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Abstract
PURPOSE To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. PATIENTS AND METHODS In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures. RESULTS The greatest correction of deformity occurred in the first year of life, but after the age of four years, remodelling was limited. The absolute leg-length discrepancy (LLD) increased throughout growth with a mean 14.3% discrepancy in tibial length. In the lengthening group, mean length gained per episode was 45 mm (35 to 60). Mean duration in frame was 192 days, with a mean healing index of 42.4 days/cm. Significantly higher rates of recurrence in LLD were seen in those undergoing lengthening under the age of ten years (p = 0.046). Four contralateral epiphysiodeses were also performed. CONCLUSION Posteromedial bowing of the tibia improves spontaneously during the first years of life, but in 20/38 (53%) patients, limb reconstruction was indicated for significant residual deformity and/or worsening LLD. For larger discrepancies and persistent deformity, limb reconstruction with a hexapod external fixator should be considered as part of the treatment options. LEVEL OF EVIDENCE Level IV (Case series).
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Affiliation(s)
- J. Wright
- Department of Orthopaedics, Great Ormond Street Hospital for Children, London, UK,Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, UK, Correspondence should be sent to J. Wright, Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, UK. E-mail:
| | - R. A. Hill
- Department of Orthopaedics, Great Ormond Street Hospital for Children, London, UK
| | - D. M. Eastwood
- Department of Orthopaedics, Great Ormond Street Hospital for Children, London, UK,Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - A. Hashemi-Nejad
- Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - P. Calder
- Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - S. Tennant
- Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, UK
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Calder P, Shaw S, Roberts A, Tennant S, Sedki I, Hanspal R, Eastwood D. A comparison of functional outcome between amputation and extension prosthesis in the treatment of congenital absence of the fibula with severe limb deformity. J Child Orthop 2017; 11:318-325. [PMID: 28904639 PMCID: PMC5584502 DOI: 10.1302/1863-2548.11.160264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Complete fibula absence often presents with significant lower-limb deformity. Parental counselling regarding management is paramount in achieving the optimum functional outcome. Amputation offers a single surgical event with minimal complications. This study compares outcomes with an amputation protocol to those using an extension prosthesis. METHOD Thirty-two patients were identified. Nine patients (2 males, 7 females; median age at assessment of 23.5 years) used an extension prosthesis. Twenty-three patients (16 males, 7 females; median age at assessment of eight years) underwent 25 amputations during childhood. Mobility was assessed using SIGAM and K scores. Quality of life was assessed using the PedsQL inventory questionnaire; pain by a verbal severity score. RESULTS The 19 Syme and one Boyd amputation in 19 patients were performed early (mean age 15 months). Four Syme and one trans-tibial amputation in four patients took place in older children (mean age 6.6 years). Only two underwent tibial kyphus correction to aid prosthetic fitting. K scores were significantly higher (mean 4 vs 2) and pain scores lower in the amputation group allowing high impact activity compared with community ambulation with an extension prosthesis. The SIGAM and PedsQL scores were all better in the amputation group, but not significantly so. CONCLUSION Childhood amputation for severe limb length inequality and foot deformity in congenital fibula absence offers excellent short-term functional outcome with prosthetic support. The tibial kyphus does not need routine correction and facilitates prosthetic suspension. Accommodative extension prostheses offer reasonable long-term function but outcome scores are lower.
