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Biomedical subjects

T K Taylor

Publications and source records attributed to T K Taylor.

At least 73 records · Page 4Linked to original sources

Desmoid tumors in childhood.

Eight cases of extraabdominal desmoid tumors in children are reviewed. Seven were located in the pelvis or forearm, and the most common presenting complaint was a slowly enlarging mass. In all cases, diagnosis was established by open biopsy, and initial treatment was by surgical excision. At follow-up (average, 5.8 years), six patients were tumor free. Desmoids are benign tumors that usually carry a good prognosis. There is no difference between the tumor behavior in children and adults. The treatment of choice is wide local excision. If vital structures are involved, it may be more appropriate to preserve function by performing partial tumor excision. For quiescent recurrent tumors, observation is appropriate management, but if further treatment is required, reexcision or radiotherapy may be tried.

Adolescent↗

Variations of the proteoglycans of the canine intervertebral disc with ageing.

A group of young (2.0 +/- 0.6 years) (group 1) and old (9.7 +/- 1.5 years) (group 2) beagle dogs were given Na2 35SO4 (1.0 mCi/kg) intravenously 60 days prior to being killed to radiolabel their proteoglycans. Lumbar discs were removed and dissected into nucleus pulposus and annulus fibrosus. Proteoglycans were extracted at 4 degrees C from these tissues with buffered 4.0 M Gdn-HCl containing proteinase inhibitors, and purified by CsCl density gradient ultracentrifugation. The average hydrodynamic size and ability of the purified proteoglycans to aggregate in the presence of excess hyaluronic acid was determined by Sepharose CL-2B chromatography. The galactosamine/glucosamine ratios of these proteoglycans as well as their non-aggregating fractions were also ascertained. The proteoglycan content of discs of old animals was significantly less than in the young. The proportion of 35S-labelled, or non-labelled proteoglycans which could aggregate in the presence of hyaluronic acid was also much lower in the preparations isolated from the older discs. In contrast, the average hydrodynamic size of the non-aggregating proteoglycans isolated from the annuli fibrosi of group 2 animals were larger than the corresponding population of group 1 animals. Aminosugar analysis of these same proteoglycan fractions from older animals afforded galactosamine/glucosamine ratios (mean 1.81 +/- 0.14) which were less than the younger age group (mean 2.63 +/- 0.40). These data suggest that with ageing and degeneration the proteoglycans of the beagle disc undergo increased degradation with the accumulation in the annulus fibrosus of a population which is of larger average hydrodynamic size and richer in keratan sulphate than proteoglycans present in younger tissues.

Aging↗

Hangman's fracture in an infant.

A case is reported of fracture of the pedicles of the axis vertebra in an infant. Non-operative management in a Minerva cast resulted in union and full recovery without complications.

Axis, Cervical Vertebra↗

A reappraisal of acute traumatic central cord syndrome.

A review of 77 patients with traumatic central cord syndrome revealed that atypical variations are more common than the existing literature suggests and that these may be seen in a wide variety of acute injuries to the cervical spine. In general the outcome is good; a favourable prognosis on admission is suggested by good hand function, hyperpathia, Lhermitte's sign and normal perianal sensation. The study has highlighted the value of regular muscle charting and has cast doubt on previous neuroanatomical assumptions about the syndrome.

Accidents, Traffic↗

Bolt-plate fixation for anterior spinal fusion.

A bolt-plate device for fixation of distal thoracic and proximal lumbar vertebral bodies has proved effective in a variety of surgical situations. The instrumentation is designed to obtain the optimum conditions for the healing of cancellous bone, namely, rigid immobilization and, if possible, close apposition of surfaces. The device may also be effectively employed to protect grafts used to replace a vertebral body.

Bone Plates↗

Intra-operative spinal cord monitoring during surgery for scoliosis using somatosensory evoked potentials.

The method of intra-operative monitoring of spinal cord function by spinal somatosensory evoked potentials (SEP), as used at the Royal Alexandra Hospital for Children during surgery for scoliosis is described. Using a non-polarisable platinum spinal epidural electrode, SEP elicited by tibial and peroneal nerve stimulation in the popliteal fossa are recorded proximal to the level of spinal correction. The large amplitude and discrete waveform of the SEP enable rapid signal acquisition and easy interpretation. The spinal SEP is stable under both therapeutic hypotension and general anaesthesia. Electrophysiological monitoring has now superceded the 'wake-up' test as an index of spinal cord function during corrective surgery for scoliosis.

