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Biomedical subjects

M B Dobbs

Publications and source records attributed to M B Dobbs.

11 recordsLinked to original sources
PubMed2000

Localization of dominantly inherited isolated triphalangeal thumb to chromosomal region 7q36.

Triphalangeal thumb is an autosomal dominantly inherited form of abnormal preaxial skeletal development. In most families, however, the triphalangeal thumb phenotype coexists with a spectrum of limb deformities, including polydactyly and syndactyly. We describe two Iowa kindreds with triphalangeal thumb. In one family, with nine affected members, triphalangeal thumb was the only manifestation of limb deformity. We performed linkage analysis on both pedigrees, demonstrating a maximum LOD score of 6.23 with marker D7S559 on chromosome 7q36. This corresponds to a previous study of a candidate region of 450 kb in which data from several families with preaxial polydactyly were employed. Further analysis of the unique family with isolated triphalangeal thumb in the current study may demonstrate allelic variability of the gene involved in these disorders.

Chromosome Mapping↗
PubMed2000

Treatment of idiopathic clubfoot: an historical review.

Idiopathic clubfoot, one of the most common problems in pediatric orthopaedics, is characterized by a complex three-dimensional deformity of the foot. The treatment of clubfoot is controversial and continues to be one of the biggest challenges in pediatric orthopaedics. This controversy is due in part to the difficulty in measuring and evaluating the effectiveness of different treatment methods. We believe the heart of the debate is a lack of understanding of the functional anatomy of the deformity, the biological response of young connective tissue to injury and repair, and their combined effect on the long-term treatment outcomes. The aim of this review is not only to assess the different methods of clubfoot treatment used over the years in light of an evolving understanding of the pathoanatomy of the deformity, but to also clarify factors that allow a safe, logical approach to clubfoot management. Further research will be needed to fully understand the pathogenesis of clubfoot, as well as the long-term results and quality of life for the treated foot.

Clubfoot↗
PubMed2000

Diabetic muscle infarction.

Diabetic muscle infarction is a rare complication of diabetes mellitus that is not clearly defined in the orthopaedic literature. This study is a descriptive case series of 7 new cases of diabetic muscle infarction and 55 previously reported cases in the literature. In the majority of patients, diabetic muscle infarction presents as a localized, exquisitely painful swelling and limited range of motion of the lower extremity. No cases affecting the muscles of the upper extremity have been observed. The onset is usually acute, persists for several weeks, and resolves spontaneously over several weeks to months without the need for intervention. Diabetic muscle infarction is a condition that should be considered in the differential diagnosis of any diabetic patient with lower extremity pain and swelling without systemic signs of infection. Magnetic resonance imaging is sensitive and specific enough to make the diagnosis. Muscle biopsy and surgical irrigation and debridement are not recommended since they are associated with complications. Pain management and activity restriction in the acute phase followed by gentle physical therapy is the treatment of choice. Recurrences in the same or opposite limb are common. Although the short-term prognosis is very good and the majority of cases resolve spontaneously, the long-term survival is uncertain in this patient population.

Adult↗
PubMed1999

Infantile and juvenile scoliosis.

The diagnosis and treatment of scoliosis in the infantile and juvenile age groups is a challenging and demanding endeavor. The diagnosis must be firmly established. Once a deformity has proven to be progressive, surgical intervention will likely be necessary because orthotic treatment is less effective in these cases. The surgeon is then faced with the dilemma of deciding on the most appropriate surgical treatment.

Child↗
PubMed1999

Osteoporosis: the increasing role of the orthopaedist.

Osteoporosis is an ever-increasing problem as our population ages. However, it is also to a large extent a preventable problem. The orthopaedist now has the ability to determine bone mass, the rate of turnover, and the fracture risk. Skeletal bone mass can be evaluated with DXA; the rate of bone resorption can be determined by assessment of collagen-degradation urinary products; and the weight status, fracture history, and history of smoking can be used to predict the fracture risk in individual patients. The orthopaedic physician also needs to take an active role in advising their younger patients about achieving peak bone mass. All individuals should follow a program that includes adequate calcium replacement, 400 to 800 units of vitamin D, appropriate exercise, avoidance of significant weight loss, and cessation of smoking. At menopause, women should evaluate their risk factors and consider the use of estrogen not only for its skeletal benefits but also for its nonosseous effects. In patients with contraindications or an aversion to hormone therapy, bone densitometry should be performed to determine risks before expensive nonhormonal treatment is initiated. Additional studies such as measurement of collagen degradation products will help establish whether the patient's resorptive rate is high or stable. If the bone mass is 2.5 SDs below normal peak or if there is an increase in resorption, use of either estrogen, bisphosphontes, or calcitonin may be appropriate. If there is evidence of low-turnover osteoporosis with decreased osteoblast formation, sodium fluoride should be considered. Two thirds of the cost of osteoporosis in the United States is due to hip fractures. The orthopaedist is the primary physician who comes in contact with these fracture patients. It is therefore his or her responsibility to become knowledgeable about the treatment and prevention of osteoporosis. The bisphosphonates, hormones, and calcitonin provide predictable restoration of bone mass and significantly decrease the rate of osteoporotic fractures.

