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Biomedical subjects

P E Scranton

Publications and source records attributed to P E Scranton.

49 records · Page 3Linked to original sources

Musculoskeletal problems in blind children.

At a regional school for the blind, 157 children were examined for musculoskeletal abnormalities. The incidence of scoliosis was 9.5 per cent; of foot deformity, 53.5 percent; and of ligament laxity, 25 per cent. Thirty-six children (23 per cent) had evidence of spastic, flaccid, or athetoid cerebral palsy or other disorders of the central nervous system. The orthopaedist should evaluate blind children carefully and repeatedly for evidence of occult cerebral palsy and progressive deformity of the spine or foot.

Abnormalities, Multiple↗

Prognostic factors in osteosarcoma. A review of 20 year's experience at the University of Pittsburgh Health Center Hospitals.

The histologic and clinical characteristics of 54 patients with osteosarcoma are reviewed. The association of rapid linear bone growth with the occurrence of this tumor is confirmed, and evidence for increased growth in these adolescent patients is presented. A significant increase in female survival is seen in this study, and the literature relevant to gender and survival is reviewed. A histologic characterization of six predominant tumor patterns is presented with correlation to survival. Increased survival is seen with two specific histologic patterns, but there is great variability in the histology and sampling of osteosarcomas, and the series is small.

Adolescent↗

Investigation of carbohydrate metabolism and somatomedin in osteosarcoma patients.

Altered carbohydrate metabolism associated with fibrosarcomas and chondrosarcomas has been well-documented in past literature. This report describes abnormal carbohydrate metabolism in 2 osteosarcoma patients, and abnormalities in growth hormone and somatomedin serum levels. Experimental evidence is presented showing in vitro suppression of osteosarcoma tumor cell proliferation by 17 beta Estradiol. Estrogen inhibition of linear bone growth, cartilage proliferation, and somatomedin is discussed with reference to possible estrogen therapy in osteosarcoma.

Adolescent↗

Hormone suppression of DNA synthesis in cultured chondrocyte and osteosarcoma cell line.

Recent evidence suggests that endocrine factors play an important role in the natural history of osteosarcoma. The occurrence of this tumor in the metaphysis of rapidly growing adolescents, coupled with increased female survival led to the investigation of the effects of various hormones on cultured osteosarcoma cells. The in vitro effects of physiologic concentrations of human growth hormone, 17beta estradiol, and progesterone on cultured osteosarcoma cells and chondrocytes are presented. Growth hormone significantly enhances 3H-thymidine incorporation in osteosarcoma cells and chondrocytes, in the presence of human serum. The use of other sera, culture media, or heat inactivation of the human serum abolishes this effect. Estradiol and progesterone, alone, or in combination produce significant suppression of DNA synthesis in cultured tumor cells. Several sera contain a heat-labile factor which has the capacity to block the suppressive effect of estradiol. This factor could be overcome by increasing the concentration of hormone, or by heat-inactivation of the serum. The use of hormone therapy in the treatment of osteosarcoma has never been reported, despite its demonstrated value in certain other malignancies. In light of these observations and considering the poor prognosis in this disease it seems reasonable to initiate a study of adjunctive hormone therapy in osteosarcama.

Cartilage↗

Tibiofibular synostosis: a cause of ankle disability.

A syndrome of ankle pain on weight-bearing while running due to post-traumatic ossification of the tibiofibular ligament is described. Pain is caused by failure of normal downward and lateral motion of the fibula. Treatment consists of complete excision of the synostosis, followed by cast immobilization for 3 weeks.

Adult↗

Growth and hormone control mechanisms in osteosarcoma. Evidence for a new therapeutic approach.

The association between osteosarcoma and growth, including altered carbohydrate metabolism has been investigated in 5 osteosarcoma patients. Serum from an adolescent osteosarcoma patient has been noted to consistently enhance 3-H-thymidine uptake in cultured chondrocytes and tumor cells. Females survive osteosarcoma more frequently than males. In vitro serum-enhanced proliferation of osteosarcoma cells is suppressed by estradiol.

