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Biomedical subjects

J D Baker

Publications and source records attributed to J D Baker.

158 records · Page 9Linked to original sources
PubMedDate not supplied

Milk intake and energy expenditure of free-ranging northern fur seal, Callorhinus ursinus, pups.

Milk ingested by mammalian offspring, coupled with offspring's utilization of this energetic investment, influences survival and growth. A number of studies have examined milk intake in otariids, but few have examined milk intake over the entire lactation period, and none has independently measured energy expenditure concurrent with milk intake. We concurrently examined milk intake, field metabolic rate (FMR), and body composition of 41 pups over the entire lactation interval in 1995 and 1996 on St. Paul Island, Alaska. One hundred two metabolic measurements were obtained with isotope dilution methods. Mean milk intake did not differ annually but increased with age and mass, ranging from 3,400+/-239 to 6,780+/-449 (+/-SE) mL per suckling bout. Milk energy consumption did not vary with age on a mass-specific basis. No differences were detected in milk volume consumed by male and female pups, either absolutely or on a mass-specific basis. Mass-specific FMR peaked during molting, was lowest postmolt, and did not vary by sex. Pups in 1995 had lower FMR than pups in 1996 and were also fatter. Mean milk energy utilized for maintenance metabolism decreased over time from 77% to 43% in 1995 and remained at 71% in 1996. Pup body mass was negatively correlated with the percentage of total body water and positively correlated with the percentage of total body lipid (TBL). Pups increased the percentage of TBL from 16% to 37%. Northern fur seal pups increased energy intake over lactation, while concurrent changes in body composition and pelage condition resulted in mass-specific metabolic savings after the molt.

Animal Nutritional Physiological Phenomena↗
PubMedDate not supplied

EEG surveillance as a means of extending operability in high risk carotid endarterectomy.

Some patients who have transient ischemic attacks are denied operation because severe occlusive lesions in other extra-cranial arteries may be inappropriately interpreted as constituting an unacceptable surgical risk, or because the lesion is so distal as to make its removal hazardous. Failure of endarterectomy is usually due to incomplete removal of the lesion or to thrombosis upon the frayed intima. Such lesions require excellent visualization and meticulous surgical technique -- not always possible with a shunt. Among 130 consecutive carotid endarterectomies performed under general anesthesia, EEG changes consistent with cerebral ischemia appeared in only nine (7%). These patients required a shunt. In 11 patients normal EEG tracings were obtained during endarterectomy despite contralateral carotid occlusion. None of these patients had a neurological deficit. Continuous EEG monitoring is a reliable method of detecting changes in cerebral perfusion, permits a more meticulous endarterectomy in high-lying lesions without a shunt, and extends operability in high risk patients. Angiographical findings may be an unreliable predictor concerning risk of endarterectomy.

Aged↗
PubMedDate not supplied

Rieger's syndrome: (oligodontia and primary mesodermal dysgenesis of the iris) clinical features and report of an isolated case.

An 11-year-old female manifested bilateral prominent Schwalbe's line, iridal adhesions, displaced and irregular pupils. She had no evidence of juvenile glaucoma. The major nonocular finding in this patient was the congenital absence of her primary and permanent maxillary central and lateral incisors. Although missing or malformed teeth may occur in other conditions such as Down's syndrome, focal dermal hypoplasia syndrome, anhidrotic ectodermal dysplasia, chondroectodermal dysplasia, and incontinentia pigmenti, the clinician should include Rieger's syndrome in his differential diagnosis in patients with oligodontia in combination with malformation of the anterior chamber of the eye. Rieger's syndrome is a rare condition characterized by ocular and dental abnormalities, namely mesoectodermal dysgenesis of the iris and cornea of the eyes and hypodontia of the dentition. This report presents a sporadic case of Rieger's syndrome in an 11-year-old female and discusses the pertinent clinical features of this condition.

Abnormalities, Multiple↗
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The correction of unilateral aphakia in children treated for orbital rhabdomyosarcoma.

The survival rate of children with localized orbital rhabdomyosarcoma is now greater than 90% 3 years after diagnosis as a result of advances in radiation and chemotherapy. Ninety percent of these children develop cataracts within 1 to 4 years after the completion of radiotherapy. The correction of aphakia in these children is complicated by the concurrent keratoconjunctivitis and dryness associated with radiotherapy. Three patients with a diagnosis of orbital rhabdomyosarcoma underwent treatment for uniocular cataract. Two of the patients were unable to use extended wear contact lenses. Both underwent epikeratophakia with poor results. One patient who had clinically significant ocular drying prior to cataract extraction underwent successful implantation of an intraocular lens as a primary procedure, with excellent visual results. Clinicians should be aware of the difficulties associated with contact lens wear and epikeratophakia tissue lenses in children who have had high doses of radiation for orbital rhabdomyosarcoma. Such patients are probably best served by primary intraocular lens implantation or by preservation of the posterior capsule at the time of cataract extraction to allow secondary lens implantation if contact lens wear is unsuccessful.

