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Biomedical subjects

S D Cook

Publications and source records attributed to S D Cook.

At least 127 records · Page 7Linked to original sources
PubMed1990

Four-year average follow up of cemented PCA total knees: clinical and roentgenographic analysis.

Twenty patients with 25 consecutive primary-cemented Howmedica PCA total knee prostheses were clinically and roentgenographically reviewed. Twenty implants were placed in 16 women and five in four men. The average patient age at surgery was 68.0 years (range, 53 to 82), and average follow up was 51 months. Total knee replacement indication was degenerative joint disease in 21 knees and rheumatoid arthritis in four. Excellent or good results were seen in 22 of 25 knees (88%) at the early follow up examination and 18 of 25 knees (72%) at the most recent follow up examination.

Aged↗
PubMed1990

Pharmacological regulation of the circulation of bone.

A study was undertaken to investigate the reactivity of the circulation of bone and to pharmacologically characterize the receptor populations that may be present in this poorly described vascular bed. The nutrient artery of the tibia in skeletally mature mongrel dogs was cannulated, under direct vision, through a posterolateral operative approach. An extracorporeal circuit was established so that the nutrient artery of the tibia could be perfused in vivo under conditions of constant blood flow. Diverse vasoactive substances were injected into the perfusion circuit in small volumes as a bolus close to the nutrient artery of the tibia. A range of doses of nitroglycerin, acetylcholine, isoproterenol, methoxamine, U46619 (a thromboxane A2 mimic), dibutyryl cyclic AMP, 8-bromo-cyclic GMP, and endothelin-1 were injected in a randomized sequence for each experiment. The antagonists that were used were atropine (a non-selective muscarinic receptor antagonist), ICI 118551 (a selective beta 2-adrenoceptor antagonist), ONO 3708 (a prostaglandin H2/thromboxane A2 receptor antagonist), and prazosin (an alpha 1-adrenoceptor antagonist). The results of changes in bone-perfusion pressure under conditions of constant blood flow indicated that the vascular bed of bone actively responds to various vasoconstrictor mechanisms, whereas vasodilator mechanisms appear to be considerably less active. Intra-arterial injections of nitroglycerin, acetylcholine, and 8-bromo-cyclic GMP resulted in dose-related decreases in bone-perfusion pressure that were weak relative to concomitant changes in systemic arterial pressure. Intra-arterial administration of methoxamine, U46619, and endothelin-1 resulted in a potent dose-related increase in bone-perfusion pressure. The results of intra-arterial injections of isoproterenol and dibutyryl cyclic AMP were surprising; both substances caused a substantial rise in bone-perfusion pressure. The responses to acetylcholine, methoxamine, and U46619 were blocked in a competitive manner after administration of atropine, prazosin, and ONO 3708, respectively.

Acetylcholine↗
PubMed1990

A survey of running injuries in 1505 competitive and recreational runners.

A 33 item multiple choice questionnaire was circulated; completed questionnaires from 1505 runners (1130 male and 375 female) were obtained. Questions focused upon training, injuries sustained, and medical care. Biomechanical imbalances such as leg length inequality appear to be a major contributing factor to running injuries. Correction of an underlying biomechanical defect may be important in the treatment of many running injuries. Female runners were found to be more susceptible than males to stress fractures at higher mileages. The cause of this increased incidence may be attributable to lower bone mineral density levels as a result of hormonal factors. Factors such as running surface, age and stretching techniques do not appear to play a significant part in the pathogenesis of running injuries.

Adult↗
PubMed1990

Clinical and roentgenographic evaluation of bipolar prostheses with noncemented anatomic medullary locking femoral stems.

Fifty-six DePuy anatomic medullary locking femoral bipolar prostheses were reviewed clinically and roentgenographically in 50 patients at an average follow-up period of 30 months (range, 24-71 months). Forty-four of the implantations were in 40 male and 12 were in ten female patients. Forty-five devices were placed in primary operations, while 11 were used in revisions. The overall average age was 53.5 years. The average Harris hip scores for the primary bipolars were 29.8 preoperative and 77.3 postoperative, while the revision bipolars had Harris hip scores of 35.9 preoperative and 75.1 postoperative. Nearly one-half (47%) of all primary and 54% of the revision patients experienced pain to some degree on ambulation. Roentgenographically, all femoral components appeared to be well fixed biologically. Roentgenographic changes occurred with time in both primary and revision prostheses. On roentgenographic zonal analysis of primary prostheses, radiolucencies greater than 1 mm were present most frequently in the most proximal lateral zone and at the distal tip of the prosthesis. Although the use of noncemented bipolar prostheses generally shows acceptable clinical results, noncemented fixed acetabular components with noncemented femoral components produce a more satisfactory clinical result.

