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Biomedical subjects

W M Thompson

Publications and source records attributed to W M Thompson.

At least 109 records · Page 6Linked to original sources
PubMed1981

Evaluation of the anode and cathode for transcatheter electrocoagulation.

The effect of changing the size and position of the anode and cathode during direct current Transcatheter Electrocoagulation (TCEC) was evaluated in dogs. The results showed that there was no difference in the time required for vessel occlusion when the size and position of the electrodes were changed. However, there were differences noted in the amount of voltage needed to maintain the constant current. Based on these results, for TCEC we recommend positioning the largest possible guidewire anode against the vessel wall. The cathode should be a highly lubricated sponge covered Bovie ground plate.

Animals↗
PubMed1981

Pancreatic abscess: importance of conventional radiology.

To determine the clinical usefulness of conventional radiographic methods in pancreatic abscess, studies from 35 patients were retrospectively evaluated. Plain films of the abdomen were obtained in 31 and showed the diagnostic finding of extraluminal gas in the pancreatic area in 18 (58%). Gastrointestinal contrast studies were done in 28 patients and confirmed the extraluminal location of abscess gas in 17 (61%). These contrast studies provided important preoperative evidence of perforation or fistula in six (21%) patients. Because of the risk of extravasation in complicated pancreatic abscesses, water soluble contrast media are recommended instead of barium. Abscess gas was shown by computed tomography (CT) in four (50%) of eight patients and sonography suggested a diagnosis in five (31%) of 16. In aggregate all radiographic methods demonstrated evidence of a pancreatic abscess in 69%. While sonography and CT are being used with increasing frequency, this experience reaffirms the value of plain film and gastrointestinal contrast studies in patients with suspected pancreatic abscess.

Abscess↗
PubMed1981

Solitary hepatic cyst and benign bile duct polyp: a heretofore unheralded association.

Solitary hepatic cysts are uncommon lesions that can produce jaundice by extrinsic compression on the extrahepatic biliary tree. In two recent cases of solitary hepatic cyst with jaundice, an intraluminal polypoid adenoma that obstructed the common hepatic duct was discovered. Concurrence of these two unusual lesions suggests that they may be associated. The importance of recognizing this association is illustrated by two case reports. In case 1, extrinsic compression by the cyst on the common hepatic duct was identified as the cause of jaundice at the initial operation. In case 2, choledocholithiasis was the initial explanation for the jaundice. In both cases, palpation and exploration of the proximal bile ducts with probes and catheters failed to discover the polyp. However, jaundice persisted postoperatively in both cases, and subsequent contrast radiography revealed an intraluminal filling defect in the common hepatic duct. In both cases, reoperation was required, and a benign bile duct polyp was discovered and excised. Thus, the presence of jaundice in a patient with a cystic hepatic mass should suggest the possibility of a concurrent bile duct polyp. Awareness of this possibility should permit recognition of such a polyp at initial operation.

Adenoma↗
PubMed1980

Vessel occlusion with transcatheter electrocoagulation.

Transcatheter intravascular electrocoagulation for therapeutic occlusion of vessels has been experimentally developed and successfully used clinically as an alternative to, and in conjunction with, more routine methods of vessel occlusion. A constant current power source and a steelguide wire anode are used for the occlusion. The subject is grounded with a standard bovie plate insulated from the skin by a highly lubricated sponge. Permanent occlusion of strategic vessels at accurately controlled sites has been achieved with little risk of embolization of non-target areas. There has been minimal damage to vessel walls, and complete occlusion has been possible despite heparinization and/or thrombocytopenia. One limitation is the inconstant ability to position the anode precisely at the desired site of occlusion. Also, a long time may be required (up to one hour) to occlude larger vessels with presently available anodes. Wider use must await refinements in development of the anode material and in its delivery system.

Arteriovenous Fistula↗
PubMed1980

Postoperative function of "free" jejunal transplants for replacement of the cervical esophagus.

The postoperative function of "free" jejunal autotransplants for replacement of the pharyngoesophagus after palliative resection was evaluated in nine patients using clinical assessment, cinefluoroscopy, manometry, and electrical studies. After an initial period of adjustment, all patients swallowed solids and liquids with minimal difficulty, gained weight appropriately and were satisfied with their operations. Cinefluoroscopy and esophageal manometry demonstrated normal function of the intact distal esophagus, which correlated with the absence of reflux symptoms. The grafts were capable of contraction in response to local distension and maintained an intrinsic myoelectrical activity. These results indicate that jejunal autotransplantation may provide excellent palliation with restoration of a near normal swallowing mechanism for patients with large resectable lesions of the pharyngoesophagus. An additional observation was that the instillation of food directly into the gastric antrum caused a change in the motor activity in the transplantd jejunum, indicating physiological hormonal control of intestinal motility.

Aged↗
PubMed1980

Esophageal carcinoma: a survey of populations at risk.

Carcinoma of the esophagus is found more commonly in association with head and neck tumors, lye stricture, achalasia, and Barrett esophagus than in the general population. Our experience with these associated entities in a population of 680 patients with carcinoma of the esophagus is reviewed. Carcinoma of the esophagus has traditionally had a very poor prognosis which continues to the present. Routine periodic use of double contrast esophagography is advocated to screen populations containing these associated high-risk entities. This may ultimately increase survival through diagnosis of earlier stages of carcinoma of the esophagus.

