Biomedical subjects

J D Atwell

Publications and source records attributed to J D Atwell.

At least 55 records · Page 3Linked to original sources

PubMed1980

Zollinger-Ellison syndrome in a child: medical treatment with cimetidine.

A 12-year-old boy presented with intestinal obstruction associated with duodenal and oesophageal ulceration. At laparotomy he was found to have an islet cell tumour in the right lobe of the liver. Gastroenterostomy was performed. Raised levels of serum gastrin were detected. Treatment with cimetidine has produced satisfactory control of his symptoms for 16 months, and is an acceptable alternative to total gastrectomy in childhood.

Child↗

PubMed1978

Renal growth following reimplantation of the ureters for reflux.

Renal growth after reimplantation of a refluxing ureter was measured in 17 patients (26 renal units). Measurements of renal length were made from intravenous pyelograms 1, 3 and 5 years post-operatively. Our findings showed that after successful antireflux surgery the rate of renal growth was greater than normal in the first post-operative year but between 1 and 5 years post-operatively was normal.

Adolescent↗

PubMed1978

Changing patterns in paediatric surgical care.

The increased use of day facilities for children undergoing surgery and the provision of a paediatric home nursing team has resulted in a change in overall care of surgical children in hospital in Southampton. The ratio of day patients to inpatients has fallen from 1 : 2 in 1970 to 1 : 1 in 1976 and the early discharge of inpatients has resulted in a fall in the average inpatient stay of 6.6 days in 1970 to 5.7 days in 1976. I am sure that Alex Simpson Smith, who experienced a traumatic hospital admission at the age of 3 years and who always had the interests of children at heart, would have appreciated and actively encouraged these changes in hospital practice if he had been alive and with us today.

Child↗

PubMed1977

The interrelationship between vesico-ureteric reflux, trigonal abnormalities and a bifid pelvicalyceal collecting system: a family study.

3 investigations have been undertaken to study the interrelationship between a bifid pelvicalyceal collecting system, vesico-ureteric reflux and lateral ectopia of the ureteric orifice. Firstly, in 30 families investigated to confirm the familial incidence of bifid and double ureters there were 3 families in which siblings were found with primary reflux. Secondly, reflux was found in 62 of 110 patients investigated with a duplex pelvicalyceal system. Reflux was to the ipsilateral kidney in 48 patients but occurred to the contralateral kidney, unaffected by duplicity, in 14. This high incidence of reflux is related to lateral ectopia of the ureteric orifice which may be either bilateral or unilateral. Thirdly, the incidence of a bifid pelvicalyceal system was determined in the parents and siblings of a series of 32 patients with primary reflux. The results support the hypothesis that primary reflux may be inherited by an autosomal dominant gene of variable penetrance in a manner similar to the inheritance of a duplex urinary tract. Thus there is a direct genetic relationship between primary vesico-ureteric reflux, lateral ectopia of the ureteric orifices and a duplex pelvicalyceal system.

Abnormalities, Multiple↗

PubMed1976

The embryology and surgical management of gastroschisis.

Thirteen cases of gastroschisis are presented and a reduction in the operative mortality to 15 per cent is recorded. The aetiology of the condition is discussed and the opinion expressed that it represents the result of an intra-uterine rupture of an incarcerated "hernia into the cord" rather than any specific failure of development of the abdominal wall musculature. Early skin closure and the creation of a ventral hernia remain the surgical treatment of choice, but it is recognized that the use of a prosthetic sac may occasionally be necessary. Infection is not the most important single factor influencing mortality, and the prolonged administration of prophylactic antibiotics is justified on this basis. Skilled management of the protracted ileus is essential. In view of the low incidence of serious coexistent malformations the children who survive the initial operation can be offered the prospect of a life of normal duration and quality.

Abdominal Muscles↗

PubMed1975