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Biomedical subjects

R Fowler

Publications and source records attributed to R Fowler.

At least 37 records · Page 2Linked to original sources
PubMed1982

Diuretic radionuclide renography in upper urinary tract obstruction.

Diuretic renography using radioidine sodium hippurate and a frusemide stimulus was used to differentiate between obstructive and nonobstructive dilatation of the urinary tract. Information was recorded by a gamma camera on line to a computer. Sixty-seven uretero-renal units (URU) were studied in 33 patients with an average age of 91/2 years. The diuretic renogram correctly indicated obstructions in 18 URU but gave false positive results in another five. Of these five, four had severely impaired function. The renogram indicated nonobstruction in 49 URU, and gave false negative results in another two; of these two one patient had a duplex kidney with a poorly functioning ureteric segment and the other patient had gross reflux and megaureters. The diuretic renogram is useful in the investigation of equivocal upper urinary tract obstruction but may be unreliable in situations of inadequate renal function.

Adolescent↗
PubMed1981

Alternatives in the handling, processing and storage of electrocardiograms.

Physicians and administrators are becoming aware that computer technology can play a significant role in the electrocardiology department. Problems related to the large number of requests for electrocardiograms, the production and communication of electrocardiographic tracings and reports, the access to stored tracings and the overall cost of providing effective services have led administrators to look for assistance through automation. Before expensive equipment and new procedures are introduced, a survey of the electrocardiology department's functions and procedures can lead to important insights. Automation can be achieved in stages, and problems can be solved by separate steps. Options range from basic word-processing support to completely automated electrocardiographic interpretation and computerized storage of records. Choosing the appropriate equipment and programs requires knowledge of the present system, awareness of the options and analysis of the costs and savings.

Computers↗
PubMed1981

Compensatory renal growth in the mouse. I. Allometric approach to the effect of age.

Allometry, defined as the relationship between the growth rates of organs to the weight of the whole body (38), was used to study the effect of age on the degree of compensatory renal growth (CRG) in the mouse. The normal growth of the kidneys relative to body weight (BW) was determined in animals between 5 to 50 days of age. In one group, nephrectomy and sham operations were performed at 5, 15, and 35 days of age. The remaining ("renoprival") kidney was removed 15 days postnephrectomy. In a second group, nephrectomy was performed on 5-day-old animals, the renoprival kidney being removed after 30 or 45 days. Regression equations were calculated by least-squares after logarithmic transformation and different groups were compared by analysis of covariance. The regression equation for the control kidney was kidney weight (KW) = 0.0093 BW0.86 (r = 0.96). The regression for renoprival kidneys in females was KW = 0.0142 BW0.83 (R = 0.96) after 15 days and, in comparison, was not significantly different from 30 to 45 days. The interval between control and renoprival regressions was equivalent to a difference of congruent to 43% KW. In male mice, the regression for renoprival kidneys after 15 days was KW = 0.0103 BM0.96 (r = 0.98) and was not significantly different from 30 to 45 days. This study suggests that in young mice the time required for complete CRG may be a maximum of 15 days and that the amount of CRG does not depend on the age at operation. After CRG, a new equilibrium is reached which is thereafter maintained up to a minimum of 50 days of age.

Adaptation, Physiological↗
PubMed1981

Compensatory renal growth in the mouse. II. The effect of growth hormone deficiency.

Allometry was used to study the effect of growth hormones (GH) deficiency on compensatory renal growth (CRG) in a dwarf mouse strain (Little). Nucleic acid and protein estimations were used to assess changes in cellular hyperplasia and hypertrophy. Nephrectomy was performed at 5, 15, or 35 days of age with removal of the renoprival kidney 15 days later. Controls underwent sham nephrectomies at 35 days of age. The allometric growth of the normal kidney in the homozygote dwarf (lit/lit) between 8 and 50 days of age was closely related to that of the normal heterozygote (lit/+). A regression line for the renoprival kidneys in lit/lit animals was parallel to that of the control right kidney (P less than 0.001). The interval between the regression lines was equivalent to a constant difference of approximately 40% between renoprival and control right kidneys and was similar to that found in the normal heterozygote (43%). Increases in DNA, RNA, and protein in control animals during CRG indicate that cell division and hypertrophy were occurring in similar proportions. In the GH-deficient mouse, the total amount of DNA in renoprival kidneys was 0.451 mg compared with 0.439 mg in controls (NS). This suggests that cell replication was suppressed. The protein:DNA ratio increased from 20.91 to 24.27 (P less than 0.001) and the RNA:DNA ratio increased from 0.732 to 0.912 (P less than 0.001), suggesting that cell size was markedly increased. These findings suggest that reduced amounts of GH may produce a dissociation between hyperplasia an hypertrophy, with CRG occurring predominantly by cellular hypertrophy.

Adaptation, Physiological↗
PubMed1977

Vesicoureteric reflux and ureterovesical obstruction.