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Affiliation(s)
- P. Calder
- The Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK,Correspondence should be sent to: Mr P. Calder, The Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK. E-mail:
| | - S. Shaw
- The Limb Rehabilitation Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK
| | - A. Roberts
- Academic Department for Military Rehabilitation, Defence Medical Rehabilitation Centre Headley Court, Epsom, Surrey, KT18 6JW, UK
| | - S. Tennant
- The Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK
| | - I. Sedki
- The Limb Rehabilitation Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK
| | - R. Hanspal
- The Limb Rehabilitation Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK
| | - D. Eastwood
- The Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK
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3
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Cann F, Corbett M, O'Sullivan D, Tennant S, Hailey H, Grieve J, Broadhurst P, Rankin R, Dean J. Phenotype-driven molecular autopsy for sudden cardiac death. Clin Genet 2016; 91:22-29. [DOI: 10.1111/cge.12778] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 11/26/2022]
Affiliation(s)
- F. Cann
- Department of Clinical Genetics; Ashgrove House; Aberdeen Scotland
| | - M. Corbett
- Pathology Department; University Medical Buildings; Aberdeen Scotland
| | - D. O'Sullivan
- North of Scotland Genetics Laboratory; Polwarth Building; Aberdeen Scotland
| | - S. Tennant
- North of Scotland Genetics Laboratory; Polwarth Building; Aberdeen Scotland
| | - H. Hailey
- Department of Clinical Genetics; Ashgrove House; Aberdeen Scotland
| | - J.H.K. Grieve
- The Forensic Medicine Unit; University Medical Buildings, Aberdeen University; Aberdeen Scotland
| | - P. Broadhurst
- Cardiology Department; Aberdeen Royal Infirmary; Aberdeen Scotland
| | - R. Rankin
- Pathology Department; Raigmore Hospital; Inverness Scotland
| | - J.C.S. Dean
- Department of Clinical Genetics; Ashgrove House; Aberdeen Scotland
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Tennant S, Simon R, Wang J, Pasetti M, Ernst R, Lees A, Galen J, Levine M. Bivalent vaccine strategies for invasive non-typhoidal Salmonella infections. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Dean J, Cann F, Corbett M, O'Sullivan D, Tennant S, Hailey H, Rankin R, Brown P, Broadhurst P, Grieve J. Molecular autopsy for sudden cardiac death - outcome of a practical approach. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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7
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Dickenson E, Greasley M, Wong K, Tennant S, Valassiadou K. Axillary ultrasound and fine needle aspiration cytology and the potential impact of intra operative molecular analysis of sentinel nodes: How many patients would benefit? Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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Al-Attar M, Tennant S, Denton E, Khan H, Grosvenor L, Lister D. Vacuum-assisted core biopsy of B3 lesions showing atypia on needle core biopsy: a worthwhile exercise? Breast Cancer Res 2010. [PMCID: PMC2978852 DOI: 10.1186/bcr2688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - S Tennant
- University Hospitals of Leicester, UK
| | - E Denton
- University Hospitals of Leicester, UK
| | - H Khan
- University Hospitals of Leicester, UK
| | | | - D Lister
- University Hospitals of Leicester, UK
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Khan AN, Hoosein M, Hartley N, Tennant S, Daintith H, Denton E, Al-Attar M. Can we predict the likelihood of malignancy in mammographically indeterminate microcalcification? Breast Cancer Res 2009. [PMCID: PMC4284854 DOI: 10.1186/bcr2393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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10
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Tennant S, Evans A, Macmillan D, Lee A, Cornford E, James J, Ellis I. CT staging of loco-regional breast cancer recurrence. A worthwhile practice? Clin Radiol 2009; 64:885-90. [DOI: 10.1016/j.crad.2009.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 05/25/2009] [Accepted: 05/27/2009] [Indexed: 11/29/2022]
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11
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Stewart JD, Tennant S, Powell H, Pyle A, Blakely EL, He L, Hudson G, Roberts M, du Plessis D, Gow D, Mewasingh LD, Hanna MG, Omer S, Morris AA, Roxburgh R, Livingston JH, McFarland R, Turnbull DM, Chinnery PF, Taylor RW. Novel POLG1 mutations associated with neuromuscular and liver phenotypes in adults and children. J Med Genet 2008; 46:209-14. [DOI: 10.1136/jmg.2008.058180] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- M Deschauer
- Department of Neurology, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
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Mulpuri K, Tennant S, Tritt B, Choit R, Tredwell S. 22 PROCEDURAL SEDATION FOR THE REDUCTION OF PAEDIATRIC FOREARM FRACTURES: EVOLUTION OF CARE. J Investig Med 2005. [DOI: 10.2310/6650.2005.00005.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Garcia CC, Blair HJ, Seager M, Coulthard A, Tennant S, Buddles M, Curtis A, Goodship JA. Identification of a mutation in synapsin I, a synaptic vesicle protein, in a family with epilepsy. J Med Genet 2004; 41:183-6. [PMID: 14985377 PMCID: PMC1735688 DOI: 10.1136/jmg.2003.013680] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A four generation family is described in which some men of normal intelligence have epilepsy and others have various combinations of epilepsy, learning difficulties, macrocephaly, and aggressive behaviour. As the phenotype in this family is distinct from other X linked recessive disorders linkage studies were carried out. Linkage analysis was done using X chromosome microsatellite polymorphisms to define the interval containing the causative gene. Genes from within the region were considered possible candidates and one of these, SYN1, was screened for mutations by direct DNA sequencing of amplified products. Microsatellite analysis showed that the region between MAOB (Xp11.3) and DXS1275 (Xq12) segregated with the disease. Two point linkage analysis demonstrated linkage with DXS1039, lod score 4.06 at theta = 0, and DXS991, 3.63 at theta = 0. Candidate gene analysis led to identification of a nonsense mutation in the gene encoding synapsin I that was present in all affected family members and female carriers and was not present in 287 control chromosomes. Synapsin I is a synaptic vesicle associated protein involved in the regulation of synaptogenesis and neurotransmitter release. The SYN1 nonsense mutation that was identified is the likely cause of the phenotype in this family.
