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Biomedical subjects

D M Montgomery

Publications and source records attributed to D M Montgomery.

30 records · Page 2Linked to original sources
PubMed1991

Measurement of optic disc and neuroretinal rim areas in normal and glaucomatous eyes. A new clinical method.

A technique based on indirect ophthalmoscopy has been devised to enable measurement of structures in the posterior pole of the eye. It has been used to measure clinically the maximal and minimal diameters of both the optic disc and cup of 130 normal eyes from 66 patients and 33 optic discs from 20 patients with glaucomatous visual field loss. The disc area and neuroretinal rim area were derived mathematically for each eye. In the normal group the neuroretinal rim area was strongly correlated with the disc area (r = 0.89, P less than 0.0001). Only 9.1% of the glaucomatous group fell within the 95% prediction interval for the normal group, indicating a high degree of sensitivity and specificity for predicting the presence of visual field loss. Discs associated with mild field loss could be discriminated from those associated with moderate or severe field loss on the basis of disc and rim area measurements.

Aged↗
PubMed1991

Cord blood gas patterns identifying newborns at increased risk of group B streptococcal sepsis.

The effect of group B streptococcal sepsis acquired in utero on umbilical cord gas values is not known. Hypothesizing that fetal acid-base balance may be affected, we sought to identify a pattern of cord gas values that might detect newborns at increased risk of group B streptococcal sepsis. This review encompassed all newborns from January 1, 1986 to March 31, 1990 who manifested group B streptococcal sepsis as confirmed by a positive blood culture. An increased-risk cord gas profile was identified as an arterial pH less than 7.18 with either an arterial carbon dioxide pressure less than 59 mmHg or bicarbonate level less than 19 mEq/L. This pattern was found in four of 11 newborns with group B streptococcal disease but in only 43 of 4290 controls, yielding a relative risk of 51.7 (95% confidence interval 13.1-224.9). Our results suggest that a mild metabolic acidosis characterized by these indices may serve as an indicator of increased risk of early-onset group B streptococcal disease.

Apgar Score↗
PubMed1990

Posterior spinal fusion: allograft versus autograft bone.

The effectiveness of allograft bone for posterior spinal fusion in neuromuscular scoliosis is controversial. Thirty patients with cerebral palsy, treated with posterior spinal fusion, were divided into two groups. Group 1 consisted of 18 patients treated by posterior spinal fusion using autogenous bone graft. Group 2 consisted of 12 patients treated by posterior spinal fusion using freeze-dried allograft bone. The average preoperative curve of 70 degrees in Group 1 was corrected to 35 degrees (50% correction). At 3.2 years average follow-up, the curves averaged 51 degrees (46% loss of correction). The average preoperative curve of 80 degrees in Group 2 was corrected to 39 degrees (51% correction). At 3.5 years average follow-up, the curves averaged 54 degrees (38% loss of correction). Anesthesia time decreased from 344 to 281 minutes (p less than 0.05), and intraoperative blood loss decreased from 2730 to 1740 ml (p less than 0.025) when allograft bone was used as a substitute for autograft bone. Freeze-dried allograft bone is a readily available, safe, and effective substitute for autogenous bone graft in patients with cerebral palsy undergoing posterior spinal fusion.

Adolescent↗
PubMed1989

Pupil dilatation with tropicamide. The effects on acuity, accommodation and refraction.

The effect of pupil dilatation with tropicamide 1% on visual acuity and accommodation was assessed in 100 eyes of 52 consecutive patients attending the general ophthalmic outpatient clinic. Snellen visual acuity remained unchanged in 55 eyes and deteriorated by one line in 41 eyes. The remaining four eyes deteriorated by two lines. Tropicamide gave rise to a reduction in the amplitude of accommodation which tended to vary inversely with the age of the patient. However, all patients who wore reading glasses for presbyopia were still able to read when their pupils had been dilated.

Accommodation, Ocular↗
PubMed1989

Cancellous bone donor site regeneration.

Patients requiring cancellous bone grafting of an extensive deficit or multiple grafting procedures often lack a sufficient quantity of autogenous cancellous donor bone. This study was designed to determine the potential for reharvesting autogenous cancellous bone donor sites in a canine model. Fixed-sized cancellous bone grafts were harvested from the ilium of 12 mature, conditioned dogs. Ilia containing the donor sites were removed from groups of 3 dogs at intervals of 6 weeks, 3 months, 6 months, and 1 year. The donor sites were evaluated by roentgenograms, histology, and histomorphometric analysis and were compared to the opposite, nonoperated ilia, which served as controls. The analysis revealed a gradual replacement of the surgical defect with new cancellous bone by 1 year. Donor site reharvesting is a potential alternative to multiple site grafting or the use of allograft material.

Animals↗
PubMed1989

Resolving solitary osteochondromas. A report of two cases and literature review.

Resolving osteochondromas were previously thought to be uncommon. Two cases are presented, including the first report of a resolving solitary osteochondroma of the proximal tibia. These cases, along with previous reports, suggest resolution may occur, especially in boys under age 12 years. Surgical excision should be delayed in this group of patients provided malignant transformation or neurovascular compromise is not a concern.

Bone Neoplasms↗
PubMed1988

Unusual penetrating injury of the knee joint. A case report.

Although not commonly recognized, glass may be radiopaque in soft tissue. Its density can be similar to that of bone, and it may be misinterpreted as fracture fragments. The radiodensity of glass is dependent on its varying quantities of iron, silicon, dioxide, aluminum, calcium, magnesium, and sodium salts. The awareness that the radiodensity of glass can be similar to that of human bone on roentgenogram can help the surgeon avoid the pitfall of misdiagnosis. Roentgenograms may be used to detect intraarticular glass and to assist in a localization of glass imbedded in the soft tissue.

Child↗
PubMedDate not supplied

Palpable unilateral sacral prominence as a clinical sign of lower limb anisomelia: a pilot study.

OBJECTIVE: To examine the role of oblique-axis sacral torsion in the presence of true or apparent short leg. DESIGN: Prospective blind trial of eighteen subjects. SETTING: A suburban chiropractic practice, a hospital and a university campus. SUBJECTS: Of 33 subjects selected, 27 completed the study, 8 exhibited elimination criteria, and 1 X-ray was nondiagnostic. MAIN RESULTS: 3 x 3 contingency table showed the presence of unilateral sacral prominence as statistically significant (p > .001) in subjects with LLI. The incidence of unilateral sacral prominence on the short leg side was also significant (p > .05). Weighted kappa confirmed both (alpha > .001). CONCLUSIONS: Oblique-axis sacral torsion may play a role in intrapelvic adaptation to anisomelia of the lower limb; further examination of this prospect is warranted.

Adaptation, Physiological↗