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Biomedical subjects

F Shapiro

Publications and source records attributed to F Shapiro.

At least 109 records · Page 6Linked to original sources
PubMed1981

Fractures of the femoral shaft in children. The overgrowth phenomenon.

Femoral overgrowth following femoral shaft fracture in children less then 13 years old has been documented by orthoroentgenogram in 74 patients from the time of healing 3 months following fracture until skeletal maturity. The femoral overgrowth averaged 0.92 centimeters (range 0.4-2.7) and was found to be independent of age, level of fracture, or position of fracture at the time of healing. The overgrowth was a universal phenomenon. Ipsilateral tibial overgrowth averaging 0.29 centimeters (0.1-0.5) occurred in 82 per cent of the patients. In the first 18 months following fracture 78 per cent of the overgrowth occurred. There was a time limit to the overgrowth phenomenon in 91 per cent of all patients following which the discrepancy persisted without change. By 18 months following fracture, however, only 12 per cent of the patients had completed the overgrowth and by 3 years and 6 months following fracture 85 per cent had completed their overgrowth. In 9 per cent of the patients overgrowth continued throughout the remaining growth period although at a slower rate than in the first 18 months following fracture.

Adolescent↗
PubMed1981

Leg-length discrepancies in monoarticular and pauciarticular juvenile rheumatoid arthritis.

A retrospective study was performed to determine the course of limb-length discrepancies occurring in patients with monoarticular and pauciarticular juvenile rheumatoid arthritis. Data were assessed on thirty-six patients followed to skeletal maturity, on fifteen patients who had not reached skeletal maturity but who had been followed for four years or more, and on forty-nine patients followed for three years or less. In seventy-two of the total of 100 patients the onset of the disease occurred before they were five years old, and ninety patients had involvement of the knee. All patients in whom the disease developed before the age of nine had overgrowth of the involved extremity, but that overgrowth never exceeded 3.0 centimeters. The major discrepancy developed within the first three or four years and either increased very slowly thereafter, remained level, or decreased. Of the thirty-six patients who were followed to skeletal maturity, in twenty-nine a discrepancy of 1.5 centimeters or more developed at some time during the period of assessment. Twelve of the thirty-six patients had diminution of the discrepancy to the extent that epiphyseal arrest was not required. Fifteen eventually had an epiphyseal arrest. Rapid premature closure of the epiphyseal growth plate occurred only in those patients in whom the disease developed after the age of nine years. This led to immediate shortening of the involved side and on occasion to marked limb-length discrepancies.

Adolescent↗
PubMed1980

Human osteopetrosis: a histological, ultrastructural, and biochemical study.

UNLABELLED: Histological ultrastructural, and biochemical studies of the tissues of a patient with osteopetrosis were done. The bone contained an increased number of osteoclasts which were characterized ultrastructurally by the absence of ruffled borders and clear zones, hallmarks of actively resorbing osteoclasts. In contrast with normal human bone, tissue collagenase was not detected in osteopetrotic bone cultured in vitro, nor was tissue collagenase activity released when the osteopetrotic bone was incubated with parathyroid hormone. No striking abnormalities of parathyroid hormone or calcitonin were found in the blood or parathyroid and thyroid glands. Except for a slight increase in the extent of lysine hydroxylation of bone collagen, no significant biochemical abnormality of collagen was found. The histological, ultrastructural, and biochemical data support the hypothesis that the basic defect in osteopetrosis is cellular and the osteoclasts, in particular, are abnormal. They appear to be unable to resorb bone and cartilage, and they do not appear to respond to parathyroid hormone in a completely normal way. CLINICAL RELEVANCE: Bone marrow transplantation has produced improvement in both experimental animals and humans and should be actively considered in a child with osteopetrosis who is not thriving.

Amino Acids↗
PubMed1980

Changes in tissue morphology and collagen composition during the repair of cortical bone in the adult chicken.

