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Biomedical subjects

J M Little

Publications and source records attributed to J M Little.

At least 181 records · Page 10Linked to original sources
PubMed1981

Vascular trauma.

Experience with vascular trauma over a nine month period is presented. Not all cases of arterial injury are obvious on initial presentation. Preoperative arteriography may be helpful but should not delay arterial reconstruction. Fractures should be established prior to arterial repair. Intra-operative arteriography may be useful, and fasciotomy should be used liberally in all cases of established ischaemia. Serious associated injuries are common and may determine the ultimate outcome.

Adolescent↗
PubMed1981

Vascular malformations.

Twenty-four patients suffering from vascular malformations have been followed by the author for between six months and fifteen years. Active arteriovenous leakage as determined by simple physical examination is all-important in determining the outcome of these lesions. Malformations occurring in the lower limb seem to have a considerably worse prognosis than those occurring elsewhere. Treatment is basically conservative, but amputation may become necessary when ischaemic ulceration or massive bleeding are uncontrollable by other means.

Adolescent↗
PubMed1981

Liver resection for neoplasm.

Major hepatic resections can now be performed with much greater safety than formerly. This is largely a consequence of improved surgical and anesthetic techniques, which have in turn resulted from better understanding of the anatomy, physiology and biochemistry of the liver. The treatment of liver tumours by resection must be reappraised in the light of these advances. This paper reports twelve patients who have undergone major hepatic resection for neoplasm at the Royal Prince Alfred Hospital over a ten-year period. The current indications for such surgery in the treatment of benign and malignant liver tumours are reviewed, and the results discussed.

Adenoma↗
PubMed1981

Consecutive exotropia after correction of hyperopia.

A study was done of 22 children in whom exotropia developed following correction of hyperopia because of accommodative esotropia that had not been corrected surgically. The early onset of esotropia and high degree of hyperopia seemed to predispose to the spontaneous development of exotropia. Reduction of the hyperopia by 50% to 60% resulted in satisfactory realignment of the eyes and some form of binocularity.

Accommodation, Ocular↗
PubMed1980

Retinoblastoma: the case for radiotherapy and for adjuvant chemotherapy.

The results of treatment for 39 consecutive children with retinoblastoma that was diagnosed between 1951 and 1978 were analyzed. Failure to achieve local control within the eye and the development of metastatic disease occurred in seven patients. These patients are considered individually. Delay in diagnosis, older age at presentation, and extraocular extension of disease at diagnosis were associated with treatment failure and were closely interrelated. Modified radiotherapy techniques using wider fields may prevent failure even in those cases diagnosed late and in those with extraocular extension. Indications for intrathecal and systemic chemotherapy in this disease are discussed.

Antineoplastic Agents↗
PubMed1980

Sandhoff's disease (GM2 gangliosidosis type 2). Histopathology and ultrastructure of the eye.

Sandhoff's disease (GM2 gangliosidosis type 2) was diagnosed in an infant in whom a progressive neurologic disorder and cherry-red foveal spots developed. At autopsy, ultrastructural examination of the retina and optic nerve disclosed abundant pleomorphic storage cytosomes in all neurons of the retina, including the inner segments of the photoreceptor cells, and in glial cells of the optic nerve. Electron microscopy of the cornea showed, within the keratocytes, distended clear lysosomes that contained some fibrillogranular material and an occasional collection of lamellae. We discuss the pathogenesis of the clinical and pathologic ocular findings with regard to the inherited absence of the enzymes hexosaminidase A and B and an accumulation of the substrates, GM2 ganglioside and asialo GM2, in the nervous system (including retina and optic nerve) and globoside and other hexosamine-containing substances in the viscera (including cornea).

Adolescent↗
PubMed1980

Initial experience wit polytetrafluoroethylene for extraanatomic bypass.

Extraanatomic bypass using polytetrafluoroethylene is a satisfactory alternative to direct aortic surgery in poor risk patients and in patients who have had previous aortoiliac reconstruction. If the disease is limited to one side, a crossover graft gives very satisfactory results with a 1 year cumulative patency of 95.6 percent. Axillofemoral grafts also give satisfactory results, especially if episodes of thrombosis are treated promptly by thrombectomy, in which case flow will be restored in most cases, with an overall 1 year cumulative patency of 89.5 percent.

Aged↗
PubMed1980

Liver injuries in sydney: a 20-year experience.

One hundred and twenty consecutive liver injuries treated at the Royal Prince Alfred Hospital have been studied prospectively. The overall mortality of 17.5% and the mortality for blunt injury of 23% compare quite favourably with figures in other reported series of similar injuries. The surgeon who treats liver injury must have a repertoire of procedures appropriate for different circumstances and must remain flexible in his approach. Simple suture haemostasis and the provision of adequate drainage will cope with most injuries. Debriding resections are safe, allow adequate haemostasis to be achieved, and give reasonably good access to the retrohepatic vena cava and hepatic veins. Formal lobectomy is very rarely indicated. Drainage of the common bile duct is to be avoided, but cholecystostomy has some marginal advantages and appears safe. The problems of retrohepatic vena caval injury and major hepatic vein tears have not all been solved.

