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Biomedical subjects

E Welch

Publications and source records attributed to E Welch.

At least 19 recordsLinked to original sources
PubMed1991

Aneurysm of the right ventricular outflow tract: a complication of aorta-main pulmonary (central) shunt.

The ascending aorta-main pulmonary artery (central) polytetrafluoroethylene (PTFE) Gore-Tex shunt was introduced in 1975 by Gazzaniga and coworker. It is a widely used palliative procedure. We present a case study with an unusual late complication. An aneurysm was discovered at autopsy in a patient who was diagnosed at birth with hypoplastic right ventricle, pulmonary valve atresia, small main and branched pulmonary arteries. At 4 days of age, the patient underwent an aorta to main pulmonary artery (PTFE) Gore-Tex shunt. Subsequent echocardiogram showed dilatation of the right ventricular outflow tract. To our knowledge, this is the first reported case of right ventricular outflow tract (RVOT) aneurysm following central aortopulmonary shunt.

Anastomosis, Surgical↗
PubMed1988

Adrenal hypoplasia and pituitary agenesis in a normocephalic infant, with a review of the literature.

A case of adrenal hypoplasia and pituitary agenesis in a normocephalic female infant is described. Twenty-eight other cases from the world literature were reviewed. There were 18 females and 11 males. More than one affected infant was described in five families, suggesting autosomal recessive inheritance. The mode of presentation, subsequent course, pathology and possible pathogenesis are discussed.

Abnormalities, Multiple↗
PubMed1984

Surgical management of spontaneous pneumothorax.

Spontaneous pneumothorax is a common surgical problem. Although the general principles of drainage of the pleural space and of prevention of recurrence seem well known, the literature shows differences in success rates concerning the treatment of a first pneumothorax and of the eventual recurrences. This is probably due to some technical factors and different views on the therapeutical strategy. In this retrospective review of 62 patients with spontaneous pneumothorax, 8 were treated by bed rest for their not enlarging and less than 20% pneumothorax, and 54 were treated by closed chest tube thoracostomy with an early success rate of 93.5% at the first admission. The simultaneous use of scarifying agents and closed chest drainage appears useful for the treatment of immediate or first recurrence. Sixteen patients were readmitted later for ipsilateral recurrence. According to the magnitude of their pneumothorax, they were treated by bed rest or tube thoracostomy with scarifying agents. Four of these patients needed thoracotomy with oversuturing of subpleural blebs and pleurodesis. The total thoracotomy rate of the initial patient population was 12.9% after an average follow up period of 24.8 months.

Adolescent↗
PubMed1984

Current status of thoracic dorsal sympathectomy.

This article summarizes over 20 years of experience (1962 to 1982) with cervical sympathectomy (thoracic dorsal sympathectomy) in 46 patients undergoing 68 sympathectomies. All operations were performed through an anterior supraclavicular approach. Indications for surgery were intractable Raynaud's disease (26 patients), atherosclerotic obliterative arterial disease (five), causalgia (five), posttraumatic sympathetic dystrophy (seven), collagen vascular disorders (eight), hyperhidrosis (12), occupational-related digital thrombosis (four), and thrombosis secondary to intra-arterial injection (one). The incidence of complications and side effects, both temporary and permanent, including Horner's syndrome, is reviewed in detail. Particular reference is made to the various surgical techniques of managing the stellate ganglion; four patients had two-third to three-fourth resection of the stellate ganglion down to and including the T-3 thoracic ganglion, two had preservation of the stellate ganglion and resection of the T-2 through T-4 ganglia, seven had excision of the entire stellate ganglion down to and including the T-4 ganglion, seven had resection of the lower third of the stellate ganglion down to and including the T-4 ganglion, and 48 had removal of the lower half of the stellate ganglion down to and including the T-3 ganglion. The study reviews the literature germane to anatomic considerations and suggests revisions in current texts and atlases. By retrospective analysis of the records and a follow-up questionnaire, which provided an 86% follow-up (average 8.4 years), the paper points to the distinctive clinical characteristics of the different groups within the population undergoing the operation and provides guidelines for patient selection and conclusions on the place for this operation in the management of vascular diseases involving the upper extremity.

Adult↗
PubMed1983

A method for documentation of tissue perfusion using instant photography.

Two techniques for obtaining Polaroid pictures of tissue after the injection of fluorescein intravenously are presented. A rabbit small intestinal volvulus model was used to determine the accuracy of the techniques. Both methods are simple, accurate and relatively inexpensive, and immediate and permanent documentation is provided. While both methods provide results equivalent or superior to ultraviolet light fluorescence, the interference filter method produced brighter fluorescence and the results were more easily interpreted. Both methods can be performed by inexperienced personnel.

Animals↗
PubMed1978

Human triclonal anti-IgG gammopathy. II. Determination of the antigenic specificity patterns of the IgG, IgA and IgM autoantibodies for the subclasses of IgG.

The specificity and reactivity patterns of monoclonal IgG, IgA and IgM anti-IgG autoantibodies isolated from the serum of one patient (Gil) have been determined for IgGs of the four gamma chain subclasses. The haemagglutination produced by the interaction of the Gil anti-IgGs and anti-Rh IgG coated erythrocytes was inhibited by a panel of intact IgGs, their polypeptide chains, and enzymatic fragments which included purified heavy chain constant region domains. Intact IgG1, IgG2, and IgG4 produced the same patterns of reactivity with the Gil anti-IgGs. When partially reduced and alkylated IgG1 heavy chains and its tryptic digests were tested, these were much more reactive than Fc fragments isolated from IgG of the four subclasses which were weaker inhibitors, and gamma chain constant region domains which were totally non-reactive. In all instances and by use of two anti-Rh antisera, the specificity patterns obtained for the Gil anti-IgGs were identical. The data combined with previous knowledge of the identity of the Gil light chains suggests that the antibody combining sites of these molecules are very similar if not identical.

Autoantibodies↗
PubMed1976

Traumatic thenar ischemia.

A case of posttraumatic digital ischemia involving the thenar portion of the hand is presented and the differential diagnosis of hand ischemia is discussed. The importance of obtaining an occupational history for assessment of possible hand trauma is emphasized. Angiography can confirm the diagnosis of posttraumatic arterial injury and will localize thrombosis or aneurysms for possible surgical repair.

Angiography↗
PubMedDate not supplied

[Purpura fulminans].

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Treatment of status epilepticus with rectally administered diazepam].

Rectal administration of diazepam is a good alternative to intravenous acute treatment in severe epileptic crises, but there is scarce information about its usefulness in status epilepticus. Treatment with rectal diazepam, 0.6 to 0.8 mg x kg of body weight as a single drug, in 10 children with 13 episodes of status epilepticus, defined as epileptic crises lasting 30 or more minutes (ten of these were generalized tonic and clonic, two were unilateral tonic and clonic, and one was of the partial complex type) is described. Nine status epilepticus episodes subsided at an average 4.4 minutes after the drug was given; in 3 cases there were no favourable effects, and one case recurred after initial response. There were no significant complications, with the exception of slight respiratory depression in a patient with encephalitis. In spite of the small size of the sample, these results suggest that rectal diazepam is an effective alternative to intravenous drug administration in the management of status epilepticus whenever venous access is difficult.

Administration, Rectal↗