Search PubMed⌕ Search

Biomedical subjects

S J Chadwick

Publications and source records attributed to S J Chadwick.

31 records · Page 2Linked to original sources
PubMed1986

Plasma fibronectin and complement activation in coronary bypass surgery.

In patients with severe sepsis, plasma fibronectin concentrations are reduced and complement is activated. It is not known whether complement activation interferes with plasma fibronectin. Cardiopulmonary bypass is known to activate complement. We have therefore used this operation to study the effect of complement activation on plasma fibronectin in the absence of sepsis. After 15 min of bypass the percentage changes of plasma fibronectin and haematocrit were similar (65.9 +/- s.e.m. 4.8 and 67.0 per cent +/- s.e.m. 2.3, respectively), but the changes in C3 and C5 (58.4 +/- s.e.m. 4.8 per cent and 52.5 per cent +/- s.e.m. 2.1) were significantly greater than those of the haematocrit, indicating complement consumption. During the first 60 min of bypass there was a significant increase in the neutrophil count which is compatible with complement activation. It is unlikely that complement activation alone, in the absence of sepsis, contributes to the reduction of plasma fibronectin concentrations.

Adult↗
PubMed1986

Changes in plasma fibronectin during acute nutritional deprivation in healthy human subjects.

1. Plasma fibronectin, a glycoprotein, is an opsonin of the reticuloendothelial system. 2. In ten healthy volunteers starved for 4.5 d, daily measurements showed a rapid reduction in plasma fibronectin, no alteration in either C3 or plasma transferrin and, at the end of the starvation period, an elevated serum albumin. 3. On refeeding, plasma fibronectin rapidly returned to its prestarvation level but plasma transferrin was significantly reduced and did not recover by the end of the study. 4. Changes in plasma fibronectin may be a sensitive index of nutritional status. The reduction of plasma fibronectin in short-term starvation may compromise host defence tolerance of injury and sepsis.

Adult↗
PubMed1986

Thyroidectomy for life threatening giant familial goitre.

Urgent thyroidectomy for giant multinodular goitre causing airway obstruction was necessary in the mater familias of a family with a high prevalence of non-endemic goitre. Post operative complications are briefly discussed. Family screening revealed a 100% incidence of nodular goitre in eight first generation descendants with hyperthyroidism in one. A euthyroid pattern was found in 6 of these, as well as in 5 of 19 second generation descendants tested. In two of the first generation descendants dyshormonogenesis was excluded as an aetiological factor by the perchlorate discharge test.

Aged↗
PubMed1985

Management of splenic trauma: the Durban experience.

In a retrospective survey of splenic trauma managed at a teaching hospital, the data of 127 patients during a 2 year period have been analysed. Splenic conservation was achieved in 47 laparotomies (38.8 per cent). Six patients with blunt abdominal trauma (4.7 per cent of all patients) were managed non-operatively. Splenic conservation by suture with or without packing with omentum or oxidized cellulose was successful in 27 out of 37 attempts. Failure of this technique was easily recognized during laparotomy and no patient required re-operation for continued splenic bleeding after splenorrhaphy. There was no significant difference between successful conservation of the spleen at laparotomy of patients below the median age (28 years) and older patients. Wound sepsis was increased after splenectomy (P less than 0.05). Splenic conservation is not appropriate for all types of splenic injury. Where conservation is not possible splenectomy and re-implantation is recommended.

Adolescent↗
PubMed1985

Detection of reticulo-endothelial blockade with low-dose test agent.

Blood clearance and organ extraction of a low-dose reticulo-endothelial test agent, technetium labelled tin colloid (TTC), was measured in groups of rabbits pretreated with reticulo-endothelial blocking agents. Electron microscopy and ultrastructure analysis confirmed that Kupffer cells extracted TTC. Pretreatment with silica caused reduced Kupffer cell uptake and spillover of TTC into the spleen. Pretreatment with sheep red cells caused reduced Kupffer cell uptake and reduced splenic uptake but anti-fibronectin caused only reduced splenic uptake of TTC. TTC is a suitable agent to detect alteration of reticulo-endothelial function.

