Biomedical subjects
Publications and source records attributed to B Palmer.
A surgical method to treat angular cheilosis is described, which does not react favourably to conservative methods. 17 operations have been performed on 13 patients. Successful results were obtained in 9 patients. 4 patients had to be reoperated, with improved results, except in 1 case with total relapse. The observation time varied from 1 to 6 years.
The effects of a composite graft of autologous marrow and demineralized autologous compact bone on the healing of a surgically created bone defect were observed in adult rabbits. A segment of the radius was bilaterally resected, demineralized, and replaced. On one side the bone graft was supplemented with autologous marrow. The new bone formation was measured 14 and 28 days after operation by roentgenography, including planimetry with scintigraphy and autoradiography using 99mTc-labelled MDP. The composite graft, i.e., demineralized compact bone and marrow, had a significantly higher (p less than 0.01) bone formation rate 14 days after operation compared with the graft with demineralized compact bone in the opposite radius. At 28 days, however, there were no differences between the sides. Viable autologous marrow cells and demineralized autologous compact bone graft accelerate the rate of osteogenesis, but only at the beginning of the healing process.
The hemodynamics were monitored during 24 hours in piglets anesthetized with Pentothal-N2O/O2, submitted to 33% full-thickness skin burn and resuscitated with 2.4 ml/kg/% burn of 100 mmol NaCl in 2.5% glucose. Three groups were studied: (I) standardized burn, (II) standardized burn and excision after 5 hours, (III) standardized burn, excision and lysine-vasopressin (LVP) given as intravenous infusion in a vasopressor dose. All groups showed similar decrease of cardiac output (CO), which was about 30% 4 hours after burn. In the two groups with burn excision, however, CO recovery was earlier than in the conservatively treated group I. The improvement was significant between group III and group I. LVP led to higher CO fraction and greater blood flow to hepatic artery, reduced flow to proximal gastrointestinal tract and skin and unchanged flow to heart, kidneys and other organs 24 hours after burn. The mean blood loss during and after burn excision was greatly reduced in group III (50 g/25 kg) compared with group II (146 g/25 kg). The therapeutic implications of LVP in excisional burn treatment are discussed.
It has been reported that both human saliva and gastric juice (cf. Slomiany, B. L., and Slomiany, A. (1980) in Cell Surface Glycolipids (Sweeley, C. C., ed) American Chemical Society Symposium, No. 128, pp. 149-176, American Chemical Society, Washington, D.C.) contain substantial amounts of certain members of a series of novel glucoglycerolipids with a 1-O-alkyl glyceryl ether backbone. We have analyzed the glycolipids present in samples of saliva obtained from 10 individuals and in samples of gastric juice obtained from 5 individuals. In both fluids, compounds corresponding in the properties studied to standards of glucosyl- and lactosylceramides were found to be the major glycolipids. Other more complex glycosphingolipids were also present in smaller amounts. Human saliva was found to contain two glucoglycerolipids that were not detected in gastric juice. Analyses of these compounds indicated that they were mono- and diglucosyl diglycerides and were probably of bacterial origin. Methanolysis of the glycolipid fractions of saliva and gastric juice failed to reveal the presence of any more than traces of 1-O-alkyl glyceryl ethers. Our results do not exclude the possibility that glyceryl ether-containing glucoglycerolipids occur in human saliva and gastric juice. However, at most they would appear to be rather minor components of either fluid.
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The present study concerns 73 patients with known unilateral breast carcinoma. Thirty of the patients had a primary invasive carcinoma removed and at a later operation contralateral subcutaneous mastectomy with implantation of a prosthesis. This was performed with or without ipsilateral breast reconstruction. Forty-three of the cases had an in situ carcinoma found by local excision, whereafter bilateral subcutaneous mastectomy was performed in 38 cases. Five cases had already had an ipsilateral mastectomy and contralateral subcutaneous mastectomy was performed. The histological examination of the subcutaneous mastectomy specimens was extensive with breasts cut into 3-5 mm slices, which were embedded and cut in large sections and cut in large sections allowing us to map all lesions. 42.5 per cent of the contralateral breasts contained invasive or in situ carcinoma. In about 70 per cent of the cases other histological lesions, considered more or less precancerous, were found in the contralateral breast. Our results speak in favor of an active approach to the contralateral breast at reconstruction, especially in cases with a long life expectancy after the first carcinoma. It is psychologically comforting to the patient to know that most of the breast gland, which could be the future origin of a new carcinoma, has been removed.
