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T Breen

Publications and source records attributed to T Breen.

11 recordsLinked to original sources
PubMed1991

The predictive value of idiopathic failure to fertilize on the first in vitro fertilization attempt.

OBJECTIVE: To investigate the subsequent performance of patients with idiopathic fertilization failure on the first in vitro fertilization (IVF) cycle. DESIGN: A retrospective study of 2,322 consecutive patients undergoing their initial IVF cycle. SETTING: Advanced infertility treatment in an IVF/general infertility clinic. PATIENTS: In 5 years, 94 couples with unexplained failed oocyte fertilization had 270 cycles of treatment. Each couple's performance was tracked through subsequent cycles of treatment. INTERVENTIONS: In vitro fertilization with husband and donor sperm. MAIN OUTCOME MEASURE(S): Investigated retrospectively after 5 years of data collection. RESULTS: Sixty-five couples of the original 94 had a second IVF attempt. Fifty of these successfully fertilized oocytes with husband's sperm and 4 with donor sperm. Nineteen of the 65 couples who continued treatment achieved a pregnancy, and only one couple had continuing fertilization failure. CONCLUSIONS: The prognosis in the study group was surprisingly favorable despite the initial failed IVF treatment cycle.

Adult↗
PubMed1991

Technical considerations in pectoralis major transfer for treatment of the paralytic elbow.

Modification of pectoralis major transfer as originally described by Clark in 1946 have not addressed concerns such as diminished strength and excursion of the transfer, along with obligatory supination of the forearm. Postoperative scarring from the long oblique chest incision further compounds the psychological impairment that accompanies brachial plexopathy. One hundred forty-three brachial plexopathies were seen over a five-year period. Seven pectoralis major transfers were done to restore elbow flexion in patients with C5-6 and C5-6-7 cord injuries. Mean age and follow-up were 26 years and 25 months respectively. The modifications of this transfer we use improve strength and range of motion by preserving dual innervation of the muscle, by tubularization of the transfer, and by restoration of the transverse aponeurosis as a fascial pulley. By transfer of the pectoralis insertion to the acromion, further anterior shoulder stability may be obtained. Aesthetics can also be improved by use of selected midline and deltopectoral incisions, along with preservation of the remaining pectoralis major and minor.

Adult↗
PubMed1988

Massive allograft replacement of hemiarticular traumatic defects of the elbow.

Four elbow osteoarticular allografts were done for four patients as salvage procedures for unreconstructable elbow fracture malunions. With a mean follow-up of 60 months (range, 12 to 72 months) all elbows were stable, free of pain, and had mean motion of 130 degrees active flexion and 27 degrees of flexion deformity, 67 degrees pronation and 62 degrees supination (preoperative mean: 104 degrees flexion, 42 degrees flexion contracture, 20 degrees pronation, and 34 degrees supination). Complications occurred in two elbows. One had a deep infection necessitating graft removal and subsequent regrafting. The second had an olecranon osteotomy nonunion. Elbow allografting is recommended as a salvage procedure for massive posttraumatic articular defects, bone loss, or malunion when neither arthrodesis nor conventional arthroplasty is indicated.

Adult↗
PubMed1986

Effect of increased current, multiple pacing sites and number of extrastimuli on induction of ventricular tachycardia.

Reproduction of spontaneously occurring ventricular tachycardia (VT) and induction of previously undocumented VT were studied prospectively in 98 patients: 48 with documented sustained VT or ventricular fibrillation, 25 with nonsustained or exercise-induced VT, and 25 with no documented VT. Patients received 1 to 4 ventricular extrastimuli and ventricular burst pacing at 2 right ventricular (RV) sites, first at twice late diastolic threshold, and then at 10 mA using a prospective, tandem study design. Spontaneously occurring VT was reproduced in 37 of 48 patients (77%) at twice late diastolic threshold and in 1 other patient (2%) at 10 mA. VT was reproduced at both RV sites in 17 of 48 patients (35%) and at 1 site in 20 of 48 patients (42%) at twice late diastolic threshold. A previously undocumented VT was induced in 7 of 25 patients (28%) with no documented VT at twice diastolic threshold and 14 of 25 patients (56%) at 10 mA. A previously undocumented VT was induced in 33 of 73 patients (45%) with a history of sustained or nonsustained VT at twice late diastolic threshold and in 47 of 73 patients (64%) at 10 mA. In patients with documented sustained VT, the use of up to 4 ventricular extrastimuli at multiple RV sites increases the sensitivity of the test. In patients without documented VT, the induction of previously undocumented VT with more than 3 ventricular extrastimuli limits the specificity of the test. Increased current provides only a slight advantage over 4 ventricular extrastimuli at twice late diastolic threshold in terms of reproduction of spontaneously occurring VT, but leads to a marked increase in induction of previously undocumented VT.

Aged↗
PubMed1985

Posterior tibial artery pseudoaneurysm following tibial fracture. A case report.

The presence of distal pulses is often times misleading and the severity of the fracture roentgenographically is frequently unrelated to the possibility of a vascular injury. Pseudoaneurysms following long bone injuries, although not as commonly seen in blunt as in penetrating trauma, are potentially limb threatening injuries requiring a high index of suspicion and the liberal use of angiography for early diagnosis and repair. A case of a pseudoaneurysm of the posterior tibial artery associated with a grade I open fracture following blunt trauma and a review of the literature concerning arterial injury in blunt trauma are presented.

Adult↗
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