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Biomedical subjects

R B Welch

Publications and source records attributed to R B Welch.

At least 55 records · Page 3Linked to original sources
PubMed1983

The rationale for primary hemiarthroplasty in the treatment of fractures of the femoral neck in elderly patients.

In summary, we believe that hemiarthroplasty in the treatment of displaced fracture of the femoral neck in elderly persons is a rational procedure (Fig. 3-4). It carries no greater morbidity or mortality rate and may even decrease these parameters when modern medical technology is employed. In the long run it would appear that greater than 90% of the prostheses are serviceable for the duration of the patient's life.

Aged↗
PubMed1982

Drinking history and sex of subject in the effects of alcohol on perception and perceptual-motor coordination.

Previous investigations of the effects of alcohol on eye-hand coordination have failed to assess the degree to which each of the individual components of this task--vision and proprioception--is affected by the drug. Such a "microanalysis" was performed in the present experiment in the context of a prism adaptation paradigm, as well as tasks involving mirror tracing and dart throwing. Twenty male and 20 female subjects were divided into equal subgroups of "heavy" and "light" drinkers. In the prism adaptation situation each subject was tested on three tasks--visual straight ahead (the visual task), pointing straight ahead (the proprioception task), and visual target pointing (the visuomotor coordination task)--before and after ingestion of either an alcoholic or nonalcoholic beverage. Measures of adaptation to 11-degree prismatic displacement were also obtained. Little evidence for interactive effects between subject's sex or drinking history and alcohol was obtained. However, there was a tendency for alcohol to retard prism adaptation and to affect the felt position of both manual limbs as well as apparent visual direction. In addition, alcoholic intoxication impaired performance on the mirror-tracing task but, surprisingly, had no effect on dart throwing.

Adolescent↗
PubMed1982

Proximal femoral fractures following total hip arthroplasty.

Thirty-one postoperative fractures around the femoral component of previous total hip arthroplasties were reviewed retrospectively until healing occurred. This type of injury seemed to be associated with either high-velocity trauma or weakening of bony stock secondary to stress risers from prior surgery or loosening. These fractures were classified as Type A at the stem tip, Type B spiralling around the stem, and Type C comminuted around the stem. Type A fractures have a significant incidence of nonunion in the face of multiple previous proximal femoral surgeries, but, after healing, usually show no loosening. Type B fractures usually will heal without operative intervention but have a high incidence of associated eventual component loosening. Type C fractures need immediate surgery to allow mobilization of the elderly patient. When postfracture revision surgery with long-stem component or plating is required, the technical order of priority should be adequate bony apposition of fracture fragments, good cement technique at the proximal femur, bone grafting.

Adult↗
PubMed1982

Retinal breaks without detachment: natural history, management and long term follow-up.

A group of patients with retinal breaks without detachment were analyzed. They were divided into a treatment and a nontreatment group. The treatment group consisted of cases that the authors felt to be at high risk for the development of retinal detachment. Most of these were cases of horseshoe tears following the onset of an acute posterior vitreous detachment. Although a number of modalities were used in the treatment, a transconjunctival cryotherapy approach with topical anesthetic drops is currently used and was the most frequently employed. It is of note that while no case in this series developed a detachment because of inadequate treatment of the original tear a certain number did develop new tears and detachments. This would speak for a frequent follow-up, especially within the first three months following treatment, to anticipate such an occurrence. In the untreated group there were essentially two types of patients. One was the asymptomatic patient in which a retinal tear was found on routine examination and the other was the symptomatic patient with a round hole with pulled out operculum. New tears and or detachments also occurred in the asymptomatic group (4 of 72 eyes) but none of the round holes with pulled out opercula detached. Complications of treatment were related to the anesthesia and included vasovagal reactions and retrobulbar hemorrhage. One case seen in consultation had evidence of scleral perforation from a bridle suture and illustrates the inherent danger in any ophthalmic ocular procedure. The question of macular pucker (pre-retinal fibrosis) as a high risk of treatment is not shown by this study and in fact was more common in the untreated group than the treated group; however the vision of patients with macular pucker in the treated group was generally less than that of those untreated. Recurrent vitreous hemorrhage from bridging or avulsed vessels represented a significant problem following treatment and led to the only case of total visual loss in this study. The prophylactic treatment of acute horseshoe tears with continuing vitreous traction significantly reduces the incidence of subsequent retinal detachment. Whatever method of treatment is chosen by the surgeon, he must follow the principles laid down many years ago by Jules Gonin and completely close the tear. However, it is important to recognize that a new tear or detachment may occur in some cases and seems related to the continuing evolution of the posterior vitreous detachment or residual vitreo-retinal adherence rather than a cause of the treatment itself.

