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Biomedical subjects

S R Simon

Publications and source records attributed to S R Simon.

At least 127 records · Page 7Linked to original sources
PubMed1979

Clinical study of total ankle replacement with gait analysis. A preliminary report.

Twenty-one ankle replacements in nineteen patients after an average follow-up of 14.7 months were analyzed with respect to their history, physical and roentgenographic findings, and gait analysis. The relief of pain and functional improvement after operation were disappointing compared with the results of prosthetic replacement in other joints and were not related to early complications, age, diagnosis, or the prosthesis used. Muscle weakness about the ankle, especially of the plantar flexors, was a prominent finding and appeared to cause abnormal patterns of gait and of ankle motion. The frequency of progressively increasing radiolucent lines was 88 per cent and of late loosening, 10 per cent. These results suggest a need for more emphasis on postoperative rehabilitation and on the uncertainty of this procedure at its present stage of development.

Activities of Daily Living↗
PubMed1978

High yield photoreagents for protein crosslinking and affinity labeling.

4-Nitrophenyl ethers are proposed as new high-yield photoreagents for protein crosslinking and affinity labeling. These are totally unreactive in the dark under biological conditions, but react quantitatively with amines at pH 8 upon irradiation with 366-nm light. The reaction of monoalkoxy-p-nitrobenzenes with an amine yields the corresponding free alcohol and substituted nitrophenylamine. In essence, the nitrophenyl group is transferred from the alcohol to the amine. Bifunctional affinity reagents of this type could be especially useful for placing the p-nitrophenyl chromophore adjacent to a binding site without blocking it. The corresponding 2-methoxy-4-nitrophenyl ethers react with amines by displacement of the methoxyl group. Thus, bifunctional reagents of this class could be photocrosslinkers. A maleimide-containing 2-methoxy-4-nitrophenyl ether was attached to human fetal hemoglobin at gamma-cysteine F9 stoichiometrically. Subsequent ultraviolet irradiation yielded a gamma-gamma crosslinked hemoglobin in 80% yield. The oxygenation properties of the derivative indicate that it is locked in a high affinity conformation and that all cooperativity is lost.

Journal Article↗
PubMed1978

Total hip replacement with and without osteotomy of the greater trochanter. Clinical and biomechanical comparisons in the same patients.

Twelve patients with bilateral hip replacement, one side performed with a trochanteric osteotomy and the other without osteotomy, were analyzed by review of the clinical records, the findings on physical examination, preoperative and postoperative Harris hip scores, each patient's evaluation, biomechanical analysis of the preoperative and postoperative roentgenograms of the hips and pelvis, and force-plate gait analysis. All operations yielded good results clinically but the majority of patients preferred the replacement done without osteotomy. Blood loss and trochanteric bursitis were greater problems in patients who had an osteotomy. There were no differences between the two groups in the postoperative Harris scores or in the biomechanical measurements made on the preoperative and postoperative roentgenograms except for the change in the abductor-muscle length. Changes in this parameter correlated well with the patients' symptoms and clinical findings.

Adult↗
PubMed1978

Role of the posterior calf muscles in normal gait.

The role of the calf muscles during the single-limb stance phase of gait was assessed in fifteen normal subjects and in seven with either an amputation or a neuromuscular deficit. Normal activity of the muscles, paralysis by nerve blocks, and stability versus instability of the ankle were studied. Pelvic displacement and velocity, step length, and step time were evaluated for each limb during the gait cycle, and the contribution of activity of calf muscles to each was determined. Limb-segment position, lower-limb joint angles, over-all cadence, velocity, and stride length were measured to reveal compensatory mechanisms in the absence of muscle strength in the calf. The results indicate that the force produced by activity of calf muscles is used to restrain the body's own forward momentum and not used to propel it further. Absence of the calf muscle causes an immediate compensatory reaction directed toward maintaining over-all stability rather than speed.

Adolescent↗
PubMed1978

Pregnancy after jejunoileal bypass. A review and report of one case.

A case of pregnancy after jejunoileal bypass is presented. Fifty-six full-term pregnancies among 44 patients reported in the literature are reviewed. Pregnancy is not contraindicated after jejunoileal bypass, as it is accompanied by few more problems than those normally encountered in the obese woman. Somewhat smaller babies are born from these pregnancies and some minor disturbances of glucose, protein, and minerals may have to be adjusted during the pregnancy. A two-year interval is suggested after jejunoileal bypass before pregnancy is undertaken, to allow a weight-loss plateau to be established. The 7% incidence of severe congenital anomalies among these 57 pregnancies is higher than normal and suggests an added risk.

Adult↗
PubMed1978

Genu recurvatum in spastic cerebral palsy. Report on findings by gait analysis.

