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Biomedical subjects

R L Harding

Publications and source records attributed to R L Harding.

At least 19 recordsLinked to original sources

Growth, body composition, hormonal and metabolic status in lambs treated long-term with growth hormone.

The effect of long-term (10 weeks) treatment with growth hormone (GH) was investigated in twin lambs, one sibling being a control and the other treated with GH (0.1 mg/kg live weight per d). The lambs were fed on a concentrate-grass cube (9:1 w/w) diet at a daily rate of 40 g fresh weight/kg live weight. The average daily live-weight gain of the GH-treated lambs was 36% greater than that of the controls (307 v. 225 g/d, P less than 0.01). The carcass composition of the GH-treated lambs changed: fat content was decreased (P less than 0.01) and protein content was increased (P less than 0.05) when expressed relative to carcass dry matter. The absolute weights and the weights when expressed relative to fleece-free empty body of some muscles were significantly increased in GH-treated lambs. The mean retention times of both particulate- and liquid-phase components of the digesta were unchanged by GH treatment, when calculated for the rumen or for the entire gastrointestinal tract. The feed conversion ratio was significantly greater (P less than 0.01) in GH-treated lambs compared with controls. Nitrogen retained per g N intake was also significantly increased (P less than 0.05) by GH treatment. Plasma urea concentrations were decreased (P less than 0.05) and glucose concentrations were increased (P less than 0.01) in GH-treated lambs, whereas non-esterified fatty acid concentrations were unchanged. Plasma insulin and total insulin-like growth factor-1 concentrations progressively increased in GH-treated lambs as treatment time continued. They were significantly correlated after week 4 of treatment. Two types of hepatic GH-binding site were detected, with high and low affinities for GH. The capacities of both binding sites were significantly increased (P less than 0.05) in GH-treated lambs when expressed per unit microsomal protein but, when expressed per liver, only the capacity of the high-affinity site was increased.

Animals

Long-term survival with thorotrast cervical granuloma.

Thorium dioxide, a radioactive contrast material, was commonly used for cerebral angiography prior to recognition of its radiation hazard. Extravasation of the material into the extravascular tissue in the neck results in granuloma formation, thorotrastoma, long-term morbidity, and an increased incidence of benign and malignant tumors. We report our experience with the management of 2 patients who underwent cerebral angiography with thorotrast more than 25 years ago. Aggressive surgical excision of involved tissue is warranted to ameliorate symptoms and diminish the risk of malignancy.

Adult

Surgical treatment of pressure ulcers.

The authors' philosophy and regimen of treatment, based on experience with 103 pressure ulcers in 75 patients, are presented. This experience illustrates that the problem of pressure ulcers can be managed well by the application of sound surgical principles in a community hospital with a rehabilitation unit. With some simplification, the standard treatment procedures can be applied easily in this setting.

Humans

The team approach to treatment of the cleft lip and palate.

The team consists of a family physician, plastic surgeon, orthodontist, prosthodontist, otolaryngologist, speech therapist, audiologist and social worker. A cleft lip is usually repaired when the child weighs 10 lb., is 10 weeks old and has 10 Gm. of hemoglobin. Defects of the secondary palate are repaired between one and two years of age; residual lip or nasal deformities are corrected before the child starts school. Further cosmetic surgery is delayed until adolescence, when facial growth has been completed.

Child

Longitudinal analysis of growth of the soft palate and nasopharynx from six months to six years.

Between the ages of six months and six years, longitudinal lateral headfilms were taken on 54 patients with palatal clefts or with unilateral and bilateral clefts of the lip and palate. They were measured and were compared to data on both normals and subjects with clefts of the lip only. The objectives of the study were: 1. To sutdy the effects of palatal surgery on the growth of the soft palate. 2. To compare the growth of the soft palate and nasopharynx among the patients with various types of clefts and normals. 3. To study the growth acceleration or so-called catch-up growth after palatal surgery at various ages. (Anterior palatal surgery at 14 months +/- 2 months. Posterior palatal surgery at 16 months +/- 2 months.) 4. To evaluate the relationship between velopharyngeal growth in cleft groups and voice quality.

Child

A longitudinal study of morphological craniofacial patterns via P-A x-ray headfilms in cleft patients from birth to six years of age.

652 P-A X-ray headfilms of 51 unilateral cleft lip and palat, UCLP; 27 bilateral cleft lip and palate, BCLP; and 62 isolated cleft palate, CP were studied longitudinally at 0-3 months, 4-6 months, and annually from 1:0-6:0 years. Breadth change, height change, and growth direction of nine paired landmarks were investigated by means of the rectangular coordinate system with right to left zygomatico-frontal suture (Zf) point line as the X-axis and the perpendicular line to this X-axis at the mid-point between the right and left Zf points as the X-axis. Major findings were: (1) Study of Sphenoid body, interorbital, bizygomatico-frontal suture, and bizygomatic arch breadths showed that BCLP had a significantly broader face than either UCLP or CP. An apparent tendency to hypertelorism still remained at 6:0 in this group while UCLP and CP groups were both close to the Bolton Standards. (2) Nasal and maxillary bredths of BCLP and UCLP were significantly wider during the first year than in CP, but they showed only a slight growth change after the age of one year, compared to constant growth in CP. (3) All marked structural differences disappeared by 6:0 suggesting the effects of lip and/or palate surgery. (4) A slight cross-bite was found in UCLP and BCLP, but there was no such cross-bite in CP. (5) The effect of clefting was seen in mandibular dimensions where the bigonial notch was slightly broader than in non-cleft averages. (6) Upper facial height occlusal height, and posterior total facial height in each cleft group seemed to be larger than the Standard, though both maxillary height and gonial notch height approximated the Standard by 6:0 (7) From 0:3-6:0, there was no noteworthy difference among the cleft groups in either growth direction or facial symmetry of upper face and mandible. It was only in the mid-facial and dental areas that notable characteristics peculiar to the type of cleft were found. The landmarks of nasal aperture, maxilla, and dental arch showed a slight medial displacement on the affected side, although the degree and amount depended on the cleft-type.

Cephalometry

The increasing complexities in the world of plastic surgery.

The increasing complexities in medicine, in medical education, and in plastic surgery seem to almost defy resolution. The best way to cope with these complexities, and to provide opportunity on an individual or a group basis, is by adherence to quality training program of the type which has served us well and in which the objective is constant. This implies the selection of high-quality candidates for training, and the control of resident flow, so that we may continue as a learned profession. History witnesses change--and time will bring new philsophies, new surgeons with changing values, and a public oriented to a different system of medical care. Shakespeare said, "when the day ends, the end will be known." I am confident that plastic surgery, with its traditional emphasis on quality and excellence, will long endure as a most learned profession.

Education, Medical