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Biomedical subjects

J M Graham

Publications and source records attributed to J M Graham.

At least 235 records · Page 13Linked to original sources
PubMed1982

Injury to popliteal vessels.

Between 1969 and 1981, 61 patients with 85 popliteal vascular injuries were seen. In the nine patients who required amputation, common risk factors included (1) extensive time delays (greater than 36 hours) between injury and repair, (2) associated bone and soft-tissue injuries leading to postoperative wound infection. amd (3) early occlusion of popliteal artery repair or delay in performance of fasciotomy. The low amputation rate in patients without operative delay or associated bone and soft-tissue injuries (2/54 = 3.7%) was attributed to the careful application of standard vascular surgery techniques in combination with early use of leg fasciotomy when indicated. Polytetrafluoroethylene grafts as substitute vascular conduits in the popliteal artery have an excellent patency rate and seem to be an acceptable prosthesis when segmental resection of the artery is necessary.

Adult↗
PubMed1982

Parasitic conjoined twins, two cases, and their relation to limb morphogenesis.

Reports of parasitic conjoined twins have appeared rarely in the scientific literature and only one study has included a detailed description of the parasitic extremities. We report here two specimens consisting for the most part of normal hosts with ectopic legs attached to the thorax (case 1, thoracoparasitus) or the abdomen (case 2, gastroparasitus). These two specimens are in agreement with several others reported in the literature in having no sign of vertebral columns. These specimens also exhibit a marked decrease in innervation (case 1) or complete absence of somatic nerves (case 2). This finding is in complete contradiction with the idea of the dependence of limb skeletal structure upon peripheral nerves. The hypothesis is presented that this type of parasitic twin may result from duplication of the Wolffian ridge.

Bone and Bones↗
PubMed1982

Carotid artery injuries.

One-hundred twenty-nine patients with carotid artery injuries were analyzed to compare the results of revascularization with those of ligation or occlusion. In patients who present with central neurologic deficit short of coma (Grades 1 to 4), revascularization is clearly the operative method of choice. Revascularization in patients with preoperative coma (Grade 5) is also indicated when ischemia has only been present for a short period of time before surgery. Controlling cerebral edema and minimizing infarct size in patients with severe deficits may be essential to optimize the chance of recovery of these patients.

Adolescent↗
PubMed1982

Analysis of facial displays and verbal report to assess subjective state in the non-invasive detection of limbic system activation by procaine hydrochloride.

The problem of scalp EEG as a measure of cortical or subcortical activity is particularly relevant to complex partial seizures as the abnormal discharging is frequently limbic in origin [14, 30]. Livingston [38] has suggested that administration of intravenous procaine as a limbic activator and cortical suppressor would be of utility in diagnosing limbic involvement in complex partial seizures. While there is considerable evidence derived from experimental animal models that procaine hydrochloride is a limbic system activator that acts preferentially on subcortical epileptic foci at lower doses than on less active epileptic foci or non-epileptic tissue [2, 4], it was necessary to demonstrate that procaine activates the human limbic system. The non-invasive approach taken in the present study was to compare the published effects of direct electrical stimulation of the human limbic system [31] to the behavioural and subjects effects of intravenous procaine administration. The areas in which we obtained the most robust procaine effects (hallucinations, emotions and alimentary sensations) were also Halgren et al.'s [31] most repeatable effects. The correspondence between electrical stimulation effects and procaine administration effects was striking - with verbal report by patients matching exactly in many instances. Furthermore, analysis of facial displays proved useful in providing access to subjects state fluctuations which would otherwise have gone undetected. The data provide strong evidence that procaine hydrochloride can be used as a human limbic system activator. Future research will investigate the clinical and diagnostic significance of differential response to procaine.

Diazepam↗
PubMed1982

Severe supravalvular aortic stenosis: successful surgical correction by extended aortoplasty.

Surgical treatment of severe discrete supravalvular aortic stenosis by placement of a patch graft across the narrowed area of aorta at one point has been associated with a substantial incidence of residual stenosis. Successful relief of a severe stenosis was achieved by a modification of a previously reported technique in which the stenotic area is expanded at two points. Use of this technique should be considered in cases of severe discrete supravalvular aortic stenosis.

Adolescent↗
PubMed1982

Determinants in the morphogenesis of muscle tendon insertions.

The factors that normally determine the location and insertion of a muscle were explored in human experiments of nature with early problems in morphogenesis. Monozygotic conjoined twins for whom there could be no genetic determinants for muscle attachments at the sites of juncture served as one model; these attachments had to follow general principles of morphogenesis. A second type of problem involved absence of bone that presumably antedated muscle and tendon development (e.g., genetically determined radial aplasia). A third category included mechanical alteration of early limb position that may have occurred prior to the development of muscle attachments (e.g., early amnion rupture sequence). The dissection findings from all three types imply a general hierachy of muscle tendon attachments. Tendons appear to attach preferentially to bone. In the absence of the bone to which they would normally attach, they will attach to the next closest bone. If no such bone is available, tendons may attach to other tendons; and if no tendons is available, occasionally they will attach to the fascia of another muscle. If there is no connective tissue attachment site, there will be no muscle, implying a need for function in the development and preservation of muscle.

