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Biomedical subjects

J L Marshall

Publications and source records attributed to J L Marshall.

At least 19 recordsLinked to original sources
PubMed1990

Vesicoureteric reflux in children: prediction with color Doppler imaging. Work in progress.

Unlike gray-scale sonography, color Doppler ultrasonography allows reliable visualization of the ureteric jet phenomenon. A study was undertaken to determine whether any measurable parameter predicts the presence of vesicoureteric reflux. Measurements of mean urine jet velocity, longitudinal angle, transverse angle, and distance of the origin of the jet from the midline of the bladder were obtained on 31 infants and children (62 ureters) with a proved urinary tract infection. Of these measurements, only the distance of the ureteric orifice from the midline of the bladder was found to correlate with vesicoureteric reflux (mean distance in the reflux group, 10.25 mm +/- 2.40 (standard deviation [SD]); in the nonreflux group, 7.98 mm +/- 2.40 [P = .004]). The authors conclude that the more laterally positioned the ureteric orifice, the more likely it is to reflux. Color Doppler ultrasound measurement of the laterality of the ureteric orifice may be useful for predicting which children with a urinary tract infection would benefit from voiding cystourethrography.

Child↗
PubMed1979

The anterior cruciate ligament: a technique of repair and reconstruction.

Both primary repair and late substitution of anterior cruciate ligaments can be accomplished by intra-articular methods. This principle is to provide temporary struts that are initially avascular but can later undergo revascularization and metaplasia to form a new ligament. The graft does afford initial support, however. An understanding of anatomic principles, suture placement, freedom of graft from impingement, avoidance of acute angular deviation of the graft, solid static stability, anatomic attachment points, and blood supply, is absolutely essential for success in this field of surgery.

Fascia Lata↗
PubMed1979

Microvasculature of the cruciate ligaments and its response to injury. An experimental study in dogs.

UNLABELLED: The normal vascular anatomy of the cruciate ligaments was investigated in eight dogs by microangiography, histology, and tissue-clearing (Spalteholz) techniques. The vessels were found to originate predominantly from the soft tissues (infrapatellar fat pad and synovial membrane) of the joint. The vascular response to partial surgical transection of the anteromedial mid-portion of the anterior cruciate ligament was evaluated in twelve dogs. This response, which was vigorous and extensive, appeared to arise from the soft tissues. Resection of the infrapatellar fat pad and synovial membrane at the time of injury tended to decrease this response. Spontaneous healing of the defect had not occurred in either group by eight weeks. CLINICAL RELEVANCE: The predominant soft-tissue, as opposed to osseous, origin of the blood supply to the cruciate ligaments may be an important consideration in the repair of these structures. The preservation and utilization of the infrapatellar fat pad and synovial envelope may optimize the vascular response and healing of the ligament.

Adipose Tissue↗
PubMed1979

Injury to the anterior cruciate ligament producing the pivot-shift sign.

The clinical entity termed the pivot shift was studied in cadaver specimens and its significance was evaluated. It was found to be highly correlated with a tear of the anterior cruciate ligament, and it corresponded to a sudden anterior-internal rotation subluxation-dislocation of the tibia and posterior horn of the lateral meniscus beneath the lateral femoral condyle.

Adolescent↗
PubMed1979

The supporting structures and layers on the medial side of the knee: an anatomical analysis.

The goal of this study was to delineate the consistent anatomical structures in the medial side of the knee and to determine their relationship to one another. One hundred and fifty-four fresh human knee joints were dissected. A three-layered pattern was found in which ligaments could be consistently placed. We have made suggestions regarding the nomenclature of these structures. The limits of of the so-called capsule and its significance as a stabilizer of the knee joint were examined. Only minor variations in the over-all anatomical pattern were found.

Dissection↗
PubMed1978

Medial collateral ligament injuries of the knee: a rationale for treatment.

Isolated MCL I and MCL II lesions evidence good recovery of integrity and function under non-operative modes of treatment. Isolated MCL III lesions may also be treated by non-operative management, but with the expectation of a slightly less successful result. However, there is an 80% incidence of concomitant ligament injury with this grade of lesion. The prognosis following injury to the MCL is significantly influenced by the presence of concurrent compromise of other ligaments, particularly that of the anterior cruciate ligament. Resolution of knee instability and dysfunction following a mixed MCL injury of any grade severity is best accomplished through operative intervention. Therefore, it is the authors' opinion that isolated MCL III and all mixed MCL lesions are best managed with operative treatment. Because of the apparent influence compromise of other ligament structures have on the recovery of MCL function, an attempt must be made to repair all acutely injured structures at the time of surgery. The keystones of a satisfactory result are early and accurate diagnosis, prompt treatment, and when indicated, complete surgical repair.

Adolescent↗
PubMed1978

Injuries of the anterior cruciate and medial collateral ligaments of the knee. A retrospective analysis of clinical records--part I.

