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Biomedical subjects

R D Montgomery

Publications and source records attributed to R D Montgomery.

At least 73 records · Page 4Linked to original sources

Muscle morphology in infantile protein malnutrition.

A study was made of the sartorius muscle in Jamaican infants dying of protein malnutrition. Total counts were made of muscle fibres and sub-sarcolemmal nuclei in transverse section and compared with controls.A striking pathology is found in severe cases. The muscle fibre is reduced to a size comparable with that of the foetus. Although there is a greatly increased concentration of cells, there is also degeneration and actual loss of fibres and of sub-sarcolemmal nuclei. The proportion of the area occupied by muscle bundles may be halved, and there is a marked relative increase in interstitial collagen. These changes profoundly affect the interpretation of the results of biochemical analysis.

Journal Article↗

HTLV-1 and tropical spastic paraparesis. 1. Clinical features, pathology and epidemiology.

The clinical profile of tropical spastic paraparesis (TSP), described in scattered tropical and subtropical territories over the past 30 years, has been more clearly defined since the discovery of its direct association with human T lymphotropic virus type 1 (HTLV-1). A chronic disease of adults, commoner in women, it usually presents as a progressive spastic paraparesis with sphincter disturbance, sometimes with backache and lower limb sensory disorder. Most cases are chair-bound within 10 years. Histology reveals a chronic lymphocytic meningomyelopathy, predominantly in the spinal cord, together with long tract demyelination and hyalinoid thickening of the media and adventitia of small blood vessels. Geographical areas of high prevalence of TSP are known in the Caribbean, South America, South Africa, southern Japan, the Seychelles and probably in India, and it is sparsely endemic elsewhere. The virus appears to exist within lymphocytes for long periods. Vertical transmission occurs postnatally, and sexual and transfusion infection are also recognized, but much remains to be clarified regarding its pathogenesis and epidemiology.

Brain Stem↗

The epidemiology of myelopathy associated with human T-lymphotropic virus 1.

A progressive spastic myelopathy is one of the principal manifestations of the human T cell lymphotropic virus type 1. Recent research is reviewed on the geography and epidemiology of this specific form of tropical spastic paraparesis. First recognized in the Caribbean, Colombia and Japan, it is now also confirmed as a major neurological problem in areas of eastern Brazil, western equatorial Africa, Natal and Seychelles, with other scattered foci world-wide. Accurate surveys call for sophisticated techniques including polymerase chain reaction amplification. The only defined modes of spread are by breast feeding, sexual contact and blood cell infusion. The onset of neurological disease is associated with high antibody titres and a high rate of spontaneous T lymphocyte proliferation. Molecular analysis has revealed no nucleotide sequence variation in cases with or without myelopathy. In non-transfusion cases the clinical attack rate is low with a very long latent period, but there are unexplained regional differences and familial cases are an important exception. Current research is focused on possible local, ethnic, or genetic co-factors.

Africa↗

A retrospective comparison of three techniques for femoral head and neck excision in dogs.

Femoral head and neck excision was performed in 169 dogs over a 7 year period. A written questionnaire completed by 56 owners, evaluating a total of 72 joints, was the basis for retrospective evaluation of the efficacy of the procedures used. There were four surgical groups: femoral head and neck excision (FHNE) in dogs with body weights over 14 kg, the same procedure in dogs with body weights less than 14 kg (SMALL), femoral head and neck excision with muscle interposition (MI), and the wedge resection technique (WRT). Although differences in results were noted, there were no statistically significant differences between any of the groups for the percentage of leg use during normal activity (p greater than 0.05), mean postoperative time until leg use, use of the leg or hopping while running, or lameness with exercise (p greater than 0.10). The results of this study suggest that there is little advantage in performing the more time-consuming and traumatic muscle interposition and wedge resection procedures.

Animals↗

Comparison of aerobic culturette, synovial membrane biopsy, and blood culture medium in detection of canine bacterial arthritis.

Canine joints were cultured 24 hours after inoculation with Staphylococcus intermedius using synovial membrane biopsy, synovial fluid on aerobic culturette and in blood culture medium, and synovial fluid incubated 24 hours in blood culture medium before being cultured. A mildly virulent strain consistently yielded positive cultures when incubated in blood culture medium 24 hours and negative cultures with the other techniques. A highly virulent strain also yielded positive cultures when incubated in blood culture medium 24 hours, which was significantly better than synovial membrane biopsy. When both strains were considered together there was no significant difference between the first three techniques; blood culture medium incubated 24 hours was significantly more reliable. These results suggest that the trauma of synovial membrane biopsy is not justified because synovial fluid culture is more reliable. Synovial fluid should be placed on an aerobic culturette and in blood culture medium, and the samples cultured immediately upon arrival at the laboratory to allow the most rapid results of culture and antibiotic sensitivity testing. The blood culture medium should be recultured after 24 hours of incubation to permit culture and antibiotic sensitivity testing of those samples (approximately 50%) that have no growth on initial culture.

Animals↗

Femoral strain distribution and subsidence after physiological loading of a cementless canine femoral prosthesis: the effects of implant orientation, canal fill, and implant fit.

Twelve normal greyhound femora were divided into three groups. In group one, femoral stems were placed in neutral position with maximal fill. Group two had undersized femoral stems placed in neutral position. Group three had undersized femoral stems placed in varus position. Intact and implanted femora were loaded from 10 newtons (N) to 300 N in axial compression at a rate of 25 N/s for 10 replications. A strain gauge analysis showed that the strain distribution of all implanted femora were substantially different from intact femora, but femora with large implants placed in neutral position had the least amount of deviation from normal. An undersized stem in neutral position had significantly less compressive longitudinal strains along the proximomedial and proximocranial cortices. An undersized stem in varus position improved implant fit along the proximomedial and distolateral cortices, which resulted in increased tensile hoop strains. There were multiple significant correlations between the strain data and implantation variables (implant alignment, canal fill, and implant fit). Subsidence was significantly greater for the undersized implant in neutral position. There was not a difference in subsidence between the large neutral and varus groups. The most important variable that decreased subsidence was increased lateral implant fit (r = -0.86, P = .0003).

