Repair of acute scapho-lunate dissociation facilitated by the "TAG" suture anchor.
A case of acute scapho-lunate dissociation is described in which the operative treatment was facilitated by the use of the "TAG" suture anchor.
Acute Disease↗
Biomedical subjects
P J Gill
Publications and source records attributed to P J Gill.
Stressful family life events and parental perception of poor appetite in children.
Explore the source record for details and available documents.
Appetite↗
Knowledge of community based practitioners regarding vaccine preventable diseases.
Explore the source record for details and available documents.
Clinical Competence↗
Incidence and prognosis of Krukenberg tumour in Northern Ireland.
The case notes of 15 patients with Krukenberg tumours were studied to determine the incidence, presentation, clinical findings and prognosis of the disease in Northern Ireland. Patients tended to be young and premenopausal. A short history of abdominal pain was the most frequent presenting complaint, abdominal swelling being second. Menstrual irregularities occurred infrequently and no patient was virilized. Tumours tended to be large, bilateral and associated with ascites. The stomach was the commonest primary site. The overall prognosis was poor, especially if the primary tumour remained covert at the time of diagnosis. The prognosis was unaffected by subsequent discovery of the primary source; extensive investigation is inconvenient for the patient and wasteful of resources. The incidence of the tumour in Northern Ireland was 0.16 per 100,000 per annum: it will be rarely encountered by general surgeons.
Adult↗
Sleep pattern and night awakening in healthy infants.
Sleep pattern and night-awakening were studied in 500 healthy infants by a semistructured interview method. A total of 92.2% infants shared bed with their mothers, 6.8% with grand parents and 1% with fathers. Paternal participation at bedtime was observed to be insignificant. Infants of non-working mothers and families with vegetarian habits slept significantly more as compared to the working mothers and families with non-vegetarian habits. Night-time awakening was reported in 96% of the infants. If a child is functioning well in other areas of life, parents can be assured that the problem is not of serious concern and unnecessary medication of infants should be avoided.
Age Factors↗
A review of 100 consecutive Richard's total knee replacements.
One hundred consecutive Richard's Maximum Contact (RMC) knee replacements were performed in Belfast between 1978 and 1982. Most of the 100 knees (86 patients) involved had been in severe pain, had marked stiffness or gross knee deformity, or were chairbound because of the knee. They were reviewed between five and eight and a half years (mean five years and eleven months) after operation. Thirteen patients (13 knees) died before review leaving eighty seven knees in 73 patients available for study. Using a modification of the British Orthopaedic Association knee function assessment chart, 26 knees (30%) were graded as excellent, 22 (25%) as good, 19 (22%) as fair and nine (10%) as poor. There were five implant failures, four the result of deep infection, one due to loosening. Six patients were chairbound at review and were also graded as failures. These results support the view that total knee replacement approaches the predictability and success of arthroplasty of the hip.
Adult↗
Stressful family life events and nonspecific somatic complaints in school children.
The relationship between stressful family life events and somatic complaints in 477 school children was studied. There was a significant association between life events and somatic complaints, with a general trend for somatic complaints to increase in almost direct proportion to the number of family life events. Overall occurrence of these nonspecific symptoms was more in girls. The somatic complaints were significantly more in children from nuclear families and of illiterate or poorly educated mothers. No significant association was observed between somatic complaints and number of children in the family or socio-economic status. Assessment of psychodevelopmental tasks and family environment during routine check up of children by the school health teams and their appropriate training in this field should be stressed upon.
Adolescent↗
Glycosaminoglycans of bovine aorta endothelial cells: identification and localization by use of a platelet factor 4-fluorescein probe.
