Sequential intestinal lengthening procedures for refractory short bowel syndrome.

Better understanding of the long-term delivery of parenteral nutrition (PN) in neonates and children has increased the survival for patients who have neonatal short bowel syndrome. Most infants with short bowel syndrome experience progressive enteral adaptation and are weaned from PN. This report describes the authors' clinical experience with nine infants and children who had refractory short bowel syndrome; single or sequential procedures were performed to lengthen the small bowel.

Management of coexistent carotid and coronary artery disease.

Simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CE) were done on 133 patients over an 8-year period. Twenty-seven patients (20%) had previous transient ischemic attacks (TIAs), 12 (9%) had previous strokes, and the remainder (71%) were asymptomatic. All asymptomatic patients had greater than 85% stenosis of the internal carotid artery demonstrated by noninvasive ultrasonography and four-vessel angiography.

Effect of a betadine connection shield on central venous catheter sepsis.

The effect on the rate of central venous catheter sepsis of incorporating the catheter hub in a povidone-iodine (Betadine) connection shield was evaluated in a randomized controlled clinical trial involving 47 Silastic catheters inserted in 35 patients solely for the administration of parenteral nutrition. All catheters were tunneled subcutaneously and once inserted were randomized to one of two subsequent management groups. Group 1 (n = 25) were managed in a standard fashion whereas Group 2 catheters (n = 22) in addition were managed by incorporating the catheter hub in a Betadine connection shield (Connection Shield 3; Travenol/Baxter).

Serum testosterone levels in women with Cushing's disease.

Serum testosterone was measured pre- and post-operatively in 31 women who obtained remission of Cushing's disease following treatment by interstitial irradiation of the pituitary gland. The mean serum testosterone was initially elevated at 3.35 nmol/l, with values ranging from 0.

Diagnosis, complications and treatment of Takayasu's arteritis.

Takayasu's arteritis is a large vessel vasculitis involving the aorta and it's major branches. Clinical diagnosis in the early stage is important as the disease may then be treatable. We present the first two cases ever reported in the Irish literature.

Arm ischemia secondary to giant cell arteritis.

Patients with severe ischemic symptoms that fail to respond to steroid therapy, despite a dramatic and continuous drop in the erythrocyte sedimentation rate, may require arterial bypass surgery to overcome arterial ischemia caused by arteritis. We report the case of a patient with bilateral subclavian artery occlusion secondary to giant cell arteritis who responded well to steroid therapy and arterial reconstructive surgery. The patient has remained well for five years.

Long-term brachial artery catheterization: ischemic complications.

The brachial artery is not used for long-term catheterization and routine hemodynamic monitoring because a high incidence of ischemic complications is anticipated. However, in a review of 157 patients who had 225 percutaneous transbrachial hepatic artery catheters placed for infusion of chemotherapeutic agents, catheters remained in situ from 1 day to 14 months (median 68 days). One hundred seventy-three catheters (77%) were removed electively and 52 catheters (23%) were removed because of complications.

Effects of short-term injection of gonadotrophins on ovarian follicle development in hypogonadal (hpg) mice.

Twice daily injections of purified ovine and human FSH were used to investigate the control of ovarian follicle development in hypogonadotrophic hypogonadal (hpg) mice. Treatment for 5 days with doses greater than 3 micrograms resulted in a significant increase in the total number of growing follicles and the development of antral follicles. This was associated with increases in uterine weights and vaginal opening, indicating that steroidogenesis had also been stimulated.

Effects of gonadotrophin deficiency on follicular development in hypogonadal (hpg) mice.

The rates of follicle growth and death in GnRH-deficient hypogonadal (hpg) mice and in normal mice were studied using the stochastic compartmental model of follicle dynamics. The rate estimates derived from this model suggest that in normal mice gonadotrophins act at several stages in the development of ovarian follicles. Gonadotrophins appear to regulate the number of follicles beginning to grow by controlling both the rate at which non-growing follicles enter the growing pool and the loss of non-growing follicles to atresia.

Postnatal ovarian follicle development in hypogonadal (hpg) and normal mice and associated changes in the hypothalamic-pituitary ovarian axis.

Significant uterine growth occurred in normal and hypogonadal (hpg) mice between Days 7 and 21 but thereafter no further growth was observed in hpg mice. The ovaries of hpg mice were significantly smaller than those of normals at all ages, but there was no significant difference between the number of non-growing follicles in the ovaries of mutants and their normal littermates at any age studied, and normal and hpg mice showed a marked reduction in the number of non-growing follicles during the first month of life. The size and composition of the growing follicle population in hpg mice, however, differed markedly from those in normal animals and by 21 days of age the number of growing follicles in mutants was significantly reduced.

The mononuclear phagocyte system of the mouse defined by immunohistochemical localization of antigen F4/80: macrophages of endocrine organs.

Macrophages of endocrine organs have been identified by immunohistochemical localization of the macrophage-specific antigen F4/80. F4/80+ cells line vascular sinuses and capillaries in anterior and posterior pituitary, adrenal cortex, corpus luteum, parathyroid, pineal gland, and islets of Langerhans. In testis approximately 20% of interstitial cells are F4/80+.

Prolactin measurements in normal and hypogonadal (hpg) mice: developmental and experimental studies.

Plasma and pituitary PRL levels are significantly greater in adult female than in male rats. This difference is thought to be brought about by ovarian steroids. We found a similar sex difference in pituitary PRL content in normal mice from 30 days of age.

Distribution of 125I-labelled follicle-stimulating hormone and human chorionic gonadotrophin in the gonads of hypogonadal (hpg) mice.

Hypogonadal mice are deficient in LH releasing hormone (LH-RH), the releasing factor for LH and FSH, with a consequent failure of postnatal ovarian and testicular development. After intravenous injection of hypogonadal females with 125I-labelled human chorionic gonadotrophin (hCG), followed by autoradiography of semi-thin (1 micrometer) slices of the ovary, labelled hCG was found to be associated with interstitial cells and thecal cells with little or no labelling of granulosa cells. Labelled human FSH was associated solely with granulosa cells.

An unusual reaction in muscle in association with Vitallium plate: a report of possible metal hypersensitivity.

A case is reported in which fractures of the radius and ulna were fixed with Vitallium plates and screws. Seven years later a painful swelling appeared over the extensor aspect of the forearm. After eight years sarcoma was suspected and a pale tumour infiltrating muscle was found at operation.