182 research outputs found
Acute non-occlusive mesenteric ischemia of the small bowel in a patient started on hemodialysis: a case report
The definitive management of Hirschsprung's disease with the endorectal pull-through procedure
From 1 July 1974 to 31 August 1985, 99 patients with Hirschsprung's disease were treated at the University of Michigan Mott Children's Hospital; 75 were initially diagnosed and treated at our institution. Of these 75 patients, 55 had standard rectosigmoid disease and 20 had long-segment disease. The endorectal pull-through (ERPT) procedure was used consecutively in 73 of the 75 patients; the other two children died, one because of total intestinal aganglionosis and the other due to severe congenital anomalies, prior to a definitive procedure. Of the 24 patients referred by other institutions, 12 underwent repeat pull-through procedures and 12 required lesser operations to deal with the complications of prior procedures. There were no postoperative deaths and no permanent enterostomies among the 73 consecutive ERPT patients. The follow-up in this series ranges from 4 months to 10 years, and all patients have fecal continence with an average of 3–4 stools daily. Our treatment plan involves the use of suction rectal biopsy for diagnosis and leveling colostomy in the neonatal period. An endorectal pull-through procedure is then carried out between 8 months and 1 year of age. The excellent functional results, 0% operative mortality, low morbidity, and technical ease of performing the ERPT underscore our enthusiasm for continued use of this procedure in Hirschsprung's disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47147/1/383_2004_Article_BF00166867.pd
Circumstellar disks and planets. Science cases for next-generation optical/infrared long-baseline interferometers
We present a review of the interplay between the evolution of circumstellar
disks and the formation of planets, both from the perspective of theoretical
models and dedicated observations. Based on this, we identify and discuss
fundamental questions concerning the formation and evolution of circumstellar
disks and planets which can be addressed in the near future with optical and
infrared long-baseline interferometers. Furthermore, the importance of
complementary observations with long-baseline (sub)millimeter interferometers
and high-sensitivity infrared observatories is outlined.Comment: 83 pages; Accepted for publication in "Astronomy and Astrophysics
Review"; The final publication is available at http://www.springerlink.co
Hirschsprung's disease in the newborn
The records of all patients with Hirschsprung's disease diagnosed and treated at our institution between 1 July 1974 and 31 August 1985 were reviewed. Of these 99 patients, 35 (35%) presented and were diagnosed within the first 30 days of life and constitute the basis of the present study group. Twenty-two infants (63%) had standard rectosigmoid disease with a male-to-female ratio of 2.2:1. Only one infant was premature. The spectrum of presenting signs included abdominal distension in 19 (54%), failure to pass meconium within the first 48 h of life in 16 (46%), “constipation” in 12 (34%), and vomiting in 9 (26%). Intestinal perforation was a presenting sign in 2 patients (6%) and enterocolitis occurred preoperatively in 4 (12%). Evaluation was facilitated by diagnostic barium enema in 60% of the patients. In those infants able to undergo elective evaluation, the definitive diagnosis was made by suction rectal biopsy, which was accurate in all cases. In addition to the high proportion of patients with long-segment disease (13 patients, 37%), there was a significant incidence of associated congenital anomalies (26%), including Down's syndrome in 5 (14%). Thirty-three of the 35 patients have undergone definitive treatment using the endorectal pull-through procedure, performed at an average age of 12 months, with no mortality related to the operation. In addition to highlighting the high incidence of congenital anomalies, the large proportion of neonates with long-segment disease, and the reliability of the diagnostic barium enema, this subgroup of patients with Hirschsprung's disease emphasizes the special diagnostic and management considerations required in the newborn infant who presents with sepsis of unknown etiology, intestinal obstruction, or constipation. A high index of suspicion, liberal use of suction rectal biopsy, early leveling colostomy, and definitive treatment by endorectal pull-through are important in achieving 0% operative mortality and excellent functional results.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47145/1/383_2004_Article_BF00166865.pd
Comparison of argon plasma coagulation in management of upper gastrointestinal angiodysplasia and gastric antral vascular ectasia hemorrhage
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Genome-wide haplotype association study identifies the FRMD4A gene as a risk locus for Alzheimer's disease.
International audienceRecently, several genome wide association studies (GWAS) have led to the discovery of 9 new loci of genetic susceptibility in Alzheimer's disease (AD). However, the landscape of the AD genetic susceptibility is far away to be complete and in addition to single-SNP analyses as performed in conventional GWAS, complementary strategies need to be applied to overcome limitations inherent to this type of approaches.. We performed a genome wide haplotype association (GWHA) study in the EADI1 study (n=2,025 AD cases and 5,328 controls) by applying a sliding-windows approach. After exclusion of loci already known to be involved in AD (APOE, BIN1 and CR1), 91 regions with suggestive haplotype effects were identified. In a second step, we attempted to replicate the best suggestive haplotype associations in the GERAD1 consortium (2,820 AD cases and 6,356 controls) and observed that 9 of them showed nominal association. In a third step, we tested relevant haplotype associations in a combined analysis of five additional case-control studies (5,093 AD cases and 4,061 controls). We consistently replicated the association of a haplotype within FRMD4A on Chr.10p13 in all the data set analysed (OR=1.68, 95% CI 1.43- 1.96; p=1.1x10-10). We finally searched for association between SNPs within the FRMD4A locus and Ab plasma concentrations in three independent non demented populations (n=2,579). We reported that polymorphisms were associated with plasma Ab42/Ab40 ratio (best signal, p=5.4x10-7). In conclusion, combining both GWHA study and a conservative three-stage replication approach, we characterised FRMD4A as a new genetic risk factor of AD
Populations of planets in multiple star systems
Astronomers have discovered that both planets and binaries are abundant
throughout the Galaxy. In combination, we know of over 100 planets in binary
and higher-order multi-star systems, in both circumbinary and circumstellar
configurations. In this chapter we review these findings and some of their
implications for the formation of both stars and planets. Most of the planets
found have been circumstellar, where there is seemingly a ruinous influence of
the second star if sufficiently close (<50 AU). Hosts of hot Jupiters have been
a particularly popular target for binary star studies, showing an enhanced rate
of stellar multiplicity for moderately wide binaries (>100 AU). This was
thought to be a sign of Kozai-Lidov migration, however recent studies have
shown this mechanism to be too inefficient to account for the majority of hot
Jupiters. A couple of dozen circumbinary planets have been proposed around both
main sequence and evolved binaries. Around main sequence binaries there are
preliminary indications that the frequency of gas giants is as high as those
around single stars. There is however a conspicuous absence of circumbinary
planets around the tightest main sequence binaries with periods of just a few
days, suggesting a unique, more disruptive formation history of such close
stellar pairs.Comment: Invited review chapter, accepted for publication in "Handbook of
Exoplanets", ed. H. Deeg & J. A. Belmont
Assessment of facial profile changes in patients treated with maxillary premolar extractions
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