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Affiliation(s)
- C C Garcia
- Institute of Human Genetics, International Centre for Life, Newcastle upon Tyne, UK
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Abstract
This article attempts to define normal development throughout childhood and provide straightforward advice in the physical assessment of the child in this situation. It also attempts to outline the groups of conditions that lead to walking abnormalities and highlight the salient physical features and special investigations that are required to make these diagnoses with confidence.
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Affiliation(s)
- S Tennant
- Royal National Orthopaedic Hospital, Stanmore
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16
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Abstract
Whilst most humeral fractures may be treated by closed methods, humeral nailing has gained popularity where a surgical option is indicated. Concern has been expressed regarding placement of proximal and distal locking screws whilst the efficiency of the ingenious intra-medullary locking device of the Seidel nail has also been questioned. The Marchetti-Vincenzi nail, which "locks" proximally with the spreading of intra-medullary pins and distally with a single screw inserted via the surgical wound, apparently avoids potential neurovascular and tendon injury. Prospectively recorded data was analysed in 19 "fresh" fractures, i.e. within 3 weeks of injury, and in 13 "late" fractures (total of 32 humeral fractures) treated with the Marchetti nail. All fresh fractures thus treated progressed to union, whilst in the late fracture group there were three non-unions all of whom were in osteoprotic females. Whilst we commend the use of the Marchetti humeral nail in fresh fractures, we have reservations about its use in "late" fractures particularly where the patient is female and osteoporotic.
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Affiliation(s)
- S Tennant
- Department of Orthopaedic Surgery, Specialist Registrar, Northwick Park Hospital, Watford Road, Harrow, Middlesex, UK
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17
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Tennant S, Williams A, Vedi V, Kinmont C, Gedroyc W, Hunt DM. Patello-femoral tracking in the weight-bearing knee: a study of asymptomatic volunteers utilising dynamic magnetic resonance imaging: a preliminary report. Knee Surg Sports Traumatol Arthrosc 2001; 9:155-62. [PMID: 11420789 DOI: 10.1007/s001670000173] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Normal patello-femoral tracking is not well defined, and conventional radiological techniques do not allow imaging in the physiological, weight-bearing stance. A vertical-access open configuration magnetic resonance scanner allows imaging of patello-femoral tracking during weight-bearing and through a wide range of knee flexion. We imaged 40 asymptomatic knees in this way, producing axial scans which were analysed qualitatively and quantitatively using sulcus angle, congruence angle, lateral patello-femoral angle and patellar centralisation, to assess patellar tilt and displacement. Mild lateral tilting in hyperextension with the quadriceps relaxed was seen, but quantitative assessment of this was impeded by internal rotation of the femur in extension. One-half of the knees were slightly laterally displaced in hyper-extension, becoming central during the first 30 degrees of knee flexion. During passive flexion of the knee in a seated position, fewer knees were laterally tilted or displaced, and no consistent change was seen during flexion. These results indicate that mild lateral tilting and displacement can be normal phenomena in the weight-bearing knee in early flexion and should not necessarily be taken as evidence of abnormal tracking in symptomatic patients. Lateral to medial movement of the patella occurs during normal knee flexion. In addition, imaging in the weight-bearing knee can provide valuable information not gained by imaging during passive knee flexion.
