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Biomedical subjects

W G Ward

Publications and source records attributed to W G Ward.

67 records · Page 4Linked to original sources

Characterization and localization of receptors for epidermal growth factor in ovine skin.

Specific receptor sites for murine epidermal growth factor (EGF) have been characterized and their distribution determined in ovine skin. Binding of 125I-labelled EGF to skin membrane particles was temperature- and time-dependent, with equilibrium being reached within 1 h at 23 degrees C. Analysis of skin biopsies collected from ten castrated Merino sheep demonstrated the presence of a single class of saturable, high-affinity binding sites with a dissociation constant of 64 +/- 4 (S.E.M.) pmol/l and a binding capacity of 33.8 +/- 4.5 fmol/mg protein. Skin particle binding of 125I-labelled EGF was inhibited equipotently by mouse salivary gland EGF, EGF produced by recombinant DNA procedures and urogastrone. The EGF peptides 1-48, 6-53 and 7-53, derived from the native molecule by enzymatic cleavage, were much less potent. The relative binding potency of these molecules was correlated with their ability to induce precocious eyelid opening in mice and to inhibit wool follicle activity. Synthetic fragments representing the major structural domains of the EGF molecule (EGF(29-44), EGF(33-42) and EGF(3-31] were inactive in both the receptor and bioassays. Autoradiography of skin sections incubated with 125I-labelled EGF in vitro or of sections from skin which was perfused with 125I-labelled EGF in vivo demonstrated that EGF receptors were localized in undifferentiated cells of the epidermis and sebaceous glands, the inner and outer root sheath and bulb of wool follicles and in dermal arterioles. Differences in receptor concentration were observed between follicles following in-vivo perfusion of 125I-labelled EGF but not when the in-vitro labelling technique was used. The presence of receptors in these regions is consistent with the morphological changes in sheep skin in response to EGF administration which have been reported previously.

Animals↗

Concomitant fractures of the capitellum and radial head.

Seven cases of coexisting capitellum and radial head fractures are reported. Our best results were obtained when early open reduction and internal fixation (ORIF) of the larger, more suitable fracture was combined with excision of the smaller fracture fragments and the early initiation of motion. Poor results were obtained when there was (a) incomplete removal of intraarticular fragments, (b) associated medial collateral ligament injuries, or (c) when ORIF was attempted on small capitellum fracture fragments.

Adolescent↗

Proximal medial longitudinal arch incision for plantar fascia release.

A curved, oblique plantar incision in the proximal aspect in the medial longitudinal arch was used to release the plantar fascia in eight feet with recalcitrant plantar fasciitis. Seven feet became pain free and the eighth was 75% improved. Normal sensation to the heel was preserved in all cases. No painful scars or neuromas of the calcaneal branch of the posterior tibial nerve developed. This approach represents a significant improvement over previously reported surgical approaches.

Adult↗

Traumatic horizontal deviation of the second toe: mechanism of deformity, diagnosis, and treatment.

Two patients with a deviated overlapping second toe due to rupture of the dorsal lateral metatarsophalangeal (MTP) collateral ligament and the lateral interosseous tendon were diagnosed, analyzed, and treated. Athletic activities were responsible for the tendon-ligament ruptures and the ensuing medial deviation of the second toe. Pain occurred in the second MTP joint, and a dorsal corn formed over the proximal interphalangeal joint (PIP). Reconstructive procedures included lengthening of the interosseous-lumbrical tendons and the collateral ligament on the medial side of the joint; a dorsal capsule incision; repair of the lateral collateral ligament and interosseous tendon; transfer of the flexor digitorum longus to the extensor digitorum longus; and shortening of the proximal phalanx in one patient. These soft tissue reconstructive procedures and realignment joint congruity are essential to relieve pain and prevent traumatic arthrosis. The treatment completed on the two patients resulted in relief of pain, satisfactory function, and alignment of the digits involved.

Adult↗

Cold water polydipsia: unheralded marker of spontaneous esophageal rupture.

I have reported two cases of spontaneous esophageal rupture (Boerhaave's syndrome) in which the patients had atypical chest pain and an unquenchable thirst for cold water in the absence of dehydration. Consumption of cold water appeared to give momentary pain relief. This symptom complex may be a typical early finding in Boerhaave's syndrome. Physicians should be alert to this atypical cause of chest and epigastric pain.

Adult↗

Fine-needle aspiration biopsy of sarcomas and related tumors.

BACKGROUND: Largely due to a lack of experience, familiarity, and/or confidence, few centers rely on simple fine-needle aspiration biopsy (FNAB) for the diagnosis of sarcomas and related tumors. METHODS: The authors have reviewed their own experience in more than 200 cases of FNAB of bone and soft-tissue tumors, as well as cases reported in the literature. RESULTS: FNAB has proven to be accurate and useful in 8 consecutive years of clinical experience. No serious complications have occurred. CONCLUSIONS: FNAB is recommended as an integral part of the initial evaluation of amenable orthopaedic tumors, including sarcomas, especially in cases with classic clinical and radiographic findings.

Adolescent↗

The role of fine needle aspiration biopsy in the diagnosis and management of osteosarcoma.

We retrospectively reviewed our experience with fine needle aspiration biopsy (FNAB) in the diagnosis and management of skeletal osteosarcoma. The bi-institutional study sample involved 30 consecutive aspirates from 29 patients (28 primary tumors, 1 pulmonary metastasis, 1 local recurrence). There were 17 children and 12 adults. Two aspirates were unsatisfactory for diagnosis. Of the adequate primary osteosarcoma cases analyzed by FNAB, 24 of 26 were diagnosed as osteosarcoma. All pediatric cases were correctly interpreted as osteosarcoma and treated appropriately. There were 2 incomplete diagnoses. A secondary osteosarcoma arising within an otherwise clinically, radiologically, and histologically typical giant cell tumor (malignant giant cell tumor) was not diagnosed preoperatively on FNAB due to nonrepresentative sampling. Chronologically, the first patient with osteosarcoma analyzed by FNAB was diagnosed simply as "spindle cell neoplasm." No complications resulted from the procedure. With adequate clinical and radiologic correlation, FNAB represents a technically, easily performed, cost-effective, and accurate procedure for establishing the diagnosis of skeletal osteosarcoma. Immediate interpretation of aspirated material allows for therapy planning and oncologic consultation at the initial clinic visit.

Adult↗