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Biomedical subjects

B M Rodgers

Publications and source records attributed to B M Rodgers.

At least 109 records · Page 6Linked to original sources
PubMed1979

Thoracoscopy: new method of early diagnosis of cardiac herniation.

Cardiac herniation is an uncommon but rapidly fatal complication of radical pneumonectomy. Although operative correction is simple, a successful clinical outcome requires early diagnosis and thoracotomy. A patient is described in whom a left-sided cardiac herniation through a pericardial defect occurred following radical pneumonectomy. The diagnosis was suspected by persistent hypotension and radiographic changes. Confirmation of the diagnosis was achieved by thoracoscopy, performed with local anesthesia in the operating room. Immediate thoracotomy resulted in a successful outcome.

Heart↗
PubMed1978

Clinical application of endotracheal cryotherapy.

A nitrous oxide cryoprobe has been developed that may be used through the infant bronchoscope. A total of 19 discrete airway lesions have been treated in 17 patients ranging in age from 2 mo to 30 yr. Three patients with periglottic lesions have had complete eradication of these lesions without the need for tracheostomy. Six patients with subglottic stenoses have been treated, with one successful extubation and one patient approaching extubation. Five patients have been treated for distal tracheal strictures, with two successful extubations and a third pending extubation. Five patients have been treated for endotracheal granulation tissue, and 3 patients have been successfully extubated. Cryotherapy allows bloodless resection of these lesions with rapid tissue healing not accompanied by residual scarring.

Adolescent↗
PubMed1978

Fasting and postprandial serum gastrin in normal human neonates.

Serum gastrin determinations were performed in 32 normal-term infants to determine the level of this hormone in normal infants at birth and its response to normal feeding. Significant differences were noted between newborn cord blood and maternal blood at birth. Further significant elevations in fasting serum gastrins were noted in these infants over the first 72 hr of life. Pre- and postprandial determinations with normal feeding failed to demonstrate a significant elevation in serum gastrin levels following ingestion of protein-containing formulas. These data suggest a relative insensitivity of the release of gastrin from the gastric antrum in response to protein, a powerful mediator of gastrin release in the adult.

Fasting↗
PubMed1978

Functional and metabolic evaluation of colon replacement of the esophagus in children.

Thirteen children with esophageal replacement with colon interposition have been followed at the University of Florida Medical Center between 1962 and 1976. Eight of these patients were evaluated with a detailed functional and metabolic protocol, four requiring colon interposition for esophageal atresia and four for esophageal strictures. Growth was noted to be somewhat delayed in the patients with esophageal atresia, especially those with associated congenital anomalies. Otherwise, excellent functional results were obtained. Significant anemia with depressed serum iron concentrations was noted in four patients, and three patients had abnormal vitamin B12 absorption. This abnormality correlated with length of terminal ileum employed with the interposed segment. Serum parameters of intestinal absorption were normal in each patient. Manometric evaluation revealed absence of peristalsis within the colonic segment, but progressive peristalsis within interposed ileal segments. Radiologic evaluation demonstrated delay in passage of thick material from mouth to stomach and wide variability in overall intestinal transit time.

Anemia↗
PubMed1978

Bilateral granulosa cell tumors of the ovaries in infancy.

A case of bilateral cystic granulosa cell tumors of the ovaries in an 11-wk-old infant is described. The patient presented with a large abdominal mass, but without sexual precocity. Treatment consisted of bilateral salpingo-oophorectomy without subsequent chemotherapy or radiation, and 2 yr follow-up has shown no evidence of recurrence of this tumor.

Female↗
PubMed1978

Laparoscopy in the diagnosis and treatment of malfunctioning ventriculo-peritoneal shunts in children.

Abdominal complications following ventriculo-peritoneal shunting for hydrocephalus are not uncommon. One of the complications that has heretofore required abandonment of the peritoneal shunt has been entrapment or encystation of the peritoneal limb of the catheter system. Four infants have been identified with malfunction of the peritoneal limb of the system by characteristic physical findings of increasing head size and dissection of fluid along the shunt track. Abdominal radiographs in multiple views revealed the tip of the peritoneal catheter to be fixed in position in each patient and sonography aided in identification of encysted catheters. These infants underwent six laparoscopic procedures to define the cause of shunt malfunction and to reposition the catheter. Cerebrospinal fluid cysts were encountered in three infants and entrapment by the falciform ligament in the fourth. All catheters were easily repositioned within the abdominal cavity with laparoscopy forceps and three of the infants presently have normally functioning shunt systems.

Cerebrospinal Fluid Shunts↗
PubMed1978

Aneurysm of anomalous subclavian artery: an unusal cause of dysphagia lusoria in childhood.

An 11-year-old female child with Down's syndrome presented with increasing dyspnea and dysphagia. Radiologic studies demonstrated a false aneurysm of an anomalous right subclavian artery which was compressing both trachea and esophagus. The etiology of this aneurysm most probably related to an unsuccessful cardiac catheterization two years prior to this admission. Proximal and distal ligation of the anomalous sublavian artery was accomplished through a right thoracotomy and the patient has remained asymptomatic.

Aneurysm↗
PubMed1978

Fasting and postprandial serum gastrin levels in infants with congenital hypertrophic pyloric stenosis.

