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Biomedical subjects

D Stanley

Publications and source records attributed to D Stanley.

At least 19 recordsLinked to original sources
PubMed2000

Treatment of osteoarthritis of the elbow: a comparison of open and arthroscopic debridement.

PURPOSE: To assess the effectiveness of open and minimally invasive techniques in the debridement of osteoarthritis of the elbow, we compared the Outerbridge-Kashiwagi (O-K) procedure with an arthroscopic modification in which arthroscopic debridement and fenestration of the olecranon fossa was performed. TYPE OF STUDY: The study took the form of a nonrandomized control trial in which subjects were allocated to a treatment depending on the hospital of presentation. MATERIALS AND METHODS: Assessment using the Mayo Clinic elbow function chart enabled comparison of the outcome in 18 cases treated by the O-K procedure and 26 patients treated by arthroscopic debridement and fenestration of the olecranon fossa. Mean follow-up was 35.3 months (minimum 12 months). Of the patients treated by the O-K procedure, 14 were men and 4 were women with a mean age of 55 years. In 83% of patients, the diagnosis was primary osteoarthritis, with the remainder post-traumatic arthritis. The patients treated by arthroscopic debridement and fenestration of the olecranon fossa included 24 men and 2 women with a mean age of 46 years, and a diagnosis of primary osteoarthritis in 91% and post-traumatic arthritis in the remainder. No patients were excluded from the study or refused to be included. RESULTS: Both procedures were shown to be effective, with no major complications. Patients treated by arthroscopic debridement and fenestration of the olecranon fossa achieved better relief of pain (P <.10), whereas those patients undergoing the O-K procedure achieved significantly greater improvement in range of flexion (P <.05). No difference between the procedures in terms of patient-perceived overall effectiveness of the surgery was found. CONCLUSIONS: In conclusion, in the treatment of osteoarthritis of the elbow, arthroscopic debridement and fenestration of the olecranon fossa may be a more suitable procedure when painful symptoms predominate. In contrast, the O-K procedure is a significantly better procedure for improving the range of flexion where this is a particular problem.

Adult↗
PubMed2000

Immunoflow cytometry and cell block immunohistochemistry in the FNA diagnosis of lymphoma: a review of 73 consecutive cases.

AIMS: To review the results of 73 consecutive fine needle aspirations (FNAs) that were collected by a pathologist and analysed by immunoflow cytometry. Material for a cell block was also collected from some of these lesions. METHODS: The setting was a large general hospital in rural New Zealand. The FNAs were performed by a pathologist, or a radiologist for image guided localisations. Material for immunoflow cytometry was collected into RPMI and, when required, material for a cell block was collected into formalin. RESULTS: Of the 73 samples collected by FNA nine were inadequate. Light chain restriction could be demonstrated in most FNA samples from B cell lymphomas (28 of 30 adequate samples). The exceptions were two cases of T cell rich B cell lymphoma. Artefactual light chain restriction was seen occasionally in T cell lymphomas, presumably as a result of autoantibodies binding to the cell surfaces. It was possible to subtype most (18 of 30 adequate samples) B cell lymphomas as chronic lymphocytic leukaemia (CLL), follicle centre cell lymphoma (FCCL), or mantle cell lymphoma. The CD4 to CD8 ratio was not usually restricted in T cell lymphomas and coexpression of CD4 and CD8 was not usually found. Loss of pan-T cell antigens was seen in some T cell lymphomas. Four of the six T cell lymphomas and three of the four non-lymphoid malignacies were diagnosed with the aid of cell block immunohistochemistry. Only one of the four cases of Hodgkin's lymphoma showed Reed-Sternberg cells in the FNA smears. CONCLUSIONS: It is not always possible to characterise lymphomas as fully with FNA and immunoflow cytometry as is possible with biopsy histology and a full battery of modern investigations. Nevertheless, in the setting of a large rural general hospital immunoflow cytometry on FNA samples is a highly effective method of diagnosing and typing B cell lymphomas. Immunoflow cytometry is of little use for T cell lymphomas or Hodgkin's lymphomas. We advocate the use of cell block immunohistochemistry in preference to immunoflow cytometry for cases in which the cytological appearance of the specimen is overtly malignant but the differential diagnosis includes non-lymphoid malignancy.

Biopsy, Needle↗
PubMed1999

The fusiform face area is selective for faces not animals.

To test whether the human fusiform face area (FFA) responds not only to faces but to anything human or animate, we used fMRI to measure the response of the FFA to six new stimulus categories. The strongest responses were to stimuli containing faces: human faces (2.0% signal increase from fixation baseline) and human heads (1.7%), with weaker but still strong responses to whole humans (1.5%) and animal heads (1.3%). Responses to whole animals (1.0%) and human bodies without heads (1.0%) were significantly stronger than responses to inanimate objects (0.7%), but responses to animal bodies without heads (0.8%) were not. These results demonstrate that the FFA is selective for faces, not for animals.

Adult↗
PubMed1999

The parahippocampal place area: recognition, navigation, or encoding?

The parahippocampal place area (PPA) has been demonstrated to respond more strongly in fMRI to scenes depicting places than to other kinds of visual stimuli. Here, we test several hypotheses about the function of the PPA. We find that PPA activity (1) is not affected by the subjects' familiarity with the place depicted, (2) does not increase when subjects experience a sense of motion through the scene, and (3) is greater when viewing novel versus repeated scenes but not novel versus repeated faces. Thus, we find no evidence that the PPA is involved in matching perceptual information to stored representations in memory, in planning routes, or in monitoring locomotion through the local or distal environment but some evidence that it is involved in encoding new perceptual information about the appearance and layout of scenes.

