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Biomedical subjects

D C Hitch

Publications and source records attributed to D C Hitch.

At least 19 recordsLinked to original sources
PubMed1992

Amino acid profiles correlate diagnostically with organ site in three kinds of malignant tumors.

The hypothesis that tumors arising in a particular organ site impose a characteristic plasma free amino acid (PFAA) pattern was tested by analyzing PFAA in fasting venous blood of preoperative patients with breast cancer, gastrointestinal tract cancer, and head and neck cancer. Healthy volunteers served as control subjects. Levels of 28 PFAA were determined in blood samples using an amino acid analyzer, and the data were compared using discriminant analysis and chi-square testing. Compared with control subjects, the concentrations of seven amino acids (glutamine, threonine, histidine, cysteine, alanine, arginine, and ornithine) in patients with tumors correlated closely with the known diagnoses. By means of discriminant analysis, these seven amino acids had the highest correlation with the specific diagnoses, indicating that PFAA profiles correlate diagnostically with the organ-site origin of three different kinds of malignant tumors.

Adenocarcinoma↗
PubMed1992

The comparative effects of abrupt vs. stepwise discontinuation of TPN in rats.

The comparative effects of discontinuing total parenteral nutrition (TPN: caloric ratio of glucose:fat:amino acid = 50:30:20) abruptly or in a stepwise manner on spontaneous food intake were investigated in two studies. Study 1: In 16 rats, TPN was given for 4 days, then stopped abruptly in eight rats. In the other eight rats, TPN was tapered; they received TPN at 75%, 50%, and 25% of their mean daily energy requirements per day for 3 consecutive days, and then switched to normal saline. Total parenteral nutrition induced a significant 60% reduction in spontaneous food intake (SFI) in both groups during the first TPN day. After 4 days of TPN, an 80% decrease in SFI had occurred in both groups. Resumption of SFI was significantly sooner in the abruptly-stopping group than in the stepwise-stopping group. But, in the latter group, there was a significantly greater cumulative caloric intake during the entire study. Study 2: In 32 rats, TPN providing either 100%, 50%, or 25% of their mean daily caloric requirements was given to three groups each of eight rats, for 3 days, then abruptly changed to normal saline; control rats received normal saline throughout. The TPN-induced decrease in SFI was proportional to the caloric density of the solution infused. Three days of 100%, 50%, or 25% TPN infusion led to an approximate 85%, 60%, or 35% decrease in SFI, respectively. Spontaneous food intake recovery was independent of the caloric density of TPN.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Dynamics of oral intake resumption after general anesthesia and operation in rats.

The influence of general anesthesia and operation on dynamics of postoperative food intake resumption was investigated in eight rats. A laparotomy was performed on each rat under anesthesia induced by intraperitoneally injected chloral hydrate. Spontaneous food intake and feeding indexes were continuously measured using an Automated Computerized Rat Eater Meter (ACREM) before and after operation. Although spontaneous food intake and all feeding indexes were depressed immediately following anesthesia and operation, each feeding index was depressed to a greater degree during the dark vs. the light cycle. Initially, rats fully capable of eating ate fewer, smaller, and shorter meals. The return to normal of each feeding index differed temporally. Thus, although meal number normalized by the third postoperative day, meal size by the sixth postoperative day, and meal duration by the fourth postoperative day, normalization of meal number during the light cycle occurred sooner than during the dark cycle, while the converse occurred with meal size and meal duration.

Anesthesia, General↗
PubMed1991

Effects of continuous graded total parenteral nutrition on feeding indexes and metabolic concomitants in rats.

