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Biomedical subjects

G M Rayan

Publications and source records attributed to G M Rayan.

At least 73 records · Page 4Linked to original sources

A comparison of human and animal mouth flora.

Human bite injuries are often believed to be more serious than animal bite injuries. One reason for this distinction might be a species difference in the microbial mouth flora. In order to compare this possibility, we cultured the mouths of humans, dogs, and cats. Human oral flora contained the smallest number of bacteria followed by dog and cat oral flora, respectively. Veillonella parvula was cultured from all humans and was also found in dog and cat mouths, but less frequently. V parvula is not usually considered a virulent organism but occasionally may become a pathogen and should not be overlooked especially following human bite injury.

Animals↗

Distal stenosing tenosynovitis.

Three patients are described with distal stenosing tenosynovitis involving the flexor digitorum profundus and the A3 pulley. One patient had isolated distal stenosing tenosynovitis and two patients had combined distal and proximal stenosing tenosynovitis of the flexor digitorum superficialis and the A1 pulley. All three patients with four digits involved had improvement of their symptoms after release of the A3 pulley. When involved, the A1 pulley was released at the same time. Patients with proximal stenosing tenosynovitis may have an associated distal stenosing tenosynovitis that if overlooked may cause persistence of symptoms after surgical treatment.

Adult↗

Recurrent anterior dislocation of the ulnar nerve at the cubital tunnel.

Recurrent anterior dislocation of the ulnar nerve at the cubital tunnel is reported in two patients. This was due to traumatic attenuation of the flexor carpi ulnaris retinaculum. The mechanism of injury in both patients was a fall with the shoulder abducted and the elbow acutely flexed. Both patients had relief of their neurologic symptoms following anterior submuscular transposition of the ulnar nerve.

Adult↗

Anomalous abductor pollicis longus insertion in the thenar muscles.

Abnormal insertion of an abductor pollicis longus slip into an anomalous thenar muscle was observed during reconstruction of the carpometacarpal joint of the thumb in two patients. The anomalous thenar muscle most probably represents duplication of the abductor pollicis brevis.

Adult↗

Hand complications in children from digital sucking.

Digital sucking is common in children. Although orthodontic complications have been reported, hand complications of digital sucking are seldom described. Five patients are reported; two had digital deformities and three had infections. Deformities of the digits were improved with splinting. Infections required surgical drainage followed by postoperative splint protection to prevent digital sucking. Splinting prohibited sucking in four of five patients.

Child↗

Nutrition and the rheumatoid hand patient.

The incidence of nutritional depletion in 40 rheumatoid patients and the factors that influence these patients' nutritional status were investigated. More than half of the patients (52.5%) were found to be nutritionally deficient.

Adult↗

Intratendinous ganglion. A case report.

Intratendinous ganglion is a rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful swelling over the dorsum of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the ganglion and its capsule followed by meticulous repair of the tendon.

Cysts↗

Eikenella corrodens in human mouth flora.

The incidence of Eikenella corrodens in the human mouth was studied in 229 individuals. Six (2.6%) had positive cultures. The incidence of positive cultures for the saliva group was 0.6% and for the tooth-scraping group it was 8.2%. When 11 isolates were tested against 33 antimicrobials by disc-agar diffusion, 82% were susceptible to penicillin, cephalothin, and cefoperazone. Susceptibility to the remaining second- and third-generation cephalosporins studied was 100%. We suggest that the use of a second- or third-generation cephalosporin only is appropriate empiric therapy for human bite injuries.

Anti-Bacterial Agents↗

Rheumatoid arthritis and Dupuytren's contracture.

Of four patients with rheumatoid arthritis and Dupuytren's contracture, two were not aware of the presence of Dupuytren's contracture. When both diseases coexist, the presence of rheumatoid hand deformities, especially flexion and ulnar deviation of the metacarpophalangeal joints, may mask the flexion deformity caused by Dupuytren's contracture. Careful clinical examination should rule out the presence of a pathologic fascial cord. When reconstructive surgery is indicated for the rheumatoid hand in the presence of advanced Dupuytren's contracture, staged surgery would be appropriate and reconstruction of Dupuytren's contracture should precede other surgery.

Aged↗

Histologic and electrophysiologic changes following subepineurial hematoma induction in rat sciatic nerve.

