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Biomedical subjects

P H Taylor

Publications and source records attributed to P H Taylor.

At least 19 recordsLinked to original sources
PubMed2001

A prospective study of bile leaks after laparoscopic cholecystectomy.

Since laparoscopic cholecystectomy rapidly became the gold standard, there is an increased morbidity of 1% to 3% for clinically significant bile leaks with this procedure, as compared with open cholecystectomy (<1%). The identification of subclinical bile leaks using cholescintigraphy occurs in the range from 31.4% to 40% after elective open cholecystectomy. At this writing, no studies exist that document the rate of subclinical bile leaks after elective laparoscopic cholecystectomy. In this study, 71 patients were evaluated using cholescintigraphy after elective laparoscopic cholecystectomy. This study represents the first prospective look at the rate of subclinical bile leaks after laparoscopic cholecystectomy in elective cases, and the findings show an overall incidence of 7.3%, as compared with historical reports of 30% to 44% for open cholecystectomy.

Acute Disease↗
PubMed2001

Formation and inhibition of chloroaromatic micropollutants formed in incineration processes.

The formation pathways for chlorinated aliphatic and chlorinated aromatic compounds in technical incineration processes are reviewed. It is shown that acetylene is converted to chloroaromatic compounds including PCDD/F in a special flow reactor by catalytic activity of CuCl2 in the temperature regime of a post-combustion zone of technical incinerators. Mechanistic pathways begin with chlorination of acetylene. Dichloroacetylene is further condensed to C-4 and C-6 units. Hexachlorobenzene is the dominant aromatic compound and a likely precursor to chlorinated phenols and PCDD/F. Two specific mechanisms of formation of chlorinated aromatic compounds including PCDD/F have been advanced. Both mechanisms begin with the formation of dichloroacetylene from flame pyrolysis products like acetylene. Condensation of dichloroacetylene is mediated by copper species via metallacyclic intermediates and/or a catalytic cycle involving copper stabilized trichlorovinyl radicals. The final pathways of conversion of chlorinated benzenes to PCDD/F via chlorophenols are under active investigation.

Acetylene↗
PubMed2000

Copper-catalyzed chlorination and condensation of acetylene and dichloroacetylene.

The chlorination and condensation of acetylene at low temperatures is demonstrated using copper chlorides as chlorinated agents coated to model borosilicate surfaces. Experiments with and without both a chlorine source and borosilicate surfaces indicate the absence of gas-phase and gas-surface reactions. Chlorination and condensation occur only in the presence of the copper catalyst. C2 through C8 organic products were observed in the effluent; PCDD/F were only observed from extraction of the borosilicate surfaces. A global reaction model is proposed that is consistent with the observed product distributions. Similar experiments with dichloroacetylene indicate greater reactivity in the absence of the copper catalyst. Reaction is observed in the gas-phase and in the presence of borosilicate surfaces at low temperatures. The formation of hexachlorobenzene is only observed in the presence of a copper catalyst. PCDD/F were only observed from extraction of the borosilicate surfaces. A global reaction model is proposed for the formation of hexachlorobenzene from dichloroacetylene.

Acetylene↗
PubMed1998

Primary non-Hodgkin's lymphoma of the larynx in an AIDS patient.

A case of primary non-Hodgkin's lymphoma of the larynx in an AIDS patient is presented with a review of the literature. Non-Hodgkin's lymphomas in AIDS patients are common but the primary laryngeal presentation is very rare. The symptoms usually include dysphonia and progressive airway obstruction requiring tracheostomy. As with laryngeal non-Hodgkin's laryngeal lymphomas in non-HIV positive patients the majority are of B cell lineage and respond well to radiotherapy. Our patient had a high grade lymphoma of B cell lineage which showed a good response to radiotherapy. The role of chemotherapy and surgery is not yet established. We suggest that the diagnosis of AIDS should not influence the management of these patients unless the individual is in the terminal disease stage.

Adult↗
PubMed1997

Otorhinolaryngological training in Europe--a comparative study.

Postgraduate training in the United Kingdom is undergoing radical changes following the 'Calman Report'. Commissioned in response to a European Union (EU) Directive, this contained recommendations to allow reciprocal recognition of all EU trained specialists. We present the findings of a postal questionnaire sent to representatives of the European Federation of Oto-Rhino-Laryngological Societies and the otolaryngology professors of the UK and Ireland with a response rate of 62.7%. Aspects assessed included clinical and surgical experience, examinations, teaching, research, length, regulation and perception of training. The programmes share similar teaching and research experience but substantial differences exist in most other areas. The accredited UK trainee has a much wider clinical and surgical repertoire than those from the Continent. Greek trainees were trained to the lowest minimum standard. The requirements of a training system are largely determined by the level of clinical experience and surgical skill required by an independent specialist in a given country.