The unusual combination of reflux and obstruction as seen in 8 of a series of 40 unduplicated ureters reimplanted for reflux is presented, with particular reference to the mechanical obstructing factors which can be demonstrated. These involve the extravesical rather than the intravesical ureter so that separate pathologic mechanisms for obstruction and reflux must be postulated. This unusual obstruction/reflux combination appears to be more common than is generally recognized, and the need for its early recognition and surgical correction contrasts with the less urgent indications for operative intervention in ureteric reflux alone.

Child↗
PubMed1977

Extravesical reconstruction for ureterovesical obstructions in childhood.

The blind empirical practice of ureteral reimplantation for all types of ureterovesical obstruction is founded on entirely speculative concepts of the nature of the obstruction. A significant proportion of ureterovesical obstructions are caused by a tilt-valve type of abnormality of the distal ureter with a normal juxtavesical segment. These can be corrected rationally by an extravesical ureteroureteroplasty. This procedure was done between 1968 and 1975 to relieve obstruction of 9 ureters in 8 children. The pathological anatomy found in these cases is defined and the technique of operative recognition and reconstruction is described. With adequate operative recognition and appropriate case selection relief of obstruction was achieved and maintained in 7 of the 9 ureters.

Child↗
PubMed1977

Ectopia in unduplicated ureters in children.

The clinico-pathological features and surgical management of 19 unduplicated ectopic ureters in 15 children are presented with special reference to the problems of recognition and treatment and to the underlying embryological and pathological significance of the wide-ranging associated abnormalities. The high incidence of renal and ureteric malformations, both ipsilateral and contralateral, is emphasised, as is also the frequent co-existence of vesical, bladder neck, urethral, genital and anal abnormalities. These associated anomalies modify the presentation of unduplicated ureteric ectopia and may mask its presence. Late recognition is common, but may be avoided by awareness of the problem. Whereas the degree of kidney involvement seems to dictate the choice and priorities of surgical treatment, the lower urinary tract anomalies have more significance as regards continuing disability and these largely determine the outcome in relation to continence.

Anal Canal↗
PubMed1976

Diet and growth in congenital heart disease.

To assess the relationship between diet and growth in congenital heart disease we studied nutrient intake, body measurements, and cardiac status in 568 affected ambulatory patients less than 11 years of age. Most had mild heart disease, 104 were cyanotic, and only 10 were in congestive heart failure. Major disturbances of growth were uncommon. For the entire group body weight was below normal but only in those studied before 2 years of age; rate of growth and weight gain were normal over the period preceding the dietary study. There was no statistically significant relationship between intake of calories, protein, or other nutrients and growth or gain, analyzing the entire group, or analyzing patients subgrouped according to age, severity of heart disease, or severity of growth retardation. Body size and growth were diminished in cyanosed compared with noncyanosed children but cardiac status had no effect on nutrient intake. We conclude that in children with growth failure associated with congenital heart disease, nutrient intake is not an important factor limiting their growth.

Body Height↗
PubMed1975

A controlled trial of intraperitoneal cephaloridine administration in peritonitis.

From a controlled therapeutic trial extending for more than 2 yr and involving 69 patients with appendicitis and peritonitis a clear-cut statistically significant result emerged. There was a major reduction in the incidence of intraperitoneal abscesses using cephaloridine by the intraperitoneal as opposed to the systemic route. After randomized selection into treatment and control groups, cephaloridine, 25 mg/kg was given by injection every 6 hr for 48 hr to the treatment group by i.p. installation and to the control group by systemic injection. Both groups received initial intraoperative peritoneal lavage with normal saline and also continued systemic injections of cephaloridine on postoperative days 3, 4, and 5. Only one out of 36 patients in the treatment group developed a residual intraperitoneal abscess, as opposed to six abscesses developing in 33 patients in the control group. Technical problems and complications of the method were trivial and have not prevented us from continuing and extending the applications of the method.

Administration, Oral↗
PubMed1975

The applied surgical anatomy of the peritoneal fascia of the groin and the "secondary" internal inguinal ring.

The preperitoneal fascia of the groin is distinct from the transversalis fascia, although often mistaken for it. This distinction, and other special features of this fascia in the inguen, are more readily appreciated in the course of the preperitoneal approach than by the conventional transinguinal approach. Certain features of this fascia which are of practical surgical significance are emphasized, especially those concerning operations for hernias, hydroceles, or undescended testes in infancy and childhood. These special features include the preperitoneal fascial ring or secondary internal ring, which appears to have been confused in the past with the transversalis fascial opening or internal ring proper. Other features concerning the relative merits of the preperitoneal approach to groin hernias as opposed to the conventional transinguinal approach are discussed.

Adult↗
PubMed1975

Percutaneous antegrade pyelography in small infants and neonates.

Percutaneous antegrade pyelography is a safe and useful alternative to retrograde pyelography in the investigation of urinary-tract malformations in the neonate or very young infant. It is preferred to arteriography in the infant with a loin mass. Satisfactory delineation of hydronephrosis or cysts is simply and directly accomplished by this method, so that more complex and less definitive investigations can often be avoided. In addition, a variety of ureteric abnormalities may be displayed.

Aortography↗