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Biomedical subjects

T R Weber

Publications and source records attributed to T R Weber.

At least 109 records · Page 6Linked to original sources
PubMed1983

Neonatal apnea, xanthines, and necrotizing enterocolitis.

This study evaluates the relationship of xanthine treatment of premature apnea and NEC in a bowel ischemia model. The superior mesenteric artery was occluded for 1.0 minute in 82 wheanling rats. Group I (n = 41) were untreated controls. Group II (n = 21) received aminophylline (AMPH) 40 mg/kg I.P., 4 hr and immediately prior to clamping. Animals were evaluated for bowel infarction, perforation, and mortality at 7 days. In 20 additional rats (10 per group) bowel was evaluated by scanning electron microscopy (EM) at timed intervals (5 and 30 min). Ischemic bowel occurred in 25 of 41 (60%) controls (18 (43%) with necrosis; 7 (17%) with perforations) and 19 of 21 (90%) rats with AMPH (15 (70%) had necrosis; 4 (19%) perforations). Mortality was 60% (controls) and 90% (AMPH) respectively (p less than .05). On EM, AMPH enhanced bacterial overgrowth however actual mucosal damage appeared similar. Following ischemia, AMPH has an adverse effect on the bowel. Use of AMPH in prematures at risk for NEC is questioned.

Aminophylline↗
PubMed1983

Massive gastric hemorrhage: an unusual complication of Henoch-Schönlein purpura.

Two severely ill children with multisystem involvement of Henoch-Schönlein purpura developed massive upper gastrointestinal hemorrhage, requiring operative ligation of gastric stress ulcers, and vagotomy and pyloroplasty. Arteriographic embolization was also used in one of the children when she developed recurrent hemorrhage. Survival in both children emphasizes the need for aggressive management of the many complications these children may develop.

Adolescent↗
PubMed1983

Rhabdomyosarcoma in childhood: analysis of survival in 98 cases.

Ninety-eight infants and children with rhabdomyosarcoma were analyzed for age, stage, site, and therapy as they relate to survival. Age and sex were not factors. Survival was 91% (10/11) for Stage I, 86% (13/15) for Stage II, 35% (12/34) for Stage III, and 5.2% (2/38) for Stage IV. Overall survival was 37% (37/98); however, 75% had advanced disease at diagnosis. Primary tumor site was genitourinary (GU) (31), extremity (17), head-neck (14), trunk (14), orbit (8), paratesticular (4), retroperitoneal (3), paraspinal (3), buttocks (3), and perianal (1). Survival was favorable in orbital, paratesticular, and (GU) sites. Survival was 20% (9/45) before and 52% (28/53) after chemotherapy and irradiation. The only survivors had embryonal cell histology. Tumor stage and site are important prognostic indicators. Chemotherapy improves survival in Stage I (91%) and Stage II (86%) and shrinks bulky Stage III tumors allowing less radical procedures in selected sites (e.g., GU). Survival is poor in Stage III (35%) and dismal in Stage IV (5.2%) despite combined therapy. Relapse was fatal despite attempts at second-look resection, and altered chemotherapy and irradiation.

Adolescent↗
PubMed1983

The diagnostic dilemma of the posterior mediastinal thymus: CT manifestations.

Extension of the normal thymus into the posterior mediastinum is rare. The CT appearance of this anomaly in an infant is presented. A mass of soft-tissue density extended from the anterior mediastinum to the posterior chest wall. The absence of any tissue-cleavage plane in the lesion and a smooth continuous lateral margin are signs of posterior extension of the thymus, and they help to distinguish this from a normal anterior thymus being present with a posterior tumor.

Diagnosis, Differential↗
PubMed1983

Unusual manifestations of histoplasmosis in childhood.

