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Biomedical subjects

C L Robinson

Publications and source records attributed to C L Robinson.

At least 19 recordsLinked to original sources
PubMed2001

Deriving the indications for laparoscopic appendectomy from a comparison of the outcomes of laparoscopic and open appendectomy.

BACKGROUND: Indications for laparoscopic appendectomy (LA) remain controversial and poorly defined. We sought to identify indications for LA through a comparison of LA and open appendectomies (OA). METHODS: We reviewed demographics, coexisting medical conditions, radiology and pathology data, hospital course, and complications from charts on all LA patients and a comparison group of OA done from 1991 to 1998. RESULTS: The following were significantly associated with LA: female sex, higher mean body mass index (BMI), coexisting medical problems, private insurance, and daytime surgery. The OA group was significantly more likely to have: a radiology report suggesting the diagnosis of acute appendicitis, perforation of the appendix, intensive care unit admission, and complications in their hospital course. Forty-one percent of the LA patients did not have appendicitis, compared with 20% of the OA patients. CONCLUSIONS: Daytime surgery, women, private insurance, coexisting medical problems, prior abdominal surgery, higher BMI, and less severe disease appear to be used by surgeons as indicators for LA. The threshold for surgical exploration appears to be lower for LA.

Adult↗
PubMed1991

Multiple primary bronchogenic carcinomas: treatment and follow-up.

A second primary bronchogenic carcinoma subsequently developed 8 to 156 months later in 19 patients who underwent curative resection of primary bronchogenic carcinomas. The second primary tumor was treated by surgical resection in 9 patients, 3 patients' tumors were considered unresectable, and the remaining 7 patients, despite having potentially resectable tumors, did not undergo resection because of insufficient pulmonary reserve or unwillingness to undergo resection. Actuarial life-table analysis of survival for the 9 patients who underwent resection showed a median survival time of 110.3 months compared with 19 months for the group with unresected but resectable tumors and 10.5 months for the group with unresectable tumors. There was no operative mortality in the group with resected tumors. We conclude that in patients in whom a second primary carcinoma of the lung develops, surgical resection prolongs survival and can be performed with a low operative mortality.

Aged↗
PubMed1989

Clinical significance and measurement of the length of the right main bronchus.

It is important for surgeons, pathologists, anesthetists and anatomists to know the length of the right main bronchus. It extends from the carina of the trachea to the origin of the right upper lobe bronchus, but an exact method for measuring it has never been described. Using bronchography, the authors measured the length of the right main bronchus in 24 patients. The posteroanterior projection taken at a standard distance (1.8 m) from the patient was used to minimize distortion due to the technique; if present, the distortion would not be more than 5% and would be an increase rather than a decrease in length. The mean length of the right main bronchus was found to be 1.09 cm (range from 0 to 2.9 cm). The clinical importance of this measurement is discussed. The authors conclude that many anatomy textbooks err in describing the length of the right main bronchus as 2.0 to 5.0 cm, but are correct in describing the left main bronchus as being about 5 cm long.

Bronchi↗
PubMed1988

Further remembrances of that revered anatomist, Dr. J. C. Boileau Grant.

From access to a detailed curriculum vitae written by Dr. Grant when he was about 75 years old, the author has learned some little-known facts of his background and life. His ancestors came from France and had been ennobled. One predecessor was a mayor of Paris. Several of his family decided to emigrate to Great Britain with the Huguenot movement. Grant graduated from the University of Edinburgh in 1908 in the same class as his future brother-in-law, William Boyd. When World War I was declared, he immediately volunteered for the army. During service on the Western Front, he was mentioned in dispatches in 1916, won the Military Cross in 1917 and a bar to the Military Cross in 1918. At the outbreak of World War II, Grant, who had been a professor of anatomy first in Winnipeg and then in Toronto for many years, volunteered again for war service, but was rejected as being too valuable a teacher to be allowed to enlist.