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Affiliation(s)
- S Tennant
- Department of Orthopaedic Surgery and Department of Radiology, St. Mary's Hospital, London, UK.
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18
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Affiliation(s)
- S Tennant
- Department of Orthopaedics, Northwick Park Hospital, Watford Road, Middlesex HA1 3UJ, Harrow, UK
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Abstract
Conventional methods of imaging in the investigation of developmental dysplasia of the hip all have disadvantages, either in definition or in exposure to radiation. We describe a new open-configuration MR scanner which is unique in that it allows anaesthesia and access to the patient within the imaging volume for surgical procedures and application of casts. We performed 13 scans in eight anaesthetised infants. Dynamic imaging revealed two dislocated hips which were then visualised during reduction. Hip spicas were applied without removing the patient from the scanner. In one hip, an adductor tenotomy was carried out. In all patients, stressing the hips during dynamic imaging allowed an assessment of stability. This was particularly useful in two hips in which an analysis of stability in different positions facilitated the planning of femoral osteotomies. This method of imaging provides new and important information. It has great potential in the investigation of developmental dysplasia of the hip and, with ultrasound, may allow management without the need for radiography.
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Affiliation(s)
- S. Tennant
- St Mary’s Hospital, Praed Street, London W2 1NY, UK
| | - C. Kinmont
- St Mary’s Hospital, Praed Street, London W2 1NY, UK
| | - G. Lamb
- St Mary’s Hospital, Praed Street, London W2 1NY, UK
| | - W. Gedroyc
- St Mary’s Hospital, Praed Street, London W2 1NY, UK
| | - D. M. Hunt
- St Mary’s Hospital, Praed Street, London W2 1NY, UK
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20
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Tennant S, Kinmont C, Lamb G, Gedroyc W, Hunt DM. The use of dynamic interventional MRI in developmental dysplasia of the hip. J Bone Joint Surg Br 1999; 81:392-7. [PMID: 10872353 DOI: 10.1302/0301-620x.81b3.8964] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Conventional methods of imaging in the investigation of developmental dysplasia of the hip all have disadvantages, either in definition or in exposure to radiation. We describe a new open-configuration MR scanner which is unique in that it allows anaesthesia and access to the patient within the imaging volume for surgical procedures and application of casts. We performed 13 scans in eight anaesthetised infants. Dynamic imaging revealed two dislocated hips which were then visualised during reduction. Hip spicas were applied without removing the patient from the scanner. In one hip, an adductor tenotomy was carried out. In all patients, stressing the hips during dynamic imaging allowed an assessment of stability. This was particularly useful in two hips in which an analysis of stability in different positions facilitated the planning of femoral osteotomies. This method of imaging provides new and important information. It has great potential in the investigation of developmental dysplasia of the hip and, with ultrasound, may allow management without the need for radiography.
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21
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Walker SR, Tennant S, MacSweeney ST. A randomized, double-blind, placebo-controlled, crossover study to assess the immediate effect of sublingual glyceryl trinitrate on the ankle brachial pressure index, claudication, and maximum walking distance of patients with intermittent claudication. J Vasc Surg 1998; 28:895-900. [PMID: 9808859 DOI: 10.1016/s0741-5214(98)70067-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The goal of the present study was to assess the immediate effect of sublingual glyceryl trinitrate (GTN) in patients with intermittent claudication. METHODS We conducted a randomized, double-blind, placebo-controlled crossover study. Inclusion criteria consisted of history of intermittent claudication, resting ankle brachial pressure index (ABPI) of 1.00 or less, a 20% or greater fall in ABPI after exercise, and maximum walking distance (MWD) of less than 250 m. Patients already receiving nitrates were excluded. In study 1, patients (n = 25) underwent a standard exercise test after randomization to receive either 800 microg of sublingual GTN or placebo. The postexercise ABPI was recorded. Then, the crossover portion of the study was performed. In study 2, patients (n = 22) had their claudication distance and MWD measured. They then were randomized to receive either GTN or placebo spray, and the exercise test was repeated, with the claudication distance and MWD recorded, followed by the crossover portion of the study. Statistical analysis was performed with the Wilcoxon matched pairs signed ranks test and the Mann-Whitney U test. RESULTS In study 1, the median postexercise ABPIs for placebo and GTN were 0.29 and 0.36 (P =.0001). In study 2, the median claudication distance for both placebo and GTN groups was 70 m (P =.59). The median MWD for the placebo and GTN groups was 105 and 125 m (P =.0084) CONCLUSION GTN can decrease the fall in ABPI after exercise and increase the MWD.