In adult rabbits a 12 mm piece of the radius was bilaterally resected and subsequently decalcified. One piece was placed in one of the radial defects and the other in a skin tube on the back. The other radial defect served as a control. The bone formation process was evaluated by roentgenographic examination and quantified radionuclide bone imaging by technetium diphosphonate scintigraphy at 3 and 6 months postoperatively. Reliability of the scintigraphy method was assessed by means of testing interexamination variability where the same sample was measured twice and where no significant difference was found. In the defect restituted with decalcified bone matrix there was a significantly (p less than 0.01) higher bone formation rate at 3 months postoperatively, with a mean increase of 47% compared to the control side. In the skin tube the implanted matrix showed mineral formation both at 3 and 6 months postoperatively and increased radionuclide uptake compared to the adjacent tissues. Technitium radionuclide imaging was found to be a suitable method for evaluation of the bone formation in these small defects.
In facial reconstructive surgery extensive studies have been performed to find substitutes to autologous vital bone as grafting material. Decalcified homologous compact bone has been found to possess a capacity of inducing new bone formation in rabbits whereas the application in man has not been successful thus far. In order to investigate the osteogenetic properties in autologous devitalized bone, the difference in bone forming capacity between decalcified and undecalcified devitalized autologous bone was studied. In rabbits, from the radius of each foreleg a piece of bone was resected, rinsed from periosteum and marrow whereupon one was decalcified in 0.6 N HCl. Both pieces were reimplanted in the radial defects 3 days later. The healing process was examined by radiography, light- and fluorescence microscopy. Decalcification seems to accelerate the osteogenetic process when bone is reimplanted to a defect in the rabbit radius.
A case of gigantomastia is reported. The breast enlargement started some years before first pregnancy, during which a tremendous acceleration was observed. Various laboratory investigations elicited normal values, except for some high values of prolactin. No treatment was given. After delivery, the patient nursed her baby. Thirteen weeks later, lactation was inhibited with bromocriptine. A further 3 weeks later, a reduction mammoplasty was performed. One year later, the prolactin values were still normal. The etiology of this disease is not known. One possible explanation is an increased number or increased sensitivity of prolactin receptors in the target organ.
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The glycolipids of human testis and sperm have been compared. Both adult testis and the sperm exhibited remarkably complex, but generally similar, patterns of glycolipids. In particular, both contained appreciable amounts of the sulfogalactosylmonoalkylmonoacylglycerol, recently shown to be the principal glycolipid of the testis and sperm of a number of animals. In contrast, immature (prebuteral) human testis did not contain this compound. To extend knowledge on the possible distribution of sulfogalactosylmonoalkylmonoacylglycerol in the testes of other chordates, we have also analysed the glycolipids of the testes of a number of birds and fish. None of the testes from these species contained the above compound. Instead, sulfogalactosylceramide was found to be a major glycolipid of the testis of mature fowl, duck and skate-fish and sulfogalactosylglucosylceramide of the testis of mature salmon and trout. Immature duck testis contained only a trace of sulfogalactosylceramide. These studies reveal intriguing differences between the sulfatides of various chordates, lend support to the concept that sulfatides increase markedly in testis at a specific stage of spermatogenesis and suggest an important role for sulfatides in testicular and spermatozoal function.
A private clinic was established in Los Angeles in late 1972 to perform acupuncture. Most individuals seeking treatment were middle-aged and well educated. All had considerable experience with traditional medical care for their problem. The principal reason for seeking care was relief from chronic pain. Thirteen per cent had received other nontraditional forms of therapy; over one-third indicated that they sought acupuncture as a "last resort." The results of certain psychological tests taken by these patients were within the range of normal. On completion of six or more treatments, 74 per cent said they had been helped; 54 per cent of those followed for three months and 24 per cent contacted one year later were improved. A subgroup of patients who received only temporary improvement had significantly different scores on psychological scales suggesting the results noted in this group may have been due to a "placebo" effect. A significant proportion of those who dropped out of treatment did so because they had achieved the desired benefits.
A unique group of more than 100 selected cases were treated surgically for massive obesity, a mal-absorption syndrome, by an intestinal shunt used to obtain significant weight reduction. The loss of skin elasticity of the slimming patient leads to a "redundant skin syndrome" creating dermatologic-cosmetic as well as psychiatric problems. A series of reductive skin plasties were performed beginning when the patient's body weight had been stable for some months. The redundant skin was found mainly in two contralateral areas: on both sides of the axillae: on the medial aspect of the upper arm and laterally below the breast, and on both sides of the inguinal ligament, on the lower abdomen and on the medial aspect of the thigh. Thirty-eight patients of the group had skin reduction plasties. The operations were performed on each site separately with a few months' interval. Operative techniques and results are presented.
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