Animals↗
PubMed1984

Plasma fibronectin and complement in surgical patients.

Plasma fibronectin and a fragment of the third component of complement (C3b) are both opsonins of the reticulo-endothelial system. Twenty patients undergoing uncomplicated gastro-intestinal surgery were studied. There was a significant reduction in plasma fibronectin and total haemolytic complement, but not C3, in the early postoperative period (days 1 to 3). In six surgical patients critically ill with severe sepsis both plasma fibronectin concentrations and C3 concentration were reduced significantly when compared with the early postoperative period of uncomplicated surgery. In addition, in the critically ill patients, direct evidence of complement activation was demonstrated. These studies show a transient reduction of humoral host defence mechanisms following surgery which may be permissive to bacteraemia and complement activation.

Adult↗
PubMed1979

Parotid fistula: current management.

The most common cause of parotid fistula is trauma. Other causes include operative complications, infection, and malignancy. In the acute phase of ductal injury, primary reconstruction, if possible, is the treatment of choice. Acute parenchymal injury is treated by tight closure and expectancy. When diverting or flow-blocking measures fail to correct chronic ductal fistula, the treatment of choice for this situation as well as for chronic parenchymal fistula may be tympanic neurectomy, which can be done under local anesthesia, is associated with low morbidity, is relatively uncomplicated and has given excellent results to date in our hands.

Humans↗
PubMedDate not supplied

Can malt whisky be discriminated from blended whisky? The proof. A modification of Sir Ronald Fisher's hypothetical tea tasting experiment.

A modified version of Fisher's tea tasting experiment was performed to test the confident assertions of some members of an academic surgical unit that they could easily distinguish malt from blend whisky. Eight male volunteers from the unit, divided into regular and inexperienced whisky drinkers, were blindfolded and given a glass of each of six whiskies. The whiskies included three malts and three blends, and each subject tasted each whisky six times. They were asked whether the whisky was malt or blended, whether they could identify the distillery, and whether they liked it (ranked on a nine-point scale). The four regular whisky drinkers identified the whiskies as malts 57 times, as blends 84 times, and did not know three times; the inexperienced drinkers identified them as malts 64 times, as blends 79 times, and did not know on one occasion. The regular drinkers correctly identified the malts 36 times and the blends 48 times, and the inexperienced drinkers correctly identified malts 30 times and blends 40 times. Statistical analysis of the data suggested that within the unit malt whisky could not be distinguished from blended whisky and that experience did not alter powers of discrimination. A surgeon with no discriminatory prowess at all could be expected to achieve complete discrimination of malt from blend whisky once in 2 occasions. These results suggest that, although "uisgebeatha" has unique properties, the inexpert drinker should choose his whisky to suit his taste and pocket and not his self image.

Alcoholic Beverages↗
PubMedDate not supplied

Routine use of ultrasound 24 hours before laparoscopic cholecystectomy can predict the need for intraoperative cholangiogram: results of a 12-month prospective audit.

Intraoperative cholangiograms and exploration of the common bile duct (CBD) during laparoscopic cholecystectomy are technically more demanding than during open cholecystectomy. This has led to many surgeons using a selective policy for cholangiography. In this study we prospectively assessed whether biliary ultrasound (CBD diameter > or = 6 mm) or one or more abnormal liver function tests (LFTs) performed in the 24 hours preoperatively could predict the need for cholangiography. Forty-five patients were studied (14 male, 31 female), mean age 47.8 years. All patients with one or both tests abnormal preoperatively (19 patients) underwent intraoperative cholangiograms. Seven CBD stones were identified (16%). There was no evidence of CBD stones in patients not undergoing cholangiography at a median follow-up of 18 months. In patients with stones, three underwent open CBD exploration, and four underwent endoscopic retrograde choledochopancreatography (ERCP) and sphincterotomy in the early postoperative period without complications. CBD diameter > or = 6 mm is a useful predictor of CBD stones. These may be treated successfully by postoperative ERCP.

Adult↗