Philosophy of surgery on the geriatric patient: the pros and cons of surgical procedures on the older patient.
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Biomedical subjects
Publications and source records attributed to G S Kaplan.
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As a preliminary report, our paper is designed to show another procedure to be used by podiatrists in lengthening metatarsals by the use of an autogenous bone graft. The procedure described should be considered when metatarsal length problems arise. Discussed were the basic physiologic properties of grafting, and the actual procedure of doing these grafts.
Ulceration due to any etiology is a diagnostic and treatment challenge to podiatric practitioners as well as our medical colleagues. The use of porcine skin grafts as an adjunct to hyperbaric oxygen is discussed here as a treatment alternative.
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Tarsal coalition is a relatively rare anomaly, and the degree of fusion between two or more tarsal bones varies. The coalition may be osseous, cartilaginous or fibrous, and it may be complete or incomplete. It usually results in rigid planovalgus deformity of the foot and may be associated with secondary spasm of the peroneal muscle group. With few exceptions, complete stabilization by arthrodesis is the treatment of choice.
Arthrodesis, the surgical fusion of a joint or joints when motion is undesirable, is one of the most exacting surgical procedures performed on the foot. In this article, the authors discuss arthrodesing techniques from the earliest attempts in 1878 to the more sophisticated and more successful corrective procedures of the present day. Their preference of the two surgical techniques used for triple arthrodesis is the method which involves two incisions--a 12-cm. incision on the medial aspect of the foot and an 8-cm. incision on the lateral aspect of the foot.
When spleen cells from mice infected with Rowson-Parr virus (RPV) were cultivated with sheep red blood cells (SRBC), antibody plaque responses were markedly lower than those in similarly cultivated spleen cells from normal mice. Addition of as few as 10(3) spleen cells from RPV-infected mice to cultures of normal aplenocytes markedly depressed the expected immune response. Although RPV-infected mice showed maximum immunodpression in vivo only during the first week after infection, their spleen cells, obtained later in the course of infection, depressed the immunologic responsiveness of normal splenocytes in vitro. Increased doses of SRBC or addition of bacterial lipopolysaccharide to cultures of spleen cells from immunodepressed, RPV-infected mice stimulated antibody formation, and near-normal numbers of antibody-producing cells were evident. Peritoneal exudate (PE) cells, but not thymus, bone marrow, or unfractioned spleen cells, restored immunocompetence to cultures of spleen cells from RPV-infected mice but did not affect the suppressive properties of the infected cells on normal splenocytes. The function of PE cell macrophages in restoring immunocompetence to infected spleen cells in cultures seemed related to a possible antigen-focusing activity of the cells; antibody-producing cell precursors in infected cultures seemed to be preferentially affected by the presence of normal PE cells.