Biomedical subjects
B Roberts
Publications and source records attributed to B Roberts.
Treatment of stenosis of the iliac artery by balloon catheter dilation.
Percutaneous balloon catheter angioplasty appears to be an effective method of treatment for localized iliac artery stenosis. Results of our experience demonstrate that it can be accomplished with an acceptable morbidity in carefully selected patients and can be done and even repeated with minimal inconvenience to the patient.
Treatment of vein graft stenosis by balloon catheter dilation.
Percutaneous balloon catheter dilation was used to treate 12 high-grade stenoses in ten autogenous vein bypass grafts since September 1978. Four lesions occurred in femoropopliteal grafts, seven in femorotibal grafts, seven in femorotibial grafts, and one in an axillofemoral graft. Balloon catheter dilation was successful and surgery avoided in 11 of the 12 lesions. Pedal pulses were restored in eight of the ten patients, and the pulse in a femorotibial bypass graft was improved in another. Postdilation arteriography demonstrated a substantial increase in luminal diameter, and ankle pressure indexes were improved in all successful cases. The tenth had an operative correction of the stenosis. There were no complications with the procedure. Percutaneous balloon catheter dilation appears to be an effective method of treating stenosis in autogenous vein grafts and a useful alternative to surgical revision.
R-looping and structural gene indentification of recombinant DNA.
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Transluminal angioplasty of the iliac, femoral, and popliteal arteries.
The recently developed Grüntzig balloon dilatation catheter has facilitated the performance of transluminal angioplasty. The authors used this catheter in 35 arteries supplying the lower extremities in 27 patients. Immediate relief of symptoms (claudication and rest pain) occurred in 30 vessels (86%) in 23 patients. The procedure was well tolerated by all patients. Over 90% of initially successful dilatations were patent at 3 to 10 months.
Birth control practices and conservatism.
This study examined the relationship of conservatism to reports of contraceptive usage, reasons for nonusage of a particular birth control method, and knowledge of birth control information. The never married high conservative subjects who were sexually experienced revealed that they had (a) a lower frequency of usage as well as a lower variety of contraceptive methods; (b) endorsed the beliefs that it was morally wrong and that it was unnatural to use a given birth control method significantly more often as reasons for not using contraceptive techniques; and (c) less knowledge of birth control methods than did low conservative subjects who were sexually experienced. Results were interpreted to support the notion that the fear of loss of control of one's impulses and hence the basis for conservative attitudes are determinants of contraceptive usage.
Acute renal failure following resection of abdominal aortic aneurysm.
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Femoropopliteal vein grafts for claudication. Analysis of 100 consecutive cases.
One hundred consecutive femoropopliteal venous grafts in 85 patients with claudication were followed for five years. At this time, three limbs had been amputated, approximately one quarter of the patients had expired, and 70% of the grafts in surviving patients remained patent. It is concluded that this operation does not appear to increase the risk of amputation and in fact, may lessen it. Moreover, it is associated with minimal risk and generally provides long term relief of claudication, thus enhancing the quality of life in most patients.
Results of 100 consecutive femoropopliteal vein grafts for limb salvage.
One hundred consecutive patients with femoropopliteal autogenous vein grafts for limb salvage were reviewed five years later. In this group 40% died and 30% of the limbs had been lost at the end of five years. Limb survival correlated best with adequacy of distal run-off, but not with the presence or absence of diabetes. Forty-seven per cent of the grafts were still patent among surviving patients, and when combined with the limbs that were viable despite failure of the original graft, 70% of the limbs were salvaged among the survivors at five years. Temporary graft patency was effective in preserving ischemic tissue by facilitating healing of ulcers or limited amputations. Femoral-popliteal bypass grafting in the presence of advanced ischemia is capable of improving the quality of life for many of these patients.
A look at psychiatric decision making.
The author reviews the efforts of medicine and psychiatry to understand their decision-making processes and notes the lack of psychiatric literature in this area. The decision table, a sophisticated form of algorithm, is introduced as a structure to help explain the decision-making process. This tool is applied to the evaluation and biological treatment of depression. Decision tables can be used as an educational tool, a method to facilitate the delivery of mental health care, a method to monitor the quality of treatment, and as a research tool.
