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Biomedical subjects

Himanshu Sharma

Publications and source records attributed to Himanshu Sharma.

14 recordsLinked to original sources
PubMed2006

Lateral versus crossed wire fixation for displaced extension supracondylar humeral fractures in children.

Reduction and percutaneous pin fixation is widely accepted treatment for displaced humeral supracondylar fractures in children, but the best pin configuration is still debatable. This study examined the outcome for crossed and lateral pins placement in type IIB and III supracondylar humeral fractures. Clinical notes and radiographs of 131 children with an average age of 6 years were retrospectively reviewed. Lateral pins fixation was used in 66 children and crossed wires in 65. The groups were similar with regard to gender, age, follow-up, severity of displacement and number of closed/open reductions. There was no statistical difference between the two groups either clinically or radiologically in the quality of outcome. However, postoperative ulnar nerve injuries occurred in 6% of patients treated with crossed wire fixation, whilst none of the group with pins inserted laterally suffered this complication. We recommend fixation of displaced humeral supracondylar fractures with two or three lateral pins inserted parallel or in a divergent fashion. This method of fixation gives similar results to crossed wires but prevents iatrogenic ulnar nerve injuries.

Bone Wires↗
PubMed2006

Paget sarcoma of the spine: Scottish Bone Tumor Registry experience.

STUDY DESIGN: Retrospective case study of 13 cases of Paget sarcoma of the spine accrued from a prospectively collected Tumor Registry database. OBJECTIVES: To analyze the clinical, radiologic, and histologic features of Paget sarcoma of the spine and to determine the factors influencing the prognosis. SUMMARY OF BACKGROUND DATA: Paget disease of bone is a common disorder with the spine being involved in over 50% of patients. However, sarcomatous degeneration in the vertebral column is an extremely rare complication. There is very little in the literature with regard to clinical presentation and prognosis of patients with Paget sarcoma affecting the vertebral column. METHODS: Between January 1944 and December 2003, 89 patients were registered with a diagnosis of Paget sarcoma in the Scottish Bone Tumor Registry. Thirteen patients with Paget sarcoma of the spine were analyzed with regard to their clinical, radiologic, and histopathologic features along with the prognostic predictors. RESULTS: The mean age was 66.9 years (range: 56-79 years). There were 10 males and three females. There were seven cases involving the sacral spine (63.6%), three cases involving lumbar vertebrae, two affecting the dorsal spine, and one with diffuse dorsolumbar involvement (D11-L3). The mode of presentation was progressively increasing low back pain (in all 13), unilateral sciatica (six; left-sided, five; right-sided, one), bilateral sciatica (two), lower limb weakness (eight), and autonomic dysfunction (four). Ten of 13 cases (76.9%) were osteosarcoma. The rest were chondrosarcoma (n = 1), fibrosarcoma (n = 1), and malignant fibrous histiocytoma (n = 1). Decompression laminectomy was performed in three patients with progressive neurologic deficit. Eight patients had received radiotherapy. The mean survival was 4.22 months. CONCLUSIONS: This series confirmed that Paget sarcoma of the spine has a very poor prognosis. We found a constellation of symptomatology in patients with sarcomatous Paget spine resulting from radiculomedullary compression, primarily lumbosacral involvement and predominantly osteosarcomatous histology. There was no significant difference observed on the overall prognosis of the patients with Paget sarcoma of the spine in the last 6 decades.

Adult↗
PubMed2006

Prolactin promotes growth of a spontaneous T cell lymphoma: role of tumor and host derived cytokines.

