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Biomedical subjects

T A Wright

Publications and source records attributed to T A Wright.

26 records · Page 2Linked to original sources
PubMed1986

Ventilatory patterns during hypoxia, hypercapnia, and exercise in adolescents with mild scoliosis.

Adolescents with mild, asymptomatic scoliosis (thoracic curvature less than 35 degrees) may have little or no impairment of resting lung volumes. Progression to more severe disease may, however, be accompanied by lung restriction, impaired exercise tolerance, and respiratory failure with CO2 retention. We wished to see whether adolescents with mild scoliosis and minimally abnormal resting pulmonary mechanics had impairment of their responses to hypercapnia, hypoxia, and progressive cycle exercise. Forty-four adolescents with idiopathic scoliosis were studied. The mean forced vital capacity (FVC), expressed as a percentage of the predicted value, was 94.3 +/- 2.2 (SE). The mean ventilatory response to hypercapnia (2.57 +/- 0.24 L/min/mm Hg) was within the normal range but was achieved with a tidal volume response (1.87 +/- .17% vital capacity [VC]/mm Hg) that was significantly lower than that previously reported in healthy young adults. Ventilatory responses to exercise were also within the normal range, the mean dyspnea index (VE-max/maximal voluntary ventilation) = 0.92 +/- 0.04. However, at a ventilation of 30 L/min, the tidal volume was 0.38 +/- 0.01% FVC, which was considerably lower than predicted. The tidal volume response to hypoxia was also abnormally low, the mean response being 0.52 +/- 0.059% VC/% decrease in arterial O2 saturation. These findings indicated that, even when scoliosis is asymptomatic and associated with minimal impairment of resting pulmonary function, abnormal patterns of ventilation occur during exercise or in response to chemical stimuli.

Adolescent↗
PubMed1984

Pulmonary function in adolescents with mild idiopathic scoliosis.

Spirometric indices, lung volumes, maximum voluntary ventilation, and maximum inspiratory and expiratory pressures were measured in 44 adolescents with mild idiopathic scoliosis (spinal curvature less than 30 degrees). All were symptom free, but six (13.6%) showed a restrictive defect with forced vital capacity less than 80% of predicted. In 12 subjects (27.3%) maximum voluntary ventilation was reduced to less than 80% of predicted normal. Forced vital capacity was significantly correlated with maximum inspiratory pressure and with maximum expiratory pressure, measures of respiratory muscle strength, but was not related to the degree of thoracic curvature. When maximum inspiratory pressure and forced vital capacity were corrected for differences in body size these variables remained positively correlated, most significantly in the girls. These data indicate that ventilatory function may be impaired in mild, idiopathic scoliosis and that the force developed by the respiratory muscles is a more important determinant of this impairment than the radiologically determined degree of spinal curvature.

Adolescent↗
PubMed1977

8. Self-compressing implants in the management of fractures.

Internal fixation of fractures has become increasingly important since the introduction of self-compressing implants. Rigidity of fixation thus ensured permits primary bone healing. Two types of self-compressing implants are available--screws and plates. The former produces compression between fracture fragments, the latter, along the long axis of the bone. Two common types of plates are the dynamic compression plate and the Osteo self-compressing plate. Use of self-compressing implants requires familiarity with the technique, a definite plan of operation, and strict asepsis and lack of infection in the patient. Indications for the technique include failure or unsuitability of closed reduction of fractures, care of associated serious soft-tissue injuries, and displaced intra-articular fractures. Use of self-compressing plates hastens rehabilitation, lessens joint stiffness and reduces the duration of hospitalization. The incidence of nonunion with self-compression techniques is lower than with traditional methods of fracture management.

Bone Plates↗
PubMed1975

Accessory spinal nerve injury.

In 7 cases of peripheral lesion of the spinal accessory nerve 4 were produced by malignancy, two by iatrogenical resection of lymph nodes, one by an en bloc dissection of the neck for arteriovenous malformation. Incapacity following the injury is quite marked and includes weakness of the sternomastoid and trapezius muscles, as well as pain presumably from traction on the brachial plexus. The importance of avoiding the nerve in surgical intervention in the neck must be strongly emphasized. A review of the literature suggests that in fresh injuries the spinal accessory nerve should be explored and resutured. Our own experience, however, with nerve repair has been disappointing.

Accessory Nerve↗
PubMedDate not supplied

Pathological plicae of the knee mistaken for arthritis.

Synovial plicae are persistent embryological folds present in normal knee joints. Plicae may become pathological and give rise to symptoms. Two brothers with pathological medial plicae are described in whom the condition was mistaken for arthritis. The role of arthroscopy in diagnosis and treatment is discussed.

Adult↗