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Biomedical subjects

C Butler

Publications and source records attributed to C Butler.

At least 91 records · Page 5Linked to original sources
PubMed1983

A new method of tracheal reconstruction.

When resection of more than 50% of the trachea is necessary, tracheal reconstruction becomes a very difficult problem. We tested a new method of tracheal reconstruction using the left main bronchus. The procedure was performed in 6 adult mongrel dogs. Through a midline sternotomy, a left pneumonectomy is performed, preserving as much of the left main bronchus as possible. The carina is preserved and mobilized, and the left main bronchus is passed under the aortic arch and reversed. The distal end of the bronchus is anastomosed to the proximal end of the resected trachea. The distal end of the resected trachea is closed by stapling. Four animals survived the procedure without apparent functional difficulty and remained healthy until they were killed five to ten months postoperatively. The anastomosis was well healed without stenosis. Anatomical measurements in 10 human cadavers revealed that the length of the left main bronchus to the level of the upper lobe takeoff is approximately 50% that of the trachea. The diameter of the left main bronchus is approximately 75% that of the trachea. We believe that the technique described can extend the limits of tracheal resection in a selected group of patients for whom there is currently no good alternative.

Animals↗
PubMed1983

Powered mobility for very young disabled children.

Nine motor-disabled children with normal intelligence and varying degrees of disability were studied to see if competent control of a motorized wheelchair is attainable between 20 and 39 months of age. Each child used a conventional motorized wheelchair with adaptive seating. Parents supervised the learning at home. Eight children drove safely and independently within 1.7 to 12 hours accumulated over a one to seven week period. Parents reported that this independent mobility stimulated their child's social, emotional and intellectual behavior.

Child, Preschool↗
PubMed1983

Comparative studies of mitral valves in rheumatic heart disease.

Mitral valve tissues from 195 patients with rheumatic heart disease removed at the time of cardiac surgery were studied by conventional histologic techniques. One hundred seven patients from a five-year period at All-India Institute for Medical Sciences in New Delhi were studied in conjunction with 88 patients undergoing cardiac surgery in Albuquerque during a similar period. In Indian patients a correlation was noted between degree of moderate or severe valvular calcification and extent of adjacent valvular mononuclear cellular infiltration often consisting of striking lymphocytic-plasma cell collections. Similar distinct correlations were not observed among the mitral valves from the Albuquerque patients. It is possible that mitral valve mononuclear cell infiltrates among Indian patients may reflect a chronic immune reaction influencing the natural course of rheumatic heart disease in this latter population.

Adolescent↗
PubMed1981

Acute thallium poisoning: toxicological and morphological studies of the nervous system.

Nine days following ingestion of 5 to 10 gm of thallium nitrate, a young man died with severe cranial and peripheral neuropathy, anuria, and heart failure. Ultrastructural examination of nerves obtained on days 7 and 9 demonstrated axonal degeneration with secondary myelin loss. Axons were swollen and contained distended mitochondria and vacuoles. Thallium levels in more than twenty organs and body fluids ranged from below 1.0 to 178 microgram/gm; concentrations in twenty areas of the nervous system ranged from 29 to 140 microgram/gm. The highest brain levels of thallium were found in gray matter. In the thalamus, 87% of the thallium was present in cell sap. Tissue concentrations of thallium did not parallel those reported for potassium, suggesting that thallium distribution differs from potassium distribution in human beings.

Acute Disease↗
PubMed1981

Surgical pathology of acute appendicitis.

