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Biomedical subjects

W A Hadden

Publications and source records attributed to W A Hadden.

At least 19 recordsLinked to original sources
PubMed2001

Association of IL-8 and MCP-1 with the development of reexpansion pulmonary edema in rabbits.

BACKGROUND: The aim of this study is to determine the relationships between the cytokines and the inflammatory response in reexpansion pulmonary edema (RPE). METHODS: We examined the cell population, epithelial permeability measured by Evans blue dye (EB), betaglucuronidase and cytokine concentrations in bronchoalveolar lavage fluid (BALF) and/or blood using a rabbit RPE model. RESULTS: We confirmed that RPE is characterized by recruitment of polymorphonuclear leukocytes (PMNs), the release of PMN granular contents into the air spaces, and increased vascular permeability. These findings were highly correlated with increased interleukin-8 (IL-8) and monocyte chemoattractant protein 1 (MCP-1) concentrations in the BALF. Growth related oncogene (GRO) was detected in the BALF from only 2 of the 7 reexpanded lungs while TNFalpha was not detected in any rabbits. A similar but less severe inflammatory response to the reexpanded lung was found in the contralateral lung. CONCLUSIONS: IL-8 and MCP-1 may play important roles in the development of RPE; the inflammatory response is independent of TNFalpha and unilateral reexpansion of the lung induces an inflammatory response not only in the reexpanded lung but also in the contralateral lung.

Animals↗
PubMed2000

alpha-Chemokine growth factors for adenocarcinomas; a synthetic peptide inhibitor for alpha-chemokines inhibits the growth of adenocarcinoma cell lines.

PURPOSE: The experiments aimed to determine if alpha-chemokine inhibitors are effective suppressors of the growth of adenocarcinomas, a neoplasm with a high mortality rate. METHODS: Expression of growth-related oncogene (GROalpha) and interleukin-8 (IL-8) was determined by enzyme-linked immunosorbent assay. Inhibition of alpha-chemokine binding to tumor cells was assessed in the presence and absence of the hexapeptide, antileukinate. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays were performed to determine the effect of alpha-chemokines, monoclonal antibodies (mAb), and antileukinate on cell proliferation. Finally, antileukinate inhibition of human, lung adenocarcinoma tumor growth, was determined in BALB/c nude mice. RESULTS: All of the adenocarcinomas tested produced either GROalpha or IL-8 or both. Proliferation of lung, stomach and colon adenocarcinoma cells was inhibited by anti-GROalpha mAb and/or anti-IL-8 mAb while recombinant human GROalpha stimulated the proliferation of lung and stomach adenocarcinomas. Antileukinate inhibited GROalpha binding to specific receptors on adenocarcinoma cells and inhibited the proliferation of all adenocarcinomas tested. Colon-derived adenocarcinomas specifically bound IL-8 and this binding was also inhibited by antileukinate. Administration of antileukinate in vivo inhibited the tumor growth of adenocarcinoma A549. CONCLUSIONS: GROalpha and IL-8 are necessary for the growth of lung, stomach and colon adenocarcinomas, and can be inhibited by the hexapeptide, antileukinate. The findings suggest the possibility of using alpha-chemokine receptor inhibitors in the treatment of adenocarcinoma.

Adenocarcinoma↗
PubMed1999

Parachuting for charity: is it worth the money? A 5-year audit of parachute injuries in Tayside and the cost to the NHS.

All parachute injuries from two local parachute centres over a 5-year period were analysed. Of 174 patients with injuries of varying severity, 94% were first-time charity-parachutists. The injury rate in charity-parachutists was 11% at an average cost of 3751 Pounds per casualty. Sixty-three percent of casualties who were charity-parachutists required hospital admission, representing a serious injury rate of 7%, at an average cost of 5781 Pounds per patient. The amount raised per person for charity was 30 Pounds. Each pound raised for charity cost the NHS 13.75 Pounds in return. Parachuting for charity costs more money than it raises, carries a high risk of serious personal injury and places a significant burden on health resources.

Accidents, Aviation↗
PubMed1998

Acute compartment syndrome of the thigh after joint replacement with anticoagulation.

We describe three patients with a compartment syndrome of the thigh, two after total hip replacement and one after total knee replacement. Two of the patients were fully anticoagulated. A compartment syndrome of the thigh is a rare, but important complication of joint replacement surgery if patients are receiving anticoagulants. Close observation is needed and when indicated monitoring of the intracompartmental pressure should be done. Early recognition of the signs and symptoms of an acute compartment syndrome and knowledge of the anatomy of the compartments of the thigh will help in the diagnosis and treatment of this potentially devastating complication.

Acute Disease↗
PubMed1996

Suture reaction following skin closure with subcuticular polydioxanone in total knee arthroplasty.

A retrospective study revealed a 20% incidence of suture reaction following closure of wounds with subcuticular polydioxanone after total knee arthroplasty. In a control group whose wounds were closed with subcuticular polyglycolic acid (Dexon, Davis & Geck, Wayne, NJ), no suture reactions occurred (P = .0012, Fisher's exact test). It is concluded that subcuticular polydioxanone should not be used for skin closure after total knee arthroplasty.

Abscess↗
PubMed1995

The Bateman bipolar prosthesis: a prospective study in primary osteoarthritis.

We present a prospective study of Bateman bipolar prosthesis performed over 5 years in Perth. All patients were treated for primary osteoarthritis using a cementless straight Moore stem and the bipolar acetabular component. Assessment was made at 6-monthly intervals. Harris hip scores were calculated and radiological parameters of inner bearing movement, component migration and proximal osteoporosis were assessed. The group comprised 76 prostheses in 72 patients. The mean Harris hip score at 3 years follow-up was 85, however with a wide range between 55 and 99. A total of 30% of patients at 3 years follow-up had a Harris hip score at less than 70. Twenty-seven per cent of the prostheses at 3 years had restriction of movement at the inner bearing and 43% were judged to have moderate or severe stress shielding around the proximal femur. The clinical results were unpredictable with thigh pain being a significant problem. Because of the unpredictable results we would not advocate the use of the Bateman prosthesis in primary osteoarthritis.

