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Biomedical subjects

W Robinson

Publications and source records attributed to W Robinson.

At least 55 records · Page 3Linked to original sources
PubMed1988

Successful surgical and anesthetic management of vein of Galen aneurysm in a neonate in congestive heart failure.

A 12-day-old infant in intractable cardiac failure due to a vein of Galen malformation was treated successfully with serial ligation of the majority of the vessels feeding the malformation. Despite some residual vascular supply to the malformation, the congestive heart failure has disappeared and growth and development have been normal over a 3-year follow-up period.

Cerebral Veins↗
PubMed1987

Evaluation of monoclonal antibodies to vWf antigen for use in autoradiographing vWf multimer analysis.

Nine monoclonal antibodies (MAb, coded ESvWF 1-5, 7-10) to human von Willebrand's factor (vWf) have been studied for their labelling characteristics with 125I and their ability to demonstrate vWf multimers by autoradiography after discontinuous SDS electrophoresis on agarose and agarose/acrylamide gels in plasma from normal and von Willebrand's disease (vWD) patients. Of ESvWF 1, 2, 4, 7, 8 and 9, ESvWF 2 gave autoradiographs most similar to those obtained with a polyclonal antibody. The others gave much fainter staining of all bands suggesting that the epitope detected by ESvWF 2 is either more common or, less easily altered by SDS than the epitopes identified by the other MAb's. ESvWF 2 gave a different staining pattern with a IIC vWD patient than that obtained using a polyclonal antibody. The most striking result, however, was shown by ESvWF 3, 5 and 10 which failed to stain the lower band of the lower molecular weight multimer. This suggests that the lower triplet band, unlike the central and upper bands of the triplet, does not contain the epitope identified by these three MAb's. With these reagents it has been possible to show, for the first time, that epitope differences do exist between the constituent bands of the vWf triplet.

Antibodies, Monoclonal↗
PubMed1987

Isotretinoin produces significant inhibition of monocyte and neutrophil chemotaxis in vivo in patients with cystic acne.

The effect of oral isotretinoin (13-cis-retinoic acid) on in vivo chemotactic responses was studied longitudinally in 7 patients with cystic acne. As measured in a microchamber chemotaxis assay, both monocyte and neutrophil chemotaxis were inhibited 98% (p less than 0.001) during isotretinoin treatment. In vivo chemotactic responses returned to normal within 2 months of cessation of treatment. Biopsies of skin chamber sites from patients on isotretinoin showed no significant dermal or epidermal leukocytic accumulation in response to autologous zymosan-activated serum, whereas chambers from controls showed extensive neutrophilic infiltrates even in the epidermis. In contrast, in vitro chemotactic responses of neutrophils and monocytes from patients on isotretinoin were not diminished. Sera and plasma from patients on isotretinoin contained no inhibitors of chemotaxis, and activated sera from these patients were excellent attractants for normal monocytes. We postulate that isotretinoin produces significant anti-inflammatory effects by inhibition of monocyte and neutrophil chemotaxis across intact biologic barriers in vivo.

Acne Vulgaris↗
PubMed1986

Laser microsurgery: a review of 105 intracranial tumors.

The relative importance or utility of the carbon dioxide laser within the total context of multimodality therapy and in comparison to conventional surgical techniques is unknown. Over a 36 month period, 421 operations for tumors of the brain and spinal cord were performed in our clinic. Of these, 111 (26%) were carried out with the aid of the laser. After excluding stereotactic and transsphenoidal operations, a comparison was made between 105 laser and 216 non-laser craniotomies. With the exception of pituitary tumors, the most frequent diagnoses in both the laser and non-laser cases were the same: malignant astrocytoma (48.6 vs 33.9%), meningioma (11.4 vs 14.2%) and low grade astrocytoma (8.6 vs 8.7%). The number of reoperations in the laser group (60.1%) was higher than in the non-laser group (32.7%; p less than 0.000001) and the mean operating time (299 minutes vs 237 minutes; p less than 0.00001) was longer, but there was no significant mean difference in mortality, CNS morbidity, mean blood loss (638 ml vs 671 ml) or mean length of stay (23 vs 25 days). For the subgroup of 134 cases of malignant astrocytoma, 82% of laser procedures were reoperations versus 50% for non-laser cases (p less than 0.0002) and the mean operating time was slightly longer (p less than 0.02). The length of stay for laser cases tended to be less (21 vs 27 days; p less than 0.04), but there was again no difference in blood loss (457 ml vs 522 ml), CNS morbidity (7.8 vs 4.8%) or mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Astrocytoma↗
PubMed1986

Percutaneous placement of ventriculoatrial shunts: four-year case experience.

