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Biomedical subjects

D A Gibson

Publications and source records attributed to D A Gibson.

At least 37 records · Page 2Linked to original sources
PubMed1978

Long-term follow-up of triple arthrodesis.

Thirty-seven children in whom 46 triple arthrodeses had been performed were followed up for 19 to 33 years (average, 24 years). Better results were evident in patients who had been operated on because of poliomyelitis, pes cavus or pes planus than in patients operated on for club foot, cerebral palsy or spina bifida. The use of staples appeared to improve the result. A neutral position of the heel is desirable. Varus positions required revision in three patients. A heel-toe gait was noticeable in 74% of patients. Osteoarthritis occurred 24% and pseudarthrosis in 4% of our patients. In 91% of patients the functional result could be described as good or excellent.

Adolescent↗
PubMed1977

Monoamine oxidase activity in cultured human skin fibroblasts.

Skin fibroblast cultures were prepared from 21 men, and found to contain types A and B activity of monoamine oxidase, with a possible slight predominance of type A, as evaluated by substrate preferences and differential inhibition by clorgyline and deprenyl. Three women had similar activities. There was a close correlation of activities with different substrates, but there was no quantitative correlation between fibroblast and blood platelet enzyme (type B) activities. The fibroblasts also contained catechol-O-methyltransferase activity exceeding, but poorly correlated with, that in erythrocytes. Fibroblasts may be advantageous in studies of monoamine oxidase in man by providing both types of enzyme as found, for example, in the central nervous system, and by providing a means of removing many in vivo chemical influences from the cells in culture. Nevertheless, great caution must be exercised in generalizing results of this "model" to other tissues, since activities of both enzymes correlated poorly with those in blood cells of the same individuals.

Blood Platelets↗
PubMed1976

The patterns of spinal deformity in Duchenne muscular dystrophy.

In a clinical and roentgenographic study of spinal deformities in sixty-two patients in the later stages of Duchenne muscular dystrophy, many patients had marked scoliosis and kyphosis, while others with hyperextended spines had comparatively little scoliosis. Based on an analysis of the data, it is suggested that the development of spinal deformity in patients with Duchenne muscular dystrophy may progress in two ways: one leading to the early establishment of a position of extension and a maximum intrinsic stability with minor deformity, and the other leading to progressive deformity. It was concluded that management for these patients should be designed to guide the early straight spine toward the late extended pattern by attempting to prevent kyphosis and pelvic obliquity.

Adolescent↗
PubMed1976

The orthopaedic aspects of spinal muscular atrophy.

To clarify the role of the orthopaedic surgeon in the management of spinal muscular atrophy, the records of 130 patients were reviewed. Seventy-three had died. Of the remaining fifty-seven, fifty were re-examined. The clinical manifestations of the disease, particularly those giving rise to orthopaedic problems, were studied. At the time of review the average age of the patients was 11.5 years. Thirty-five could not walk and all had some degree of muscle weakness, more marked proximally and in the lower limbs. The most common medical problem was repeated respiratory infection and the major orthopaedic problem was scoliosis, often severe. Nine of the thirty-five patients with scoliosis had had spine fusion. Most of them suffered some functional loss in attaining spinal stability.

Adolescent↗
PubMed1975

Role of the wheelchair in the management of the muscular dystrophy patient.

During the postambulatory period, patients with pseudohypertrophic muscular dystrophy depend entirely on their wheelchairs for comfort and spinal support. Without the comfort they are unable to enjoy and participate in every waking activity; without the spinal support they are destined to accept a bedbound life, not so much by the actual weakness as by the progression of spinal deformity. Present-day wheelchairs are not comfortable and they do not provide adequate spinal support. A novel spinal support system (brace) has been prescribed for 50 patients during the last 24 months. It consists of a contoured seat, mounted on a modified wheelchair frame, with integral armrests, footrests and headrest. All patients are clearly more comfortable and spend between 9 and 14 hours a day in their special wheelchairs, compared with 2 to 3 hours at a time in standard wheelchairs. Parents, teachers and therapists have reported a definite improvement in the attitudes of these patients. Although we have measured no progression in spinal deformity and have recorded regression in a few patients, we cannot yet assess the final value of this promising method of support in preventing spinal collapse.

Braces↗
PubMed1975

Cell rigidity: Effect on concanavalin A-mediated agglutinability of fibroblasts after fixation.

A quantitative hemadsorption assay distinguishes the effects of membrane fixation on concanavalin A-mediated agglutinability of fixed cells with unfixed cells. We observed undiminished adherence of unfixed erythrocytes to glutaraldehyde-fixed normal and virus-transformed hamster fibroblasts coated with concanavalin A. Fixation of the erythrocytes abolished agglutination with fixed fibroblasts. The agglutinability of fixed cells is more likely related to increased cell rigidity than to decreased membrane fluidity.

Agglutination↗
PubMed1975

The management of spinal deformities in Duchenne muscular dystrophy. A new concept of spinal bracing.

A clinical study of 62 patients with Duchenne Muscular Dystrophy has suggested 2 pathways in the pathogenesis of the spinal deformities. In the first pathway, the patients develop an initial kyphosis due to the loss of paravertebral muscle thus placing the intrinsic ligamentous spine in an unstable position. The spine then develops a lateral curve accentuated by pelvic obliquity. In the final form, axial rotation of the spine and pelvis occurs to produce a severe deformity. In the second pathway the intrinsic spine assumes the more stable position of hyperextension with a level pelvis. This position remains relatively unchanged during the period of wheelchair confinement even though muscle deterioration progresses. A significant increase in the severity of the deformity occurs with age in those patients with unstable spines. None of the other factors examined affected the severity of the lateral curvature. A spinal brace has been designed to keep the spine extended and the pelvis level while the patients sits in his wheelchair. The purpose is to encourage the inexorable progression of muscular deficiencies to follow the second pathway. Various modifications of wheelchairs also may help to maintain spinal stability.

Activities of Daily Living↗