PubMed HealthSearch

Biomedical subjects

R R Nesbit

Publications and source records attributed to R R Nesbit.

8 recordsLinked to original sources

Current role of cryoamputation.

Cryoamputation or physiologic amputation has been used at our institution for more than 30 years. From 1971 through 1989, 891 major lower extremity amputations were performed in 750 patients. With the use of dry ice or mechanical refrigeration, 320 (36%) physiologic amputations were performed in 292 patients. After physiologic amputation, the initially elevated white blood cell count and temperature decreased. Complications of physiologic amputation were unusual; 3% of patients developed minor freezing above the tourniquet, which did not alter the amputation level, while 1% had purulence at the level of surgical amputation that required delayed stump closure. The overall operative mortality rate in patients who underwent physiologic amputation was 11%, which was equivalent to the rate in patients undergoing primary amputation. Revision was required in 9% of amputations after preliminary physiologic amputation compared with 17% of primary amputations. Physiologic amputation is a simple technique, controls local infection, avoids emergency surgery, and allows for medical stabilization prior to surgery. Amputation revision after physiologic amputation is required less often than after primary amputation, while the mortality rate is comparable to that of patients undergoing primary amputation.

Adolescent

Bilateral internal carotid artery aneurysms.

Two patients were treated for bilateral internal carotid artery aneurysms. One had resection and restoration of continuity on the right side nine years after ligation of the left internal carotid artery. The second had sequential resection and reconstruction of both vessels. Complications of carotid aneurysms include embolization, rupture, and thrombosis. Preferred treatment is resection with reconstitution of the flow. Patients with carotid aneurysms should be investigated for similar lesions on the opposite side. Patients who have had one carotid aneurysm treated should be followed up for the possible occurrence of a contralateral aneurysm.

Adult

Treatment of metabolic alkalosis with intravenous hydrochloric acid.

Severe alkalosis requires aggressive treatment. Twenty patients at the Talmadge Memorial Hospital have been treated for metabolic alkalosis by infusion of dilute hydrochloric acid through a central venous line. The treatment was effective and there were no major complications. Intravenous hydrochloric acid is preferred to other modes of therapy for refractory alkalosis, especially in the presence of hepatic or renal failure.

Adolescent

Mesenteric venous thrombosis and oral contraceptives.

Reported is a case of mesenteric venous thrombosis occurring in a 46-year-old woman who had taken an oral contraceptive for six years. Seventeen cases of mesenteric venous thrombosis have been reported in young women taking oral contraceptives. An association between oral contraceptive agents and mesenteric venous thrombosis is suggested.

Contraceptives, Oral

72 kidney transplants at the Medical College of Georgia 1968-1976.

Seventy-two kidneys have been transplanted-47 from related donors, and 25 from cadaver donors-into 63 recipients. No donor died or experienced a complication requiring more than one extra week of hospitalization. Six recipients died. Three of the six recipients died from complications. Two of the six died only because they declined to resume hemodialysis, and one died in prison of unusual circumstances after seven and one-half years of good health and kidney function. Five patients are surviving by virtue of a second transplant. Eight patients are now on hemodialysis. Seven patients with transplants are not in excellent physical health and five other patients with excellent health and renal function are nonetheless frequently depressed and easily upset over minor physical disabilities. A majority of the recipients have been rehabilitated to a gratifying extent.

ABO Blood-Group System

Leiomyosarcoma of a vein: survival for six years.

A 7-year old girl with leiomyosarcoma of the femoral vein is alive without evidence of recurrence six years after radical resection. This is, to our knowledge, the longest survival recorded of a patient with this condition.

Child