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Biomedical subjects

C Smith

Publications and source records attributed to C Smith.

At least 1,207 records · Page 67Linked to original sources
PubMedDate not supplied

Intermediate follow-up of a simple method of hip arthrodesis in adolescent patients.

Thirteen male patients (average age, 15.6 years) underwent intraarticular hip arthrodesis for unilateral disabling hip disease. Follow-up averaged 6.6 years. Seven patients had excellent or good Harris hip scores. Ten patients had low back pain, and seven patients had knee pain on the side of the fused hip. Limb-length discrepancy averaged 3.7 cm. A progressive hip adduction drift (average, 7 degrees) occurred during follow-up. Patients whose hips were fused in a position of 20-25 degrees flexion and whose limb-length discrepancies were < 2 cm had significantly lower incidences of back pain. Cybex muscle testing revealed significantly decreased quadriceps strength (29%) on the hip-fusion side. Gait laboratory analysis demonstrated decreased velocity, stride length, and cadence. There were two mildly symptomatic nonunions. Based on these results, we recommend that the hip fusion be positioned in 20 degrees flexion and 0 degree abduction. The joint must be completely debrided down to viable bone to maximize chances for union. Maintaining a limb-length discrepancy of < 2 cm is essential to minimize the incidence of low back pain, quadriceps deficiency, and abnormal gait parameters.

Adolescent↗
PubMedDate not supplied

One course versus two courses of antithymocyte globulin for the treatment of severe aplastic anemia in children.

PURPOSE: The aim of the therapeutic trials was to optimize the treatment of severe aplastic anemia (SAA) and moderate aplastic anemia in children who lack a suitable bone marrow donor, using immunosuppressive therapy in the most effective combination and dose. PATIENTS AND METHODS: Two sequential therapeutic trials for the treatment of severe and moderate aplastic anemia in children were conducted by 10 institutions. The treatment protocols included antithymocyte globulin (ATG), prednisone, and cyclosporine A (CSA); patients entered on the first protocol, 0190 (ATG X 2), were given two courses of ATG, and those enrolled on the second protocol, 0190B (ATG X 1), were given only one course of ATG. Ten patients were evaluable on ATG X 2. All patients had SAA; three had hepatitis-induced severe aplastic anemia (HI-SAA). Twelve patients were evaluable on ATG X 1; all had SAA, one of whom had HI-SAA. RESULTS: Seven of 10 patients on ATG X 2 responded, and eight of 12 patients treated on ATG X 1 responded. CONCLUSION: Treatment with immunosuppressive therapy using ATG, CSA, and prednisone was very well tolerated. The response rates in both protocols were similar, and results compare favorably with those of previous therapeutic trials, suggesting that a second course of ATG is not necessary.

Adolescent↗
PubMedDate not supplied

Both-bone midshaft forearm fractures in children.

To determine whether closed treatment of both-bone midshaft forearm fractures routinely results in acceptable clinical outcome for children less than 16 years of age, we retrospectively studied all such patients treated at our two hospitals between 1970 and 1982. All children less than 10 years of age at the time of fracture had excellent results. Of 14 patients between the ages of 10 and 16 years, closed treatment failed in nine. We conclude that the incidence of poor results from closed treatment of the fractures in children greater than 10 years of age is seriously underestimated.

Adolescent↗
PubMedDate not supplied

Surface charge of red blood cells in insulin-dependent diabetic patients with incipient and overt nephropathy.

The negative surface charge of red blood cells was studied in adults with insulin-dependent diabetes mellitus, using a chemical assay based on the binding of the cationic dye Alcian-blue 8GX to anionic sites on the cell surface. Twenty-one healthy non-diabetic adults, 21 normo-albuminuric diabetic patients, 25 diabetic patients with incipient nephropathy, and 19 diabetic patients with overt nephropathy were studied. The diabetic patients were matched for age, duration of diabetes, and glycaemic control. The red cell surface charge was nearly identical in the four groups studied. Our study does not suggest that loss of membrane negative charge is a generalized phenomenon in insulin-dependent diabetic patients with albuminuria.

Adolescent↗
PubMedDate not supplied

Eccrine angiomatous hamartoma: report of three patients.

Eccrine angiomatous hamartoma is a rare, benign entity. The histologic features include proliferation of eccrine sweat glands and angiomatous capillary channels. We report three children who each had a single lesion on a limb. These lesions were clinically angiomatous, and we obtained the diagnosis by histologic and immunohistochemical studies.

