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Biomedical subjects

M Clancy

Publications and source records attributed to M Clancy.

At least 55 records · Page 3Linked to original sources
PubMed1991

Coronal decompensation produced by Cotrel-Dubousset "derotation" maneuver for idiopathic right thoracic scoliosis.

From 1985 to 1987, 82 patients with idiopathic scoliosis followed 12 to 44 months underwent selective fusion and correction of their right thoracic curves by Cotrel-Dubousset instrumentation using the "derotation" maneuver. Preoperative, postoperative, and follow-up standing anteroposterior roentgenograms of the spine were analyzed. For curves in which there was deviation from the midline (plumb line) and rotation of the lumbar segments, an increased incidence of decompensation was produced after surgery, when posterior Cotrel-Dubousset instrumentation and fusion were carried to the "stable" vertebra with one rod bend and hook alignment on the left sided derotation rod. Previous guidelines established for selective fusion with conventional posterior instrumentation (Harrington or Luque rods) may not be applicable to derotation with Cotrel-Dubousset instrumentation.

Adolescent↗
PubMed1990

Use of Ames SG10 Urine Dipstick for diagnosis of abdominal pain in the accident and emergency department.

In a prospective study of 1112 patients presenting to the Accident and Emergency Department with abdominal pain; the SG10 Ames Urine Dipsticks were shown to be a valuable screening test for the detection of infected urine. Introducing this technique would reduce by at least 37% the number of urgent requests for microscopy of midstream urines (MSUs). Dipstick testing however was not a reliable screening test for microscopic haematuria.

Abdominal Pain↗
PubMed1990

Treatment of slipped capital femoral epiphysis. Spica-cast immobilization.

Thirty-two patients (thirty-seven hips) who had a so-called acute-on-chronic or chronic slipped capital femoral epiphysis were treated with traction for relief of symptoms and then with immobilization in a spica cast for eight to sixteen weeks. The disappearance on radiographs of a metaphyseal juxtaphyseal radiolucency, rather than closure of the physis, was used as the criterion for removing the cast. In one (3 per cent) of the thirty-seven hips, the slip progressed; possibly this could have been prevented by keeping the cast on for a longer period of time. Narrowing of the cartilage space was seen after treatment in a cast in seven (19 per cent) of the thirty-seven hips. In five of these seven hips, this was true chondrolysis; in one, the diagnosis of chondrolysis had been apparent before treatment. Avascular necrosis did not develop as a result of treatment in any patient. Treatment in a spica cast should be considered as an alternative for patients who have an acute-on-chronic or chronic slipped capital femoral epiphysis.

Adolescent↗
PubMed1989

The effect of magnetic resonance imaging on metal spine implants.

In Part 1 of this study, the forces and torques exerted on metallic spine implants by a 0.3-T magnetic field were evaluated using a cantilever system sensitive to forces as low as 250 mg and torques as low as 4 g/cm. Results indicated that the 0.3-T magnification field did not cause forces or torques that could be measured within this range. It is concluded that patients with spine implants may safely undergo magnetic resonance scanning. In Part 2, the magnetic resonance scans from 33 patients (61 studies) then were reviewed to determine which, if any, parameters could be adjusted to minimize artifact. Magnetic power, slice thickness, plane of scan, and pulse sequence were considered. Plane of scan was found to be the most significant parameter in achieving useful studies, with the sagittal plane being the preferred orientation. Scans of patients who had posterior wiring were more likely to be useful, while scans of patients with spinal rods usually showed a large amount of artifact.

Humans↗
PubMed1989

Increased gene expression by the first intron of maize shrunken-1 locus in grass species.

The first intron of the shrunken-1 (Sh1) locus of maize was incorporated into constructs containing the chloramphenicol acetyltransferase gene (CAT) coupled with the nopaline synthase 3' polyadenylation signal. Transcription was driven with the 35S promoter of the cauliflower mosaic virus (CaMV) or the Sh1 promoter of maize. Transient gene expression was monitored following electroporation into protoplasts of Panicum maximum (guineagrass), Pennisetum purpureum (napiergrass), or Zea mays (maize). The 1028 base pair intron increased gene expression in cells of each species when transcription was driven with the 35S promoter. Eleven to 91-fold increases were observed. Expression levels observed in maize were two and eight times those observed in napiergrass and guineagrass, respectively. The 35S promoter gave CAT activity 10 to 100 times that observed with the Sh1 promoter. Whereas expression driven by the 35S promoter was reproducible, that observed with the Sh1 promoter proved quite variable. In similar constructs the first intron of the alcohol dehydrogenase-1 (Adh1) gene of maize led to increased gene expression of only 7 to 10% of that observed with the Sh1 first intron. The increased level of gene expression caused by the Sh1 first intron is approximately 10 times higher than that caused by any other plant introns that have been used. Thus, the Sh1 first intron may prove quite useful in increasing expression of foreign genes in monocots and possibly other plants.

