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Biomedical subjects

B H Kaufman

Publications and source records attributed to B H Kaufman.

12 recordsLinked to original sources
PubMed1992

Survival and functional outcome of children with severe cerebral palsy following gastrostomy.

Survival, functional outcome, care setting, early and late complications, and caregiver satisfaction were determined in 61 children with severe cerebral palsy requiring gastrostomies during a six-year period. Fifty-three (87%) of the initial gastrostomies included a Nissen fundoplication. Early and late complications were 32.8% and 39.3%, respectively. Survival after initial surgery was 84.2% at one year, and 67.6% at four years. One child died within one month of surgery. Seventy percent of the children remained totally dependent in self-care, mobility, and communication; an additional 29% had significant limitations in function. Only 4 children (6.5%) ultimately became independent in feeding. Ninety-three percent of the children were cared for at home. Ninety-four percent of the parents/caregivers believed the gastrostomy was beneficial in management of the child. Survival was unexpectedly high compared to studies of adults and mentally retarded children requiring similar surgical procedures.

Activities of Daily Living↗
PubMed1990

Pediatric urological complications with intraoperative radiation therapy.

Intraoperative radiotherapy with variable energy electrons has been used as a supplemental boost to treat 6 children with locally advanced retroperitoneal malignancies. Of the patients 4 had treatment-related injuries to portions of the urinary tract within the intraoperative and external radiation fields. Three patients had significant renal impairment requiring surgical correction. The pathogenesis and management of treatment-induced injury to the urinary tract are discussed.

Adolescent↗
PubMed1988

Fibrin glue for the treatment of persistent lymphatic drainage.

A 7-year-old girl underwent resection of an abdominal wall lymphangiomatous tumor. Postoperative serous drainage, up to 300 mL per day, developed despite application of external pressure to the wound. Thirty-three days after the initial procedure, fibrin glue was applied to the draining tract. Concentrated fibrinogen was prepared from one unit of blood donated by the patient's mother. Ten milliliters fibrinogen and 10 mL thrombin (1,000 U/mL) were injected simultaneously through the wound drain as it was slowly removed, and pressure was reapplied for 48 hours. No further drainage occurred, and at 2- and 14-week follow-up examinations the wound had healed normally without reaccumulation of fluid. Fibrin glue successfully sealed this persistently draining abdominal wall tract. It is a painless, safe, and effective biologic sealant, and when prepared from homologous plasma it carries a low risk of virus transmission.

Abdominal Muscles↗
PubMed1988

Trends in infantile hypertrophic pyloric stenosis in Olmsted County, Minnesota, 1950-1984.

In the 35-year period, 1950-1984, 154 Olmsted County, Minnesota, infants were diagnosed with definite infantile hypertrophic pyloric stenosis (IHPS). Patients were identified using outpatient and inpatient records of all providers of care to the circumscribed population, and ascertainment was complete insofar as diagnosed cases are concerned. The overall incidence of IHPS was 2.6 per 1000 person-years (95% confidence interval: 2.2-3.0), with a male:female ratio of 4.1:1. A dramatic rise in incidence was seen among male infants over the study period, but not for females, so that by 1980-1984 the rates for the two sexes were 6.2 and 0.9 per 1000 person-years, respectively. Improvements in diagnostic capabilities and case identification may have occurred but seem unlikely to entirely account for these changes. Aetiologic hypotheses should reflect the different trends for male and female infants.

Cohort Studies↗
PubMed1987

Drapanas shunt using a spiral saphenous vein graft.

An alternative technique for creation of a Drapanas shunt was used in a 12-year-old boy with upper gastrointestinal bleeding. Dissatisfaction with available prosthetic grafts and the inherent limitations of other autogenous materials led to the use of a spiral saphenous vein graft to bridge the superior mesenteric vein and the inferior vena cava. Patency of the graft was demonstrated 1 year postoperatively, and the patient has not had further bleeding episodes for 2 years postoperatively. Continued use of this operation is necessary to determine its usefulness.

Gastrointestinal Hemorrhage↗
PubMed1987

Abdominal Burkitt's lymphoma: role of early aggressive surgery.

