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Biomedical subjects

R Sanders

Publications and source records attributed to R Sanders.

At least 181 records · Page 10Linked to original sources
PubMed1989

Treatment of supracondylar-intracondylar fractures of the femur using the dynamic condylar screw.

Forty-nine distal femur fractures were treated with the Dynamic Condylar Screw (DCS) between 1982 and 1985. The results in 35 fractures were reviewed in 32 patients with an average follow-up of 27.5 months. Functional results were graded using a stringent traumatic knee rating scale and Schatzker's criteria. The overall results were seen to be excellent to good in 71%, and excellent to good to fair in 83% of the cases. Using Müller's fracture classification, the less comminuted fractures were found to have better results than those with more comminution. Ease of insertion, the ability to obtain good fixation even in osteoporotic bone, and the capability of revising non-unions with a simple plate exchange are distinct advantages of the DCS over the 95 degree condylar blade plate. Medially placed iliac crest bone grafting should be performed if there is proximal extension of the fracture.

Activities of Daily Living↗
PubMed1989

A technique for obtaining bone graft.

A technique is described for obtaining large amounts of morselized cancellous graft to fill significant bony defects. This method uses an acetabular reamer placed against the outer wall of the posterior pelvis. Advantages of this technique include the procurement of copious amounts of homogeneous cancellous bone graft, ease of performance, little postoperative pain, and minimal bleeding. This technique should not be performed in elderly or osteopenic patients.

Bone Transplantation↗
PubMed1989

Learned helplessness, test anxiety, and academic achievement: a longitudinal analysis.

The stability of individual differences in test anxiety and learned helplessness over a 2-year period and their relation to concurrent and future school achievement were examined. Several issues regarding the assessment of learned helplessness are also addressed. 82 children were administered measures of test anxiety and helplessness in the third grade and again in the fifth grade. Teachers also provided reports of learned helpless and mastery-oriented behaviors at these 2 grade levels. It was found that: (a) both self-report and teacher-report measures of helplessness were stable over the 2-year period; (b) helplessness in the third grade was related to achievement test scores in the fifth grade; and (c) teacher reports may be a viable means of identifying helplessness. These findings are discussed in terms of cognitive developmental changes in children's understanding of effort and ability, and their implications for the assessment of learned helplessness are outlined.

Achievement↗
PubMed1989

Analgesic effects of 3-methoxybenzamide in rats.

The i.p. injection of 3-methoxybenzamide (3-MBA) in rats produces a dose-related elevation of the threshold for response to a painful stimulus. Metoclopramide, also a substituted benzamide, has analgesic activity that is attenuated by bromocriptine, a dopamine receptor agonist, and by the narcotic antagonist, naloxone, suggesting involvement of dopamine and opiate receptors in the action of this drug. The involvement of these receptors in the analgesic action of 3-MBA has been examined using L-dopa and naloxone. Neither significantly altered the analgesic action. Although the results are preliminary, the analgesic action of 3-MBA would not seem to occur via opiate or dopamine receptors.

Analgesics↗
PubMed1989

Etiologic factors in renovascular fibromuscular dysplasia. A case-control study.

The role of several factors that have been suggested as being of etiologic importance in renovascular fibromuscular dysplasia was examined in a case-control study of 33 patients with angiographically demonstrated fibromuscular dysplasia and 61 renal transplant donor control subjects with normal renal arteries. The factors studied included use of oral contraceptive agents or markers of sex hormone dysfunction, mechanical stress to the renal artery wall, human lymphocytic antigen (HLA) type, cigarette smoking, history of hypertension for more than 5 years, and family history of cardiovascular disease. The risk of fibromuscular dysplasia was significantly (p = 0.003) increased (odds ratio = 4.1, 95% confidence interval = 1.5-10.9) among cigarette smokers. A significant (p less than 0.001) dose-response relation was noted between cigarette use and the risk of fibromuscular dysplasia developing (odds ratio = 8.6 for those who had smoked more than 10 pack-years). Personal history of hypertension more than 5 years was also associated (odds ratio = 5.0, 95% confidence interval = 1.1-22.8) with a significantly (p = 0.036) increased risk for the development of fibromuscular dysplasia. HLA-DRw6 antigen was more common in the 33 fibromuscular dysplasia patients than in the 61 renal transplant donor control subjects (odds ratio = 3.00, p = 0.067) or a second group of 934 ambulatory control subjects (odds ratio = 2.51, p = 0.031). Adjustment for cigarette smoking increased the odds ratio to 5.0 (95% confidence interval = 1.3-19.6). There was a positive though not statistically significant (odds ratio = 1.7, p = 0.175) association noted between family history of cardiovascular disease and fibromuscular dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

When radiotherapy offers no more: the surgical management of advanced breast malignancy.