Using high-speed motion pictures, electromyography, a dynamic piezoelectric force plate, and computer analysis of the data, the gait patterns of fifteen children, four to sixteen years old, with spastic cerebral palsy and genu recurvatum were analyzed to determine the mechanisms producing genu recurvatum and the effect of fixed-ankle below-the-knee orthoses. In all children the recurvatum during stance phase began when the tibia stopped moving forward and disappeared when tibial movement resumed. In six patients (Group I), excessive activity of the calf muscles in response to the increasing dorsiflexion moment about the ankle produced by the foot-floor reaction force arrested the forward motion of the tibia. In six others (Group II), the contraction of the calf muscles was not sufficiently strong to resist the dorsiflexion moment and the tibia moved forward until maximum dorsiflexion had occurred and then stopped. In both instances recurvatum was produced when the femur continued to move forward over the stationary tibia and an extension moment was produced at the knee. In no patient did activity of the knee flexors prevent recurvatum, which was eliminated only by resumption of forward movement of the tibia. This movement of the tibia was produced either by heel-off (Group I) or by sudden unweighting of the limb due to opposite heel-strike (Group II). In Group I, when tibial motion stopped in the first half of stance phase the position of the hip rapidly changed from flexion to extension and there was forward leaning of the trunk, while in Group II the change from hip flexion to extension occurred with backward leaning of the trunk. The fixed-ankle below-the-knee orthosis, by preventing excessive dorsiflexion and plantar flexion, produced more normal moments about all joints, especially the knee. In the three children (Group III) whose recurvatum was permanently corrected by the brace, no explanation for the improvement was evident in these studies.

Adolescent↗
PubMed1976

Influence of globin structures on the state of the heme. Ferrous low spin derivatives.

Studies of high spin ferrous and ferric derivatives led us to conclude that in the quaternary R structure the state of the hemes is similar to that in the free alpha and beta subunits, but in the T structure a tension acts on the hemes which tries to pull the iron and the proximal histidine further from the plane of the porphyrin. We have now studied the effect of inositol hexaphosphate (IHP) on the three low spin ferrous compounds of hemoglobin with O2, CO, and NO. IHP failed to switch the quaternary structure of carbonmonoxy- and oxyhemoglobin A to the T state, but merely caused a transition to an as yet undefined modification of the R structure. IHP is known to cause a switch to the T structure in hemoglobin Kansas. We have found that this switch induces red shifts of the visible alpha and beta absorption bands and the appearance of a shoulder on the red side of the alpha band; these changes are very weak in carbonmonoxy- and slightly stronger in oxyhemoglobin Kansas. As already noted by previous authors, addition of IHP to nitrosylhemoglobin A induces all the changes in uv absorption and CD spectra, sulfhydryl reactivities, and exchangeable proton resonances normally associated with the R leads to T transition, and is accompanied by large changes in the Soret and visible absorption bands. Experiments with nitrosyl hybrids show that these changes in absorption are caused predominantly by the hemes in the alpha subunits. In the accompanying paper Maxwell and Caughey (J. C. Maxwell and W. S. Caughey (1976), Biochemistry, following paper in this issue) report that the NO in nitrosylhemoglobin without IHP gives a single ir stretching frequency characteristic for six-coordinated nitrosyl hemes; addition of IHP causes the appearance of a second ir band, of intensity equal to that of the first, which is characteristic for five-coordinated nitrosyl hemes. Taken together, these results show that the R leads to T transition causes either a rupture or at least a very dramatic stretching of the bond from the iron to the heme-linked histidine, such that an equilibrium is set up between five- and six-coordinated hemes, biased toward five-coordinated hemes in the alpha and six-coordinated ones in the beta subunits. The reason why IHP can switch nitrosyl-, but not carbonmonoxy- or oxyhemoglobin A, from the R to the T structure is to be found in the weakening of the iron-histidine bond by the unpaired NO electron and by the very short Fe-NO bond length.

Binding Sites↗
PubMed1975

"Stiction-friction" of total hip prostheses and its relationship to loosening.

The static friction, or "stiction-friction", in McKee-Farrar and Charnley-Müller prostheses in a hip joint simulator was compared with dynamic friction determined while the prostheses were oscillated. Under physiological conditions stiction-friction differed little from dynamic friction in both metal-on-metal and metal-on-plastic prostheses, and was affected very little by the lubricant as long as some fluid was present. Stiction-friction increased significantly only after relatively long stationary periods and high loads. However, the frictional forces generated in total hip-replacement prostheses were at least forty times higher than those generated in normal joints and may well be enough to cause late loosening of acetabular components by fatigue failure.

Acetabulum↗