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Biomedical subjects

G Keyes

Publications and source records attributed to G Keyes.

13 recordsLinked to original sources

Medial unicompartmental arthroplasty. A survival study of the Oxford meniscal knee.

One hundred twenty-one knees with medial compartment osteoarthrosis were treated by unicompartmental arthroplasty with the Oxford Knee. The strict selection criteria were (1) the presence of a functioning anterior cruciate ligament, (2) fully correctable deformity, and (3) full thickness of articular cartilage in the lateral compartment. The mean elapsed time from surgery was 44.4 months. One knee has required revision for a loose tibial component. The results at this stage are as acceptable as those of tricompartmental knee arthroplasty and better than those of high tibial osteotomy.

Aged

Lymphoma: an unusual oral presentation.

A lymphoma which was originally diagnosed as an inflammatory process is reported. A brief review of lymphoma's etiology, predilection for the oral cavity, and similarities to inflammation is presented. Particular emphasis is placed on the premise that an initial benign diagnosis may not be accurate and that monitoring patients is essential in any disease entity whether benign or malignant.

Humans

Procedural due process in the dismissal of residents.

Legal commentators and court decisions have defined, generally, procedural due process for students and faculty in institutions of higher learning. Dental residents (GPRs, oral surgery residents, etc.) occupy a unique niche in this educational structure. On the one hand they are students pursuing advanced training; on the other, they are employees and instructors in a hospital or similar institution. As advanced student-clinicians, residents have significant autonomy in patient care. Those who are charged with monitoring a resident's care can be held liable for the resident's negligence. Hospital administrators and residency program directors have concerns about minimizing the chances of malpractice liability, while simultaneously having to observe procedural due process guarantees when a resident's performance mandates dismissal or suspension. This article will briefly review procedural due process issues concerning dismissal or suspension of students and faculty. Court decisions involving dismissal of medical and dental residents will be analyzed to see if the courts follow the student model or faculty model. The cases will demonstrate that the courts generally follow the faculty due process model when residents are suspended or dismissed. Key administrative law decisions will briefly be reviewed that point out the differences of opinion existing over the student/employee status of residents. Also, it will be shown that when patient safety is at stake, procedural due process guarantees can be modified to allow immediate suspension or dismissal of the resident.

Dental Service, Hospital

Intracranial intravenous digital subtraction angiography.

Intravenous digital subtraction angiography (iDSA) promises to significantly alter the use of conventional cerebral angiography in the workup of neurological patients. Understanding its diagnostic potential and its limitations are important in incorporating this new examination into the diagnostic thought process of neuroradiologic tests. Different image processing techniques such as integration of mask and contrast images promise to improve image quality for neuroradiologic application. At present, iDSA is suitable for the diagnosis and follow-up of vascular lesions (atherosclerosis, aneurysms, arteriovenous malformations, venous sinus occlusion), and tumor (meningioma). Although limited, the spatial resolution of iDSA studies is capable of demonstrating diffuse vascular disease such as arteritis and vasospasm after subarachnoid hemorrhage. In some patients in conjunction with the CT scan, iDSA may prove sufficient as the primary and only diagnostic angiographic test necessary, supplanting conventional angiography.

Arteriosclerosis

Myospherulosis.

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Adult

A quantitative in vivo comparison of six contrast agents by digital subtraction angiography.

Digital subtraction angiography (DSA) technology can now visualize many significant arterial structures from intravenous injections of contrast media. Image quality of these DSA studies is related to contrast agent enhancement. This study compares contrast agents of differing iodine concentration, viscosity, and osmolarity. A technique is described that utilizes a scanned projection digital radiographic system to compare quantitatively degrees of intra-arterial opacification after the administration of six intravenous contrast agents: iothalamate (at four different concentrations and in combinations with two different cations), diatrizoate, and ioxaglate. The quantitative arterial enhancement was compared in dogs utilizing an extra-period latin-square multiple change-over clinical trial design. The contrast agents span a range of organically bound iodine from 282 mg I/ml. When rate and volume of contrast agent injected are held constant, intra-arterial opacification is directly a function of the iodine concentration (mg I/ml) of the agent injected, while osmolarity and viscosity have no effect on opacification. These studies support the use of agents with high iodine concentration for maximum vascular visualization.

Angiography