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Biomedical subjects

P Blume

Publications and source records attributed to P Blume.

At least 19 recordsLinked to original sources
PubMed2001

The safest surgical incisions and amputations applying the angiosome principles and using the Doppler to assess the arterial-arterial connections of the foot and ankle.

Knowing the arterial anatomy of the foot and ankle in addition to understanding the angiosome concept provides the basis for careful and safe planning of incisions. The Doppler allows the surgeon to map out the actual vascular anatomy that exists preoperatively and therefore allows for appropriate adjustment to the planned incisions. If the vascular flow is inadequate for the planned surgery, then the vascular surgeon has to intervene to improve the existing blood flow. If the vascular tree is so compromised that successful revascularization of the affected angiosome is impossible, then the revascularization is likely to fail. Serious consideration to a below-knee amputation should then enter the decision tree at that time. Most of the time, however, the blood flow is adequate or can be sufficiently augmented with vascular surgery. The foot and ankle surgeon can then perform preoperative mapping of the arterial blood supply with the Doppler. By making the necessary adjustments to the planned incision, surgery can proceed safely with uneventful healing.

Amputation, Surgical↗
PubMed2001

Calciphylaxis: a poor prognostic indicator for limb salvage.

INTRODUCTION: Calciphylaxis (calcific uremic arteriolopathy) is a rare complication of end-stage renal disease in patients with secondary hyperparathyroidism. Subcutaneous skin nodules and extensive tissue necrosis with vascular calcification characterize this process. DESIGN AND SETTING: The design of the study included case series and literature review. The study was set in a tertiary care hospital. PATIENTS: Four patients presented over an 8-month period with extensive tissue loss and the subsequent diagnosis of calciphylaxis. Two of these patients were revascularized. One underwent primary amputation, and the final patient died before revascularization. The mortality rate for this group was 75%. All patients had significant vascular complications outside the area of initial presentation. CONCLUSIONS: These individuals represent a subset of patients who may not benefit from revascularization or may require extensive regulation of divalent metabolism before consideration for revascularization.

Aged↗
PubMed2000

Diabetic Foot Disease.

The authors review the impact, areas of influence, and treatment protocols for diabetic foot disease.

Journal Article↗
PubMed1998

Prostate-specific antigen testing practices and outcomes.

OBJECTIVES: To characterize prostate-specific antigen (PSA) testing practices in a hospital-based primary care clinic, and to determine the outcomes of PSA testing, including urology referrals, biopsies, cancers detected, and cancer treatments. DESIGN: Retrospective cohort study. Data were obtained from computerized Department of Veterans Affairs (VA) files and the statewide New Mexico Surveillance, Epidemiology, and End Results (SEER) tumor registry. SETTING: Primary care clinics in a university-affiliated VA Medical Center. PATIENTS: Subjects were 1,448 men without cancer undergoing PSA testing in 1993 with follow-up through 1994. MAIN RESULTS: Twenty-one percent of clinic enrollees at least 40 years of age were tested with PSA, including 58 who were 75 years of age or older. By the end of 1994, 40.0% (95% confidence interval [CI] 37.2%, 42.8%) were retested; 25.6% (95% CI 21.7%, 29.5%) of initial retesting occurred within 6 months. Overall, 20.7% (95% CI 18.9%, 22.5%) of PSA tests in the cohort were for men aged 75 years or older and were repeated within 6 months. Among the 193 subjects with PSA values > or = 4.0 ng/mL, 86.0% (95% CI 81.1%, 90.9%) were followed-up in urology clinic, and 46.1% (95% CI 39.1%, 53.1%) underwent biopsy. Only 11 of 51 men aged 75 years or older who were referred to urologists for an elevated PSA underwent biopsy. Forty cancers were diagnosed-a detection rate of 2.8% (95% CI 2.0%, 3.6%). Of these, 28 were organ-confined, 7 had regional invasion, and 3 had distant metastases. CONCLUSIONS: Primary care providers frequently ordered PSA tests, but a substantial proportion of testing occurred outside recommended age ranges and screening intervals. Older patients with elevated PSA values often did not complete diagnostic workups. Better adherence to screening guidelines may limit the number of both PSA tests and urology referrals.

Adult↗
PubMed1991

Design of a clinical laboratory computer system.

A clinical laboratory is a dynamic organization that suffers when constrained to a static environment. Its approach to information management must be predicated on an ability to deal comfortably with change whenever necessary. It is important to view an information system as a dynamic process rather than a static object to be used for some time and then discarded for a newer model.

Clinical Laboratory Information Systems↗
PubMed1990

Interfacing a flow cytometer computer with a PC-based patient information system.

We have established an interface between our flow cytometer's computer and the personal computer (PC) which supports our patient database system. The PC has been equipped with a commercially available IEEE-488 bus interface board which is connected to the interface bus of the cytometer's Hewlett-Packard 9000/300 computer (HP). The PC is set as a bus device with the same address as that of the HP's printer. It is programmed to examine the stream of data sent to the printer and extract from it and store in an MS-DOS text file selected information which subsequently may be transferred to the database system.

Computer Communication Networks↗
PubMed1989

A spectrophotometric method for determining the stream sample core diameter of a flow cytometer.

A simple, rapid, and accurate method is described for the determination of flow cytometer stream sample core diameters. A precisely formulated solution of potassium dichromate is introduced as a sample, the stream is collected, and its absorbance is measured using a spectrophotometer. This permits the calculation of the factor by which the original solution was diluted and, given the stream diameter, the sample core diameter.

