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Biomedical subjects

L C Meyer

Publications and source records attributed to L C Meyer.

30 records · Page 2Linked to original sources
PubMed1983

Foam bones. Experimental teaching aid.

The teaching of surgical anatomy is an important aspect of an orthopedic training program. The fabrication of polyurethane bones by the authors' staff has proved to be a simple, inexpensive, and rapid means of duplicating bones, permitting the orthopedic surgeons to experiment with new surgical techniques as well as to teach surgical skills. Polyurethane bones may be purchased commercially but are much less costly and more instructive when made by staff members.

Audiovisual Aids↗
PubMed1982

Acid-base and metabolic responses to anion infusion in the anesthetized dog.

This study evaluated the acid-base and metabolic effects of several organic anions which might have application in the correction of metabolic acidosis during hemodialysis. Anesthetized dogs were infused intravenously with the sodium salts of either chloride, bicarbonate, acetate, lactate, or pyruvate. Acetate perturbated metabolism more than any of the other organic anions infused. These perturbations included hypoxemia, reductions in serum potassium and phosphorus, a decrease in plasma, glucose, and increases in intermediary metabolites such as lactate, acetoacetate and beta-hydroxybutyrate. Transferance of our findings to hemodialysis suggests that acetate would compromise the ability of dialysis to reduce body burdens of potassium and phosphorus and provide proper base repletion. Pyruvate would appear superior to acetate as a base substitute by virtue of its lesser effects on oxygen consumption and electrolyte distribution and its capacity to produce glucose. However, the significant production of lactate with pyruvate infusion, coupled with diffusive losses of bicarbonate during dialysis and the possible instability of pyruvate in solution, would still hinder proper base repletion. Bicarbonate generation with lactate infusion was too slow to provide a practical alternative for base repletion in hemodialysis. Bicarbonate infusion caused minimal alterations in intermediary metabolism. This, in conjunction with obviating diffusive losses, suggests the use of bicarbonate would allow more appropriate base repletion during hemodialysis.

Acetates↗
PubMed1982

Proximal femoral focal deficiency: a 50-year experience.

The case histories of 91 patients (54 male, 37 female) with proximal femoral focal deficiency identified measurements which allow the physician to predict ultimate growth and pelvo-femoral stability early in the patient's life. For unilateral patients, the classification correlated with percentage of femoral inhibition, acetabular index, shelf index and acetabular dysplasia, enabling prediction to be made within the first two years of life. A constant percentage of femoral inhibition was confirmed in both unilateral and bilateral patients, and the effects of classification and associated anomalies were determined. Bilateral proximal femoral focal deficiency occurred twice as frequently among males, and function at maturity was primarily dependent upon leg-length differential, foot position and associated anomalies, and secondarily upon absolute leg-length and pelvo-femoral stability.

Abnormalities, Multiple↗
PubMed1981

Pantalar arthrodesis: a long-term follow-up.

Eighty-three pantalar arthrodeses in 69 patients performed at the Shriners Hospital for Crippled Children, Greenville, South Carolina, between 1941 and 1977 were evaluated. Follow-up was from 1 to 33 years. Diagnoses included poliomyelitis, myelodysplasia, arthrogryposis, clubfeet, and extremity or spinal cord trauma. Methods of fusion were one-stage pantalar arthrodesis, two-stage triple ankle fusion, one-stage completion of prior tarsal fusion, and one-stage denudation of the talus. Pantalar arthrodesis is successful in the paralytic sensitive foot with a stable knee and there is no greater incidence of nonunion in the one-stage (Hunt-Thompson) procedure than in the two-stage procedure. Complications and failure of fusion are common in the insensitive foot.

Ankle Joint↗
PubMed1975

Myelodysplastics--fate of those followed for twenty years or more.

Of a total of 143 myelodysplastic patients treated between 1928 and 1951, there were sixty-three patients with severe myelodysplasia whose records allowed long-term review. At the time of writing twenty-nine were alive and were twenty to forty-three years old. All were walking in the hospital while under an intensive physical therapy program. However only two of the nine with twelfth thoracic-second lumbar function were walking at final follow-up as adults, while nineteen of the twenty with function at the third lumbar level were doing so. The status of the hips did not correlate with the ability to walk. One-third of the survivors were self-supporting at the time of writing. About one-half had scoliosis and in one-third was greater than 20 degrees.

