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Biomedical subjects

W C Johnson

Publications and source records attributed to W C Johnson.

At least 181 records · Page 10Linked to original sources
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↗
PubMed1979

A 10-year experience with topical mechlorethamine for mycosis fungoides: comparison with patients treated by total-skin electron-beam radiation therapy.

A group of 243 patients with mycosis fungoides (MF) received treatment with topical applications of dilute aqueous solutions of mechlorethamine and/or systemic chemotherapy over the past 10 years. The likelihood of a complete and relapse-free remission and survival was found to correlate inversely to the magnitude of disease as denoted by a simple staging system. Although disease-free intervals of greater than 3 years have occurred thus far in 32 (13%) patients, the permanency of these remissions and the curability of disease remain uncertain because of the variability of disease progression characteristic of MF. Comparison of treatment results with those published on a large group of patients treated with total-skin electron-beam radiation therapy indicates that the chemotherapeutic approach to the treatment of MF is equally effective in promoting survival.

Administration, Topical↗
PubMed1979

Preliminary experience with expanded polytetrafluoroethylene grafts.

This early clinical experience of members of the New England Society for Vascular Surgery with expanded polytetrafluoroethylene (PTFE) grafts was evaluated. Questionnaires were distributed to 52 active members of the Society and 32 answers were received. A total of 186 graft insertions were evaluated, of which 112 were positioned in the lower limb; 106 grafts were inserted for libm salvage. Patency rates for femoral-popliteal bypass grafts were determined by life-table analysis. Our results show a 6 to 9 month cumulative patency rate of 91% for PTFE grafts with a popliteal anastomosis above the knee, and a 52% patency rate for below-knee anastomosis. Two complications, aneurysmal dilatation and graft sepsis, were noted in this series. The new graft material exhibits an early patency rate higher than bovine or Dacron grafts which warrants long-term use and evaluation.

Aneurysm↗
PubMed1978

Doppler ankle systolic blood pressure. Prognostic value in vein bypass grafts of the lower extremity.

The prognostic value of Doppler-derived ankle systolic pressure indices for predicting the patency of vein bypass grafts in the lower extremity was analyzed in 126 vein bypass grafts performed for limb salvage. Early or late graft failure was not found to correlate with the preoperative ankle systolic pressure index (ASPI). Intraoperative blood flow measurements did not correlate with the preoperative ASPI. An intraoperative graft flow of less than 0.7 at 24 to 48 hours, or an increase in ASPI of less than 0.4 were prognostic signs of early vein graft failure.

Adult↗
PubMed1978

Esophagogastric variceal hemorrhage: its treatment by percutaneous transephatic coronary vein occlusion.

The angiographic technique percutaneous transhepatic coronary vein occlusion was used to treat esophagogastric variceal bleeding in 38 patients. There were two categories of patients: those actively bleeding who had not been controlled by continuous vasopressin infusion and/or Blakemore tube tamponade, and those with portal hypertension who were not actively bleeding at the time of transhepatic portal venography but who were at high risk for recurrent variceal hemorrhage. Coronary vein occlusion was achieved in 33 patients by (1) metal clip and cotton devices(one); (2) balloon catheter occlusion (two); (3) heat-treated autogenous clot and powdered absorbable gelatin sponge (Gelfoam) (13); and (4) Gelfoam strips soaked in sodium tetradecyl sulfate (17). Percutaneous coronary vein occlusion was effective in controlling 81% of the patients with actively bleeding varices. In patients who were not actively bleeding, percutaneous transhepatic coronary vein occlusion seemed to afford good protection for recurrent variceal hemorrhage.

Coronary Vessels↗
PubMed1978

Observations on the medical efficacy of computed tomography of the chest and abdomen.

In a retrospective study of 687 computed tomographic (CT) examinations of the chest and abdomen performed over a 1 year period, 16% of the examinations produced information not otherwise available which altered patient diagnosis, prognosis, or therapy. Sixteen thoracotomies and 18 laparotomies were avoided as a result of information available only from CT examinations. CT was of particular value in the evaluation of mediastinal masses, in the assessment of suspected or proven lung cancer, and in the evaluation of pleural and extrapleural masses. It was of notable clinical value in evaluating patients with intraabdominal abscesses, pancreatic disease, staging of malignancies for radiation therapy and surgery, and excluding the presence of suspected masses.

Abdomen↗
PubMed1978

Pitfalls of transhepatic portal venography and therapeutic coronary vein occlusion.

Coronary vein occlusions via transhepatic portography for bleeding esophageal varices was attempted in 24 patients. Problems occurred that either prevented the attempt or resulted in less than adequate occlusion. These included blood flow in the left gastric (coronary) vein toward the liver due to occluded or stenotic splenorenal shunts, spontaneous left gastric vein to inferior vena cava shunts, and failure of powdered Gelfoam and heat-treated autogenous clot to cause permanent occlusion. Of 89 total transhepatic portographies, 65 for diagnosis and 24 for occlusion, major complications occurred in two.

Catheterization↗
PubMed1978

Smooth muscle hamartoma associated with Becker's nevus.

Two cases of smooth muscle hamartoma with Becker's nevus are reported. Clinically and histologically the lesions resemble Becker's nevi with the exception that on histologic examination a hamartomatous proliferation of smooth muscle is prominent.

