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Biomedical subjects

W R Stewart

Publications and source records attributed to W R Stewart.

At least 37 records · Page 2Linked to original sources
PubMed1988

A new silicone-prosthesis in the modified Thiersch operation.

Experience with a new silicone prosthesis in the modified Thiersch operation for rectal procidentia in 16 extremely poor-risk patients is presented. The technique of implantation, structural details of the prosthesis, and the clinical results are described. The use of a new silicone prosthesis in the modified Thiersch procedure is a viable alternative in this group of patients. Surgical technique is a primary determining factor in preventing complications.

Humans↗
PubMed1987

Effect of barium meals on gastric electromechanical activity in man. A fluoroscopic-electrogastrographic study.

UNLABELLED: The relationship between the cutaneously recorded electrogastrogram (EGG) and gastric contractions in man is unclear. We investigated: (1) the relationship between the electrogastrogram (EGG) signals and gastric contractions elicited by barium meals and (2) the effects of barium meals on frequency and amplitude of EGG signals. As documented by fluoroscopy in four healthy subjects, barium meals stimulated three per minute gastric peristalsis which corresponded with simultaneously recorded three cycle per minute (cpm) EGG waves. Eighteen other healthy volunteers ingested 45% (w/v) or 60% barium suspensions. As determined by Fourier analysis, the dominant EGG frequency before barium was 3 cpm in 16 subjects; two subjects had no distinct frequency peaks. After barium ingestion, the mean amplitude or power at 3 cpm and 1 cpm increased, but the increase was significant only after 45% barium. IN CONCLUSION: (1) individual EGG waves after barium reflect gastric peristaltic sequences, which are reflected in increases in amplitude or power of 3 cpm EGG activity; (2) density or viscosity of the barium meal affects the gastric myoelectric response; and (3) mechanical correlates of 1 cpm EEG activity are unknown.

Adolescent↗
PubMed1987

The efficacy of barium-enema examinations in patients with anorectal disease.

This retrospective study examines the value of an air contrast barium enema examination in detecting proximal neoplasia in the patient presenting with benign anorectal disease as determined by history, physical examination, rigid, and flexible sigmoidoscopy. In 428 of these patients, the roentgenographic studies showed proximal colonic cancer or polyps in less than 1 percent of patients reviewed. In addition, a review of 402 patients with known colon and rectal cancer were surveyed using the same criteria for diagnosis, and less than 1 percent were misinterpreted as having benign anorectal disease.

Adult↗
PubMed1987

Urecholine prophylaxis for urinary retention in anorectal surgery.

A randomized prospective trial with 108 patients undergoing anorectal surgery was conducted comparing the use of Urecholine orally or subcutaneously to no treatment controls. There was no difference in postoperative urinary retention rates and caudal or general anesthesia, nor was there an earlier postoperative bowel movement with Urecholine. The volume of intravenous fluids significantly affected retention rates.

Anal Canal↗
PubMed1987

Initial clinical experience with a biofragmentable ring for sutureless bowel anastomosis.

Twenty-seven patients have had bowel anastomoses with a biofragmentable ring for sutureless bowel anastomosis. There were no complications associated with the anastomotic technique. One patient developed an ischemic stricture on the proximal side of the anastomosis due to compromised circulation. There was no leakage. Technical factors regarding the BAR anastomosis are described. A properly placed purse-string suture is of primary importance. Advantages appear to be a more rapid and easy anastomosis with better healing.

Aged↗
PubMed1987

Spectral analysis of tachygastria recorded during motion sickness.

The purpose of the present experiment was to study frequency changes in gastric myoelectric activity of healthy human subjects and the development of symptoms of motion sickness as brought about by vection or illusory self-motion. Fifteen fasted healthy human subjects were seated inside a circular vection drum, the rotation of which produces visual signals of self-motion that are in conflict with vestibular signals (i.e., mismatched sensory input). An electrogastrogram was obtained for three 15-min. periods: baseline, rotation, and after drum rotation stopped. Respiration, symptoms volunteered by subjects, and a continuous measure of intensity of symptoms were recorded. Five subjects showed a continuation of normal 3-cycles/min. activity during drum rotation and reported no symptoms of motion sickness. Ten subjects showed a shift of their dominant gastric frequency from 3 cycles/min. to 4-9 cycles/min. during drum rotation and reported symptoms of motion sickness. Running spectral analysis revealed a close correspondence over time between tachygastria and reports of symptoms of motion sickness.

Adult↗
PubMed1985

Prevention of colostomy in partial colonic obstruction by intraoperative rectal tube irrigation.