Recently attempts have been made to demonstrate the possible role of hypergastrinemia in the production of congenital hypertrophic pyloric stenosis in infants. Eleven infants with congenital hypertrophic pyloric stenosis, ranging in age from three to 11 weeks, were evaluated for fasting and postprandial serum gastrin levels. Two to ten weeks following successful pyloromyotomy, a similar evaluation was undertaken to demonstrate the possible role of elevated serum gastrin levels in the etiology of congenital hypertrophic pyloric stenosis. The average fasting and postprandial serum gastrin levels in infants with congenital hypertrophic pyloric stenosis did not differ significantly from levels noted in control infants. Similarly, no statistically significant difference was noted between the pre- and postoperative levels of serum gastrin in the affected infants. Several experimental studies have been reported within the past few years describing the production of hypertrophic pyloric stenosis in the offspring of dogs injected with pentagastrin during pregnancy. The results of our study minimize the direct importance of serum gastrin in the production of congenital hypertrophic pyloric stenosis. The role of the hormone secretin in the etiology of this condition is hypothesized.

Female↗
PubMed1978

Necrotizing enterocolitis (ischemic enteropathy) with the sequel of colonic atresia.

Two cases of acquired colonic atresia subsequent to necrotizing enterocolitis (ischemic enteropathy) in the neonatal period are reported. These infants were noted to have complete atresia of the colon in the region of the splenic flexure 8 and 11 weeks after small bowel resection and ileostomy formation. Recognition of this and other late sequelae of ischemic enterocolitis becomes critical to the successful outcome of these patients as survival rates increase.

Colon↗
PubMed1977

Wilms' tumor with acute abdominal pain.

Acute abdominal pain is the presenting manifestation in approximately 30% of all patients with Willms' tumor. In a small proportion of these patients this pain is significant enough to engender a diagnosis of an acute surgical abdomen. Six of 38 patients with Wilms' tumors treated between the years 1965 and 1975 at the Shands Teaching Hospital of the University of Florida Medical Center have had significant pain. Our experience with these patients emphasizes the importance of thoroughly palpating the abdomen of any child with a suspected acute surgical condition, following induction of anesthesia and prior to initiating the operation. In the absence of any evidence of an acute surgical problem at the time of the exploratory laparotomy, it is also imperative that a careful intra-abdominal examination be performed to exclude the presence of conditions, such as Wilms tumor of the kidney, that may occasionally present in this manner.

Abdomen, Acute↗
PubMed1977

Endobronchial cryotherapy in the treatment of tracheal strictures.

Modern advances in ventilatory support systems have introduced a patient population requiring long term endotracheal intubation or tracheostomy. The formation of tracheal strictures in such patients remains a very significant clinical problem despite new modifications in endotracheal tube design and materials. Dissatisfied with standard modalities of treatment for these lesions, we have explored the usefulness of endobronchial cryotherapy for the treatment of such stricture. Cervical tracheal strictures were produced in 11 sheep. In six animals a prototype cryosurgical probe was passed through the bronchoscope and these lesions frozen to -80 degrees C. Respiratory epithelial regeneration was complete, but significant reduction in strictures was not noted. Utilizing the cryosurgical probe in conjunction with the endobronchial resection of tracheal strictures in three animals did, however, produce significant reduction in stricture size. Healing following cryonecrosis was associated with minimal fibrosis. Endobronchial cryotherapy is easily performed and has been well tolerated by these animals.

Animals↗
PubMed1977

Surgical management of massive ventral hernias in children.

The management of 7 children with massive abdominal wall hernias is reviewed, utilizing a technique of stabilizing the defect by insertion of a Teflon mesh prosthesis followed by pneumoperitoneum and staged reduction. Teflon mesh has proven ideally suited for this purpose because of its flexibility, elasticity, and relative nonreactivity, allowing it to be applied directly over the surface of exposed bowel without inducing fistula formation. Although the mesh is securely incorporated into the fascial perimeter of the abdominal wall, a pseudomembrane is formed at the point of contact with the bowel surface which allows subsequent dissection and removal of the prosthesis with relative ease. Having limited the size of the defect by insertion of the mesh, an ideal situation is created for use of pneumoperitoneum to expand the peritoneal cavity and stretch the normal tissues of the abdominal wall, thus facilitating subsequent operative reduction of the ventral hernia. Utilizing this approach, excellent cosmetic and functional results have been achieved in all 7 patients.

Abdominal Muscles↗
PubMed1977

Serum polyamine and octopamine changes following partial hepatectomy and portacaval shunt.

Factors influencing hepatic regeneration following major hepatic resection are poorly understood and often may be modified by associated surgical procedures. Experimental and clinical evidence would suggest that hepatic regeneration may be impaired following hepatectomy performed in conjunction with portacaval shunting. A patient is described who offered a clinical situation in which it was possible to evaluate the effects of complete portal-venous diversion on hepatic regeneration following massive hepatic resection. The usefulness of biogenic amines as a monitor of the course of hepatic regeneration is demonstrated. The potential development of hepatic encephalopathy was evaluated by serial determinations of serum ammonia and the biogenic amine, octopamine, which correlated well with the patient's clinical state.

Ammonia↗
PubMed1977

Traumatic perforation of the hypopharynx in infants.

Three cases of traumatic perforation and pseudodiverticulum of the hypopharynx in newborn infants are presented. This lesion may be encountered with increasing frequency as a result of the more aggressive management of newborn infants with respiratory distress. Early recognition of this complication is essential to successful therapy. Appropriate management includes local drainage, treatment with antibiotics, and use of a nasogastric tube or gastrostomy to provide a safe route for intestinal alimentation.

Humans↗