We utilized platelet factor 4 (PF4) conjugated to fluorescein to stain the proteoglycans of permeabilized fixed bovine aorta endothelial cells in monolayer culture. Treatment of the monolayers with chondroitin ABC lyase and/or a preparation from Flavobacterium heparinum was used to remove chondroitin sulfate and/or heparan sulfate before staining, with resultant separate identification and partial localization of these glycosaminoglycans. When PF4-fluorescein was utilized with untreated control monolayers, fairly uniform reticular, perinuclear, and cell surface fluorescence was seen. After treatment with chondroitin ABC lyase, fluorescence was retained only on the cell surface. In contrast, treatment with the F. heparinum preparation resulted in the loss of all cell surface fluorescence. Use of both glycosaminoglycan lyases together resulted in loss of essentially all the fluorescence. The cell surface heparan sulfate observed by fluorescence after removal of cell surface chondroitin sulfate appeared to be unevenly distributed, with a heavier accumulation at one pole of each cell. This technique offers a specific method for identification and partial localization of cell surface heparan sulfate.
Animals↗
Cell-surface proteoheparan sulfate structure-function relationships.
Explore the source record for details and available documents.
Cell Adhesion↗
Investigation of the mechanical properties of bone using ultrasound.
This paper examines the serial use of ultrasonic velocity measurement to monitor fracture healing. New Zealand White rabbit tibiae were fractured using a constant-energy technique and the ultrasonic velocity along the bone measured in animals sacrificed at 16 day intervals up to 96 days from fracture. In parallel with these measurements the mechanical performance of the healed tibiae were determined using a three-point bending test. Regression analysis failed to show a sufficiently good correlation between ultrasonic velocity measurements and the bending properties of healing fractures for the method to be of use clinically.
Animals↗
The influence of fetal number on antepartum uterine activity.
Home uterine activity monitoring was performed by 54 women with singleton, 30 with twin, and 34 with triplet gestations. Data were analyzed to determine the relationship between antepartum uterine activity, preterm labor, and fetal number. Preterm labor in singleton and twin gestations was preceded by significant increases in pre-labor contraction frequency (P less than .01). However, in triplets, preterm labor was not preceded by increased pre-labor contractions. Triplet and twin gestations with term labor were associated with higher baseline contraction frequencies than were high-risk singleton gestations with term labor (P less than .05). Fetal number had no impact on pre-labor contraction intensity, although triplet gestations had a significantly greater proportion of uterine activity occupied by low-amplitude, high-frequency contractility.
Female↗
Perforated duodenal ulcer: which operation?
Between January 1968 and December 1977 a total of 230 patients with a perforated duodenal ulcer underwent emergency operation in the Royal Victoria Hospital. Simple suture closure of the perforation was carried out in 205, and in the remaining 25 a definitive ulcer procedure was performed in addition. Four patients died following operation, a mortality rate of 1.7%.During a mean follow-up period of 10.3 years at least 107 patients (52%) who had simple suture closure of their perforation developed further ulcer symptoms. Of these, seven re-perforated and a further 56 required elective definitive ulcer surgery. A strong case can be made for a definitive ulcer operation at the time of emergency surgery for a perforated chronic duodenal ulcer.
Adult↗
Antepartum ambulatory tocodynamometry: the significance of low-amplitude, high-frequency contractions.
The clinical significance of low-amplitude, high-frequency contractions was examined during pregnancy in 142 women who underwent daily ambulatory tocodynamometry between 23-36 weeks' gestation. The results indicate that patients destined to develop preterm labor had this contractility pattern significantly more often than did their counterparts who delivered at term (13.5 versus 9.2%; P less than .01). Parity and gestational age had no effect on the occurrence of low-amplitude, high-frequency contractility, but this pattern was also significantly more prevalent in the presence of multifetal gestations, independent of the occurrence of preterm labor. The institution of tocolytic therapy was accompanied by a 50% decrease in the proportion of time occupied by low-amplitude, high-frequency contractions. Although this contraction pattern occurred significantly more often among patients who later developed preterm labor, calculations of its predictive values, specificity, and sensitivity indicate that its presence has relatively limited clinical significance.
Female↗
Effects of heparan sulfate removal on attachment and reattachment of fibroblasts and endothelial cells.
