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Biomedical subjects

J H Calhoun

Publications and source records attributed to J H Calhoun.

At least 73 records · Page 4Linked to original sources

Regional alterations in long bone produced by internal fixation devices. Part I. 85Sr clearance.

We examined the effect of rigid plate application on the radiostrontium clearance of the intact canine femur at 6 months. We examined each of the component surgical steps. We calculated the clearance both for the whole bone and for each of the five transverse sections of the whole bone. Screw application, but not drilling, increased the clearance in the segment about the screw holes. Plate application produced an increase in the segment beneath the plate as well as around the screws and in the whole bone. These changes are accomplished not only by an absolute increase in clearance to the middle three segments, but by a relative diminution in clearance by the most proximal and distal segments. The histomorphometric changes in long bones following rigid plating may be accompanied by regional increases in bone blood flow.

Animals↗

Regional alterations in long bone 85Sr clearance produced by internal fixation devices. Part II. Histomorphometry.

The effects of each of the surgical stages involved in compression plating on the development of cortical thinning and porosity were assessed in the intact midshaft, stress-shielded femoral segments of adult mongrel dogs 6 months postoperatively. The data were evaluated in terms of a postsurgical tetracycline-based measure of remodeling and terminal 85Sr clearance (SrC) values for the plated segments of bone. Drilling had no effect on any parameter. Screw application was associated with minimal cortical thinning (p less than 0.05), while plate fixation clearly promoted thinning (p less than 0.01) and porosity (p less than 0.05). The percentage of labeled osteons, a measure of remodeling activity, increased only after plate fixation (p less than 0.05), and the labeling patterns suggested that most osteons had formed during the first 4 postsurgical months. That none of these changes were correlated with the 6-month SrC values suggests that the development of plate-induced osteopenia involves disparate histomorphometric time constants, rather than lack of any association.

Animals↗

Treatment of diabetic foot infections: Wagner classification, therapy, and outcome.

A total of 850 cases of septic diabetic foot infections were reviewed in 355 patients. Age, sex, other chronic diseases, site, etiology, Wagner grade, treatment, and results were analyzed. One third of the patients were in their sixth decade of life. There were 180 women and 175 men. Chronic diseases included hypertension, congestive heart disease, and renal failure. Staphylococcus aureus was the most common bacteria. Treatment was considered to meet protocol standards if Wagner's algorithms and infectious disease principles were followed. Thirty-nine Wagner grade 0 infections were seen: only one was not treated appropriately. Eighty-eight percent treated per protocol healed and the one not treated appropriately failed. In grade 1, 79% of the 154 evaluable patients were treated appropriately with a 86% success rate versus a 53% success rate for those not treated per protocol. Of three quarters of the 64 patients with grade 2 infections treated according to protocol, 73% healed. One of those in grade 2 who was not treated according to protocol healed. In grade 3, 64% of the 251 patients were treated per protocol with a 79% success rate versus a 12% success rate for those who were not treated per protocol. Most of the 189 patients with grade 4 cases were treated according to protocol with 88% success; the 20 not treated per protocol had a 15% success rate. Thirty of the 32 grade 5 patients were treated per protocol and all but one healed. Protocol therapy had a statistically significant effect by chi 2 test in the treatment of all groups.

Adult↗

Asymmetry in congenital ocular motor apraxia.

A 10-month-old girl presented with apparently unilateral ocular motor apraxia (OMA). Electro-oculography confirmed an inability to generate a saccade for fixation or in response to an optokinetic or vestibular evoked stimulus to the right. Fixation and optokinetic saccades and vestibular evoked nystagmus were present to the left. Magnetic resonance imaging revealed a small cerebellar vermis but no localizing unilateral abnormality or tumour. Subsequent review of video recordings of 16 children with congenital OMA revealed that 5 demonstrated asymmetry in the generation of fixation saccades. Two of the five also demonstrated asymmetry of vestibular evoked nystagmus, and an additional child had optokinetic asymmetry.

Apraxias↗

Occurrence of strabismus in infants born to drug-dependent women.

