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Biomedical subjects

P Welsh

Publications and source records attributed to P Welsh.

29 records · Page 2Linked to original sources
PubMedDate not supplied

Abortion in adolescence: a four-country comparison.

The purpose of this study was to conduct a comparison, using qualitative analytic methodology, of perceptions concerning abortion among health care providers and administrators, along with politicians and anti-abortion activists (total n = 75) in Great Britain, Sweden, The Netherlands, and the United States. In none of these countries was there consensus about abortion prior to legalization, and, in all countries, public discussion continues to be present. In general, after legalization of abortion has no longer made it a volatile issue European countries have refocused their energy into providing family planning services, education, and more straightforward access to abortion compared with similar activities in the United States.

Abortion, Induced↗
PubMedDate not supplied

The vacuum arthrogram in the shoulder: correlation with rotator cuff disease.

Plain radiographs of the shoulder can demonstrate a vacuum arthrogram delineating the articular surfaces. In a review of 122 consecutive arthrograms with radiographic contrast injections, there were 25 vacuum arthrograms on the preceding plain films. We have found the presence of a vacuum arthrogram to be an accurate predictor of an intact rotator cuff, with a specificity of 0.98 and a positive predictive value of 0.96.

Humans↗
PubMedDate not supplied

A polar substituent-containing acylation agent for the radioiodination of internalizing monoclonal antibodies: N-succinimidyl 4-guanidinomethyl-3-[131I]iodobenzoate ([131I]SGMIB).

The objective of this study was to develop an acylation agent for the radioiodination of monoclonal antibodies that would maximize retention of the label in tumor cells following receptor- or antigen-mediated internalization. The strategy taken was to add a polar substituent to the labeled aromatic ring to impede transport of labeled catabolites across lysosomal and cell membranes after antibody degradation. Preparation of unlabeled N-succinimidyl 4-guanidinomethyl-3-iodobenzoate (SGMIB) was achieved in six steps from 3-iodo-4-methylbenzoic acid. Preparation of 4-guanidinomethyl-3-[131I]iodobenzoic acid from the silicon precursor, 4-(N1,N2-bis-tert-butyloxycarbonyl)guanidinomethyl-3-trimethylsilylbenzoic acid proceeded in less than 5% radiochemical yield. A more successful approach was to prepare [131I]SGMIB directly from the tin precursor, N-succinimidyl 4-(N1,N2-bis-tert-butyloxycarbonyl)guanidinomethyl-3-trimethylstannylbenzoate, which was achieved in 60-65% radiochemical yield. A rapidly internalizing anti-epidermal growth factor receptor variant III antibody L8A4 was labeled using [131I]SGMIB in 65% conjugation efficiency and with preservation of immunoreactivity. Paired-label in vitro internalization assays demonstrated that the amount of radioactivity retained in cells after internalization for L8A4 labeled with [131I]SGMIB was 3-4-fold higher than that for L8A4 labeled with 125I using either Iodogen or [125I]SIPC. Catabolite assays documented that the increased retention of radioiodine in tumor cells for antibody labeled using [131I]SGMIB was due to positively charged, low molecular weight species. These results suggest that [131I]SGMIB warrants further evaluation as a reagent for labeling internalizing antibodies.

Acylation↗
PubMedDate not supplied

Renovascular hypertension in pediatric patients.

Fifteen pediatric patients (ages 5-17 years) with renovascular hypertension (RVH) are reported. The diagnosis was made by arteriogram in all patients as the intravenous pyelogram was not helpful in this group. Five patients had a coarctation of the abdominal aorta. Four of these had associated renal artery stenosis. Renal artery stenosis alone was present in 14 patients, unilateral in 8, and bilateral in 6. Three of the former had a contralateral hypoplastic kidney. A nephrectomy was performed in 2 patients, both of whom continue to be hypertensive. Renal revascularization was performed in 13 patients; one of these died of sepsis. Eight are normotensive, 2 are improved (normotensive with diuretics), and 2 remain hypertensive. The follow-up is from 1 to 15 years.

Adolescent↗
PubMedDate not supplied

Intraoperative blood measurements following revascularization of the lower extremities with chronic arterial occlusive disease.

We have measured blood flows in 155 limbs with chronic arterial occlusive disease after revascularization procedures. Blood flows were recorded during standard electromagnetic flowmeter techniques. Base line flows after maximal vasodilatation with papaverine were recorded. The most important measurement to determine immediate results was the percentage increase of the basal flow after intraarterial injection of 30 mg papaverine. In aorto-iliac revascularization we found a significant difference according to the outflow tract, whether the superficial femoral was patent or occluded. Grafts in which proximal anastomosis were at the aorta on the axillary artery yielded better flows than those from the opposite femoral artery. A vein graft of inadequate caliber may determine a pressure gradient higher than 10 mm. Hg. In these circumstances the the blood flow is lower. Blood flow measurements may aid in the selection of the adequate surgical procedure in cases of arterial lesions of doubtful significance.

Aortic Diseases↗
PubMedDate not supplied

Fibromuscular dysplasia of the distal cervical internal carotid artery.

Fibromuscular dysplasia of the internal carotid artery is the most frequent extracranial localization of the disease. It can produce TIA or cerebral infarct through formation of fibrinous thrombi or complete occlusion of the artery. Seven cases are presented with disease localized in the distal segment of the carotid artery, usually considered inaccessible through standard exposure. A surgical approach is described to treat these lesions by performing a mandible osteotomy. This allows a resection of the internal carotid and its replacement with autologous saphenous vein graft as performed in six cases. The distal anastomosis was performed 1 or 2 cm. below the base of the skull. One case could not be corrected due to disease extending into the skull. All patients were operated on for TIA and one had a cerebral infarct. Six patients had an uneventful recovery and no further neurological symptoms. One patient had a postoperative hemiplegia. Pathologic specimens were described as fibromuscular dysplasia in all cases. Three of them had also a dissecting aneurysm, two of these also showed a ruptured intima. Intraluminal dilatation is regarded as a potentially risky procedure; resection and replacement through a mandible osteotomy is recommended for very distal internal carotid lesions.

Adult↗