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Biomedical subjects

B Taylor

Publications and source records attributed to B Taylor.

At least 253 records · Page 14Linked to original sources
PubMed1983

Double stapling technique for low anterior resection.

A report is given on 26 patients (18 men and 8 women) undergoing low anterior resection for carcinoma of the rectum, using both the TA 55 and EEA staplers. The average age was 65 years (range, 45 to 92 years). The preoperative level of the lesion from the anal verge averaged 9.8 cm (range, 4 to 17 cm). All had well-differentiated or moderately well-differentiated lesions. All lesions were removed using the following technique. The TA 55 stapler was placed across the lower rectum at the distal resection margin. The EEA stapler was introduced into the rectum with the anvil removed. The shaft was then passed through the rectum stump either through or immediately adjacent to the staple line. The anvil was refitted and the anastomosis completed between the more proximal colon and the rectal stump. A defunctioning colostomy was employed in only one patient. There has been no mortality. Follow-up has been 2 to 16 months, and there has been no early recurrence. The postoperative level of the anastomosis averaged 5.5 cm (range, 2 to 11 cm). Stapler-related complications occurred in three patients. One of these patients developed a postoperative anastomotic leak, which necessitated a defunctioning colostomy. Two anastomotic strictures occurred following either an anastomotic leak or postoperative radiation therapy. Early incontinence to gas, night-time anal soilage, and urgency occurred in eight patients (30 per cent). These symptoms improved or disappeared within three months following operation. The authors' preliminary experience has shown the double stapling technique to have definite advantages. It obviates the use of lower purse-string suture and permits a lower and easier anastomosis. It avoids the problem of disparity of sizes of the two ends of the bowel. The rectum is not opened and fecal spillage is minimized. To date, results have been good without excessive complications.

Adenocarcinoma↗
PubMed1983

School-based prenatal services: can similar outcomes be attained in a nonschool setting?

The purpose of this study is to evaluate whether enhancement of hospital-based prenatal care of adolescents results in pregnancy outcomes comparable to those found in adolescents receiving care at school-based clinics. An initial study comparing hospital clinic and school clinic programs administered by the St. Paul Maternal and Infant Care Project (MIC) from 1973-1976 indicated that delivered teens from the high school clinics had earlier and more frequent prenatal visits and fewer low birth weight babies than delivered adolescents who received care at hospital based clinics. After the initial study of 1976, MIC hospital based services for the adolescents were enhanced to include additional educational and support services. A follow up study, (1976-1979) was subsequently conducted, using criteria similar to the previous study, to compare the results of hospital and school-based programs for pregnant teens. The follow up data demonstrated that the School Group initiated care much earlier and had significantly more prenatal visits than the Comparison Group, but the Comparison Group demonstrated a dramatic improvement in both areas when compared to the first study. Rates of obstetrical complications and infant outcomes were more similar for both groups than in the initial study, supporting the premise that while the school provides a superior setting for provision of prenatal services, similar services at nonschool sites can be greatly enhanced and can demonstrate significant improvement in obstetrical outcomes.

Adolescent↗
PubMed1983

Teenage mothering, admission to hospital, and accidents during the first 5 years.

One thousand and thirty-one singleton children of teenage mothers were compared with 10 950 singleton children of older mothers in a national longitudinal cohort study. Children born to teenage mothers and living with them during the first 5 years were more liable to hospital admissions, especially after accidents and for gastroenteritis, than were children born to and living with older mothers. Frequent accidents, poisoning, burns, and superficial injuries or lacerations were more often reported by teenage mothers. The association of teenage mothering with greater likelihood that children would have accidents or be admitted to hospital remained highly significant even after controlling for social and biological confounding influences. Although in part a marker for adverse socioeconomic circumstances, low maternal age appears to be a health hazard for children.

Accidents↗
PubMed1983

Family type and accidents in preschool children.

Children living in single-parent families or stepfamilies were found to be more likely to suffer accidental injuries in their first five years of life than children living with two natural parents. Frequent household moves, low maternal age, and perceived poor behaviour in the child were all more strongly associated with overall accident rates than family type, and these disadvantages were more common in atypical families. Family type appeared to be the most important influence on hospital admission after accidents. Overall, there was a close similarity in accident rates between children of single-parent families and stepfamilies, and both groups were more at risk than children living with both natural parents.