UNLABELLED: An animal model was developed to study the histology and collagen chemistry of healing cortical bone. A hole was cut through the cortex of the mid-shaft of the humerus of the adult chicken, which allowed for repair at a mechanically stable site. After one to two weeks the collagen of the repair tissue, which consisted principally of woven bone, contained almost three times as much hydroxylysine as the collagen of normal adult bone and thus resembled the collagen of embryonic long bones. By eight weeks, when lamellar one predominated, the hydroxylysine content had fallen to normal levels. Type I was the major genetic type of collagen present throughout. No type-II collagen, characteristic of cartilage, was detected; this was consistent with the histological findings. The results established that hydroxylysine-rich type-I collagen can be made by osteoblasts of adult animals as well as by those of embryos and early postnates. CLINICAL RELEVANCE: In order to understand the biological characteristics of fracture healing, it is vital to study not only the macroscopic organization of the repair tissue but also the chemical properties of its molecular components. The strength of healing fractured bone, and indeed of normal bone, depends largely on the properties of the structural protein collagen. To date, it is not known whether the collagen in healing fractures is the same as that in normal bone, or whether it has distinct chemical features that may suit it for bone repair.

Animals↗
PubMed1979

Gross and histological abnormalities of the talus in congenital club foot.

Gross and histological abnormalities were demonstrated in a club-foot talus from a boy with multiple congenital anomalies who died when he was nine days old. Both tali were studied, the one from the club foot and the one from the normal foot. The gross anomalies involved the smaller size of the club-foot talus and the increased medial deviation of a stunted, misshapen head and neck region. Serial histological sections of both tali allowed for a three-dimensional geometric appreciation of both bones and an assessment of the nature and extent of histological and cytological features. The ossification center of the club-foot talus was absolutely and relatively smaller than that of the normal talus. It was eccentrically positioned, being more lateral and anterior than that of the normal talus. The marked histological abnormalities seen in the head and neck region of the club-foot talus involved extensive breaching of the endochondral sequence by vessels. The posterior aspect of the endochondral sequence and ossification center was normal. The extra-osseous and intra-osseous blood supply of the two tali was normal with the exception of the increased and irregular breaching of the endochondral sequence in the club-foot talus. This study demonstrates histological abnormalities in the head and neck region of the club-foot talus, which was most abnormal grossly. The eccentric position of the secondary ossification center as well as its related vascular abnormalities do not support a theory of developmental arrest of the talus but appear sufficiently abnormal to support the theory of a primary defect in the cartilage anlage. Clinically, one must bear in mind that early open reduction of the talocalcaneal navicular joint in a foot such as this would have served to reposition the navicular onto a talus that still was structurally abnormal.

Clubfoot↗
PubMed1979

Dietary management of patients with diabetes treated by hemodialysis.

Early experience with the treatment of patients with insulin-dependent diabetes and renal failure by chronic hemodialysis indicated a high mortality and increased incidence of medical complications. Since 1972, a marked improvement in survival and reduction in incidence of complications has been attributed to more rigorous control of fluid overload, hypertension, and blood sugar levels by insulin therapy and careful dietary management. A diet has been developed which combines the diet used by dialysis patients with suitable modifications for the insulin-dependent patient with diabetes. The importance of patient education is stressed in an attempt to improve patient compliance.

Diabetes Mellitus↗
PubMed1978

Unsolved technical problems of maintenance dialysis.

The present paper describes some of the technical inadequacies in the clinical practice of dialysis. Problem areas of hemodialysis, i.e., those related to blood access, dialyzer and delivery system, are treated in depth. Corollaries with peritoneal dialysis are obvious. Research priorities, in particular development of a more sophisticated delivery system, are suggested. The intent of this discussion is to outline a rational progression in improvement of care of the end-stage renal disease patient.

Kidneys, Artificial↗
PubMed1977

Organization and cellular biology of the perichondrial ossification groove of ranvier: a morphological study in rabbits.

