Bone and joint infections in children.
The current approach to the diagnosis and treatment of bone and joint infections in children is presented. Guidelines for the surgical and medical regimen of each are outlined.
Biomedical subjects
Publications and source records attributed to K Edwards.
The current approach to the diagnosis and treatment of bone and joint infections in children is presented. Guidelines for the surgical and medical regimen of each are outlined.
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In the country of Papua New Guinea, with its diverse population of nearly 3 million people, some disease patterns have a strange similarity to those seen in tropical Africa. Kaposi's sarcoma is a condition which is commonly seen in adult males; childhood Kaposi's sarcoma is relatively uncommon. Six cases, all males, aged from 6 months to 12 years have been detected since 1978. The primary organ involvement included skin in four cases, oral cavity in one case and lymph node in one case. The varied clinico-pathological features are described. This is the first report of such cases from Papua New Guinea.
We evaluated bladder, rectal, and esophageal temperatures compared with nasopharyngeal temperatures in 12 patients who underwent cardiac surgery that required CPB. Changes in bladder temperature lagged behind those of esophageal and nasopharyngeal temperature during rapid cooling and rewarming. Changes in rectal temperature were the slowest. Bladder and rectal temperatures were similar after surgery. Monitoring bladder temperature represents the core temperature in a steady state.
A rare case of Kaposi's Sarcoma primarily originating in the oral cavity of a 2-year-old male child with subsequent metastatic spread to the lymph node is presented and the literature reviewed.
Double-lumen subclavian catheters have recently been released for use as a temporary blood access for extracorporeal circulation. Initial reports indicate that once properly inserted, these catheters are safe. However, massive mediastinal hematoma that occurred 3 days after insertion and uneventful initial dialysis with a double-lumen subclavian catheter has been documented. The patient experienced excruciating pain immediately after the onset of the subsequent dialysis and was found to have developed a massive mediastinal hematoma. It appears that at some point after the completion of the initial dialysis, the catheter tip eroded the vein and entered the mediastinum. As a result, the proximal (arterial) perforations were inside the vein, allowing blood to freely enter the circuit and be forcefully pumped into the mediastinum through the distal (venous) perforations near the tip. Prompt recognition of the problem and immediate discontinuation of dialysis prevented a potential fatal outcome in this case.
Changing sodium intake from 70-200 mmol/day elevates blood pressure in normotensive volunteers by 6/4 mmHg. Older people, people with reduced renal function on a low sodium diet and people with a family history of hypertension are more likely to show this effect. The rise in blood pressure was associated with a fall in plasma volume suggesting that plasma volume changes do not initiate hypertension. In normotensive individuals the most common abnormality in membrane sodium transport induced by an extra sodium load was an increased permeability of the red cell to sodium. Some normotensive individuals also had an increase in the level of a plasma inhibitor that inhibited Na-K ATPase. These individuals also appeared to have a rise in blood pressure. Sodium intake and blood pressure are related. The relationship differs in different people and is probably controlled by the genetically inherited capacity of systems involved in membrane sodium transport.
A porcine prorelaxin gene has been constructed partly by synthetic means and partly from its natural messenger RNA. A gene coding for the 32 N-terminal amino acids including a chain initiator methionine codon (B gene) was synthesised and inserted in a plasmid at a site downstream from a tryptophan promoter in such a way that its expression is under the control of the trp promoter. DNA corresponding to the rest of the prorelaxin was prepared using reverse transcriptase extension of a primer complementary to relaxin mRNA and joined at a suitable restriction site to the B gene. Transformation of E. coli with this plasmid followed by suitable induction resulted in the synthesis of a new protein identified as prorelaxin by its size and its antigenic similarity to relaxin.
