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D Stanley

Publications and source records attributed to D Stanley.

At least 19 recordsLinked to original sources
PubMed2005

Revision surgery for nonunion after early failure of fixation of fractures of the distal humerus.

Sixteen patients who underwent a revision operation for nonunion of fractures of the distal humerus following previous internal fixation were reviewed at a mean follow-up of 39 months (8 to 69). The Mayo elbow performance score was excellent in 11, good in two, fair in two and poor in one. In 15 patients union was achieved and in one with an infected nonunion a subsequent bone graft was necessary in order to obtain union.Age, gender, a history of smoking, mechanism of the injury and the AO classification of the initial fracture did not correlate with the development of nonunion. In 12 patients (75%), the initial fixation was assessed as being suboptimal. The primary surgery was regarded as adequate in only three patients. Our findings suggest that the most important determinant of nonunion of a distal humeral fracture after surgery is the adequacy of fixation.

Adult↗
PubMed2005

Bollgard cotton and resistance of tobacco budworm (Lepidoptera: Noctuidae) to conventional insecticides in southern Tamaulipas, Mexico.

Insecticide susceptibility in tobacco budworm, Heliothis virescens (F.) (Lepidoptera: Noctuidae), was determined for 8 yr (1991-2001) with larvae sampled from cotton in southern Tamaulipas, Mexico. Before 1996, when Bollgard cotton expressing the Cry1A(c) delta-endotoxin was introduced into the region, two important patterns were documented. The first was economically significant increases in resistance to certain insecticide groups. The second was occurrence of virtually complete control failures in the field during 1994 and 1995. The largest resistance changes were recorded for the type II pyrethroids cypermethrin and deltamethrin. These products are the most widely used products in the region. Resistance ratios for these products increased up to > 100-fold from 1991 to 1995. After 1996, the resistance levels declined. These findings did not occur with other products of scant use (e.g., permethrin, profenofos, and endosulfan) or low tobacco budworm efficacy coupled to a high use pattern (e.g., methyl parathion). This clear trend toward reversal of resistance to type II pyrethroids can be understood, in part, with respect to two factors: 1) the high adoption rate of transgenic cotton in the region, from 31.2% in the beginning (1996) to approximately 90% in 1998; this has considerably curbed the use of synthetic insecticides, with the attending loss of selection pressure on this pest; and 2) the potential immigration to the region of susceptible tobacco budworms from cultivated and wild suitable hosts as well as from transgenic cotton might have influenced the pest population as a whole. The influence of transgenic cotton on southern Tamaulipas can be more clearly seen by the drastic reduction of insecticide use to control this important pest. Now tobacco budworms in this region are susceptible to type II pyrethroids. Two effective and fundamentally different pest management tools are now available to cotton growers in southern Tamaulipas: transgenic cotton, coupled with careful use of pyrethroids, offers the possibility of sustainable and profitable cotton production.

Animals↗
PubMed2003

Treatment of primary degenerative arthritis of the elbow by ulnohumeral arthroplasty. A long-term follow-up.

Between 1990 and 1996 we performed 20 consecutive ulnohumeral arthroplasties for primary osteoarthritis of the elbow. The outcome was assessed using the Disabilities of Arm, Shoulder and Hand Score (DASH) and the Mayo Elbow Performance Score (MEPS) at a mean follow-up of 75 months (58 to 132). There were excellent or good results in 17 elbows (85%) using the DASH score and in 13 (65%) with the MEPS (correlation coefficient 0.79). The mean fixed flexion deformity had improved by 10 degrees and the range of flexion by a mean of 20 degrees. In 16 elbows (80%) the benefits of surgery had been maintained, and of 16 patients working at the time of operation, 12 (75%) had returned to the same job. There was no correlation between radiological recurrence of degenerative changes and the amount of fixed flexion deformity, the flexion arc, or the elbow scores.

Adult↗
PubMed2003

Rehabilitation after two-part fractures of the neck of the humerus.