During the past 4 years, we have used percutaneous placement of the atrial catheter in 39 patients who have undergone ventriculoatrial shunting. The age range of our patients has been from 9 to 74 years of age, with routine indications existing. Both subclavian and internal jugular venous access have been utilized, with the latter being our preferred route of access for reasons of safety. Average operative time has been approximately 35 to 40 minutes. Both traditional and split-sheath introducer catheters have been used. Patient follow-up has been up to 4 years. Intraoperative complications have been limited to puncture of the carotid artery on two occasions; neither affected the ultimate performance of the procedure. Postoperative complications have been limited to those peculiar to shunt procedures in general and have required revision in four instances. One patient suffered an infection secondary to shunting. The benefits of this procedure seem to include safety, decreased operative site exposure, and decreased operative time, all factors that may contribute to a lower than normal infection rate and may warrant consideration of this procedure in adolescents and adults for whom ventriculoatrial shunting is indicated.

Adolescent↗
PubMed1986

Malpractice reform: what will it take to patch up the system. Interview by James E. Orlikoff.

Numerous economic, legal, and human variables are entangled in the current malpractice crisis. To help governing boards gain perspective on the malpractice situation, James Orlikoff, program director in the American Hospital Association's division of hospital governance, recently spoke with four experts who are familiar with the different areas involved in the crisis: Dixie Arthur, vice-president, Health Providers Insurance Corp.; Richard Epstein, senior vice-president and general counsel, American Hospital Association; James Hughes, partner, Bricker and Eckler, Columbus, OH, and general counsel to the Ohio Hospital Insurance Co.; and William Robinson, AHA senior vice-president and president, Health Provider Insurance Co.

Governing Board↗
PubMed1985

Prolactin and growth hormone dynamics in epileptic patients receiving phenytoin.

Resting growth hormone and prolactin levels and dynamic responses to bromocriptine and metoclopramide have been measured in epileptic patients before treatment, and compared with a matched group taking phenytoin alone. Mean resting levels of prolactin were higher in patients taking phenytoin (untreated patients 204 mU/l, phenytoin treated patients 302 mU/l), but dynamic responses to metoclopramide and bromocriptine were unaffected. Mean resting levels of growth hormone were also higher in patients taking phenytoin (untreated patients 1.4 mU/l, phenytoin treated patients 6.0 mU/l) and paradoxical suppression was seen following bromocriptine. Phenytoin is unlikely to have any major action on the D2 receptor present on the lactotroph. The abnormalities in growth hormone may explain the well recognized effects of phenytoin on connective tissue.

Adolescent↗
PubMed1984

Bretylium in hypothermia-induced ventricular fibrillation in dogs.

We undertook a study to determine the ability of intravenous bretylium to cause "chemical defibrillation" or facilitate electrical defibrillation of hypothermia-induced ventricular fibrillation in the dog. Two groups of ten dogs were cooled to 22 C and placed into ventricular fibrillation. Following initiation of cardiopulmonary resuscitation, bretylium 15 mg/kg or normal saline was administered and the dogs were defibrillated according to a standard protocol. Both groups were equivalent in mean arterial pressure and arterial blood gases throughout the investigation. Seven dogs in each group were converted from ventricular fibrillation to an organized cardiac rhythm (P greater than .05). Despite the possible value of prophylactic bretylium in the setting of hypothermia, its use as active treatment for hypothermia-induced ventricular fibrillation in dogs does not seem to be beneficial.

Animals↗
PubMed1984

Immunochemistry of 7 S domain of type IV collagen.