Capillaries↗
PubMedDate not supplied

Noel's resurrection.

Explore the source record for details and available documents.

Amputees↗
PubMedDate not supplied

Instrumentation problems with implanted neuroaugmentive devices.

An analysis of the technical problems encountered in the implantation of 218 neurostimulation systems during the period 1971--1977 is reviewed. Multiple transmitter and antenna failures were seen. The most significant failures involved lead conductors and/or insulation in the internal portion of the system. The failures seen often required surgical revision. The observed incidence of lead wire failure appears to increase in relation to age of the devices. This survey indicates that significant material and design changes in the neuroaugmentive devices surveyed are necessary.

Electric Stimulation Therapy↗
PubMedDate not supplied

Silver sulphadiazine: a comprehensive in vitro reassessment.

The antimicrobial activity of silver sulphadiazine has been determined agonist 409 strains from 12 different genera. MICs were usually in the range 16-64 micrograms/ml. Multi-resistant species, such as methicillin-resistant Staphylococcus aureus and Acinetobacter spp., were uniformly sensitive. MICs always exceeded the reported aqueous solubility of silver sulphadiazine. No resistant strains were found, and there was no correlation between MIC of silver sulphadiazine and resistance to sulphonamides. Time-kill experiments showed that sulphonamide-resistant S. aureus (but not Staphylococcus epidermidis) were killed significantly more slowly than were sulphonamide-sensitive strains.

Acinetobacter↗
PubMedDate not supplied

In utero fetal urine analysis and renal histology correlate with the outcome in fetal obstructive uropathies.

We evaluated 8 second-trimester fetuses who had undergone termination because of obstructive uropathies and correlated the renal histopathology with fetal urine biochemical prognostic parameters. Prenatal evaluation included serial vesicocentesis, karyotyping, and sonography. According to the urinary biochemical parameters, 3 fetuses were classified to be in the good prognostic category, 2 in the borderline prognostic category, and 3 in the poor prognostic category. The kidneys were evaluated both grossly and microscopically for hydronephrosis, pelvicaliceal dilatation, cystic changes and fibrosis. Fetuses in the poor prognostic category had severely damaged renal architecture, microcysts, macrocysts, and extensive fibrosis. Fetuses in the good prognostic category had minimal histopathologic changes with preservation of the architecture. Fetuses in the borderline category showed a moderate degree of renal damage but with focally preserved architecture. We conclude (1) that there is a direct correlation between elevation in urinary electrolytes and proteins and extent of underlying renal histopathological damage and (2) that appropriate detailed prenatal evaluation of the renal function can identify fetuses who could potentially benefit from in utero therapy.

Calcium↗
PubMedDate not supplied

Reference values for serial vestibular testing.

This study defines the normal limits of day-to-day variation in vestibular function. A short-acting caloric test was used and nystagmus intensity was measured by means of an interactive computerized technique. Data were analyzed from 30 normal subjects tested on three successive days and from ten of these subjects who were also tested on 11 additional occasions. Individual caloric test scores generally remained between 55% and 170% of their initial value; narrower ranges resulted when scores were averaged together. There was very little habituation of caloric responses. The upper normal limits of test-retest variation in scores for right-left difference and directional preponderance of caloric responses were 24% and 22%, respectively.

Caloric Tests↗
PubMedDate not supplied

Correlation of tumor volume with local control in laryngeal carcinoma treated by radiotherapy.

An analysis of 37 patients with laryngeal carcinoma (T2 or greater) treated with radical radiotherapy, with surgery reserved for failure, was performed to determine if tumor volume, alone or in association with other prognostic factors, accurately predicted the probability of local control. Patient records were reviewed retrospectively and the following data extracted: age, sex, laryngeal region and number of sites involved by tumor, T and N categories, and success or failure of radiotherapy. Tumor volume for each patient was calculated from pretreatment computed tomograms by summing the products of the cross-sectional tumor area on each CT cut and the interval in millimeters between sequential CT cuts. The mean tumor volume for patients failing radiotherapy was 21.8 cm3, and the mean volume for patients primarily controlled by radiotherapy was 8.86 cm3. Tumor volume significantly predicted disease-free interval (p = .045) and outcome with radiotherapy (p = .02). The study suggests that tumor volume is a significant factor in determining the outcome of primary radiotherapy in advanced laryngeal carcinoma.