Adult↗
PubMed1990

Electromyographic analysis of rowing stroke biomechanics.

Electromyography was used to study muscle activity in the upper and lower extremities and torso during the rowing stroke. Five experienced male rowers were tested while rowing on a Concept II ergometer. In order to fully evaluate the rowing stroke, six phases were utilized to identify the transition points where individual muscles become more active due to body angle or nature of the motion. The results indicate that the strength of an individual muscle is most likely not as important to the rowing stroke as the combined activity of two or more groups of muscles. Thus, in addition to strength, it is of great value to the oarsman to develop technical skill to coordinate his upper and lower body reactions.

Adult↗
PubMed1990

Clinical and roentgenographic evaluation of noncemented porous-coated anatomic medullary locking (AML) and porous-coated anatomic (PCA) total hip arthroplasties.

Eighty-four primary noncemented porous-coated total hip arthroplasties (THAs) in 78 patients were reviewed clinically and roentgenographically at an average follow-up period of 37 months. The average patient age was 51.9 years. Sixty-four Anatomic Medullary Locking (AML) devices were placed in 58 patients, and 20 Porous-Coated Anatomic (PCA) devices were placed in 20 patients. The AML devices had been in situ an average of 36 months (range, 24-49 months), and the PCA devices had been in situ an average of 40 months (range, 29-51 months). The average patient ages were 52.7 and 49.2 years for AML and PCA patients, respectively. The AML devices included three that were fully coated, 59 that were five-eighths coated, and two that were one-third coated. The average preoperative Harris hip score was 38.2 for the AML devices and 33.2 for the PCA devices. The average postoperative Harris hip score was 80.7 for the AML devices and 83.8 for the PCA devices. Pain related to the implant was present in 30% of the AML devices and 30% of the PCA devices. Roentgenographically, no component demonstrated complete radiolucency, and all components demonstrated roentgenographic evidence of bone ingrowth. Roentgenographic changes with time noted for both the AML and PCA devices included: neck roundoff, neck osteolysis, neck corticocancellization, endosteal bone bridging, and distal hypertrophy. On roentgenographic zonal analysis, radiolucency greater than 1 mm was observed most frequently in the most proximal lateral zone and distal tip of the femoral component. The current series of cases, although clinically acceptable, does not support the current widespread enthusiasm for primary noncemented AML and PCA total hip systems. Cemented THA appears to produce superior clinical results, particularly when contemporary cementing techniques are employed.

Adult↗
PubMed1989

Detection of latent virus mRNA in tissues using the polymerase chain reaction.

The polymerase chain reaction (PCR) has been adapted for use in gene expression studies. Using this technique, we have been able to specifically detect Herpes simplex virus gene expression in the amount of RNA equivalent to that present in a single mouse ganglion. We have also detected specific transcription of the ras oncogene in biopsies of hepatocellular carcinoma tissue. The single tube RNA PCR reaction should be readily adaptable for use as a rapid screening tool in virus diagnosis; it is capable of detecting several virus infections simultaneously using extremely small tissue biopsies.

Animals↗
PubMed1989

Quantitative histologic analysis of tissue growth into porous total knee components.

Histologic and radiographic analysis was performed on 85 porous-coated, uncemented knee components (26 femoral, 34 tibial, and 25 patellar) retrieved from 45 patients for malposition or instability, unexplained pain, late infection, postmortem or postamputation, and posttrauma. No component was clinically or radiographically loose at the time of removal. The average patient age at removal was 62.1 years (range, 39-85 years), and the average time in situ was 12.4 months (range, 2 weeks to 53 months). Radiographs from 31 of the 45 patients (69%) were examined for implant alignment, fit, subsidence, loose beads, and the presence of sclerotic and lucent lines. Histologic and microradiographic sections of the implant and adherent tissue were examined for type, amount, and anatomic location of tissue ingrowth. Overall, 52% of the components showed no evidence of bone ingrowth, 29% showed minimal (less than 2%), 12% showed moderate (2-5%), and 7% showed extensive (5-10%) bone ingrowth. In no case was bone present in more than 10% of the available pore volume of any component. There were no significant differences in the incidence or extent of bone ingrowth among femoral, tibial, and patellar components, nor in the extent of bone ingrowth observed in comparing different implant designs, materials, or porous coating types. When bone ingrowth was observed, the anatomic location was consistent in each type of component. The presence of a lucent line radiographically was indicative of fibrous encapsulation, while a sclerotic line or absence of any radiographic abnormality was seen with both fibrous tissue and bone ingrowth.

