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Biomedical subjects

K S Oh

Publications and source records attributed to K S Oh.

At least 91 records · Page 5Linked to original sources

Left aortic arch with right descending aorta.

A left aortic arch with a right descending aorta is a rare congenital anomaly. The radiographic findings in 13 previously described cases and three additional cases are discussed. Characteristic findings on the plain radiograph and esophagram can usually obviate the need for aortography. The anomaly was associated with a vascular ring in at least four and probably five of the 16 patients. Additional and more complex studies may be needed in patients with suspected symptomatic vascular rings.

Aorta↗

Clinical implications of postoperative unilateral phrenic nerve paralysis.

Unilateral phrenic nerve paralysis (PNP) folowed 32 (1.7 percent) of 1,891 consecutive cardiac surgical procedures during an 8 year peroid. Diagnosis was based on radiographic criteria with comparison of preoperative and postoperative chest radiographs and was confirmed in all 21 evaluated by fluoroscopy. Six had persistent radiographic abnormality more than 12 months postoperatively. PNP occurred most frequently in association with Blalock-Taussig shunts. These operations represented 22 percent of this series, and PNP complicated 7 percent of all Blalock-Taussig shunts. PNP was less well tolerated in the 14 infants than in the 18 older children. Eleven infants had serious difficulties during weaning from mechanical ventilatory support. Five infants required tracheostomy, one underwent diaphragmatic plication, and three died. Infants had a mean duration of mechanical ventilation of 24 days and required prolonged intensive care and long-term hospitalization. In comparison, older children had a more benign postoperative course. Diaphragmatic plication should be considered in infants with paradoxical motion of the hemidiaphragm who remain dependent on mechanical ventilatory support for more than 2 weeks postoperatively.

Adolescent↗

Pulmonary hyperinflation in ventricular septal defect.

Pulmonary hyperinflation (PH) has frequently been seen in patients with ventricular septal defect (VSD). Mean age of patients at the time of cardiac catherization and operation was less in Group II (PHI) than in Group I (normal pulmonary inflation). There is a statistically significant difference in the ratio of mean pulmonary to mean systemic blood flow and the ratio of mean peak pulmonary to mean peak systemic systolic pressures, with the higher values recorded for Group II. There is no statistically significant difference in the pulmonary vascular resistance in the two groups. Thirty-five of the 44 patients with PHI developed normal inflation within a month after surgical correction of VSD. Possible mechanisms of PHI in VSD are discussed. PHI is prolong and perpetuate respiratory distress and can lead to progressive lung disease. PHI is therefore another indication for early surgical correction of VSD.

Adolescent↗

Internal auditory canal enlargement in neurofibromatosis without acoustic neuroma.

Acoustic neuroma has always been reported to accompany neurofibromatosis in patients with enlargement of the internal auditory canal. The authors describe a case in which the internal auditory canal was enlarged but there was no tumor. This may represent a normal variant or a manifestation of the bony dysplasia of neurofibromatosis.

Adult↗

Evaluation of the atretic distal esophageal segment.

In infants with congenital esophageal atresia with a gasless abdomen, we have determined the length of the distal esophageal segment by injecting air into the stomach through a gastrostomy tube and causing the infant to burp. It is a safe and accurate method and can be done with or without fluoroscopic control.

Air↗

Pyloroduodenal deformity due to liver malformation associated wtih omphalocele.

While congenital malformed and malpositioned livers are rare, they are relatively common in patients with omphaloceles. A malpositioned, malformed liver causing pyloroduodenal deformity and apparent pyloric obstruction in an infant or child with an omphalocele has not been previously reported. Thee such cases are described in which symptoms of upper gastrointestinal obstruction developed shortly after primary closure of the omphaloceles. Recognition of this condition at the time of primary closure of an omphalocele may allow consideration of additional procedures to prevent postoperative pyloric obstruction.

Constriction, Pathologic↗

The syndrome of bronchial atresia or stenosis with mucocele and focal hyperinflation of the lung.

Three cases of "the syndrome of bronchial atresia or stenosis with mucocele and focal hyperinflation of the lung" are added to 28 proven cases (26 with atresia and 2 with stenosis) previously reported in the English literature. One case is of particular interest since serial roentgenograms during the first week of life showed fetal lung fluid to be trapped distal to the atresia. The radiographic findings in this syndrome are reviewed and the presumed etiology and pathophysiology discussed.

Body Fluids↗

Current perspectives on giardiasis.

Giardia lamblia infestation can cause severe diarrhea and malabsorption, and the diagnosis is usually made by identification of cysts in the feces, but small intestinal biopsy or smears may be required. A wide spectrum of roentgen changes may be seen. In patients with a normal immune status, the small bowel is normal or shows an inflammatory bowel disease pattern. Eradication of the parasite reverses these changes. In some patients with IgA deficiency, nodular lymphoid hyperplasia occurs, and this is usually not reversible. Other patients with hypogammaglobulinemia or dysgammaglobulinemia and giardiasis may show a sprue pattern. This pattern most often persists after eradication of the parasite. Although the triad of giardiasis, IgA deficiency, and nodular lymphoid hyperplasia has a particularly high association, these, together with diarrhea, malabsorption, and various altered immune states may occur in any combination.

Adult↗

Pulmonary edema and continuous positive pressure breathing (CPPB).

We have successfully treated severe pulmonary edema of various etiologies and the concomitant hypoxia in 17 infants and children with continuous positive pressure spontaneous breathing. The pressure used was 8 to 14 cm of water above atmospheric pressure. No significant changes occurred in arterial or central venous blood pressure, and no patient developed clinical evidence of peripheral venous engorgement. Pulmonary edema cleared within 24 hours in all cases. We believe this rapid clearing may differentiate pulmonary edema from pneumonia and pulmonary hemorrhage. The pathophysiology and the roentgenologic findings are presented.

Child, Preschool↗