Biomedical subjects
W R Harris
Publications and source records attributed to W R Harris.
Clinical criteria and ankle pressure measurements in predicting healing of below-knee amputations.
Since the ultimate success or a below-knee amputation depends upon preoperative, intraoperative and postoperative factors, it is not surprising that success or failure is difficult to predict on the basis of assessment of a single preoperative variable. In this study, discriminant function analysis was carried out on data obtained prospectively from 33 patients who had below-knee amputation. It showed that, by using the level of ankle systolic pressure and the severity of diabetes and of infection as discriminators, patients could be divided quite accurately into two groups - those whose amputation would be successful and those whose amputation would not. The study also showed that by using multivariate analysis to construct a single index of prediction, success can be forecast with a reasonably high degree of accuracy. Multivariate analysis is more accurate than the single-variate method.
Siderophilin metal coordination. Difference ultraviolet spectroscopy of di-, tri-, and tetravalent metal ions with ethylenebis[(o-hydroxyphenyl)glycine].
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Factors affecting the prognosis of brachial plexus injuries.
The clinical results in a series of 131 patients with 134 brachial plexus injuries were analysed to determine the factors affecting prognosis. Isolated injuries to the upper trunk had the best prognosis, but the prognoses of isolated injuries to the cords, upper roots and lower trunk were not as good. Complete injuries of the plexus had the worst prognosis. Pain which persisted for more than six months was a bad prognostic sign for neurological recovery regardless of the location of the lesion. Horner's syndrome was not always accompanied by a bad prognosis. Operation did not affect the prognosis except in open lacerations. A pseudomeningocele detected by myelography usually precluded recovery in the root at the level of the pseudomeningocele.
Femoral neck fractures following surface replacement.
A femoral neck fracture following surface replacement of the hip has been studied and five potential causes of failure were noted. These consisted of; removal of a hip nail during surgery, use of a too small femoral cup, initial reaming in varus, notching of the femoral neck, and failure to completely seat the cup.
Sulfonated catecholamide analogues of enterobactin as iron sequestering agents.
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Traumatic winging of the scapula.
Fourteen patients with traumatic winging of the scapula were reviewed, all of whom had had injuries producing sudden depression of the shoulder girdle from either a direct blow to the top of the shoulder or downward traction on the arm. The diagnosis was commonly missed for a considerable interval. Seven patients recovered spontaneously within six months of injury. Three of the other seven patients were treated by reattachment of the insertion of the sternal portion of the pectoralis major muscle via a fascia lata graft to the lower pole of the scapula. In one of these patients a reoperation was needed, but all three ultimately recovered satisfactory function of the shoulder. Anatomical studies suggested that the injury results from compression of the long thoracic nerve against the second rib and not from entrapment of the nerve by the scalenus medius muscle.
Complexation and oxygenation equilibria of cobaltous chelates of dipeptides with coordinating side groups.
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The irreversible redox rearrangment of cobalt oxygen complexes of dipeptides.
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Oxygenation equilibria of cobalt (II) complexes of amino acids and dipeptides.
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A study of weight transmission through the knee joint with applied varus and valgus loads.
An electromechanical device is described which permits measurement of the amount of weight borne on each compartment of the knee during varying amounts of lateral angulation. A lateral angulation of only 3 degrees in either direction completely unloaded the opposite condyle. The correction to be obtained by tibial osteotomy of varus or valgus knee deformity should permit the mechanical axis of the extremity to pass the tibial spines on the side opposite the deformity. An angular deviation of 3 degrees more than that required to restore the mechanical axis to normal position is sufficient.
Avulsion of lumbar roots complicating fracture of the pelvis.
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High tibial osteotomy for osteo-arthritis of the knee.
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Cerebrotendinous xanthomatosis.
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Partial amputations of the hand: a follow-up study.
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Solitary eosinophilic granuloma of a vertebral body causing paraplegia. Report of a case.
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Design of in vivo cadmium-mobilizing agents: synthesis and properties of monobenzyl meso-2,3-dimercaptosuccinate.
A novel method for the synthesis of monoesters of meso-2,3-dimercaptosuccinic acid (DMSA) is presented which utilizes the reaction of the vicinal sulfhydryl-protected anhydride with the corresponding alcohol in the presence of a base. The product is then treated successively with mercuric chloride to remove the protecting group and form the mercuric complex, and hydrogen sulfide to regenerate thiol groups by removal of mercury as HgS. This strategy was exploited to synthesize monobenzyl meso-2,3-dimercaptosuccinate (MBzDMS), C6H5CH2O(O)CCH(SH)CH(SH)C(O)OH, and demonstrates a feasible synthesis of monoesters difficult to obtain by direct esterification, via the use of the reactive anhydride. The resultant compound was found to be an effective cadminum-mobilizing agent when used with cadmium-exposed rats or mice and when administered by any one of several routes (ip, iv, po). This monobenzyl ester (MBzDMS) of DMSA was found to be somewhat less effective than the corresponding monoisoamyl ester (Mi-ADMS) in mobilizing cadmium from such cadmium deposits. The ability of MBzDMS to mobilize cadmium into the urine is significantly decreased by the coadministration of p-aminobenzoic acid, in support of the hypothesis that MBzDMS enters renal cells via an anion transport system. An analysis of the structural features of vicinal dithiols examined as antagonists for chronic cadmium intoxication allows a hypothesis to be formulated indicating essential features required for the design of effective new cadmium antagonists of this type.
Late revision of fibular malunion in ankle fractures.
Eleven patients with fibular malunion after ankle fracture healed with stiff, painful joints and radiographic evidence of fibular malunion, diastasis of the ankle mortice, and talar tilt. Reconstruction was performed by mobilizing the fibula (by osteotomy or through the old fracture site), lengthening the fibula, and restoring the ankle mortice anatomically. The operation was done three months to three years after the initial fracture in patients ranging in age from 26 to 52 years. The average follow-up period was 3.3 years. Radiographically, seven patients had the ankle joint restored anatomically. Four patients had residual talar tilt. On clinical assessment, eight patients were rated as good, two fair and improving, and one poor resulting in fusion. Good functional results were maintained at long-term follow-up examination. The factors that determined the success of the revision were the duration of the malunion, the quality of the reduction achieved, and the condition of the articular cartilage at the time of revision. Late correction of the malunited fibula with diastasis of the ankle mortice is an effective means of salvaging function in a joint otherwise destined to be stiff and painful.