Surgeons, Pediatric Surgeon
12 years of experience
Video profile
Accepting new patients
Juniata Park - Feltonville
St Christopher's Pediatric Associates
3601 A St
Philadelphia, PA 19134
215-427-5000
Locations and availability (3)

Education ?

Medical School Score
Thomas Jefferson University (1998)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Awards  
Castle Connolly's Top Doctors™ (2013)
Patients' Choice Award (2008 - 2009, 2013)
Associations
American Board of Surgery

Affiliations ?

Dr. Arthur is affiliated with 9 hospitals.

Hospital Affilations

Score

Rankings

  • St. Luke's Hospital/Bethlehem
    801 Ostrum St, Bethlehem, PA 18015
    • Currently 4 of 4 crosses
    Top 25%
  • Saint Christopher's Hospital for Children
    Pediatric Surgery
    3601 A St, Philadelphia, PA 19134
    • Currently 3 of 4 crosses
    Top 50%
  • St. Luke's Miners Memorial Hospital
    360 W Ruddle St, Coaldale, PA 18218
    • Currently 2 of 4 crosses
  • Capital Health System - Mercer Campus
    446 Bellevue Ave, Trenton, NJ 08618
    • Currently 2 of 4 crosses
  • Capital Health System - Fuld Campus
    750 Brunswick Ave, Trenton, NJ 08638
    • Currently 2 of 4 crosses
  • Abington Memorial Hospital
    1200 Old York Rd, Abington, PA 19001
    • Currently 2 of 4 crosses
  • St Luke's Quakertown Hospital
    300 S 11th St, Quakertown, PA 18951
    • Currently 2 of 4 crosses
  • St Lukes Health Network
  • Saint Luke's Hospital - Allentown Campus
    1736 W Hamilton St, Allentown, PA 18104
  • Publications & Research

    Dr. Arthur has contributed to 9 publications.
    Title A Comparison of Laparoscopic and Open Nissen Fundoplication and Gastrostomy Placement in the Neonatal Intensive Care Unit Population.
    Date April 2010
    Journal Journal of Pediatric Surgery
    Excerpt

    The aim of this study was to compare outcomes after laparoscopic and open techniques for Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit (NICU) population.

    Title Complete Bilateral Tracheobronchial Disruption in a Child with Blunt Chest Trauma.
    Date June 2009
    Journal The Journal of Trauma
    Title Proteasome Gene Upregulation: a Possible Mechanism for Intestinal Adaptation.
    Date February 2006
    Journal Journal of Pediatric Surgery
    Excerpt

    BACKGROUND/PURPOSE: The mechanisms that control intestinal adaptation remain unknown. To better understand the adaptive process, microarray technology was used to analyze gene expression in a rat model of intestinal adaptation. METHODS: Adult male Sprague-Dawley rats underwent either a massive small bowel resection (70%) with anastomosis or a sham operation with small bowel transection and reanastomosis. After 21 days, ileal mucosa RNA was extracted. Individual RNA samples (n = 5 per group) were labeled and hybridized to 10 separate RAE 230A rat GeneChips. The signal values were calculated and the 2 groups were compared using a t test with the multiple testing correction of Benjamini and Hochberg (false discovery rate of 10%). Probe sets were analyzed for overrepresented physiologic pathways using Expression Analysis Systematic Explorer (EASE). RESULTS: Of the 15,866 probe sets on the RAE 230A GeneChip, 5437 probe sets were unexpressed and excluded. Of the remaining 10,429 probe sets, several overrepresented pathways (EASE score <0.01 after Bonferroni correction) were identified. Further analysis revealed that 13 probe sets related to proteasome degradation (an enzyme complex implicated in the regulation of cell proliferation) were significantly upregulated in the intestinal adaptation group compared to the sham group. CONCLUSIONS: Proteasomes may play a critical role in regulating the proliferation of intestinal mucosa during intestinal adaptation.

