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Biomedical subjects

F Rimell

Publications and source records attributed to F Rimell.

8 recordsLinked to original sources
PubMed2001

Tracheal reconstruction with a synthetic material in a porcine model.

The technique of tracheal reconstruction with costal cartilage or a pericardial patch has resulted in successful management of many patients with tracheal stenosis. Yet, it is often difficult, if not impossible, to harvest enough cartilage in a neonate. Pericardial patches are flimsy and can collapse. This pilot study evaluated the use of absorbable plates made of an alloplastic material, Lactosorb, as a substitute for cartilage on a growing porcine trachea. The rectangular plates were fashioned into an inverted U and placed into the airway through an anterior tracheal split. This placement resulted in granulation formation and failure. The plates were then fashioned into an I configuration and placed inside and outside the tracheal lumen. This attempt also resulted in failure, secondary to respiratory distress. Finally, the plates were fashioned into an inverted U and placed outside the trachea. In 67% of the subjects, the distraction was maintained and growth continued for the duration of the study. The stent was completely absorbed, with minimal scar or granulation tissue, in 4 months. In 1 subject, the stent migrated, and 1 subject died of a mucous plug. This study suggests that Lactosorb has no role in intraluminal stenting, but that it may be a viable alternative to a pericardial patch or cartilage in tracheal reconstruction when it is placed outside the airway lumen in a young animal.

Absorbable Implants↗
PubMed2000

Upper airway complications in children after bone marrow transplantation.

OBJECTIVE: To describe the upper and lower airway complications in children during bone marrow transplantation (BMT). STUDY DESIGN: Review of medical records of patients requiring airway intervention during BMT over a 4-year period. RESULTS: During the 4-year period, 832 pediatric BMTs were performed. Of these, 87 patients (10.5%) required mechanical ventilation. Patients had intubation for a mean of 79 days (range, -7-638 d) after BMT. Patients received mechanical ventilation for a mean of 12 days (range, 1-85 d). Duration of ventilation was significantly longer in patients with difficult intubation; in these 54 patients there were 64 intubations. Of these intubations, 19 (30%) were difficult. These difficult intubations occurred in 16 (30%) patients. Patients with Hurler syndrome and congenital immunodeficiencies had significantly more difficult intubations than children with leukemia. The incidence of complications causing difficult intubation were difficulty visualizing cords, because of the presence of blood (63%); difficulty visualizing cords, because of edema (19%); anatomically narrowed airway (13%); limited neck extension (13%); and limited jaw opening (6%). The resulting mortality rate was 82% in children requiring intubation. Survivors were significantly younger than nonsurvivors. CONCLUSIONS: Pediatric BMT has become increasingly more common. Airway management is rarely required during the engraftment phase, but when intervention is required, it is often difficult, particularly in the nonleukemic child, and may require the skills of an otolaryngologist. Representative cases are presented, and management is discussed.

Adolescent↗
PubMed1998

The near complete tracheal ring deformity.

Congenital complete and near-complete tracheal rings are extremely rare tracheal deformities. There are fewer than 100 cases of congenital complete tracheal rings, and only four cases of near-complete described in the literature. Long-segment occurrences of these anomalies are usually incompatible with life. We describe the presentation of the long-segment near complete tracheal ring deformity and long-segment anterior fusion of cartilage rings (cartilage sleeve deformity) in a living infant. The literature is reviewed, and the embryology, presentation, and management of these extremely rare anomalies are discussed.

Female↗
PubMed1993

Injuries of the hard palate and the horizontal buttress of the midface.

Traumatic injuries to the hard palate occurred in 20% of all Le Fort midfacial fractures. The side of a palatal split was directly related to the side that received the highest Le Fort injury. In a symmetric midfacial injury, the palate had a true midline split. Repair of palatal injuries from blunt trauma involved either wire and splinting (eight patients) or miniplate fixation without a splint (11 patients). There were fewer complications in those treated by the miniplate fixation technique (two of 11), as compared to those treated with wire and splinting (four of eight). In miniplate fixation of midfacial fractures, attention is focused on the reconstruction of the supporting buttresses of the midface, both vertical and horizontal. In regard to the palate, this requires union of the inferior horizontal buttress. Gunshot wounds accounted for 21% of the patients and resulted in large bony disruption of the palate, which required free soft tissue and bone grafts for repair of the inferior horizontal buttress.

Adolescent↗
PubMed1993

Cholinergic agents in the laryngeal chemoreflex model of sudden infant death syndrome.

The laryngeal chemoreflex results in apnea, laryngospasm, and cardiovascular changes that can be fatal when a liquid stimulus is placed on the laryngeal mucosa of infant mammals. This study of 35 piglets assessed the effects of the cholinergic agents atropine and edrophonium on this laryngeal reflex response. Atropine, when placed intrathecally, resulted in a significant reduction of apnea as well as a decrease in the cardiovascular changes that occur during the reflex 60 minutes following its injection. Edrophonium, when placed intrathecally, resulted in a significant prolongation of apnea as well as death by asystole in 2 animals during laryngeal stimulation. Atropine placed intravenously also resulted in a significant reduction of apnea length, but required greater than 180 minutes to do so.

Animals↗
PubMed1992

In situ hybridization and laryngeal papillomas.

The technique of in situ hybridization with biotin-labeled probes was applied to 20 patients with laryngeal papillomatosis (9 with adult-onset disease and 11 with juvenile-onset). Ten patients were noted for epithelial transformation of their laryngeal disease. All patients, regardless of their clinical outcome, tested positive for human papillomavirus group 6/11. The biotin method of in situ hybridization proved to be a sensitive method in this study, identifying the infecting viral group in 23 of 24 samples. This study also tested for group 16/18 and is the first to test for the presence of group 31/33/35 in the larynx. These viruses or members of related groups have been reported in malignancies of the head and neck as well as the uterine cervix. They have yet, however, to be identified in benign laryngeal papillomas or laryngeal papillomas that have undergone epithelial transformation.

Adolescent↗
PubMedDate not supplied

Substance P immunoreactive sensory axons as a subset of the total axonal population in the maxillary sinus of the rabbit: a characterization of normal and infected mucosa.

Substance P (SP), one of the neuropeptides released from sensory nerves, is thought to mediate neurogenic inflammation. Although SP immunoreactive axons have been described in the sinus mucosa, no attempt has been made to characterize SP fibers as a subset of all axons present in the sinus mucosa. In addition, no study to date has characterized the changes in infected sinus mucosa. The maxillary sinus mucosa of New Zealand white rabbits was harvested from control animals and in animals with induced maxillary sinusitis. Immunohistochemical staining of the sinus mucosa for both Protein Gene Product 9.5 (PGP), a nonspecific marker for all nerves, and for SP was performed on 11 animals: 3 controls and 8 infected. In sinus mucosa from the control rabbits, <50% of all axons labeled by PGP were immunoreactive for SP. In infected mucosa, the absolute number of axons found by PGP staining decreased and nearly all of these remaining fibers were also immunoreactive for SP. We conclude that the phenotypical labeling of nerve fibers seen in normal mucosa is altered by bacterial-induced infection.

Animals↗