Adolescent↗
PubMed1973

Purpura fulminans.

Explore the source record for details and available documents.

Amputation, Surgical↗
PubMedDate not supplied

Centers of excellence: a medical measurement or marketing myth?

Managed care organizations, physician groups and hospital systems are all increasingly pressured to identify new modes of treatment that produce verifiable outcomes while reducing the revolving door pattern of health care for the chronically ill. Providers are also faced with creating systems of care to differentiate themselves from the competition in the marketplace. Disease-specific health management programs are being used to address both issues. When used properly, they can be promising tools in the battle to maintain health care quality while containing costs. Skillful balancing of these two important factors can ensure maximum value for both patients and payers. Are centers of excellence the critical pathway of the future? Or are they merely a marketing ploy to generate incremental growth and profitability for savvy business executives and medical group management entrepreneurs? This article provides an overview of the center of excellence concept, addresses its misuse in the industry and discusses the strategic and marketing implications for organizations considering this approach as a tool to demonstrate full accountability and meritorious outcomes.

Case Management↗
PubMedDate not supplied

Emergicenters. Opportunity or threat?

Political, social, and economic pressures on the healthcare industry are resulting in the development of new approaches to the delivery of quality health care to consumers. One of the newest responses to these change forces has been the development and proliferation of freestanding emergency centers. This article examines the underlying causes behind their development, describes the distinct services and strengths of the "emergicenter" concept, and shows how medical group practices can turn a potential competitive threat into an opportunity for future growth.

Ambulatory Care Facilities↗
PubMedDate not supplied

Proximal femoral focal deficiency: natural history and treatment.

The leg-length discrepancy in patients with proximal femoral focal deficiency is difficult to treat and is often unmanageable except by amputation. To identify candidates for ablative and nonablative surgery and to outline a rational treatment program, 91 patients (120 femurs) were retrospectively analyzed to determine the relationship of absolute femoral length, relative femoral length, and pelvofemoral stability to the functional effects at maturity of various operative and nonoperative management. The direct relationship of function to Aitken classification was documented and correlated with percent femoral inhibition (p less than 0.01), and pelvofemoral stability as determined by the acetabular index (p less than 0.05), shelf index (p less than 0.001), and acetabular dysplasia (p less than 0.001). In unilateral cases, two therapeutic subgroups were identified: Class I (patients with less than 17 cm of projected extremity shortening, and evidence of pelvofemoral stability), and Class II (patients with greater than 17 cm of predicted extremity shortening). Class I patients are potential candidates for height equalization by ipsilateral lengthening and/or contralateral shortening. Class II patients should have early ablative procedures and conversion to an above-knee or below-knee amputee. In bilateral PFFD, function at maturity was primarily dependent upon leg-length differential, foot position, and associated anomalies.

Anthropometry↗
PubMedDate not supplied

Proximal tibiofibular bifurcation synostosis for the management of longitudinal deficiency of the tibia.

Three adults with severe longitudinal deficiency of the tibia (LDT), in which an unossified proximal tibial anlage was present, who had been treated with proximal tibiofibular bifurcation synostosis (PTFBS) in early childhood, were evaluated between 20 and 31 years after the index procedure. All three were found to be functioning well as below-the-knee (BK) amputees. Mediolateral stability and anteroposterior instability of the knee were present in all cases. Instrumented motion analysis revealed diminished loading characteristics of the prosthetic limb, similar to that described for BK amputees in general. The most significant gait deviations at the knee unique to this study group were a quadriceps-avoidance gait pattern and an increased dynamic varus alignment. Instrumented muscle testing suggested that these deviations were a consequence of ligamentous instability. This study supports the concept that the presence of a proximal tibial anlage in severe LDT is indication for a surgical strategy that preserves the biological knee joint. The PTFBS maintains the integrity of the knee-extensor mechanism, the fibular collateral ligament, the tibiofemoral joint capsule, and the medial collateral ligament, enhancing the long-term stability and function of the knee joint.

Adult↗