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At least 865 records · Page 48Linked to original sources
PubMed2006

Total oesophagogastric dissociation: experience in 2 centres.

BACKGROUND/PURPOSE: Neurologically impaired (NI) children have an increased incidence of gastroesophageal reflux and many will require surgery. METHODS: The case notes of 50 NI children who underwent total oesophagogastric dissociation (TOGD) were reviewed. Thirty-four were done as a primary procedure, and 16 were rescues for failed fundoplications. RESULTS: There was no operative mortality. Morbidity consisted of 1 subphrenic collection, 1 oesophagojejunal dehiscence and 2 stenoses that responded to dilatation, and 2 bowel obstructions. In 1 case, partial gastric resection was needed because of transhiatal herniation of stomach. Gastrostomy feeding was established by 3 to 5 days. The mean hospital stay was 10.9 days. At 4 months to 11 years of follow-up, there was no recurrence of reflux. Children who could swallow enjoyed oral feeds. Their general health and weight SD scores improved. Food aspiration, chest infections, and hospitalizations were reduced, with an improvement in quality of life. There were 5 late deaths in the "primary" and 7 in the "rescue" group from deterioration in their original condition. CONCLUSION: Total oesophagogastric dissociation is a safe and versatile procedure without immediate mortality and limited surgery-related morbidity. Review of our practice suggests TOGD should be considered as a primary procedure in severely NI children with gastroesophageal reflux and significant oropharyngeal incoordination and dependence on enteral tube feeding. Rescue TOGD carries a greater morbidity because of previous surgery with consequent difficult dissection, poor oesophageal tissue, and higher incidence of vagal nerve injury.

Adolescent↗
PubMed2002

Regional hemodynamic effects of nociceptin/orphanin FQ in the anesthetized rat.

This study examined the vasodilator action of nociceptin, an endogenous opioid receptor-like ligand (ORL1), in thiobutabarbital-anesthetized rats, via the triple-isotope microspheres technique. Nociceptin (10, 30 nmol/kg, left ventricular injection) reduced mean arterial pressure (-27, -29 mm Hg), total peripheral resistance (-36, -41% of baseline) and heart rate (-8, -11% of baseline), but did not significantly affect cardiac output. The vehicle (0.9% NaCl) did not alter hemodynamics. Both doses of nociceptin caused similar changes in arterial flow and conductance of all tissues. Nociceptin increased flows to the skeletal muscle, slightly reduced flows to the caecum and colon, but did not alter flows to other organs and tissues. With flow normalized by pressure to reflect intrinsic vascular tone, nociceptin was found to increase arterial conductance of all tissues, except for the intestine, spleen, caecum and colon. Its dilator influence was greater in the skeletal muscle ( approximately 250% of baseline conductance) than the lungs, heart, liver, stomach, kidneys, skin, testes and brain (140-160% of baseline). Thus, nociceptin causes generalized vasodilatation; its greatest influence is on the skeletal muscle bed.

Analysis of Variance↗
PubMed1987

Visceral ischemia secondary to gastric dilatation: a rare complication of Nissen fundoplication.

Antireflux operations are now commonly performed for severe gastroesophageal reflux with life-threatening presentations like recurrent aspiration pneumonia and apnea. We report a child who presented 2 years after Nissen fundoplication with jejunal volvulus resulting in massive gastric dilatation, gastric rupture, pneumoretroperitoneum, pneumomediastinum, and severely compromised circulation to the lower extremities. Because of the intense intraabdominal pressure from the gastric dilatation, there was severe ischemia of the pancreas, duodenum, small bowel, colon, and gallbladder. We suggest that gastrointestinal symptoms in a child who has had Nissen fundoplication should be promptly evaluated to avoid delay in recognition of acute gastric dilatation and to prevent a fatal outcome.

Child, Preschool↗
PubMed2002

Serum cardiac troponin I and cardiac troponin T concentrations in dogs with gastric dilatation-volvulus.