    Title Hepatocyte Growth Factor Treatment Ameliorates Diarrhea and Bowel Inflammation in a Rat Model of Inflammatory Bowel Disease.
    Date June 2004
    Journal Journal of Pediatric Surgery
    Excerpt

    BACKGROUND/PURPOSE: Transfection of the HLA-B27 gene into normal Fischer rats induces phenotypic changes similar to inflammatory bowel disease (IBD). This study investigated the benefits of 2 doses of hepatocyte growth factor (HGF) on the manifestations of IBD in this rat model. METHODS: Fischer rats and HLA-B27 rats were divided into 4 groups: Fischer rats treated with saline, HLA-B27 rats treated with saline, HGF at 150 microg/kg/d, and HGF at 300 microg/kg/d. HGF or saline was infused for 14 days via an osmotic pump attached to a catheter in the internal jugular vein. After treatment, rats were evaluated for diarrhea and reduction in gross and microscopic bowel inflammation. Statistics were determined using analysis of variance (ANOVA). A P value < or =.05 was considered significant. RESULTS: Administration of HGF at 150 microg/kg/d decreased diarrhea by 40%, gross inflammation by 41%, and microscopic inflammation by 72% (P < or =.05). At 300 microg/kg/d HGF decreased diarrhea by 46%, gross inflammation by 45%, and microscopic inflammation by 54% (P < or =.05). CONCLUSIONS: HGF administration reduces the clinical manifestations of IBD in this rat model. Similar effects were seen at both doses of HGF administration, implying that there is a plateau above which further increases in HGF levels provides no added benefit. HGF administration may be clinically useful in the management of IBD.

    Title Hepatocyte Growth Factor Ameliorates Inflammatory Bowel Disease in a Rat Model.
    Date May 2004
    Journal Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
    Excerpt

    This study was designed to investigate the benefits of administration of hepatocyte growth factor in a rat model of inflammatory bowel disease. Transfection of the HLA-B27 gene into Fisher rats induces a phenotype similar to inflammatory bowel disease. Fisher rats and HLA-B27 rats were divided into six groups: (1) Fisher, intravenous saline; (2) HLA-B27, intravenous saline; (3) HLA-B27, intravenous hepatocyte growth factor; (4) Fisher, luminal saline; (5) HLA-B27, luminal saline; and (6) HLA-B27, luminal hepatocyte growth factor. Rats received a 14-day infusion through an osmotic pump attached to a catheter positioned in either the jugular vein or the terminal ileum. Rats were evaluated for stool character, and gross and microscopic bowel inflammation. Statistics were analyzed using analysis of variance or the Kruskal-Wallis nonparametric test. A value of P<0.05 was significant. Compared to untreated HLA-B27 rats, intravenous administration of hepatocyte growth factor decreased diarrhea by 41% and microscopic inflammation by 54% (P<0.05). Luminal hepatocyte growth factor exposure decreased total bowel lesions by 53% and microscopic inflammation by 40% compared to untreated HLA-B27 rats (P<0.05), but it did not have an effect on diarrhea. Administration of hepatocyte growth factor ameliorates many of the features of bowel disease in this rat model and theoretically could have therapeutic applications in the management of inflammatory bowel disease in humans.

    Title A Possible Mechanism for Prevention of Intestinal Programmed Cell Death After Ischemia-reperfusion Injury by Hepatocyte Growth Factor Pretreatment.
    Date February 2003
    Journal Journal of Pediatric Surgery
    Excerpt

    BACKGROUND/PURPOSE: Intestinal ischemia-reperfusion (IR) injury produces necrosis and apoptosis resulting in tissue loss. The authors have observed previously that pretreatment with hepatocyte growth factor (HGF) attenuates enterocyte apoptosis after IR. This study investigated the effects of HGF on tissue levels of caspase-8, an apoptosis initiator, and caspase-3, an apoptosis effector, in intestinal mucosa after IR. METHODS: Thirty rats underwent placement of jugular venous catheters connected to osmotic pumps; 15 rats received vehicle, and 15 rats received HGF (150 microg/kg/d). After a 48-hour infusion, 5 rats from each group underwent either 35 minutes of superior mesenteric artery occlusion alone, or ischemia followed by 2 or 6 hours of reperfusion. Mucosal protein was analyzed for caspase-8 and caspase-3 activity. DNA fragmentation was used to measure the presence of apoptosis. Statistical significance was determined using analysis of variance. RESULTS: After 6 hours of reperfusion, caspase-3 activity was increased significantly in control animals (P <.05). In HGF-pretreated animals, caspase-8 and caspase-3 activities were significantly reduced at 6 hours compared with control animals (P <.05). CONCLUSION: By preventing the activation of enterocyte caspase enzymes, and, thus, reducing apoptosis, HGF may enhance preservation of the intestine after IR injury.

