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Biomedical subjects

M M Woolley

Publications and source records attributed to M M Woolley.

At least 55 records · Page 3Linked to original sources
PubMed1978

Pancreatitis in childhood.

Thirty cases of pancreatitis in children are reviewed. Diagnosis is based on the clinical findings of pancreatic inflammation, laboratory confirmation with elevated serum and/or urinary amylase values, and in some cases surgical or postmortem tissue substantiation. Four major classes of pancreatitis are defined in children: (1) traumatic; (2) systemic-disease associated; (3) drug-induced, caused by drug therapy for various life-threatening diseases, and (4) chronic pancreatitis, with or without an anatomic abnormality. If cases of traumatic pancreatitis are excluded, females outnumber males 5 to 1. A high index of suspicion is necessary to make the diagnosis, and this is very important if the mortality for pancreatitis in children is to be lowered. Awareness and consistent early aggressive intervention should increase the salvage rate.

Adolescent↗
PubMed1978

Reduced hepatic bilirubin uridine diphosphate glucuronyl transferase and uridine diphosphate glucose dehydrogenase activity in the human fetus.

Hepatic bilirubin uridine diphosphate glucuronyl transferase (UDPG-T) activity was 0.14 and 0.22 units in two fetuses aged 17 and 22 weeks, respectively, and less than 0.1 unit in 15 fetuses, aged 8--19 weeks compared to 0.68--1.99 units in 21 normal adults. Hepatic uridine diphosphate glucose dehydrogenase (UDPG-D) activity in 14 fetuses, aged 8--18 weeks, ranged from 6.2--15.0 units (mean = 11.3 +/- 0.7) compared to 28.8--49.2 units (mean = 39.6 +/- 2.5) in eight normal adults (P less than 0.001). There was no correlation between UDPG-D activity and gestational age. The hepatic UDPG-D activity was 16.5 units in a 33-day-old full term, female infant, 42.4 and 24.3 units in two 2-year-old infants, respectively, and 24.3 units in a 5.5-year-old child. In three human fetuses, the apparent Km UDPG was 0.54 x 10(-4) M. Thus, both hepatic bilirubin UDPG-T and UDPG-D activity are markedly reduced in the human fetus during the second trimester of gestation. Retarded development of hepatic UDPG-D may extend beyond the first month of life.

Adult↗
PubMed1978

Progress in the use of elemental diets in infants and children.

The clinical use of elemental diets to provide adequate nutrition in the infant or child in a catabolic state will, undoubtedly, increase as experience confirms the effectiveness and safety of this technique. The value of total parenteral nutrition and nutrition given through the peripheral vein should, in no way, be underestimated, since many infants and children will still require this form of nutrition during periods when the intestine is not available for alimentation. The use of elemental diets in the transitional period between total parenteral nutrition and more conventional feedings as well as in providing nutritional support when the intestine is totally or partially available provides a method of earlier discontinuance of parenteral nutrition and, hence, decreases the incidence of mechanical, metabolic and septic complications associated with intravenously administered nutrition. Each patient should be considered individually and a decision made as to whether or not enteral hyperalimentation can be used in place of, or in conjunction with, parenteral nutrition.

Amino Acids↗
PubMed1977

Peripherally located congenital arteriovenous fistulae in infancy and childhood.

Significant macrofistulae between arteries and veins of congenital origin may result in the extremes of life-threatening hemorrhage or simply a cosmetically displeasing mass. The most helpful diagnostic aid is that of adequate arteriography both to determine the size, location, and extent of the fistulae. After adequate clinical and angiographic evaluation, therapy should be conservative enough to afford optimal function and radical enough to prevent death due to hemorrhage. This report includes eight patients who underwent angiographic evaluation and surgical therapy for arteriovenous malformation. Of the six living patients, five are known to have residual arteriovenous shunting.

Adolescent↗
PubMed1977

Pulmonary sequestration in children: a twenty-five year experience.

Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. In most cases the sequestered pulmonary tissue receives its blood supply from anomalous systemic vessels. This paper considers 15 children, 11 boys and four girls, ranging in age from one day to 14 years, with ten extralobar sequestrations and five intralobar pulmonary sequestrations. Although roentgenographic examination of the chest may suggest the diagnosis, conclusive diagnosis can only be obtained by arteriography and/or surgical exploration. Arteriography is strongly advocated in all cases, not only for its diagnostic value, but for its preoperative localization of the aberrant blood vessels that are the major technical concern to the surgeon.

Adolescent↗
PubMed1976

Esophageal atresia and associated anomalies.

One hundred and two patients with esophageal atresia possessed 237 additional anomalies. Risk grouping of these patients was useful and showed a direct relationship between the increased incidence of anomalies, low birth weight, and nonsurvival. Fifty-seven per cent of the patients with additional anomalies possessed multiple anomalies, most frequently occurring in the gastrointestinal, cardiovascular, and musculosketetal organ systems. Fifty-five per cent of the deaths appeared to result from the coexistent severe anomaly, while the remaining 45% of the deaths appeared to occur as a result of the presence of esophageal atresia. It is our suspicion that the insult producing esophageal atresia with a high incidence of associated anomalies occurs at a more critical time in organogenesis than that event that produces the esophageal atresis alone or with one moderate anomaly.

Abnormalities, Multiple↗
PubMed1976

Congenital posterolateral diaphragmatic hernia.

The infant who is born with a posterolateral diaphragmatic hernia who becomes symptomatic at or soon after birth requires urgent care. Surgical reduction of the diaphragmatic hernia must be accomplished quickly. Respiratory and metabolic acidosis must be treated appropriately. The parents should be informed of the gravity of their infant's problem and reassurred by appropriate explanation of the nature of the defect and the therapeutic requirements. If the infant dies, the parents are in need of empathy, reassurance, and adequate explanation so that they do not have lingering doubts regarding the etiology of the anomaly and the adequacy of the therapy. If the infant lives, the medical team can share the feeling of a job well done.

Acidosis↗
PubMed1974

Congenital partial gastric antral obstruction, an elusive cause of abdominal pain and vomiting.

The patient with partial gastric antral obstruction due to a diaphragm may present with obstructive symptoms at any age in life. Including the four patients presented, there are now 50 reported cases. Since the diagnosis has been unduly delayed in many adults, it is particularly important that those physicians and surgeons caring for infants and children be aware of this entity. If properly treated in infancy and childhood, many years of suffering and debility can be obviated.

Air↗