We undertook a prospective, controlled trial which compared two rehabilitation programmes for 86 patients who sustained two-part fractures of the proximal humerus. Patients were randomised either to receive immediate physiotherapy within one week (group A) or delayed physiotherapy after three weeks of immobilisation in a collar and cuff sling (group B). At 16 weeks after the fracture, patients in group A had less pain (p < 0.01) and had greater shoulder function (p < 0.001) than those in group B. At 52 weeks, the differences between the groups had reduced. Although group A still had greater shoulder function and less pain, there was no statistical difference when compared with group B. By analysis of the area under the curve, an overall measure up to the 52-week period, group A experienced less pain as measured by the SF36 general health questionnaire and had improved shoulder function. Our results show that patients with two-part fractures of the proximal humerus who begin immediate physiotherapy, experience less pain. The gains in shoulder function persist at 52 weeks which suggests that patients do not benefit from immobilisation before beginning physiotherapy.

Adult↗
PubMed2003

Total elbow replacement using the Kudo prosthesis. Clinical and radiological review with five- to seven-year follow-up.

Between 1993 and 1996, we undertook 35 Kudo 5 total elbow replacements in a consecutive series of 31 rheumatoid patients. A total of 25 patients (29 procedures) was evaluated at a mean follow-up of six years (5 to 7.5) using the Mayo Clinic performance index. In addition, all patients were assessed for loosening using standard anteroposterior and lateral radiographs. At review, 19 elbows (65%) had either no pain or mild pain, ten (35%) had moderate pain and none had severe pain. The mean arc of flexion/extension was 94 degrees (35 to 130) and supination/pronation was 128 degrees (30 to 165). A fracture of the medial epicondyle occurred during surgery in one patient. This was successfully treated with a single AO screw and a standard Kudo 5 implant was inserted. Postoperatively, there were no infections. One patient had a dislocation which was treated by closed reduction and five had neurapraxia of the ulnar nerve. Radiologically, there was no evidence of loosening of the humeral component, but two ulnar components had progressive radiolucent lines suggestive of loosening. Two other ulnar components had incomplete and non-progressive radiolucent lines. With definite radiological loosening as the endpoint, the probability of survival of the Kudo 5 prosthesis at five years using the Kaplan-Meier method was 89%.

Adult↗
PubMed2002

Prostaglandin biosynthesis by midgut tissue isolated from the tobacco hornworm, Manduca sexta.

We describe prostaglandin (PG) biosynthesis by isolated midgut preparations from tobacco hornworms, Manduca sexta. Microsomal-enriched midgut preparations yielded four PGs, PGA/B(2), PGD(2), PGE(2) and PGF(2alpha), all of which were confirmed by analysis on gas chromatography--mass spectrometry (GC--MS). PGA and PGB are double bond isomers which do not resolve on TLC but do resolve by GC; for convenience, we use the single term PGA(2) for this product. PGA(2) was the major product under most conditions. The midgut preparations were sensitive to reaction conditions, including radioactive substrate, protein concentration (optimal at 1mg/reaction), reaction time (optimal at 0.5 min), temperature (optimal at 22 degrees C), buffer pH (highest at pH 6), and the presence of a co-factor cocktail composed of reduced glutathione, hydroquinine and hemoglobin. In vitro PG biosynthesis was inhibited by two cyclooxygenase inhibitors, indomethacin and naproxen. Subcellular localization of PG biosynthetic activity in midgut preparations, determined by ultracentrifugation, revealed the presence of PG biosynthetic activity in the cytosolic and microsomal fractions, although most activity was found in the cytosolic fractions. This is similar to other invertebrates, and different from mammalian preparations, in which the activity is exclusively associated with the microsomal fractions. Midgut preparations from M. sexta pupae, adult cockroach, Periplaneta americana, and corn ear worms, Helicoverpa zea, also produced the same four major PG products. We infer that insect midguts are competent to biosynthesize PGs, and speculate they exert important, albeit unrevealed, actions in midgut physiology.

Animals↗
PubMed2002

Complex fractures of the distal humerus in the elderly. The role of total elbow replacement as primary treatment.