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Affiliation(s)
- S R Walker
- Department of Vascular and Endovascular Surgery, Queens Medical Centre,Nottingham, UK
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22
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Abstract
Peripheral conversion of gender steroid precursors has been implicated in playing a role in bone turnover in postmenopausal women. It has been reported that aromatase cytochrome P450 (P450arom) is present in primary bone and bone marrow (BM), and that P450arom mRNA has been identified in cultured BM and osteoblast-like cell lines. However, there are no reports that P450arom transcripts have been detected in skeletal tissue that has not been cultured. We therefore elected to test for the presence of P450arom mRNA in primary human bone and BM in normal and fractured necks of femora using the reverse transcription-polymerase chain reaction method. Although the RNA extracted from these tissues was of good quality as demonstrated by the expression of transcripts for interleukin-6, P450arom transcripts failed to be detected in normal primary cortical bone and fatty BM containing trabecular bone. However, P450arom transcripts were detected in the latter when they were cultured. Transcripts for P450arom were also detected in total RNA extracted from six fractured necks of femora and semiquantitative PCR demonstrated that P450arom mRNA was present in similar abundance in the same amount of RNA analyzed from buttock adipose tissue and fractured bone/BM. P450arom mRNA expression was also detected in cultured peripheral blood leukocytes, suggesting that this might be the source of the enzyme. In these cultures no correlation was detected between the expression of P450arom mRNA and cell proliferation. PCR failure was excluded in cases when P450arom transcripts failed to be detected in bone/BM by coamplifying RNA from human and rat brain mRNA, known to express P450arom mRNA, using primers that detect both P450arom mRNA from both species. These products were analyzed by Southern blot using oligonucleotide probes, which label either human or rat P450arom cDNA. The blots confirmed the absence of P450arom in nonfractured human bone and BM and preclude PCR failure. Our results indicate that P450arom mRNA is not detected in either normal human bone or BM, but can be induced in this microenvironment under pathological conditions. We propose that tissue grown in vitro is analogous to a wound and this explains why P450arom transcripts were detected in cultured normal skeletal tissue, whereas they failed to be detected in primary normal bone and BM.
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Affiliation(s)
- C K Lea
- Department of Histopathology, Imperial College School of Medicine at St. Mary's, London, UK
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Chen RH, Tennant S, Frost D, O'Beirne MJ, Karwowski JP, Humphrey PE, Malmberg LH, Choi W, Brandt KD, West P, Kadam SK, Clement JJ, McAlpine JB. Discovery of saricandin, a novel papulacandin, from a Fusarium species. J Antibiot (Tokyo) 1996; 49:596-8. [PMID: 8698645 DOI: 10.7164/antibiotics.49.596] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- R H Chen
- Abbott Laboratories, Abbott Park, IL. 60064, USA
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24
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Abstract
Between 1 January 1985 and 31 December 1991, 2426 patients underwent arterial surgery. Three hundred and seventy one reoperations were performed on 258 patients within 30 days of the initial procedure. One hundred and ninety three (52%) of the operations were attempted revascularisations, 95 (26%) were amputations and 58 (16%) were to control bleeding. One hundred and sixty nine (66%) of first operations were successful, but 76 patients required a further 113 reoperations. The mortality of reoperation was 16%, while the mortality of patients not requiring reoperation was 9% (p < 0.01). The mean hospital stay in days was higher in patients requiring reoperation (p < 0.05). Where appropriate, patients should be informed of the significant incidence of reoperation and reoperative mortality after vascular surgery. The increased hospital stay in reoperated patients has financial implications.
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Affiliation(s)
- R L Ng
- Vascular Studies Department, Bristol Royal Infirmary, U.K
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