The perichondrial ossification groove of Ranvier, a circumferential groove in the periphery of the epiphyseal cartilage, was studied in rabbits whose ages ranged from one week to eight months using light and electron microscopy, autoradiography after labeling with 3H-thymidine, 3H-proline, and 3H-glucosamine, and histochemical staining for proteoglycans and alkaline phosphatase. By these methods, three groups of cells were identified within the groove: 1. A group of densely packed cells deep in the groove, which are the progenitor cells for the osteoblasts that form the bone bark, a cuff of bone surrounding the epiphyseal growth-plate region and the adjacent part of the metaphysis. 2. A group of more widely dispersed, relatively undifferentiated mesenchymal cells and fibroblasts, some of which are chondroblast precursors that probably contribute to appositional chondrogenesis and growth in width of the epiphyseal cartilage. 3. Fibroblasts and fibrocytes among sheets of highly oriented and organized collagen fibers which form a fibrous layer that is continuous with the outer fibrous layer of the periosteum and with the perichondrium. This layer also sends fibers into the epiphyseal cartilage and anchors the periosteum firmly to the epiphyses as bone growth proceeds.

Animals↗
PubMed1976

Carbenicillin inactivation of aminoglycosides in patients with severe renal failure.

Carbenicillin appears to produce clinically important inactivation of aminoglycoside antibiotics in patients with severe renal failure. If combination carbenicillin/aminoglycoside therapy is used in patients with severe renal failure, the dose of carbenicillin must be adjusted to renal function and serum levels of both drugs should be monitored. Even with therapeutic serum carbenicillin levels (100-200 mug/ml), large doses of aminoglycosides may be required to achieve therapeutic serum levels and this may increase the risk of toxicity.

Aged↗
PubMed1975

The Mitchell distal metatarsal osteotomy in the treatment of hallux valgus.

Many of the fair and poor results are directly traceable to errors in technique. Patient selection is also important. The operation can be done in adolescents since there is no growth plate at the distal end of the first metatarsal. We do not currently recommend this procedure for those over 60, for those with first metatarsophalangeal osteoarthritis or hallux rigidus or for those with moderate or severe rheumatoid arthritis. For these patients we usually do a Keller excisional arthroplasty. Our use of the osteotomy-bunionectomy operation for the patient with hallux valgus with an associated metatarsalgia or short first metatarsal has now become more cautious. We feel that the operation is not indicated for those with significant preoperative metatarsalgia, especially if the first metatarsal is shorter than the second, or for those whose first metatarsal is more than 4 or 5 millimeters shorter than the second, regardless of preoperative metatarsalgia. In these patients a McBride procedure or a proximal opening-wedge osteotomy is done.

Adolescent↗
PubMed1975

Medical services at outdoor music festivals. Risks and recommendations.

Those planning provision of medical services should consider the type of music, the anticipated size of the crowd, the locale, the available local resources, the length of the festival, the numbers and types of patients to be treated, and especially the potential criminal and civil liability.

Emergency Medical Services↗
PubMed1975

Depressed in vitro aggregation of platelets of chronic hemodialysis patients (CHDP): a role for cyclic AMP.

1) On log-log-coordiantes a direct correlation has bee shown to exist between plasma cyclic AMP and plasma Cr levels. 2) hemodialysis results in a significant reduction in the arterial plasma cyclic AMP levels, but a return of plasma cyclic AMP to pre-dialysis levels is seen within 30 mins post-dialysis. 3) the dialyzer clearance of cyclic AMP, both in vitro and vivo, is commensurate with its M.W. 4) In vitro platelet aggregation responses, to ADP, EPI, and COLL are not influenced by PRP cell counts between 150,000 and 300,000/mm3. 5) the BT of NC and CHDP are not significantly different, indicating that the in vivo hemostatic properties of the CHDP are otherwise intact. 6)the CHDP have PVPC significantly lower than the NC, a finding commensurate with the usual mold thrombocytopenia of renal failure. 7)the aggreation responses of the CHDP to COLL and to both Lo and Hi concentrations of ADP and EPI are significantly less than those of the NC. 8)A statistically significant inverse correlation between aggregation response and plasma cyclic AMP is observed.

Adenosine Diphosphate↗