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Biomedical subjects

R Gillespie

Publications and source records attributed to R Gillespie.

At least 37 records · Page 2Linked to original sources

Hazards of internal fixation in the treatment of slipped capital femoral epiphysis.

We reviewed the records of 202 patients (308 hips) in whom a slipped capital femoral epiphysis had been fixed with pins or screws. A serious complication that was directly related to the use of internal fixation developed in eighty hips (26 per cent). The rate of complications in the 202 patients was 40 per cent. In thirty-six (18 per cent) of the 202 patients, an additional procedure was done to correct a pin-related complication. Forty-one hip joints had been penetrated by a pin. Other complications included avascular necrosis (fourteen hips), chondrolysis (nine), fracture (one), infection (one), further slippage (one), sciatic-nerve injury (one), and breakage of a screw (eight). Ways of decreasing the incidence of complications of fixation were explored.

Bone Nails↗

Gold-conjugated arabinogalactan-protein and other lectins as ultrastructural probes for the wheat/stem rust complex.

Arabinogalactan-protein (AGP, "beta-lectin") was isolated from leek seeds, tested for specificity, conjugated with gold colloids, and used as a cytochemical probe to detect beta-linked bound sugars in ultrathin sections of wheat leaves infected with a compatible race of stem rust fungus. Similar sections were probed with other gold-labeled lectins to detect specific sugars. AGP-gold detected beta-glycosyl in all fungal walls and in the extrahaustorial matrix. Other lectin gold conjugates localized galactose in all fungal walls except in walls of the haustorial body. Limulus polyphemus lectin bound only to the outermost layer of intercellular hyphal walls of the fungus. Binding of these lectins was inhibited by their appropriate haptens and was diminished or abolished in specimens pretreated with protease, indicating that the target substances in the tissue were proteinaceous or that polysaccharides possessing affinity to the lectin probes had been removed by the enzyme from a proteinaceous matrix by passive escape. Binding of Lotus tetragonolobus lectin was limited to the two outermost fungal wall layers but was not hapten-inhibitable. Limax flavus lectin, specific for sialic acids, had no affinity to any structure in the sections. In the fungus, the most complex structure was the outermost wall layer of intercellular hyphal cells; it had affinity to all lectins tried so far, except to Limax flavus lectin and to wheat germ lectin included in an earlier study. In the host, AGP and the galactose-specific lectins bound to the inner domain of the wall in areas not in contact with the fungus. At host cell penetration sites, affinity to these lectins often extended throughout the host wall, confirming that it is modified at these sites. Pre-treatment with protease had no effect on lectin binding to the host wall. After protease treatment, host starch granules retained affinity to galactose-specific lectins, but lost affinity for AGP.

Carbohydrate Metabolism↗

Water-soluble contrast medium for intraoperative evaluation of anterior cervical discectomy. Technical note.

When anterior cervical discectomy is performed for either "hard" or "soft" cervical disc herniation using either the Cloward approach or simple discectomy, it is often difficult to confirm intraoperatively the adequacy of the lateral, superior, and inferior margins of the dissection. Placement of a nonionic contrast material, iohexol, into the disc space before obtaining anteroposterior and lateral x-ray spine films can indicate the adequacy of the margins of dissection of the soft disc or bone ridge to prevent a poor operative result.

Cervical Vertebrae↗

Relationships between Rorschach variables as relevant to the interpretation of structural data.

The protocols of 100 adult nonpatients who had been administered the Rorschach twice in a long term temporal consistency study were used in this study. Separate intercorrelational matrices were calculated for each testing with R partialed. Means of the pairs of partial correlations were calculated, the square root of which is considered the best available estimate of the correlation between each pair of variables. Fifteen of the 120 partial correlations are considered to be significant. The findings are discussed in terms of their potential relevance for configurational interpretation of structural data.

Journal Article↗

Anteroposterior instability of the knee: a sign of congenital limb deficiency.

