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Biomedical subjects

M E Sesto

Publications and source records attributed to M E Sesto.

7 recordsLinked to original sources
PubMed2005

Short-term changes in upper extremity dynamic mechanical response parameters following power hand tool use.

Dynamic mechanical response parameters (stiffness, damping and effective mass), physiological properties (strength and swelling) and symptoms of the upper limb were measured before power tool operation, immediately following and 24 h after power tool operation. Tool factors, including peak torque (3 Nm and 9 Nm) and torque build-up time (50 ms and 250 ms), were controlled in a full factorial design. Twenty-nine inexperienced power hand tool users were randomly assigned to one of four conditions and operated a pistol grip nutrunner four times per min for 1 h in the laboratory. Isometric strength decreased immediately following tool use (15%) (p < 0.01) and 24 h later (9%) (p < 0.05). Mechanical parameters of stiffness (p < 0.05) and effective mass (p < 0.05) were affected by build-up time. An average decrease in stiffness (43%) and effective mass (57%) of the upper limb was observed immediately following pistol grip nutrunner operation for the long (250 ms) build-up time. A previously developed biomechanical model was used to estimate handle force and displacement associated with the tool factors in the experiment. The conditions associated with the greatest predicted handle force and displacement had the greatest decrease in mechanical stiffness and effective mass, and the greatest increase in localized discomfort.

Adolescent↗
PubMed1992

Cephalic vein grafts for lower extremity revascularization.

From 1980 to 1989 infrainguinal revascularization was performed with cephalic vein grafts in a consecutive series of 34 patients (35 limbs) whose saphenous veins were either inadequate or already had been harvested for previous coronary (N = 16, 47%) or ipsilateral lower extremity bypass (N = 19, 56%). Surgical indications included ischemic rest pain or focal tissue necrosis in 25 limbs (71%), disabling claudication in six (17%), and popliteal aneurysms or prosthetic femoropopliteal graft infections each in two (6%). Preliminary arteriovenous fistulas were constructed in the arms of 23 patients (68%) to enhance the diameter of their cephalic veins, and 24 (69%) of the 35 infrainguinal procedures in this series were performed with use of cephalic vein alone. The distal popliteal artery was used for the outflow anastomosis in 10 limbs (29%), a tibial vessel was used in 12 (34%), and the peroneal artery was used in 13 (37%). Fourteen graft occlusions (40%) and six amputations (17%) have occurred during follow-up intervals of 1 to 107 months (mean, 28 months; median, 27 months). At 3 years the cumulative primary patency rate is 40%, the secondary patency rate is 46%, and the limb salvage rate is 82%. Despite their relative inconvenience, cephalic vein grafts appear to be preferable to prosthetic materials for infrainguinal revascularization below the knee.

Adult↗
PubMed1987

Hepatic resection in 128 patients: a 24-year experience.

The records of 128 patients who underwent hepatic resection at the Cleveland Clinic Foundation between 1960 and 1984 were reviewed. Sixty patients (47%) had major resections and 68 patients (53%) had wedge or segmental resections. One hundred five patients had malignant tumors; 29 were primary liver tumors and 78 were metastatic (61 from a colorectal primary). Twenty-three patients had benign hepatic tumors. The overall operative mortality rate was 7% (7.6% for malignant tumors and 4.3% for benign lesions). Survival rate after resection of a hepatocellular carcinoma (22 patients) at 3, 5, and 10 years was 50%, 33%, and 12%. Survival rate after resection of colorectal metastases at 3, 5, and 10 years was 44%, 28%, and 21%. Overall survival was better for patients who were less than 56 years of age (p = 0.003) and for patients with no tumor at the line of resection (p less than 0.001). In patients with colorectal metastases, survival after wedge or segmental resection was better than after a major anatomic resection (p = 0.004). In these patients, the number or size of the metastases, the time interval between resection of the primary tumor and of the hepatic metastases, and/or the presence of mesenteric lymph node metastases were not significant. Most patients with primary malignant tumors require major hepatic resection. Patients with benign tumors and metastatic colorectal carcinomas require resection only to the extent that the tumor is sufficiently encompassed.

Adolescent↗