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Biomedical subjects

M Dinner

Publications and source records attributed to M Dinner.

At least 19 recordsLinked to original sources
PubMed1993

Succinylcholine increases intraocular pressure in the human eye with the extraocular muscles detached.

BACKGROUND: The increase in intraocular pressure in the human eye that is associated with the use of intravenous succinylcholine has long been ascribed to contraction of the extraocular muscles leading to compression of the globe. This created concern that such contraction would extrude global contents in the patient with an open globe, and led clinicians to avoid the use of succinylcholine in these patients. METHODS: The authors studied 15 patients undergoing elective enucleation, and compared the intraocular pressure change after the administration of succinylcholine in the diseased eye after all the extraocular muscles had been detached to that of the normal eye that had the extraocular muscles attached. RESULTS: The authors found no difference in baseline intraocular pressure (mmHg) between eyes (15.1 vs. 16.1) or at peak intraocular pressure (25.2 vs. 24.7), but did observe a significant difference in pressure in both eyes when baseline was compared with peak pressure. CONCLUSIONS: The authors concluded that extraocular muscle contraction does not contribute to the increase in intraocular pressure after succinylcholine.

Adult↗
PubMed1992

Ventriculoatrial shunt utilizing the azygos vein.

Long-term ventricular cerebrospinal fluid shunting can prove difficult in the neonatal population, particularly in those neonates who have had previous abdominal and vascular procedures. This article presents a technique of providing vascular access for ventriculoatrial shunting via the azygos vein for patients with limited vascular access and in whom ventriculoperitoneal shunting is not feasible.

Azygos Vein↗
PubMed1992

Induction and maintenance characteristics of anesthesia with desflurane and nitrous oxide in infants and children.

To determine the induction and maintenance characteristics of desflurane in pediatric patients, the authors anesthetized 206 infants and children aged 1 month to 12 yr with nitrous oxide plus desflurane and/or halothane in oxygen. Patients were assigned to one of four groups: anesthesia was 1) induced and maintained with desflurane after premedication with an oral combination of meperidine, diazepam, and atropine; 2) induced and maintained with desflurane; 3) induced with halothane and maintained with desflurane; or 4) induced and maintained with halothane. An unblinded observer recorded time to loss of consciousness (lid reflex), time to intubation, and clinical characteristics of the induction and maintenance of anesthesia. Moderate-to-severe laryngospasm (49%) and moderate-to-severe coughing (58%) occurred frequently during induction of anesthesia with desflurane; the incidence of these was not altered by premedication. In contrast, laryngospasm and coughing were rare during induction of anesthesia with halothane. In unpremedicated patients, time to loss of lid reflex (mean +/- SD) was similar for desflurane (2.4 +/- 1.2 min) and halothane (2.1 +/- 0.8 min). During induction of anesthesia, before laryngoscopy and intubation, mean arterial pressure less than 80% of baseline was more common with halothane; heart rate and mean arterial pressure greater than 120% of baseline were more common with desflurane. Intraoperatively, heart rate greater than 120% of baseline was more common with desflurane; blood pressures were similar for the two anesthetics. The authors conclude that the high incidence of airway complications during induction of anesthesia with desflurane limits its utility for inhalation induction in pediatric patients. Anesthesia can be safely maintained with desflurane if induced with a different anesthetic.

Anesthesia, Inhalation↗
PubMed1982

Results of testicular autotransplantation using the microvascular technique: experience with 8 intra-abdominal testes.

Children with intra-abdominal testes comprise a small group presenting for surgical management of the undescended testicle. During the last 4 years 6 children with 8 intra-abdominal testes have undergone testicular surgery. In 7 testicles the technique involved high intraperitoneal division of the testicular pedicle with reanastomosis of the distal spermatic artery and vein to the inferior epigastric artery and vein using the operating room microscope. Microsurgery on the 7 intra-abdominal testicles led to good results in 6 cases. In 1 testicle venous infarction occurred secondary to venous congestion. Although many children with intra-abdominal testes have been managed using the standard Stephens-Fowler technique, we believe that microsurgical reanastomosis will improve the previously reported results.

Adolescent↗
PubMed1980

Technique of testicular autotransplantation using a microvascular anastomosis.

The use of the operating room microscope to accomplish microscopic anastomosis is gaining wider application. The technique to accomplish autotransplantation of the intra-abdominal testes involves division of the spermatic artery and vein with reanastomosis to the inferior epigastric vessels under the operating room microscope. The over-all success rate cannot be assessed without long term follow-up study, but this procedure offers more potential success than vascular pedicle division alone and will eliminate staged orchiopexy.

Cryptorchidism↗
PubMed1980

Exophytic (pedunculated) malignant melanoma--Cleveland Clinic experience.

Since few cases of exophytic malignant melanoma have been reported, their nature, history, and prognosis have been uncertain and controversial. We report 26 cases followed at the Cleveland Clinic from 1969 to 1975. Twenty men and 6 women ranging in age from 19 to 65 years were followed. There were 16 deaths, 3 patients are alive with lymph node metastases, and 3 patients are alive with distant metastases, for a 2-year disease-free survival of 15% and 5-year survival of 33%. All patients had lesions of either Clark level III, IV, or V with no correlation to survival. All lesions were 2 mm or more in thickness. A 44% disease-free survival was found for lesions 2 to 3 mm in thickness and no disease-free survival for lesions thicker than 3 mm. Our findings support the concept that exophytic malignant melanomas have increased malignant potential. We believe all malignant melanomas should be classified according to both Clark levels and Breslow's micrometer thickness measurements.

Adult↗
PubMed1978

The rhomboid flap and partial mastectomy.

The use of a rhomboid flap in segmented breast resection is described. This reconstructive technique allows large areas of the breast to be resected with minimal deformity and nipple-areola displacement.

Axilla↗
PubMed1977

Hirschsprung's disease.

Hirschsprung's disease is one of the most common causes of intestinal obstruction in the neonatal period. In Hirschsprung's disease the aganglionic segment extends for a variable distance along the bowel, and there are three types: (i) short-segment, (ii) long-segment, (iii) total aganglionosis of the bowel. The long-segment group forms +/- 20% of the total group. In approximately 5%, however, the entire colon and even the small bowel may be involved; one such case is described together with its management, some of the problems encountered, and the operation of choice.

Colectomy↗