PubMed Health⌕ Search

Biomedical subjects

W H Bunch

Publications and source records attributed to W H Bunch.

17 recordsLinked to original sources
PubMed1992

The stresses of the surgical residency.

UNLABELLED: Concern over resident work hours prompted us to study the stress of surgical residencies and determine if the experience might be associated with an increased use of alcohol and drugs. Two hundred fifty-seven surgery residents were selected from a stratified, randomized sample of residents (n = 1728) from the AMA files and were given an eight-page self-administered questionnaire. RESULTS: Surgical residents reported very long hours and heavy duties and complained of loss of sleep and exhaustion, both of which correlated with nights on call. Despite the heavier work load, surgical residents showed no more emotional stress than other residents. Surgery residents were more likely to have used alcohol in the last month than other residents (P less than .05) but 70% had used it fewer than 10 times in the month. All surgical residents were less likely to have used marijuana, cocaine, or other drugs than were other residents. Surgical residents seem to cope well with the extreme stresses of surgery training programs; however, more research needs to be done if we are to fully understand the process for training surgeons.

Alcohol Drinking↗
PubMed1989

Factors influencing the penetration of wires into the neural canal during segmental wiring.

We evaluated the influence of the penetration of wires into the neural canal during segmental wiring in a three-part study. First we examined the anatomy of the thoracic spine, specifically the laminar and interlaminar dimensions, as well as the epidural space. In the second part, we evaluated the depth of penetration of wires into the spinal canal at the time of their passage during spinal segmental instrumentation, using direct laboratory measurements for three configurations of the wire: first with a straight wire, and then with two wires of varying curvature. The measurements were repeated after removal of a portion of the lamina. In the third and final part of the study, we assessed the relationship between the observed penetration of the wires and the depth of penetration as calculated using mathematical models for the three wire configurations. When a wire with the largest possible diameter of curvature was passed under the lamina, there was significantly less penetration using the curved-wire configuration. This was seen in calculated models, as well as in normal specimens of the thoracic spine that were obtained from cadavera. Little epidural space was found to be available for passage of the wire. In most instances, passage of the wire must result in contact with and displacement of the dural sac and its contents. To minimize the depth of penetration at any given spinal level, it is recommended that the wire be curved to the maximum degree that will allow it to pass under the lamina.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

Dermatomal somatosensory evoked potentials in children with myelomeningocele.

Evoked responses were obtained from electrical stimulation of dermatomes representing individual lumbar and sacral roots. Normal ranges of latency have been established for adults, but have not been extended to children at this time. DSSEPs can be utilized, however, to sequentially follow lumbo-sacral cord function in individual children at risk of progressive myelopathy.

Adolescent↗
PubMed1978

Osteogenesis imperfecta in one of twins. Case report.

The is a report of a 5-year-old girl with osteogenesis imperfecta, an uncommon abnormality considered to encompass several distinct disorders and biochemically classified as a connective tissue disease. Affected individuals, in the more severe form of the disease, often die in utero or shortly thereafter secondary to birth trauma. The patient was one of dizygotic twins discordant for osteogenesis imperfecta tarda inherited as an autosomal dominant trait.

Adolescent↗
PubMed1978

Legg-Perthes disease in children less than four years old.

In children with Legg-Perthes disease who were less than four years old, better results were seen after treatment by recumbency and abduction bracing than with no treatment. All results were better in children having mild epiphyseal involvement (Catterall Groups I and II) than in those with more extensive disease.

Age Factors↗
PubMed1977

Kyphosis in the paralytic spine.

The paralytic spine without supplementary support is unstable and susceptible to axial collapse. The biomechanical factors responsible for spinal stability should be considered in any treatment regimen for paralytic spines. If posterior fusion is elected as the treatment, kyphosis must be corrected so that the eccentric loading and kyphotic bending moment is very small. When this is done, posterior fusion alone is adequate to give spinal stability and increased function to the individual.

Adolescent↗
PubMedDate not supplied

The Milwaukee brace in paralytic scoliosis.

The Milwaukee brace possesses excellent passive properties in addition to the well known dynamic action, and is of definite value in the bracing of paralytic curves in children in whom a fusion should be de-delayed. This application is a temporary but at the same time a long term expedient to allow spine growth prior to surgery.

Biomechanical Phenomena↗
PubMedDate not supplied

Conversion reactions in pediatric athletes.

We report five children and adolescents who displayed a conversion reaction in response to stresses induced by athletic competition. Failure to make proper diagnosis led to additional physician referral, needless testing, rehabilitation, or orthotic management. Patients are characterized as high achievers who are frequently younger than peers in the sport. Conversation between child and physician identified the source of conflict in four patients. Physical therapy helps resolve symptoms associated with an acute episode and facilitates transition into psychotherapy. Psychotherapy is recommended only for patients with persistent maladaptive behavior.

Adolescent↗
PubMedDate not supplied

The epidemiology of "schooliosis".

Questionnaires submitted to children subsequent to school screening for scoliosis reveal that 13% of respondents recall being referred to a physician. This rate is considerably higher than the 3% referral rate reported by school health officials. The discrepancy points to misperceptions by students and their parents as a likely cause of "schooliosis, " a condition which brings a flood of normal children into the offices of orthopaedists and pediatricians. Correcting possible communications problems, rather than blaming the screening program, should ease the over-referral phenomenon and allow screening to continue at its present efficient levels.

Adolescent↗
PubMedDate not supplied

Psychological factors in failure to wear the Milwaukee brace for treatment of idiopathic scoliosis.

Youngsters who fail to successfully adapt to a Milwaukee Brace displayed measurable psychological differences from those who do adapt satisfactorily to this treatment approach. The study did not encompass all conceivable variables which might affect orthotic wearing, however, use of logical and empirical approach to further delineate important variables seems feasible and desirable. In fact, one can hypothesize a predictive test battery which will detect high risk patients and thus afford the physician the option of alternative treatment modes, or intensified psychological intervention if the orthosis is preferred. The nature of such a psychological test battery, as well as the actions which would constitute effective intervention, will depend on future research. Based on our data, adolescent idiopathic scoliosis patients can be considered high risks for compliance with a Milwaukee Brace program if they display the following psychological characteristics: lower overall intelligence uith relative deficits in general information, reading recognition and reading comprehension skills; greater potential for acting-out/rebellious behavior; relatively lower sense of personal power or "potency", less tension associated with doctors; self reports of very active personal and family life styles.

Achievement↗
PubMedDate not supplied

Factitial synovitis.

This unusual case of trauma depicts a 17-year-old female who had a history of chronic synovitis of her left knee for several months. The patient demonstrated persistent knee effusion despite treatment of several physicians. Failure of the left knee to respond to several surgical procedures, as well as the finding of numerous foreign bodies not present previously, evoked a high index of suspicion leading to the diagnosis of factitial synovitis. The paper further defines the entity, describes the personalities involved and the numerous methods used to inflict trauma. Lastly, the treatment regime is given.

Adolescent↗
PubMedDate not supplied

The effect of denervation on bony overgrowth after below knee amputation in rats.

Bony overgrowth of amputated limbs of children is an infrequent but difficult problem. This article presents the hypothesis that the bony overgrowth is under nerve control and may represent an abortive form of partial limb regeneration. Tested in young rats, denervation produces a significant reduction in the mass and length of the bony overgrowth and a reduced rate of periosteal cell mitosis.

Amputation, Surgical↗