The sciatic nerves of 34 rats were used to study the effects of intraneural, extrafascicular hematoma, exclusive of any other trauma. Electrodiagnostic, histologic, and electron microscopic techniques were used. The amount of nerve fiber damage was assessed using computerized planimetry. The effects of hematoma evacuation were also investigated. Changes consistent with partial denervation, such as prolongation of insertion activity and distal latency, and the presence of positive waves and fibrillations, were present in the blood-injected but not in the control groups. Degenerative nerve fiber changes localized to the area of hematoma were present in the blood-injected group and were significantly higher than those in the control group. Although there was a difference in the amount of nerve damage between the blood-injected and the hematoma-evacuated group (less damage), this difference was not statistically significant. These findings suggest that intraneural extrafascicular hematoma produces electrophysiologic and histologic evidence of axonal degeneration affecting nerve fibers in the vicinity of the hematoma. Early evacuation of the intraneural hematoma appears to slightly reduce the deleterious effects of the lesion.

Animals↗

Functional assessment of bilateral wrist arthrodeses.

We studied the functional results of 18 wrist arthrodeses in nine patients with rheumatoid arthritis. Objective evaluation included radiographic assessment, goniometer assessment of the upper extremity (UE), range of motion (ROM), grip and pinch strength, and the Jebsen-Taylor function test. Subjective evaluation consisted of a questionnaire that compared the upper extremity function of various activities of daily living preoperatively and postoperatively. The mean total range of motion for all patients was below normal on the dominant and nondominant sides, as was the average grip and pinch strength. Results of the Jebsen-Taylor test, compared with results of normal persons, were normal 38% of the time and abnormal 62% of the time. Subjective evaluation revealed postoperative improvement of the hand function in seven patients, whereas the function in two patients remained the same. Bilateral wrist arthrodeses does not seem to adversely affect function of the upper extremity in spite of abnormal grip strength and upper extremity range of motion.

Activities of Daily Living↗

Skin necrosis complicating mallet finger splinting and vascularity of the distal interphalangeal joint overlying skin.

Two patients are reported with full-thickness skin necrosis over the dorsum of the distal interphalangeal (DIP) joints after dorsal splint immobilization in hyperextension to treat acute mallet finger. An investigation was carried out to study the relationship of hyperextension to the dorsal circulation of the DIP joint. In 66 digits, the average degree of DIP joint hyperextension at which the skin blanches was 50% of the total passive hyperextension. It is recommended, therefore, when the DIP joint is immobilized to treat acute mallet finger, the degree at which the dorsal skin begins to blanch must be determined, and the amount of hyperextension should not exceed that degree. Excessive localized pressure to the dorsal skin should be avoided by adjusting the angle of the dorsal splint.

Adolescent↗

Microbiologic flora of human fingernails.

The incidence of and nature of fingernail flora was studied in 20 patients. These patients underwent routine preoperative hand scrubbing in a clinical setting, without nail trimming or cleaning. Nineteen (95%) of 20 had a moderate to heavy growth of Staphylococcus epidermidis. These isolates were very susceptible to antibiotics. Thirteen (65%) of 20 patients had fungi (molds and yeast). In spite of adequate preoperative hand scrubbing, the fingernails were heavily contaminated. Such organisms may become pathogens and should not always be considered contaminants. This study also confirmed the importance of preoperative fingernail trimming and cleaning.

Female↗

Aerobic mouth flora of the rhesus monkey.

The aerobic and facultative anaerobic mouth flora of 17 rhesus monkeys was studied qualitatively, including antibiotic susceptibilities. The organisms most often encountered were Neisseria species (19.8%), alpha haemolytic streptococci (19.8%), and Haemophilus parainfluenzae (17.2%). All Haemophilus parainfluenzae isolates were susceptible to cefoperazone. The combination of penicillin and cefoperazone may be the most appropriate initial antibiotic treatment for monkey bite injuries.

Animals↗

Gouty tenosynovitis and compression neuropathy of the median nerve.

Two cases of gouty tenosynovitis were associated with carpal tunnel syndrome. Both patients had carpal tunnel release with good relief of symptoms. In one patient, gout was not suspected before operation; this patient developed wound dehiscence with tophaceous urate crystal drainage that eventually disappeared. Proper preoperative antigout therapy may have prevented this complication. Carpal tunnel syndrome associated with gout is rare. Preoperative investigations for gout may be indicated in patients with carpal tunnel syndrome.

Carpal Tunnel Syndrome↗