The influence of graded amounts of total parenteral nutrition (TPN) on food intake and feeding indexes was investigated in 90 rats housed in Automated Computerized Rat Eater Meter metabolic cages with free access to water and chow. When food intake was stable after catheter placement, 10 control rats continued with the 3 ml/h normal saline used for catheter patency, whereas study rats were given graded TPN continuously for 3 days, amounting to the equivalent of 26% (TPN-26), 53% (TPN-53), 81% (TPN-81), or 114% (TPN-114) of their daily caloric needs. TPN consisted of glucose, fat, and amino acids in the caloric ratio of 50:30:20. In study rats, the graded TPN depressed food intake, meal number, meal size, and eventually food consumption rate, meal sniffs, and intermeal sniffs in a dose- and time-dependent manner. During graded TPN, rats decreased total food intake by eating fewer, smaller, shorter meals at a decreasing consumption rate; sniffing activities were correspondingly curtailed. Stopping TPN led to normalization of feeding indexes. Blood glucose did not change while plasma insulin rose with graded TPN. A decrease in hepatic glycogen and an increase in hepatic triglycerides occurred. Plasma valine, phenylalanine, and methionine rose in a TPN dose-dependent manner. TPN-26 and TPN-53 significantly decreased whole brain amino acids; with TPN-114 no change occurred. Brain influx of tryptophan remained unchanged, but a progressive decrease in brain influx of tyrosine occurred. Whole brain dopamine and serotonin were depressed with TPN-26 and TPN-81 but were normal with TPN-114.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗
PubMed1990

Automated computerized rat eater meter: description and application.

A real-time Automated Computerized Rat Eater Meter was developed by modifying commercially available metabolic cages. Food access via a feeding tunnel was monitored by photocells. Food consumption was measured by an electronic scale. The signals thus generated were processed by a computer. This allowed us to continuously measure the spontaneous feeding behavior of free-feeding nondeprived Fischer rats for a sum total of 35 study days. Based on our data, we defined a meal as an episode of food consumption preceded and followed by at least 5 minutes of no feeding. Fischer rats showed periodic nychthemeral eating behavior. Food consumption, number of meals, meal sniffs, intermeal sniffs, and, consequently, eating activity were greater during the dark cycle than the light cycle. Meal duration, meal size, and thus food consumption rates remained constant throughout both cycles. Our modification of commercially available metabolic cages provides unique data for continuously monitoring rat feeding patterns over prolonged periods of time.

Animals↗
PubMed1989

Familial congenital diaphragmatic hernia is an autosomal recessive variant.

Forty families that have had more than one sibling with a congenital diaphragmatic hernia have been identified. The 85 children among the 40 families describe a subset of congenital diaphragmatic hernia displaying an autosomal recessive inheritance mode. The chance of a diaphragmatic hernia among siblings within this subset is 25%.

Cohort Studies↗
PubMed1988

The role of tissue ischemia in the pathogenesis of anastomotic stricture.

In a chronic dog model, colocolostomies with intact blood supplies were constructed with the circular stapler. By means of "tight" stapling, an ischemic suture line was induced (suture line blood flow reduced to less than 10% of baseline mucosal blood flow). Under these conditions, only one of 20 anastomoses resulted in stenosis at 1 month. Correctly stapled colocolostomies were then performed in bowels rendered ischemic by removal of all mesenteric arcades for 4 to 6 cm. Mucosal blood flow in such ischemic bowels was reduced to 30% and 16% of control, respectively, and suture line blood flow was as low as that of the tightly stapled anastomoses. Significant stenosis (more than 68% reduction of the lumen) was observed in the group with 6 cm of mesenteric clearance. In no dogs did peritonitis or colonic gangrene develop. Gross and histologic revascularization was evident when dogs were killed at 6 weeks. These findings suggest that it is ischemia of the bowel, rather than ischemia at the suture line itself, that leads to anastomotic stricture. In view of the known susceptibility of the human intestine to ischemia, the model may have overstated the degree of ischemia necessary to produce strictures in clinical practice. Since the induced acute ischemia did not persist in the chronic state, we conclude that it is the adequacy of collateral development that determines the outcome in this model.

Animals↗
PubMed1987

Perirectal mucocele after imperforate anus repair.

