Biomedical subjects

W K Shim

Publications and source records attributed to W K Shim.

15 recordsLinked to original sources

PubMed2001

Intraoperative localization of ectopic gastric mucosa in the nonduplicated intestinal lumen with technetium 99m pertechnetate scanning.

The occurrence of ectopic gastric mucosa in Meckel's diverticula and duplications of the intestinal tract is a source of serious morbidity from bleeding and perforation in children. Intraoperative localization of the ectopic mucosa is aided by its occurrence in the duplicated intestinal segment or Meckel's diverticulum. However, its identification in the nonduplicated intestine poses problems for the surgeon faced with removal of the affected segment. The authors present a case of ectopic gastric mucosa in a nonduplicated jejunal segment and discuss the use of technetium 99m pertechnetate scanning in its localization.

Child, Preschool↗

PubMed1999

Near-total intestinal aganglionosis in the Waardenburg-Shah syndrome.

Both pigmentation and otic defects of Waardenburg Syndrome and Hirschsprung's disease have a common origin in neural crest cells and were described in 1951 and 1887, respectively. The clinical manifestations of both in the same patient were described in 1981 in 12 infants so afflicted. The authors present such a case of long segment aganglionosis in a 15-day-old Marshallese girl with Waardenburg-Shah syndrome and discuss diagnosis, treatment, and prognosis.

Fatal Outcome↗

PubMed1999

Fifteen years' experience with an antirefluxing biliary drainage valve.

PURPOSE: The aim of this study was to examine the efficacy of the antirefluxing, mucosal-flap valve (AMFV) for biliary drainage relative to technical feasibility, surgical complications, and incidence of ascending cholangitis (AC). METHODS: Twenty-seven infants requiring biliary tract reconstruction underwent valve construction. Twenty biliary atresia (BA) patients received the Kasai procedure, and 7 choledochal cyst (CC) infants had cystectomy and hepatoenterostomy. A retrospective review of all patients was performed including radiographic evaluation of the current valve function in 10 patients. RESULTS: Construction was successful in all cases, and no morbidity was incurred by incorporation of the valve. Of 7 CC patients, there have been no known episodes of AC with mean follow-up of 4.4+/-4.2 years. Of 20 BA patients, there have been 5 deaths (25%), 7 liver transplants (35%), 2 (10%) lost to follow-up, and 6 (30%) survivors. Nine BA patients (45%) have had AC, with patients in all 4 outcome categories represented. Ten patients (5 CC and 5 BA) have been evaluated with barium small bowel radiographs, with no reflux to the liver hilum in all cases. CONCLUSIONS: The AMFV has caused no morbidity and continues to prevent reflux to the liver hilum. Despite functioning as designed, it does not appear to influence the occurrence of AC. Because CC patients had no AC, we feel that infection is related to the underlying atresia rather than to reflux.

Biliary Atresia↗

PubMed1985

Anti-refluxing Roux-en-Y biliary drainage valve for hepatic portoenterostomy: animal experiments and clinical experience.

In five dogs, we have created an anti-refluxing Roux en-Y jejunal anastomosis by removing the antimesenteric half of the seromusculature from five cm of the biliary limb proximal to the anastomosis prior to coating the gastric and biliary limbs. In the presence of increasing intraluminal pressure in the gastric and vertical limbs of the Y, the wall of the biliary limb collapses and occludes the lumen, acting as a nonrefluxing one-way valve. All three limbs of the Y were then exteriorized as enterostomies. Saline was instilled into either the gastric or distal limb with the other clamped. There was never reflux from the biliary limb despite intraluminal pressures of 200 mm Hg. We have used the anti-refluxing valve in seven infants. Three are alive at 17, 7, and 2 months postoperatively, one of which had a brief episode of fever without leukocytosis or increasing jaundice. Three have died of unresolved obstruction and one has been lost to follow-up.

Animals↗

PubMed1974