Administration, Intranasal↗
PubMed1995

A noninvasive, reattachable skull fiducial marker system. Technical note.

As computer-interactive technologies become more widely used in neurosurgery, radiology, and radiation therapy, the need for an optimum skull fiducial marker system increases. In the past, intracranial localization methods required precisely machined metal frames and rigid pin fixation to the skull. Recently, this function has been performed using "frameless" computer-based systems that calculate brain position relative to a series of external reference points, the most accurate of which are screwed directly into the skull. A penetrating fiducial marker system, however, is not well suited for applications requiring multiple volume registrations over an extended time period. We describe a new skull fiducial marker system that attaches to the maxillary teeth and can be used repeatedly on different occasions. A curved bar, known as a Banana Bar (BB) extends backward from a custom mouthpiece around the side of the patient's head; the bar contains sites of attachment for screw-in radiographic fiducial markers. Repositioning accuracy was quantitated using a photographic technique. A BB prototype was constructed and tested in three subjects. The BB weighs less than 100 g and can be comfortably held in position for up to 30 minutes. It takes less than 1 minute to screw in the mouthpiece and only seconds to secure the BB to the teeth. One hundred twenty photographic measurements were analyzed from 60 repositionings over a minimum 3-week period. Standard deviations for the measurement series ranged from 0.29 to 0.86 mm. Results suggest that the BB may be an inexpensive, efficient, and accurate method for providing the external reference points needed for a wide range of emerging computer-interactive applications.

Brain↗
PubMed1993

Production of the cytokines interleukin 1 and 6 by murine brain microvessel endothelium and smooth muscle pericytes.

Murine brain microvessel endothelial cells and smooth muscle/pericytes (SM/P) cells were cultured from newborn BALB/c (normal strain) and SJL/j (autoimmune-prone strain) mice. These cells were evaluated for their ability to produce interleukin (IL)-1 and IL-6 cytokines. The expression of mRNA for IL-1 and IL-6 was shown in highly purified BALB/c endothelial cells and SM/P cells using polymerase chain reaction with specific primers for IL-1 alpha, IL-1 beta and IL-6. IL-6 but not IL-1 mRNA was detected in unstimulated SJL/j brain microvessel cells. The presence of IL-1 and IL-6 mRNA in the BALB/c brain microvessel endothelial cells and SM/P was confirmed by in situ hybridization. By D10.G4.1 assay, unstimulated BALB/c endothelial cells were shown to produce active IL-1 to a higher degree than SM/P. By B9 bioassay, a low amount of active IL-6 was detected in the supernatant of endothelial cells and SM/P. The production of IL-1 and IL-6 in the bioassays was upregulated by lipopolysaccharide (LPS) activation of the cells in a time- and dose-dependent way. IL-6 production was also shown to be upregulated by IL-1 beta activation of the cells. Brain microvessel endothelial cells of SJL/j origin released equivalent amounts of IL-6 compared to endothelial cells of BALB/c origin. However, the production of IL-6 was markedly higher in SM/P of SJL/j origin than in those of BALB/c origin. These observations, together with our previous data showing that brain microvessel SM/P cells produce GM-CSF, emphasize the possibility for active participation of brain microvasculature SM/P as well as endothelium in inflammatory reactions of the central nervous system.

Animals↗
PubMed1990

dgq: a drosophila gene encoding a visual system-specific G alpha molecule.

We describe the isolation and preliminary characterization of a new G alpha gene (dgq) in Drosophila. The dgq gene is differentially spliced, yielding two putative proteins, both of which contain guanine nucleotide binding and hydrolysis domains and share 50% identity with transducins and other G proteins. These proteins represent a new class of G alpha subunits because they lack both high amino acid identity with other G alpha proteins and the pertussis toxin ADP ribosylation site. The dgq mRNA is detected by RNA-RNA Northern hybridization in wild-type heads but not in wild-type bodies or in the mutant eyes absent heads. Tissue in situ hybridization detects dgq expression only in the retina and ocellus of the adult head, making it a prime candidate for encoding the Drosophila transducin analog, the G protein required for phototransduction.

Adenosine Diphosphate Ribose↗