Maternal drug abuse during pregnancy exposes the fetus to the possibility of toxic or addicting effects. At a methadone hydrochloride maintenance program providing medical care to drug-dependent women and their infants, ophthalmologic examinations of all infants born during a 36-month period were performed. Twenty-nine infants prenatally exposed to psychoactive drugs were seen at birth and on follow-up. The 24% prevalence of strabismus found in the drug-exposed infants was significantly greater than that of 2.8% to 5.3% reported in the general population. These data suggest that maternal drug abuse and increased methadone dosage during pregnancy may predispose infants to the development of strabismus.

Female↗

Problems of the lacrimal system in children.

The lacrimal system is composed of various glands to produce tears and a drainage system for tear removal. The most common abnormality is a defect or blockage in the drainage system, a blocked nasolacrimal duct. Most of the evidence favors conservative management of this condition, reserving probing for those that fail to resolve by one year of age.

Child↗

Persistent strabismus presenting after cataract surgery.

To determine causative factors of persistent strabismus presenting after cataract surgery, the surgical techniques and subsequent motility findings of eight patients who had persistent postoperative strabismus were studied. In two of the eight patients, complications related to the placement of the bridle suture were believed causative based on subsequent surgical findings. A similar etiology could be speculated in an additional three patients. An isolated vascular accident coincident to the cataract operation could account for a sixth case. The final two patients were believed to have a decompensated congenital fourth nerve palsy. In no patients could the myotoxic effect of a local anesthetic or the hypoxic effect of an ocular pressure-reduction device plausibly account for the deviation.

Aged↗

Osteochondritis dissecans of the lunate.

Osteochondritis dissecans of the lunate has not been previously reported in the English-language literature. A case of osteochondritis dissecans of the lunate and an ulnar positive variance in a 16-year-old girl is presented. Several possible causes of the lesion and its surgical treatment are discussed.

Adolescent↗

Surgical management of large angle congenital esotropia.

Ninety-seven patients with congenital esotropia with deviations of 50 prism dioptres or greater underwent large (6 and 7 mm) bimedial rectus recessions. The overall success rate with one operation was 83.5%. Judgment of final alignment was made at the last follow-up examination, six to 61 months (average 23.4 months) postoperatively. Large bimedial rectus recessions for congenital esotropia are an effective surgical treatment which does not significantly alter adduction.

Child, Preschool↗

Tumoral calcinosis in the neck.

Tumoral calcinosis manifests soft-tissue calcification, usually near major joints. It variably includes hyperphosphatemia, elevated 1,25-dihydroxycalciferol, and an affected sibling. Serum calcium, alkaline phosphatase, and parathyroid hormone are normal. Tumoral calcinosis of the head and neck is very rare, but this diagnosis should be considered when x-ray film of a poorly defined mass shows irregular soft-tissue calcification.

Adult↗

Fourth cranial nerve palsy following spinal anesthesia. A case report.

Fourth nerve palsy has been rarely seen following lumbar puncture, myelogram, or spinal anesthesia. We report a case of 4th nerve and 6th nerve palsies following spinal anesthesia. The 4th nerve palsy was best detected by using a Maddox rod. If all 6th nerve palsies occurring after spinal anesthesia were examined with a Maddox rod, more cyclovertical palsies might be discovered.

Abducens Nerve↗

Ocular motility disturbances following cosmetic blepharoplasty.

Five patients developed diplopia following cosmetic blepharoplasty. While temporary diplopia and visual disturbances are known to occur following this type of surgery, the persistence of diplopia with demonstrable muscle imbalance is not common. We encountered ocular motility complications involving the inferior or oblique muscle, inferior rectus muscle, and superior oblique tendon.

Diplopia↗

Results of late probing for congenital nasolacrimal duct obstruction.

One hundred four consecutive patients (138 eyes) with congenital nasolacrimal duct obstruction were probed after the age of 13 months. One hundred twenty-nine eyes (93.5) were cured after the first probing. Based on this study and others showing the effectiveness of medical management, it is the current practice of the authors to delay probing until the patient is at least 13 months of age.

Child↗

Lead poisoning from a gunshot wound to the hand.

Lead intoxication from retained bullets is uncommon but potentially fatal. A 45-year-old man was shot in the left wrist with a .32-caliber rifle. He was first seen 16 months later with symptoms, signs, and laboratory values that were consistent with the diagnosis of plumbism. The factors leading to plumbism, its evaluation, and treatment are reviewed.

Humans↗