The present study was conducted to investigate the effect of prolactin (PRL) on the progressive growth of a T cell lymphoma. Using a murine model of a transplantable T cell lymphoma, designated as the Dalton's lymphoma (DL) it is shown that in vivo administration of PRL to tumor bearing mice reduces the survival duration of tumor-bearing host due to an augmentation of tumor growth. In vitro studies demonstrated that PRL directly stimulates the proliferation of DL cells in a dose and time dependent manner. PRL-treated DL cells showed an increase in cell size along with a decrease in cells with apoptotic morphology. Evidence also is presented to show the involvement of tumor and macrophage-derived cytokines: IL-1, IL-2, TGF-beta, and M-CSF in PRL-dependent augmentation of tumor growth. Moreover, PRL treatment was found to inhibit Caspase-activated DNase (CAD) expression in DL cells indicating that PRL acts through modulation of caspase dependent pathway of apoptosis. The study is of novel significance as it demonstrates for the first time that PRL can promote growth of a T cell lymphoma involving host and tumor-derived tumor growth promoting cytokines.

Animals↗
PubMed2006

Water quality improvement through bioretention media: nitrogen and phosphorus removal.

High nutrient inputs and eutrophication continue to be one of the highest priority water quality problems. Bioretention is a low-impact development technology that has been advocated for use in urban and other developed areas. This work provides an in-depth analysis on removal of nutrients from a synthetic stormwater runoff by bioretention. Results have indicated good removal of phosphorus (70 to 85%) and total Kjeldahl nitrogen (55 to 65%). Nitrate reduction was poor (< 20%) and, in several cases, nitrate production was noted. Variations in flowrate (intensity) and duration had a moderate affect on nutrient removal. Mass balances demonstrate the importance of water attenuation in the facility in reducing mass nutrient loads. Captured nitrogen can be converted to nitrate between storm events and subsequently washed from the system. Analysis on the fate of nutrients in bioretention suggests that accumulation of phosphorus and nitrogen may be controlled by carefully managing growing and harvesting of vegetation.

Agriculture↗
PubMed2006

Outcome of Girdlestone's resection arthroplasty following complications of proximal femoral fractures.

Twenty two patients who underwent a Girdlestone resection arthroplasty of the hip (pseudarthrosis coxae) following failed operative treatment for hip trauma from 1993 to 2002 were retrospectively reviewed. The indications included failed osteosynthesis of fractures of the neck of the femur (n=8), septic hemiarthroplasty (n=9), aseptic loosening of hemiarthroplasty (n=3) and recurrent dislocation of a hemiarthroplasty (n=2). The mortality was 68.2% (15 patients, mean age: 78.8 years, 80% females) with a mean time interval between operation and death of 25.6 months. All the seven surviving Girdlestone patients had failed hemiarthroplasties previously. One of these had subsequently undergone re-implantation of a femoral prosthesis, and was excluded from the study. There were four females and two males. The age ranged from 62 to 94 years with a mean age of 79.6 years. There were 4 right-sided and 2 left-sided operations. The patients were followed-up for a mean 37.1 months (range : 6 months to 8 years). Pain relief was achieved in 100% patients with none to mild pain. All the patients had infection control. Four patients needed a frame support for walking, while the remaining two were chairbound. Overall 83.3% patients expressed their satisfaction with the Girdlestone procedure. The Girdlestone operation appears as a viable solution to achieve pain relief and to control infection at the cost of limited mobility in this specific subgroup of patients with failed operative treatment for hip trauma.

Aged↗
PubMed2005

Sarcomatous change in the Pagetoid tibiae.

We reviewed 13 cases of tibial Paget's sarcoma constituting 14% of all registered Paget's sarcoma cases of the Scottish Bone Tumour Registry between January 1947 and June 2004. Eleven patients were male, and in ten patients the tumour involved the upper half of the tibia. In all cases, the main presenting feature was progressively worsening pain followed by a mass in six, a pathological fracture in five and tibial bowing in four. In nine patients, a lytic lesion was seen radiologically. Histologically, there were three osteosarcomas and ten malignant fibrous histiocytomas. Limb ablation was carried out in 11 patients, of whom nine had trans-femoral amputation. Six patients received adjuvant radiotherapy and/or chemotherapy. Post-operative complications included stump revision in two cases, non-union of a pathological fracture of the tibial tuberosity and a stress fracture. The median survival was 17 months.