Accidents↗
PubMed1983

Breast feeding, eczema, asthma, and hayfever.

The association of breast feeding with rates of atopic illness during the first five years of life was assessed in a national study of 13 135 children studied during the first week and at age 5 years. Eczema was reported more often in children who had been breast fed; this relationship persisted even after allowance was made for social and family factors influencing the likelihood both of breast feeding and of eczema; the other factors most significantly associated with rates of eczema were parental history of eczema or asthma and advantaged family socioeconomic status. A similar, but less pronounced, positive association of breast feeding with reported hayfever became non-significant after adjustment for intervening factors. Rates of reported asthma were not influenced by breast feeding. "Any wheezing" including asthma was reported more often in children who had not been breast fed, but this association disappeared after adjustment for parental asthma and maternal smoking. Breast feeding does not appear to protect against these atopic diseases. The positive association with reported eczema might relate to accuracy of diagnosis or to associated influences not considered in the analysis; alternatively, it might be due to (recent) environmental contaminants crossing in breast milk, causing eczema in the child.

Asthma↗
PubMed1983

Primary perineal wound closure following excision of the rectum.

Management of the perineal wound following rectal excision was assessed in 57 patients at the Toronto General Hospital; 40 had ulcerative colitis, 4 had Crohn's disease, 10 had carcinoma of the rectum, 2 had carcinoma of the anus and 1 had anal incontinence. The preferred technique was careful anatomical dissection with meticulous hemostasis, and primary skin closure with a laterally placed closed Hemovac suction system. Alternatively, wounds were packed and allowed to heal secondarily. Overall, the perineal wound healed primarily in 41 patients (72%). Primary closure was possible in 50 patients (88%); in 41 (82%) the wound healed without complication but in 9 (18%) the wound had to be opened because of hematoma and abscess (8 patients) or bleeding (1 patient). In 41 (91%) of the 44 patients with inflammatory bowel disease the perineal wound was closed primarily; 34 wounds (83%) healed without complication. In seven patients the perineal wound was packed at surgery because of bleeding (four), fecal spillage (two) or sepsis (one). Healing time averaged 6 months. These results indicate that primary closure is the optimal management of perineal wounds. Primary healing is achieved in a high proportion of patients and postoperative morbidity is decreased. Results are excellent in patients with inflammatory bowel disease as well as in those with carcinoma.

Adult↗
PubMed1983

Role of resection in the management of metastases to the liver.

The results of 22 hepatic resections for metastatic disease are reviewed. There were no operative deaths and survival was encouraging. Life-table analysis of all 22 patients predicted a 5-year survival of 56.4%, and if 16 patients who had primary colorectal tumours are considered separately, the expected 42-month survival was 42.2%. Patients with a single metastasis generally lived longer, and there was no difference in survival between hepatic metastases resected synchronously or metachronously. The authors recommend an aggressive approach to the treatment of hepatic metastases.

Actuarial Analysis↗
PubMed1982

Vaccinations and the physically handicapped child.

The vaccination status of 98 physically handicapped children was examined to identify factors associated with an inadequate vaccination status. Of the 98 children, 57 had cerebral palsy, 14 had myelomeningocele, 3 had muscular dystrophy and 24 had myelomeningocele, 3 had muscular dystrophy and 24 had other motor disabilities. According to the available vaccination records, only 17 children had received all the recommended injections on schedule; 26 had missed at least one injection, and 3 of them had never been vaccinated. The overall rate of vaccination in our study group (63%) was lower than expected. The children with moderate to severe limitation of function due to cerebral palsy were significantly less likely (P less than 0.05) than those with less severe limitations to have received a basic series of vaccinations. Health departments must ensure that physically handicapped children receive the preventive health measures viewed normal and appropriate for other children.

Adolescent↗
PubMed1982

Central, as well as peripheral naloxone administration suppresses feeding in food-deprived Sprague-Dawley and genetically obese (Zucker) rats.

