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Biomedical subjects

T R Waugh

Publications and source records attributed to T R Waugh.

52 records · Page 3Linked to original sources

[Spondylolisthesis and related conditions; pathology, clinical aspects and treatment].

Close pathogenetic and morphologic relationships exist between the alterations of the lumbosacral spine designated as spondylolysis, spondylolisthesis and praespondylolisthesis. The initial management of 105 patients with such conditions was conservative. However, of this group 34 patients with persistent instability and/or intractable neurologic symptoms were subsequently treated surgically, and the majority of them obtained lasting benefits.

Adolescent↗

Radiation exposure during scoliosis screening radiography.

Screening programs to detect scoliosis in the adolescent population are active in most communities. Two percent of children screened will be referred for treatment or observation. Increasing concern has been voiced regarding the amount of the potential effects of the radiation administered in such screening programs. Radiation dosage was directly measured on 19 children participating in an established school scoliosis screening program, using lithium fluoride thermoluminescence dosimeters. The mean gonadal doses are measured to be 19 mrem in males and estimated at a maximum 95 mrem in females. The mean entrance skin dose was 174 mrem. A lack of uniformity in the radiographic techniques employed by individual technician was identified. The measured doses were within established acceptable limits and are comparable or below the average dose of 100 mrem received annually by the general public from the environment.

Adolescent↗

Surgical management of osteochondritis dissecans of the capitellum.

Ten cases of osteochondritis dissecans of the humeral capitellum which were treated surgically are reviewed. All 10 cases were males and involved the dominant side. The ages at surgery ranged from 13 to 17 years. Follow-up ranged from 1 to 7 years. All of the youths had competed in organized athletics, either baseball or football. By position there were three pitchers, two catchers, two infielders, and one outfielder; in addition there were one quarterback and one linebacker. Only one patient presented with locking of the elbow, whereas the others presented with pain and limitation of extension. The locked elbow was explored immediately and the others were explored after immobilization failed to relieve their symptoms. In seven of the joints a loose fragment of the capitellum was found lying either in the joint or in a defect in the capitellum. The fragment had multiple small holes. In three cases there was no loose fragment. In this situation a corticol window was cut above the capitellum. The capitellum was then drilled and bone was grafted from above. Over all, there were one excellent, six good, one fair, and two poor results. There seemed to be little difference between curretting alone or curetting and drilling. The cases with the cartilage intact and bone grafted from above did worse, with one fair and one poor result of three cases. The two poor results required further surgery, which consisted of partial excision of the capitellum. All cases lacked elbow extension before and after surgery, but nine of 10 gained some motion after surgery. Pre- and postoperative x-rays are shown in this report and a brief review of the literature concerning osteochondritis dissecans is presented.

Adolescent↗

Laboratory evaluation of various cold therapy modalities.

An attempt to evaluate the potential of four modalities to cool soft tissue mass has been done under laboratory conditions using canines. The cooling of deep soft tissues within the thigh after application of various cooling devices was recorded over a 60-min exposure period. Under these circumstances, ice performed best, a frozen gel pack performed in a parallel but slightly less efficient manner. Two other modalities, an inflatable bladder filled with refrigerant gas and an endothermic chemical reaction, were least efficient in cooling.

Acute Disease↗

Irvine ankle arthroplasty. Prosthetic design and surgical technique.

A total ankle arthroplasty (IAA) design is presented for highly selected cases. The design stems from investigations on the anatomical and biomechanical characteristics of the human ankle joint. The prostheses are inserted through an anterior approach. Full weight-bearing is well tolerated within a few days. The immediate results on 20 ankles are most encouraging.

Ankle Joint↗

The nature and designation of osteoarthritis determined by its histopathology.

Specimens of synovial tissue and articular cartilage removed at operations of patients with primary degenerative joint disease were scrutinized for defined histopathological parameters. The findings in the synovial membrane were subsequently compared as to frequency and intensity with identical parameters ascertained in specimens removed from patients with definite rheumatoid arthritis. These examinations disclosed the presence of synovial inflammatory features, although at lesser incidence and intensity than in rheumatoid arthritis; therefore the designation of arthritis is indicated. On the basis of the concurrently examined tissue specimens of the articular cartilage, and in consensus with the generally acknowledged start of the degenerative joint disease by disintegrating changes in the articular cartilage, the prefix of chondrosis is appropriate.

