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Biomedical subjects

A Tindall

Publications and source records attributed to A Tindall.

16 recordsLinked to original sources
PubMed2006

Case of the month: The skin wrinkle test: a simple nerve injury test for paediatric and uncooperative patients.

Assessment of the distal neurological status after injuries to the hand and fingers is one of the most frequent parts of standard trauma practice. Two-point discrimination as clinical examination is often sufficient to identify such lesions, but difficulties occur in the comatose, young or otherwise uncooperative patient. This article describes a simple pain-free alternative method of assessing digital nerve integrity by submerging the finger tip in water and observing if wrinkles develop on the skin.

Adult↗
PubMed2006

15-year follow-up results of the hydroxyapatite ceramic-coated femoral stem.

PURPOSE: To evaluate the clinical and radiological outcomes following implantation of the Furlong hydroxyapatite ceramic-coated femoral stem in total hip arthroplasty. METHODS: A longitudinal cohort of 116 consecutive patients (134 hips) was followed up prospectively. The follow-up period was at least 13 years (range, 13- 15 years). Clinical and radiological assessments were made using the Merle d'Aubigne and Postel score and Engh score for fixation and stability, respectively. Osteointegration was assessed radiographically by examining the bone implant interface using the method described by Gruen. RESULTS: 22 patients died during the study period and 6 were lost to follow-up. The respective mean Merle d'Aubigne and Postel scores for pain, range of movement, and ability to walk were 2.2, 2.8, and 2.4 preoperatively and 5.8, 4.8, and 5.4 postoperatively. Engh described satisfactory bony ongrowth as 10 points or more; the mean Engh score for fixation and stability was 24.7 (fixation=10, stability=14.7). One femoral stem was revised for a periprosthetic fracture caused by a fall, but none was revised for loosening. This gave a 99% survival at 13 years (95% confidence interval 94-100). CONCLUSION: The long-term results of this hydroxyapatite ceramic-coated femoral prosthesis are very satisfactory.

Adult↗
PubMed2005

The anatomy of the dorsal cutaneous branch of the ulnar nerve - a safe zone for positioning of the 6R portal in wrist arthroscopy.

The dorsal branch of the ulnar nerve passes close to the 6 Radial portal used in wrist arthroscopy. We examined 20 cadaveric limbs to establish the course of this nerve. We found it consistently crossed a line between the ulnar styloid and the fourth web space at an average of 2.4 cm from the ulnar styloid (range 1.8-2.8 cm). This represented 23% (+/- 2.5 STD range 19-27%) of the distance from the styloid process to the fourth web space. Recommendations are made to help avoid iatrogenic injury to the nerve during arthroscopy. The literature on the anatomy of this nerve and its variations and the clinical relevance of this knowledge are discussed.

Arm↗
PubMed2005

Microsomal prediction of in vivo clearance and associated interindividual variability of six benzodiazepines in humans.

The intrinsic clearances (CLint) of midazolam, triazolam, diazepam, nordiazepam, flunitrazepam and alprazolam were determined from two liver banks (n=21) by formation kinetics of ten metabolites. A literature-collated database of in vivo CLint values (811 subjects) was used to assess predictions and variability. The in vivo clearance of six benzodiazepines was generally underpredicted by in vitro data and the degree of bias was in agreement with a database of structurally diverse compounds (n=37). The variability observed for in vitro clearances (11--19--fold for midazolam, diazepam and nordiazepam in liver bank 1; 101--269--fold for triazolam, flunitrazepam and alprazolam in liver bank 2) exceeded the in vivo variability for the same compounds (4--59 and 10--29, respectively). This mismatch may contribute to the bias in microsomal predictions and it highlights the need for careful selection of representative livers for human liver banks.

Benzodiazepines↗
PubMed2005

Results of a hydroxyapatite-coated (Furlong) total hip replacement: a 13- to 15-year follow-up.

We describe the survival of 134 consecutive JRI Furlong hydroxyapatite-coated uncemented total hip replacements. The mean follow-up was for 14.2 years (13 to 15). Patients were assessed clinically, using the Merle d'Aubigné and Postel score. Radiographs were evaluated using Gruen zones for the stem and DeLee and Charnley zones for the cup. Signs of subsidence, radiolucent lines, endosteal bone formation (spot welds) and pedestal formation were used to assess fixation and stability of the stem according to Engh's criteria. Cup angle, migration and radiolucency were used to assess loosening of the cup. The criteria for failure were revision, or impending revision because of pain or loosening. Survival analysis was performed using a life table and the Kaplan-Meier curve. The mean total Merle d'Aubigné and Postel score was 7.4 pre-operatively and 15.9 at follow-up. During the study period 22 patients died and six were lost to follow-up. None of the cups was revised. One stem was revised for a periprosthetic fracture following a fall but none was revised for loosening, giving a 99% survival at 13 years. Our findings suggest that the long-term results of these hydroxyapatite-coated prostheses are more than satisfactory.

Adult↗
PubMed1995

MR and cognitive testing of patients undergoing osmotic blood-brain barrier disruption with intraarterial chemotherapy.

