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Biomedical subjects

A C Howard

Publications and source records attributed to A C Howard.

12 recordsLinked to original sources
PubMed2000

Alleviation of neuronal ganglioside storage does not improve the clinical course of the Niemann-Pick C disease mouse.

Niemann-Pick disease Type C (NP-C) is a progressive neurodegenerative disorder caused by mutations in the NPC1 gene and characterized by intracellular accumulation of cholesterol and sphingo-lipids. The major neuronal storage material in NP-C consists of gangliosides and other glycolipids, raising the possibility that the accumulation of these lipids may participate in the neurodegenerative process. To determine if ganglioside accumulation is a crucial factor in neuropathogenesis, we bred NP-C model mice with mice carrying a targeted mutation in GalNAcT, the gene encoding the beta-1-4GalNAc transferase responsible for the synthesis of GM2 and complex gangliosides. Unlike the NP-C model mice, these double mutant mice did not exhibit central nervous system (CNS) accumulation of gangliosides GM2 or of glycolipids GA1 and GA2. Histological analysis revealed that the characteristic neuronal storage pathology of NP-C disease was substantially reduced in the double mutant mice. By contrast, visceral pathology was similar in the NP-C and double mutant mice. Most notably, the clinical phenotype of the double mutant mice, in the absence of CNS ganglioside accumulation and associated neuronal pathology, did not improve. The results demonstrate that complex ganglioside storage, while responsible for much of the neuronal pathology, does not significantly influence the clinical phenotype of the NP-C model.

Animals↗
PubMed1999

Peri operative ultrasound guided needle localisation of amputation stump neuroma.

Ten patients with clinically suspected neuromas following amputation were submitted for ultrasound examination. Neuromas in seven of the ten patients were identified as the cause of pain with ultrasound guided infiltration of local anaesthetic. Pre operative localisation, using breast localisation wires allowed the neuromas to be surgically excised with reduced dissection. This small study demonstrates that ultrasound is an effective method for identifying and localising neuromas in amputation stumps. This leads to reduced dissection and may lead to a better outcome in these patients.

Adult↗
PubMed1999

Targeted intervention to improve compliance in an urban hemodialysis population.

Noncompliance impacts the successful delivery of care to the "urban" ESRD population. It is our belief that noncompliance can be an extension of the dysfunctional coping mechanisms of patients who lack adequate psychosocial support. In this article, we have described a pilot program providing on-site, targeted intervention for patients identified at increased risk for poor clinical outcomes, based on failure to comply with the prescribed dialysis treatment prescription. This collaboration between our "nephrology practice," an outpatient "HD facility," and a "C-L psychiatry service" has resulted in extremely low no-show rates in an urban dialysis population. We have also discovered an opportunity for reducing hospitalizations. Targeted intervention can improve compliance and prove to be cost effective.

Algorithms↗
PubMed1994

Improving the appearance of pin-site scars.

Broad, depressed pin-site scars often remain after the use of external fixators. We describe a new method of surgical revision which combines W-plasty to break up the outline of the scar, with burial of a dermal island to improve the surface contour. We obtained excellent results with this technique in five patients (19 scars).

Adult↗
PubMed1994

Neglected bilateral congenital recurvatum of the knee.

The authors report two cases of neglected bilateral congenital recurvatum of the knee, one in a ten-year-old girl and the other in a 23-year-old man. The treatment of this rare deformity in infancy and childhood is described. A surgical approach to the deformity, which is not known to have been reported, is also presented.

Adult↗
PubMed1993

Wrist arthrodesis in rheumatoid arthritis. A comparison of two methods of fusion.

17 wrists were arthrodesed in 13 patients with severe wrist disease due to rheumatoid arthritis. Eight fusions in seven patients were carried out using a radial sliding bone graft technique whilst nine fusions in nine patients were undertaken using a third tubular AO plate. Subjective, objective and radiological assessments confirmed the efficacy of both methods but indicated a shorter period of post-operative immobilization for patients treated using the AO plate fixation technique. The importance of this is discussed.

Adult↗
PubMed1986

Developmental play ages of physically abused and nonabused children.

Although the specific effects of physical abuse are largely unknown, studies have shown deficiencies in the social behaviors of physically abused children. Because play is an important developmental process influencing socialization, physical abuse may adversely affect the developmental play age of children. This study compared the developmental play age of two groups of children aged 1 to 5 years, 12 of whom were physically abused and 12 of whom were not physically abused. Children's play behaviors were recorded using the Preschool Play Scale. Deficits in developmental play age and play imitation were found in the abused group. These results have implications for occupational therapy practice in the identification, assessment, and treatment of physically abused children.

Child Abuse↗