Data are presented to compare fluid flow parameters for steady flow with those for time-varying flow in a simplified two branch model which simulates the region of the abdominal aorta near the celiac and superior mesenteric branches of the dog. Measurements in the model included laser doppler anemometry velocity profiles during steady flow, sinusoidal flow with a superimposed mean flow (referred to as simple oscillatory flow) and arterial pulsatile flow. Shear rate measurements were made by an electrochemical technique during steady flow. Flow visualization studies were done during steady and pulsatile flow. Fluid flow effects in the simplified model during steady flow showed many similarities to the results from previous steady flow studies in a canine aortic cast. Shear rates in the region of the proximal (first, or celiac) branch were independent of flow rates in the distal (second, or mesenteric) branch, but the shear pattern within the proximal branch changed significantly as flow in the proximal branch increased. Shear rates on the proximal flow divider (leading edge into the distal branch) depended primarily on the flow rate to the proximal branch, but not on flow to the distal branch. At certain daughter branch flow ratios (approximately 2:1, proximal to distal), flow separation was promoted at the outer wall of the second branch, but flow separation did not occur in the first branch. In contrast to the canine aortic case results, flow separation was never detected on the distal (mesenteric) flow divider of the simplified model. This observation reflects the subtle effects of geometry on flow since the mesenteric flow divider in the canine cast protrudes into the main flow whereas the distal flow divider in the simplified model does not. There were distinct differences in the flow phenomena between steady, simple oscillatory and arterial pulsatile flow. Peak shear rates during pulsatile flow were as much as 10--100 times greater than steady flow shear rates at comparable mean flow rates. Particularly noteworthy for the pulsatile flow with a Womersley parameter of sixteen were very blunt velocity profiles throughout systole, and the absence of flow separation or reversal in those regions of the model that exhibited flow separation during steady flow. The shape of the waveform influences the nature of the flow during time-varying flows. Future studies of fluid dynamics in model systems must consider the pulsatile nature of the flow if a true interpretation of arterial flow phenomena is to be made.
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We determined 90% of the primary structure of E.coli MRE 600 23S rRNA by applying the sequencing gel technique to products of T1, S1, A and Naja oxiana nuclease digestion. Eight cistron heterogeneities were detected, as well as 16 differences with the published sequence of a 23S rRNA gene of an E.coli K12 strain. The positions of 13 post-transcriptionally modified nucleotides and of single-stranded, double-stranded and subunit surface regions of E.coli 23S rRNA were identified. Using these experimental results and by comparing the sequences of E.coli 23S rRNA, maize chloro. 23S rRNA and mouse and human mit 16S rRNAs, we built models of secondary structure for the two 23S rRNAs and for large portions of the two mit rRNAs. The structures proposed for maize chloroplast and E.coli 23S rRNAs are very similar, consisting of 7 domains closed by long-range base-pairings. In the mitochondrial 16S rRNAs, 3 of these domains are strongly reduced in size and have a very different primary structure compared to those of the 23S rRNAs. These domains were previously found to constitute a compact area in the E.coli 50S subunits. The conserved domains do not belong to this area and contain almost all the modified nucleotides. The most highly conserved domain, 2042-2625, is probably part of the ribosomal A site. Finally, our study strongly suggests that in cytoplasmic ribosomes the 3'-end of 5.8S rRNA is basepaired with the 5'-end of 26S rRNA. This confirms the idea that 5.8S RNA is the counterpart of the 5'-terminal region of prokaryotic 23S rRNA.
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Adenine nucleotide levels could be precisely and reproducibly adjusted in liver cell suspensions by partially depleting the ATP pool with D-fructose or glycerol. Thus, it was possible to quantitatively correlate rates of protein synthesis and secretion with intracellular levels of ATP and with derived parameters, such as the adenylate energy charge. Half the maximum rate of incorporation of leucine into protein was observed at an energy charge of 0.80, a ratio of ATP to ADP of 2.6, and an ATP level of 1.05 mumol per g of wet cells. Proteins were secreted with half the maximum rate at an energy charge of 0.85, a ratio of ATP to ADP of 3.1 and an ATP concentration of 1.1 mumol per g of wet cells. Protein secretion did not depend on continued synthesis. Inhibitors of oxidative phosphorylation inhibited protein secretion in addition to protein synthesis, in contrast to observations by other authors on liver slices.
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