Biomedical subjects
Publications and source records attributed to P M Jacobs.
An analog of methionine, DL-S-(10-dimethylsulfidooctahydrodecaborane)methionine, was synthesized from fully protected homoserine. A protected dipeptide with glycine is described.
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It has been 140 years since the invention of the ophthalmoscope in 1851 by Herman von Helmholtz. Since then, a considerable amount of time and effort has been devoted to improving the clinician's view of the fundus both for diagnostic and therapeutic reasons. Recently, there have been some notable advances in this respect, such as the 90 diopter lens, the "2.2 pan retinal" lens, and numerous "wide angle" fundus-viewing contact lenses to which the Volk Quadraspheric fundus lens has been the most recent addition. This paper is a review of the optical principles underlying the methods of fundus examination currently available.
Foot pain is a most unusual presentation of metastatic malignancy. Metastases to the hands or feet (acrometastases) have been recognized in only a few cases. A 68-year-old male, with a history of chronic gout, presented with left foot pain for 3 months duration. After conservative treatment failed to relieve his pain, radiographic and eventual bone biopsy of a cystic lesion involving the first metatarsal head revealed a Grade IV adenocarcinoma.
The recent development of small bone suture anchors has created several potential applications in reconstructive surgery of the foot. Mitek bone anchors are simple to insert, require less aggressive dissection and surgical time than reefing of the redundant posterior tibial tendon, and are a reliable method of tendon-to-bone fixation. Mitek bone anchors are an excellent technique for the treatment of redundant tibialis posterior tendon following a modified Kidner procedure. In modified Kidner procedures involving an excessively large os tibiale externum, Mitek anchoring of the redundant tibialis posterior tendon to the navicular bone is an excellent means for secure plication of the posterior tibial tendon in cases involving intraoperative tendon laxity. A description of the Mitek Anchor System and technique of application in a modified Kinder procedure is presented. The purpose of this study was to describe patient satisfaction and long-term clinical outcomes of the modified Kinder procedure with and without the Mitek bone anchoring system. A retrospective study of the modified Kinder procedure was performed with 13 patients being evaluated, seven with Mitek anchoring and six without. The University of Maryland 100-point Painful Foot Center Scoring System was modified to be more specific to the modified Kinder procedure for assessment of subjective long-term results. Patient overall satisfaction was rated good to excellent by 85.6% of patients in the Mitek group and by 100% of patients in the non-Mitek group. Use of the Mitek anchor allowed for quicker postoperative recovery to resumption of ambulation without assistive devices (average of 3 weeks vs. 4.42 weeks) and a quicker return to pain-free ambulation in normal shoegear (average of 4 weeks vs. 6 weeks). Mitek anchoring of the tibialis posterior tendon, theoretically, increases medial arch support as evidenced by 14% of the Mitek group and 67% of the non-Mitek group requiring postoperative orthotics.
A study was conducted of the long-term results on Silastic implant arthroplasties of the first metatarsophalangeal joint in 88 feet. Silastic implants were evaluated on the basis of patient satisfaction, function, and radiographic findings. The period of follow-up ranged from 6 months to 12 years, with an average follow-up of 6.3 years for hemi-joint implants and 2.1 years for total joint implants. The results showed that a majority of patients with hallux valgus and hallux limitus had good results with either hemi-implant or total implant. The most common complication found was hallux extensus.