Search PubMed⌕ Search

Biomedical subjects

J H Harris

Publications and source records attributed to J H Harris.

At least 37 records · Page 2Linked to original sources
PubMed1992

Hyperextension-dislocation of the cervical spine. Ligament injuries demonstrated by magnetic resonance imaging.

We reviewed the magnetic resonance (MR) images of eight adults with acute hyperextension-dislocation of the cervical spine. The images were obtained to evaluate damage to the spinal cord. All eight patients had disruption of the anterior longitudinal ligament and of the annulus of the intervertebral disc, and separation of the posterior longitudinal ligament from the subjacent vertebra. Some, but not all, showed widening of the disc space, posterior bulging or herniation of the nucleus pulposus, and disruption of the ligamentum flavum. The MR demonstration of these ligament injuries, taken with the clinical and radiographic findings, establishes the mechanism of hyperextension-dislocation, confirms the diagnosis, and is relevant to management.

Cervical Vertebrae↗
PubMed1992

Report on Gardnerella vaginitis.

Gardnerella vaginitis is one of the most common diagnoses in our outpatient clinic. From January 1, 1989 through July 30, 1989 we had 230 positive cultures for G. vaginitis. Eighty-three compliant patients in this group had unabated symptoms with documented positive cultures for Gardnerella after treatment with metronidazole. This led to the use of alternative regimens of ceftriaxone or clindamycin. A survey of antibiotic choice and post-treatment culture obtained 103 entries from 34 active duty women soldiers and 60 women dependents. This paper presents the results of the survey after an introduction beginning with a 1953 article in U.S. Armed Forces Medical Journal.

Ceftriaxone↗
PubMed1991

Magnetic resonance imaging of hyperbaric oxygen treated rats with spinal cord injury: preliminary studies.

Magnetic resonance imaging (MRI) has been performed to assess the efficacy of hyperbaric oxygen (HBO) treatment on experimental spinal cord injury in a rat animal model. A moderately severe injury, similar to Type III injury seen in humans (Kulkarni et al. Radiology 164:837;1987) has been chosen for these studies. An improvement in the neurologic recovery (based on Tarlov scale) has been observed following HBO treatment over a period of 72 hr. Based on MRI, HBO treatment appears to arrest the spread of hemorrhage and resolve edema.

Animals↗
PubMed1991

The radiology of upper airway obstruction in maxillofacial trauma.

One of the prime considerations in the management of maxillofacial trauma is the diagnosis and prevention of acute upper airway obstruction. Each division of the upper aerodigestive tract may cause respiratory obstruction. In the oral cavity, a "flail" mandible, an "Andy Gump" deformity, and a sublingual hematoma may occur. In the nasopharnynx, an impacted midface, a split palate, and a nasopharyngeal hematoma may result. In the oropharynx and hypopharynx, an expanding hematoma in the retropharyngeal or lateral pharyngeal spaces may be seen. Although airway obstruction in maxillofacial trauma is a clinical diagnosis, the judicious use of radiographs helps to identify patients at risk. In this study, we review the anatomy of the upper aerodigestive tract and the potential sites of airway obstruction. A review of the radiology of airway obstruction in maxillofacial trauma will also be presented.

Acute Disease↗
PubMed1991

The current status of faculty staffing and resident training in emergency radiology. Results of a survey.

The results of a survey of United States and Canadian radiology residency programs in hospitals maintaining major emergency departments indicate that (1) radiologic faculty assignment to emergency medicine may include "all faculty," "specific faculty," "specific and other faculty," "general," and "musculoskeletal" faculty; (2) a chief of emergency radiology section is designated in less than 35% of radiology departments providing emergency room services; (3) radiology resident rotation in emergency radiology occurs in less than 2/3 of the surveyed programs; and (4) radiology resident experience in emergency radiology ranges from two to 16 weeks in 40% of these programs, the remainder being "unspecified." The effect of this circumstance upon the emergency department patient care and resident teaching in emergency radiology is discussed and remedial suggestions presented.

Canada↗
PubMed1990

Histopathologic correlation of magnetic resonance imaging signal patterns in a spinal cord injury model.

Magnetic resonance imaging (MRI) provides a noninvasive method of monitoring the pathologic response to spinal cord injury. Specific MR signal intensity patterns appear to correlate with degrees of improvement in the neurologic status in spinal cord injury patients. Histologic correlation of two types of MR signal intensity patterns are confirmed in the current study using a rat animal model. Adult male Sprague-Dawley rats underwent spinal cord trauma at the midthoracic level using a weight-dropping technique. After laminectomy, 5- and 10-gm brass weights were dropped from designated heights onto a 0.1-gm impounder placed on the exposed dura. Animals allowed to regain consciousness demonstrated variable recovery of hind limb paraplegia. Magnetic resonance images were obtained from 2 hours to 1 week after injury using a 2-tesla MRI/spectrometer. Sacrifice under anesthesia was performed by perfusive fixation; spinal columns were excised en bloc, embedded, sectioned, and observed with the compound light microscope. Magnetic resonance axial images obtained during the time sequence after injury demonstrate a distinct correlation between MR signal intensity patterns and the histologic appearance of the spinal cord. Magnetic resonance imaging delineates the pathologic processes resulting from acute spinal cord injury and can be used to differentiate the type of injury and prognosis.