Adolescent↗
PubMed1977

Predictability of healing of ischemic leg ulcers by radioisotopic and Doppler ultrasonic examination.

In a prospective study of twenty-six patients with ischemic ulcerations of the lower extremity, the predictive reliability with regard to spontaneous wound healing of diabetes, pedal pulses, ankle blood pressure (ABP) as measured by doppler ultrasound, and "leg ulcer scan" as performed by the intra-arterial injection of radioactive albumin was evaluated. The results suggest that only the leg ulcer scan is significantly reliable in predicting the likelihood of spontaneous healing. The following format for the evaluation of the ischemic leg ulcer is therefore suggested: (1) If pedal pulses are present, a three week trial of conservative therapy is indicated before further evaluation. (2) If the doppler ABP is 50 mm Hg or less, the ulcer will not heal spontaneously. (3) Leg ulcer scan is indicated: (a) in the absence of pedal pulses if ABP is less than 50 mm Hg; (b) in the presence of pedal pulses if there is no evidence of spontaneous healing after three weeks of conservative therapy.

Humans↗
PubMed1977

Predicting circular-dichroism spectra of pyranoid monosaccharides.

Fragment spectra are presented that may be summed algebraically to predict the vacuum-ultraviolet, circular-dichroism spectra of certain pyranoid monosaccharides. It is shown that a limited number of these fragment spectra can be used to calculate a larger number of circular-dichroism spectra that had been measured previously. Furthermore, the circular-dichroism spectra of a number of other monosaccharides, whose spectra have not yet been measured, can be predicted.

Circular Dichroism↗
PubMed1977

Is axillo-bilateral femoral graft an effective substitute for aortic-bilateral iliac/femoral graft?: an analysis of ten years experience.

During the past ten years, 88 aorto-bilateral iliac/femoral grafts and 56 axillo-bilateral femoral grafts were electively performed for occlusive disease of the abdominal aorta or iliac vessels. The results of this retrospective study indicate that the axillo-bilateral femoral graft, although performed in an older population and more frequently for limb salvage, has a lower operative mortality than does conventional aortic bypass surgery with similar patency (76%) and survival (67%) at five years. However, axillo femoral grafting requires more frequent remedial surgery to obtain long term patency.

Amputation, Surgical↗
PubMed1977

Control of bleeding varices by vasopressin: a prospective randomized study.

From July 1975 to November 1976 25 patients with bleeding esophagogastric varices documented by endoscopy who failed to respond to conservative medical treatment were transferred to the Surgical Service. These patients, who were mainly Child's Class "C" alcoholic cirrhotic patients, were treated with vasopressin infused continuously using a standardized dose into either a peripheral vein or the superior mesenteric artery (SMA) according to a predetermined randomization. No significant difference in efficacy for control of bleeding (average rate = 56%) related to route of administration was found. Because catheter-related complications in the SMA group were significantly greater, we concluded that the method of choice in vasopressin treatment of esophagogastric variceal bleeding is a continuous infusion by way of a peripheral vein.

Catheterization↗
PubMed1977

A comparison of the late patency rates of axillobilateral femoral and axillounilateral femoral grafts.

A total of 130 axillofemoral grafts were peformed in 120 patients from 1966 to present; 66 were axillobilateral femoral moral and 64 were axillounilateral femoral grafts. The average patient age was 66 years. The indications for operation were occlusive disease with rest pain or gangrene in 102 patients, severe claudication four, and bypass of a thoracic aneurysm in one. The one month operative mortality rate was 8 percent (ten patients). Four deaths occurred in elderly patients operated upon as emergencies with acute aortic occlusion. In the 126 elective cases, there were six postoperative deaths (4.7 percent). Twenty thrombectomies were performed in 15 axillobilateral femoral grafts of which 15 (75 percent) were successful. In the unilateral grafts there were 25 thrombectomies in 22 grafts, of which only eight (32 percent) were successful. The 5 year patency rate by the life-table method was 74 percent for axillobilateral femoral grafts and 37 percent for axillounilateral femoral grafts. This difference in patency rates is statistically significant (p < 0.01). Average flow measured by electromagnetic flow meter in six axillobilateral femoral grafts was 621 c.c. per minute and in 11 unilateral femoral grafts was 273 c.c. per minute. We attribute the higher patency rate in axillobilateral femoral grafts to this increased flow. These data indicate that axillobilateral femoral grafts may be performed with anticipation of a 5 year patency rate comparable to that with conventional aortoiliac reconstruction and that axillobilateral femoral grafts should be performed in preference to axillounilateral femoral grafts in poor-risk patients requiring extra-anatomic bypass for aortoiliac occlusive disease.

Aged↗
PubMed1977

Topical chemotherapy and immunotherapy of mycosis fungoides: intermediate-term results.

A group of 220 patients with mycosis fungoides (MF) and other lymphomatous diseases was treated with sustained topical applications of dilute aqueous solutions of mechlorethamine hydrochloride for intervals ranging in excess of seven years. Response to treatment, immunologic responsiveness, and subsequent course and survival were inversely related to magnitude of disease at time of starting treatment. Relapses were common and in most instances were related to failure to maintenance of topical therapy rather than to drug resistance. In selected patients topical therapy with an analog of mechlorethamine (nor-mechlorethamine) and with topical immunogenic agents provided additional improvement.

Administration, Topical↗