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J R Gage

Publications and source records attributed to J R Gage.

16 recordsLinked to original sources
PubMed1992

[Treatment of deformities of the locomotor system in hemiplegia].

In spastic hemiplegia mainly one side of the body is affected. In both the upper and the lower extremity the distal parts (hand and foot) are more severely involved than the proximal region. In cases of minor involvement the goal of treatment in the upper extremity is to achieve functional improvement by means of splinting and surgery. In cases of severe alterations cosmetic improvement without much functional gain is all that can be expected. Gait analysis has demonstrated that there are four basic patterns that can be related to the severity of involvement. In type I muscle imbalance exists without a contracture. In type II there is contracture of the muscles of the posterior compartment of the calf. In type III, in addition to the changes around the ankle joint, contractures around the knee are present, and in type IV also hip problems. Functional improvement can be achieved by means of splinting and surgery in all types. Basic principles of treatment have developed as a result of the application of gait analysis and dynamic electromyography. Specific examples of such treatment principles have recently been presented by Gage.

Child↗
PubMed1992

Clinical determination of femoral anteversion. A comparison with established techniques.

We evaluated femoral anteversion preoperatively in fifty-nine patients (ninety-one hips), using a clinical method that we developed, Magilligan radiographs, and computed tomographic scans. These measurements were then compared with values for anteversion that were obtained intraoperatively. To determine femoral anteversion clinically, the patient was placed in the prone position and the maximum lateral trochanteric prominence was related to the degree of internal rotation of the hip. Compared with computed tomographic scanning and Magilligan radiographic determination, the clinically determined anteversion correlated most closely (to within 4 degrees) with the amount measured at the time of the operation. The clinical method was found to be superior to radiographic techniques for determination of the degree of femoral anteversion in children who have not had a previous operation about the hip.

Biometry↗
PubMed1991

Human papillomavirus type 16 immortalized cervical keratinocytes contain transcripts encoding E6, E7, and E2 initiated at the P97 promoter and express high levels of E7.

Human cervical keratinocytes represent the specific host for the genital human papillomaviruses (HPV). Transfection of these cells with the DNA of a number of the oncogenic HPVs including type 16 was recently shown to result in their immortalization but not in malignant transformation. In this report we show that viral transcripts for E6 and E7 in these cells were as abundant as in cancer derived cell lines. However, in contrast to cancer derived cell lines, immortalized cervical keratinocytes contained RNA with the potential to encode a full-length E2 protein. In addition, the levels of the E7 oncoprotein were at least as high as in cancer derived cell lines, suggesting that E2 interruption, observed in cancer derived cell lines, is not causally related to the high level of E7 expression and, therefore, deregulation of the P97 promoter may not be a prerequisite for HPV-16 associated cancer development. Furthermore, we show that E6, E7, and E2 encoding transcripts all originate from the viral promoter, P97. Unlike in cancer derived cell lines, all transcripts terminated at the early poly(A) site.

Blotting, Northern↗
PubMed1990

The E7 proteins of the nononcogenic human papillomavirus type 6b (HPV-6b) and of the oncogenic HPV-16 differ in retinoblastoma protein binding and other properties.

The E7 early viral protein of the oncogenic human papillomavirus type 16 (HPV-16) has been strongly implicated in the maintenance of the malignant phenotype in cervical cancers and cancer-derived cell lines. HPV-16 E7 is a nuclear phosphoprotein that can cooperate with ras to transform baby rat kidney cells, transactivates the adenovirus E2 promoter, and binds to the retinoblastoma (RB) protein. The E7 phosphoprotein of the nononcogenic HPV-6b, which is generally associated with benign genital warts, is similar to the HPV-16 E7 in amino acid sequence but differs dramatically in migration in sodium dodecyl sulfate-polyacrylamide gels, sedimentation in nondenaturing glycerol gradients, and the ability to bind the RB protein. Our results indicate that the RB protein preferentially binds the phosphorylated form of HPV-6b E7, which comprises a minor fraction of the total E7 expressed in transiently transfected COS-7 cells. These characteristics may help to explain the difference in the oncogenic potential of the oncogenic and nononcogenic types of genital papillomaviruses.

Amino Acid Sequence↗
PubMed1990

Surgical treatment of knee dysfunction in cerebral palsy.

The prerequisites for normal gait are: (1) stability in the stance phase of gait, (2) clearance of the foot in the swing phase, (3) proper foot preposition in swing, and (4) an adequate step length. In the stance phase, the knee provides shock absorption and energy conservation; in the swing phase, it allows foot clearance. To accomplish these functions, the knee must extend fully in stance and flex approximately 60 degrees in swing. Consequently, balanced muscle action at the hip, knee, and ankle joints, combined with adequate acceleration from the hip flexor and triceps surae muscles, is essential. In the crouch gait of spastic cerebral palsy, hamstring lengthening alone often converts the flexed-knee gait to an extended-knee, stiff-legged gait with inadequate swing-phase knee flexion. This unwanted conversion is due to cospasticity of the quadriceps and hamstring muscles. Restoration of normal knee function in patients with spastic paralysis is more successful when fractional hamstring lengthening is combined with a transfer of the distal rectus femoris tendon to either the iliotibial band or the distal tendon of the semitendinosus.