Recurrent local carcinoma of the breast can present a challenging problem of control and reconstruction to the surgeon. The pattern of ulceration, which may extend over a wide area of the chest wall and deeply into the ribs and pleura, is often similar in appearance to the sequelae of excessive radiation therapy, which can therefore be considered as a similar management problem. Advanced carcinoma of the breast can make the last few months of life miserable. Surgery can greatly assist in the amelioration of appearance, smell, and discharge from the ulcer. We report 41 patients managed surgically between 1978 and 1987.

Breast Neoplasms↗
PubMed1989

Treatment of open fractures of the tibial shaft: Ender nailing versus external fixation. A randomized, prospective comparison.

A randomized, prospective study comparing Ender nailing with external fixation for open fractures of sixty-three tibiae (sixty patients) was undertaken. Ender nailing proved to be at least as effective as external fixation with respect to seven parameters: time to union, tibial alignment, total number of operations, ranges of motion of the knee and ankle, pain, presence of infection, and complications. Ender nailing is a safe alternative to external fixation for grade-I and grade-II open fractures. It should not be used for comminuted fractures, which might shorten about the nails.

Adolescent↗
PubMed1988

Comparison of two laser Doppler flowmetry systems for bone blood flow analysis.

The development of laser Doppler flowmetry (LDF) has provided a real-time, reliable method for monitoring capillary perfusion in multiple tissues. LDF has potential for the experimental and clinical assessment of bone blood flow. To compare the accuracy and ease of use of two commercially available laser Doppler flowmeters with different mechanisms for processing the Doppler-shifted component of light, estimates of bone blood flow were obtained in a sheep model using the two systems, and the values derived then compared with estimates of bone blood flow also obtained in a sheep using the technique of injection of labeled microspheres. The single-channel laser Doppler flowmeter, the LD 5000, processes the reference and Doppler-shifted beams on the surface of a single photodetector using optical heterodyning for measurement. The dual-channel flowmeter, the Periflux 2, uses two optical fibers to transmit reference and Doppler-shifted light to two separate photodetectors. The differential amplification and detection system improves the signal-to-noise ratio. Measurement of both metaphyseal (cancellous) and diaphyseal (cortical) blood flow using both LDF systems was compared with values obtained with an injection of 85Sr-labeled microspheres in three sheep. The LDF measurements were repeated after occlusion of the left femoral artery, and a 46Sc microsphere injection was performed prior to animal sacrifice. Two of the animals developed vasomotor instability, resulting in poor correlation between the measurements obtained with the Periflux 2, which is motion sensitive, and the values obtained with the microsphere method. High correlation was apparent in two of the three animals for the LD 5000 and the microsphere values.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Split skin grafting using topical local anaesthesia (EMLA): a comparison with infiltrated anaesthesia.

The analgesic efficacy of EMLA cream was compared with that produced by infiltration of lignocaine solution when used to provide anaesthesia for cutting of skin grafts. The study was performed as an open parallel group comparison in 80 patients. Pain felt during administration of the anaesthetic and during cutting of the graft was assessed using visual analogue and verbal rating scales. During graft cutting, the anaesthesia produced by EMLA was at least as effective as infiltration. On administration, infiltration produced varying amounts of pain in all patients, but in contrast EMLA produced no discomfort. In view of this lack of discomfort and the consequent greater freedom afforded regarding the area of donor site anaesthetised, EMLA can be considered the treatment of choice when skin grafts are harvested under local anaesthetic.

Administration, Cutaneous↗
PubMed1988

A prototype device for nonimmersion shock wave lithotripsy using ultrasonography for calculus localization.