Aphakia, Postcataract↗
PubMedDate not supplied

Surgery in the prism adaptation study: accuracy and dose response. Prism Adaptation Study Research Group.

Three hundred twenty-two patients underwent strabismus surgery for acquired esotropia according to a rigid protocol in the Prism Adaptation Study (PAS). This report describes the PAS surgical technique and the methods used to evaluate and assure adherence to the surgical protocol. We present analyses of the discrepancies between the amount of recession surgery planned by the surgeon and the amount of recession estimated by the masked graders from documentary photographs. In 74% of patients, the total discrepancy (combined from both medial rectus operations) was 1 mm or less. There was a distinct trend for masked graders to estimate larger recession amounts than were dictated by the protocol and claimed to be done by the surgeon. In 24% of patients, the masked graders estimated that the recession was more than 1 mm greater than that claimed by the surgeon, while in 2%, the graders estimated that the surgery was more than 1 mm less than planned. Of the 74 patients for whom the graders' estimated total recession was more than 1 mm greater than the amount planned by the surgeon, 88% were successful. Of the six patients for whom the graders' estimated total recession was more than 1 mm less than the amount planned by the surgeon, five (83%) were successful. We propose new surgical tables for patients with acquired esotropia. Enhanced amounts of recession appear to be necessary to decrease the rate of undercorrection for each group of patients.

Adaptation, Ocular↗
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Retinal examinations in infants after extracorporeal membrane oxygenation.

BACKGROUND: Ophthalmic examinations performed in infants undergoing extracorporeal membrane oxygenation (ECMO) are recommended because ocular abnormalities have been known to occur after this procedure. METHODS: We reviewed medical records of infants treated with ECMO was subsequently underwent routine ophthalmic examination prior to or immediately after hospital discharge. Examinations were performed in a fashion similar to that for retinopathy of prematurity screening. RESULTS: Eye examinations were recorded for 171 patients (342 eyes). Fundus examination was normal in 302 eyes (88%). Abnormal retinovascular findings such as venous dilation or intraretinal hemorrhages, when present, were not considered vision threatening and required no treatment. CONCLUSION: Clinically important retinal findings were not identified in our patients undergoing postECMO screening. Routine dilated fundus examination is probably not cost effective and places additional and potentially unnecessary stress on these infants.

Extracorporeal Membrane Oxygenation↗
PubMedDate not supplied

Effects of intermittent pneumatic calf compression in normal and postphlebitic legs.

The changes in common femoral vein flow produced by three different intermittent pneumatic compression devices were recorded with a Doppler velocity detector in 20 normal legs and 20 with postphlebitic syndrome. Mean and peak velocity increases were measured and expressed as a percent of resting baseline values. There was no significant difference in the peak velocity increase produced by the three devices in normals and abnormals; however, there were differences in the mean velocity increases. The devices worked as well on postphlebitic legs as on normal ones. Correct cuff application was more critical than indicated by the manufacturers, suggesting that some of the failures of intermittent pneumatic compression may have resulted from improper cuff placement. The results show that different designs of intermittent pneumatic compression equipment accelerate venous flow in the leg.

Adult↗
PubMedDate not supplied

Reinforced graft-to-artery anastomosis: an experimental study.

UNLABELLED: This experiment was designed to study the effects of reinforcing graft-to-artery anastomoses. A section of infrarenal aorta was replaced with a Dacron graft in 24 dogs. In eighteen animals one anastomosis was reinforced with a cuff of Dacron graft material, while the remaining six dogs both anastomoses were reinforced, one with graft material and the other with Dacron mesh. The animals were sacrificed at three week to six month intervals. The grafts were examined grossly and microscopically, and the tensile strength of the anastomosis determined. There was no difference in tensile strength or in the luminal healing. There was only limited fibrous healing under the graft material cuff whereas there was full incorporation of the mesh cuff. CONCLUSIONS: Reinforcement is not required routinely. When used, the cuff should be made with mesh rather than graft material.

Animals↗
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Suprarenal abdominal aortic aneurysm managed by excision and primary repair using a lateral suture technique.

Suprarenal abdominal aortic aneurysms are rare and pose special problems in diagnosis and management. These aneurysms often involve one or more visceral branches and frequently require a thoracoabdominal approach for surgical repair. The operative management of an unusual saccular suprarenal aortic aneurysm suspected to be of mycotic etiology is discussed. The diagnosis was made preoperatively with the aid of CT scanning and arteriography. Surgical repair was accomplished through an abdominal approach by excision and primary closure using a lateral suture technique.

Aorta, Abdominal↗