Pathologic findings and clinicopathologic correlations in 276 consecutive appendectomies performed in a university hospital are reviewed. In 59 cases, appendectomy was incidental to another elective procedure. In the other 217 cases exploration was performed as an emergency, and acute appendicitis was present in 160 of the cases (74 per cent); 54 of these were complicated by perforation. In the remaining 57 cases there was either some other pathologic process clinically distinct from appendicitis or no identifiable source of the preoperative symptoms. The major findings were as follows: (1) Although appendicitis appears to be the result of initial mucosal injury, not all inflamed appendices show clear evidence of lumen obstruction by a fecalith or another mechanism. (2) Perforation, which greatly increases the morbidity in appendicitis and disproportionately affects children, is the consequence of transmural necrosis and is related much more to prolonged symptoms prior to surgery than to the presence of a fecalith or any other evidence of lumen obstruction. (3) The clinical course of appendicitis varies enormously, and the duration of symptoms has a wide range that is partly independent of the pathologic findings (which may include evidence of considerable chronic inflammation). The conclusions are that the current widely accepted practice of prompt exploration on suspicion of appendicitis is fully justified, that the inflammation in appendicitis may have quite different rates of progression from patient to patient, and that the etiopathogenesis of appendicitis may not be uniform and in some cases may involve important immunologic factors.

Acute Disease↗
PubMed1977

Morphologic aspects of experimental esophageal lye strictures. II. Effect of steroid hormones, bougienage, and induced lathyrism on acute lye burns.

Among 77 dogs surviving standardized transmural esophageal lye injury for at least 2 weeks and as long as 12 weeks, 24 were untreated, 26 received corticosteroids and bougienage (S&B), and 27 received only the lathyrogen beta-aminoproprionitrile (BAPN). Stricture frequency was reduced markedly and significantly in the S&B and BAPN groups when compared to the controls (p less than 0,01). Strictures resulted from inward circumferential remodeling of all mural layers, not proliferating bulky scar tissue, and persistent ulceration was apparently not an influential factor in any group. The S&B dogs invariably showed reduction of the internal or mucosal length of the injured segment as compared to the outer length; these relations were quite variable in the other two groups so that mean internal shortening was significantly greater (p less than 0.01) in the S&B group. Marked mural thinning in the injured zone was present in all three groups but was most frequent in the BAPN-treated animals. The major conclusion is that BAPN-induced changes in the physical properties of reparative tissue can increase the ultimate caliber of an injured hollow viscus without resort to mechanical bougienage. In addition, the data suggest that wound contraction may play a role in stricture formation in this model.

Adrenal Cortex Hormones↗
PubMed1977

Intravascular aggregation and pulmonary sequestration of platelets during IgE-induced systemic anaphylaxis in the rabbit: abrogation of lethal anaphylactic shock by platelet depletion.

Significant alterations in the circulatory properties of platelets have been documented during IgE-induced systemic anaphylactic shock in the rabbit. Within 30 to 60 sec after i.v. antigen challenge, platelet aggregation occurs in both the venous and arterial circulations. The platelet aggregates then sequester in small blood vessels of various organs, particularly in the lung. The organ sequestration results in the development of a profound thrombocytopenia within 3 to 5 min after antigen challenge. Fifteen min later deaggregation of platelets occurs and the platelets return to the peripheral circulation within normal, prechallenge levels by 60 min. Additional experiments demonstrated that platelet depletion before antigen challenge abrogates the lethal effects and significantly reduces the pathophysiologic manifestations of IgE-induced systemic anaphylaxis. We conclude that the IgE-induced platelet alterations, probably induced by the intravascular release of basophil and perhaps mast cell-derived platelet-activating factor (PAF), play a major role in the pathogenesis of systemic anaphylaxis in the rabbit.

Anaphylaxis↗
PubMed1976

Diaphragmatic changes in emphysema.

The diaphragms and lungs of 95 men were quantitatively examined at autopsy, and the following observations were made. The area of the whole diaphragm had a significant inverse correlation (r= -0.412, P less than 0.001) with the percentage of the lung occupied by emphysematous lesions. Most of the reduction in the area of the whole diaphragm associated with advanced emphysema occured in the muscular portion; in contrast, the thickness of the diaphragm was not affected by percentage of the lung occupied by emphysematous lesions. Neither body height nor postmortem lung volume had as close a relation to area of the whole diaphragm as did percentage of the lung occupied by emphysematous lesions. The conclusion drawn from these observations is that the diaphragm area reduction associated with emphysema is related to altered thoracic shape, probably diaphragm flattening in particular, and is better described as contracture than as atrophy. It is speculated that these morphologic changes contribute to the altered diaphragmatic function characteristic of chronic obstructive pulmonary disease, and thereby to the ventilatory abnormalities seen in patients with this disorder.

