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Biomedical subjects

W L Buntain

Publications and source records attributed to W L Buntain.

At least 37 records · Page 2Linked to original sources
PubMed1979

Bilateral Wilms tumor presenting with acute renal failure and clinical findings mimicking cardiac failure.

A six-year-old girl presented with clinical signs and symptoms of right-sided heart failure. Cardiac catheterization demonstrated filling defects in both pulmonary arteries felt to represent metastatic lesions or thromboemboli. Intravenous pyelogram revealed bilateral renal masses and intrarenal obstruction. Acute renal failure was unresponsive to standard therapy. An open renal biopsy revealed Wilms tumor with favorable histology. Aggressive chemotherapy and irradiation were undertaken and renal function returned. This case adds to the heterogeneity of presentations described for Wilms tumor, and review of the literature reveals no other cases with similar presenting signs.

Acute Kidney Injury↗
PubMed1979

Transcutaneous oxygen (tcPO2) measurements as an aid to fluid therapy in necrotizing enterocolitis.

Impaired peripheral perfusion is a major problem in necrotizing enterocolitis with delayed recognition and definite documentation being primary factors. While blood pressure and other clinical measurements may improperly estimate the severity of the problem, changes in transcutaneous oxygen measurements and their relationship to arterial oxygen (the tcPO2/PaO2 ratio) potentially afford a sensitive measurement of peripheral perfusion. Experience in our unit confirms a close relationship between tcPO2/ and PaO2 being 0.97 +/- 0.04 (SE). Ten infants with birth weights of 640 to 1380 g, who subsequently developed necrotizing enterocolitis, had strikingly lower ratios initially (0.00, 0.00, 0.00, 0.17, 0.21, 0.43, 0.44, 0.48, and 0.56). Use of the tcPO2/PaO2 ratio to monitor fluid therapy was related to outcome, suggesting that this ratio is important in managing necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1979

Pulmonary arteriovenous malformations in children.

Pulmonary arteriovenous malformations are a life-threatening, but curable, cause of persistent cyanosis in children. Abnormal communications may be single or multiple and are usually in the lower lobes. Three patients with pulmonary arteriovenous malformations have recently been managed at this hospital. Ranging in age from 2 to 4 yr, all were female, all were from families with Rendu-Osler-Weber syndrome, and all underwent pulmonary angiography with confirmation of diagnosis. All have had uneventful resection, one of the left lower lobe, one the right upper lobe, and the other the right middle and lower lobes.

Arteriovenous Malformations↗
PubMed1979

Christmas bow tragedies.

Two cases of fatal accidents involving plastic buttons from Christmas bows are described. Although accidents are the commonest cause of death in children less than 3 years old, governmental mechanisms, properly enforced, can be instrumental in preventing such catastrophies.

Child, Preschool↗
PubMed1979

Splenorrhaphy: changing concepts for the traumatized spleen.

Established doctrine dictating splenectomy for the traumatized spleen has come under considerable critism since the report of fatal postsplenectomy sepsis by King and Shumacher in 1952. With expanding knowledge of immunologic and physiologic function, splenectomized persons have been proven at risk in different areas, but the most important impetus for splenic preservation has been the observation of overwhelming postsplenectomy sepsis. Several reports have confirmed this concern, with a documented increase in morbidity and death of splenectomized patients of 50 to 200 times the normal. Successful results with surgical repair of traumatized spleens have been reported, experimentally and clinically proving excellent healing capabilities. It is not uncommon to frequently find little if any active bleeding with such injuries; in fact, even significant bleeding can be controlled with splenic salvage. Several different techniques to accomplish this have been reported. These are reviewed, two new successful and previously unreported techniques are outlined in detail, and statistical information supporting the use of these techniques is presented.

Hemostatic Techniques↗
PubMed1978

Pancreatitis in childhood.

Thirty cases of pancreatitis in children are reviewed. Diagnosis is based on the clinical findings of pancreatic inflammation, laboratory confirmation with elevated serum and/or urinary amylase values, and in some cases surgical or postmortem tissue substantiation. Four major classes of pancreatitis are defined in children: (1) traumatic; (2) systemic-disease associated; (3) drug-induced, caused by drug therapy for various life-threatening diseases, and (4) chronic pancreatitis, with or without an anatomic abnormality. If cases of traumatic pancreatitis are excluded, females outnumber males 5 to 1. A high index of suspicion is necessary to make the diagnosis, and this is very important if the mortality for pancreatitis in children is to be lowered. Awareness and consistent early aggressive intervention should increase the salvage rate.

Adolescent↗
PubMed1978

Ventriculoperitoneal (VP) shunt migration causing an acute scrotum: a case report of Doppler evaluation.

The diagnosis and management of a scrotal complication of a ventriculoperitoneal shunt simulating testicular torsion in a neonate is outlined. Radiologic evaluation determined the location of the shunt tube and adequate blood flow to the testicle was confirmed by use of the Doppler stethoscope, allowing for definitive therapy by extraperitoneal shortening of the shunt catheter. Surgery to the scrotum was, thus, avoided.

Cerebrospinal Fluid Shunts↗
PubMed1977

Pulmonary sequestration in children: a twenty-five year experience.

Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. In most cases the sequestered pulmonary tissue receives its blood supply from anomalous systemic vessels. This paper considers 15 children, 11 boys and four girls, ranging in age from one day to 14 years, with ten extralobar sequestrations and five intralobar pulmonary sequestrations. Although roentgenographic examination of the chest may suggest the diagnosis, conclusive diagnosis can only be obtained by arteriography and/or surgical exploration. Arteriography is strongly advocated in all cases, not only for its diagnostic value, but for its preoperative localization of the aberrant blood vessels that are the major technical concern to the surgeon.

Adolescent↗
PubMed1975

The surgical management of pediatric breast masses.

Information regarding the surgical management of breast masses in the pediatric age group is sparse and is primarily directed at unusual neoplasms. We have reviewed the surgical treatment of 50 patients with inflammatory and neoplastic breast masses occurring in a 15-year period (1957 to 1973) at the Children's Hospital of Los Angeles. There were 42 girls and 8 boys, ranging in age from 12 days to 18 years. All patients had either surgical excision or incision and drainage of the masses with a subsequent histologic diagnosis. A variety of pathologic entities were encountered, but there were no primary malignancies. There were 33 patients with fibroadenomas, including four patients with multiple masses. Thirteen patients, six of whom were male, had cellulitis with an underlying breast abscess. The offending organism was gram-negative in one third of these abscesses. While none of the masses in this series were malignant, surgery was indicated to (1) establish diagnosis, (2) allay fears of patient, family, and referring physician, and (3) correct an obvious cosmetic deformity. Surgical drainage encouraged resolution of the inflammatory process, aided in the recovery of the organism, and assured appropriate drug therapy.

Abscess↗