OBJECTIVE: To determine whether serum concentrations of cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are increased in dogs with gastric dilatationvolvulus (GDV) and whether concentrations correlate with severity of ECG abnormalities or outcome. DESIGN: Prospective case series. ANIMALS: 85 dogs with GDV. PROCEDURE: Serum cTnl and cTnT concentrations were measured 12 to 24, 48, 72, and 96 hours after surgery. Dogs were grouped on the basis of severity of ECG abnormalities and outcome. RESULTS: cTnl and cTnT were detected in serum from 74 (87%) and 43 (51%) dogs, respectively. Concentrations were significantly different among groups when dogs were grouped on the basis of severity of ECG abnormalities (none or mild vs moderate vs severe). Dogs that died (n = 16) had significantly higher serum cTnI (24.9 ng/ml) and cTnT (0.18 ng/ml) concentrations than did dogs that survived (2.05 and < 0.01 ng/ml, respectively). Myocardial cell injury was confirmed at necropsy in 4 dogs with high serum cardiac troponin concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate that concentrations of cTnI and cTnT suggestive of myocardial cell injury can commonly be found in serum from dogs with GDV and that serum cardiac troponin concentrations are associated with severity of ECG abnormalities and outcome.

Animals↗
PubMedDate not supplied

Influence of thoracic conformation and genetics on the risk of gastric dilatation-volvulus in Irish setters.

Body measurements, history of gastric dilatation-volvulus (GDV), and other data were obtained for 155 Irish setters at the 1994 National Specialty Show. The dogs ranged in age from 6.5 months to 12.4 years (mean+/-standard deviation [SD], 3.6+/-2.6 years); 11 (7%) of the dogs had histories of GDV. Gastric dilatation-volvulus risk increased 33% for each year of age (p of 0.01). Dogs with the deepest thorax relative to width (ratio range, 1.61 to 1.85) had a significantly greater GDV risk than those with the shallowest thorax (ratio range, 1.20 to 1.50); the odds ratio was 8.45; the 95% confidence limits were 1.44 to 49.57; and the p value equaled 0.02. Having a relative (particularly a parent) with GDV also increased GDV risk. Five-generation pedigrees yielded a significantly higher mean coefficient of relationship for the 11 dogs with GDV than for the 11 dogs without GDV.

Animals↗
PubMed1978

[Role of a decrease in the body's heat content on the thermoregulatory reaction of the vessels of the external ear].

At the constant ambient temperature 28--30 degrees C the rabbit ear vessels were dilated and their temperature was 34.8/0.1 degrees C. Administration of the 23--29 degrees water into the stomach entailed thermoregulatory constriction of the ear vessels within 15--25 min. The response occurred at various combinations of temperature changes in different parts of the body. The heat content of the rabbit body, as calculated by the blood temperature in the aorta arc, reduced by 266.3 +/- 26.2 cal/kg at the beginning of the response. The decrease in the organism heat content seems to serve as a signal for occurrence of a corresponding thermoregulatory response.

Animals↗
PubMed1978

[The management of corrosive oesophagitis (author's transl)].

Regardless of the treatment used against corrosive oesophagitis, the laryngologist must play a role from the beginning and throughout the course. The fibroblasts and collagen fibres which results are the natural agents of healing but, at the same time, are responsible for virtually inexorable stenosis if the corrosion has passed through to the muscular layers. Infection is constant and contributes to stenosis. The effectiveness of antibiotics is certain. They must be used from the beginning and continued for as long as necessary. As far as fibroiss is concerned, dilatations remain the basic treatment, their application requiring great experience and much patience and tenacity. Replacement surgery is attractive. It comes up against the stenosing perioesophageal inflammatory process which tends to die down in time but remains active for a long period. The nENT specialist must therefore pay careful attention from the very end of the postoperative period onwards. The gravity of oesophageal burns justifies intensification of preventive measures. Since it impossible to complete eliminate corrosive oesophagitis, efforts must be directed towards the discovery of substances capable of inhibiting collagen synthesis. Corticosteroids used in the treatment of shock do not prevent stenosis. In the laboratory, B.A.P.N. has shown its effectiveness in the rat. Also in the rat, particularly difficult experiments are in progress using penicillinamine. Although such methods have as yet to be extended to human clinical use, there are nevertheless grounds for hope.

Adrenal Cortex Hormones↗