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Biomedical subjects

R W Powell

Publications and source records attributed to R W Powell.

At least 55 records · Page 3Linked to original sources
PubMed1986

Castleman's disease in children.

A three and one-half-year-old girl and a 12-year-old boy presented with features of the two clinical presentations of Castleman's disease or giant lymph node hyperplasia. The girl presented with anemia, fever, night sweats, hypergammaglobulinemia, and a palpable abdominal mass. Her symptoms were consistent with those seen in the plasma-cell type of this disease. The boy presented with acute appendicitis and a left hilar mass was noted on his chest radiograph. His asymptomatic presentation was typical of the hyaline-vascular form. Both patients are well without evidence of recurrence four years following resection. Castleman's disease is a benign disorder of lymph nodes that occurs rarely in children. Since the original report in 1954 we could find only 18 cases in the 16-year and younger age group and our patient with the symptomatic form represents the youngest patient reported in the English literature. The management requires surgical resection of the enlarged nodes both for diagnosis and therapy since the enlarged nodes can mimic malignant tumors of the lymphoid system. No recurrences have been reported in pediatric patients.

Child↗
PubMed1986

Gastroesophageal reflux. pH probe-directed therapy.

Two groups of newborns and infants with gastroesophageal reflux (GER) were retrospectively analyzed for the diagnostic accuracy and therapeutic guidance offered by extended intraesophageal pH monitoring. There were 28 patients in group I whose major presenting sign was recurrent pneumonia due to GER, and 22 patients in group II, with apnea caused by GER. The pH probe was 100% accurate in identifying the presence of GER. Barium esophagram was accurate 46% of the time. The pH probe accurately identified the appropriate mode of therapy in all patients. In the medically treated GER/Pneumonia group, the mean number of episodes of GER per 24 hours was 24, whereas in the surgical group the mean number was 63. Similarly, in the medically treated GER/Apnea group, the mean number of reflux episodes per 24 hours was 26, whereas the surgical group experienced 64. Had the pH probe been used to guide therapy, no patient would have been treated inappropriately. The number of patients in this report is not large. Prospective verification of these observations is required before this methodology can be utilized routinely in patients with GER.

Apnea↗
PubMed1985

Intraoperative diagnostic pneumoperitoneum in pediatric patients with unilateral inguinal hernias: the Goldstein test.

Over a four-year period 256 infants and children presenting with unilateral inguinal hernias underwent intraoperative diagnostic pneumoperitoneum to evaluate the contralateral groin. Sixty one patients had positive results and underwent contralateral hernia repair. Of the 195 negative tests 3 presented later with either a hernia, communicating hydrocele or cord hydrocele (false negative rate of 1.5%). This test represents a safe, economical, rapid, and accurate means to evaluate the contralateral groin in the pediatric patient presenting with a unilateral inguinal hernia.

Child↗
PubMed1984

Magnetic resonance imaging in the diagnosis of breast disease: use of transverse relaxation times.

The ability of magnetic resonance imaging (MR) to demonstrate breast carcinoma depends upon significantly different relaxation times in benign and malignant tissues. The authors conducted an in vitro study of transverse relaxation times (T2) of 393 breast tissue samples in order to establish a range of values for normal tissue, benign lesions, and carcinoma. All T2 values were multiexponential. Benign lesions were readily distinguished from both invasive and noninvasive carcinoma in samples containing fat or a mixture of fat and fibrous tissue; however, in purely fibrous samples there was some overlap of T2 values in benign and malignant tissues. Although the data acquisition and analysis requirements involved in this in vitro study exceed the capabilities of present whole-body MR imagers, the added understanding gained through efforts of this type may aid both interpretation of current images and future developments.

Adenofibroma↗
PubMed1983

Pseudotorsion of testis.

Unilateral scrotal inflammation was noted in an otherwise asymptomatic three-day-old male and was initially believed to be due to testicular torsion. It proved, however, to be the result of peritonitis from a thermometer-induced rectal perforation presenting via a communicating hydrocele. Treatment included primary closure of the rectal perforation with colostomy diversion combined with parenteral antibiotics. Preoperative evaluation of neonates with acute unilateral inflammation of the scrotum and a known hydrocele or hernia with flat and oblique x-ray films may reveal significant unsuspected intra-abdominal pathology.

