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Biomedical subjects

P J Millett

Publications and source records attributed to P J Millett.

12 recordsLinked to original sources
PubMed2001

Spinal epidural hemangioma related to pregnancy.

We report the case of a 39-year-old woman with adolescent idiopathic scoliosis presenting with myelopathy secondary to a spinal epidural hemangioma. MRI showed an epidural soft tissue mass within the spinal canal between T5 and T9 with severe spinal cord compression. Symptoms had a temporal relationship to her pregnancy. Surgical removal of the epidural hemangioma rapidly relieved her symptoms and neurologic deficits. Follow-up examination 2 years later demonstrated normal motor and sensory function, without any neurologic sequelae or progression of deformity.

Adult↗
PubMed2001

The role of capsular distention in the arthroscopic management of arthrofibrosis of the knee: A technical consideration.

Arthroscopic treatment of arthrofibrosis of the knee is a technically challenging procedure. Capsular distention with fluid before arthroscopy results in easier and safer insertion of arthroscopic instruments with improved arthroscopic visualization. In addition, it stretches the entire capsule, including the difficult to access posterior capsule. This report describes a simple technique for capsular distention before arthroscopic treatment of arthrofibrosis of the knee.

Arthroscopy↗
PubMed2000

Limb salvage using distraction osteogenesis.

Distraction osteogenesis is a novel technique for the biological restoration of segmental bone defects. Definitive treatment of musculoskeletal tumors often requires large bony resections that can leave patients with significant osseous defects. Limb salvage using distraction osteogenesis is an attractive reconstructive alternative that may, in fact, offer advantages over other conventional techniques. We present our initial experience with the use of distraction osteogenesis in limb salvage.

Adolescent↗
PubMed1999

Idiopathic pseudoaneurysm of the dorsalis pedis artery mimicking pigmented villonodular synovitis.

Pseudoaneurysm of the dorsalis pedis artery is uncommon and is usually associated with a history of trauma to the vessel. Without such a history, the diagnosis may be challenging, because the mass may be confused with other common soft tissue masses in the foot. This case report describes a 67-year-old man with an idiopathic pseudoaneurysm of the dorsalis pedis artery that mimicked pigmented villonodular synovitis.

Aged↗
PubMed1997

The effects of particulate cobalt, chromium and cobalt-chromium alloy on human osteoblast-like cells in vitro.

Particulate wear debris can induce the release of bone-resorbing cytokines from cultured macrophages and fibroblasts in vitro, and these mediators are believed to be the cause of the periprosthetic bone resorption which leads to aseptic loosening in vivo. Much less is known about the effects of particulate debris on the growth and metabolism of osteoblastic cells. We exposed two human osteoblast-like cell lines (SaOS-2 and MG-63) to particulate cobalt, chromium and cobalt-chromium alloy at concentrations of 0, 0.01, 0.1 and 1.0 mg/ml. Cobalt was toxic to both cell lines and inhibited the production of type-I collagen, osteocalcin and alkaline phosphatase. Chromium and cobalt-chromium were well tolerated by both cell lines, producing no cytotoxicity and no inhibition of type-I collagen synthesis. At the highest concentration tested (1.0 mg/ml), however, chromium inhibited alkaline phosphatase activity, and both chromium and cobalt-chromium alloy inhibited osteocalcin expression. Our results clearly show that particulate metal debris can modulate the growth and metabolism of osteoblastic cells in vitro. Reduced osteoblastic activity at the bone-implant interface may be an important mechanism by which particulate wear debris influences the pathogenesis of aseptic loosening in vivo.

Alkaline Phosphatase↗
PubMed1995

Early mobilization in the treatment of Colles' fracture: a 3 year prospective study.

Ninety consecutive women with unilateral Colles' fractures were randomized into two different treatment groups. The control group was treated for 5 weeks in conventional short-arm, below the elbow plaster of Paris casts. The other group (N = 45) was treated similarly in plaster casts for 3 weeks and then had flexible casting applied for the remaining 2 weeks which allowed for early joint mobilization. Functional recovery was assessed by measuring grip strength and joint mobility at intervals over the 3 years. Radiographic and overall assessments were also made during 3 year course of study. Virtually all patients reported greater comfort after switching to the flexible casting. Mean grip scores and joint mobilities were higher at all time points with early mobilization, reaching levels of statistical significance at 6 months for grip score and at 3 months for joint mobility. By 3 years most differences between treatment groups had resolved. We found no evidence that early mobilization was detrimental to recovery. We conclude that early mobilization is a satisfactory treatment option for Colles' fracture, and may, in fact, hasten functional recovery.

Adult↗
PubMed1995

Effect of exercise training programme on bone mineral density in novice college rowers.

