PubMed HealthSearch

Biomedical subjects

G M Baur

Publications and source records attributed to G M Baur.

9 recordsLinked to original sources

Human umbilical cord vein allograft arteriovenous fistula for chemotherapy access.

Seven patients who received chronic chemotherapy and required vascular access underwent construction of an arteriovenous fistula of the leg using gluteraldehyde-tanned human umbilical cord vein allografts. No wound or graft complications have occurred and patient tolerance of the operative procedure and subsequent use of the fisulas for chemotherapy has been excellent. Our preliminary results suggest that the use of umbilical vein allograft arteriovenous fistulas is quite satisfactory for long-term chemotherapy access.

Adult

Antigenicity of venous allografts.

With isolated exceptions, the clinical use of venous allografts has been disappointing. Considerable evidence indicates that allograft antigenicity plays a major role in the failure of venous allografts when used as arterial replacements. Recent reports suggest that DMSO-cryopreservation of venous allografts may reduce allograft antigenicity while preserving allograft viability. The present study examines the effect of modifications of vein allografts on subsequent allograft antigenicity. Skin grafts were transplanted from ACI to Lewis inbred strains of male rats. Primary skin graft rejection occurred in 9.0 +/- 1.0 days. Subcutaneous implantation of fresh inferior vena cava from ACI rate into Lewis rats resulted in subsequent skin graft rejection in 5.0 +/- 1.0 days, confirming the antigenicity of venous tissue. Cryopreservation of ACI inferior vena cava for seven days prior to implantation, with or without 15% DMSO, resulted in subsequent skin graft rejection in 5.0 +/- 1.0 days. Treatment of ACI inferior vena cava with 0.30% gluteraldehyde for 20 minutes prior to implantation in Lewis rats resulted in skin graft rejection in 9.0 +/- 1.0 days, the same time as a first set rejection. This study indicates that unmodified veins are normally antigenic and that this antigenicity is not eliminated by cryopreservation with or without DMSO. Gluteraldehyde treatment appears to reduce allograft antigenicity, but results in a nonviable graft. At the present time, there is no known way to reduce the antigenicity of viable venous allografts.

Animals

Value of angiography in the management of abdominal aortic aneurysm.

The value of angiography in the management of abdominal aortic aneurysms (AAA) was assessed in 100 consecutive patients with AAA. Angiographic information influenced management decisons and/or surgery performance in 75: In 23 patients at high risk for surgery because of associated medical problems, it helped in deferring surgery; in 52 patients it resulted in a change of operation from a standard aneurysm resection with conventional grafting to a more conservative procedure (three patients), more extensive grafting (45 patients) and/or the addition of other vascular reconstructions (32 patients). Angiography is considered an integral step in the routine preoperative workup of AAA and is particularly valuable for the determination of important anatomic details about the aneurysm (upper and lower extensions, relation to the renal arteries), the detection of associated vascular disease (of renal, visceral, pelvic and peripheral arteries), and the demonstration of aberrant renal arteries and collateral visceral circulation. Catheter techniques are considered most suitable and safe for examination of AAA.

Aged

The role of arteriography in abdominal aortic aneurysm.

The results of arteriography in the management of 100 consecutive patients with abdominal aortic aneurysms are presented. Arteriographic information had substantial influence upon management decisions and performance of surgery in 75 per cent of cases. We found the preoperative knowledge of the precise vascular pathology or anatomic variants not only permitted a more rational recommendation for or against surgery but aided in the selection of the most suitable surgical procedure.

Aged

Lower extremity amputation for ischemia.

Three hundred-twenty-four amputations of the lower extremity for ischemia at the University of Oregon Health Sciences Center over the past ten years are presented. Striking differences between the first and second five-year periods are noted in level of amputation. The primary healing rate of all patients in the two periods was similar. Diabetics tended to have more distal amputations but primary healing was lower than that of nondiabetics.

Amputation, Surgical

Rapid onset of hand ischemia of unknown etiology: clinical evaluation and follow-up of ten patients.

Ten patients presenting with a history of the acute onset of hand ischemia have undergone detailed clinical, immunologic, and arteriographic evaluation. The disease is characterized by the acute onset of hand ischemia proceeding to fingertip ulceration, in the absence of recognized systemic disease. None of the patients had any evidence of large artery obstruction. Arteriography showed diffuse obstruction of the palmar and digital arteries. No evidence was found in any patient of any systemic disease process associated with small artery obstruction. These patients are suspected of having a previously unreported variant of hypersensitivity angiitis. Patients are left with permanent obstruction of the palmar and digital arteries. Follow-up suggests the disease in non-recurrent and is characterized by progessive clinical improvement associated with the development of collateral circulation. Conservative management of the condition is recommended.

Adolescent

Intra-arterial sympathetic blockade in the treatment of clinical frostbite.

Regional medical sympathectomy achieved by the intra-arterial injection of reserpine appeared to be of benefit in the treatment of five patients with acute or chronic frostbite injuries. Clinical improvement was associated with a significant increase in arteriographically determined regional perfusion.

Adult

The clinical significance of Raynaud's syndrome.

This study was performed to determine the frequency of occurrence of associated autoimmune disease in a group of patients presenting with Raynaud's symptoms. A consecutive group of 100 patients presenting with Raynaud's syndrome underwent detailed prospective clinical and immunologic evaluation. Magnificantion hand arteriography was performed in certain patients. Based on current diagnostic criteria, the following autoimmune diseases were diagnosed or were suspected strongly: Raynaud's syndrome with scleroderma or CRST--28 patients; Raynaud's syndrome with lupus erythematosus--ten patients; Raynaud's syndrome with miscellaneous autoimmune disease--43 patients: Raynaud's syndrome without diagnosable autoimmune disease--19 patients. Fourteen of the 19 patients in the latter group had isolated serologic abnormalities. Arteriography showed combined organic arterial obstruction and vasospasm of the palmar and digital arteries in all patients. Patients with severe Raynaud's symptoms had more extensive arterial obstruction than did patients with mild or moderate Raynaud's symptoms. These results suggest that all patients with Raynaud's syndrome should be regarded as at high risk for having an associated autoimmune disease.

Adult