The difficulty in diagnosing and subsequently treating lesions of the anterior cruciate ligament (ACL) is demonstrated in a review of 136 cases. Twenty-one patients noted a "pop" at the time of injury and each had a lesion of the ACL. The mechanism of injury may be helpful. The commonly seen valgus external rotation injury was noted in 60% of the cases but internal rotation with hyperextension and/or hyperflexion were also reported. The anterior drawer sign, if present, increases the accuracy to 92.1%. Failure of early cast treatment occurred if the ACL was torn but not in lesions confined to the MCL. Early meniscectomy in the cruciate deficient patient did not alleviate the need for further surgery in this group. At surgery the medial meniscus was torn in 93/124 ligament injuries but in addition 14 tears of the lateral meniscus were found. Wound complications were frequent with infection (4.8%) always being associated with hematoma formation (9.5%).

Adult↗
PubMed1977

Lysosomal activation by neutral saccharides in cell cultures of synovium.

On exposure to sucrose or neutral polysaccharides, cell cultures from human synovium showed cytoplasmic vacuolation, increased numbers of lysosomes, and ultrastructural changes simulating those described in rheumatoid synovial intima and similarly treated embryonic caritlage and bone. These changes were accompanied by raised intracellular lysosomal enzyme activity without corresponding increases in the extracellular level of these enzymes. Structural changes and enzymic responses were less intense during exposure to the neutral polysaccharides. The secretion of large polymers of hyaluronic acid was consistently decreased during sucrose treatment. Evidence of heightened hyaluronidase-like activity was found in cellular extracts of sucrose-treated cultures, but not in the culture medium.

Acetylglucosaminidase↗
PubMed1977

Patella tracking.

Explore the source record for details and available documents.

Biomechanical Phenomena↗
PubMed1977

Surgical repositioning of the medial collateral ligament. An anatomical and mechanical analysis.

Analytical techniques using multiple-exposure roentgenograms were employed to investigate surgical repositioning of either the femoral or the tibial attachment of the medial collateral ligament. The motion of the femoral attachment of the ligament with respect to the tibial attachment was used to compute the changes in length of the borders of the ligament for normal knees and for knees with repositioned attachments. The results support the conclusion that when advancement of the medial collateral ligament is utilized in the treatment of medial instability, optimization is accomplished by distal and anterior advancement with the knee in 30 degrees of flexion. Femoral displacement (proximal realignment) or tibial displacement at knee-flexion angles greater than 45 degrees is not recommended.

Biomechanical Phenomena↗
PubMed1977

The cruciate ligaments of the canine stifle: an anatomical and functional analysis.

Fifty canine stifles were used to study the anatomy and function of the cruciate ligaments. The morphology of the ligaments and the shape of their bony attachments were determined by dissection. The relative tension of the ligaments in flexion and extension was determined by identifying the points of attachment of ligament fibers with small pins and making multiple radiographs as the stifle was taken through a range of motion. The distance between these points was then measured and the linear changes in the ligaments were defined. Measurements of rotation, craniocaudal displacement, extension, and flexion were made before and after cutting of one or both ligaments. It was found that both cruciate ligaments were composed of 2 component parts and that the geometry of their femoral attachments was responsible for a reciprocal loosening and tightening of these components through a range of motion. It was also found that transection of one or both cruciate ligaments resulted in marked joint instability.

Animals↗
PubMed1976

The anterior cruciate ligament. A functional analysis based on postmortem studies.

In forty fresh human cadaver knees the function of the anterior cruciate ligament and of its two component parts, the posterolateral part and the anteromedial band, were studied by cutting these ligaments and others in different sequences and combinations and then manually stressing the knees. The anterior drawer sign cannot be obtained unless the anteromedial band is severed. The postolateral part and the medial collateral ligament are, respectively, the secondary and tertiary restraints limiting the anterior drawer sign. Both internal and external rotation are limited by the anterior cruciate ligament, especially when the knee is in extension. The anterior cruciate ligament also limits hyperextension.

Autopsy↗
PubMed1975

Porous hydrophilic polymer: good and bad news in the orthopedic application of cruciate ligament substitution.

In the configuration used, the Hydron sponge did not enhance the ingrowth of bone into the Dacron for prosthesis anchorage. In fact, the presence of the Hydron seemed to retard such ingrowth, even though there was bony incorporation of portions of the Hydron polymer. Fixation was more rigid when Dacron was implanted bare. Hydron sponge does not appear to remain intact within a joint. It would not seem suitable for intra-articular protection of a prosthesis or local delivery of antibiotics here. We did not search further for the polymer in the regional lymph nodes. Hydron sponge is capable of eleciting an unusual phenomenon of woven bone formation. This is "good news" for its potential, but realization of such potential will certainly require additional study. Double and triple interval fluorochrome labelling would be especially helpful in further studying the localization and rate of this bone formation.

Acrylates↗