Adult↗
PubMed1992

Medical cover for 'The Open' golf championship.

A review of 10 years' provision of medical cover at a major golf championship is presented. The average consultation rate was approximately 1 in 200 of those attending of whom 3% required transfer to hospital, the majority to orthopaedic or general medical departments. Familiarity with acute resuscitation and musculoskeletal complaints is required of the medical attendants. The provision of physiotherapy and chiropody services is essential, especially for the participants' complaints, two-thirds of which affected the axial skeleton. Good communications and close liaison with the Chief Marshal, Police and Ambulance Services are vital.

Emergency Medical Service Communication Systems↗
PubMed1990

A comparative study of closed-wound suction drainage vs. no drainage in total hip arthroplasty.

One hundred consecutive primary total hip arthroplasties performed by the same surgeon over 4 years were retrospectively reviewed. In the first 50, closed-suction drains were used; the following 50 were not drained. Comparison between the two groups revealed no statistically significant differences in wound problems, postoperative pyrexias, or other short-term complications. No wound infections occurred. A mean of 2.6 units of blood per patient was transfused to the nondrained group. In the drained group, a mean of 3.4 units of blood per patient was transfused. This difference was not statistically significant. The mean postoperative fall in haemoglobin concentration was 2.4 g/dl in the nondrained group, and 1.9 g/dl in the drained group. This difference was not statistically significant. This study demonstrated no advantage to the use of suction drains in uncomplicated total hip arthroplasty, and perhaps their routine use should be questioned.

Adult↗
PubMed1987

Interfragmentary screw fixation of fractures of the tibial shaft.

The records of 54 patients treated with interfragmentary screws were reviewed a mean of 2 years after surgery. Fifty-one fractures were of moderate severity (Ellis, 1950), 31 had a ratio of fracture length to tibial diameter of 2 or more and 17 were comminuted. An anatomical reduction, achieved initially in 44 fractures, was lost before union occurred in 14 (32 per cent), despite plaster splintage. Excellent results, with anatomical healing, were achieved in 30 patients (55 per cent) and good results with less than 5 degrees malalignment in 6 (11 per cent). There was a statistically highly significant association of satisfactory results with initial anatomical operative reduction of the fracture, a ratio of fracture length to tibial diameter of 2 or more and the absence of comminution. The orientation and number of screws, delayed operation, the degree of initial displacement of the fracture and the patient's age were not shown to affect the outcome. Delayed union occurred in 4 patients (7.4 per cent) and non-union in 3 (5.5 per cent). Deep infection occurred twice (3.7 per cent). As more satisfactory results could be expected for these fractures using other techniques, we conclude that this method cannot be recommended.

Adolescent↗
PubMed1985

Multiple level injuries of the cervical spine.

In a group of 105 patients admitted to hospital with injuries of the cervical spine, the incidence of injuries at multiple levels was 24 per cent. Multi-level injuries occurred in 17 out of 54 patients (31 per cent) sustaining a noteworthy neurological injury and in 8 out of 51 when such an injury was absent. This incidence is higher than previously reported, probably due to increasingly elaborate investigations. In the majority of cases, treatment of the dominant injury was unchanged by the demonstration of injuries at other levels, but in a small number, serious errors in treatment arose or could have arisen. Careful multi-level assessment, including assessment of the cervicothoracic junction, is indicated before selecting management. While conventional or computerized axial tomography may occasionally be necessary to achieve this, good conventional radiography remains the most important investigation. Computerized axial tomography is particularly useful in establishing the anatomy of complex injuries in the upper cervical spine.

Adolescent↗
PubMed1983

Results of AO plate fixation of forearm shaft fractures in adults.

A series of 111 forearm fractures in 108 individuals involving 177 individual bones, and treated by AO plating is reported. There were 18 different surgeons. Open fractures occurred in 24 per cent of limbs. Reviews at a mean of 3 years after the accident showed 97 per cent of bones to be solidly united, and satisfactory function to be achieved in 80 per cent of limbs. Deep infection occurred 6 times, and non-union in 7 bones. Cross-union developed in 6 patients, all of whom had sustained head injuries. Seven patients sustained operative nerve injuries. It is felt that the implant of choice at the moment is the small fragment Dynamic Compression Plate (DCP).

Adolescent↗
PubMed1982

Hip fractures of rheumatoid arthritis.

The results of treatment of 73 transcervical and 49 extracapsular fractures of the femoral neck in patients with rheumatoid arthritis were compared with the results in 152 normal patients. In undisplaced transcervical fractures that were internally fixed and followed up for more than six months, there was no significant difference in results between the rheumatoid patients (5 acceptable results in 8 patients) and the control patients (8 acceptable results in 9 patients). In displaced fractures, when internally fixed, the rheumatoid group (8 acceptable results in 27 patients) did significantly less well than the control group (17 acceptable results in 30 patients). In hips affected by the disease, the results were worse (1 acceptable result in 9 patients). Hemiarthroplasty gave acceptable results in two-thirds of the rheumatoid patients with transcervical fractures, whether used as primary treatment of displaced fractures or as revision of failed pinnings. This was not affected significantly by the presence of disease in the joint. In extracapsular fractures, the presence of rheumatoid arthritis, whether or not it affected the hip, did not appear to affect the outcome. The presence of osteoporosis was associated with poor results.

Aged↗