Aged↗
PubMed1989

Biologic response to hydroxylapatite-coated titanium hips. A preliminary study in dogs.

Hydroxylapatite (HA)-coated and uncoated Ti-6A1-4V alloy femoral endoprostheses were evaluated in adult dogs. The femoral stems had proximal anterior, posterior, and medial pockets of either a commercially pure titanium porous coating or a grooved macrotexture. They also had a medial collar, with an inferior surface pocket of either the porous coating or the grooved macrotexture. HA-coated and uncoated specimens of each type were evaluated. The devices were placed as unilateral hemiarthroplasties in 12 dogs and remained in function for up to 52 weeks. Histologic sections from the uncoated grooved implants showed no direct bone-implant apposition in the proximal regions after up to 10 weeks; the HA-coated grooved implants demonstrated extensive direct bone-coating apposition after 5 weeks. Sections from uncoated porous implants evaluated after 10 weeks demonstrated approximately equivalent in-growth to those sections from the HA-coated devices after 6 weeks. All HA-coated implants demonstrated consistent bone-implant apposition with no fibrous tissue interposition. The HA-coated surfaces were associated with increased bone deposition and proliferation at early implantation periods. In no histologic section examined was there any evidence of deterioration of the HA coating, nor was any separation of the coating from the substrate material observed.

Alloys↗
PubMed1989

Detection of herpes simplex virus type 1 gene expression in latently and productively infected mouse ganglia using the polymerase chain reaction.

The polymerase chain reaction (PCR) was employed to detect herpes simplex virus (HSV) sequences in the DNA, and HSV gene expression in total cell RNA, extracted from cervical and trigeminal ganglia of mice during productive and latent infection with HSV-1, strain SC16. Such gene expression was detected in 1 microgram or less of RNA, the quantity anticipated to be present in one or two cervical ganglia. Within the limits of the primers available, gene expression during latency appeared to be restricted to the latency-associated transcript (LAT). The 195 base portion of the LAT amplified by the PCR was sequenced and found to contain several base changes and deletions with respect to published sequences for different HSV strains. These mutations, within the putative open reading frame 2 of the LAT, formed stop or terminator signals, which suggests that the LAT does not act to establish or maintain latency through translation to a protein. The primers for the LAT also amplified a 300 bp fragment from any murine and some other mammalian RNAs. Apart from the oligonucleotide primers, this fragment did not show any homology with HSV.

Animals↗
PubMed1989

MHC-restricted autoantigen-reactive T cell clones in multiple sclerosis.

Multiple sclerosis is a demyelinating disease of the central nervous system with genetic, viral and autoimmune characteristics. Myelin basic protein (MBP) is a suspected target autoantigen since it induces experimental autoimmune encephalomyelitis, an animal model closely resembling multiple sclerosis. The disease is mediated by Class II restricted, MBP-reactive T cells possessing the T helper/inducer phenotype. In the present study, we have isolated MBP-reactive T cell clones from the peripheral blood of a chronic progressive multiple sclerosis patient. The clones displayed blastogenic memory responses when rechallenged with the autoantigen and irradiated autologous lymphocytes. MBP recognition by the autoantigen-reactive T lymphocytes was restricted by major histocompatibility complex Class II antigens. Both CD4+8- and CD4-8+ MBP-reactive T cell clones were obtained.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1989

Wear characteristics of the canine acetabulum against different femoral prostheses.

We studied cartilage degeneration in 45 canine acetabula after implantation of prostheses with articulating surfaces of low-temperature isotropic (LTI) pyrolytic carbon, cobalt-chromium-molybdenum alloy and titanium alloy for periods ranging from two weeks to 18 months. Gross specimens and histological sections were compared with the nonoperated (control) acetabulum of the same animal. Cartilage articulating with LTI pyrolytic carbon exhibited significantly lower levels of gross wear, fibrillation, eburnation, glycosaminoglycan loss, and subchondral bone change than with metallic surfaces. Survivorship analysis showed a 92% probability of survival for cartilage articulating with LTI pyrolytic carbon at 18 months, as compared to only a 20% probability of survival for cartilage articulating with either of the metallic alloys.

