Injuries of the tarso-metatarsal joints. Etiology, classification and results of treatment.
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Biomedical subjects
Publications and source records attributed to D W Wilson.
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The long-term results, after applying the various methods of treatment for the different types of facture of the os calcis, were studied over a period of five years. Fractures with minimal displacement showed a satisfactory functional and economic end result. Those patients with the more severe types of fractures who had undergone arthrodesis early were free from pain early and were able to return to work earlier than those who underwent it as a delayed procedure.
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Co-ordinators of external quality assessment schemes in the U.K. despatch samples of quality control material to participant laboratories at frequent intervals to assess laboratory performance. We show, via a controlled experiment on the plasma progesterone assay, that the current analysis performed by the external assessors is inadequate and often leads to erroneous conclusions about a laboratory's performance. It is concluded that for a proper assessment of a laboratory's performance, the external assessor should prepare large pools of plasma and distribute them to all participants in the scheme to use as internal quality control material.
Quality control data from a radioimmunoassay of progesterone are analysed. The measurements are found to have a lognormal distribution. A likelihood analysis of the change-point is described. Some rival continuous inspection schemes are compared and it is pointed out that more efficient schemes than Shewhart's can be implemented in clinical laboratories with the aid of a computer.
Estimates of analyte concentrations, obtained by immunoassay, have error distributions which are generally underestimated. Better estimates, which take into account the distribution of the response metameter of the calibration curve and uncertainties associated with the location of the fitted curve, have been obtained by computer simulation using practical immunoassay data. The increased use of curve-fitting software in automated immunoassay equipment has prompted the investigation of reported analyte concentration distributions for three commonly used functions, namely the logit-log, the 4-parameter logistic and the four-parameter Amersham models. The stimulation model is of potential value for a variety of situations.
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To investigate the relevance of the major histocompatibility complex (MHC) in longevity, we carried out a molecular analysis of the MHC in 432 unrelated healthy individuals. The comparison of individuals < or = 25 years and > 25 years showed that the 5.8-kb DQA1 allele, which corresponds to HLA-DR53, was negatively associated with longevity (p = 0.0035) resulting mainly from decreased homozygosity with age for that allele (p = 0.008), and restricted to males (p = 0.008). The difference was more striking for the 5.8 kb DQA1: 9.0 kb HSP70 haplotype again only in males (26.3 vs. 6.2%; p = 0.017, OR = 5.4, 95% CI = 1.5 - 19.5). The oldest male subject homozygous for this DQA1: HSP70 haplotype was 54 years (p = 0.005). Comparing leukemic patients and healthy individuals with the same ethnic and geographical origin, homozygosity for these genotypes was more frequent in the young leukemic group. The results suggested the existence of recessive deleterious genes in a segment of HLA-DR53 haplotypes.
The comparative metabolism of the pyrrolizidine alkaloid, [14C]monocrotaline, was studied using rat and guinea pig hepatic microsomes. Metabolites were quantified to the nanomole level using HPLC and radiometric detection. Triorthocresylphosphate and carbon monoxide were used to assess the involvement of carboxylesterases and cytochrome P-450 in the hepatic microsomal metabolism of monocrotaline, respectively. Esterase hydrolysis accounted for 92% of the metabolism in the guinea pig; the rat displayed no esterase activity. This result may explain the guinea pig's resistance to pyrrolizidine alkaloid toxicity. Dehydropyrrole was found to be the major pyrrolic metabolite in the guinea pig, although colorimetric analysis indicated multiple pyrrolic moieties in the rat microsomal incubations.
The pyrrolizidine alkaloid monocrotaline (MCT) has been shown to cause hepatic necrosis and pulmonary hypertension in the rat. To better understand the mechanism of action, tissue distribution and covalent binding studies were conducted at 4 and 24 hr following administration of [14C]MCT (60 mg/kg, 200 microCi/kg, sc). For the 4 hr study, the levels of MCT equivalents were 85, 74, 67, 36, and 8 nmol/g of tissue for red blood cells (RBC), liver, kidney, lung, and plasma, respectively, while the covalent binding levels were 125, 132, 39, 64, 44 pmol/mg of protein for tissues as listed above. The 24-hr tissue distribution levels were 49, 25, 9, 10, 2 nmol/g of tissue for RBC, liver, kidney, lung, and plasma, respectively, while covalent binding was 74, 28, and 55 pmol/mg of protein for liver, kidney, and lung, respectively. We also studied the kinetics of [14C]MCT (60 mg/kg, 10 microCi/kg, iv), which demonstrated rapid elimination of radioactivity with approximately 90% recovery of the injected radioactivity in the urine and bile by 7 hr. The plasma levels of radioactivity dropped from 113 nmol/g of MCT equivalents to 11 nmol/g at 7 hr while RBC levels decreased from 144 to only 81 nmol/g at the same time point. The apparent retention of MCT equivalents in the RBC suggests that this organ may act as the carrier of metabolites from the liver to other organs including the lung and may play a role in the pulmonary toxicity.
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