Journal Article↗
PubMed1989

Congenital pseudarthrosis of the tibia. Long-term follow-up study.

Review of the literature reveals how difficult it is to assess the results of treatment of pseudarthrosis of the tibia. There is disagreement as to when the result can be considered final. This study reviewed the long-term results of treatment to determine if skeletal maturity could be considered the definitive end point of treatment or if the results deteriorate past skeletal maturity. In addition, the effect of neurofibromatosis on pseudarthrosis of the tibia is analyzed. Forty-one patients were reviewed. Only 25 had sufficient follow-up data to be included in this study. Eighteen of the 25 had neurofibromatosis. The results were classified according to criteria developed by Morrissy et al. At skeletal maturity, there were ten good results, three fair results, and three poor results, with nine patients having had amputation. At long-term follow-up evaluation (average 36 years; range five to 62 years), one patient with a fair result had elected amputation. About one half of the patients with neurofibromatosis required amputation. This study suggests that the results at skeletal maturity are reliable indicators of long-term results.

Adolescent↗
PubMed1989

Scoliosis surgery in neurofibromatosis.

Twenty-three patients who were treated by posterior spinal fusion with neurofibromatous scoliosis were reviewed to study the adequacy of spinal fusion, rate of pseudarthrosis, and incidence of complications. Twenty patients achieved a solid fusion with posterior surgery alone. Thirteen patients required one or more posterior augmentation procedures because of progressive deformity. Three patients with dystrophic kyphoscoliosis required an anterior spinal fusion in addition to the posterior fusion to achieve a solid fusion mass. The type of graft material, Harrington instrumentation, and degree of kyphosis or scoliosis had no effect on the rate of pseudarthrosis. Preoperative neuroradiographic evaluation was found to be warranted for all patients with neurofibromatous scoliosis.

Adolescent↗
PubMed1988

A draping technique for spinal surgery using the Stagnara wake-up test.

This draping procedure has been used at our hospital in more than 200 spinal procedures. The main advantage is that the surgeon has a direct view of the feet and can personally observe the results of the test. The draping procedure is simple, and it eliminates the chance of contamination when lifting the drapes. No disadvantages have been noted to date, and there have been no infections.

Humans↗
PubMed1988

The mutation bronze-mutable 4 derivative 6856 in maize is caused by the insertion of a novel 6.7-kilobase pair transposon in the untranslated leader region of the bronze-1 gene.

The Ds-controlled allele, bz-m4 Derivative 6856 [bz-m4 D6856], is reported to have an altered temporal- and tissue-specific pattern of gene expression. We have cloned this allele and have characterized it at the molecular level. The mutation was caused by the insertion of a complex transposon-like structure 36 base pairs downstream from the Bz mRNA cap site. The insert is 6.7-kbp long. Ds elements, each approximately 2 kbp in length, are at both ends of the insert. The sequence between the Ds elements is a partial duplication of flanking sequences from the 3' end of the Bz gene. These data suggest that Ds initially inserted near the 3' end of the gene and mobilized adjacent sequences as it transposed.

Base Sequence↗
PubMed1988

Juvenile idiopathic scoliosis followed to skeletal maturity.

The authors reviewed 43 patients with the onset of idiopathic scoliosis between 4 and 9 years who were followed to skeletal maturity to document the natural history, effects of bracing, and factors associated with progression. Average age at onset was 7.1 years for female and 6.7 for male patients. Twelve were treated with observation only; six improved, five progressed, and one refused an orthosis and required surgery. Thirty-one patients wore an orthosis; five patients improved or were unchanged, and 26 progressed, including 13 who subsequently required surgery. All patients treated with observation had a rib vertebral angle difference (RVAD) of less than 10 degrees; whereas patients progressing despite orthosis and all but one patient requiring operation had an RVAD greater than 10 degrees. Thoracic hypokyphosis (less than 20 degrees) was present in 20% of observed patients, 64% of those treated with an orthosis, and 78% of those requiring operation.

Bone Development↗
PubMed1988

Computer tomography evaluation of Cotrel-Dubousset instrumentation in idiopathic scoliosis.

In 30 adolescent patients with 36 structural curves undergoing posterior spinal arthrodesis using Cotrel-Dubousset (CD) instrumentation, computer tomography (CT) was performed to evaluate the change in rotation and in the sagittal plane. The average preoperative Cobb angle was 51.7 degrees, and improved to 18.7 degrees postoperatively, or 64.9%. The angle of rotation of the apical vertebra relative to the anterior midline of the body (RAML) improved from 27.9 degrees preoperatively to 21.5 degrees postoperatively (23.9%). The angle of rotation relative to the sagittal plane (RAsag) improved from 15.2 degrees preoperatively to 13.4 degrees postoperatively (14.3%). The kyphotic angle increased an average of 10.6 degrees in the 14 patients whose preoperative angle was less than 25 degrees. As measured by CT, CD instrumentation improves both the rotational and sagittal plane deformities better than that reported for other systems.

