Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Impact Of Suture Choice On Stricture Formation Following Repair Of Esophageal Atresia, Shawn D. St Peter, Patricia A. Valusek, Charles L. Snyder, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

Background/ Purpose: The most common complication following repair of esophageal atresia is anastomotic stricture. Despite strong opinions of pediatric surgeons regarding the type of suture used for the anastomosis, these opinions remain unsubstantiated by any data present in the literature. Therefore, we investigated the rate and severity of stricture formation relative to the suture size and material.
Materials & Methods: A retrospective analysis of our most recent 20-year experience with repair of esophageal atresia and tracheoesophageal fistula (EA/TEF) was performed. Stricture was defined as the need for dilation. Outcomes were analyzed based on absorbability, texture, and type of …

Gastroesophageal Reflux Disease And Fundoplication In Infants And Children, Shawn D. St Peter, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

Gastroesophageal reflux disease (GERD) can be one of the most distressing conditions developing at different ages in infants and children. The disease itself is a complex process along with ongoing dynamic anatomic and physiologic changes occurring during normal development. Therefore among referring physicians, considerations regarding the role of surgery for GERD in children varies widely depending on individual experiences in managing these patients. These varied opinions result in discrepancies in the operative experience with fundoplication among pediatric surgeons. It is unclear how much of the current opinions stem from published evidence, particularly with regard to the safety and efficacy of …

Pancreatic Operations In Children, An Institutional Experience And Review Of Literature, Varun Puri, Lisa Martin, Shawn D. St Peter, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

Pancreatic operations are not commonly performed in the pediatric age group. Tumors, chronic pancreatitis, trauma and hyperinsulinemic hypoglycemia are the main diseases leading to pancreatic resections in children. Excluding patients with acute pancreatitis and pseudocysts, over the last 5 years we have performed operations in 11 children for pancreaticoduodenal pathology. The diagnoses encountered were tumors or tumor like conditions (four), angiodysplasia (one), chronic pancreatitis (one), traumatic pancreatic transection (three), traumatic pseudocyst, and neonatal hyperinsulinemic hypoglycemia (one). Operations performed were: pancreaticoduodenectomy (PD) in three patients, subtotal or distal pancreatectomy in six patients, distal pancreaticojejunostomy with oversewing of the proximal pancreatic duct …

Biomechanical Testing Of Two-Level Cervical Disc Arthroplasty, Laura J. Gilmour

Theses and Dissertations (ETD)

In vitro biomechanical studies comparing two-level cervical disc arthroplasty with two-level fusion were completed using an established cadaveric cervical spine model. Three conditions were tested: non-instrumented, instrumented with two-level fusion (C5-C6 and C6-C7), and instrumented with two-level arthroplasty (C5-C6, C6-C7) using the Prestige Low-Profile (Medtronic Sofamor Danek, Memphis TN) or ProDisc-C (Synthes Spine, West Chester PA) prosthetic disc. Specimens were tested non-destructively in physiologic flexion-extension, lateral bending, and axial rotation to an end-limit load of 3-Nm or 45o rotation. Rotations at the superior, implanted, and inferior motion segment units (MSU) of the instrumented conditions were normalized to the non-instrumented condition …

Open Versus Laparoscopic Pyloromyotomy For Pyloric Stenosis: A Prospective, Randomized Trial., Shawn D. St Peter, G W. Holcomb Iii, Casey M. Calkins, J Patrick Murphy, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pyloric stenosis, the most common surgical condition of infants, is treated by longitudinal myotomy of the pylorus. Comparative studies to date between open and laparoscopic pyloromyotomy have been retrospective and report conflicting results. To scientifically compare the 2 techniques, we conducted the first large prospective, randomized trial between the 2 approaches.

METHODS: After obtaining IRB approval, subjects with ultrasound-proven pyloric stenosis were randomized to either open or laparoscopic pyloromyotomy. Postoperative pain management, feeding schedule, and discharge criteria were identical for both groups. Operating time, postoperative emesis, analgesia requirements, time to full feeding, length of hospitalization after operation, and complications …

Incidence And Outcome Of Cardiopulmonary Resuscitation In Patients With Shunted Single Ventricle: Advantage Of Right Ventricle To Pulmonary Artery Shunt., Eric M. Graham, Geoffrey A. Forbus, Scott M. Bradley, Girish S. Shirali, Andrew M. Atz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Cardiac Transplant Following Failed Fontan Or Glenn Procedures., Naveen L. Pereira, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Detection Of Microcracks During Bone Cutting Using Acoustic Emission Techniques, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