A large perirectal mucocele developed in a child over an 11-year period following repair of an imperforate anus. Renal failure and large bowel obstruction secondary to compression by the mass were the presenting symptoms. Computed tomographic evaluation of the pelvis was critical for preoperative assessment of this previously unreported complication of imperforate anus repair.

Anus, Imperforate↗
PubMed1987

Mucocele after endorectal pull-through for imperforate anus.

This report documents a patient with imperforate anus in whom an endorectal pull-through with incomplete excision of the macroscopic mucosa led to the formation of a 1,500 mL mucosal lined pelvic mucocele, obstructing both the rectum and ureter. All macroscopic mucosa should be removed during endorectal pull-through.

Anus, Imperforate↗
PubMed1982

Enhanced gastroduodenal motility in children.

Metoclopramide hydrochloride was administered to nine children for the treatment of gastric stasis (N=6) and unexplained vomiting (N=3). One additional patient with gastric stasis displayed no response to the test dose of metoclopramide. Both the frequency and apparent forcefulness of the gastric and duodenal waves increased with the administration of metoclopramide in the nine patients receiving treatment. Eight clinical aspects were monitored, with improvement seen in all during therapy; the rates of both improvement and freedom from symptoms were time dependent. After one month, the median rate of improvement in individual symptoms was 86%, and the median rate of freedom from symptoms was 54%. Only two of the nine patients became totally asymptomatic within the month. However, sustained improvement was maintained after discontinuance of metoclopramide administration. Within the administered dosages and within the study population, metoclopramide was found to be safe.

Adolescent↗
PubMed1982

Improved results with hepatic portoenterostomy: a reassessment of its value in the treatment of biliary atresia.

As reported in 1974, the initial experience at the Oklahoma Children's Memorial Hospital with the Kasai procedure for biliary atresia was unsatisfactory. A subsequent series of 20 patients, in which 50% of the patients are alive and improved and 25% jaundice-free, is described. Modifications of the initial operative technique have been utilized. Postoperative complications in the ten children with sustained bile flow included cholangitis in five, hyponatremia in four, esophageal variceal hemorrhage in two, stomal bleeding in two, and gallbladder conduit malfunction in two patients. The improved outcome is attributed to earlier diagnosis and correction, attention to operative details, intensive postoperative nutritional support, and prompt recognition and management of complications.

Adolescent↗
PubMed1982

The use of diethyl-IDA Tc 99m clearance curves in the differentiation of biliary atresia from other forms of neonatal jaundice.

A family of isotope elimination curves that reflects changes in the biodistribution of diethyl-IDA Tc 99m in neonatal cholestatic jaundice and biliary atresia is defined. Time/activity curves generated from equal areas over the heart and liver were evaluated separately and in conjunction with the scintigraphic data. Patients without scintigraphic evidence of significant hepatic uptake and with a hepatic curve that resembled the cardiac curve were found to have neonatal hepatitis. Good hepatic uptake and a hepatic curve with a terminal portion that appeared to be parallel to or divergent from the cardiac curve were associated with biliary atresia. Apparently converging hepatic and cardiac curves were associated with biliary patency. Although preliminary, these results provide further documentation that diethyl-IDA Tc 99m is useful in discriminating biliary atresia from other causes of cholestatic jaundice, while reducing radiation exposure and the need for pharmacologic intervention.

Bile Ducts↗
PubMed1981

Differentiation of cholestatic jaundice in infants. Utility of diethyl-IDA.

Time-activity curves of technetium-labeled diethyl-IDA were used to evaluate 31 patients in an effort to differentiate infants with cholestatic jaundice. Results can be obtained rapidly with minimal radiation exposure and no known secondary effects. The combination of diethyl-IDA time-activity curves and gamma glutamyl transferase activity was found to discriminate biliary atresia from neonatal hepatitis. The group with neonatal hepatitis was characterized by abnormal, yet lower, gamma glutamyl transferase activities and diethyl-IDA time-activity curves which peaked within 1 minute of injection, yet decayed in a manner similar to cardiac activity. The group with biliary atresia was characterized by elevated gamma glutamyl transferase activities, hepatic peaks at 8 minutes and markedly delayed decay. In that early operative intervention is associated with increased survival in biliary atresia, prompt differentiation should improve prognosis.