Adult↗
PubMed1980

Clostridium septicum infection associated with colonic carcinoma and hematologic abnormality.

Six patients with Clostridium septicum sepsis seen at Duke University Medical Center over a two-year period also had other abnormalities, consisting of hematologic disorders in 3 and colon tumors in 3. Three patients died of sepsis; 2 survived following disarticulation of the arm to control gas gangrene, while the sixth patient survived the sepsis but died of metastatic disease. When anaerobic cultures are positive for C. septicum, antibiotics should be given immediately. The high incidence of underlying colon tumor, especially in the cecum, should prompt consideration of a barium-enema examination.

Adenocarcinoma↗
PubMed1980

Hemophilus influenzae purulent pericarditis in children: diagnostic and therapeutic considerations.

Purulent pericarditis is an unusual complication of infection in infancy and has been associated with an extremely high mortality rate. Early diagnosis followed by combined antibiotic therapy and surgical drainage of the pericardium has markedly improved survival. Between APril, 1975, and February, 1979, nine patients with purulent pericarditis secondary to Hemophilus influenzae type B were treated at the Oklahoma Children's Memorial Hospital. In every case signs and symptoms of congestive heart failure were present, and a pericardial effusion was demonstrated by echocardiography and confirmed by pericardiocentesis. The organism was identified with countercurrent immunoelectrophoresis and antibiotic sensitivity determined by rapid beta lactamase assay. All patients were treated with a combination of parenteral antibiotics and open surgical drainage of the pericardium. There were no deaths and all patients demonstrated marked improvement following operation. Follow-up echocardiography revealed no evidence of pericardial effusion or signs of constriction in any patient.

Anti-Bacterial Agents↗
PubMed1980

Double contrast technique in the proximal stomach.

The double contrast technique is of particular value in the proximal stomach, where one is able to detect ulcers and masses not recognized on a conventional upper gastrointestinal series. Pseudotumors which may occur in the fundus with the conventional barium technique are readily resolved. When a lesion in the proximal stomach is suspected by conventional radiography, immediate use of double contrast radiography may confirm or better delineate the lesion. Double contrast examination of the proximal stomach may thus be used as a primary or immediate secondary procedure to increase radiologic accuracy.

Adenocarcinoma↗
PubMed1979

Computed tomography in the diagnosis of intra-abdominal abscesses.

The diagnosis of intra-abdominal abscess by radiographic means often relies on combining the results of several different imaging modalities. Computed tomography (CT) has been shown to be a safe, accurate and rapid diagnostic method of diagnosing these abscesses. Five patients with a variety of intra-abdominal abscesses are presented in whom the CT scan alone provided the correct diagnosis. The various imaging modalities available for the radiologic diagnosis of intra-abdominal abscess are described and are compared to CT diagnosis regarding their pitfalls.

Abscess↗
PubMed1979

Alimentary tract complications after renal transplantation.

A computer analysis of post renal transplantation gastrointestinal problems was performed to identify important associated clinical factors. Thirty-seven per cent of all transplant recipients developed one or more significant problems. Hemorrhage, nondiverticular intestinal perforation, and esophagitis occurred most frequently in hospitalized patients. Pancreatitis, diverticulitis, and gastroduodenal perforation occurred characteristically in long-term survivors with well functioning allografts. Eleven of 32 HLA identical recipients treated with maintenance corticosteroids during stable kidney function developed gastrointestinal disease while only one of 13 HLA identical recipients not given maintenance steroids developed a problem, which strongly suggests a causal role for steroids in the development of late complications. The association of preexisting peptic ulcer and diverticular disease with hemorrhage and perforation supports previous recommendations that documented peptic ulcer disease or diverticulitis should be corrected surgically prior to transplantation.

Adolescent↗
PubMed1979

Type II choledochal cyst: ultrasonographic appearance.

The ultrasonic findings in a rare Type II choledochal cyst are described. In patients with a right upper quadrant mass in whom the clinical, ultrasonic, or radiographic findings are atypical for other etiologies, this diagnosis should be considered.

Biliary Tract Diseases↗
PubMed1979

Vessel occlusion with transcatheter electrocoagulation: initial clinical experience.

Transcatheter electrocoagulation (TCEC) was used for vessel occlusion in combination with embolization by Gelfoam and/or Ivalon in six patients in whom other interventional or surgical techniques were considered dangerous or unfeasible. The technique was effective in decreasing or obliterating the blood supply to variously located lesions in all cases. The only complications were small skin burns in one patient and a small ulceration of the upper lip in another.

Adult↗
PubMed1979

Intraabdominal abscess: current concepts in radiologic evaluation.

Forty patients with suspected abdominal abscess had computed tomography (CT) and plain film examinations; 15 also had ultrasound study. CT was found to be the most consistently accurate examination, both for the detection of abscess and evaluation of its extent. Ultrasound was positive in a high percentage of cases in which it was used. Although plain films correctly suggested the presence of an abscess in over half the proven cases, confirmatory evidence from CT or ultrasound was often required to persuade clinicians of the presence of an abscess and to provide detailed information regarding its extent and configuration.

Abscess↗