Between 1995 and 2000, 19 consecutive patients with fractures of the distal humerus were treated by primary total elbow replacement using the Coonrad-Morrey prosthesis. No patient had inflammatory or degenerative arthritis of the elbow. The mean age at the time of injury was 73 years (61 to 95). According to the AO classification, 11 patients had suffered a C3 injury, two a B3 and two an A3. One fracture was unclassified. Two patients died from unrelated causes and one was unable to be assessed because of concurrent illness. The mean time to follow-up was three years (1 to 5.5). At follow-up 11 patients (68%) reported no pain, four (25%) had mild pain with activity and one had mild pain at rest. The mean flexion arc was 24 degrees to 125 degrees. The mean supination was 90 degrees (70 to 100) and pronation 70 degrees (50 to 110). No elbow was unstable. The mean Disabilities of the Arm, Shoulder and Hand score was 23 (0.92 to 63.3) and the mean Mayo elbow performance score was 93 (80 to 100). Of the 16 patients, 15 were satisfied with the outcome. Radiological evaluation revealed only one patient with a radiolucent line at the cement-bone interface. It was between 1 and 2 mm in length, was present on the initial postoperative radiograph and was non-progressive at the time of follow-up. Primary total elbow arthroplasty is an acceptable option for the management of comminuted fractures of the distal humerus in elderly patients when the configuration of the fracture and the quality of the bone make reconstruction difficult.

Aged↗
PubMed2000

Treatment of osteoarthritis of the elbow: a comparison of open and arthroscopic debridement.

PURPOSE: To assess the effectiveness of open and minimally invasive techniques in the debridement of osteoarthritis of the elbow, we compared the Outerbridge-Kashiwagi (O-K) procedure with an arthroscopic modification in which arthroscopic debridement and fenestration of the olecranon fossa was performed. TYPE OF STUDY: The study took the form of a nonrandomized control trial in which subjects were allocated to a treatment depending on the hospital of presentation. MATERIALS AND METHODS: Assessment using the Mayo Clinic elbow function chart enabled comparison of the outcome in 18 cases treated by the O-K procedure and 26 patients treated by arthroscopic debridement and fenestration of the olecranon fossa. Mean follow-up was 35.3 months (minimum 12 months). Of the patients treated by the O-K procedure, 14 were men and 4 were women with a mean age of 55 years. In 83% of patients, the diagnosis was primary osteoarthritis, with the remainder post-traumatic arthritis. The patients treated by arthroscopic debridement and fenestration of the olecranon fossa included 24 men and 2 women with a mean age of 46 years, and a diagnosis of primary osteoarthritis in 91% and post-traumatic arthritis in the remainder. No patients were excluded from the study or refused to be included. RESULTS: Both procedures were shown to be effective, with no major complications. Patients treated by arthroscopic debridement and fenestration of the olecranon fossa achieved better relief of pain (P <.10), whereas those patients undergoing the O-K procedure achieved significantly greater improvement in range of flexion (P <.05). No difference between the procedures in terms of patient-perceived overall effectiveness of the surgery was found. CONCLUSIONS: In conclusion, in the treatment of osteoarthritis of the elbow, arthroscopic debridement and fenestration of the olecranon fossa may be a more suitable procedure when painful symptoms predominate. In contrast, the O-K procedure is a significantly better procedure for improving the range of flexion where this is a particular problem.

Adult↗
PubMed2000

Immunoflow cytometry and cell block immunohistochemistry in the FNA diagnosis of lymphoma: a review of 73 consecutive cases.

AIMS: To review the results of 73 consecutive fine needle aspirations (FNAs) that were collected by a pathologist and analysed by immunoflow cytometry. Material for a cell block was also collected from some of these lesions. METHODS: The setting was a large general hospital in rural New Zealand. The FNAs were performed by a pathologist, or a radiologist for image guided localisations. Material for immunoflow cytometry was collected into RPMI and, when required, material for a cell block was collected into formalin. RESULTS: Of the 73 samples collected by FNA nine were inadequate. Light chain restriction could be demonstrated in most FNA samples from B cell lymphomas (28 of 30 adequate samples). The exceptions were two cases of T cell rich B cell lymphoma. Artefactual light chain restriction was seen occasionally in T cell lymphomas, presumably as a result of autoantibodies binding to the cell surfaces. It was possible to subtype most (18 of 30 adequate samples) B cell lymphomas as chronic lymphocytic leukaemia (CLL), follicle centre cell lymphoma (FCCL), or mantle cell lymphoma. The CD4 to CD8 ratio was not usually restricted in T cell lymphomas and coexpression of CD4 and CD8 was not usually found. Loss of pan-T cell antigens was seen in some T cell lymphomas. Four of the six T cell lymphomas and three of the four non-lymphoid malignacies were diagnosed with the aid of cell block immunohistochemistry. Only one of the four cases of Hodgkin's lymphoma showed Reed-Sternberg cells in the FNA smears. CONCLUSIONS: It is not always possible to characterise lymphomas as fully with FNA and immunoflow cytometry as is possible with biopsy histology and a full battery of modern investigations. Nevertheless, in the setting of a large rural general hospital immunoflow cytometry on FNA samples is a highly effective method of diagnosing and typing B cell lymphomas. Immunoflow cytometry is of little use for T cell lymphomas or Hodgkin's lymphomas. We advocate the use of cell block immunohistochemistry in preference to immunoflow cytometry for cases in which the cytological appearance of the specimen is overtly malignant but the differential diagnosis includes non-lymphoid malignancy.

