Biomedical subjects

A D Soutter

Publications and source records attributed to A D Soutter.

4 recordsLinked to original sources

PubMed1997

Ventriculofemoroatrial shunt: a viable alternative for the treatment of hydrocephalus. Technical note.

Children with shunted hydrocephalus often have a myriad of other medical conditions. When these concomitant problems involve the pleura, peritoneum, and/or the venous system, placement of the distal catheter may prove to be problematic. This report presents preliminary results in three hydrocephalic children following ventriculofemoroatrial shunt placement. The peritoneal and pleural cavities in each of these children were compromised and there was no vascular access into the superior vena cava due to intercurrent disease. An alternative technique for ventriculoperitoneal shunt placement was performed via the femoral vein. Fluoroscopic guidance was used to confirm the intraatrial position of the distal end of the shunt catheter. Follow-up review to date shows no complications. This newly described technique provides a feasible alternative to distal shunt catheter placement in patients in whom more traditional sites are unavailable.

Cerebrospinal Fluid Shunts↗

PubMed1994

Splenosis is regulated by a circulating factor.

Splenic rupture may result in splenosis, the growth of splenic fragments. We used a parabiotic model to test the hypothesis that splenotic growth is governed by a circulating mediator(s). Pairs of C57B1/6 mice underwent side-to-side anastomosis. After 2 weeks, each of four groups underwent a second operation in which one or both of the partners had a sham operation or a splenectomy, or had splenic fragments transplanted into their peritoneums, or some combination thereof. Six weeks later, splenotic fragments were excised and weighed. Spleen fragments involuted when inserted into the pairs that had two intact spleens. In contrast, in pairs with one intact spleen and one set of fragments, multiple splenules developed, whose aggregate mass was approximately half (ratio, 0.53 +/- 0.04 [mean +/- SE]) that of the original transplanted fragments. Significantly more splenosis (P < .01) developed in pairs with no intact spleens and one set of fragments (0.82 +/- 0.04). The pairs with no intact spleens and twice as many fragments had an intermediate amount of splenosis (0.66 +/- 0.08). The authors conclude that (1) splenosis is inhibited by a factor (or factors) that circulates across the capillary network in a parabiotic pair of mice, and (2) the level of inhibition of splenosis appears to be directly proportional to total splenic mass. The authors speculate that spleen-saving operations, even if partial, may decrease the incidence of splenosis in the patient with a shattered spleen.

Animals↗

PubMed1993

Basic fibroblast growth factor secreted by an animal tumor is detectable in urine.

Basic fibroblast growth factor (bFGF or FGF-2) is abnormally elevated in the serum and urine of patients with many types of cancer. However, the source of the bFGF is unclear. We developed a model that could distinguish between tumor-derived and host-derived bFGF. We gave athymic mice s.c. injections of cells of the murine K1000 tumor, which secretes a bFGF mutein (bFGF CS23) as its dominant angiogenic factor. Controls were given injections of Lewis lung carcinoma or saline. Urine was collected for 9 weeks, and bFGF was quantitated using two immunoassays which can discriminate between tumor bFGF CS23 and native bFGF. None of the mice had detectable urinary native bFGF, and no control mice had detectable urinary bFGF CS23. In contrast, urine from mice bearing the K1000 tumor revealed detectable bFGF CS23 by 2 weeks, and bFGF CS23 increased with increasing tumor volume throughout the study. Because bFGF CS23 is not produced by other cells, the bFGF CS23 in the urine most likely came from the K1000 tumor and not from the host. These results suggest that the source of elevated bFGF in the urine of human cancer patients is, at least in part, the tumor itself.

3T3 Cells↗

PubMedDate not supplied

Wilms tumor presenting with abdominal pain: a special subgroup of patients.

BACKGROUND: Although significant progress has been made in the management of children with Wilms tumor, two major controversies still exist: the extent of radiographic evaluation necessary before surgery and the role of preoperative chemotherapy. This study sought to determine whether patients with Wilms tumor who presented with abdominal pain defined a special subset of patients who might require a more extensive preoperative work-up and neoadjuvant chemotherapy. METHODS: From 1970 to 1995, 250 children were treated for Wilms tumor at a single pediatric institution. A retrospective chart review determined presenting signs and symptoms for each patient. RESULTS: Thirty-four (14%) patients (mean age 5.5 years) sought medical attention with a chief complaint of abdominal pain. The stage distribution for these patients tended to be higher and was significantly different (P <.001, chi(2)-analysis) from those presenting without pain. Four (14%) of 29 patients with tumor available for analysis were found to have anaplastic histology. CONCLUSION: These data suggest that patients with Wilms tumor who present with abdominal pain represent a special subgroup that tends to be older and has an increased incidence of tumor rupture, anaplasia, and higher stage. These patients may benefit from a more extensive preoperative evaluation and consideration of neoadjuvant chemotherapy.

Abdominal Pain↗