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Biomedical subjects

T T White

Publications and source records attributed to T T White.

At least 55 records · Page 3Linked to original sources
PubMed1976

Operative and endoscopic pancreatography in the diagnosis of pancreatic cancer.

X-rays of the pancreatic duct can now be obtained by a nonoperative endoscopic approach (endoscopic retrograde cholangiopancreatography-ERCP). After more than 2 years experience we have found that the pancreatic duct can be visualized in 85 to 90% of patients. This test is used to detect pancreatic carcinoma in the symptomatic patient and in searching for an operative pancreatic lesion in a patient with known recurrent or chronic pancreatitis. Many of these patients have pain or a transiently elevated amylase; a few have steatorrhea or abnormalities of the duodenal sweep on barium meal. Stenosis or obstruction of the main pancreatic duct with or without proximal duct dilation are the characteristic abnormalities noted in pancreatic carcinoma. A rare pancreatic tumor which is not in juxtaposition with the duct will have a normal pancreatogram although the common duct may be obstructed by cholangiography as it passes through the head of the pancreas. In patients with chronic pancreatitis it may be difficult to differentiate an inflammatory from a neoplastic stricture by either operative or endoscopic pancreatography. In the future, cytologic and biochemical examination of the pancreatic secretions obtained at ERCP may increase the accuracy of diagnosing carcinoma.

Adult↗
PubMed1976

Sequestrectomy and hyperalimentation in the treatment of hemorrhagic pancreatitis.

Surgical treatment has been used in those patients with hemorrhagic pancreatitis who deteriorate after several days of intensive medical therapy, or in those patients in whom the diagnosis cannot be established early in the course of treatment. Initial therapy consisted of: cholecystostomy or T-tube drainage in those patients who have gallstones, jaundice, or distended biliary tree; gastrostomy for prolonged gastric decompression; jejunostomy to provide a portal for enteroalimentation; and appropriate soft rubber drainage of the pancreatic bed as a simple, safe, and effective means of treating severe hemorrhagic pancreatitis. Adjunctive daily hyperalimentation and later sequestrectomy of necrotic pancreatic tissue provided a mortality of 20 per cent and complete rehabilitation of sixteen of thirty patients so treated. Delaying the initial approach to necrotic pancreas allows precise delineation of necrotic material so that sequestrectomy, leaving behind normal pancreas, can be carried out to avoid exocrine and endocrine deficiencies after the acute episode has passed.

Acute Disease↗
PubMed1976

A rapid method of relating protein to flow in human pancreatic secretions.

A method of obtaining linear plots of protein-flow data from human pancreatic ductal secretions is described. The protein concentration in pancreatic secretions, when related to flow rates in two individuals, gave similar regression lines, with the correlation coefficients or r = -0.97 and -0.98, respectively, and slopes m = -1.02 and -0.82.

Chronic Disease↗
PubMed1976

A demonstration that the ratios between human pancreatic enzymes can change in 4 days.

Electrophoretic studies of inactive ductal pancreatic secretions, collected on five successive days following operation, demonstrated up to 18 protein bands. Comparison of the densitometric scans on the first and fourth days was as follows: the patterns from different individuals appeared similar during the periods of slow secretion immediately following surgery, there were obvious changes in the proportions of the slower-moving enzymes between the first and fourth days; the most apparent alteration was in the trypsinogen 2 band which was markedly higher on the fourth as opposed to the first day, and during the 4th-6th days, the patterns for a given individual resembled one another, showing only minor changes among the 8-hour collections.

Amylases↗
PubMed1975

Inflammatory diseases of the pancreas.

The first attack of acute pancreatitis is best treated medically, by fasting and general supportive measures unless complications ensue or the patient does not get better. There is no specific therapy for this disease at the present time (while trypsin inhibitors have not proved to be effective, there is some question as to whenter the newer version will be valuable). Since, at least in private hospitals, the majority of patients with acute pancreatitis have gallstones, surgery in these individuals is directed primarily toward removal of the gallbladder and/or common bile duct stones, or to the drainage of cysts. Most acute cysts are small and can be treated medically. Otherwise they shouldbe drained 8-10 weeks later into the adjacent stomach...

Acute Disease↗
PubMed1973

Visceral pain.

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Abdomen↗