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Biomedical subjects

M A Goodman

Publications and source records attributed to M A Goodman.

53 records · Page 3Linked to original sources

Delayed surgical repair of ruptured ligaments: a comparative biomechanical and histological study.

The importance of prompt surgical repair of complete ligament ruptures was quantitated using 38 rabbits with standardized transection injuries ofthe medial collateral ligament of one knee. Tensile testing of the mechanical properties, coupled with histological evaluation allowed assessment of the integrity of suture repairs performed immediately after ligament injury, versus those with 3 and 10 day delay times as well as those with non-operative management. Surgical repair performed within the first 3 days is beneficial in terms of final repair strength. Irreversible ligament strength and stiffness deficits progressively accumulate during the 10 days immediately following injury. Surgical repair after more than 10 days postinjury is contraindicated since the postoperative mechanical properties of the healed ligament do not differ from those for non-operative injury management.

Animals↗

Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication.

Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: a) control--immobilization; b) control--immobilization plus periosteal stripping; c) simple fracture--osteotomy; d) delayed union--osteotomy plus periosteal stripping; and e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The nonunion group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning with quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment.

Animals↗

Hepatocellular carcinoma in association with androgen therapy.

The case of a young man with hypogonadism, who was treated for five years withmethyltestosterone and who developed hepatocellular carcinoma, is discussed. He received a course of 5-fluorouracil via the hepatic artery. Complete regression has been maintained for four years. It is likely that the androgen therapy is implicated in the development of the liver tumour. Recent reports of untoward effects of steroid hormones are reviewed.

Adult↗

Primary osteosarcoma of the skull.

In 33 cases of primary osteosarcoma of the skull in a relatively old age group, the sex ratio and poor prognosis is the same as in osteosarcoma of long bones. However, patients in the second decade of life free of neurologic disease have a better prognosis.

Adolescent↗

The quality of blood used for transfusion.

The current risk of disease transmission through homologous blood transfusion has lead to a revival in the use of autologous blood. The development of a coagulopathy increases the usage of blood and blood products and therefore the risk of disease transmission. Blood salvaged at operation is subjected to physical and humoral activating factors. The potential systems to be activated are located either in the plasma or non red cell cellular elements. Homologous blood and blood salvaged at operation before and after washing was examined for activation of the plasma and cellular systems by measuring the presence of fibrin degradation products (xDP's), activated complement (C3a) and plasminogen activator and inhibitor activity from the plasma systems; and elastase, serotonin, lysophospholipids, leukotriene B4, lysoplatelet factor and phospholipase A2 from the cellular systems. The plasma systems were activated in the salvaged blood which had elevated levels of xDP's and C3a compared to the patient's blood (p less than 0.05). The products of cellular activation were also elevated in operatively salvaged blood (p less than 0.01 for all the above products). The levels xDP's were normal but the levels of C3a increased in stored blood. The levels of the cellular systems, elastase, serotonin and lysoplatelet activating factor, increased with the duration of storage of bank blood. Unwashed and aged stored blood contains potentially harmful products. Consideration should be given to removal of non red cell elements in blood stored for surgery.

Blood Cells↗

A system for the surgical staging of musculoskeletal sarcoma.

A surgical staging system for musculoskeletal sarcomas stratifies bone and soft-tissue lesions of any histogenesis by the grade of biologic aggressiveness, by the anatomic setting, and by the presence of metastasis. The three stages: I--low grade; II--high grade; and III--presence of metastases, are subdivided by (a) whether the lesion is anatomically confined within well-delineated surgical compartments, or (b) beyond such compartments in ill-defined fascial planes and spaces. Operative margins are defined as intralesional, marginal, wide, and radical, and relate the surgical margin to the lesions, its reactive zone, and anatomic compartment. The system defines prognostically significant progressive stages of risk which also have surgical implications. When the system is linked to clearly defined surgical procedures, it permits appropriate evaluation and comparison of the new treatment protocols designed to replace standard surgical treatment.

Bone Neoplasms↗