Adolescent↗

The effect of bilateral medial meniscectomy on articular cartilage of the hip joint.

Bilateral medial meniscectomy of the knee joint was undertaken in 4 mature greyhounds. Four greyhounds of similar age served as nonsurgical controls. Six months after meniscectomy, all animals were sacrificed and femoral head articular cartilage (FHC) examined for collagen, uronic acid, galactosamine, glucosamine and hyaluronic acid (HA) content. The sequential extractability of proteoglycans (PG) with non-dissociative (0.5 M GuHCl) and dissociative (0.4 M GuHCl) solvents was also investigated. The levels of collagen, uronic acid, galactosamine and glucosamine of the FHC of the meniscectomized group remained normal relative to FHC taken from the control greyhounds but the level of HA was significantly depressed (p less than 0.05). The amount of PG extracted by 0.5 M GuHCl from the FHC of the meniscectomized group was 2.5 X that extracted from control cartilage. In addition, subsequent extraction of the residues with 4.0 M GuHCl only released half the amounts of PG extracted from control FHC under the same conditions.

Animals↗

Effect of postoperative immobilisation on the regrowth of the knee joint semilunar cartilage: an experimental study.

Bilateral total medial meniscectomy was undertaken in the knee joints of 12 adult greyhounds. One-half of the animals had one meniscectomised joint immobilised by an external fixation system for 5 weeks following meniscectomy. All animals were sacrificed 6 months after surgery. The menisci (regrown and normal) were examined for collagen content and analysed histochemically to assess collagen assembly and glycosaminoglycan (GAG) distribution. Although the collagen content of regrown tissues were not statistically different from normal medial or lateral menisci, the fibre development and GAGs were abnormal. It is concluded that movement following meniscectomy is likely beneficial to the matrix formation in the regenerating tissue, but this together with weight bearing may have a detrimental effect on articular cartilage of the medial joint compartment.

Animals↗

The evolution of eosinophilic granuloma of bone: a case report.

A case of eosinophilic granuloma in the humerus of a three and a half year old boy is described with serial roentgenographic evidence of the lesion developing over a period of two months prior to the commencement of treatment. After open biopsy and local steroid injection the lesion was observed to heal during the next ten months.

Bone Diseases↗

The effects of postoperative joint immobilization on articular cartilage degeneration following meniscectomy.

Bilateral medial meniscectomy was performed in 12 mature greyhounds. One knee joint of half the group was immobilized by a Kirschner splint for a period of 5 weeks immediately following meniscectomy, after which the device was removed and the animals were allowed free movement for a further 21 weeks before sacrifice. Three greyhounds served as controls. While the collagen levels of articular cartilage from the femoral condyles and tibial plateaus of meniscectomized animals were the same as that of controls, differences were found for proteoglycan (PG) content and extractability using nondissociative conditions (0.5 M guanidinium hydrochloride (GuHCl) but not dissociative conditions (4.0 M GuHCl). With nondissociative conditions, twice as much PG was extracted from medial femoral condyle of meniscectomized animals encouraged to bear weight on joints immediately after surgery compared to that from controls or animals in whom joints were immobilized after surgery. Proteoglycans from medial tibial plateau cartilage of the free contralateral joints of the immobilized group were more readily extracted using 0.5 M GuHCl and also showed a statistically significant depression of uronic acid levels relative to both controls and tissues of other surfaces. The data suggest that postoperative management of meniscectomy in the human may be more important than has hitherto been recognized.

Animals↗

The early management of thoracolumbar fractures by open reduction and internal fixation.

Twenty-eight patients with thoracolumbar fractures treated by open reduction and internal fixation with Harrington instrumentation are reviewed. An unresolved problem is the selection of patients for surgical management. It is a major operation requiring a surgeon experienced in both the care of spinal cord injuries and the use of spinal instrumentation. The technique permits more rapid mobilization, retraining and rehabilitation than nonoperative management.

Adolescent↗

Intervertebral disc calcification syndromes in children.

One hundred and twenty-seven cases of intervertebral disc calcification in children, including 11 previously unreported cases, have been analysed. A distinction is made between symptomatic and asymptomatic patients, whose age, sex and spinal distributions of the calcifications have been shown to differ. Radiologically detectable protrusions and later resorption of the calcifications are common events in symptomatic children, but are unrecorded in asymptomatic children. The spinal distribution of paediatric calcifications is quite different to that of adult and canine calcifications of the nucleus pulposus.

Adolescent↗