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Biomedical subjects

B Parker

Publications and source records attributed to B Parker.

At least 91 records · Page 5Linked to original sources

Preoperative diagnosis of unilateral multicystic kidney with hydropelvis.

We present 2 patients with congenital unialteral multicystic kidney disease with hydropelvis. In the first patient the diagnosis was made by precutaneous puncture of a renal cyst followed by injection of contrast medium; in the second the diagnosis was confirmed by percutaneous puncture of the renal pelvis and injection of contrast medium, although an earlier ultrasonic examination had been strongly suggestive. Since in this condition the cysts and the renal pelvis communicate, either can be punctured to make the diagnosis. The procedures herein described are definitive for the diagnosis and should be followed whenever the urologist desires such a diagnosis.

Biopsy, Needle↗

Common connectors.

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Electronics, Medical↗

Pacemaker failures characterized by continuous direct current leakage.

Pulse generator failure caused by continuous leakage of direct current through an output capacitor has not previously been appreciated. Routine post-explant electronic evaluation has identified the defect in six implanted and one external pulse generator. The constant direct current in the implantable units, 0.14 to 0.26 milliamperes, is in the range that produces ventricular arrhythmias in dogs although this did not occur in our patients. Evidence of local myocardial damage existed in four cases and of electrode deterioration in three. The implant failures occurred without warning and in four cases within 2 weeks of demonstrated normal function, blunting the predictive benefits of pacemaker monitoring programs. Capacitor discharge circuits used in many pacers are inherently capable of developing direct current leakage in the event of output capacitor short circuit. In one model of pacemakers such continuous direct current leakage caused 8.3 percent (3 of 36) of pulse generator failures, widely scattered in time at 23, 27 and 46 months after implant. Capacitor short circuit causing constant direct current leakage can masquerade as primary battery failure and should be suspected when cessation of pacer function is associated with increased threshold or poor myocardial electrogram without evidence of wire break or displacement.

Aged↗

Finding medical reasons for psychiatric behavior.

Medical disease was the cause of the primary disability in the majority (61.2 percent) of 116 elderly psychiatric patients treated at Bellevue Hospital Center. A change in behavior signaled the onset of medical illness with acute brain syndrome. The history that documented a change in behavior was derived from sources other than the patient. It is important to obtain such history during admission evaluation of elderly persons who are confused or whose memory is impaired. Multidiciplinary services enabled many patients to improve so that they could return home rather than being institutionalized. Had such services been available before their admission, many patients might have avoided hospitalization. As a result of this study, the geriatrics unit at Bellevue Hospital Center began to devote its efforts to elderly persons in the community.

Acute Disease↗

Posterior psoas transfer and hip instability in lumbar myelomeningocele.

Seventy-two posterior psoas transfer operations performed in forty-four children with lumbar myelomeningocele were reviewed one to eight years after operation in an attempt to assess its value. Muscle charting, an objective recording of the child's walking ability, and radiographic examination of the hips were done. Hip stability was improved: 49 per cent were stable at the time of psoas transfer and 94 per cent at review. Functional results depend mainly on the level of neurological activity present: 57 per cent of the children had an acceptable functional result. Usually, posterior psoas transfer should be done as soon after the age of nine months as the child's condition will allow. Over the age of two years it should be restricted to children with activity in the third and fourth segments of the lumbar cord.

Child↗

Pacemaker longevity.

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Electrodes, Implanted↗