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Biomedical subjects

C F Ackman

Publications and source records attributed to C F Ackman.

5 recordsLinked to original sources

Changing profiles in vasectomy subjects in the past decade.

Two groups of vasectomy patients were reviewed: 376 men operated upon between 1968 and 1971 and 608 between 1974 and 1978. Average age, length of marriage, and number of living children prior to vasectomy were greater in the first group (P less than 0.01). The results are compatible with the idea that couples are planning smaller families and turning increasingly to vasectomy as a reliable permanent birth control method immediately following the completion of their families.

Adult

Experience with polytetrafluoroethylene grafts in patients on long-term hemodialysis.

Expanded polytetrafluoroethylene (PTFE) is a new material now being used to create subcutaneous arteriovenous anastomoses for vascular access in hemodialysis. The authors have been impressed with the versatility of grafts made from this material and, where failure occurs, the ease with which surgical revision can be carried out. Two cases are described to illustrate the adaptability of this material to reconstruction. The authors' initial impression based on 22 months' experience is that PTFE grafts have appreciably modified the management with respect to vascular access, of many patients on long-term hemodialysis.

Aged

Polytetrafluorethylene (PTFE) grafts for hemodialysis. 18 months' experience.

18 months clinical experience with 6 mm polytetrafluorethylene forearm grafts for hemodialysis access has been described. 35 grafts were implanted, all in patients who had unsuitable vessels for construction of a regular Brescia-Cimino forearm fistula. The overall patency was 71% with mean duration of 10.3 months, and at any one time more than 85% of the grafts at risk were functional. Complications, including undesirable flow rates, edema, thrombosis, aneurysm and cardiac failure have been discussed and rational methods of avoidance described. We believe the polytetrafluorethylene (PTFE) graft represents an important advance in hemodialysis access.

Adult

Canadian clinical trial of antilymphocyte globulin in human cadaver renal transplantation.

A multicentre, randomized clinical trial of antilymphocyte globulin (ALG) was conducted among patients who had undergone cadaver kidney transplantation; follow-up was continued for a minimum of 1 year. Of the 179 patients 92 were given conventional treatment only, while 87 were given in addition ALG (from a standardized, highly immunosuppressive, common pool of equine ALG), 20 mg/kg-d intravenously for 10 days after transplantation. The ALG-treated group had better accumulated graft survival, fewer nephrectomies, better graft function, less than half the number of acute rejection episodes and less prednisone use. There was a beneficial drug (ALG)-related effect in both the graft and the host during the first 3 months after transplantation.

Antilymphocyte Serum

Vasectomy: benefits and risks.

Bilateral occlusion of the vas deferens, vasectomy, is progressively becoming the method of choice for couples seeking permanent contraception at a younger age, with smaller families. They are apparently well-informed and view the procedure as a natural step. Vasectomy is an inexpensively performed office procedure that causes minimal disruption of routine and has a high degree of community acceptance. The risks of significant hematoma, infection, discomfort and other sequelae are within acceptable limits. Improved techniques will continue to reduce the small failure rate. Antibodies observed in half of the patients have not been linked to systemic disease, although they are a hazard for the one patient in 500 returning for a vasovasostomy. Refinements in microsurgery and availability of artificial insemination enhance vasectomy as the method of choice. Evidently, extending the minimum time of sterility confirmation permits detection of occasional recanalization from technical failures. Adequate screening of the couple's motivation and expectations can prevent the rare psychologic disturbances, the greatest risk with this procedure and a problem associated with all options. For the male, there is no competitive technique at this time. In a world striving for equal rights, where the female still carries the burden of temporary contraception, the simplicity and popularity of vasectomy for permanent contraception add the desired undertones of social equilibrium.

Adult