Biomedical subjects
Publications and source records attributed to L D Baker.
Between May 1975 and March 1977, 193 bovine heterografts and 184 polytetrafluoroethylene (PTFE) grafts (Impragrafts) have been placed for hemodialysis access. A comparison of these materials demonstrates that Impragrafts have significantly fewer late thromboses, increased resistance to infection, and comparable longevity, and they are easier to repair.
Recent laboratory and clinical investigations have demonstrated a specific configuration of polytetrafluoroethylene (PTFE) to be a superior biocompatible material for small artery replacement. Twenty such vascular grafts have been implanted in eighteen patients. Grafts were placed in the femoropopliteal or femoral posterior tibial or anterior tibial positions in fifteen patients and in the aortorenal position in three patients. The early results have been satisfying as judged by follow-up angiography and/or clinical examination. There has been no aneurysmal formation in this series of Impragrafts. No infections have been noted. We believe that Impragraft may offer a logical substitute for the inadequate or surgically absent saphenous vein autograft.
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The early results with 84 PTFE grafts used as subcutaneous A-V conduits for vascular access in 72 patients requiring chronic hemodialysis have been quite promising. Initial follow-up has revealed that these grafts functioned at least as well as the bovine heterograft, and the complications seen within the 2 groups being somewhat similar. Should the complications and rate of complications with PTFE be no greater than those seen with the bovine heterograft, then its availability, ease of handling and significant decrease in cost would make the PTFE graft a significant improvement as a means of creating vascular access for chronic hemodialysis.
In order to examine the effect of legalized abortion on the complications of criminal abortion, a surveillance system was established at a large urban hospital in Atlanta, Georgia. Between 1969 and 1973, legally induced abortions at this hospital increased logarithmically from 8 to 498 per quarter year. The number of women admitting to attempts at illegal abortion decreased significantly, but the decline began only after three years of increasing numbers of legal abortions. A slight decrease in the number of septic "spontaneous" abortions also occurred. Making legal abortion services available can result in a decrease in morbidity associated with illegal abortions, but the availability of legal abortion must be sufficiently broad to obviate having to resort to criminal means.
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A comparison of optometrists' leadership style and the preferred leadership style of their optometric assistants as well as both groups' interpersonal need orientations indicated: 1) optometrists' consideration and initiating structure orientations were lower than those preferred by their assistants, structure was significantly lower (p less than .01) while consideration approached significance (p = .08); 2) optometrists had significantly lower needs for expressing control than their assistants had for wanting to be controlled (p less than .01), assistants had significantly higher needs for expressing participation and inclusion than optometrists had for wanting to be included (p less than .05), and optometrists had significantly higher needs for wanting to be controlled and influenced than their assistants had to control and influence them (p less than .05). Implications for the optometrist-assistant working relationship are discussed.
Regional myocardial metabolism was examined by means of coronary venous sampling in dogs having acute nonsimultaneous occlusions of the left anterior descending (LAD) and circumflex (CIRC) coronary arteries. Regional coronary venous metabolic sampling was not found to separate ischemic from nonischemic myocardium in LAD occlusion and did so imperfectly in isolated CIRC occlusion. Myocardial metabolic consequences of subtotal and total coronary artery occlusion were compared in dogs during LAD and CIRC occlusion and in human subjects with subtotal and total anterior coronary artery occlusion. In spite of ECG evidence of greater myocardial ischemia during total coronary artery occlusion in the dog, transmyocardial metabolic changes were more consistent during subtotal occlusion. Human subjects stressed during cardiac catheterization exhibited a similar apparent paradox. This suggests variable coronary venous washout from ischemic myocardium during total coronary artery occlusion and, in humans, may also reflect the presence of scar tissue. Caution is advised when interpreting myocardial metabolic information in the presence of total coronary artery occlusion, since underestimation of the extent of myocardial ischemia is more likely than with an occlusion of lesser degree.
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