Adult↗
PubMedDate not supplied

Experience of HIV disease in a London District General Hospital.

The aim of this paper is to describe and discuss the experience of HIV disease in Central Middlesex Hospital, London up to June 1993. A retrospective study of the total number of HIV-positive patients cared for was performed. In addition, prospectively collected data as part of local epidemiological surveillance from January 1987 to June 1993 on all HIV test requests was analysed. Between January 1987 and June 1993 3695 individuals were tested for HIV-1 antibody at Central Middlesex Hospital. Of these, 101 HIV-1 seropositive individuals were identified and have attended this District General Hospital. Seven HIV-1 seropositive individuals were identified from before December 1986. Sixty (56%) had acquired their infection heterosexually. Thirty-eight (35%) originated from the UK and 47 (44%) from sub-Saharan Africa; the remaining 23 (21%) originated from the rest of Europe, South America and the Caribbean. Thirty-four (31%) of the patient group developed AIDS during follow-up at the hospital and in 26 individuals AIDs developed within 2 months of their first positive HIV result. The mean survival of 20 patients after AIDS-defining diagnoses was 7 months 18 days. This unselected group of HIV-1 seropositive patients present late in the course of their HIV disease and survival following AIDS is poor.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Congenital vertical talus.

This series consisted of 15 congenital vertical tali in 12 patients, 11 of which were treated surgically and the remainder conservatively. Conservative treatment (casting alone) yielded poor results in three of four feet, while the results in the surgical group were four good, six fair, and one poor at an average follow-up of 8 years. The surgical procedures included a one-stage release with transfer of the anterior tibial tendon to support the neck of the talus. A Grice arthrodesis was performed either concurrently or within 2 to 4 years. The best results were obtained with early subtalar arthrodesis (Grice) and biplanar K wire fixation. Complications included skin sloughs, avascular necrosis of the talus, and pin tract drainage. Attempts to augment push-off power with tendon transfers were unrewarding.

Ankle Joint↗
PubMedDate not supplied

Monitoring therapy by serum HER-2/neu.

We have evaluated the performance of the Bayer Immuno 1 serum HER-2/neu assay. The precision is excellent and varied between 1.7% and 2.1% at values of HER-2/neu ranging from 16.8 ng/mL to 108.6 ng/mL. In normal women who were followed on a monthly basis the average deviation was 6%. The concentration (mean +/- SD) in normal women was 8.7 +/- 3.2 ng/mL. There was no difference between pre and postmenopausal women. The normal/abnormal cutoff was defined as greater than 15 ng/mL. In normal women and those with benign disease the specificity varied between 95% and 100%. In women with breast cancer the sensitivity was 1.7% in stage I disease, 3.0% in stage II, 16.7 in stage III and 35.5% in stage IV. There were 56 elevations (14.7%) in the total group of 285 women with breast cancer. There was an excellent correlation with a microtitre plate method (r=0.9944). Longitudinal studies showed clearly that women who expressed HER-2/neu in their tissue had elevated serum levels and these levels reflected the clinical course of the patient. More extensive control studies are required to establish the role of HER-2/neu assays in the management of women with breast cancer.

Antibodies, Monoclonal↗
PubMedDate not supplied

Pesticide exports from U.S. ports, 1997-2000.

U.S. Customs records reveal that 3.2 billion pounds of pesticide products were exported in 1997-2000, an average rate of 45 tons per hour. Nearly 65 million pounds of the exported pesticides were either forbidden or severely restricted in the United States; however, no banned pesticide export was recorded for the year 2000. 2.2 million pounds of pesticides regulated under a treaty on persistent organic pollutants (POPs) were exported between 1997 and 1999, with no such export in 2000. Exports of pesticides subject to the prior informed consent (PIC) treaty decreased 97% from the 1997 total of nearly 3 million pounds. Thus, international efforts to reduce the trade in hazardous pesticides may be bearing fruit. However, they are balanced by high rates of export of pesticides designated "extremely hazardous" by the WHO (89 million pounds), pesticides associated with cancer (170 million pounds), and pesticides associated with endocrine disrupting effects (368 million pounds), mostly to developing countries. These findings point in two directions: first, progress is possible, and second, the focus of international efforts should be expanded. From public health and environmental protection perspectives, exports of hazardous pesticides remain unacceptably high.

Animals↗