    Title Intraoperative Ultrasound Reduces Ecmo Catheter Malposition Requiring Surgical Correction.
    Date June 2002
    Journal Journal of Pediatric Surgery
    Excerpt

    BACKGROUND/PURPOSE: One hundred ninety-three cannulation procedures for extracorporeal membrane oxygenation (ECMO) have been performed at the authors' institution from 1994 to now. Before 1996, their practice had been to position these catheters exclusively by clinical assessment and chest radiograph. Since then, the authors have utilized intraoperative ultrasound guidance during cannulation procedures to confirm proper tip position. This retrospective analysis was undertaken to establish whether this practice has reduced the rate of surgical repositioning of ECMO catheters in these patients. METHODS: A retrospective chart review was performed for all infants who underwent ECMO cannulation procedures at the authors' institution. Numbers of infants requiring surgery to readjust ECMO catheter position were totaled. Cases were categorized according to the presence or absence of intraoperative ultrasound scan. Statistical significance was determined using X(2) analysis, Student's t test, or analysis of variance where appropriate. RESULTS: There were 193 ECMO cannulations performed. Of the 101 procedures done without ultrasound scan, 18 necessitated surgical repositioning. In contrast, only 3 of the 92 catheters placed with ultrasound assistance required reoperation. This represents a reduction the rate of repositioning from 17.8% to 3.3% of cannulations (P =.003). CONCLUSIONS: Based on these findings, the authors advocate the use of intraoperative ultrasound imaging to optimize the position of ECMO catheters. This high rate of initial success helps avoid the potential morbidity of ECMO circuit malfunction, repeat neck dissection, and catheter manipulation in these critically ill, anticoagulated patients.

    Title The Galactocele of Male Infants: an Intriguing Entity. Study and Reflection About a Case, with Review of the Literature.
    Date
    Journal Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
    Excerpt

    Abstract In this report, the authors investigate and discuss a galactocele that developed in the breast of a six month-old male. Based on the histological and immunohistochemical findings, they suggest that the rare and intriguing process that is exclusively observed in males in the absence of any detectable hormonal stimulation at time of investigation could represent a developmental anomaly possibly promoted by an obstructive phenomenon involving a defect of hollowing of some primary epidermal buds, the precursors of the mammary ducts. The paper also includes the first magnetic resonance imaging (MRI) of an infantile galactocele.

    Title Early Experience with Single Incision Thoracoscopic Surgery in the Pediatric Population.
    Date
    Journal Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
    Excerpt

    Abstract Introduction: Single incision pediatric endosurgery is gaining popularity in children. We have recently applied the single incision approach for thoracoscopic procedures. We report our initial experience with single incision thoracoscopic surgery in the pediatric population. Methods: A retrospective chart review of the first 10 single incision thoracoscopic operations done at our institution was conducted. The patients' mean age and weight and the median operative time, postoperative length of stay, and time until discontinuation of chest tubes were determined. Results: The 10 procedures were performed in eight patients (two patients each had bilateral procedures). The procedures performed included wedge resection and mechanical pleurodesis for spontaneous pneumothorax (n = 7), wedge biopsies for lymphoma (n = 1) and chronic granulomatous disease (n = 1), and resection of an apical extrapulmonary neuroblastoma (n = 1). All of the procedures were completed without intraoperative complication or significant blood loss. In each case, multiple trocars and/or unsheathed instruments were passed through a single small incision, which was subsequently used for the chest tube(s). The mean patient age was 13.5 years (range 3-18 years). The mean weight was 47 kilograms (range 16-63 kg). The median operative time was 64 minutes (range 50-201 minutes). The median postoperative length of stay was 7 days (range 3-19 days). The median time until chest tube removal was 3 days (range 2-15 days). The mean follow up was 7 months (range 3-12 months). One patient developed a recurrent pneumothorax and persistent air leak after having undergone a wedge resection and pleurodesis for a spontaneous pneumothorax and required a reoperation. Conclusion: Single incision thoracoscopic surgery is a feasible alternative to the traditional multiple incision approach in the pediatric population. The in-line positioning of the camera and instruments often proves to be an advantage rather than a hindrance.


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