Evaluation models and theoretical bias.
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A ruptured abdominal aortic aneurysm presenting as inferior vena caval obstruction.
The case report of a patient presenting with inferior vena caval obstruction secondary to ruptured abdominal aortic aneurysm is presented. The cause of the obstruction was not diagnosed prior to laparotomy. Management included replacement of the aneurysm, plication of the thrombosed inferior vena cava, and evacuation of the hematoma. So far as the authors are aware, this is the first case of this type to be reported and one which adds another possible diagnostic consideration in managing inferior vena caval obstruction.
Dallas paramedic system.
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Carotid bruit as a risk factor in aortoiliac reconstruction.
Records of 248 patients undergoing aortoiliac reconstruction for occlusive disease between 1957 and 1975 were reviewed. Carotid bruits were ausculted in 35 patients (14%). Five of the patients with bruits also were thought to have symptoms of transient ischemia. Strokes occurred after operation in four of the 248 patients (1.6%). No patient with a previously noted bruit developed postoperative stroke. Two patients with transient cerebral ischemia and no confirmed bruit before operation did develop postoperative strokes. Cerebral angiography was performed in 18 of the patients with carotid bruits. Two of these patients underwent carotid endarterectomy prior to aortoiliac reconstruction. None of these 18 patients developed strokes following their carotid surgery of aortoiliac reconstruction. A third patient with no bruit but with retinal cholesterol emboli also underwent arteriography and endarterectomy without complication. The results suggest that the asymptomatic carotid bruit alone does not indicate an increased risk of stroke during aortoiliac reconstruction. The authors conclude that their experience does not support prophylactic carotid endarterectomy in the asymptomatic patient prior to aortoiliac reconstruction.
Patterns of incorporation of tritiated thymidine by the dorsal polytene foot-pad nuclei of Sarcophaga bullata (Sarcophagidae:Diptera).
The incorporation of tritiated thymidine into the DNA of the dorsal foot-pad nuclei of Sarcophaga bullata, during pharate adult development, was studied by scintillation counting and autoradiography. Incorporation was maximal on day 4 and showed a progressive temporal decline on days 5 to 8. Autoradiographs of chromosomal arms A1, A2 and D1, from late stages of the prolonged S period, showed discontinuous incorporation. On days 7 and 8 loci which incorporated the radio-labeled precursor were almost exclusively associated with DNA granules. DNA granules were associated with 8 specific loci in chromosomal arm A1, 10 in A2, and 8 in D1. The relationship between patterns of incorporation of tritiated thymidine and DNA granules is discussed.
A twenty-two year review of elective resection of abdominal aortic aneurysms.
The clinical presentation and history of abdominal aortic aneurysm has changed little in the last 22 years. The improved results of elective resection of these lesions have occurred subsequent to advances in various aspects of treatment of this disease as well as increased experience in surgical management. The operative mortality associated with elective resection of abdominal aortic aneurysms has dropped to such a level that elective intervention is reinforced as the treatment of choice for this lesion. It is hoped that, with the continued improvement in the diagnostic phase resulting in earlier detection and surgical intervention, there may be a further reduction in the incidence of rupture of abdominal aortic aneurysms and further prolongation of life in those patients in whom such lesions develop.
Instructional materials for severely/profoundly retarded learners.
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The volume and DNA content of extrachromosomal inclusions in the dorsal foot-pad nuclei of Tricholioproctia impatiens (Sarcophagidae, Diptera).
The chromosomes of the giant dorsal foot-pad cells of Tricholioproctia impatiens produce numerous extrachromosomal bodies which consist of a central spherical core of DNA surrounded by a ribonucleoprotein layer. The bodies are either free within the nucleoplasm or attached by thin threads of chromatin to chromosomal bands. The DNA content and the volume of DNA of unattached spherules fell into distinct classes in a regular geometric progression.