A clinical sign of anteroposterior instability of the knee has been noted in patients with evidence of a congenital lower limb deficiency. This instability can be a reliable diagnostic sign during infancy when radiologic deficiency is barely evident. Furthermore this sign is evidence that apparent isolated deficiencies of femur, tibia, or fibula are actually deficiency in the development of the entire limb.

Bone Diseases, Developmental↗

Classification and management of congenital abnormalities of the femur.

Sixty-nine patients with congenital abnormality of the femur were reviewed. Their manifestation of femoral dysplasia ranged from an intact femur approximately 60 per cent of the length of the normal leg to a subtotal absence of the femur in which only the femoral condyles remained, often with a congenital fusion of the knee joint. Two groups were defined: Group I consisted of those with congenital hypoplastic femur in which the hip and knee could be made functional and where, in some patients at least, leg equalisation was possible; Group II consisted of those with true proximal focal femoral deficiency where the hip joint was never normal and the knee joint was always useless. The patients in each group were examined and evaluated with respect to clinical signs, surgical procedures performed, and prosthetic requirements and function. A protocol of treatment for both groups is suggested.

Ankle Joint↗

Rotationplasty of the lower limb for congenital defects of the femur.

The operative technique for combined fusion of the knee and rotationplasty of the limb in the management of congenital deficiency of the femur is presented. The technique described allows earlier definitive prosthetic fitting of a child with proximal femoral deficiency; it has reduced the number of operative procedures needed to obtain the optimal function from that deficient limb; and it has enabled these procedures to be performed at an earlier age. The technique differs from those previously described and represents a significant improvement in management of the patient with femoral deficiency.

Arthrodesis↗

The use of shortened periods of rigid postoperative immobilization in the surgical treatment of idiopathic scoliosis.

Seventy-eight consecutive patients with idiopathic scoliosis treated by Harrington instrumentation and spine fusion were allowed to walk shortly after operation, first in an underarm plaster cast for ten weeks and then in a canvas-front, hard-back Rohadur or Lexan brace until all external support was discontinued six months after operation. Sixty-four patients were followed for two years or more. Single thoracic curves, comprising almost half of the series, had an average final correction of 48 per cent, while all curves had an average final correction of 44 per cent. The average total loss of correction was 8 degrees, with approximately equal amounts lost in the first and second three months after operation. The incidence of pseudarthrosis was 1.5 per cent and the complications were minor. This series demonstrated that, for cooperative patients with idiopathic scoliosis of less than 90 degrees, the operative procedure and postoperative immobilization described can be expected to result in solid fusion without excessive loss of initial correction, pleasing cosmetic results, and less inconvenience to the patient because of decreased time in a plaster cast and early ambulation.

Adolescent↗

Clinical evaluation of UNB 3-state myoelectric control for arm prostheses.

This report describes an attempt to conduct (in 1978 during a period of one week) an intensive, thorough, and objective evaluation of a prosthetic control system in such a manner that the evaluation avoids what are seen as shortcomings common among evaluation procedures described in the literature. The evaluation, in terms of benefits to patients, involved consideration on an interdisciplinary basis among an engineering team, prosthetics team, and therapy team. Nine below-elbow and two forequarter amputees participated. The device evaluated was the University of New Brunswick 3-state myoelectric control system, in the 12-volt version designed in 1975. This system is intended for use where there are not enough control sites to permit use of an Otto Bock or similar control system, and permits on/off control of a powered hand or other device in two directions from a single muscle. Observations on each patient by the 14-person evaluation team are summarized, and an Appendix presents questionnaires with summarized responses of the subjects and their families.

Adolescent↗

Surgical management of thoracic kyphosis in adolescents.

Twenty-seven patients of a group of twenty-nine who underwent posterior spine fusion using Harrington compression instrumentation for Scheuermann's disease or postural roundback deformity were reviewed with a mean follow-up of 27.6 months. The mean curve before operation was 72 degrees and at review, 46.1 degrees. The mean loss of correction in the fusion from initial examination to final follow-up was 5.7 degrees. This procedure can achieve satisfactory correction of deformity as well as pain relief. We think that Harrington compression instrumentation and spine fusion is indicated in selected cases of roundback deformity.

Adolescent↗