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Biomedical subjects

L Silver

Publications and source records attributed to L Silver.

At least 37 records · Page 2Linked to original sources
PubMed1987

The anatomical basis for incisions around the foot and ankle in clubfoot surgery.

Skin problems are the cause of a high incidence of recurrent clubfoot problems. With respect to the demonstrated vascular territories (angiosomes) of the ankle and foot, the incisions which seem to be safest are vertical as opposed to transverse, and between angiosomes. The safest of all are the posteromedial incision with an additional vertical lateral incision if necessary, and the posterolateral with an additional medial incision.

Ankle↗
PubMed1987

Burns of the hand and wrist. Current concepts in diagnosis and treatment.

Correct acute care is critical in the treatment of burns of the hand, particularly in the younger patient in order to avoid complications that may interfere with the patient's quality of life and ability to be self-sufficient and self-supportive. Objectives of management are to prevent edema, prevent prolonged immobilization and poor position and prevent infection and preserve viable tissue. The various modalities that are used to achieve these objectives and how they may be individualized to meet the patient's specific needs are described and discussed.

Burns↗
PubMed1986

Argon laser photocoagulation of port wine stain hemangiomas.

A total of 66 patients with port wine stains is reported. All of these were tested and 46 patients treated (80 treatments). Good to excellent results (significant lightening of color and/or smoother texture of skin) was achieved in 74% of tests (0 scar) and in 82% of treatments (4.3% scar). Treatment results correlate well with test spots but vary somewhat as the lesions are not homogeneous and skin textures vary. The lowest energy density commensurate with successful treatment should be used to reduce the incidence of scarring. Future methods of manipulating the PWS may make it possible to achieve better results with less scarring. Teenagers fared well in this series, while the problem of successful treatment in the young child remains unsolved.

Adolescent↗
PubMed1984

The effect of high molecular weight kininogen on surface-adsorbed fibrinogen.

High molecular weight kininogen (HMWK) plays an important role in altering the association of plasma fibrinogen with surfaces. Plasma initially deposits fibrinogen onto most materials, but on hydrophilic surfaces within 10 min adsorbed plasma fibrinogen cannot be detected on the surface by anti-fibrinogen antisera. However, using HMWK-deficient plasma, fibrinogen remains immunologically identifiable. The interrelationship of adsorbed plasma fibrinogen with kininogen on hydrophilic surfaces is studied further using glass slides stained for protein with Coomassie Blue, and oxidized silicon crystal slices in an automated ellipsometer. On glass slides when plasma that is deficient in both low molecular weight kininogen (LMWK) and HMWK, is reconstituted with HMWK (0.04 Units/ml), fibrinogen is no longer detected on the surface. This finding is specific for HMWK, since, when the same plasma is reconstituted with LMWK (220 micrograms/ml), the amount of fibrinogen detected on the surface is unchanged. The alteration of surface-adsorbed fibrinogen by HMWK is not due to plasmin-induced fibrinolysis, since it occurs in plasminogen-free plasma. In the ellipsometer, surface adsorption of normal plasma is associated with a significantly less (p less than 0.0005) thick protein layer (1.99 +/- 0.08 degree change in azimuth) than plasmas deficient in HMWK (2.32 +/- 0.11). Using ellipsometry, HMWK in plasma is shown to shorten the time in which immunologically detectable surface-adsorbed fibrinogen was removed or altered. These studies in a whole plasma system present further evidence that HMWK specifically modifies the association of plasma fibrinogen with hydrophilic surfaces.

Adsorption↗
PubMed1984

Continuous monitoring of critically ill patients with transcutaneous oxygen and carbon dioxide and conjunctival oxygen sensors.

Transcutaneous (PtcO2) and conjunctival (PcjO2) oxygen tensions and transcutaneous (PtcCO2) carbon dioxide tension were serially measured in 31 critically ill patients. Sixteen patients maintained a normal or greater blood pressure and 15 patients were severely hypotensive (MAP less than 60 mm Hg) or suffered cardiac arrest while in the emergency department. In hemodynamically stable patients, the correlations between PtcO2 and PaO2, PcjO2 and PaO2, and PtcCO2 and PaCO2 were significant, with correlation coefficients (r values) of 0.62, 0.48, and 0.73, respectively. In hemodynamically unstable patients, there was poor correlation between PtcO2, PcjO2, PtcCO2, and arterial blood gas values. In the severely hypotensive patients, however, PtcO2 and PcjO2 were sensitive real-time monitors of peripheral perfusion and tissue oxygen delivery. Increases in PcjO2 and PtcO2 occurred within three minutes in patients who regained a palpable blood pressure from a pulseless baseline. PtcO2 fell one to five minutes after the loss of blood pressure in patients whose clinical condition deteriorated in the emergency department. Decreases in PcjO2 from previously stable levels occurred over three to four minutes before loss of blood pressure. Transcutaneous and conjunctival sensors can be used as continuous monitors of respiratory status in hemodynamically stable patients. In severely hypotensive patients and during cardiopulmonary resuscitation, these sensors no longer accurately reflect arterial blood gases, but act as sensitive real-time monitors of cardiac function and peripheral perfusion. PcjO2 can detect deterioration of clinical state before alterations in blood pressure occur.