Adult↗
PubMed1980

Ontogenesis of intestinal bile salt absorption in the neonatal rat.

In vitro uptake of taurocholate by weanling rat ileum was characterized. The neonatal development of the ileal mechanism was determined, and the effect of steroid treatment on this development was assessed. Mucosal uptake of taurocholate by ileum of 26-day-old and adult rats was linear with time and, when measured as a function of concentration, tended toward a plateau. Mucosal concentration of taurocholate was significantly reduced by metabolic inhibitors and was competitively inhibited by taurochenodeoxycholate. The capacity to concentrate taurocholate in ileal mucosa was undemonstrable in 12-day-old neonates, first appeared at 15 days, and reached adult levels by 26 days of age. Mucosal uptake of taurocholate by ileum of 12-day-old offspring of steroid-treated mothers or of 12-day-old neonates given dexamethasone directly was significantly increased over control values. The results indicate that the ileal bile salt absorption found in weanling rats is an active process that does not begin to develop in neonatal rats until 15 days after birth, and that the appearance of ileal active transport can be accelerated by maternal or neonatal steroid treatment.

Aging↗
PubMed1980

Fetal rat hepatic ultrastructural changes associated with organ culture and glucocorticoid treatment.

Fetal hepatic ultrastructure was examined from 18 days gestation to term. Such structure was compared to that of tissue obtained at 18 days gestation which had been maintained in organ culture for 24, 48, and 72 h. In addition, the effects of maternal glucocorticoid administration in vivo and in vitro organ culture glucocorticoid exposure upon fetal hepatic morphogenesis were examined. Enhanced fetal hepatocyte ultrastructural maturation, characterized by a reduction in hematopoietic percursors, an increased frequency of hepatocyte-hepatocyte contact, a complete compliment of intracellular organelles, and the development of bile canaliculi by either maternal in vivo or in vitro fetal organ culture glucocorticoid exposure, was demonstrated. These studies extend previous observations concerning bile salt synthesis and secretion by fetal hepatic tissue both in vivo and in vitro by providing an ultrastructural basis for the functional changes observed and reported to occur in response to steroid therapy

Animals↗
PubMed1980

Ocular defects and short stature.

The presence of ocular anomalies in a short child raises the possibility of hypothalamic-pituitary dysfunction or other intracranial abnormalities. The ocular, endocrine and neurologic findings in three children with short stature are described in this article. The first child had a large basal encephalocele, agenesis of the corpus callosum, mild optic atrophy in one eye, a retinal pigment epithelial defect in the other eye and bitemporal hemianopia; the second child had septo-optic dysplasia and the third child had Rieger's anomaly. All had deficient or abnormal growth hormone responses and two of the children had other pituitary hormonal abnormalities. It is suggested that an arrest of development during organogenesis can produce a spectrum of abnormalities involving ocular, endocrine and neurologic structures. Early diagnosis is important so that endocrinologic and neurologic investigations can be undertaken and appropriate therapy implemented.

Adolescent↗
PubMed1980

Peter's anomaly with congenital aphakia.

An Inuit boy was born with microphthalmia and a central corneal opacity of the right globe. Histopathologic examination revealed a central adherent corneal leukoma (Peter's anomaly) as well as absence of the lens. We are not aware of other well documented histopathologic reports of congenital aphakia and Peter's anomaly occurring in the same eye.

Aphakia↗
PubMed1979

Intestinal pseudo-obstruction.

Intestinal pseudo-obstruction is a fairly common clinical condition. It is often asosociated with the taking of phenothiazines, tricyclic antidepressants and anti-Parkinsonian drugs, or with another disease. Treatment is conservative, unless gross colonic distension cannot be relieved or perforation is suspected. Vasopressin (Pitressin) may be a useful adjunct in management.

Aged↗
PubMed1979

Intestinal absorption of bile salts: immature development in the neonate.

The intestinal absorption of sodium taurocholate was studied in fetuses, neonates, infants, children, and adults. Absorption rates were measured in vitro in everted rings of jejunum and ileum. Mucosal accumulation of 3H-taurocholate against a concentration gradient was consistently demonstrated in rings of ileum from adults, children, and infants older than 8 months, whereas fetal and neonatal ileal mucosal concentrations were not significantly above those in the incubation medium after exposure of the mucosa to 0.003, 0.03, and 0.3 mM taurocholate. There were no significant differences in mucosal uptake of taurocholate by perinatal jejunal and ileal rings. Incubations of mucosa from older infants, children, and adults in 0.3 mM taurocholate exhibited saturation phenomena. It is concluded that the ileal mechanism for active transport of taurocholate is undeveloped in the fetus and newborn infant. It is probable that the enterohepatic circulation of bile salt during the perinatal period is limited to that fraction of bile salt absorbed passively. The results suggest that losses of bile salt from the immature intestine may contribute to the steatorrhea and so-called diarrhea of newborn infants.

Aged↗