Surgeons may use a number of cutting instruments such as osteotomes and chisels to cut bone during operative procedures. The initial loading of cortical bone during the cutting process results in the formation of microcracks in the vicinity of the cutting zone with main crack propagation to failure occurring with continued loading; microcracking acts as a stimulus for main crack formation and has also been shown to occur during the propagation of the main crack. It has also been reported that Acoustic Emission (AE) is generated due to microcrack formation and crack growth, prior to, and during final fracture in …

Surgical Images: Soft Tissue. Incarcerated Gallbladder In A Parastomal Hernia., Shawn D. St Peter, Jacques Heppell

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Effects Of Tensioning Errors In Split Transfers Of Tibialis Anterior And Posterior Tendons, Stephen J. Piazza, Matthew F. Moran, Neil A. Sharkey, Robert L. Adamson, James O. Sanders

All PTHMS Faculty Publications

Background: Split transfers of the tibialis anterior and posterior tendons are commonly performed to address hindfoot varus deformities in patients with cerebral palsy, stroke, or brain injury. Poor outcomes from these procedures are often attributed to a failure to tension the transferred tendon properly, but the mechanical effects of this aspect of the procedure have not been quantified, to our knowledge. The purpose of the present study was to use a cadaver model to examine changes in the actions of these muscles that occur when the tensions in the halves of the split tendon are intentionally balanced or unbalanced to …

Update - May 2002, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- The Compleat Physician
-- Informed Consent Documentation for Total Artificial Hearth Technology
-- Ralph J. and Carolyn Thompson Endowment established in 2001

Beta-Galactosidase As A Marker Of Ischemic Injury And A Mechanism For Viability Assessment In Porcine Liver Transplantation., Shawn D. St Peter, Charles J. Imber, Inigo Lopez De Cenarruzabeitia, James Mcguire, Tim James, Richard Taylor, Peter J. Friend

Manuscripts, Articles, Book Chapters and Other Papers

Glycohydrolases are a group of enzymes contained predominantly within lysosomes, which are released during Kupffer cell activation or death. One of these, beta-galactosidase, has been proposed as a marker of ischemia-reperfusion injury in the liver because Kupffer cell activation represents a primary event in the injurious reperfusion cascade. In this study, we compared B-galactosidase with more traditional indicators of liver injury and function in a porcine model of liver preservation. Porcine livers were allocated into two groups: group C (n = 5), preserved in University of Wisconsin solution by standard cold storage for 24 hours, and group W (n = …

Association Of Viral Genome With Graft Loss In Children After Cardiac Transplantation., Girish S. Shirali, J Ni, R E. Chinnock, J K. Johnston, G L. Rosenthal, N E. Bowles, J A. Towbin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The survival of recipients of cardiac allografts is limited by rejection, lymphoproliferative disease, and coronary vasculopathy. The purpose of this study in children who had received heart transplants was to evaluate the cardiac allografts for myocardial viral infections and to determine whether the presence of viral genome in the myocardium correlates with rejection, coronary vasculopathy, or graft loss.

METHODS: We enrolled heart-transplant recipients 1 day to 18 years old who were undergoing evaluation for possible rejection and coronary vasculopathy. Endomyocardial-biopsy specimens were evaluated for evidence of rejection with the use of standard criteria and were analyzed for the presence …

Posttransplant Recoarctation Of The Aorta: A Twelve Year Experience., Girish S. Shirali, C E. Cephus, M A. Kuhn, K K. Ogata, L K. Vander Dussen, R E. Chinnock, N F. Mulla, J K. Johnston, L L. Bailey, S R. Gundry, A J. Razzouk, R L. Larsen

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation.

BACKGROUND: Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta.

METHODS: This was a retrospective review of all children (ageyears) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the …

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Factors Which Influence Women's Decisions For Choice Of Primary Surgery For Stage I And Stage Ii Breast Cancer, Barbara Mastaglia

Theses : Honours

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive …

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

Update - December 1996, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Bioehtics Endowment Honors Jack and Margaret Provonsha
-- Partial Birth Abortion: Ethical Issues
-- Partial Birth Abortion: Mandates, Methods, and Morality
-- Partial Birth Abortion Dialogue

Update - October 1996, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Is Organ Reanimation a Better Mousetrap?
-- Reanimation of Dead Hearts
-- Reanimation Dialogue
-- James W. Walters publishes second book on ethics and aging

Update - July 1996, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Stress and Distress in Pediatric Nurses: The Hidden Tragedy of Baby K
-- Ethics Grand Rounds: The Year in Review
-- CEJA Reverses Its Stance on Using Anencephalic Neonates as Live Organ Donors
-- AMA Council's Ethics Overwhelmed by Public Sentiment

