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Biomedical subjects

R C Monson

Publications and source records attributed to R C Monson.

6 recordsLinked to original sources
PubMed1987

1-Desamino-8-D-arginine vasopressin (desmopressin) decreases operative blood loss in patients having Harrington rod spinal fusion surgery. A randomized, double-blinded, controlled trial.

To evaluate the effect of 1-desamino-8-D-arginine vasopressin (desmopressin) on blood loss in surgery, we conducted a randomized, double-blind trial of the drug in 35 patients with normal hemostatic function who were having spinal fusion with Harrington rod instrumentation. Seventeen patients were designated to receive 10 micrograms/m2 of desmopressin, and 18, to receive a placebo. Preoperative testing showed that desmopressin increased factor VIII coagulant activity, von Willebrand antigen concentrations, glass bead platelet retention, and prothrombin consumption and decreased the partial thromboplastin and bleeding times (p less than or equal to 0.0003). During surgery, desmopressin reduced blood loss by 32.5% (547 mL; 95% confidence interval [CI], 19 to 1075; p = 0.015) and reduced the need for concentrated erythrocyte transfusions by 25.6% (0.86 units; 95% CI, 0.08 to 1.65; p = 0.022). After surgery, desmopressin reduced the duration of treatment with analgesic agents by 13.1% (34.0 hours; 95% CI, -5.2 to 72.7; p = 0.105), presumably by decreasing bleeding in the surgical wound. When adjusted for the origin of the scoliosis by two-way analysis of variance, this effect was even more evident (p = 0.014). Multiple regression analysis showed that the best three predictors of blood loss in surgery and transfusion requirements were the bleeding time, glass bead platelet retention, and the use of desmopressin.

Adolescent↗
PubMed1982

The significance of cytoplasmic chondrocyte inclusions in multiple osteochondromatosis, solitary osteochondromas, and chondrodysplasias.

Lesions from two patients with multiple osteochondromas and from three patients with solitary osteochondromas were studied. The histologic and ultrastructural features in both conditions were identical. The chondrocyte population in osteochondromas resembled those in normal hyaline cartilage but the cells in osteochondromas exhibited an accumulation of granular and filamentous materials within markedly dilated cisterns of ergastoplasm. These accumulations formed eosinophilic cytoplasmic inclusions which did not stain with Alcian blue, but were PAS positive after diastase digestion. Chondrocytic inclusions of similar or diverse morphology are found in a number of chondrodysplasias. The findings suggest that the solitary osteochondromas, like the lesions of multiple osteochondromatosis, share a common morphologic feature with the chondrodysplasias.

Cartilage↗
PubMed1980

Vein reconstruction of a mycotic internal carotid aneurysm.

Carotid aneurysms are an extremely rare entity; mycotic carotid aneurysms are even more uncommon. Most articles in the past have advocated ligation as treatment of mycotic carotid aneurysms due to the dangers of graft placement in an infected field. Unfortunately, stroke occurs in many patients so treated. As the cerebral complications were so high, bypass using autogenous vein and fine monofilament polypropylene sutures is attractive. This technique was used in a patient having a mycotic carotid aneurysm who was referred to the Vascular Service of the Shands Teaching Hospital. Pre- and postoperative antibiotics, resection of the aneurysm, anastomosis in a noninfected area, and long-term oral antibiotics were felt to be other important aspects of the patient's treatment. This individual is well one year after operation without neurological sequelae. This case suggests that if strict operative and therapeutic guidelines are observed, bypass with autogenous vein is a feasible operative alternative in patients having mycotic carotid aneurysms. The risk of this procedure must be carefully weighed against the devastating neurological sequellae that might result with ligation.

Aged↗
PubMed1977

Serum polyamine and octopamine changes following partial hepatectomy and portacaval shunt.

Factors influencing hepatic regeneration following major hepatic resection are poorly understood and often may be modified by associated surgical procedures. Experimental and clinical evidence would suggest that hepatic regeneration may be impaired following hepatectomy performed in conjunction with portacaval shunting. A patient is described who offered a clinical situation in which it was possible to evaluate the effects of complete portal-venous diversion on hepatic regeneration following massive hepatic resection. The usefulness of biogenic amines as a monitor of the course of hepatic regeneration is demonstrated. The potential development of hepatic encephalopathy was evaluated by serial determinations of serum ammonia and the biogenic amine, octopamine, which correlated well with the patient's clinical state.

Ammonia↗
PubMedDate not supplied

Acquired spondylolysis after posterolateral spinal fusion.

A case of spondylolysis occurring immediately above a posterolateral lumbar spinal fusion in a 12-year-old girl is described. This case illustrates a potential problem of stress concentration at the pars interarticularis, previously only described after posterior interlaminar fusion.

Child↗