Exercise has important effects on skeletal mineralization. Changes in bone mineral density (BMD) and bone mineral content (BMC) as measured by dual energy X-ray absorptiometry were investigated in a group of 17 male novice college oarsmen over a 7-month period and were compared with eight age-matched controls. The rowing training programme consisted of approximately 8 h rowing, 1 h weight training, and 1 h running per week. After 7 months training the mean BMD of the lumbar spine (L1-L4) had increased significantly by 2.9% (P < 0.001) and the mean BMC had increased by 4.2% (P < 0.001). There was no significant change in the control group. Neither group showed a significant change in BMD or BMC in the femoral neck, greater trochanter or Ward's triangle. This study provides further evidence that exercise plays an important role in bone mineral formation.

Absorptiometry, Photon↗
PubMed1994

A rapid, quantitative assay for measuring alkaline phosphatase activity in osteoblastic cells in vitro.

Alkaline phosphatase (ALP) is the most widely recognized biochemical marker for osteoblast activity. Although its precise function is poorly understood, it is believed to play a role in skeletal mineralization. The aim of this study was to develop an assay suitable for measuring the activity of this enzyme in microtiter plate format. Using the well-characterized osteoblast-like cell line Saos-2, this paper describes an optimized biochemical assay suitable for measuring ALP activity in tissue culture samples. We have determined that a p-nitrophenyl phosphate substrate concentration of 9 mM provides highest enzyme activities. We have found that cell concentration, and hence enzyme concentration, affects both the kinetics and precision of the assay. We also tested several methods of enzyme solubilization and found that freeze-thawing the membrane fractions twice at -70 degrees C/37 degrees C or freeze-thawing once with sonication yielded highest enzyme activities. The activity of the enzyme decreased by 10% after 7 days storage. This assay provides a sensitive and reproducible method that is ideally suited for measuring ALP activity in isolated osteoblastic cells, although sample preparation and storage can influence results.

Alkaline Phosphatase↗
PubMedDate not supplied

Motion loss after ligament injuries to the knee. Part I: causes.

Motion loss continues to be a difficult complication after ligament injury and surgery to the knee. A better understanding of the pathoanatomic causes of motion loss can lead to improved prevention and treatment strategies. When motion loss does occur, early recognition and appropriate treatment can be expected to restore motion and improve function in most patients. Treatment options, although varied, should improve outcome when implemented appropriately. This article is composed of two parts. The first part reviews the current concepts on definitions, incidence, and causes of motion loss. In the second part, to be published later, current strategies on prevention and treatment of motion loss after ligament injury to the knee are reviewed. Emphasis is placed on risk factors and prevention as well as on diagnosis and treatment. The article summarizes the latest information from the basic sciences as well as clinical studies on the problem of motion loss of the knee and attempts to provide a rational approach to these difficult clinical problems.

Humans↗
PubMedDate not supplied

Motion loss after ligament injuries to the knee. Part II: prevention and treatment.

This is the second part of a two-part review on motion problems after ligament injuries to the knee. The first part, published in the September/October 2001 issue, discussed normal and abnormal knee motion, terminology, risk factors, and pathoanatomy. The purpose of this article is to review current concepts on prevention and treatment of motion problems, summarizing the recent and pertinent studies that discuss this complicated clinical problem. The first part of this article will discuss the different classification schemes that have been published on motion loss of the knee. Prevention strategies will be discussed next, followed by early recognition. Finally, a discussion of the various treatment options and published results will be presented in detail, together with the authors' nine-step systematic surgical approach to the stiff knee.

Anterior Cruciate Ligament↗
PubMedDate not supplied

Open debridement and soft tissue release as a salvage procedure for the severely arthrofibrotic knee.

Postoperative loss of knee motion is a well-recognized phenomenon. This paper reports our results with open debridement and soft tissue release as a salvage procedure in the treatment of patients with severe arthrofibrosis on whom arthroscopic surgical techniques had failed. Eight knees (eight patients) were identified retrospectively. There were four men and four women; mean age was 29 years. All had severely restricted motion with extensive intraarticular and periarticular fibrosis. Range of motion averaged 62.5 degrees preoperatively (flexion 81 degrees, loss of extension 18.8 degrees). Patients underwent open debridement and soft tissue release to restore motion. There were no complications. Motion improved to an average of 124 degrees after surgery. Average flexion improved from 81 degrees to 125 degrees . Loss of extension improved from 18.8 degrees to 1.25 degrees. Functional outcome was good, with Lysholm II scores averaging 79. Patient satisfaction was high. There was a high incidence of patellofemoral arthritis at follow-up. Furthermore, the patellar tendon shortened approximately 6 mm over time. While we do not advocate open debridement and soft tissue release as a first-line treatment for arthrofibrosis, we do conclude that it can be effective as a salvage procedure to restore motion in the profoundly arthrofibrotic knee.

Adult↗