Nine previously healthy children were seen with unique, and in several instances, unreported manifestations of acute histoplasmosis. Presenting manifestations included: obstructive airway disease; subacute parotitis; unilateral cervical lymphadenopathy; anterior mediastinal mass-simulating neoplasm; immune hemolytic anemia; a cutaneous lesion with regional lymphadenopathy; mediastinal mass and pericardial effusion; pulmonary infarction; and a symptom complex of cervical lymphadenopathy, CSF pleocytosis, arthritis, and interstitial nephritis. In eight children histoplasmosis was not initially considered, and the correct diagnosis was made only after complex, and sometimes invasive, diagnostic evaluation and considerable delay. All patients recovered fully without antifungal therapy. Reports of uncontrolled trials of new antifungal agents for treatment of histoplasmosis in immunocompetent hosts should be cautiously evaluated.

Adolescent↗
PubMed1982

Tapering enteroplasty in infants with bowel atresia and short gut.

Antimesenteric tapering enteroplasty was evaluated as an alternative to resection in 16 babies. Tapering enteroplasty was done for jejunal atresia (11), ileal atresia (three), total colonic aganglionosis (one), and colonic atresia (one). Most had short gut with proximal bowel dilation. There were no anastomotic leaks but slight functional delay (eight to 14 days). One patient with 14 jejunoileal atresias received continuous-drip feeding while the remainder took regular diet. Mean weight gain was in the 25th percentile at 1 year of age, and the 35th percentile at 2 years of age. There were two deaths from liver failure and brain damage. Antimesenteric tapering enteroplasty is particularly useful in selected instances of intestinal atresia associated with short gut, where preservation of bowel length may be essential for survival. Gastrointestinal function, bowel movement patterns and growth and development have been gratifying.

Colon↗
PubMed1982

Total colonic aganglionosis. Analysis of 16 cases.

Sixteen of 116 infants (14 percent) with Hirschsprung's disease had total colonic aganglionosis. Treatment was delayed in 6 of 16 patients because the condition was not recognized. Diagnosis was eventually achieved by rectal biopsy and the extent of aganglionosis was documented after multiple intestinal biopsies. All patients were initially managed by diverting enterostomy. Ileoanal pull-through operation was performed in nine patients at 12 to 24 months of age with no operative mortality. The overall mortality rate was 25 percent, including the deaths of two infants with diagnostic delay. Survivors had normal growth and satisfactory bowel function, Hirschsprung's disease should be suspected and rectal biopsy performed in infants with persistent or intermittent abdominal distention and constipation. Instances of total colonic aganglionosis can be documented by appropriate biopsies at the time of laparotomy. The modified Duhamel operation is an acceptable procedure for this condition. A ganglionic antimesenteric patch enteroplasty may prove a useful adjunct in infants with extensive aganglionosis involving the proximal small bowel.

Ganglia, Parasympathetic↗
PubMed1982

One-stage resection for massive cervicomediastinal hygroma.

Cervicomediastinal cystic hygroma has long been recognized as a serious cause of respiratory distress in infancy. This report describes the management of ten infants and children with large cervicomediastinal hygromas. Ages ranged from the newborn to 4 years (average 18.4 months). Six were boys and four were girls. Eight presented with respiratory distress. Neck examination, ultrasonography, and chest x-ray examination were usually diagnostic. In four infants the intrathoracic component was initially clinically unsuspected. The neck lesion descends into the chest between the subclavian vein and artery. At operation the mass was dissected off the pericardium; phrenic, vagus, and recurrent laryngeal nerves; esophagus; aortic arch; and subclavian vessels. Complete resection was possible in each case. Nine of ten patients survived. Death occurred in a newborn with bilateral tumor and pulmonary hypoplasia. Three patients developed Horner's syndrome. There were no recurrences (follow-up 9 months to 10 years). These data indicate that a one-stage resection using an inverted hockey stick (sternum-splitting) incision is well tolerated, curative, and superior to other methods of treatment in infants with cervicomediastinal cystic hygroma.

Child, Preschool↗