Adolescent↗
PubMed1999

A posterior approach to the elbow joint.

We describe a posterior approach to the elbow which combines the advantages of both splitting and reflecting the triceps. It gives protection to the ulnar nerve and its blood supply during the operation while providing excellent exposure of the distal humerus. During closure, the triceps muscle can be tensioned, thereby improving stability of the elbow. This approach has particular relevance to unlinked total elbow arthroplasty allowing early rehabilitation of the joint.

Arthroplasty, Replacement↗
PubMed1998

Free tendon interposition grafting for the repair of ruptured extensor tendons in the rheumatoid hand. A clinical and biomechanical assessment.

Sixteen ruptured extensor tendons were repaired in seven rheumatoid hands using autogenous palmaris longus tendon as a free interposition graft. The patients were reviewed at an average of 17 months (range, 5-45) after repair. Subjectively all patients were satisfied with the clinical results, and achieved a return to their level of ability before tendon rupture. A biomechanical model suggests that tendon repair using an interposition graft, rather than a traditional end-to-side tendon transfer retains the anatomical axis of tendon function, and achieves greater forces during active finger extension.

Adult↗
PubMed1997

Ulnar variance and age.

Ulnar variance was determined on 1,023 radiographs of normal wrists taken in standardized fashion. There were 468 women and 555 men. The age range was 13 to 109 years. In both sexes, ulnar negative variance decreased significantly with increasing age. Possible reasons for this are discussed.

Adolescent↗
PubMed1997

Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies.

Anthropology, Cultural↗
PubMed1997

Traditional birth in Zimbabwe.

Modern medical and technically advanced ways of giving birth are available in Zimbabwe; it is an advancing country. However, this is not the only, nor always the most appropriate, approach to pregnancy and childbirth.

Female↗
PubMed1996

Zimbabwe "my whay".

The following essay explores the impressions, experience and observations of an Australian Midwifery Tutor who has just completed over 2 years working with qualified midwives, student midwives and traditional midwives in remote rural Zimbabwe. It outlines the different approaches to hospital and clinic birth in Zimbabwe. How Sbona women deal with pain in labour, the effects of HIV/AID on the rural community and the customs associated with traditional birth.

Australia↗
PubMed1995

Dearth of locums.

Explore the source record for details and available documents.

Animal Technicians↗
PubMed1995

Fractures of the coracoid process.

We have reviewed 12 fractures of the coracoid process. In two of these patients the fracture extended into the body of the scapula and resulted in displacement of the glenoid. In some cases, there were associated acromioclavicular and glenohumeral dislocations or fractures of the clavicle and the acromion. Two patients required internal fixation to restore congruence of the glenoid; the others were treated conservatively with success. We present a new classification of coracoid fractures which helps in their management.

Adult↗
PubMed1994

Posterior decompression and fusion in rheumatoid disease of the cervical spine: redressing the balance.

Forty-seven patients with rheumatoid disease of the cervical spine were followed over an 8-year period. Twenty-one patients with isolated atlantoaxial subluxation and four with combined atlantoaxial and subaxial disease had their atlantoaxial instability treated by posterior decompression and fusion. The incidence of surgical mortality was 8%, and clinical improvement was noted in 75%. There was no neurological deterioration in those patients who survived long term. We have found posterior decompression and fusion to be a satisfactory procedure for the treatment of atlantooccipital subluxation. In our experience, anterior decompression has not been found necessary for successful treatment of atlantoaxial subluxation in patients with rheumatoid cervical spine disease.

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↗
PubMed1993

Prediction of the outcome 24 hours after carpal tunnel decompression.

A prospective study has been performed on 47 wrists treated by surgical decompression for carpal tunnel syndrome. In all cases where there was symptomatic relief within the first 24 hours postoperatively, a good or excellent outcome was obtained when the patients were reviewed six weeks after surgery. If subjective improvement was not obtained by 24 hours, a good outcome was still possible but a poor outcome became more likely.

Adolescent↗
PubMed1993

Arthroscopic fenestration of the olecranon fossa in the treatment of osteoarthritis of the elbow.

A new arthroscopic approach to the treatment of elbow osteoarthritis that permits debridement of the elbow joint together with the removal of intraarticular loose bodies is described. Twelve patients (11 male, one female) with an age range of 29-64 (mean 47.5 years) underwent the procedure. Post-surgery all patients had relief of elbow-locking and experienced a reduction in elbow pain (follow-up 3-30 months, mean 16 months). The technique is offered as a treatment option for patients with elbow osteoarthritis.

Adult↗
PubMed1993

A prospective study of diagnostic epidural blockade in the assessment of chronic back and leg pain.

A consecutive series of 100 patients with back and leg pain were evaluated prospectively. All had a detailed clinical assessment together with radiculography and computed tomography (CT) of the lumbosacral spine. In addition, each patient underwent diagnostic epidural blockade that identified three kinds of response. Injection of local anaesthetic into the epidural space relieved the symptomatic pain--the positive result (51 patients). Local anaesthetic injection had no effect on the symptomatic pain--the negative result (30 patients). In 19 patients, saline injection into the epidural space relieved the symptomatic pain--the placebo result. The results of this investigation were assessed in the light of the number of inappropriate physical signs found on clinical examination, together with the result of the radiculogram and CT scan. No statistical correlation was found with any of these parameters.

Adult↗