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Biomedical subjects

R M Vance

Publications and source records attributed to R M Vance.

6 recordsLinked to original sources
PubMed1980

Multiple extremity amputations in hypotensive patients treated with dopamine.

Dopamine hydrochloride has been established as effective in the treatment of hypotension and shock in patients with adquate blood volume. The physiological response is dose related. Administration of more than 10 microgram/kg/min results in alpha-receptor stimulation and vasoconstriction, and peripheral extremity ischemia has been reported. Four patients treated with dopamine subsequently had the development of peripheral ischemia and gangrene, resulting in the need for multiple extremity amputations. These reactions represent a major complication of treatment.

Aged↗
PubMed1980

Dupuytren's contracture. An electron microscopic, biochemical, and clinical correlative study.

Fascial specimens were obtained from twenty-four patients treated operatively for Dupuytren's contracture. The nodules and cords were examined by electron microscopic and biochemical techniques. The clinical course and response to operative treatment were then correlated with the tissue findings. Electron microscopic analysis revealed myofibroblasts in the nodules of seven of twenty-four patients. Fibroblasts containing prominent microtubules were found in ten patients. The fascia contained type-III collagen, increased amounts of collagen per unit of dry weight, and an increase in reducible cross-links of collagen. While the nodules were noted to contain a greater increase in reducible cross-links than the cords, there was little variation in the biochemical findings from patient to patient. Clinical recurrence was not related to the age of the patient at onset, duration, or severity of disease. Recurrence was related to the electron microscopic findings of myofibroblasts in the nodules and fibroblasts containing prominent microtubules in the fascia of these patients.

Aged↗
PubMed1979

Fractures at the base of the thumb: treatment with oblique traction.

Oblique traction on the thumb metacarpal, originally described for the treatment of Bennett's fracture, has been applied to comminuted intra-articular fractures of the thumb metacarpal to counter the forces that cause shortening and varus angulation. It also has been applied to fractures of the trapezium to restore congruity of the trapeziometacarpal joint. It was successful in achieving and maintaining a satisfactory reduction in eight patients with these three types of fractures.

Evaluation Studies as Topic↗
PubMed1978

Acute ulnar neuropathy with fractures at the wrist.

Injury to the ulnar nerve associated with or following a fracture at the wrist is unusual. Three cases of this association are presented. Previously reported cases have been reviewed. The associated lesions tend to occur in young adults after higher-energy trauma and more dorsal displacement of the distal radial fragment than are generally seen in patients with Colles fractures. The return of function in the three wrists was related to the promptness and accuracy of reduction of the fracture and to the decompression of the ulnar nerve in Guyon's canal. We present a regimen for treatment of this injury stressing accurate reduction of the fracture and early surgical decompression when necessary.

Adult↗