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Biomedical subjects

J Howe

Publications and source records attributed to J Howe.

17 recordsLinked to original sources

Effect of tension and placement of a prosthetic anterior cruciate ligament on the anteroposterior laxity of the knee.

We wished to determine the optimal tension required to restore normal joint laxity to anterior cruciate ligament (ACL)-deficient knees using a braided polyethylene ACL prosthesis (PACL). In 10 cadaveric specimens, we measured the anteroposterior (AP) laxity of the intact knee at 10 degrees, 30 degrees, 60 degrees, and 90 degrees of flexion. The ACL was then removed and replaced with the PACL using tunnel-tunnel (T-T) and "over-the-top" (OTT) placement techniques. In both positions, the PACL was initially tensioned to 0, 9, 18, and 27 N with the knee flexed to 30 degrees. AP joint laxity was then measured at each flexion angle. With an increase in initial tension, there was a corresponding decrease in AP laxity. At 30 degrees and 90 degrees of flexion, AP laxity was not significantly different from normal using T-T placement and an initial tension of 0 N. At 90 degrees of flexion, AP laxity was not significantly different from normal using OTT placement at 0 or 9 N of initial tension. For both positions, all other tension levels and flexion angles constrained AP laxity. No laxity differences were detected between the OTT and T-T positions at any flexion angle. The variability in AP laxity of the T-T position was significantly greater than OTT. With a 150-N anterior shear force applied to the proximal tibia, the maximum tensions developed in the PACL were not significantly different between the two positions except at 90 degrees. The results suggest that implantation of the PACL is best performed using OTT positioning with an initial tension of 0 N applied at 30 degrees of knee flexion.

Adult

Research resources.

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Community Mental Health Services

A Blastocystis species from the sea-snake, Lapemis hardwickii (Serpentes: Hydrophiidae).

Observations were made on Blastocystis isolated from the sea-snake, Lapemis hardwickii. Exponential growth of the organism was observed between 2 and 4 days of culture. Vacuolated, amoeboid and granular forms were observed in cultures, similar to B. hominis. The optimal growth temperature for the sea-snake Blastocystis was 24 degrees C compared with 37 degrees C for B. hominis. The karyotypic patterns of B. hominis and the sea-snake Blastocystis were studied in the clamped homogeneous electric field (CHEF) technique and found to be different. Based on the above differences, the sea-snake Blastocystis was designated as Blastocystis lapemi sp. nov.

Animals

Primary Sjögren's syndrome in north east England--a longitudinal study.

We have documented the initial clinical features of 100 patients with primary Sjögren's syndrome (SS) together with the results of their baseline investigations. The evolution of the disease in these patients has been followed for a median of 34 months (range 3-84 months). The majority of patients were females aged 40-60 years, and common clinical features included eye symptoms (100%), xerostomia (100%), polyarthralgia (94%), Raynaud's phenomenon (81%) and salivary gland swelling (47%). Thyroid disease was relatively common (14%) while other endocrine disease was rare. Four patients died during follow-up, and three cases of lymphoma were detected. Other serious complications included pericarditis (10%), pleuroparenchymal lung disease (9%), renal tubular acidosis (3%) and cerebrovascular accidents (2%). The presence of anti-Ro antibodies identifies patients with more severe systemic disease. Spontaneous improvement occurred in 12 patients, while steroids were required for specific complications in 18. Overall, although lymphoma was found to excess in our group, the high mortality reported with primary SS elsewhere was not seen.

Adolescent

On the putative mechanism of induction and regulation of melanogenesis by L-tyrosine.

The stimulation of melanogenesis by L-tyrosine in hamster melanoma is several-fold higher than that by norepinephrine, epinephrine, clonidine and isoproterenol and absent in the case of tyramine dopamine and phenylephrine. Therefore, the melanogenic effect of L-tyrosine in hamster melanoma follows a different pathway than that linked to the activation of dopaminergic and adrenergic receptors.

Animals

The tymobox, a sequence shared by most tymoviruses: its use in molecular studies of tymoviruses.

The 5'-terminal sequences of the virion protein mRNAs of ononis yellow mosaic and kennedya yellow mosaic tymoviruses were determined, and also the positions in the genomes of the transcription initiation sites of those mRNAs. Comparisons of the available genomic sequences of tymoviruses revealed two conserved regions, one at the initiation site and another longer sequence of sixteen nucleotides to the 5' side of it. The longer sequence, which we call the tymobox, was tested as a target for a designed ribozyme, which cleaved appropriate genomic fragments of three tymoviruses. A synthetic oligonucleotide with sequence complementary to the tymobox was shown to be a tymovirus-specific probe for diagnosing and identifying tymoviruses, except for wild cucumber mosaic tymovirus. The tymobox sequence was also used as a primer for the second strand DNA synthesis of dsDNA representing the virion protein gene of cacao yellow mosaic tymovirus, a tymovirus with unknown sequence. Thus, the tymobox is a useful tool in molecular studies of tymoviruses.

Base Sequence

AIDS--the rights approach.

When confronted by Aids, nurses may react in different ways, but they must always keep the rights of the individual sacrosanct. This article illustrates how individual rights may be ignored simply because people have become entangled in the Aids issue.

Acquired Immunodeficiency Syndrome

Disc excision and spine fusion in the management of lumbar disc disease. A minimum ten-year followup.