PURPOSE: To determine whether osmotic blood-brain barrier disruption is associated with MR abnormalities or cognitive deterioration and, if so, whether the MR findings correlate with cognitive test results. METHODS: Fifteen brain tumor patients who had a complete tumor response (nine central nervous system lymphoma, three germ cell and two astrocytoma, and one primitive neuroectodermal tumor) treated with blood-brain barrier disruption procedures (318 total procedures) with intraarterial chemotherapy were included. MR images were evaluated for the development of white matter hyperintensity, vascular lesions, or atrophy. Cognitive testing was performed to assess deterioration caused by this therapy. RESULTS: In two patients white matter hyperintensity developed, in two small vascular lesions developed, and in one mild atrophy developed. One infarct was asymptomatic and the second one resulted in mild dysesthesia in one upper extremity. No patient showed diminished cognitive function on the posttherapy evaluation. CONCLUSION: In patients undergoing blood-brain barrier disruption with intraarterial chemotherapy, new abnormalities on MR imaging may develop. These patients maintain the same level of cognitive and neurologic function and MR findings do not correlate with the results of cognitive testing.

Adolescent↗
PubMed1989

Effect of steroids during Escherichia coli endotoxinaemia in rabbits.

A study was carried out on the effect of high doses of methylprednisolone to rabbits in combination with or after challenging them with Escherichia coli endotoxin. The animals given steroids simultaneously with the endotoxin or 2-6 h thereafter all had significantly higher white cell counts 24 h after endotoxin infusion. A second dose of endotoxin given 24 h after the first caused a rapid fall in white cell count, and no difference between the groups could then be observed 2 h later. The most striking effect was observed when methylprednisolone was administered simultaneously with the endotoxin. This caused a suppression of the clearance of endotoxin from the circulation, and this in turn could probably account for some newly synthesized thromboplastin expressed by the circulating monocytes. Furthermore, monocyte activation appears to be significantly higher in the animals receiving steroids than in the controls when the animals are subjected to two doses of endotoxin injections 24 h apart. Thus, high doses of methylprednisolone cannot be seen to have any beneficial effect as judged from the parameters tested in the present study.

Animals↗
PubMed1989

Effects of morphine and pethidine in vitro on longitudinal and circular muscle tension of bovine coronary artery.

The effects of morphine and pethidine on the tension in longitudinal and circular muscle from bovine coronary arteries have been compared. Pethidine caused constriction in circular muscle while morphine caused relaxation. In longitudinal muscle, pethidine caused relaxation while morphine had no effect. Like morphine, noradrenaline in comparable doses relaxed circular muscle and had minimal effects on longitudinal muscle. If the difference in the response to morphine and pethidine demonstrated here also applies to human coronary arteries, the clinical implications are potentially important.

Animals↗
PubMed1987

Changes in guinea pig muscle histology in response to reduced mobility.

Dorsiflexion of one hind foot has been prevented in guinea pigs by means of a light prosthesis. The gastrocnemius and soleus muscles of both hind legs have been removed after a period of 2 weeks, and the fiber cross-sectional areas of type 1 and 2 fibers in both muscles have been measured. Comparison of the values in normal and affected muscles shows that the limited reduction in free movement of the foot led to a significant atrophy in types 1 and 2 fibers in both muscles. The use of this simple prosthesis appears to have no effect on any other function of the leg except for the restriction of the lengthening of gastrocnemius and soleus muscles, and the results show that some of the hypotheses about the muscle atrophy seen in fully immobilized limbs cannot account for the changes observed in the present experiments and seem to be of limited validity.

Animals↗
PubMed1986

Thromboplastin content in the vessel walls of different arteries and organs of rabbits.

Homogenized arterial walls of rabbits were shown to possess significant amounts of thromboplastin activity. The specific activity, percent activity per mg tissue, varied in different arteries. Thus the thromboplastin activity of the carotid was found to be about ten-fold higher compared to the femoral. Thromboplastin activity measurements of different organs revealed a very high level of thromboplastin in lung, whereas kidney and spleen had respectively 6 and 25 times less activity than the lung. Induction of generalized Shwartzman reaction by giving two doses of endotoxin 24 hours apart, caused no significant rise in thromboplastin activity of either arteries or organs, but induced a 35-fold increase of thromboplastin activity of circulating monocytes. The very high thromboplastin activity in the lung probably reflects the widespread and dense population of vessel in this particular organ. It is concluded that the amount of thromboplastin present in the vessel wall gives the possibility for a potent activation of the clotting system in normal haemostasis.

Animals↗
PubMed1984

Diameter changes in rabbit aorta during fixation at physiological pressure.

The rabbit aorta distends considerably during glutaraldehyde infusion at 100 mm Hg, the distension at the beginning being both fastest and greatest. Over a 2-h period the degree of distension approached a maximum value which was clearly above the in vivo distension. Intimal folds were largely flattened, especially in experiments with the largest distension, but were clear among those with the least distension.

Animals↗
PubMed1981

On caecal synthesis and absorption of amino acids and their importance for nitrogen recycling in willow ptarmigan (Lagopus lagopus lagopus).

The willow ptarmigan has two large caeca housing dense populations of microorganisms. Urine, containing uric acid, is transported from the cloaca into the caeca when these are filled. Here the uric acid is rapidly broken down, suggesting that the caeca take part in a recycling of excretory nitrogen. In this work it is shown that ammonia produced by the uric acid decomposition is incorporated into new amino acids in a glutamic dehydrogenase catalyzed reaction. We have, however, not been able to detect any absorption of amino acids from the caeca, indicating that nitrogen recycling via the amino acid route does not occur.

Absorption↗