Adolescent↗
PubMed1987

Magnetic resonance imaging (MRI) in the evaluation of spinal cord injured children and adolescents.

In order to determine the indications and usefulness of MRI scanning in evaluating spinal cord trauma, MRIs on 43 subacute and chronic spinal cord injured children were compared with CT myelograms and other diagnostic tests. MRI scans were superior to CT myelograms in evaluating post-traumatic syrinx, disc pathology and the physiological status of the cord. CT myelogram remains an essential study before considering spinal cord decompression. The presence of internal fixation is not a contraindication to MRI scanning.

Adolescent↗
PubMed1987

Proximal femoral focal deficiency: radiologic analysis of 49 cases.

Proximal femoral focal deficiency, an uncommon congenital anomaly, necessitates early radiologic classification for surgical planning and treatment. Objective radiographic criteria, including femoral length index, acetabular depth index, acetabular angle index, and shape of the proximal femur were determined in 49 patients before cartilaginous ossification of the femoral capital epiphysis; final classification was based on follow-up radiographs or findings at arthrography or surgery. These parameters were analyzed to determine the accuracy and contributions of each in classification. Correct classification into one of three groups was possible in 86% of cases with use of three of the parameters: femoral length index, acetabular depth index, and shape of the proximal femur. The acetabular angle was found to contribute insignificantly to classification. Magnetic resonance imaging, used in only one case, depicted the nonossified cartilaginous femoral capital epiphysis, thus obviating the need for invasive diagnostic procedures and facilitating early classification.

Acetabulum↗
PubMed1987

Iliofemoral fusion for proximal femoral focal deficiency.

Iliofemoral fusion, as performed for proximal femoral focal deficiency, is designed so that the knee, acting at the level of the triradiate cartilage, will act as the hip. This procedure was indicated in four of our patients to promote fitting of a prosthesis. The results after follow-up of more than five years are reported. Two of the patients also had a Van Nes rotationplasty and two had a Syme amputation. The Syme amputation produced better results. Distal epiphyseodesis of the ipsilateral femur also was performed in three of the four patients to minimize the anterior prominence of the knee. Two patients required a closing wedge osteotomy of the distal part of the femur to improve the alignment. All four patients walked well as functional above-the-knee amputees.

Amputation, Surgical↗
PubMed1985

Intracerebroventricular administration of ethylcholine mustard aziridinium ion (AF64A) reduces release of acetylcholine from rat hippocampal slices.

Ethylcholine mustard aziridinium ion (AF64A), or vehicle, was infused bilaterally (3 nmol/3 microliter per side) into the lateral ventricles of rats. The effect of such treatment on various cholinergic responses was measured in the hippocampus, cortex and striatum. Potassium-stimulated release of acetylcholine from superfused slices of hippocampus was reduced, 7 and 21 days after treatment with AF64A, to 24 and 35% of control, respectively. The activity of choline acetyltransferase in the hippocampus also decreased, to 42% of control, both 7 and 21 days after treatment with AF64A. Similarly, the activity of acetylcholinesterase and the high affinity transport of choline in the hippocampus were reduced, to 40 and 30% of control; and to 33 and 48% of control, respectively, 7 and 21 days after treatment with AF64A. Synthesis of acetylcholine in slices of hippocampus was also decreased after treatment with AF64A (71 and 51% of control, 7 and 21 days post-AF64A respectively). Only the binding of [3H]QNB in the hippocampus was unchanged at 7 days after treatment with AF64A, although a small reduction (11%) was noted 21 days after treatment with AF64A. The activity of choline acetyltransferase and acetylcholinesterase, the high-affinity transport of choline and the binding of [3H]QNB in cortex and striatum were unaffected by treatment with AF64A under the same experimental conditions. Using a substantially smaller dose than that earlier reported in mice, the earlier finding was thus confirmed, and extended, in rats, of a highly selective effect of AF64A on several components of the cholinergic system. Under the conditions of this study, these effects appeared to be confined to the hippocampus.

Acetylcholine↗
PubMed1985

The effect of an incomplete interochanteric osteotomy on Legg-Calvé-Perthes disease.

In an attempt to accelerate the healing process, an incomplete intertrochanteric osteotomy was performed over a ten-year period in fifty-three patients (fifty-four hips) with Legg-Calvé-Perthes disease. Radiographs of the hips that had been operated on were reviewed to establish the length of time that was required to attain completion of bone-healing of the femoral head and completion of the resorption stage of the disease. These healing times were then compared with those of a control group of thirty-six patients (forty-three hips) who had had non-operative treatment for Legg-Calvé-Perthes disease in our institution, as well as with the data from other studies on this subject in the orthopaedic literature. In our experience, an incomplete intertrochanteric osteotomy did not in any way alter the rate of healing of Legg-Calvé-Perthes disease.

Child↗