Aged↗

The alterations of the synovial membrane in rheumatoid arthritis treated with corticosteroids.

Sections of synovial tissue removed from patients with rheumatoid arthritis treated, for a long period of time or a brief period of time or not at all, with corticosteroids were examined for the incidence of histopathologic changes. Comparison of the quantification of these changes in the differently treated groups revealed that prolonged administration of corticosteroids had an inhibiting effect on the occurrence of lymphocytes and histiocytes in inflammatory infiltrates as well as on the hypertrophy of synoviocytes, on the proliferation both of fibroblasts and fibrocytes, and on the formation of villi and collagen fibers.

Adrenal Cortex Hormones↗

Total knee arthroplasty in 1984.

In total knee arthroplasty, as little bone as possible should be removed, all intact ligaments should be saved, and fixation by biologic ingrowth, rather than methylmethacrylate, should result in the lowest incidence of loosening.

Adult↗

Anaerobic infection after total hip replacement. Report of three cases.

In a series of 387 consecutive total hip replacements there were nine infections (2.3% infection rate). Three of the infections were caused by an anaerobic gram positive cocci, Peptococcus. This is an increased incidence of infection for this previously rare pathogen. The anaerobic infections occurred despite prophylactic antibiotic coverage with Keflin. No causative factors such as hospital, operating time, operating personnel, medical disease, or blood loss could be associated with the observed anaerobic infections. Two of the anaerobic infections appeared late. This is consistent with other reports of anaerobic infections in implants. Drainage after total hip arthroplasty operation must be cultured for anaerobes as well as aerobes, especially late infections in patients on prophylactic antibiotics. Drainage which is sterile to aerobic culture should alert the physician to a possible anaerobic infection.

Adult↗

Body type and rotational laxity of the knee.

Forty young adult males were somatotyped according to the Health-Carter Modified Method and were separated into 2 groups. One group was a meso-endomorphic body type (5-6-1) and the other was ectomorphic body type (3-2-4). Measurement of rotational laxity of the knee in 90 degrees flexion showed a statistically significant increase (p less than .001) in external rotation and total rotation in ectomorphs compared to meso-endomorphs. Rotational laxity of the knee is associated with body type. Lateral radiographs were used to measure patellae alta in each group. No statistical difference was found, and patellae alta does not appear to be associated with body type.

Humans↗

The synovial changes in rheumatoid arthritis under corticosteroid treatment.

Light microscopic examination of histological sections of synovial membrane from patients with rheumatoid arthritis revealed that prolonged administration of corticosteroids had an inhibiting effect on the participation of lymphocytes and histiocytes in inflammatory infiltrates, as well as on the hypertrophy of synoviocytes, the proliferation of fibroblasts, the accumulation of fibrocytes, the deposition of fibrous tissue, and the formation of villi. Short-term (i.e., 12- to 24-h) steroid administration inhibited proliferation of fibroblasts only.

Adrenal Cortex Hormones↗

Management of arthritis of the ankle. An alternative of arthrodesis.

Twenty-eight patients treated by total ankle arthroplasty at the University of California, Irvine, were evaluated on a 100-point ankle analysis scale preoperatively and postoperatively. The average preoperative score was 35 and the average postoperative score was 74. Significant improvement occurred in function, pain relief and range of motion. The average follow-up period for these patients was 9 months. Although the number in each group is small, it does not appear that the procedure has merit for the treatment of ankle arthritis from such diverse causes as trauma, rheumatoid arthritis, aseptic necrosis of the talus and talectomy. Complications included wound healing problems in 3 patients. Malalignment of the prosthesis occurred in 2 other patients; one required revision. Ankle replacement failed in 2 patients. One patient required a fusion; the other an amputation following occlusion of the posterior tibial artery after surgery. At the present time, ankle replacement appears to be an acceptable alternative to ankle arthrodesis.

Ankle Joint↗