5 results on '"Young, H. L"'
Search Results
2. Protective effect of RibCys following high-dose irradiation of the rectosigmoid.
- Author
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Rowe JK, Zera RT, Madoff RD, Fink AS, Roberts JC, Johnston GR, Feeney DA, Young HL, and Bubrick MP
- Subjects
- Anastomosis, Surgical adverse effects, Animals, Cobalt Radioisotopes, Colon, Sigmoid metabolism, Colon, Sigmoid pathology, Colon, Sigmoid surgery, Cysteine analogs & derivatives, Male, Oxygen Consumption drug effects, Oxygen Consumption radiation effects, Pressure, Prodrugs administration & dosage, Radiation Dosage, Radiation Injuries, Experimental etiology, Radiation Injuries, Experimental metabolism, Radiation Injuries, Experimental pathology, Radiation-Protective Agents administration & dosage, Radioisotope Teletherapy, Rectum metabolism, Rectum pathology, Rectum surgery, Rupture, Swine, Thiazoles administration & dosage, Thiazolidines, Colon, Sigmoid drug effects, Colon, Sigmoid radiation effects, Prodrugs pharmacology, Radiation-Protective Agents pharmacology, Rectum drug effects, Rectum radiation effects, Thiazoles pharmacology
- Abstract
Unlabelled: Ribose-cysteine (RibCys) is a prodrug of L-cysteine that stimulates glutathione biosynthesis. Increased glutathione levels have been shown to have a protective effect against radiation-induced injury and oxidative stress. Surface oximetry has previously been used successfully to predict anastomotic leakage., Purpose: The following study was done to evaluate the protective effect of RibCys and the predictive value of PtO2 determinations in a swine model., Methods: Domestic swine were divided into three groups: Group A served as a nonradiated control; Group B received 6,000 to 6,500 rad to the rectosigmoid; and Group C received RibCys (1 g/kg) prior to receiving 6,000 to 6,500 rad. Radiated animals and controls underwent rectosigmoid resection after a three-week rest period. Intraoperative anastomotic PtO2 was checked with a modified Clark electrode. Anastomoses were evaluated radiographically at three and seven days; animals were sacrificed, and bursting strength was recorded at 10 days., Results: Mean bursting pressures were 243.8 +/- 59.4, 199.5 +/- 37.8, and 209.5 +/- 54.9 mmHg (NS) for Groups A, B, and C, respectively. Anastomotic PtO2 ranged from 19 to 98 mmHg and could not be correlated with anastomotic leaks or bursting pressure. There were 11/15 radiation-related deaths and leaks (eight deaths and three leaks) in the radiated group and 4/12 radiation-related deaths and leaks (three deaths and one leak) in the group receiving radiation and RibCys (P < 0.04)., Conclusions: 1) RibCys protected animals against radiation-related deaths and anastomotic leaks following high doses of pelvic irradiation; 2) anastomotic PtO2 levels did not correlate with anastomotic healing in this model.
- Published
- 1993
- Full Text
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3. Tissue oxygen tension as a predictor of colonic anastomotic healing.
- Author
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Sheridan WG, Lowndes RH, and Young HL
- Subjects
- Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Female, Humans, Male, Middle Aged, Colectomy, Colon metabolism, Oxygen metabolism, Wound Healing
- Abstract
Inadequate blood flow causing tissue hypoxia can result in failure of anastomotic healing. Tissue oxygen tension (ptO2) measurement has been used to predict anastomotic leakage in animals, but its use in humans has not been described previously. A Clark-type oxygen electrode was used to measure ptO2 on the colon of 50 patients undergoing colonic resection and anastomosis. Baseline ptO2 levels were lowest on the descending colon (31.8 +/- 7.4 mmHg, mean +/- SD) and tended to increase at all sites with increasing arterial paO2 (r greater than .76, P less than .001). Perianastomotic ptO2 levels were predictive of subsequent anastomotic leakage when they were less than either 20 mmHg; 50 percent of the preresection ptO2; 15 percent of the arterial paO2; or 40 percent of the ptO2 at a control site (ileum). It is concluded that perioperative ptO2 measurements are of value in the prediction of anastomotic leakage.
- Published
- 1987
- Full Text
- View/download PDF
4. Spleen size in patients with inflammatory bowel disease. Does it have any clinical significance?
- Author
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Pereira JL, Hughes LE, and Young HL
- Subjects
- Body Height, Body Weight, Colitis, Ulcerative surgery, Crohn Disease surgery, Female, Humans, Male, Postoperative Complications etiology, Prognosis, Prospective Studies, Recurrence, Reference Values, Sex Factors, Spleen anatomy & histology, Colitis, Ulcerative pathology, Crohn Disease pathology, Spleen pathology
- Abstract
The finding that splenic atrophy is associated with a high complication rate in colitis has led to a long-term, prospective study of spleen size in inflammatory bowel disease. The spleen has been measured in 116 patients undergoing laparotomy for inflammatory bowel disease--80 Crohn's disease and 36 ulcerative colitis--from 1975 to 1985. Small spleen size, of lesser degree than that of classic splenic atrophy, is associated with presurgery disease complications as well as infective problems after surgery. Spleen size was not related to site or extent of disease, or to recurrence, but the wide range of spleen size seen in inflammatory bowel disease, comparable to that seen in malignancy suggests that more sophisticated tests of splenic function might show a closer correlation with disease patterns.
- Published
- 1987
- Full Text
- View/download PDF
5. A multicenter trial of the use of the proteolytic enzyme inhibitor aprotinin in colorectal surgery.
- Author
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Sheridan WG, Shandall AA, Alexander-Williams J, Keighley MR, Boulos PB, and Young HL
- Subjects
- Anastomosis, Surgical, Aprotinin therapeutic use, Clinical Trials as Topic, Double-Blind Method, Female, Humans, Infusions, Intravenous, Male, Multicenter Studies as Topic, Postoperative Complications prevention & control, Prospective Studies, Random Allocation, Wound Healing drug effects, Aprotinin administration & dosage, Colectomy
- Abstract
Animal studies have demonstrated the value of the proteolytic enzyme inhibitor, aprotinin, in reducing collagen breakdown and improving the healing of experimental colonic anastomoses. A double-blind, multicenter, prospective trial has evaluated the use of aprotinin in the prevention of anastomotic leakage in patients. Two hundred sixteen patients undergoing colonic resection and anastomosis were studied. Patients were randomized to receive either aprotinin or placebo intravenously, peroperatively, and for the first three postoperative days. Anastomotic integrity was assessed clinically and by Hypaque enema on the tenth postoperative day. Although the use of aprotinin was not associated with a significant overall decrease in anastomotic leakage rates, in 95 patients undergoing anterior resection, leakage rates in those receiving aprotinin (clinical 10.8 percent; radiologic 32.4 percent) were lower than in those receiving placebo (17.2 percent and 43.1 percent, respectively). An apparent adverse association was noted, however, in patients undergoing left hemicolectomy or sigmoid colectomy who received aprotinin.
- Published
- 1989
- Full Text
- View/download PDF
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