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Biomedical subjects

G H Thompson

Publications and source records attributed to G H Thompson.

At least 19 recordsLinked to original sources
PubMed1992

CT during arterial portography: diagnostic pitfalls.

Computed tomography (CT) during arterial portography (CTAP) is an important technique for evaluating the liver before hepatic tumor resection. With this technique, most tumors are of low attenuation compared with that of enhancing parenchyma. At times, low-attenuation lesions are encountered that represent perfusion abnormalities rather than tumor deposits. These perfusion abnormalities can be categorized as (a) those resulting from improper technique; (b) those extending from hilum to capsule (straight-line sign), with or without an obstructing mass; (c) perihilar and periligamentous abnormalities; (d) subcapsular defects (linear or wedge shaped); and (e) those seen with cirrhosis or regenerating nodules. Adjuvant use of delayed CT, magnetic resonance imaging, and intraoperative ultrasound aids in characterization of these nontumorous defects, thereby improving specificity. The authors conclude that when potential candidates are evaluated for hepatic tumor resection, knowledge of the existence of the various diagnostic pitfalls of CTAP and their imaging characteristics is imperative to avoid inadvertent false results.

Angiography, Digital Subtraction↗
PubMed1992

Post-mortem description of slipped capital femoral epiphysis.

We found, in a museum collection of skeletons, nine adult hips with untreated slipped capital femoral epiphyses. All the specimens were from men, five black and two white. Their mean age at death was 44 years. Seven of the femora were retroverted beyond neutral and five had true varus deformities. Osteoarthritis was detected in eight of the hips and the most severe degeneration was seen in the most deformed hips. Radiography revealed that cysts which appeared to occupy the femoral head in fact lay in the metaphyseal bone of the femoral neck.

Adult↗
PubMed1990

Primary neoplasms of the thoracic and lumbar spine. An analysis of 29 consecutive cases.

Primary osseous neoplasms of the thoracic and lumbar spine are uncommon lesions. Between 1965 and 1982, of 1971 patients with musculoskeletal neoplasms, only 29 (1.5%) had primary osseous tumors in these locations. There were eight children and 21 adults. Back pain was the most common complaint in 25 patients (86%), and neurologic symptoms or deficits were present in 16 patients (55%). All lesions were visible on routine spine roentgenograms, while computed tomography and myelography demonstrated spinal canal encroachment and extradural spinal cord compression in 19 patients (66%). The histologic diagnoses included 11 benign and 18 malignant lesions. Benign lesions occurred predominantly in children and malignant tumors in adults. Treatment was individualized, based on the histologic diagnoses. Twenty-two patients had surgical resection of their lesions. Laminectomy without stabilization and arthrodesis resulted in late instability and neurologic deterioration in three of seven patients (43%) with malignant lesions. Resection and decompression combined with arthrodesis did not predispose to late instability. Twenty-one patients were followed for a mean of 4.1 years (range, two to 14 years). Eight patients died from malignant disease between one month and seven years after diagnosis.

Adolescent↗
PubMed1990

Late-onset tibia vara (Blount's disease). Current concepts.

Idiopathic tibia vara or Blount's disease can be classified into three age-onset groups: (1) infantile, less than three years; (2) juvenile, four to ten years; and (3) adolescent, 11 years or older. The latter two groups comprise late-onset tibia vara, which is much less common than the infantile-onset form. In a comparison of eight juvenile-onset patients (13 knees) and seven adolescent-onset patients (nine knees), there were essentially no significant clinical, roentgenographic, or physeal-histopathologic differences. Both groups had severe obesity, mild to moderate varus deformities, and less-pronounced roentgenographic characteristics. Histopathologic analyses of the entire physis from the proximal tibia in five cases (seven knees) were essentially identical in patients with the infantile form as well as in those with slipped-capital femoral epiphyses, suggesting a common etiology. Recurrence of deformity after surgical correction occurred frequently in the juvenile onset males but not in juvenile onset females or the adolescent onset group. Incomplete correction of the varus deformity occurred more frequently in the latter group. The etiology for tibia vara appears to involve varus stress growth suppression, and disruption of endochondral ossification. The major differences between the three groups is due to the age at clinical onset, the amount of remaining growth, and the magnitude of the medial compression forces across the medial aspect of the knee.

Adolescent↗
PubMed1989

Endovaginal and transabdominal sonography of ovarian follicles.

Endovaginal and transabdominal sonography (EVS and TAS, respectively) are effective methods for monitoring ovarian follicular development. Our study evaluates both modalities by subjective comparisons and objective correlations with serum estradiol levels. In 21 of 41 studies, TVS showed more follicles over 1 cm than did TAS. The same number was seen by both in 17 studies and more by TAS in only 3 studies. Margins of the follicles were sharply defined in 37 of 41 EVS studies (90%) but only in 18 of 41 TAS studies (41%). In each of the 4 cases in which follicles were not sharply defined by EVS the ovaries were located high in the pelvis. In 29 sonographic studies, there were corresponding estradiol levels. The number and size of dominant follicles correlated well with estradiol levels (r = .9074) for EVS but less so (r = .3816) for TAS. EVS has several advantages when monitoring follicular development.

Abdomen↗
PubMed1988

Anterior and posterior marginal fracture-dislocations of the distal radius. An analysis of the results of treatment.

Anterior and posterior marginal fractures of the distal end of the radius associated with dislocation of the carpus are rare injuries. The results of 20 patients with 12 anterior and eight posterior marginal fracture-dislocations of the distal radius were reviewed. Eleven patients had closed reduction and plaster cast immobilization, including three with external fixation, while nine patients required surgery and internal fixation. At a mean of 3.2 years, 40% were rated as excellent, 45% as good, 5% as fair, and 10% as poor. There was roentgenographic evidence of posttraumatic arthritis in 13 patients (65%). Major factors affecting the clinical results were accurate articular realignment and the presence of ipsilateral carpal injuries. There were no significant differences in results between anterior and posterior marginal fractures or between closed or operative methods of treatment when the radiocarpal articular surface was restored to less than 1 mm residual displacement. Restoration of articular congruency is the primary goal of management of these fractures.