Flow Cytometry↗
PubMed1986

Laboratory medicine in the age of information.

Information systems in laboratory medicine reflect and respond to the major changes now taking place in health care. This fruitful and practical area for medical information science encompasses problems in medical information science, shop floor control and issues in clinical behavior.

Clinical Laboratory Information Systems↗
PubMed1985

Correlation between in vitro autoradiographic results and histological WHO grades in human urothelial bladder tumours.

253 biopsy specimens of 106 urinary bladder tumours have been examined by means of in vitro autoradiography and the results compared with the WHO grading. An increase of the average labelling index occurred parallel to increasing WHO grades. However, great inter-tumorous differences in proliferation behaviour existed particularly in papillary G2 and G3 urothelium carcinomas. Possible causes of this heterogeneity are discussed. In vitro autoradiography is a suitable method for the objective characterization of the malignancy potential of urinary bladder tumours.

Adenocarcinoma↗
PubMed1984

[Histological and autoradiographic studies of the objective characterization of the degree of dysplasia in the urothelium].

282 biopsy specimens of tumorous and tumor-free urinary bladders have been examined by histological and autoradiographical means. There is no recommendation unified on an international scale for the histological classification of intra-urothelial cell and nucleus abnormities . The classification into three degrees of dysplasia is proposed. The exact characterization of urothelium requires additional objective methods. The increase of the average labeling index parallel to the increasing degree of dysplasia has been proved autoradiographically. Moreover, the change of proliferation pattern with the increasing degree of dysplasia points to the loss of physiological regeneration.

Adenocarcinoma↗
PubMed1983

[Correlation of computer tomographic, kidney vasographic and histological study results in solid kidney tumors].

Computertomography evaluates renal expansion precisely. In 105 patients differential diagnosis by means of computertomography was 95% accurate. In 93% of the cases it agreed with renovasographic and histological findings. It was possible to demonstrate or exclude the intrusion of a tumour into the renal vein in 61% of cases of tumour of the left kidney and in 55% of growths on the right side. The computertomographic evaluation of the vena cava inferior was confirmed by the histological findings in 71% and 65% of the cases, respectively. It was possible to exclude lymphogenous metastasis in 89% of the cases. In 4% computertomography gave falsely positive findings. In so far as computertomographic examination can give an unambiguous evaluation of a renal growth and a certain proof or disproof of the intrusion of a tumour into the venous system is made, preoperative renovasography can be dispensed with. Information on the operability of the tumour should be supplemented by clarification of lymphogenous and distant metastasis.

Adolescent↗
PubMed1982

Early electrochemical events in lectin-lymphocyte interaction. I. Mechanism of lectin-mediated changes in the electrophoretic mobility of lymphocytes.

Concanavalin A, at extremely low concentrations, will produce significant increases in the electrophoretic mobility of murine splenic T lymphocytes. It has been established that the alteration in cellular surface charge is mediated by a factor produced by those lymphocytes that have reacted directly with con A. We originally conjectured that the mobility change might be the consequence of an alteration in the distribution of the charged moieties of membrane glycoproteins. The results of experiments conducted at low temperature raise some questions about this mechanism. Further experiments have been performed to establish the nature of the physicochemical alterations in the peripheral zone of the factor-stimulated lymphocytes that are manifest as changes in cellular surface charge. The results of these studies indicate that, subsequent to the interaction of T lymphocytes with con A, there is a reduction in the number of positively charged amino groups effective at the electrophoretic surface of the cells.

Animals↗
PubMed1978

Analytical particle electrophoresis applied to immunologic research.

The technique of analytical particle electrophoresis has been applied to the study of membrane phenomena associated with lectin stimulation of lymphocytes. It has been observed that such treatment results in a significant increase in the electrophoretic mobility of murine T-cells. Moreover, it has been demonstrated that the mobility changes in most cells are attributable to the release of a factor from relatively few cells. Preliminary evidence suggests that the murine factor has a comparatively low relative molecular mass, is heat-labile, and will alter the mobility of cultured human T-cells.

Animals↗
PubMed1975

Traumatic kidney rupture in hydronephrosis.

The hydrostatic pressure, intrapelvic volume, and specific elasticity and strength of strips of tissue from the parenchyma and the pelvis of eight hydronephrotic kidneys were investigated and compared with the tissue characteristics of the pelvis of four control kidneys. Hydronephorsis manifested itself by a sixfold reduction of tissue strength, and dynamically by a ninefold reduction of the energy absorptive capacity of the parenchyma as compared with the pelvis. Its further response to trauma appeared to be influenced by internal pressure, the law of mass variation, and the energy absorptive capacity of surrounding anatomical structures. The vulnerability of the hydronephrotic kidney in situ depends on its volume and topography, the parenchyma being the part that may be regarded as the site most predisposed to rupture.

Biomechanical Phenomena↗
PubMed1975

Application of differential light scattering to the latex agglutination assay for rheumatoid factor.

When a suspension of particle is irradiated with a collimated beam of monochromatic polarized light of a wavelength close to the particle size and the intensity of the scattered light is measured as a function of angle, the scatter intensity is characterized by a series of relative maxima and minima. The nature of the signal depends on several significant variables that are characteristic of the particles. We have constructed a differential light scatter photometer and have applied the technique to analysis of rheumatoid factor by using latex particles coated with fraction II gamma-globulin. The results suggest that such a photometer may have potential applications in antigen-antibody assays based on the use of sensitized particles.

Evaluation Studies as Topic↗