Search PubMed⌕ Search

Biomedical subjects

H W Scott

Publications and source records attributed to H W Scott.

At least 55 records · Page 3Linked to original sources
PubMed1981

Experimental study of double staple lines in gastric partitions.

Results of this study suggest that, when separated by 1 centimeter, the gastric wall situated between the two staple lines is relatively ischemic compared with the gastric wall outside the staple lines. The potential for perforation within this isolated segment is consequently greater. Therefore, placing two rows of staples 1 centimeter apart is dangerous and should be avoided. On the other hand, the gastric partitions can be safely reinforced by placing a double row of staples immediately adjacent to each other. Although placing two rows of staples 2 centimeters apart may be safe, there is little, if any, reinforcement of the proximal suture line, and it is not recommended.

Animals↗
PubMed1981

Surgical experience with hyperparathyroidism.

This is a retrospective analytic review of 208 patients with hyperparathyroidism studied and treated at Vanderbilt University Hospital from 1935 to 1980. Follow-up in these patients has been completed to date or to death in a great majority of patients. Results indicate the value of excision of isolated adenomas and of subtotal parathyroidectomy for primary and secondary hyperplasia.

Adenoma↗
PubMed1980

The role of vagotomy in pancreaticoduodenectomy.

In a series of 41 pancreatoduodenectomies the Whipple procedure was done in 27 patients and total pancreatoduodenectomy in 14 others with two postoperative deaths. Among 39 survivors, seven developed evidence of stomal ulcer 20 days to six years after operation; details of their courses are summarized. Proven stomal ulcer occurred in five of 14 patients who did not have concomitant vagotomy with pancreatoduodenectomy (36%). Each of these required vagotomy secondarily in management. When two patients with hematemesis in whom stomal ulcer was suspected but not proven are included, the incidence of stomal ulcer in nonvagotomized patients with pancreatoduodenectomy (7/14) is 50%. There were no stomal ulcers in patients with pancreatoduodenectomy who had concomitant vagotomy (0/25). It is logical to add the protective effects of vagotomy to pancreatoduodenectomy, especially when the disease process favors prolonged survival.

Adenocarcinoma↗
PubMed1979

Microbial colonization and hepatic abnormalities in jejunoileal bypass with resection, ileal mucous fistula, and ileocolostomy.

A role for bacterial colonization of the intestines in the pathogenesis of hepatic abnormalities after jejunoileal bypass was sought. Dogs were divided into groups according to the disposition of the bypassed segment; resection (group I), exteriorization as an ileal mucous fistula (group II), and drainage via an ileocolonic anastomosis (group III). Weight loss, abnormalities in liver function, and hepatic steatosis were significantly greater in groups II and III than in group I. Concomitantly, there was a significant increase in the total number of bacterial colony-forming units in groups II and III. Moreover, a greater number of specific anaerobic genera was isolated in group III than in group II. It is concluded that: (1) retention of the bypassed intestinal segment is associated with greater changes in liver function and structure than when the segment is resected; (2) the changes in the liver correlated with bacterial proliferation in the bypassed intestinal segment; and (3) despite a greater number of anaerobic genera in the ileocolostomy than in the mucous fistula, both procedures were associated with hepatic abnormalities.

Animals↗
PubMed1979

Coarctation of the abdominal aorta: pathophysiologic and therapeutic considerations.

Coarctation of the aorta is the most frequent cause of hypertension in infants and children. Ninety-eight per cent of coarctations occur in the descending aorta near the ligamentum arteriosus. Five patients are presented with the relatively rare problem of coarctation of the abdominal aorta. The anatomic,pathophysiologic and clinical aspects in these patients cover a range of variants. Clinical and laboratory studies of the genesis of hypertension in coarctation are reviewed in chronologic outline. An experimental model of abdominal coarctation with hypertensive and renin-angiotensin II correlations suggests but does not prove a renal mechanism for the hypertension. The same conclusion must be drawn from study of the clinical cases.

Adolescent↗
PubMed1977

Morbid obesity: problems associated with operative management.

A review of the problems associated with extensive jejunoileal bypass for morbid obesity in a series of 175 carefully selected patients is presented. Five postoperative deaths occurred (3%). Nonfatal complications occurred in 21%, with wound infections (14 patients) being the most common. Good results marked by weight reduction to the range of ideal weight without significant electrolyte or metabolic aberrations was observed in 82% of the patients receiving the current dimensional modificatiom of end-to-end jejunoileal bypass (30 cm to 20cm). An additional 13% had fair results and only 5% had poor results. There were six deaths during follow-up: liver failure in four patients (secondary to alcohol abuse in two), myocardial infarction in one, and one from unknown causes. Bypass reversal was necessary for refractory liver failure in three patients (two from alcohol abuse), and for persistent diarrhea with secondary electrolyte depletion in two patients. One of these patients was complicated by severe emotional instability. This experience suggests that the majority of carefully selected patients will have a good response to jejunoileal bypass.

Adolescent↗
PubMed1977

Surgical experience with Cushing's disease.

During the period 1952 to 1976 at Vanderbilt University Hospital 119 patients with pituitary-dependent hypercortisolism or Cushing's disease were studied. The less severe cases, which constitute a majority, were treated by pituitary irradiation with endocrinologic cure or improvement in two-thirds of the treated patients. Bilateral total adrenalectomy was reserved for the most severe cases and for failures of pituitary irradiation. In 29 patients with total bilateral adrenalectomy there was one postoperative death. Two of 28 survivors had incomplete relief of hypercortisolism and required additional therapy for its control. One patient with recent operation is improved and another with early improvement died suddenly at home three months after operation. The 24 other adrenalectomized patients, followed 6 months to 20 years, were considered endocrinologic cures of Cushing's disease. One patient in the group who had not received pituitary irradiation developed signs of expanding pituitary tumor after adrenalectomy (Nelson's syndrome) with satisfactory response to radiation therapy.

Adolescent↗