Four patients with partial obstruction of the colon, in whom adequate standard preparation for colonic resection was not possible, are presented. Clinically, these patients did not show sufficient signs of obstruction to require a preliminary colostomy. A technique of quarantining the area of tumor resection from the abdominal cavity is described, allowing for adequate preparation of the colon lumen at the site of anastomosis. After completion of the anastomosis, a large caliber (36 French) colonic tube is inserted, per rectum, through the anastomosis and the proximal colon irrigated with Betadine solution adequately emptying and sterilizing the lumen of the bowel to allow for primary anastomosis without a protective colostomy. The criteria for selection of patients for this technique are discussed. No complications, of significance, ensued. This method of intraoperative rectal tube irrigation, for prevention of colostomy in partial colonic obstruction, is safe when properly performed in the appropriate patient.

Adult↗
PubMed1985

Mucosal advancement in the treatment of anal fistula.

One hundred eighty-nine patients with anal fistula treated within an eight-month to seven-year period by anal fistulectomy and rectal mucosal advancement are presented. An 80 percent follow-up revealed a 90 percent asymptomatic group and a ten percent group who had minor symptoms. Eight percent of the symptomatic patients had minor soiling; 7 percent were incontinent for gas, and 6 percent were incontinent for loose stools. No patient was incontinent for solid feces. There was a 1.5 percent rate of recurrent anal fistula comparable to other techniques.

Adolescent↗
PubMed1985

Tachygastria and motion sickness.

Cutaneously-recorded electrogastrograms (EGGs) were obtained from 21 healthy volunteers who were seated within a drum, the rotation of which produced vection or illusory self-motion. Fourteen subjects developed symptoms of motion sickness during vection and in each the EGG frequency shifted from the normal 3 cpm to 5-8 cpm, tachygastria, an abnormal pattern. In 6 of 7 asymptomatic subjects, the 3 cpm EGG pattern was unchanged during vection. It was concluded that illusory self-motion produces tachygastria and motion sickness in susceptible subjects.

Adolescent↗
PubMed1983

Survival after colonic perforation during barium-enema examination. Modified radical surgical debridement.

Four of five patients survived perforation of the colon incidental to barium-enema examination, while the other survived without sequela of infection until hemiplegia and pneumonia supervened two and 36 days, respectively, postoperatively. It is postulated that adequate intravenous fluids, early operation, with complete cleansing by antibiotic irrigation and mechanical debridement of the abdominal cavity, along with excision of the perforated segment of bowel with establishment of an end colostomy or ileostomy and distal mucous fistula, if possible, are keys to survival in these patients. Triple antibiotics, using ampicillin, gentamicin, and clindamycin, or metronidazole, should be administered in all patients as soon as the diagnosis is made, and continued postoperatively as indicated until there is no evidence of infection. An intraluminal intestinal tube, for stichless plication of the small bowel, may be helpful in some patients. A stomacone should be used for a barium enema through a colostomy stoma. Care should be exercised in performing barium contrast studies in patients with inflammatory bowel disease.

Adult↗
PubMed1980

Viloxazine in the treatment of depressive neurosis: a controlled clinical study with doxepin and placebo.

In a four-week, double-blind, clinical trial thirty-one patients with depressive neurosis were treated with viloxazine, doxepin, or placebo. There were no differences among the three groups in therapeutic effects. Many depressed out-patients improve on placebo. Viloxazine hydrochloride is one of a series of compounds developed to explore the central nervous system activity of the aryloxypropanolamine type of beta-adreno-receptor antagonists. Initial clinical study support the hypothesis that viloxazine has antidepressant properties in man (Bayliss et al, 1974; Bereen, 1973; Pichot et al., 1975; Tsegos and Ekdawi, 1974).

Adult↗
PubMed1978

Skeletal metastases of melanoma.

Sixteen hundred and seventy-seven melanoma patients were treated at Duke University Medical Center from 1956 to 1976. Osseous metastases were more common than previously reported and occurred in 116 patients (6.9 per cent), most often in the axial skeleton. Diagnosis was made by roentgenogram, bone scan, or both in the symptomatic patient. Seventy-five patients sustained pathological fractures, most of which were successfully treated conservatively. Nine of the ten patients with neurological symptoms were improved by laminectomy. The grave prognosis for melanoma patients with osseous metastases (mean survival, 3.6 months) led to conservatism even for an impending pathological fracture. Unstable pathological fractures of long bones were treated by internal fixation and irradiation.

Adult↗
PubMed1978

Hand metastasis from melanoma: a case study.

Metastases to the hand are rare. Most frequently they result from carcinomas of the lung, breast or kidney. This is a case report of a rare peripheral metastatic lesion in a 24-year-old man with melanoma. There are no previously reported hand metastases from melanoma. Because of the extremely poor prognosis for patients with osseous metastases from melanoma, treatment should be palliative.

Adult↗