Aged↗
PubMed2004

A report of 18 blackthorn injuries of the upper limb.

This study aims to analyse various manifestations and to evaluate the clinical outcome in the patients who had exploratory procedures following blackthorn (Prunus spinosus) injury. We performed a retrospective review of a consecutive series of 18 patients admitted between April 1997 and March 2001 to a District General Hospital of the UK. In all the cases, the site of injury was the upper limb. The mean age at presentation was 39.1 years. There was a male predominance (83.33%) and a marginal right side preponderance. The majority of the patients (83.33%) presented between March and August, which correlates with hedge-cutting time. The mean delay in presentation was 3 days (range: 1-14 days). The final postoperative outcome was satisfactory in all cases. We conclude that conservative treatment alone failed to resolve the symptoms. We recommend that all patients presenting with a history of blackthorn injury should undergo an immediate and thorough exploration to avoid undue complications.

Abscess↗
PubMedDate not supplied

Pigmented villonodular synovitis of the foot and ankle: Forty years of experience from the Scottish bone tumor registry.

Fourteen cases of pigmented villonodular synovitis (PVNS) of the foot and ankle accrued from the Scottish Bone Tumor Registry are presented with an average follow-up of 4.6 years. This study analyzed the clinical, radiological, and histopathological features and investigated their clinical behavior and the factors influencing recurrence. The mean age of the patients was 26.4 years (range, 8-52 years). There were 8 women and 6 men. The mean delay in presentation was 10.3 months. The anatomical sites were phalanges (n = 2), tarso-metatarsal area (n = 3), and hindfoot (n = 9) (6 extraarticular soft tissue swellings around the ankle, 2 ankle, 1 subtalar joint). Eight (57.1%) cases presented with a painless lump, 5 (35.7%) patients had painful masses, and 1 case had a lump associated with toe deformity. Peri-articular tissue invasion and cortical infiltration were found in one third on plain films. Magnetic resonance imaging findings were suggestive of synovial sarcoma in 2 cases because of extensive low-signal soft tissue hypertrophy and bone erosion. Excision of the lump was performed in 4 cases with a complete recovery. Phalangeal lesions were treated with toe amputation through the metatarsophalangeal joint, and no cases had recurrence. There were 2 recurrences affecting the ankle and the subtalar joint. There was a 14.3% recurrence rate, while complete recovery was achieved in 85.7% cases (12/14). A high index of suspicion for PVNS should be observed for cases presenting with a painless or painful mass in the foot and ankle region. Complete recovery can be achieved in the majority by complete excision. Toe amputation may be considered for foot phalangeal PVNS.

Adolescent↗
PubMedDate not supplied

Water quality improvement through bioretention: lead, copper, and zinc removal.

Intensive automobile use, weathering of building materials, and atmospheric deposition contribute lead, copper, zinc, and other heavy metals to urban and roadway runoff. Bioretention is a low-impact-development best management practice that has the potential to improve stormwater quality from developed areas. The practice represents a soil, sand, organic matter, and vegetation-based storage and infiltration facility used in parking lots and on individual lots to treat runoff. Investigations using pilot-plant laboratory bioretention systems and two existing bioretention facilities documented their effectiveness at removing low levels of lead, copper, and zinc from synthetic stormwater runoff. Removal rates of these metals (based on concentration and total mass) were excellent, reaching close to 100% for all metals under most conditions, with effluent copper and lead levels mostly less than 5 microg/L and zinc less than 25 microg/L. Somewhat less removal was noted for shallow bioretention depths. Runoff pH, duration, intensity, and pollutant concentrations were varied, and all had minimal effect on removal. The two field investigations generally supported the laboratory studies. Overall, excellent removal of dissolved heavy metals can be expected through bioretention infiltration. Although the accumulation of metals is a concern, buildup problems are not anticipated for more than 15 years because of the low metal concentrations expected in runoff.

Biodegradation, Environmental↗