Europe↗
PubMed1994

An algorithmic approach to aspergillus sinusitis.

The effective management of paranasal sinus aspergillosis requires early diagnosis, histological classification, surgery and where appropriate, chemotherapy. Fungal sinusitis may be easily missed unless a high index of suspicion is maintained and specific culture and histology requested. The disease is classified into invasive and noninvasive types, each being divided into two subgroups: invasive aspergillosis may be either fulminant or indolent and noninvasive disease localized or allergic. The literature is reviewed and an algorithmic approach to aspergillus sinusitis proposed. The importance of histologically differentiating invasive from noninvasive aspergillosis prior to selecting the appropriate treatment options is stressed. CT scan should precede definitive surgery, and be used in follow-up. Close and prolonged follow-up is essential.

Algorithms↗
PubMed1994

Mirizzi syndrome.

Compression of the common bile duct by a stone impacted in the cystic duct is an uncommon cause of obstructive jaundice. We present a case study and review of the literature pertaining to the presentation, diagnosis, and surgical treatment of Mirizzi Syndrome.

Cholangitis↗
PubMed1990

Early and late complications of totally implantable venous access devices.

We reviewed the records of 66 consecutive patients who underwent placement of totally implantable venous access devices (TIVADs). Fourteen patients (21%) experienced complications related to the TIVAD. Complications included hematoma, infection, pneumothorax, subclavian vein thrombosis, and chronic clavicular pain. The 1 month mortality rate following insertion of a TIVAD was 24% (16 of 66 patients); however, none of the patients died as a direct consequence of port insertion or its associated complications. Overall patient and physician acceptance of TIVADs was good, and we encourage continued use and study of this device.

Adult↗
PubMed1978

Guanosine 3',5'-monophosphate: a central nervous system regulator of analgesia.

The dibutyryl derivative of guanosine 3',5'-monophosphate (cyclic GMP), administered centrally, totally abolishes response to noxious stimuli without depressing the central nervous system. Analgesic properties of the nucleotide are not reversed by naloxone. Microinjected intracerebrally into different sites, dibutyryl cyclic GMP does not mimic the action of morphine. Pharmacological effects of dibutyryl cyclic GMP suggest that endogenous cyclic GMP modulates an inhibitory pain pathway distinct from that on which morphine acts.

Analgesia↗
PubMed1978

Cerebrospinal fluid otorrhoea and otorhinorrhoea following closed head injury.

A discussion of acute traumatic CSF otorrhoea and otorhinorrhoea is presented. The incidence of meningeal infection is reviewed and the management of these cases is outlined with special emphasis on the indications for surgical intervention and the otological procedures available. Two patients who sustained transverse fractures of the petrous temporal bone are described in whom subsequent attacks of meningitis were prevented by a new, simple yet effective operation.

Adult↗
PubMed1977

Glossopharyngeal neuralgia with syncope.

Thirty-two cases of glossopharyngeal neuralgia complicated by syncope, cardiac arrhythmias or convulsions, singly or together, have been reported in the world literature. A further case is described and the clinical features of these thirty-three are reviewed. It is recommended that treatment should be undertaken as a matter of urgency. In the first place, Carbamezapine, with often the addition of Atropine, may prove effective. However, surgical intervention appears to give a better chance of permanent relief. Four alternative methods of surgery are discussed and the cervical or the intracranial approach recommended. Surgery should not be delayed in patients who fail to respond to medical treatment or in whom recurrence of symptoms occurs.

Adult↗
PubMed1975

Sudden deafness following chromic acid application to a perforation of the tympanic membrane.

It is current practice in the treatment of many ear diseases to instil locally into the ear potentially ototoxic agents. It is now becoming increasingly clear that some of these agents may pass from the middle to the inner ear despite the presence of intact labyrinthine windows and hence produce deafness. This paper reports a case of severe sensorineural deafness which developed following the application of chromic acid to a perforation of the tympanic membrane--a hitherto unrecognized complication. Therefore, the risks outlined above should be carefully considered prior to local therapy with any such agents and they should be applied with extreme caution.

Adult↗