Bile Ducts↗
PubMed1981

Assessment of hepatic function after hepato-porto-enterostomy for biliary atresia using Tc-diethyl-IDA.

A quantifiable biliary function index has been developed from analysis of hepatic time--activity curves. Diethyl-IDA, a technetium-labeled iminodiacetic acid was given intravenously 27 times in 11 patients with proven biliary atresia. An estimated bile bilirubin clearance index derived from the inscribed hepatic absorption and elimination curves appears to be a reliable indicator of bile bilirubin clearance. The actual bile bilirubin clearance, previously shown to be a major determinant of survival, was clinically correlated in five patients studied before and after surgery and confirms the experimental findings. The clearance index should allow objective assessment of the efficacy of surgery for biliary atresia.

Adolescent↗
PubMed1981

Bilateral juvenile granulosa cell tumors in a 4-month-old dysmorphic infant. A clinical, histologic, and ultrastructural study.

Juvenile granulosa cell tumors were encountered within bilateral cystic ovarian masses in a 4-month-old infant. The child was the product of a consanguinous pregnancy, and manifested poor growth, relative microcephaly, facial asymmetry, and a malformed left ear. There was no history of gestational drug or hormone ingestion, and no evidence of abnormal endocrine activity after birth, however, the serum alpha-fetoprotein level was mildly elevated. The tumors were well defined by sonography and there was no evidence of metastasis. Histologically, a dense proliferation of round to oval tumor cells showed considerable individual cell necrosis and frequent microcyst formation. There was no evidence of luteinization and only mild nuclear pleomorphism. Immunoperoxidase study failed to reveal alpha-fetoprotein. Ultrastructural study supported the granulosa cell nature of the tumor, but a few cells contained bundles of intracytoplasmic filaments. There has been no evidence of recurrent disease during a 16-month follow-up period, and serial alpha-fetoprotein determinations have remained in the reference range. Comparison with two previously reported bilateral juvenile granulosa cell tumors suggests that this tumor occurs in young infants, and is amenable to conservative therapy.

Abnormalities, Multiple↗
PubMed1980

The impact of chemotherapy and radiation therapy on secondary operations for neuroblastoma.

From January, 1969 through July, 1979, 37 children with neuroblastoma were cared for at the Oklahoma Children's Memorial Hospital. Nineteen patients with extensive disease were studied to examine the interrelationships of chemotherapy, radiation therapy and secondary surgery. Eleven children had secondary surgery in the abdomen or cervical region with one postoperative death. All patients had chemotherapy and ten had radiation therapy between the primary and secondary operation or death. Five children survived. Four of five survivors were less than one year of age at diagnosis and initial treatment. Fourteen of 15 patients, one year of age or older, died. Each case had pathologic examination of tumor before and after therapy. All survivors showed sequential maturation of tumor tissue but only one nonsurvivor had this finding. Unusual metastatic spread was found in patients having combined therapy. Multimodal therapy for advanced neuroblastoma accentuates the need for sensible timing and utilization of secondary operative procedures. The secondary procedures ideally eradicate the primary focus of tumor, and may also serve to excise selective areas of metastatic disease or to biopsy residual disease in aiding continuing therapy. Secondary surgery ought to follow the onset of radiation therapy by four to six weeks, or of chemotherapy by 12 to 24 weeks. This delay allows maximum control of primary and generalized disease, as well as maturation, differentiation, encapsulation and shrinkage of extensive initially unresectable primary tumors.

Abdominal Neoplasms↗