Adolescent↗

On the nature of stress fractures.

It is felt that stress fractures are caused by excessive, repetitive muscle forces acting across the affected bone. These fractures should be suspected in participants of athletic endeavors who present with a history of persistent, focal, activity-related pain regardless of their stage of physical conditioning. Associated physical findings are localized tenderness and swelling without evidence of a generalized systemic response. Bone scans and serial roentgenograms including specialized views may be required for documentation. Limitation of the athletic activity is the hallmark of the treatment program.

Adolescent↗

Gait analysis. Alterations in support phase forces using supportive devices.

This study documents changes in momentary distribution of forces under the foot, comparing barefoot gait to that with heel cups, medial arch supports, and low-dye taping. Cholesterol crystal force plate analysis and a computerized Kistler force platform were used in the study. Low-dye taping or a heel cup significantly diminished the duration of forces under the midfoot, medializing the instant center of forces. A medial arch support shifted the instant center of forces laterally, though it did not diminish the duration of forces under the arch. The relationship between these alterations of force distribution and the treatment of common runner's ailments such as plantar fasciitis, posterior tibial tendinitis, metatarsalgia, and shin splints is much clearer in the light of these results.

Athletic Injuries↗

Differences in friction and torsional resistance in athletic shoe-turf surface interfaces.

This study evaluated the shoe-surface interaction of 15 football shoes made by 3 manufacturers in both anterior translation and rotation using a specially designed pneumatic testing system. The shoes included traditional cleated football shoes, "court" shoes (basketball-style shoes), molded-cleat shoes, and turf shoes. Under an 11.35-kg (25-pound) axial load, all shoes were tested on synthetic turf under wet and dry conditions and on natural stadium grass. Test-retest reliability, as calculated using the Pearson Product-Moment Correlation test, was 0.85 for force of translation and 0.55 for the moment of rotation. The wet versus dry surface values on translation were significantly different for rotation about the tibial axis. Spatting, which is protective taping of the ankle and heel applied on the outside of the shoe, resulted in a reduction of forces generated in both translation and rotation. No overall difference between shoes on grass versus AstroTurf was noted. However, there were significant differences for cleated and turf shoes. Shoes tested in conditions for which they were not designed exhibited reproducible excessive or extreme minimal friction characteristics that may have safety implications. On the basis of this study, we urge shoe manufacturers to display suggested indications and playing surface conditions for which their shoes are recommended.

Equipment Design↗

Anterior tibiotalar spurs: a comparison of open versus arthroscopic debridement.

We compared the difference in operative time, hospitalization and recovery time in two groups of patients who underwent open or arthroscopic resection of anterior, tibiotalar, impinging spurs. The operative time was approximately the same, but the average length of hospitalization and time to recovery were shorter in the arthroscopic group. A classification system is proposed that grades the degree of spur formation and assists in predicting the length of recovery time and whether the patient is a candidate for open or arthroscopic spur resection. In this series, grade I spur patients recovered and resumed full activity at 5.0 weeks, grade II at 5.6 weeks, grade III at 6.4 weeks, and grade IV at 10.0 weeks postoperatively. Grade IV patients are not suitable candidates for an arthroscopic debridement.

Ankle Joint↗

Dynamic fibular function: a new concept.

Fibular function has long been a point of controversy in the literature. Until recently the fibula's role during gait has been thought of as entirely static. A review of the literature reveals an important dynamic function for the fibula in maintaining ankle mortise stability during weight bearing. Roentgenographic and anatomical studies confirm the hypothesis of progressive distal fibular descent. A taut interosseous membrane and deepened mortise result when be flexors of the foot contract during stance phase. Congenital deformities of the ankle may stem from aberration in the dynamic role of the fibula. Stress fractures and problems resulting from impaired distal migration and synostosis formation are interpreted as disorders of the dynamic role of the fibula.

Adolescent↗