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Biomedical subjects

D T Wilcox

Publications and source records attributed to D T Wilcox.

66 records · Page 4Linked to original sources
PubMed1994

Toothbrush ingestion by bulimics may require laparotomy.

Two girls accidentally swallowed their toothbrush while inducing emesis; both had bulimia. Early removal of the brush is advised to prevent complications. Endoscopic removal is the preferred method, but because of the toothbrush's geometric qualities, surgical retrieval is often required.

Adolescent↗
PubMed1994

Pathophysiology of congenital diaphragmatic hernia. IX: Correlation of surfactant maturation with fetal cortisol and triiodothyronine concentration.

In addition to pulmonary hypoplasia and an altered pulmonary vascular bed, the abnormal lung development caused by congenital diaphragmatic hernia (CDH) is associated with an impairment in the pulmonary surfactant system. The aim of this study was to correlate fetal serum cortisol and triiodothyronine (T3) levels, known indicators of surfactant development, with maturation of the surfactant system in the lamb CDH model. Analysis of the products of bronchoalveolar lavage in CDH showed decreased phospholipid (P < .01) and increased protein concentration (P < .02) per gram of lung tissue when compared with controls, but cortisol and T3 concentrations did not differ significantly between the two groups. These results suggest that the surfactant deficiency in CDH is not related to an alteration in cortisol or T3 levels but may be directly related to the mechanical effects of the intrathoracic bowel.

Animals↗
PubMed1994

Pathophysiology of congenital diaphragmatic hernia. V. Effect of exogenous surfactant therapy on gas exchange and lung mechanics in the lamb congenital diaphragmatic hernia model.

The aim of this study was to assess the impact of surfactant deficiency on the pathophysiology of congenital diaphragmatic hernia (CDH). Pregnant ewes were operated on at 80 days of gestation for creation of a diaphragmatic hernia in the lambs. Twenty-one lambs survived to be delivered by cesarean section and were studied. Compliance was improved when surface tension effects were removed by saline solution in lungs of both control animals and lambs with CDH; however, the lungs of the lambs with CDH still had significantly impaired compliance. In a second series of experiments, two groups were studied: a surfactant-treated and a control, nontreated group. Surfactant was given prophylactically into the liquid-filled lungs before the first breath. All lambs were paralyzed and sedated and their lungs mechanically ventilated with 100% oxygen for 30 minutes; gas exchange was then assessed, pressure-volume data were obtained, and compliance was calculated. Surfactant significantly improved gas exchange; arterial oxygen pressure increased from 39 +/- 11.4 to 316 +/- 53.6 mm Hg, arterial carbon dioxide pressure decreased from 148 to 63 mm Hg, and pH increased from 6.87 to 7.16 (p < 0.001). Lung volume at 25 cm H2O, functional residual capacity, and compliance were all increased (p < 0.02). Thus, in the CDH lamb model, pulmonary mechanics are impaired by both parenchymal and surfactant abnormalities. Both lung mechanics and gas exchange are markedly improved by exogenous surfactant therapy.

Animals↗
PubMed1993

Antenatal diagnosis of pediatric surgical anomalies. Counseling the family.

Improvements in screening and diagnostic techniques now mean that hundreds of congenital anomalies can be antenatally diagnosed. It is, however, impossible and inappropriate to submit all pregnant women to a barrage of investigations. Screening is necessary before specific invasive investigations are initiated. These include history, physical examination, MS-AFP screening, estriol and hCG screening, and a Level II ultrasonography scan. Once at-risk pregnancies have been identified, a multidisciplinary team approach is commenced and further studies including Level II ultrasonography, amniocentesis, chorionic villus sampling, or cordocentesis can be performed so that an accurate diagnosis is available. Counseling of the parents throughout is essential so that appropriate decisions regarding this and further pregnancies can be made.

Cordocentesis↗
PubMed1989

Contrast sensitivity function and mobility in elderly patients with macular degeneration.

Eleven control subjects, 64-79 years of age, and 10 subjects with macular degeneration, 70-82 years of age, were included in this study. Each participant was tested for visual acuity, spatial and temporal contrast sensitivity, and mobility in an unfamiliar environment. The course was designed with a pair of steps, ramps, and a level pathway. The subjects were timed and videotaped. The number of errors was recorded. Visual acuity and contrast sensitivity were significantly different between groups. The time to complete the course was significantly different between groups; however, the difference did not remain significant after age-adjustment.

Aged↗