Acetabulum↗
PubMed1989

The effects of calcium on bone mineral density in postmenopausal women with colles fractures.

The increased incidence of fracture in postmenopausal women may be attributable, in part, to osteoporosis. Prediposing factors other than age include genetic constitution, physical activity, alcohol and caffeine abuse, and dietary calcium deficiency. A group of 15 postmenopausal women between the ages of 43 and 85 years were analyzed for bone mineral density within 4 weeks of an acute fracture of the distal radius. Dual photon absorptiometry scanning was performed on the first through fourth lumbar vertebrae. Results indicate that bone mineral densities below the fracture threshold (0.965 g/cm2) were seen in 9 of 15 (60%) patients. Each woman was given 1500 mg/day calcium supplementation for 1 year. At 1 year, each woman was contacted for a follow-up bone mineral density analysis. While no significant increase in bone mineral density was seen, calcium supplementation appeared to inhibit further bone loss. The results of this study support previous work which has indicated that supplemental calcium may be beneficial in combatting age-related bone loss.

Adult↗
PubMed1989

Roentgenographic measurement of pedicle screw penetration.

Potential complications due to pedicle screw penetration of the anterior cortex include injury to vascular, visceral, ureteral, sympathetic, and neural structures. This study examined the accuracy of lateral roentgenographic techniques in determining actual screw penetration in vertebral levels T12 through S1 of ten unilateral sets of pedicles in five anatomic specimens. A true lateral roentgenogram alone was inaccurate for determining the penetration of the anterior cortex by a pedicle screw. The greatest discrepancy between roentgenographically apparent and actual screw penetration was found at the L4 and L5 levels. Deviation from a true lateral roentgenographic axis resulted in the most pronounced change in roentgenographically apparent screw penetration at L4 and L5. The roentgenographic axes resulting in the closest approximation of actual screw penetrations were 5 degrees and 10 degrees above the true lateral axis for the T12-L3 and the L4-S1 levels, respectively. At 50% apparent penetration, the screw may be safely assumed to not be penetrating the anterior cortex using a true lateral roentgenogram. At 80% apparent penetration, 30% and 10% probabilities of actual screw penetration of the anterior cortex exist at L4 and L5, respectively. At 100% apparent penetration, there is an almost 100% probability that the screw is actually protruding through the anterior cortex.

Biomechanical Phenomena↗
PubMed1988

The effect of post-sintering heat treatments on the fatigue properties of porous coated Ti-6Al-4V alloy.

Porous coated Ti-6Al-4V alloy implant systems provide a biocompatible interface between implant and bone, resulting in firm fixation and potential long-term retention via bony ingrowth. In order to achieve an acceptable porous coating structure, the sintering protocol for Ti-6Al-4V alloy systems often requires that the material be heat treated above the beta transus. This transforms the as-received equiaxed microstructure, recommended for surgical implants, to a lamellar alpha-beta distribution, which has been shown to have the worst fatigue properties of the most common structures attainable in Ti-6Al-4V alloy. However, post-sintering heat treatments may be used to improve these properties by producing microstructures more resistant to crack initiation and propagation. This study investigated the influence of microstructural variations on the fatigue properties of porous coated Ti-6Al-4V alloy material. Nonporous coated and porous coated Ti-6Al-4V alloy fatigue specimens were subjected to a standard sintering heat treatment to produce a lamellar microstructure. In addition, two post-sintering heat treatments were used to produce coarse and fine acicular microstructures. Rotating beam (reversed bending) fatigue testing was performed and the endurance limits determined for the noncoated and porous coated microstructures. The values determined were 668 MPa (noncoated as-received equiaxed), 394 MPa (noncoated lamellar), 488 MPa (non-coated coarse acicular), 494 MPa (noncoated fine acicular), 140 MPa (porous coated lamellar), 161 MPa (porous coated coarse acicular), and 162 MPa (porous coated fine acicular). The noncoated coarse and fine acicular specimens displayed an approximate 25% increase over the noncoated lamellar specimens. The porous coated coarse and fine acicular specimens showed an approximate 15% improvement over the porous coated lamellar specimens.

Alloys↗