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Biomedical subjects

J R Doyle

Publications and source records attributed to J R Doyle.

32 records · Page 2Linked to original sources
PubMed1988

Symphalangism in Hawaii: a study of three distinct ethnic pedigrees.

Symphalangism was introduced into Hawaii by a Cherokee Indian in the late 1800s. The resultant pedigree, along with two other racially distinct pedigrees, confirms that the condition is an autosomal dominant genetic trait. Associated conditions include carpal and tarsal coalitions, cervical fusions, brachydactylism, symphalangism of the toes, and hearing loss. Surgical intervention in the hands is seldom, if ever, indicated but correction of the associated hearing loss is rewarding.

Adolescent↗
PubMed1987

Occupational illness in the arts.

Artists and craftspeople are exposed to the same hazardous materials as workers in industry. Art materials, including solvents, stones, clay, metals and dyes, are all potential health hazards. Patients whose symptoms cannot be easily categorized or who do not respond to initial treatment should be questioned about personal activities in the arts and crafts. A questionnaire devised by the Occupational and Environmental Health Committee of the American Lung Association may be useful.

Art↗
PubMed1981

The effect of succinylcholine on denervated skeletal muscle.

Succinylcholine, commonly used in anesthesia, paralyzes normal skeletal muscles by blocking transmission at the myoneural junction, but in denervated muscle, it produces sustained muscle contractions lasting several minutes. This denervation hypersensitivity, believed to be due to the progressive enlargement of the receptor area, begins within 2 to 3 weeks and may last for months. Three patients with denervation hypersensitivity were studied: one with isolated denervation of the flexor pollicis longus and two with combined median and ulnar nerve palsy. Within 1 to 2 minutes after administration of succinylcholine, sustained contraction of the denervated muscles occurred and lasted 4 to 5 minutes. Succinylcholine, due to its ability to produce sustained muscle contraction in denervated muscles, may be a useful diagnostic aid in distinguishing loss of function due to nerve injury from tendon disruption.

Adult↗
PubMed1980

Restoration of elbow flexion in arthrogryposis multiplex congenita.

In 15 patients with arthrogryposis multiplex congenita, 18 operations were performed to improve elbow function. These operations were for seven cases of pectoralis transfer, seven cases of anterior transfer of triceps, two cases of posterior elbow release, and two cases of Steindler flexoroplasty. Results were evaluated on two simple criteria: single-hand feeding and improved elbow joint motion. These criteria showed that the pectoralis transfer was the most effective procedure.

Arthrogryposis↗
PubMed1979

Recovery of sensibility after suture of digital nerves.

A group of 49 patients with 74 injured digital nerves was studied more than 5 years following epineurial nerve suture. Three tests of return of sensibility were used: von Frey plastic filaments, a modified Weber two-point discrimination device, and a dynamic test--the plastic ridge. The correlation between two-point discrimination and tactilegnosis in the range of 8 to 12 mm was poor. The plastic ridge device detects the presence or absence of tactilegnosis in patients in the intermediate range of two-point discrimination between 8 and 12 mm. Of the factors studied, the patient's age at the time of nerve suture was found to be directly related to the return of sensibility by both two-point discrimination and ridge criteria.

Adolescent↗
PubMed1977

Anatomy of the flexor tendon sheath and pulleys of the thumb.

Studies of the pulley systems of the flexor tendon of the thumb demonstrate one oblique and two annular pulleys. Significant decrease in angular motion of the distal joint resulted when both the proximal annular pulley and the oblique pulley were removed, but isolated loss of either did not affect the motion appreciably. If the oblique pulley was intact, then loss of the distal annular pulley did not result in significant loss of motion.

Humans↗
PubMed1976

Treatment of Dupuytren's contracture. Long-term results after fasciotomy and fascial excision.

Of 359 hands treated surgically for Dupuytren's contracture, 135 were available for study after two years or more, often because of recurrence. Of the sixty-five hands treated by excision of the involved fascia (subtotal fasciectomy), 63 per cent had recurrences in the area operated on but only 15 per cent had sufficient deformity to warrant another operation. Of the forty-one hands treated by palmar fasciotomy, 43 per cent had recurrent deformities severe enough to warrant further surgical treatment. After palmar fasciotomy, improvement at the metacarpohalangeal joint persisted; but, as expected, the deformity at the proximal interphalangeal joint progressed just as it did in an untreated control group. The average postoperative period of disability was fifty-nine days after fasciectomy and twenty-one days after fasciotomy. Stiffness and hematoma occurred after fasciectomy but were not observed after fasciotomy. A digital nerve was severed during one fasciotomy and one fasciectomy. Excision of the involved fascia, therefore, gave the best long-term results but was associated with a higher incidence of postoperative complications.

Dupuytren Contracture↗
PubMed1974

Concentration effects of platelets, fibrinogen and thrombin on platelet aggregation and fibrin clotting.

The effects of varying concentrations of platelets, fibrinogen and thrombin on platelet aggregation and on fibrin clotting were investigated. The results indicated that a threshold thrombin to platelet concentration ratio may be required to cause platelet activation. Above the threshold ratio, platelets exhibited properties which enhanced thrombin action in causing aggregation and fibrin clotting. At T/P ratios below the threshold level, the presence of platelets reduced thrombin activity, in other words, platelets exerted an antithrombin action. Fibrinogen at low concentrations (0.02-1.5 mg/ml) enhanced platelet aggregation induced by thrombin; whereas, at high concentrations of fibrinogen (2.0-4.0 mg/ml), aggregation was markedly inhibited. Continuous mixing of samples of paltelets and fibrinogen at physiological concentrations with thrombin at low concentrations (less than 2.0 U/ml) resulted in platelet aggregation. On the other hand, fibrin clots formed in samples without mixing or with high thrombin concentrations (greater than or equal to 5.0 U/ml). These results suggested that the quantitative relationships between platelets, fibrinogen and thrombin, and the presence or absence of cell contact may be important factors in determining the overall hemostasis.

Antithrombins↗
PubMed1969

Dupuytren's contracture--etiology and principles of treatment.

Although Dupuytren's contracture was first described more than 300 years ago, the cause is not yet certainly known. It is only agreed that the disease process affecting the palmar fascia is most commonly found in older-aged males of Caucasian descent. Conservative or non-surgical treatment is usually ineffective. Surgical treatment includes fasciotomy, partial fasciectomy and total fasciectomy. Fasciotomy is indicated for localized disease or for patients with medical conditions which preclude more extensive operation. Subtotal fasciectomy with or without skin graft is the most commonly employed procedure. Total palmar fasciectomy is seldom indicated. Improved function of the hand can be anticipated after adequate surgical intervention.

Dupuytren Contracture↗
PubMed1968

The carpal tunnel syndrome. A review of 100 patients treated surgically.

The carpal tunnel syndrome, or compression neuropathy of the median nerve at the wrist, is a common cause of burning pain, numbness and tingling in the hand. The diagnosis is suggested by nocturnal paresthesias in the thumb, index and long fingers associated with signs of irritability of the median nerve in the carpal tunnel at the wrist. Surgical treatment in the form of incision of the transverse carpal ligament should be performed before irreversible motor and sensory changes occur.

Adolescent↗