Animals↗

The intercondylar fossa of the normal canine stifle an anatomic and radiographic study.

The intercondylar fossa (ICF) in dogs consists of a cranial outlet, intercondylar shelf, caudal arch, caudal outlet, a medial wall, and a lateral wall. The normal cranial outlet is bell-shape and, in mixed-breed dogs (mean body weight 19.2 kg, N = 21), measured 5.8 mm cranially, 8.1 mm centrally, and 10.3 mm caudally. The ICF is oriented 12 degrees from the dorsal plane of the femoral diaphysis and obliqued 7 degrees, proximolateral to distomedial, in the sagittal plane. To adjust for dog size, a fossa width index (FWI) was calculated by dividing the cranial outlet width by the distance between epicondyles. The normal FWI as determined in this study was 0.18 cranially, 0.25 centrally, and 0.32 caudally. The fossa height index 0.31. Contact between the ICF and the cranial cruciate ligament began at about 115 degrees of extension. The contact area moved cranially in the intercondylar fossa as the stifle was extended. Evaluation of the ICF can be performed radiographically but positioning is critical.

Analysis of Variance↗

The effect of intercondylar notchplasty on the normal canine stifle.

This study evaluated the effect of notchplasty (enlargement of the intercondylar fossa) in stable and unstable canine stifles. Bilateral notchplasty and unilateral cranial cruciate ligament (CrCL) transection were performed in 6 dogs. Exercise, consisting of walking 1.5 miles three times a week, began 1 month after surgery and continued until euthanasia 6 months after surgery. Evaluation methods included orthopedic examination, serial radiographs, thin section radiography, histopathology, and gross pathology. Notchplasty in the stable stifle did not cause lameness beyond 3 weeks, joint instability, or degenerative joint disease. In the stable stifle, smooth resurfacing of the notchplasty site with fibrous and osseous tissue occurred. Stifles with notchplasty and CrCL transection exhibited persistent lameness, instability, and degenerative joint disease. In CrCL deficient stifles osteophytes formed within the notchplasty site, resulting in a rough surface. Our observations indicated significant refilling in notchplasties of both stable and unstable stifles (P < .05). However, the intercondylar fossa (ICF) width 6 months after notchplasty was significantly smaller in unstable stifles compared with stable stifles (P < .05) indicating that greater refilling of the notchplasties occurred in the unstable stifles. In clinical cases, notchplasty should be larger than the desired final result to accomodate the partial refilling that occurs even in stable stifles.

Animals↗

The effects of implant orientation, canal fill, and implant fit on femoral strain patterns and implant stability during catastrophic testing of a canine cementless femoral prosthesis.

Cementless femoral stems were placed into 12 normal greyhound femora. The implanted femora were divided into three groups by stem orientation and implant size and loaded in axial compression at a rate of 25 newtons (N) per second until failure. Rosette strain gauges were used to measure femoral principal strains at 500 N, 1,000 N, 1,500 N, and at maximum load. During maximum load, varus orientation of the femoral stem had significantly higher tensile hoop strains in the proximomedial cortex, whereas neutral orientation had higher tensile hoop strains along the cranial cortex. Femoral fractures occurred in these areas of peak tensile strain. There was no difference in maximum load between groups, therefore varus orientation did not predispose to fracture. Maximizing canal fill and implant fit increased implant stability.

Animals↗

A comparison of laparoscopic and belt-loop gastropexy in dogs.

A simplified technique for laparoscopic gastropexy (group 1) was compared to belt-loop gastropexy (group 2) in eight adult male dogs randomly divided into two groups of four dogs each. Our hypothesis was that a satisfactory laparoscopic gastropexy would approximate the strength and operative time required for belt-loop gastropexy. Operative time, surgical complications, postoperative morbidity, gross and histological appearance, radiographic microvascularization, and maximal tensile strength were measured and compared between the two groups. All dogs recovered from surgery. No morbidity was associated with either procedure. The mean (+/- SD) duration of surgery was 69.75 +/- 7.23 minutes for group 1 and 58.75 +/- 7.63 minutes for group 2. Fifty days after surgery, the microvascular appearance of the gastropexy site was similar for both groups. Blood vessels were observed within each seromuscular flap but vascular ingrowth to the abdominal musculature was observed in only two dogs, one from each group. The maximum tensile strength at 50 days was 76.55 +/- 22.78 for group 1 and 109.21 +/- 22.29 N for group 2. Differences between surgical duration and maximum tensile strength were not statistically significant (P > .05). Histologically, all gastropexies consisted of an adhesion composed of dense fibrous connective tissue. The results of this study indicate that laparoscopic gastropexy provides a minimally invasive alternative to open abdominal prophylactic gastropexy in dogs.

Abdominal Muscles↗

Radiographic, computed tomographic and magnetic resonance imaging evaluation of a chronic long digital extensor tendon avulsion in a dog.

Long digital extensor tendon avulsion is reported in a 5 month old Great Dane. Clinically the dog presented with a unilateral weight-bearing pelvic limb lameness. Joint effusion was present and there was pain and crepitance associated with flexion of the stifle. Orthopedic evaluation and radiographs were suggestive of a long digital extensor tendon injury which was confirmed by computed tomography and magnetic resonance imaging. The injury was surgically repaired with screw and spiked washer fixation.

Animals↗