Food intake over 90 min post-injection was studied in groups of food deprived (20 hr) female Sprague-Dawley (S.D.) rats, fatty Zucker (fa/fa) rats and their heterozygous lean litter mates (Fa/fa) of various ages, that bar-pressed for food pellets on a FR-1 schedule following a subcutaneous (SC) or an intracerebroventricular (IVT) injection of sterile saline or naloxone HCl. Subcutaneous injections of naloxone HCl (10 mg/kg) reduced feeding in all three groups of rats compared to SC saline; in addition, a greater percentage reduction in food intake over the whole 90 min test period occurred in the fa/fa rats given SC naloxone compared to the Fa/fa group. Intracerebroventricular naloxone (50 micrograms) decreased feeding over the initial 30 min period in the S.D. and Fa/fa rats but a 100 micrograms IVT dose was needed to reduce feeding in the fa/fa group. The results demonstrate that central naloxone administration can suppress feeding in both non-obese and obese strains of rats as it is known to do when given peripherally. These findings add yet further evidence to the premise that endogenous opioid peptides may play an intricate and important physiological role in the regulation of feeding behavior.

Animals↗
PubMed1982

Distribution of ribosomal gene length variants among mouse chromosomes.

The ribosomal genes (rDNA) in mouse inbred strains have a multichromosomal distribution. Using a structural feature of rDNA [variable length rDNA segment (VrDNA)] that shows length polymorphism within and among inbred strains, we studied the chromosomal distribution of the variant ribosomal gene type through genetic analysis. Our results show that five of the length variant classes can be divided into three discrete linkage groups. The variants present on a particular chromosome pair appear to be unique to that pair and absent from nonhomologous chromosomes. The chromosomal location of particular variants appears to be the same in two unrelated inbred strains suggesting that the observed linkage patterns predate the origin of inbred mice. The nonrandom chromosomal distribution of these rDNA classes suggests that only a limited degree of genetic exchange occurs among nucleolus organizer regions on nonhomologous chromosomes. We have localized one particular VrDNA linkage group to chromosome 12. These and other restriction fragment polymorphisms can be used in the construction of detailed mouse linkage maps.

Animals↗
PubMed1982

Specific IgA and IgE in childhood asthma, eczema and food allergy.

Allergen-specific IgA and IgE antibodies were compared in 250 children with asthma (Dermatophagoides pteronyssinus, rye grass pollen), in eighty-six children with eczema (whole egg, cow's milk) and in two groups of children with egg and cow's milk allergy. In each of the conditions investigated, food allergy, asthma and eczema increasing atopy was associated with increasing specific IgE levels to relevant allergens. There was no association of high IgE antibody levels with low IgA antibody levels in any of the conditions or allergens studied. There was, however, a tendency for subjects with more severe asthma to have high IgA levels with high IgE levels. IgA deficiency does not appear to be associated with atopic conditions of childhood.

Antibodies, Anti-Idiotypic↗
PubMed1982

Reinnervation of denervated parasympathetic neurones in cardiac ganglia from Rana pipiens.

1. The sequence of events during reinnervation of the cardiac ganglion in the frog following interruption of the vagosympathetic nerve supply was studied with both electrophysiological and morphological techniques. 2. When cardiac ganglia were denervated by crushing the vagosympathetic nerve supply to the heart all synaptic endings on parasympathetic ganglion cells degenerated. Vacated post-synaptic densities were detected on denervated neurones for periods of at least 7 weeks. 3. The earliest signs of reinnervation were subthreshold responses evoked by stimulating the regenerating vagosympathetic trunks 2 1/2-3 weeks after crushing the cardiac branches of the vagus nerves. Analysis of the reversal potentials of these responses indicated that these synapses were distant from the cell body. 4. At slightly longer times (4-5 weeks), regenerating synapses could be recognized on post-ganglionic axons; no synapses were detected on the neuronal perikarya at these times. 5. By 6-7 weeks following denervation, vagal synapses reinnervated neuronal perikarya as well as post-ganglionic axons. At the same time, vacated post-synaptic densities declined in number. Furthermore, vagal stimulation at this stage evoked large, suprathreshold post-synaptic potentials. 6. These studies indicate that post-ganglionic axons are the initial sites for reinnervation of parasympathetic neurones in the heart. Only some time later are neuronal perikarya reinnervated and ganglionic transmission completely restored.

Animals↗