Adult↗
PubMed1987

Expression of human papillomavirus type 6 E1, E2, L1 and L2 open reading frames in Escherichia coli.

Open reading frame (ORF) fragments (putative gene fragments) from human papillomavirus type 6b (HPV-6b) were inserted into the bacterial expression vector pHK413 to provide viral antigenic determinants. Approximately 86% of the entire L1 ORF, 82% of the E2 ORF, and 52% of the L2 ORF were expressed in Escherichia coli. The E1 ORF was cloned as two fragments. The constructions containing E1n (coding for the N-terminal region) and E1c (coding for the C-terminal region) expressed 27% and 16% of the E1 ORF, respectively. Protein encoded by the L1 ORF, but not that encoded by the L2 ORF, reacted with antibodies elicited by disrupted bovine papillomavirus. These reagents will be extremely useful in unravelling the HPV-6b replication cycle.

Antigens, Viral↗
PubMed1987

Legg-Calvé-Perthes disease. Current concepts and controversies.

Legg-Calvé-Perthes disease is a common, controversial pediatric hip disorder. It is currently accepted that the disorder represents idiopathic avascular necrosis (osteonecrosis) of the capital femoral epiphysis. Treatment by conservative or surgical containment is recommended primarily for older children with extensive femoral head involvement. The results of containment treatment indicate improved results over the natural history of the disease process.

Child↗
PubMed1986

Achilles tendon rupture. Occurrence with a closed ankle fracture.

A 61-year-old man, involved in an automobile accident, sustained a complete Achilles tendon rupture with an ipsilateral, closed slightly displaced medial malleolus ankle fracture. The tendon rupture was not diagnosed before operation but was recognized at the time of open reduction of the ankle. This rare combination of injuries was apparently secondary to hyperdorsiflexion of the foot. The tendon rupture would have been missed had surgical treatment not been required. Unrecognized tendon ruptures associated with closed ankle fractures may be a cause of residual ankle-foot weakness, pain, loss of motion, or a combination thereof.

Achilles Tendon↗
PubMed1985

Segmental spinal instrumentation in idiopathic scoliosis. A preliminary report.

Eighty-six patients with idiopathic scoliosis who underwent a posterior spinal fusion using sublaminar segmental spinal instrumentation were analyzed retrospectively. There were two operative groups: group 1, 66 patients who had Harrington rod instrumentation and segmental wiring, and group 2, 20 patients who had Luque rod instrumentation. The clinical and radiographic data of the two groups were similar except for the passage of more sublaminar wires and increased intraoperative blood loss in group 2. Twenty intraoperative or postoperative complications occurred in 19 patients (22%) including 14 neurologic complications. Three patients (3%) had major spinal cord injuries, while 11 patients (13%) had transient sensory changes. There was no significant difference in the incidence of neurologic complications between group 1 or group 2. The remaining intraoperative complications were due either to anesthesia, positioning during surgery, or technique (dural tear). Late complications occurred in two patients in group 1 only: one each with rod breakage and hook displacement. Only one patient (1%) has required additional surgery. Our results indicate that although segmental instrumentation can be beneficial in idiopathic scoliosis, the incidence of complications, primarily neurologic, will be higher than expected. The major reason appears to be surgeon inexperience with passage of sublaminar wires. As experience increases, the incidence of complications declines and becomes comparable with conventional Harrington rod instrumentation alone.

Adolescent↗
PubMed1985

Comprehensive management of arthrogryposis multiplex congenita.

Arthrogryposis multiplex congenita syndrome, characterized by multiple congenital joint contractures, is a manifestation of a neurogenic or myopathic disorder of unknown etiology. An accurate diagnosis is critical in management strategy. Muscle biopsy is usually the most important diagnostic procedure. Once the diagnosis is established, a team approach to comprehensive care is instituted, and the child is assisted in achieving maximum cognitive, physical, and social development. Physicians, nurse clinicians, therapists, social workers, and others constitute the team and work in coordination to develop an individual habilitation plan. The treatment plan is continually updated and modified as needed. Because the musculoskeletal deformities are generally the most prominent abnormality, the orthopedist usually has the major role in management. The orthopedist may serve as coordinator of the comprehensive care team and therefore must have a fundamental understanding of and global approach to management.

Arthrogryposis↗
PubMed1979

Erythromelalgia.

Erythromelalgia is an extraordinary disorder of unknown etiology and pathophysiology that resembles the post-traumatic reflex dystrophy syndromes but has not been described previously in the orthopedic literature. Its distinctive triad of intense burning extremity pain associated with erythema and increased skin temperature are diagnostic. Primary or idiopathic and a secondary or associated form have been identified. The latter occurs in association with an underlying disease process, especially myeloproliferative disorders. Treatment with pharmacologic agents and surgery are ineffective except in the secondary group where treatment of the associated disorder generally results in a remission. Symptoms in the primary group can be minimized by appropriate environmental control with cooling and avoiding heat-producing situations that would raise skin temperature above a critical thermal threshold.

Adolescent↗
PubMed1978

Healed untreated anterior cervical spine dislocation. A case report.

Fracture and fracture-dislocations of the cervical spine are serious injuries that rarely go undiagnosed. A case report of a bilateral facet dislocation with anterior displacement is presented that went undiagnosed and untreated, and healed without neurologic sequelae. No previous similar reports are known.

Aged↗