Anti-Bacterial Agents↗
PubMed1983

X-ray calcifications as the only basis for breast biopsy.

Two hundred fifty-one consecutive patients were treated between 1964 and 1982 with mammographic calcifications as the only reason for breast biopsy. Patients with either clinical or x-ray findings other than calcifications were excluded. A correlation of the x-ray, pathology, and clinical experience is the basis of this report. Specimen radiography with paraffin section histology (i.e., no frozen section) was performed on all biopsy material. The procedure of specimen radiography that was utilized is described. A team approach involving radiologists, pathologists, and surgeons has been essential both to confirm excision of the calcifications and localize them for pathology study. Carcinoma was found in 45 patients (17%). A retrospective study of the calcifications was also undertaken to determine characteristics that would permit definitive radiographic diagnosis of benign or malignant disease.

Biopsy↗
PubMed1983

Latissimus dorsi blood supply after thoracodorsal vessel division: the serratus collateral.

The reliability of the latissimus dorsi musculocutaneous flap for breast reconstruction following radical mastectomy and an axillary dissection that may have divided the thoracodorsal vessels is enhanced by preservation of the serratus collateral into the flap. Observations during axillary dissections have confirmed the constant presence of the serratus branch. Primate studies document latissimus dorsi flap viability when elevated on this branch. Studies during microvascular transfer document reversal of flow in the serratus branch to supply the latissimus dorsi muscle after division of the thoracodorsal artery. Latissimus dorsi flap elevation as an island may be reliably based on the serratus branch.

Animals↗
PubMed1982

Congenital colonic atresia.

Nineteen cases of congenital colon atresia are presented with two deaths resulting in a mortality rate of 10.5%. The authors conclude that operative management of atresias proximal to the splenic flexure should include resection of the dilated proximal colon with primary ileotransverse colostomy or ileosigmoidostomy. Atresias distal to the splenic flexure should be managed with a colostomy with later establishment of gastrointestinal continuity.

Colon↗
PubMed1982

Megarectum: a rare complication of imperforate anus repair and its surgical correction by endorectal pullthrough.

Nine patients ranging in age from 3 mo to 15 yr presented with severe constipation and/or increasing incontinence. All had a huge, dilated atonic rectum and rectosigmoid demonstrated by barium enema. Six patients underwent resection of the abnormal bowel by an endorectal pull-through procedure with good to excellent results while 1 patient was corrected by a Swenson procedure.

Adolescent↗
PubMed1982

Early evaluation of potential worker exposure problems associated with the Claus-type sulfur recovery process.

Early evaluation of process plants, such as the Claus-type SRU (sulfur recovery unit), in the design stage not only minimizes worker exposure to toxic chemicals and noise, but also reduces costs for retrofit engineering controls. The Claus-type SRU converts the hydrogen sulfide in refinery acid gas into elemental sulfur. In the process, the SRU handles toxic gases containing high concentrations of H2S, SO2, and other sulfur compounds. These gases can be emitted into the worker's breathing zone during start-ups, shutdowns, routine operations, emergencies, and turnarounds. This paper describes the Claus-type sulfur recovery process, the potential sources of worker exposure to toxic chemicals and noise, and the engineering controls that should be adopted at the plant design stage to minimize the risks of worker exposure. Engineering controls include improved pump seals and a choice of sample configurations based on the physical form and concentration of H2S in the process lines.

Equipment Design↗
PubMed1980

Strongyloidiasis in immunosuppressed hosts. Presentation as massive lower gastrointestinal bleeding.

Two cases of massive lower gastrointestinal hemorrhage in immunosuppressed patients were due to complicated infestation with Strongyloides stercoralis. The very high mortality of disseminated strongyloidiasis may in part be attributed to delays in diagnosis and treatment resulting from the complex life cycle of this nematode. Successful therapy in the cases presented consisted of reduction of corticosteroid dosage, use of thiabendazole in excess of that recommended for uncomplicated infestation, parenterally administered nutrition, multiple transfusion of blood products, and vigorous supportive management. Emphasis is given to proper categorization of patients and measures designed to prevent, detect, and treat hyperinfection in patients in whom immunosuppression is anticipated.

Adult↗
PubMed1978

Delro??

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Delaware↗