The 7 S domain of type IV collagen was isolated from various basement membranes by pepsin and bacterial collagenase digestion. The antibodies were raised in rabbits against human placental 7 S and bovine cortex 7 S. The antisera were studied for their binding to 7 S samples. The results showed a lack of tissue specificity to 7 S from the same species. In contrast no cross-reactivity was found between 7 S from different species. A set of peptides from 7 S were also prepared and tested for their binding to antiserum, showing retention of some antigenic sites.

Adult↗
PubMed1983

Characterisation, experimental infection and serological response to caprine retrovirus.

A virus (151) isolated from synovial membrane explant cultures from a goat with arthritis-synovitis was characterised with respect to cytopathic effect in synovial membrane cell cultures, virus morphology, buoyant density and presence of RNA dependent DNA polymerase. Virus 151 was shown to be a retrovirus with similar properties to caprine arthritis-encephalitis virus in the United States of America. Inoculation of the virus into uninfected goats caused the development of arthritis-synovitis lesions and the virus was recovered from affected joints and lung 361 days post-inoculation. The development of antibody to virus 151 was detected using an enzyme linked immunosorbent assay (ELISA). Other goats with arthritis-synovitis, progressive pneumonia or viral leukoencephalomyelitis all had antibody that reacted in this ELISA. Viruses similar to virus 151 were recovered from a number of cases. Goats inoculated with one of the viruses produced serum antibody that cross-reacted in ELISA using maedi-visna virus and virus 151 as antigens.

Animals↗
PubMed1983

Effect of colostrum deprivation of goat kids on the natural transmission of caprine retrovirus infection.

An investigation was conducted to determine if depriving goat kids of colostrum and rearing them away from the herd would prevent transmission of caprine retrovirus infection. Twenty-four newborn goat kids were deprived of colostrum and reared on cow's milk away from their dams from an endemically infected goat herd. Twenty-three colostrum-deprived kids had no evidence of retrovirus infection at birth. One kid had sucked briefly and obtained some colostrum resulting in passive transfer of antibody but it did not develop evidence of infection. Nineteen showed no serological evidence of infection over the 370 days of the study. One colostrum-deprived, segregated goat was subsequently found to be infected and developed arthritis-synovitis. Three had doubtful positive response in one or 2 serological tests during the period but no evidence of infection in leucocyte co-cultures. Cells centrifuged from colostrum of infected goats were co-cultivated with foetal goat synovial membrane cultures. Caprine retrovirus was isolated from cells in the colostrum from the 3 goats examined.

Animals↗
PubMed1983

Haemophilus influenzae b bacteremia and meningitis in infant rabbits after intranasal inoculation.

A suitable model of Haemophilus influenzae meningitis will facilitate better understanding of the pathophysiology, therapy, and prevention of the disease and its sequelae. Bacteremia and meningitis were induced in infant New Zealand white rabbits by intranasal inoculation of H. influenzae type b. Intranasal trypsin prior to challenge significantly increased (p = 0.002) the rate of bacteremia from 64% (7/11) to 100% (45/45). In the trypsin-treated group, H. influenzae b was isolated from the CSF of 89% (25/28) of 17- to 21-day-old rabbits and from 76% (13/17) of 23- to 30-day-old animals, p = 0.3; fatality rates were 88% and 31%, respectively, p = 0.001. Bacteremia developed within 24 hr of inoculation and meningitis within 96 hr. Death occurred 1 to 7 days after the development of meningitis. Histologic evidence of nasopharyngitis and meningitis was found at autopsy. The intranasal route of infection, the age-dependent outcome, the size of the animal, and its low cost and availability make the infant rabbit an appropriate model of H. influenzae b meningitis.

Animals↗
PubMed1980

CT findings in multicentric glioblastoma: diagnostic-pathologic correlation.

Computerized cranial tomography (CCT) and angiographic findings in three cases of multicentric glioblastoma are reported. Differentiation of multicentric glioblastoma from diffuse metastatic deposits or multiple abscesses can be difficult with CCT. Apart from demonstrating a mass effect in one case and tumor neovascularity in the second case, angiography did not provide additional helpful information. The pathological diagnoses of these lesions were confirmed by biopsy and subsequent autopsy. Pathological differentiation of the multifocal or multicentric nature of the glioblastoma can be made only at autopsy.

Adult↗