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Biomedical subjects

J W Baker

Publications and source records attributed to J W Baker.

At least 73 records · Page 4Linked to original sources
PubMed1978

Repair of major defects of the chest wall and spine with the latissimus dorsi myocutaneous flap.

The latissimus dorsi myocutaneous flap is a remarkably durable and versatile flap. Flap necrosis did not occur in any of our patients. One can safely carry with it skin segments as narrow as 3 cm, or as wide as 30 cm. In addition to the 5 cases presented, we have used the flap to repair axillary burn contractures, for breast reconstruction after a transverse incision, and for coverage of the upper arm and shoulder. The applications of this flap challenge the creative imagination of the surgeon and allow a simplified reconstruction, compared to other good methods. The newly described posterior advancement of a latissimus dorsi myocutaneous flap is suggested as the preferred method to repair meningomyelocele defects.

Aged↗
PubMed1978

Fetal-maternal macrotransfusion--a study of 400 postpartum women.

The results of postpartum fetal cell counting in 400 Rh-negative patients delivering Rh-positive infants are presented and correlated with the mode of delivery and the ABO blood group relationship of baby and mother. Manipulative procedures, especially Caesarean section, are shown to increase the incidence of macrotransfusion. To make the most economical use of the new 125 microgram doses of anti-D gamma globulin, quantitation of fetal-maternal transfusions is shown to be vital if the existing level of protection from rhesus sensitization is to be maintained or increased.

ABO Blood-Group System↗
PubMed1976

Complications of vagotomy in the treatment of hiatal hernia.

Inclusion of vagotomy and pyloroplasty in the surgical treatment of gastroesophageal reflux associated with hiatal hernia has long been controversial. To evaluate the morbidity of vagotomy in the treatment of reflux esophagitis, a retrospective study of 311 patients treated by the Hill posterior gastropexy technique of hiatal hernia repair was tabulated. Vagotomy with the anti-reflux operation was performed upon 159 patients (51%). Vagotomy was not included for 152 patients (49%). The incidence of postoperative symptoms with or without vagotomy was almost equally divided--41% without vagotomy and 47% with vagotomy. However, the major postoperative symptoms that occurred in both groups were abdominal cramps and bloating which usually disappeared in the early postoperative period and were attributed to the anti-reflux procedure and not to vagotomy. When vagotomy was included with the anti-reflux operation, the incidence and duration of long term, disabling postoperative symptoms were significantly increased. Diarrhea occurred two times more frequently. Nausea and vomiting occurred ten times more frequently and dumping was present only in vagotomized patients. Long term postoperative symptoms, judged on a basis of symptoms lasting longer than three months duration, occurred in 1% of patients without vagotomy and 26% when vagotomy was included. This study revealed that no additional protection against recurrent symptoms of gastroesophageal reflux or radiographic evidence of recurrent hiatal hernia was provided by inclusion of vagotomy. In conclusion, vagotomy is contraindicated in the treatment of gastroesophageal reflux except in the presence of peptic ulcer disease.

Diarrhea↗
PubMed1976

Rhinovirus and influenza type A infections as precipitants of asthma.

Specimens from 49 persons, 3 to 60 years of age, who were prone to attacks of apparently infectious asthma were cultured for viruses and bacteria during episodes of symptomatic respiratory infection from September 1972 to June 1973. Seventy-one of 128 episodes (55 per cent) of symptomatic respiratory infection occurred with asthma. Shedding of respiratory pathogens was associated with 43 of the 128 episodes, and 19 of the 43 etiologically defined episodes occurred with wheezing. Seven of 15 rhinovirus symptomatic respiratory infections were linked with asthma, as were 4 of 5 influenza type A (H3N2) and 2 of 3 respiratory syncytial virus infections. A total of 21 different rhinovirus serotypes have been identified from asthmatic patients during 2 years of study; 14 of these were associated with wheezing, indicating that the ability to cause asthma is not restricted to only a few types. Other viruses that were shed during wheezing-associated symptomatic respiratory infections included para-influenza type 3, adenovirus type 7, and 2 unidentified viruses. Although infectious asthma was not easily defined in adults and some older children, viruses that appeared to precipitate asthma were distributed among patients of widely differing ages.

Asthma↗
PubMed1976

Elevated plasma antidiuretic hormone levels in status asthmaticus.

Elevated plasma antidiuretic hormone (ADH) levels were noted in seven patients with status asthmaticus during the acute illness. These values returned to normal with resolution of the disease. The mechanism of this release is not completely understood but is consistent with the hypothesis that bronchospasm leads to decreased pulmonary blood flow, decreased volume return to the left atrium, and stimulation of the atrial volume receptors regulating ADH release. Planning for fluid therapy in patients with status asthmaticus should take into account a high probability of increased plasma ADH concentration during the acute illness. Water intoxication as well as hypoxia and hypercarbia should be considered as a possible cause of an altered state of consciousness associated with status asthmaticus.

Acute Disease↗
PubMed1976

Modification of the Hill technique for repair of hiatal hernia.

The major modification of this technique allows accurate placement of sutures through the median arcuate ligament and eliminates the dissection required to expose the aorta at the origin of the celiac artery. Use of a separate row of sutures to create a sling at the esophagogastric junction maintains the desired intraluminal diameter when the esophagogastric junction is secured to the median arcuate ligament.

Hernia, Diaphragmatic↗
PubMed1974

Greater frequency of viral respiratory infections in asthmatic children as compared with their nonasthmatic siblings.

A longitudinal clincal and microbiologic surveillance was conducted from October to May, 1971-72, on 16 children with infectious asthma and 15 of their nonasthmatic siblings. Asthmatic children experienced a significantly greater frequency of viral respiratory infections than did nonasthmatic ones (5.1 vs. 3.8 per subject). This increased incidence appeared to be largely the result of a greater number of rhinovirus infections. While respiratory infections of identical etiology that occurred concurrently in an asthmatic and his sibling were equivalent in severity, illnesses were longer (but not significantly so) in asthmatic children.

Asthma↗