Abnormalities, Multiple↗
PubMed1982

Vascular injuries of the axilla.

Between January 1970 and December 1980, 65 patients sustaining 85 vascular injuries of the axillary artery and/or vein were managed at the Ben Taub General Hospital in Houston, Texas. Concomitant injuries of the subclavian and/or brachial vessels were noted in 34 per cent of patients. A variety of exposure techniques was used in approaching the axillary vessels. Emphasis upon preservation of collateral vessels led to an increased use of substitute vascular conduits over end-to-end anastomosis. The ready availability of prosthetic conduits, absence of graft infection, and excellent short-term patency have made them a primary choice for axillary arterial reconstruction in our recent experience. Associated brachial plexus injury (35%) accounted for the most significant long-term morbidity. The operative mortality was 3.1%, and one patient required upper extremity amputation following failure of repeated revascularization attempts.

Adolescent↗
PubMed1982

Innominate vascular injury.

Survivors of innominate and other major cardiovascular injuries are being seen with increasing frequency. Penetrating injuries more frequently involve the distal innominate artery and innominate veins. Associated subclavian and carotid artery injuries are more frequent following penetrating trauma. Blunt trauma typically involves the proximal innominate artery. A variety of operative exposures is useful but the selection of incision frequently depends upon the presence or absence of associated mediastinal injuries. Partial or complete median sternotomy in combination with various cervical and thoracic extensions is advised. Successful management of innominate artery injury can be performed without the aid of cardiopulmonary bypass or arterial shunts.

Blood Vessel Prosthesis↗
PubMed1982

CHARGE association.

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Abnormalities, Multiple↗
PubMed1982

Cranial synostosis and intra-uterine compression: a developmental study of human sutures.

The following hypothetical statements can be made. 1) Increased intra-uterine compression of the human cranium during the third trimester appears to produce sagittal synostosis by irreversibly altering the still immature sutural tissue that separates the parietal bones. 2) Intra-uterine compression does not cause facial sutures to fuse because they are physically shielded by the larger neurocranium and their ligaments are sufficiently mature to survive a chronic compressive force. 3) Postnatal compression of cranial and facial sutures normally does not result in bony fusion because their vascularized, differentiated, mature ligaments are capable of repair and regeneration.

Embryo, Mammalian↗
PubMed1982

The wounded soul.

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Adolescent↗
PubMed1982

Preliminary observations on language and learning in XXY boys.

Difficulties with processing, storing and retrieving, and producing linguistic information were particularly evident among the XXY boys. These decrements in abilities were associated with decreased achievement in a variety of reading and spelling tasks in this study as well as in that of Graham et al [4]. The data suggest that a continuum of language disability is present throughout the early life of these children and is associated with the XXY anomaly. Furthermore, when considered in relation to cross-sectional observations on older Turner syndrome patients, these data suggest the possibility that pathologic variations in sex chromosome complements may differentially affect brain development and subsequent functioning of the children.

Aneuploidy↗
PubMed1981

Cell-surface radioiodination with the sparingly soluble catalyst Iodogen. Difference between the dividing and non-dividing populations of rodent thymocytes.

The surface proteins of dividing and non-dividing subpopulations of rat and mouse thymocytes have been labelled by using a new method of radioiodination. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis and autoradiography of the labelled proteins shows distinct differences in labelling between the mouse and rat cells and also, in the case of the rat, between the dividing and non-dividing populations.

Animals↗
PubMed1981

Tinnitus in children with hearing loss.

The results are reported of a survey of tinnitus in deaf children in secondary-school age. Of 158 children in five units for the partially hearing and two schools for the deaf. 78 were found to have tinnitus. The tinnitus was constant in two children and intermittent in the remaining 76. The frequency with which the tinnitus occurred, and its duration and loudness, are reported. Some children claimed that tinnitus reduced their hearing ability and speech discrimination. It some, tinnitus was associated with headache or vertigo. When it was unilateral, tinnitus was more commonly on the side of the better-hearing ear. A group of children was defined in whom the tinnitus had features that made it a particularly troublesome symptom.

Child↗
PubMed1981

Coloboma, congenital heart disease, and choanal atresia with multiple anomalies: CHARGE association.

We report 21 patients with choanal atresia or ocular coloboma or both who have certain other associated anomalies, including congenital heart disease, postnatal growth deficiency, mental retardation and/or CNS anomalies, microphallus and cryptorchidism, and ear anomalies and/or deafness. Facial palsy, micrognathia, cleft palate, and swallowing difficulties were also common. It has not been possible to define a single etiology or a syndrome in these patients. We propose the mnemonic CHARGE (C-coloboma, H-heart disease, A-atresia choanae, R-retarded growth and retarded development and/or CNS anomalies, G-genital hypoplasia, and E-ear anomalies and/or deafness) to describe the features of this association.

Abnormalities, Multiple↗