Biopsy, Needle↗
PubMed1999

The fusiform face area is selective for faces not animals.

To test whether the human fusiform face area (FFA) responds not only to faces but to anything human or animate, we used fMRI to measure the response of the FFA to six new stimulus categories. The strongest responses were to stimuli containing faces: human faces (2.0% signal increase from fixation baseline) and human heads (1.7%), with weaker but still strong responses to whole humans (1.5%) and animal heads (1.3%). Responses to whole animals (1.0%) and human bodies without heads (1.0%) were significantly stronger than responses to inanimate objects (0.7%), but responses to animal bodies without heads (0.8%) were not. These results demonstrate that the FFA is selective for faces, not for animals.

Adult↗
PubMed1999

The parahippocampal place area: recognition, navigation, or encoding?

The parahippocampal place area (PPA) has been demonstrated to respond more strongly in fMRI to scenes depicting places than to other kinds of visual stimuli. Here, we test several hypotheses about the function of the PPA. We find that PPA activity (1) is not affected by the subjects' familiarity with the place depicted, (2) does not increase when subjects experience a sense of motion through the scene, and (3) is greater when viewing novel versus repeated scenes but not novel versus repeated faces. Thus, we find no evidence that the PPA is involved in matching perceptual information to stored representations in memory, in planning routes, or in monitoring locomotion through the local or distal environment but some evidence that it is involved in encoding new perceptual information about the appearance and layout of scenes.

Adolescent↗
PubMed1999

A posterior approach to the elbow joint.

We describe a posterior approach to the elbow which combines the advantages of both splitting and reflecting the triceps. It gives protection to the ulnar nerve and its blood supply during the operation while providing excellent exposure of the distal humerus. During closure, the triceps muscle can be tensioned, thereby improving stability of the elbow. This approach has particular relevance to unlinked total elbow arthroplasty allowing early rehabilitation of the joint.

Arthroplasty, Replacement↗
PubMed1998

Free tendon interposition grafting for the repair of ruptured extensor tendons in the rheumatoid hand. A clinical and biomechanical assessment.

Sixteen ruptured extensor tendons were repaired in seven rheumatoid hands using autogenous palmaris longus tendon as a free interposition graft. The patients were reviewed at an average of 17 months (range, 5-45) after repair. Subjectively all patients were satisfied with the clinical results, and achieved a return to their level of ability before tendon rupture. A biomechanical model suggests that tendon repair using an interposition graft, rather than a traditional end-to-side tendon transfer retains the anatomical axis of tendon function, and achieves greater forces during active finger extension.

Adult↗
PubMed1997

Ulnar variance and age.

Ulnar variance was determined on 1,023 radiographs of normal wrists taken in standardized fashion. There were 468 women and 555 men. The age range was 13 to 109 years. In both sexes, ulnar negative variance decreased significantly with increasing age. Possible reasons for this are discussed.

Adolescent↗
PubMed1997

Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies.

Anthropology, Cultural↗
PubMed1997

Traditional birth in Zimbabwe.

Modern medical and technically advanced ways of giving birth are available in Zimbabwe; it is an advancing country. However, this is not the only, nor always the most appropriate, approach to pregnancy and childbirth.

Female↗