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Biomedical subjects

J L Talbert

Publications and source records attributed to J L Talbert.

27 records · Page 2Linked to original sources

Serum polyamine and octopamine changes following partial hepatectomy and portacaval shunt.

Factors influencing hepatic regeneration following major hepatic resection are poorly understood and often may be modified by associated surgical procedures. Experimental and clinical evidence would suggest that hepatic regeneration may be impaired following hepatectomy performed in conjunction with portacaval shunting. A patient is described who offered a clinical situation in which it was possible to evaluate the effects of complete portal-venous diversion on hepatic regeneration following massive hepatic resection. The usefulness of biogenic amines as a monitor of the course of hepatic regeneration is demonstrated. The potential development of hepatic encephalopathy was evaluated by serial determinations of serum ammonia and the biogenic amine, octopamine, which correlated well with the patient's clinical state.

Ammonia

Traumatic perforation of the hypopharynx in infants.

Three cases of traumatic perforation and pseudodiverticulum of the hypopharynx in newborn infants are presented. This lesion may be encountered with increasing frequency as a result of the more aggressive management of newborn infants with respiratory distress. Early recognition of this complication is essential to successful therapy. Appropriate management includes local drainage, treatment with antibiotics, and use of a nasogastric tube or gastrostomy to provide a safe route for intestinal alimentation.

Humans

Traumatic para-mediastinal air cyst. A case report.

The roentgenographic features of a paramediastinal air cyst following chest trauma are reported. After an initial period of enlargement the lesion completely resolved in one month. Experience with this patient and a review of similar cases reported in the literature suggests that lesions of this type may be observed for spontaneous resolution.

Accidents, Traffic

Intrahepatic cholestasis with parental alimentation.

From July 1971 to March 1975, elevan infants receiving total or partial parenteral alimentation at the University of Florida showed histologic evidence of intrahepatic cholestasis. The clinical records of these patients have been examined. These infants were critically ill and had protracted hospital courses with only two survivors. Liver biopsies demonstrated marked cholestasis with some fibrosis and thickening of the limiting membrane of the hepatocyte. In those patients in whom serial liver biopsies were obtained, hepatic histology returned toward normal, paralleling improvement in liver function studies, as intravenous alimentation was discontinued. Careful monitoring of the liver function tests is essential to detect this progressive abnormality as early as possible and discontinue intravenous alimentation. Follow-up as long as two and a half years in the two surviving patients has demonstrated no chronic dysfunction.

Alkaline Phosphatase

Thoracoscopy for diagnosis of intrathoracic lesions in children.

Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the patient spontaneously breathing oxygen. A fiberoptic rod lens system is employed for the direct observation and biopsy of pulmonary parenchymal or chest wall lesions. Adequate tissue has been obtained in each case to allow a specific diagnosis. There has been no mortality from this procedure and only minor morbidity. We believe that this technique offers a rapid and simple method for the diagnosis of diffuse or localized disease of pulmonary parenchyma or chest wall in children.

Adolescent

Complications following gastric surgery in children.

Although the diagnosis of peptic ulcer disease may be difficult in the pediatric age group, this problem is being faced increasingly by the physicians charged with the care of these children. Chronicity of symptoms has been documented in over 50 per cent of the patients demonstrating early peptic ulcers and therefore an aggressive approach to management has been advocated. Although the numbers are small, postgastrectomy syndromes of mechanical and nutritional nature appear less common in the young patient than in adults. Satisfactory growth and development are reported in nearly all series of patients followed after various gastric procedures. Both pyloroplasty and vagotomy and vagotomy and antrectomy appear to be extraordinarily well tolerated by the pediatric patient. Experimental evidence suggests that these patients should enjoy normal growth and development.

Adolescent

Treatment of gastroschisis and omphalocele with biological dressings.

Porcine skin grafts and human amniotic membranes have been used as biological dressings for the treatment of gastroschisis or omphalocele in 16 newborn infants. Eleven infants with gastroschisis were managed initially by the Silastic pouch technique but delayed healing resulted in separation of the Silastic sheeting from the wound margins and required use of biologic dressings to achieve complete closure. Biological dressings were used in five patients with intact omphaloceles for all or part of their course. Average time to achieve complete closure was 55 days. Three patients died of associated anomalies. One patient developed an enteric fistula. Biologic dressings appear to be useful adjuncts in the management of some patients with gastroschisis or omphalocele.

Abdominal Muscles