Human skin fibroblasts and calf aorta endothelial cells were grown as tissue culture monolayers in the presence of [35S]sulfate in order to label the glycosaminoglycan portions of proteoglycans for investigation of their role in cell attachment. The [35S]glycosaminoglycans were then selectively removed from the cell monolayers by the addition of various glycosaminoglycan-degrading enzymes. As previously described, in contrast to trypsin treatment none of these enzymes removed any cells from the culture plates. Incubation with a preparation from Flavobacterium heparinum left only small stubs of [35S]glycosaminoglycans on the cell monolayers, indicating that all the cell-surface proteoheparan [35S]sulfate and proteochondroitin [35S]sulfate was accessible to this enzyme preparation. The treatment did not change the amount or time of incubation with trypsin necessary for release of the cells from the monolayers. Thus, cell attachment was not weakened by removal of heparan sulfate or chondroitin sulfate. In contrast, neither fibroblasts nor endothelial cells in suspension would reattach in the presence of the F. heparinum preparation while reattachment occurred readily in the presence of chondroitin ABC lyase. This provides evidence that heparan sulfate, but not chondroitin sulfate, is involved in the process of cell attachment even though neither is necessary for maintaining attachment.
Animals↗
Assessment of uterine activity in ambulatory patients at high risk of preterm labor and delivery.
With use of an ambulatory tocodynamometer, prelabor uterine activity was recorded daily during pregnancy in 34 patients at increased risk of preterm labor and delivery. The data indicate that the frequency of contractions was significantly greater among women who subsequently developed preterm labor when compared to that observed among women who labored at term. This difference was present up to several weeks before the onset of labor. An additional significant rise in frequency of contractions could be observed within the last 24 hours before the development of clinically apparent preterm labor, as evidenced by progressive cervical dilation and effacement. If these results can be reproduced in a larger sample, intermittent ambulatory monitoring may offer an effective way to better identify patients at risk of preterm labor as well as enhance the early diagnosis of this event.
Adult↗
Uterine activity during pregnancy in ambulatory patients: comparison of singleton and twin gestations.
Prelabor uterine activity was monitored daily in a group of ambulatory outpatients who were delivered at term. The study included 22 patients with one fetus and 18 with twin gestations. The mean weekly frequency of uterine activity during twin gestations was found to be significantly higher throughout pregnancy than that identified during pregnancies with a single fetus. In twin gestations a gradual significant rise in frequency of contractions could be observed with advancing gestational age. The data presented could help establish the guidelines for evaluation of uterine activity records during pregnancies complicated by a multifetal gestation.
Adult↗
Detection of preterm labor by ambulatory monitoring of uterine activity for the management of oral tocolysis.
A study to evaluate whether ambulatory tocodynamometry at home could enhance the management of oral tocolysis was performed. On discharge from the hospital, after completing parenteral tocolysis, 60 patients received a lightweight tocodynamometer, designed for storage and transmission of uterine activity data. Sixty additional contemporary patients, who were matched for maternal age, parity, and risk factors, served as a control group. In addition to instructions regarding self-detection of recurrent preterm labor, monitored patients recorded uterine activity for greater than or equal to 200 min/day and then transmitted the data to the study center. Tocolytic dosage was adjusted to maintain mean uterine contraction frequency of less than 4/hr. Persistent uterine contractions of greater than or equal to 4/hr lead to in-hospital evaluation for recurrent preterm labor. The results indicate that the monitored group had a lower incidence of preterm births mostly because of a decrease in the proportion of patients with failed tocolysis. It is suggested that surveillance of uterine activity at home during oral treatment for preterm labor may be instrumental in improving perinatal outcome in high-risk patients.
Adult↗
Maternal perception of prelabor uterine activity.
Patient perception of uterine activity was assessed objectively in 44 women at risk for preterm labor using a tocodynamometer designed for ambulatory outpatient use. The monitor allowed patient-activated marking of the data whenever contractions were perceived. After instruction in self-detection of uterine activity, tocodynamometry was performed daily for 8.5 weeks per patient. Patients identified an average of 15% of their contractions during the study (range 0-78%). Numerous marks were placed in the absence of any detectable uterine activity. Of multiple obstetric variables analyzed, only multifetal gestation and preterm labor in the current pregnancy had any significant impact on perception. Results suggest that self-detection of uterine activity may not be reliable as the only means for the earliest possible detection of preterm labor.
Female↗