Extracorporeal shock wave lithotripsy has revolutionized the clinical treatment of renal calculi. A device was constructed with a spark gap for shock wave generation and a water-filled ellipsoidal reflector to focus the shock wave energy. A membrane coupled the device to the pig and an ultrasonic transducer was used for stone visualization. Initial in vitro experiments and in vivo studies using dwarf pigs demonstrated fragmentation of calculi.

Animals↗
PubMed1988

Optimal duration of cefotaxime prophylaxis in abdominal and vaginal hysterectomy.

Previous studies have demonstrated that short course perioperative antibiotic prophylaxis reduces septic morbidity after hysterectomy from up to 40% down to 10 to 15%. The residual morbidity is predominantly urinary tract infection (UTI) occurring 2 to 3 days after cessation of antibiotic. We hypothesised that surgery impairs urinary drainage for 3 to 4 days postoperatively and that prolonged prophylaxis was required to prevent all postoperative sepsis. Accordingly, 224 abdominal and 69 vaginal hysterectomy patients were randomly allocated to short course (2g cefotaxime IV at anaesthesia) or long course (2g cefotaxime at anaesthesia plus 7 doses of 1g 12-hourly) prophylaxis. UTI was effectively prevented by the long course (0.9 vs 18.4% short); both treatments effectively prevented wound and pelvic sepsis. We conclude that 4 days of postoperative antibiotic is required to prevent UTI.

Adult↗
PubMed1987

Endophthalmitis following cataract extraction.

We describe a case of bacterial endophthalmitis complicating routine cataract extraction and intraocular lens implantation in a 91-year-old woman. The ocular and systemic factors that may have predisposed to intraocular infection in this case, and the possibility of predicting these pre-operatively, are discussed.

Adenocarcinoma↗
PubMed1987

Crosstalk due to activation of atrial sense marker function of DDD pulse generators.

We studied the occurrence and characteristics of crosstalk related to the atrial sense marker function of the Intermedics Cosmos DDD pulse generator in 29 patients. Upon activation of the atrial sense markers, the pulse generator delivers a series of markers in the form of triggered atrial stimuli at 0.025 ms in duration at the programmed voltage output of the atrial channel. Under certain circumstances, these atrial sense marker stimuli may cause crosstalk when they are sensed by the ventricular sensing amplifier. This form of crosstalk may be eliminated in most cases by decreasing ventricular sensitivity and/or atrial output voltage.

Atrioventricular Node↗
PubMed1986

New developments for upper rate response in DDD pacing.

Although widely accepted as an effective method of dealing with rapid atrial rates in a DDD pacemaker, Wenckebach-type and multiblock-type upper rate behaviors may exacerbate pacemaker-mediated tachycardia through AV dissociation. In addition, pathologic atrial rates (e.g., atrial fibrillation, atrial flutter, automatic atrial tachycardia, etc.) frequently result in ventricular pacing at inappropriately high rates. New, more sophisticated algorithms available in today's microprocessor-based DDD pacing systems provide the capability to discriminate successfully a normal atrial rate response to exercise from a pathologic atrial rate. These and other improved capabilities allow the clinician to provide safe rate-responsive pacing to patients in whom rate-responsive pacing was previously contraindicated.

Electrocardiography↗
PubMed1986

Lipomatous tumors of the liver: evaluation with CT and US.

Seven cases of lipomatous masses within the liver parenchyma were demonstrated with computed tomography (CT). Five of these cases were obtained from a retrospective review of 50 cases of renal angiomyolipoma in which the liver was adequately demonstrated. The other two cases were from the files of the Armed Forces Institute of Pathology and had no associated renal lesions. Three of the five cases were associated with tuberous sclerosis. In all seven cases, the fatty tumors appeared on CT scans as a well-defined, 0.8-13-cm mass, with attenuation coefficients of less than -30 HU. On ultrasound studies, the lesions were well circumscribed, highly echogenic, and similar to hemangiomas. While distinctly rare lesions, these lipomatous masses are not as unusual as the literature would indicate. One may anticipate such masses in patients with renal angiomyolipomas and in a relatively high percentage of those with tuberous sclerosis.

Adult↗