Adult↗
PubMed1976

Lung surface area in various morphologic forms of human emphysema.

The relation between lung surface area and the extent and morphologic type of emphysema was examined at autopsy in 69 men. It was found to be conceptually preferable to express the area as internal surface area per unit lung volume (specific surface area) rather than to use the more conventional, inversely related, mean linear intercept for comparison with other morphometric data. In the whole group, fixed inflated lung volume generally increased with increasing per cent involvement of lung parenchyma by emphysema, and total internal surface area decreased, but those changes were not so regular as the decline in specific surface area with increasing per cent emphysema (r=-0.574). Lungs with no emphysema had a significantly higher specific surface area than did lungs with very little emphysema (1 to 9 per cent), suggesting noticeable effects on the physical properties of lung by minimal degrees of this disease at high levels of inflation. The way in which specific surface area decreased with increasing percentage of emphysema was not noticeably different among patients with centrilobular, panlobular, or mixed forms of emphysema, although lungs with only centrilobular emphysema were much more common and had a significantly lower mean percentage of emphysema than did those with only panlobular emphysema; the prevalence and mean percentage of emphysema of the mixed group were intermediate. These observations, coupled with the association of older mean age with increasing percentage of emphysema, were interpreted as support for the concept that many examples of panlobular emphysema are derived from confluence of extensive centrilobular emphysematous lesions.

Adult↗
PubMed1976

IgE-induced respiratory and circulatory changes during systemic anaphylaxis in the rabbit.

We studied systemic anaphylaxis induced by the administration of 200 mug of horseradish peroxidase into 11 anesthetized rabbits known to be producing anti-horseradish peroxidase antibodies only of the IgE class. Ventilatory changes included a transient, abrupt decrease in breathing frequency followed by increased minute ventilation; lung mechanical changes included decreased dynamic lung compliance and increased total pulmonary resistance; cardiovascular changes included pulmonary hypertension, systemic hypotension, and, frequently, a transient bradycardia. Recovery from these physiologic changes took place within 60 min. After recovery, the administration of 2 mg of horseradish peroxidase into 6 of the rabbits induced a second reaction indistinguishable from the first with respect to ventilatory and circulatory alterations; however, lung mechanical changes were less prominent. No histologic evidence of pulmonary edema or intraluminal plugging of the pulmonary edema or intraluminal plugging of the pulmonary circulation was observed by light microscopy. Although the first anaphylactic reaction was accompanied by disappearance of stainable basophils from the circulating blood, the second reaction occurred despite the absence of circulating basophils. These studies characterize further the effects of antigen challenge in rabbits producing detectable concentrations of IgE, but not other classes of antibody to the antigen.

Airway Resistance↗
PubMed1975

Pulmonary interstitial fibrosis from paraquat in the hamster.

The effects of paraquat in hamsters were evaluated to find a rodent model of interstitial pulmonary disease free from spontaneous infection. Because the repeated doses necessary to produce chronic lung injury suggested hypersensitivity mechanisms, concurrently administered Freund adjuvant and adenocorticotrophic hormone (ACTH) were tested separately. Effects were measured by mortality, change in body weight, and morphometric estimate of lung injury. Findings were as follows: (1) only repeated doses in a very narrow range produced chronic interstitial injury; (2) ACTH clearly protected animals from the general systemic and pulmonary effects of paraquat; and (3) adjuvant specifically protected against the pulmonary injury alone. There was no evidence of immunologic contribution to paraquat injury.

Adrenocorticotropic Hormone↗