Animals↗
PubMed1990

Posterior hip dislocation associated with acute traumatic injury of the thoracic aorta: a previously unrecognized injury complex.

Posterior hip dislocation associated with acute injury to the thoracic aorta is a previously unrecognized injury complex. This study reveals that 8% of patients with posterior hip dislocation have associated injury to the thoracic aorta because of abrupt deceleration injuries. This study defines the association of traumatic posterior hip dislocation and acute traumatic injury of the thoracic aorta, describes the mechanism of injury, and discusses the evaluation of a patient with a suspected acute traumatic aortic injury.

Adult↗
PubMed1990

Acute spinal cord injury. A study using physical examination and magnetic resonance imaging.

Magnetic resonance imaging (MRI) was performed on 37 patients with acute spinal injury using T1- and T2-weighted images. Three different types of MRI signal patterns were detected in association with these spinal cord injuries. A classification was developed using these three patterns. Type I, seen in ten (27.0%) of the patients, demonstrated a decreased signal intensity consistent with acute intraspinal hemorrhage. Type II, seen in 16 (43.2%) of the patients, demonstrated a bright signal intensity consistent with acute cord edema. Type III, seen in three (8.1%) of the patients, demonstrated a mixed signal of hypointensity centrally and hyperintensity peripherally consistent with contusion. The remaining eight patients had normal cords by MRI. All 37 patients had an admitting neurologic assessment and classification of their spinal injury according to the Frankel classification and the Trauma Motor Index (TMI). At an average of 12.1 months postinjury, their neurologic function was reassessed. Patients with Type I patterns showed no improvement in their Frankel classification and minimal improvement in their TMI, 32.1 to 42.4. In comparison, all of the Type II and III patterns improved at least one Frankel classification. The Type II TMI increased from 70.8 to 91.9 and Type III from 37.3 to 75.7. This preliminary report indicates a distinct correlation between the pattern of spinal cord injury as identified by MRI and neurologic recovery. It appears that the ability of MRI to aid in examination of the condition of the spinal cord will offer a means of predicting neurologic recovery following acute spinal cord injury.

Adult↗
PubMed1989

Acute injuries of the axis vertebra.

A retrospective analysis of 165 patients admitted to Hermann Hospital with acute injuries of the axis vertebra revealed 68 (41%) dens fractures, 62 (38%) cases of traumatic spondylolisthesis ("hangman's" fracture), 21 (13%) extension teardrop fractures, 10 (6%) hyperextension dislocations, and 2 (1.0%) fractures each of the laminae and spinous processes. Of the 68 dens fractures, none (0%) were of the Anderson and D'Alonzo Type I; 21 (31%) were Type II ("high"); and 47 (69%) were Type III ("low"). The 62 traumatic spondylolistheses included 13 (21%) Effendi type I, 35 (56%) type II and 3 (5%) type III. This review disclosed an additional 11 (18%) patients with an atypical variety of traumatic spondylolisthesis, not previously reported, in which one or both fractures involved the posterior cortex of the axis body. Of the axis injuries 31 (18%) were limited to the axis body alone. Of these, 21 (61%) were hyperextension teardrop fractures and 10 (32%) were hyperextension dislocations. Axis injuries were associated with acute injuries of other cervical vertebrae in 14 (8%) of the patients.

Axis, Cervical Vertebra↗
PubMed1988

The role of three-dimensional computed tomography in the management of maxillofacial trauma.

Open reduction and internal fixation of facial fractures demand a detailed understanding of the three-dimensional pattern of injury. This is difficult if not impossible to obtain with present radiographic methods. The purpose of this study was to define the role of three-dimensional computerized tomography (3DCT) in surgical management of facial fractures. The two-part investigation: 1) compared the diagnostic accuracy of 3DCT with conventional CT and plain film studies; and 2) examined the clinical usefulness of 3DCT to surgeons. Twenty-four acute trauma patients suspected of having facial fractures were examined radiographically with analysis of every facial bone and specific facial regions. Particular attention was directed to the course of the fracture lines and the number, size, and displacement of fracture fragments. The surgeons were then asked to conceptualize the reported and the personally observed radiographic information and document their impressions on preprinted diagrams of the facial skeleton. They also completed questionnaires designed to indicate whether patient management would be influenced by the 3DCT. The radiographic findings were correlated with intraoperative observations. The 3DCT provided superior definition of fracture lines (especially horizontal) and the extent of comminution was better appreciated. This additional information improved the surgeons' ability to plan placement of interfragmentary wires and/or plates. Surgeons were also able to more accurately predict those patients requiring immediate bone grafting. Large, life-size 3D images of the facial skeleton made intraoperative conceptualization of the injury pattern easier. The accuracy of the 3DCT images corroborated the intraoperative findings in all cases. The following conclusions are offered: 1) The diagnosis of most mandibular fractures can be made equally well with conventional and 3DCT techniques. 2) Improved diagnosis of fracture lines and the specific patterns of comminution in midface fractures is made possible with 3DCT. 3) If open reduction and internal fixation is the mode of treatment, 3DCT is desirable because the added information makes preoperative planning more accurate and thereby facilitates surgical intervention.

