animals↗
PubMedDate not supplied

Orbital implants and prostheses: postoperative computed tomographic appearance.

Computed tomographic (CT) scans of 19 patients with 10 right and nine left orbital implants were reviewed. Except for orbital soft-tissue swelling due to recent surgery or infection, CT scans obtained with both the implant and prosthesis in place showed relative symmetry of the postoperative side and the native globe. Benign air collections were often associated with either the implant or prosthesis interface or with seating of the prosthesis in the conjunctival fornices. Six patients had either cartilage, silicone, or glass beads placed surgically along the orbital floor to elevate the implants, four having had prior depressed orbital floor fractures. CT identified implant migration in five patients. The orbital prosthesis, usually constructed of solid methylmethacrylate, is fitted over the implant and simulates the appearance of the eye of the contralateral side. The operative anatomy and its relation to the CT appearance of the implant and external prosthesis are reviewed.

Cartilage↗