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Marc S Arkovitz

Publications and source records attributed to Marc S Arkovitz.

8 recordsLinked to original sources
PubMed2007

Fetal lung-head ratio is not related to outcome for antenatal diagnosed congenital diaphragmatic hernia.

UNLABELLED: We asked if fetal lung-to-head ratio (LHR) of 1.0 or lower or liver herniation had a statistical effect on survival or need for extracorporeal membrane oxygenation (ECMO), compared with LHR above 1.0 in patients with congenital diaphragmatic hernia (CDH). METHODS: Antenatal records of all patients diagnosed with CDH from January of 2002 to June of 2005 were examined. Inclusion criteria were isolated left-sided CDH and absence of significant cardiac or other anomalies/syndromes, treated solely at this institution. Lung-to-head ratio values were compared based on the value currently proposed for fetal intervention: LHR of 1.0 or lower vs LHR above 1.0. Outcome was assessed as survival (discharge to home) or need for ECMO. RESULTS: Twenty-eight patients met inclusion criteria. Overall survival was 86% (24/28). Postnatal survival in fetuses with LHR of 1.0 or lower (8/11) was not statistically different from LHR above 1.0 (16/17) (73% vs 94%, P = .114). The need for ECMO in the group with LHR of 1.0 or lower (3/11) was not significantly different from those with LHR above 1.0 (1/17) (27% vs 6%, P = .114). Herniation of the fetal liver into the chest did not affect survival or need for ECMO (P = .228). CONCLUSION: Neither LHR of 1.0 or lower nor liver herniation identified a risk factor significant enough to warrant fetal intervention. Multicenter studies may be more appropriate to investigate this clinical problem.

Body Weights and Measures↗
PubMed2005

Perforated appendicitis presenting as appendicoumbilical fistula.

Perforated appendicitis is one of the most common diagnoses treated by pediatric surgeons. Although rare, a perforated appendix can present with a cutaneous fistula. Here we present the second reported case of perforated appendicitis presenting as an appendicoumbilical fistula.

Adult↗
PubMed2005

Hereditary multiple exostoses of the ribs: an unusual cause of hemothorax and pericardial effusion.

A 6-year-old girl with hereditary multiple exostoses presented with spontaneous hemothorax and pericardial effusion. Chest computed tomographic scan showed left-sided costal exostoses protruding into the left side of the chest. She underwent successful thoracoscopic resection of 3 left rib exostoses and made a full recovery. This report illustrates this rare clinical scenario and reviews the previously published reports of this complication of costal exostoses.

Child↗
PubMed2005

Lung development is not necessary for diaphragm development in mice.

BACKGROUND/PURPOSE: Congenital diaphragmatic hernia affects approximately 1 in every 2000 live births. The etiology of these diaphragmatic defects is unknown. Using mice with a targeted deletion of fibroblast growth factor 10 (FGF10), which display a complete lack of lung tissue, we have examined the relationship between lung hypoplasia and diaphragmatic development. METHODS: The diaphragms of FGF10 null mice were examined at 2 embryonic time-points and compared with their heterozygous and wild-type littermates. RESULTS: FGF10 null mice had phenotypically normal diaphragms when compared with wild-type littermates at both time-points studied. CONCLUSION: Normal diaphragm development appears to occur independent of lung development in mice.

Animals↗
PubMed2004

Newborns with diaphragmatic hernia: initial chest radiography does not have a role in predicting clinical outcome.

BACKGROUND: The management of life-threatening congenital diaphragmatic hernia (CDH) has undergone significant change over the last two decades. When CDH was felt to be a surgical emergency treated promptly after birth, survival rates of 50% were typical. Recent changes in medical management of these patients prior to surgery have had a dramatic influence on clinical outcome with survival rates over 80%. OBJECTIVE: This study was performed to assess under the current 80% survival rates whether there is predictive value in the appearance of the initial chest radiograph and clinical outcome in patients with CDH. MATERIALS AND METHODS: Initial chest radiographs on 56 newborns with CDH were retrospectively reviewed for percent aeration of ipsilateral lung, percent aeration of contralateral lung, percent mediastinal shift, and content of hernia and correlated with clinical outcome. RESULTS: There was no significant relationship between radiographic analysis of the percent of ipsilateral lung aeration (P=0.43), contralateral aeration (P=0.52) mediastinal shift (P=0.18), or content of hernia and clinical outcome. All CDH lesions tend to "look the same" on radiographs, regardless of favorable or fatal outcome. CONCLUSION: Chest radiography serves to confirm the diagnosis of CDH, but does not predict outcome.

Female↗
PubMed2004

Bowel injury as a complication of microdiscectomy: case report and literature review.

Intestinal injury is a rare complication of lumbar disc surgery, resulting from inadvertent penetration of the anterior annulus fibrosus and anterior longitudinal ligament. Patients typically complain of abdominal pain and distention developing over the course of several days. Imaging with plain upright chest radiographs or abdominal computed tomography may demonstrate free air in the abdominal cavity. We report a case of intestinal perforation after microscopic lumbar discectomy and present the diagnostic postoperative imaging. In addition, we review the relevant literature and discuss techniques that may be employed to avoid this complication.

Adult↗