Facial Injuries↗
PubMed1988

The prevalence and significance of missed scapular fractures in blunt chest trauma.

Recent concepts regarding surgical management of fractures of the glenoid and scapular neck provide a new imperative to their early recognition. The initial routine supine chest radiograph obtained in patients with major blunt chest trauma provides the earliest opportunity to identify scapular fractures. A retrospective analysis of 100 patients with major blunt chest trauma who were discharged with the diagnosis of scapular fracture was performed to determine (1) the frequency with which the diagnosis of scapular fracture was made on the initial chest radiograph and (2) the prevalence and type of regional injuries that could serve to identify which of these patients are most likely to have sustained scapular fracture(s). The scapular fracture was diagnosed on the initial chest radiograph in only 57 (57%) of 100 patients and, although present, was not recognized in 43 (43%) of 100. In the group in which the fractures were not recognized, the fracture was visible and frankly overlooked in 31 (72%) of 43. The fracture was not included on the examination in eight (19%) of 43; and it was obscured by superimposed structures or artifacts in four (9%) of 43. Ipsilateral regional injuries were present in 88 (88%) of 100. These included multiple upper rib fractures in 40 (40%), clavicular fractures in 17 (17%), acromioclavicular separation in six (6%), and "other" in 26 (26%). "Other" included subcutaneous emphysema, pneumothorax, pleural effusion, and pulmonary contusion. The presence of ipsilateral regional skeletal injuries and soft-tissue injuries after major blunt chest trauma should prompt a diligent search for concomitant scapular fractures.

Female↗
PubMed1988

Diagnostic radiology. One week prelude to the clinical continuum.

A one-week comprehensive program of diagnostic radiology was presented to 205 junior medical students just entering the clinical phase of their education. Course objectives were to familiarize the students with the various imaging modalities and their application to common clinical situations and to introduce an organized approach to interpretation of conventional radiographs. This course's one-week time frame was unique. Various educational activities were employed to allow the large number of students to participate actively in the educational process and to enable them to cope with the intensive presentation of unfamiliar vocabulary, materials, and modalities. Through this course, the students achieved an understanding of the impact of radiologic findings on clinical situations and of the necessity of designing an orderly radiologic workup tailored to patient needs and clinical presentation. Most importantly, they gained a functional knowledge of the decision-making process involved in radiology as well as in clinical medicine.

Education, Medical, Undergraduate↗
PubMed1987

Three-dimensional computed tomography in acute cervical spine trauma: a preliminary report.

Numerically integrated, three dimensional images obtained from axial computed tomography (CT) data are vastly superior to mentally-integrated, individual, multiplanar CT images for the evaluation and diagnosis of acute cervical spine injury. This superiority results primarily from the visual display of spatial relationships. In addition, three-dimensional CT is capable of detecting injuries not found by conventional radiography or by multiplanar computed tomography (MPCT). The purpose of this preliminary report of four specially selected cases is to illustrate the superiority of three-dimensional CT over other imaging modalities (including MPCT) for the demonstration of cervical spine injuries.

Acute Disease↗
PubMed1987

Acute spinal cord injury: MR imaging at 1.5 T.

Thirty-seven magnetic resonance (MR) imaging studies were performed with a 1.5-T magnet and surface coils in 27 patients with suspected spinal cord injuries. Imaging was performed 1 day to 6 weeks after injury. Cord abnormalities were seen with MR in 19 patients, while skeletal and/or ligamentous injuries were seen in 21 (78%). Three types of MR signal patterns were seen in association with cord injuries. Acute intraspinal hemorrhage was seen in five patients with cord injuries and demonstrated decreased signal intensity on T2-weighted images obtained within 24 hours of injury. Cord edema and contusion had high signal intensity on T2-weighted images and were observed in 12 cases with cord injury. Neurologic recovery, determined in 16 patients, was insignificant in patients with intraspinal hemorrhage; however, patients with cord edema or contusion recovered significant neurologic function. MR at 1.5 T is extremely useful in the diagnosis of acute cord injury and also demonstrates potential in predicting neurologic recovery.

Acute Disease↗
PubMed1986

Injury to the glenoid fossa.

An illustrated case of fracture through the confines of the glenoid fossa by the mandibular condyle is presented. The mechanism of injury and postinjury sequelae of this rarely reported but frequently suspected occurrence are discussed and a treatment rationale proposed. The key to the diagnosis of this entity is an awareness of vector forces directed to the region of the glenoid fossa with or without evidence of subcondylar fracture.

Accidents, Traffic↗