Biomedical subjects
Publications and source records attributed to G Harverson.
Intraosseous gas formation may occasionally be seen within vertebral crush fractures after spinal osteoporosis. This is due to a vacuum phenomenon which follows impaired fracture healing and may be related to avascular necrosis. Four cases are reported from rural Thailand. A high incidence may reflect inappropriate steroid therapy.
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The efficacy of single site, intradermal human diploid cell rabies vaccine (HDCV) was assessed in patients exposed to rabies, who were treated at a rural mission hospital in central Thailand. Intradermal HDCV, 0.1 ml on days 0, 3, 7 and 14, resulted in protective antibody levels by day 14, with measurable titres present at one year. 98% of 219 patients completed primary vaccination and 84% returned for a one-year booster. No case of rabies has been seen in those vaccinated. Intradermal HDCV in small doses has given results superior to those from vaccination with nervous tissue vaccine with conventional schedules. This intradermal HDCV regimen has proved acceptable to patients, and is suitable for post-rabies-exposure care in developing countries where low cost is essential.
Intradermal (i.d.) human diploid-cell vaccine (HDCV) has been routinely used for post-exposure treatment of rabies at a rural mission hospital in central Thailand since 1979. Four 0.1 ml doses have been given over a fortnight, reconstituted vaccine being regularly stored for repeated use. No significant side effects have been encountered. Consistent antibody formation has been shown. In patients followed up for one year no case of rabies has been observed. Post-exposure intradermal HDCV is safer and more effective than nervous tissue vaccine and is of moderate cost. It should be more widely employed within the Third World.
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Tarsal bone disintegration is characterised by fragmentation and progressive collapse of one or more tarsal bones. It occurs in 10% of leprosy patients, and is responsible for many severe foot deformities associated with this disease. The main cause is micro-traumata, but sensory impairment, sepsis and osteoporosis are predisposing factors. In this series of 400 consecutive patients the talus and navicular were involved most frequently (2% of 119 tarsal lesions). Treatment, including prolonged immobilisation of the foot, results in dense sclerosis of the affected bone, and leaves a functional limb. Initial radiological features include: (i) Bone fragmentation. (ii) Calcified fragments in adjacent soft tissues. (iii) Linear fractures. (iv) Progressive compression and deformity of the affected bone. (v) Loss of density of the affected bone. (vi) Flattening of the longitudinal plantar arch. Illustrative case histories are presented, and the differential diagnosis discussed.
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