Anatomy↗
PubMed1987

Benign metastasizing leiomyoma.

The cases of 2 patients with benign metastasizing leiomyofibroma are reviewed. Although extremely rare both in our experience and in the literature, benign metastasizing leiomyofibroma is an important differential diagnosis in young women seen with multiple lung nodules. Our patients underwent staged thoracotomies for diagnosis and treatment, and have experienced no evidence of recurrence over a six-year period.

Adult↗
PubMed1987

Autologous blood for pleurodesis in recurrent and chronic spontaneous pneumothorax.

Open operation for recurrent pneumothorax may be necessary to resect or oversew a bulla. At the same time, to stimulate adhesions, the pleura may be abraded with gauze, chemicals used to cause inflammation or a partial pleurectomy performed. Operation is necessary to decorticate the lung if it has developed a thick peel, in the presence of gross bleeding (hemopneumothorax) or if a large bulla is present. Occasionally, a chronic pneumothorax is due to a persistent leak caused by an adhesion holding open a bulla. The adhesion may be cut at thoracoscopy, using diathermy, and the leak will close. Many chemical agents have been used to encourage adhesions: iodized talcum powder, silver nitrate, 50% glucose and water, Atabrine, nitrogen mustard and tetracycline. In this series, one to three instillations each of 50 ml of autologous blood were used after the lung was fully expanded, usually after the use of an apical chest tube. This procedure was successful in 21 (85%) of 25 patients with difficult, chronic or recurrent pneumothoraces. It is a practical and easy method of causing a chemical pleurodesis, without serious side effects.

Blood↗
PubMed1985

The management of chylothorax.

A series of 15 patients was treated for chylothorax over a 20-year period. The anatomy, physiology, and diseases of the thoracic duct are described, and a plan for the management of chylothorax is presented. If conservative therapy (e.g., aspiration or drainage with restriction of oral intake and intravenous replacement) is not successful after two to three weeks, surgical treatment is necessary and efficacious. The thoracic duct is explored by a full thoracotomy on the side of the effusion. It is readily seen if 6 to 8 oz of a mixture of milk and cream is given to the patient a few hours before operation. The milky fluid drips from the open duct, which is easily oversewn.

Adult↗
PubMed1982

New acetohydroxy acid synthase activity from mutational activation of a cryptic gene in Escherichia coli K-12.

A mutation in an allele identified as ilvJ662 causes the expression of acetohydroxy acid synthase activity that is resistant to feedback inhibition by L-valine. the ilvJ662 allele was transduced as an unselected marker into a strain, CU1126 (ilvB, ilvHI), deficient in acetohydroxy acid synthase activity. The ilvJ662 allele appears to code for a new acetohydroxy acid synthase activity (acetohydroxy acid synthase IV), with physical, kinetic, and physiological properties distinct from the other three isozymes. The catalytic function of acetohydroxy acid synthase IV is highly stable at 37 degrees C in the presence or absence of ethylene glycol. However, sensitivity to feedback inhibition by valine is rapidly lost at 37 degrees C, but this property is somewhat stabilized by ethylene glycol. The rate of synthesis of acetohydroxy acid synthase IV is uniquely repressed by either leucine or isoleucine. These results suggest that the ilvJ+ allele is cryptic for acetohydroxy acid synthase IV, an isozyme distinct from the other acetohydroxy acid synthases.

Acetolactate Synthase↗
PubMed1981

Lobectomy and bronchoplasty for cancer.

The experience with lobectomy and bronchoplasty in the management of patients with lung cancer at the University of British Columbia is described for the period 1959 to 1979. Thirty-eight patients underwent resection, the majority for squamous cell carcinoma. The early mortality was 5%. Of 16 patients operated on before 1974, 5 (31%) survived for more than 5 years. Seventeen (44%) of the 38 are still alive at periods of 1 to 10 years after resection.

Adenocarcinoma↗