Current surgical teaching advocates debulking of the abdominal Burkitt's lymphoma to decrease tumor burden and improve survival. The records of 16 children who had Burkitt's lymphoma were reviewed. Eleven of these children presented with abdominal tumors. Five of these 11 patients are long-term survivors and six have died. Three of the tumors were primarily resected; two were in patients who became long-term survivors. One resection was complicated by acute renal failure, leading to the early demise of the patient. Four tumors were debulked; only one of these was in a long-term survivor. Acute renal failure also complicated the hospital course in one of these children. Finally, four patients underwent initial incisional biopsies and plans were made for subsequent resection of any residual tumor 6 weeks later. Two of these children survived and two have died. The results of this pilot study do not confirm that there is a clear advantage to aggressive operative cytoreduction. Although this approach decreases the total tumor burden, it may also impose severe metabolic complications and postpone the administration of chemotherapy. These results do suggest the need for a multi-institutional review of the surgical management of abdominal Burkitt's lymphoma.

Abdominal Neoplasms↗
PubMed1986

Progress in pediatric solid tumors.

Since 1980, impressive progress in the treatment of solid tumors has altered the practice of pediatric surgical oncology. Because these advances have been balanced by both liberal and conservative viewpoints, an accurate reassessment of traditional approaches has been possible. Noteworthy alterations in chemotherapy, radiation therapy, and surgical attitudes have improved survival rates and lessened the morbidity associated with malignant disease. Close cooperation among surgeons, pediatricians, and oncologists remains the common denominator in the successful treatment of pediatric solid tumors. This article presents examples of progress in the treatment of Hodgkin's disease, metastatic pulmonary disease, Wilms' tumor, and rhabdomyosarcoma and discusses the role of surgical intervention in conjunction with chemotherapy and radiation therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Wilms' tumor in a 'lump' kidney associated with sacral agenesis.

Many cases of Wilms' tumor developing in a horseshoe kidney have been previously reported. We present a case of Wilms' tumor developing in a "lump" kidney, associated with sacral agenesis. We discuss the implications for staging and make recommendations for follow-up in these cancer-prone children.

Bone and Bones↗
PubMed1985

Distribution and quantitation of immunoreactive gut neuropeptides in piebald mice and their normal littermates.

Piebald mice inherit congenital megacolon associated with distal aganglionosis. To study the distribution of intrinsic peptidergic nerves in the gut of piebald mice and their normal littermates, we used specific radioimmunoassays to measure the tissue concentrations of the following immunoreactive neuropeptides: vasoactive intestinal peptide (VIP), peptide histidine-isoleucine (PHI), [Met]enkephalin (Enk), substance P (SP), and bombesin-like intestinal peptide (BLIP). In the normal littermates, all neuropeptide concentrations were significantly greater in the colon than in the proximal gut. SP, Enk, VIP, PHI, and BLIP levels were all decreased in the distal colon of piebald mice as compared to normal littermates, SP, BLIP, and Enk levels were also decreased in the dilated proximal colon of piebald mice. These results suggest that there are abnormalities in the peptidergic innervation of the proximal and the distal colon in piebald mice. The abnormalities localized to the proximal colon of piebald mice may be related to functional obstruction of the colon.

Animals↗
PubMed1985

Pediatric endocrine surgery.

The pediatric surgeon is in a unique position to understand endocrine surgery and, therefore, is expected to develop considerable expertise in this area. In recent years numerous advances and changes have occurred in pediatric endocrine surgery that have led to greater understanding of the disease processes and syndromes and the development of new diagnostic techniques and surgical approaches.

Adolescent↗
PubMed1978

Pancreaticojejunostomy for chronic pancreatitis. Two- to 21-year follow-up.

Between 1954 and 1975, 80 pancreaticojejunostomies were performed on 77 patients for intractable pain of chronic pancreatitis. All patients had a history of chronic alcoholism. Drainage operations done primarily for pseudocysts were excluded. Operative procedures included seven caudal pancreaticojejunostomies, 42 longitudinal pancreaticojejunostomies with splenectomy and implantation of the pancreas into the jejunum, and 31 side-to-side pancreaticojejunostomies. Eighty-one percent of the patients noted substantial improvement or complete resolution of their abdominal pain on follow-up that ranged up to 21 years. The operative mortality was 5%. Thirty-two patients died during the period of the follow-up. Continued alcohol abuse, carcinoma, and cardiovascular disease were the leading causes of mortality. Data from this review confirm the effectiveness of pancreaticojejunostomy in relieving the pain of chronic relapsing pancreatitis.

Adult↗