Biomechanical Phenomena↗
PubMed1989

Cerebral palsy.

Explore the source record for details and available documents.

Adolescent↗
PubMed1987

Rectus femoris transfer to improve knee function of children with cerebral palsy.

Stance phase stability and swing phase clearance, prerequisites for normal ambulation, often are lost in the gait of children with cerebral palsy. Lengthening of the hamstrings usually will improve stance-phase knee extension but will not greatly alter swing-phase knee flexion. This paper presents the outcome of transfer of the distal end of the rectus femoris in conjunction with hamstrings lengthening in 37 knees, and compares it with a control group of 24 knees in which only hamstrings lengthening was done. In the first group swing-phase knee flexion was improved by 16.0 +/- 14.4 degrees, compared to 9.5 +/- 7.5 degrees in the control group, and residual knee flexion in stance was reduced to 8.9 +/- 8.1 degrees, compared to 15.1 +/- 13.8 degrees in the controls. Poor outcome in the transfer-plus-lengthening group was associated mainly with foot rotation in excess of 8 degrees internally or externally, or postoperative knee flexion in stance. Criteria for selection of cases and methods of improving surgical outcome are discussed.

Adolescent↗
PubMed1978

Complications after cuneiform osteotomy for moderately or severely slipped capital femoral epiphysis.

Wedge osteotomy of the femoral neck for slipped capital femoral epiphysis was performed in seventy-seven hips of seventy-one children at Gillette Children's Hospital during the period 1938 to 1973. The major complications were avascular necrosis (28.5 per cent) and cartilage necrosis (37.6 per cent). This high incidence of severe complications led to the use of an osteotomy through the base of the neck for the treatment of severely slipped capital femoral epiphysis which has given satisfactory results in six hips to date.

Adolescent↗
PubMed1977

Long-term follow-up of Perthes' disease treated nonoperatively.

Forty-six patients with Perthes disease treated nonoperatively were reviewed 10 to 43 years later. The median follow-up was 17 years. The patients were analyzed according to sex, age of onset, quantity of head involvement, type of treatment, duration of treatment, functional end result based on the Harris hip scale, and anatomic end result based on Mose templete evaluation. Most patients were treated with an ischial weight-bearing brace. The anatomic results of this treatment tended to be poor, probably worse than no treatment at all. In general, poor results were correlated with late onset, greater quantity of head involvement, and lateral subluxation of the femoral head. As reported in other series, the anatomic results did not correlate well with the functional results, only two patients having Harris hip scales below 70.

Female↗
PubMedDate not supplied

The fate of the nonoperated hip in cerebral palsy.

Thirty-six cerebral palsied patients who underwent a unilateral operative procedure for spastic hip subluxation or dislocation were reviewed for assessment of the effect on the nonoperated hip. Unilateral soft tissue procedures on patients less than 9 years of age had a definite untoward effect on the contralateral, nonoperated hip (progressive subluxation and development of a windswept pelvis deformity). The effect of unilateral bony procedures on the nonoperated hip was not statistically significant. Following unilateral surgery, nonambulators are at increased risk of demonstrating deterioration of the nonoperated hip in comparison to ambulators.

Cerebral Palsy↗
PubMedDate not supplied

A comparative study of ambulation-abduction bracing and varus derotation osteotomy in the treatment of severe Legg-Calvé-Perthes disease in children over 6 years of age.

Thirty-six patients with severe Legg-Calvé-Perthes disease were reviewed retrospectively to compare the results of ambulation-abduction bracing with varus derotation osteotomy. There were 17 brace patients and 19 osteotomy patients, and all were aged greater than 6.9 years. Treatment results were equal. The percentage of acetabular coverage, extent of lateral femoral subluxation, and the age of the patient affected outcome. The varus neck-shaft angle and leg length discrepancy resulting from the osteotomy were not permanent. The articular trochanteric distance appeared to be affected more by the neck-shaft angle recovery than by epiphysiodesis of the greater trochanter.

Adolescent↗
PubMedDate not supplied

Three-dimensional lower extremity joint kinetics in normal pediatric gait.

Gait analysis is becoming a more integral part of the decision-making process in treatment of children with neuromuscular problems. A normal reference, however, must be available for comparison when one makes decisions. We wished to develop a normal pediatric database for joint kinematics and kinetics which could then be used as a reference for clinical gait analysis. Thirty-one normal children underwent a complete gait analysis including calculations of three-dimensional joint kinematics and kinetics. The pediatric data were similar to that of normal adults.

Adolescent↗
PubMedDate not supplied

Differentiation of idiopathic toe-walking and cerebral palsy.

Kinematic data were collected on two groups of children with diagnoses of idiopathic toe-walking and mild spastic diplegia. Although both groups lacked a heel strike at initial contact, two distinct gait patterns were found. The toe-walkers displayed a variable pattern of ankle motion with moderate to severe plantarflexion at stance. The cerebral palsy patients showed a repeatable gait pattern with only minimal deviation from normal. The absence of a heel strike in this group is due to the sustained knee flexion at terminal swing and initial contact, which was significantly greater than in the toe-walkers.

Ankle↗