Adult↗
PubMed1980

Spontaneous anterior chamber hemorrhage from the iris: a unique cinematographic documentation.

A 54-year-old white female was observed with an apparent spontaneous idiopathic anterior chamber hemorrhage from the pupillary border of the iris. This event was documented by cinematography. A review of the literature concerning anterior chamber hemorrhage is presented and reports of spontaneous hyphema enumerated. The relationship of the entity of pupillary vascular tufts to the present report are discussed and etiologic factors considered. It is apparent that closer scrutiny of the pupillary border should be performed and iris angiography obtained in a variety of eyes to delineate normal and abnormal variants.

Cineradiography↗
PubMed1979

Fenestrated sheen macular dystrophy. A new autosomal dominant maculopathy.

A new, slowly progressive, autosomal dominant macular dystrophy was found in five patients from three generations of a family, with follow-up for long as 27 years. The mild functional abnormalities of this dystrophy were roughly correlated with age; in the sixth decade of life, paracentral scotomatous areas were noted. The earliest ophthalmoscopic findings were present in a 4-year-old and consisted of a yellowish refractile sheen with red fenestrations within the sensory retina of the macula. By the third decade, an annular zone of hypopigmentation of the retinal pigment epithelium (RPE) appeared around the area of the sheen and progressively enlarged. Surrounding the annular zone of hypopigmentation and at its center was slightly hyperpigmented RPE (bull's-eye lesion). Fluorescein angiography showed no abnormalities in the sensory retina and intact perfusion of choriocapillaris.

Adult↗
PubMed1978

Retinitis pigmentosa and exudative vasculopathy.

A patient with bilateral retinitis pigmentosa and exudative vasculopathy was initially seen with a blind and painful left eye, which was enucleated. Results of clinical study of the right eye and histopathologic and ultrastructural study of the enucleated left eye showed the abnormal vessels to be derived from the choroidal circulation. Previous clinical reports of retinitis pigmentosa with exudative vasculopathy have described retinal vascular abnormalities similar to those found in Coats' disease. From the comparison of our case with those previously reported, we conclude that different types of exudative vasculopathy may develop in the setting of retinitis pigmentosa.

Adolescent↗
PubMed1978

Amelanotic small flat lesions of the choroid.

On routine examination, three patients demonstrated yellow-white lesions in the posterior third of the fundus. These lesions have a subtle but unique appearance. They are in the choroid and have definite borders, minimal or no elevation, a lack of secondary changes in the overlying pigment epithelium or neuroepithelium, and no pigment within the lesion or at its borders. Ophthalmoscopic and fluorescein angiographic data permit discussion of the differential diagnosis of these lesions. They may represent amelanotic nevi of the choroid.

Adolescent↗
PubMed1977

Bilateral retinal hemorrhages and disk edema in migraine.

A 27-year-old patient with severe migraine developed bilateral disk edema and retinal hemorrhages during a prolonged attack of his illness, lasting at least two months. The combination of bilateral disk edema and diffuse superficial retinal hemorrhages was considered to be a manifestation of prolonged valsalva efforts accompanying the migraine attack and of not persistent raised intracranial pressure.

Adult↗
PubMed1977

Fluorescein angiography in sickle-cell retinopathy and von Hippel-Lindau disease.

Fundus involvement in sickle-cell-hemoglobin C disease and von Hippel-Lindau disease was ascertained by clinical observation with the benefit of indirect ophthalmoscopy. Fluorescein angiography, however, has added new dimensions to our understanding of early lesions in these entities, the morphology of full-blown lesions, and the evaluation of therapeutic efforts to obliterate them. Like so many adjunct studies available to us today in medicine, it does not replace clinical acumen, but enhances evaluation.

Anemia, Sickle Cell↗
PubMed1977

Bietti's tapetoretinal degeneration with marginal corneal dystrophy crystalline retinopathy.

In 1937 Bietti reported a tapetoretinal degeneration with associated corneal deposits at the limbus. The hallmark of the disease was the crystalline characteristics of the retinal spots as well as those at the corneal limbus. Bagolini and Ioli-Spade in 1968 presented a 30 year follow-up on Bietti's cases and presented six additional cases. The present report delas with this entity in Orientals, a Chinese woman and a Japanese man. Corneal and conjunctival biopsy from the female patient revelaed a lipid deposition in both fibroblasts and epithelium. The term "crystalline retinopathy" has been added to the description of this entity since it defines the most characteristic feature of the syndrome.

Adult↗