Ventricular Remodeling Following Infant-Pediatric Cardiac Transplantation. Does Age At Transplantation Or Size Disparity Matter?, Girish S. Shirali, F Lombano, W L. Beeson, D A. Dyar, N F. Mulla, A Khan, J K. Johnston, R E. Chinnock, S R. Gundry, A J. Razzouk

Manuscripts, Articles, Book Chapters and Other Papers

Early left ventricular (LV) remodeling following pediatric cardiac transplantation has not been described. To identify patterns and determinants of change in left ventricular mass and volume posttransplant, we studied 125 consecutive children who underwent cardiac transplantation between January 1, 1989 and July 31, 1993. Two-dimensional imaging-directed M-mode echocardiograms were studied weekly until 26 weeks post-transplant. LV mass and volume (indexed to BSA1.5) were measured. LV mass index increased until 3 weeks post-transplant, and then decreased. The mean decrement in LV mass index after 8 weeks post-transplant (relative to baseline) was significantly larger in patients with donor-recipient weight ratio > 1.5 compared …

Update - October 1995, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Managed Care: Challenges Facing Interdisciplinary Health Care Teams
-- Anencephalic Neonates as Live Organ Donors: AMA and CEJA
-- Can Evil Even End?

Update - July 1995, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Gender Discrimination in the Medical Community

[ Responses to the American Medical Association of the Use of Anencephalic Neonates as Organ Donors ]
-- Maintain the "Dead Donor Rule"
-- Stairway to Hell
-- Let Parents Choose
-- Revisiting the Issues

Ai : Artificial Insemination Of Sheep, David Windsor

Journal of the Department of Agriculture, Western Australia, Series 4

Artificial insemination (Al) is used widely in the dairy and beef industries and often performed by farmers themselves. By contrast, sheep breeders generally require assistance from vets when frozen semen is to be used. However, recent experiments with frozen semen are indicating that do-it-yourself Al may soon become a reality.

Update - September 1993, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Abortion in Context: Individual, Family, and Community
-- Abortion Guidelines, Seventh-day Adventist Church, October 12, 1992
-- Holding Values in Tension: The 1992 Abortion Guidelines
-- Adventist Abortion Guidelines: A Clinical Ethicist's Perspective

[ Behind the Scenes: Development of the Abortion Guidelines ]

Update - May 1992, Loma Linda University Center For Christian Bioethics

Update

In this issue:

[ Faith, Medicine, and Religious Liberty - Part 2, Christian Science ]
-- Spiritual Healing for Children
-- Religious Liberty, Spiritual Healing, and the Health Care of Children
-- Spiritual Healing, Laws, and Constitutional Free Exercise of Religious Rights
-- Baby Theresa: Parental Choice Must Reign in the Case of Brain-Absent Newborns
-- Anencephalic Infants as Organ Donors: Do We Follow Rules or Emotions?

Update - May 1990, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- James Walters wins NEH Grant
-- Fraud in Modern Medicine
-- Roy Branson serves as guest professor of medical ethics
-- Cambridge publishes Michael Pearson's study of Adventist ethics

[ RU486: Blessing or Curse? ]
-- Medical Aspects of RU486
-- The Curse of RU486: The Death Pill
-- RU486: A Very Mixed Blessing

-- Robert Wirth sparks aging project

Update - June 1989, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Etienne-Emile Baulieu discusses RU486
-- Walters edits War No More?

[ Abortion: Ethical Issues ]
-- Excerpts of papers presented at the "Abortion: Ethical Issues and Options" international conference

-- Elder, Guy, Provonsha and Winslow assess AIDS at A.P.C.

Update - November 1987, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Gerald Winslow joins LLU faculty
-- Thompson library opens September 25

[ Anencephalic Infants as Organ Donors: Ethical Issues ]
-- A Neonatologist's Concern
-- A Neonatologist's Reply
-- Should the Law be Changed?
-- Would Anencephalic Neonates be Citizens?
-- Cadaveric Donors Should be Dead

-- Ethics Center seeks $100,000

Update - July 1986, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Baby Jessie and Beyond
-- Newsbriefs
-- The Bouvia Decision: Right But Inadequate
-- LLU plans conference on ethics and transplantation

[ Apartheid and Morality Today ]
-- Growing Up White in South Africa
-- In Favor of Constructive Engagement
-- Divestment: Realistic Moral Opposition to Apartheid

-- What should treatment committees consider?
-- Religion and Politics on Sabbath (Editorial)
-- George Otto Schumacher, MD (1913-1986)
-- Thomas Gordon Goman, PhD (1944-1986)