Adult↗
PubMed1984

Bone scan in the hand-foot syndrome.

The Hand-Foot Syndrome is a form of sickle cell disease that occurs in infancy. A bone scan performed on such a patient showed evidence of infarction in the hand. This was useful in the management of the patient.

Anemia, Sickle Cell↗
PubMed1984

Conjunctival and transcutaneous oxygen monitoring during cardiac arrest and cardiopulmonary resuscitation.

To define the utility of transcutaneous and conjunctival oxygen sensors in the emergency setting, we measured serial conjunctival (PcjO2) and transcutaneous (PtcO2) oxygen tensions during CPR in 11 patients. There was no significant correlation between PaO2 and PtcO2 or PcjO2. Improvement or deterioration in clinical condition as assessed by return or loss of palpable blood pressure was consistently and accurately reflected by PcjO2 and PtcO2. PcjO2 responded to changes in physiologic state more rapidly than did PtcO2, with a reaction time of approximately 60 sec. Conjunctival and transcutaneous oxygen sensors provided continuous information on the effectiveness of CPR in terms of peripheral perfusion and tissue oxygenation, and were a valuable adjunct in monitoring the clinical condition of these critically ill patients.

Conjunctiva↗
PubMed1980

Production of extrachromosomal r-determinant circles from integrated R100.1: involvement of the E. coli recombination system.

The drug resistance plasmid R100.1 can integrate into the E. coli chromosome at several sites on the plasmid. Many of the resulting Hfr strains continuously produce extrachromosomal circular forms of the r-determinant. These r-det 'plasmids' seem incapable of stable autonomous replication. We show that their presence in the cell requires the continuous activity of functional recA and recC genes but does not require the lexA function. The production of r-det circular forms is correlated with an increased copy number of r-det sequences, relative to RTF sequences, This copy number increase is, however, also found in a recA- background where no circular forms of r-det are found. These results show that a specific replication of r-det sequences, not present in the wild-type R100.1 plasmid, occurs in these R-Hfr strains. They suggest that a rec promoted recombination, posterior to the specific replication event, is needed for the production of circular r-det forms.

DNA Replication↗
PubMed1979

Tn10 mediated integration of the plasmid R100.1 into the bacterial chromosome: inverse transposition.

Upon integration into the bacterial chromosome the drug resistance plasmid R100.1 often loses its tetracycline resistance character. We have analyzed an Hfr strain formed by such an integration and an R-prime plasmid derived from it. We find that integration took place within the Tn10 transposon, that the two IS10 sequences were retained, but that at least 80% of the transposon segment located between them, and carrying the tetracycline resistance genes, had been lost. We suggest that integration of R100.1 was mediated by an inverse transposition using the IS10 sequences.

Chromosomes, Bacterial↗
PubMed1979

Erroneous thyroid-stimulating hormone radioimmunoassay results due to interfering antibovine thyroid-stimulating hormone antibodies.

Apparent elevation of serum thyroid-stimulating hormone (TSH) levels was found in a case of a patient receiving adequate replacement therapy after thyroidectomy for a follicular carcinoma. This was an artifact due to interference with the radioimmunoassay by circulating antibovine TSH antibodies. The double-antibody technic showed spuriously elevated levels, and the single-antibody technic showed low levels of serum TSH by radioimmunoassay in the presence of antibodies.

Animals↗
PubMed1978

Hypertrophic Riedel's lobe of the liver.

Riedel's lobe, noted on 99mTc-sulfur colloid liver scintigraphy, was present in 86 (3.3%) of 2604 patients reviewed. Hypertrophied Riedel's lobe was found in 30 cases of which 25 (83%) were females and 5 (17%) were males. Liver scintigraphy will detect the presence of a hypertrophied Riedel's lobe and is recommended in all cases of right sided abdominal masses.

Abdominal Neoplasms↗