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Biomedical subjects

J Howe

Publications and source records attributed to J Howe.

At least 73 records · Page 4Linked to original sources
PubMed1989

Hip arthroplasty after biplanar femoral osteotomy.

Hip arthroplasty in patients who have had previous biplanar femoral osteotomy (eg, Southwick) is a technical surgical problem. Distorted proximal femoral anatomy may make routine insertion of a femoral prosthesis impossible. The authors report the short-term results in three patients with hip arthroplasty after biplanar femoral osteotomy. The technique consists of a biplanar closing wedge osteotomy at the level of the lesser trochanter to correct the previous surgical deformity. The remaining proximal femur becomes a vascularized bone graft that is skewered by the femoral prosthesis, which also gains purchase in the medullary canal of the proximal femoral shaft. This technique allows restoration of anatomic femoral alignment and the use of standard prostheses with preservation of bone stock. The initial results have been very good. The appearance of the hip is very similar to that in primary hip arthroplasty.

Adult↗
PubMed1989

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↗
PubMed1988

A new second-generation anti-HIV-1 enzyme immunoassay using recombinant envelope and core proteins.

In a multicenter collaborative study a new second-generation HIV-1 antibody enzyme immunoassay (Abbott recombinant HIV-1 EIA) using Escherichia coli-expressed recombinant p24 and p41 proteins as solid-phase antigens was compared with the first-generation H9 cell-line-based Abbott HIV-1 EIA. The results of the confirmatory assays (Western blot, immunofluorescence), combined with clinical information, were used as the reference standard for the detection of HIV-1 antibodies in 10,676 random blood donor serum specimens, in a panel of 840 specimens from symptomatic and asymptomatic patients and a total of 63 serial blood specimens from 23 people at risk. With fresh blood donor sera, the specificity of the first-generation assay ranged between 99.54 and 99.76% (95% confidence limits, CL) compared with 99.81-99.95% (95% CL) for the second-generation EIA. With panel specimens the recombinant HIV-1 EIA achieved an overall sensitivity of 100% and a specificity range of 98.3-99.7% (95% CL); the corresponding sensitivity and specificity ranges observed for the first-generation EIA were 98.0-99.5% (95% CL) and 94.3-96.8% (95% CL), respectively. The improved sensitivity for the second-generation assay was confirmed by testing serial samples from seroconverting patients. The use of recombinant proteins eliminated non-specific reactions due to class II human leukocyte antigen (HLA)-directed antibodies.

Blood Donors↗
PubMed1988

Femoral head histology under THARIES surface replacement.

Because of widespread reports of unacceptable results, surface replacement arthroplasty is infrequently performed. In this study, femoral head and neck specimens from two surface replacement arthroplasties revealed fibrous tissue ingrowth and avascular necrosis.

Adult↗
PubMed1987

[Therapeutic lymphapheresis in leukostasis-induced priapism].

Priapism occurred as a result of leukostasis due to an extreme rise in leukocyte count (503,000/microliter, 96% lymphocytes) in a 46-year-old man with chronic lymphatic leukaemia. In addition to surgical treatment, anticoagulant administration and cytostatic treatment several courses of lymphapheresis were performed using a cell separator. This latter procedure quickly reduced the number of lymphocytes and improved the patient's operability.

Combined Modality Therapy↗
PubMed1985

The effects of questionnaire design on the determination of end results in lumbar spinal surgery.

Two hundred and seven patients followed a minimum of 10 years after a single lumbar disc operation were evaluated using 14 different questionnaires that measure surgical outcomes. Dependent on the questionnaire design, the satisfactory outcomes for this population ranged from 97% to 60%, which is statistically significant. The authors conclude that the reported outcomes for lumbar spinal surgery are significantly manipulated by the criteria selected for the assessment of end results.

Follow-Up Studies↗
PubMed1985

Early and rapid diagnosis of acute haemorrhagic conjunctivitis with tear specimens.

Picornavirus particles and serotype-specific neutralizing antibody were demonstrated in tears collected during early onset of acute haemorrhagic conjunctivitis. Virus particles deposited from tears by airfuge ultracentrifugation and stained with potassium phosphotungstate were easily recognized by electron microscopy. Tear neutralizing antibody in the ultracentrifuged supernatant was detected by the neutralization test in monolayer HeLa cells grown in microtitration plates. The presence of virus particles and specific neutralizing antibody in tear specimens correlated with the serological findings.

Conjunctivitis, Acute Hemorrhagic↗
PubMed1984

Inherited partial trisomy #15 complicated by neuroblastoma.

The proband in this study had multiple congenital malformations and a constitutional 46,XY,-13, + der(13),t(13;15)(q34;q23)mat chromosome complement. A bone marrow aspirate revealed neuroblastoma, and cytogenetic studies on tumor cells revealed, in addition to the partial trisomy #15 and probable partial monosomy #13, hypotetraploidy with a mean chromosome number of 82-84, including 3 or 4 copies of each autosome, 2 X chromosomes, no Y chromosome, and a marker. Translocations involving chromosomes #1, #2, #3, #7, and #14 were present, along with multiple double minutes. The possibility that the inherited partial trisomy #15 (and/or partial chromosome #13 monosomy) predisposed to neuroblastoma and additional chromosome changes in this tumor is discussed.

Chromosome Aberrations↗
PubMed1980

A comparison of the effects of membrane and bubble oxygenators on platelet counts and platelet size in elective cardiac operations.

To compare the effects of membrane and bubble oxygenators on platelet counts and the size of circulating platelets, serial hematocrits, platelet counts, and platelet sizing were measured in 23 patients undergoing elective cardiac operations. In 10 patients a bubble oxygenator was used and in 13, a SciMed membrane oxygenator. The two groups were statistically similar with respect to age, weight, time on bypass, and mean blood flow rates during bypass. It was found that platelet counts, when corrected for hemodilution, did not fall from control levels during or up to 24 hours after cardiopulmonary bypass in either group. In both groups, the relative number of platelets per gram of hemoglobin increased slightly during and after bypass, and this increase was significant in the bubble oxygenator group. The average size of circulating platelets increased only in the bubble oxygenator group, and then only in the one-day postoperative sample. These findings suggest that the membrane oxygenator offers no advantage with respect to preservation of platelets during cardiopulmonary bypass lasting up to 2 to 3 hours.

Adult↗
PubMed1978

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↗
PubMed1978

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↗