Seventy-nine percent of 312 patients who underwent lumbar disc surgery were evaluated at least 10 years postoperatively (mean equal to 13.7 years). Residual back and nerve root symptoms and functional impairment were equally as common among the 143 patients who underwent fusion as they were among the 64 patients who did not. Thirty percent of the patients whose spines were fused and 37.7% of those patients whose spines were not fused were considered long-term failures because of persistent symptoms or the need for reoperation. Thirty-seven percent of the fusion patients had persistent graft donor site symptoms. Examined patients showed a high percentage of residual neurologic defects. An unexplained positive Trendelenburg sign was present in 14.8% of the fusion patients and in 18.2% of the patients whose spines were not fused. Although retrospective studies often have problems of accuracy, this analysis confirms other observations that midline spinal fusion offers few benefits in the management of lumbar disc disease.

Adult

Failed lumbar disc surgery requiring second operation. A long-term follow-up study.

Forty-five patients who had lumbar disc surgery 10 or more years previously, and had required a second operative procedure, have been evaluated. Failures occurred up to 16 years after the first operation, and were most commonly due to pseudoarthrosis in the patients who underwent spinal fusion initially, and to recurrent disc lesions at the same level as previous surgery in the patients who did not have fusion. The clinical and functional results in the second group of patients who required a second procedure were comparable to those of patients who required only a single procedure. In contrast, patients who had undergone spinal fusion who required a second procedure had significantly worse clinical and functional results, both in comparison to the patients who did not undergo fusion as well as to patients who had had fusion as a single procedure. The only predictable, demonstrable source of failure was acquired spondylolysis. Frequently, repair of pseudoarthrosis did not lead to symptomatic relief. These data suggest that spinal fusion, when it fails, has a significantly worse prognosis than simple disc excision in the management of lumbar disc disease.

Adult

Precocious aging and dementia in patients with Down's syndrome.

Fifty unselected institutionalized patients with Down's syndrome were studied to determine the clinical course of precocious aging and mental and neurological deterioration. In our studies we establish statistically significant differences in neurological and psychiatric abnormalities and mental deterioration in patients below and above age 35, indicating progressive changes in the central nervous system. We demonstrate higher incidence of recent memory loss, impairment of short-term visual retention, frontal release signs, hypertonia, hyperreflexia, long-tract signs, and psychiatric problems. We also note the presence of external features of precocious aging. Down's syndrome appears to be a human chromosomal abnormality in which genetically determined biochemical defects leading to precocious aging and dementia can be studied.

Adolescent

A comparison of radiographic findings in fusion and nonfusion patients ten or more years following lumbar disc surgery.

Ninety-six patients who had undergone disc excision and midline spinal fusion and 36 patients who had had simple disc excision had spinal radiographs made 10 or more years postoperatively. Claw spurs were found most commonly at the L2-3 and L3-4 levels in fusion patients, particularly male laborers. Traction spurs with segmental hypermobility were found more commonly at the L4-5 level in patients whose spines were not fused, particularly women. Total lumbar flexion-extension was greater in nonfusion than in fusion patients, but the L1-3 mobility was greater in those who had undergone fusion, suggesting a compensatory increase in the range of lumbar motion. Segmental mobility at levels of surgery in nonfusion patients was similar in those with good and those with poor clinical results. Disc space narrowing was common at levels of operation, but did not correspond to the clinical result. Pseudarthrosis was demonstrated in 26% of fusion patients, but was of no clinical significance. Although complex radiographic changes follow lumbar disc surgery, with or without failure, it is concluded that the plane radiograph is of little aid in determining the source of postoperative pain. The sole exception is that of acquired spondylolysis, which was found in 2.5% of this group of fusion patients, and was clearly associated with a poor clinical outcome. Symptomatic degenerative disc disease at levels above lumbar spinal fusions appears to be an uncommon clinical problem.

Female

Molecular mechanisms governing melanogenesis in hamster melanomas: relative abundance of tyrosinase and catalase-B (gp 75).

Variants of the Bomirski family of hamster melanomas whose proliferative rates differ inversely with the genetically determined degree of melanogenesis were probed for two proteins critical in melanogenesis: tyrosinase and catalase-B (gp 75). The parental black tumor Ma contained both proteins in abundance. The amelanotic variant Ab, inducible in culture with L-tyrosine or L-dopa to form melanosomes and to melanize, had minimal tyrosinase, despite high levels of (tyr)mRNA, and no gp 75. Variant MI, hypomelanotic despite abundant tyrosinase, and synthesizing predominantingly pheo-(red) melanin, expressed barely detectable gp 75. These findings suggest a regulatory control of melanogenesis distal to (tyr)mRNA and strengthen the hypothesis that in vivo tyrosinase without catalase-B favors pheo- over eumelanogenesis.

Animals

The long-term effects of spinal fusion on the sacroiliac joints and ilium.

Ninety-six patients who had lumbar disk excision and primary posterior fusion were studied 10 or more years after their operations. Thirty-seven per cent complained of persistent graft donor site pain. A comparison of fused patients with and without donor site pain and 36 patients who underwent simple disk excision, revealed no differences in the flexion-extension mobility of the sacroiliac joints, or degenerative changes in the sacroiliac joints. Ectopic bone formation at graft donor sites, and cluneal nerve neuromata did not influence the result. Patients with graft donor site pain had significantly greater complaints of persistent low back pain, postoperative leg pain, and lost more time from work. If the graft was taken from the same side as that of preoperative leg pain, persistent complaints were more common. It is concluded that the sacroiliac joints are not adversely affected by lumbar spine fusion, and that persistent donor site pain is more likely part of a total pain complex referred from the lumbar spine. The sacroiliac joints appear to be relatively noncontributory to problems following lumbar disk surgery.

Bone Transplantation