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Biomedical subjects

C Drake

Publications and source records attributed to C Drake.

At least 55 records · Page 3Linked to original sources

In vitro biomechanical comparison of the strength of the linea alba of the llama, using two suture patterns.

OBJECTIVE: To compare the strength of the sutured linea alba, in vitro, using 2 suture patterns. ANIMALS: 12 clinically normal llamas. PROCEDURE: 2 incisions in the linea alba of 12 llamas were closed with a simple continuous or inverted cruciate pattern, and tissue was harvested after 10 days. In 6 llamas the simple continuous line was intact; the inverted cruciate specimens contained 6 sutures. In 6 llamas, 1 knot was excised in the simple continuous pattern to simulate a failed line; the cruciate pattern contained 5 knots. Tissue sections were taken from cranial, between, and caudal to the linea alba incisions to compare fascial thickness. The sutured specimens were mounted in a mechanical testing system and tested to failure. A mixed-model ANOVA was used to evaluate the effects of suture pattern and incisional position on mechanical properties. RESULTS: Significant differences were not found between suture patterns or between location for yield force, failure force, or yield strain, whereas failure strain was lower for the intact simple continuous pattern than the inverted cruciate pattern (P = 0.003). From histomorphometric analysis, the caudal tissue specimens were significantly thinner than the middle tissue specimen cranial to the umbilicus (P = 0.006). CONCLUSION: There was no significant difference in monotonic breaking strength of the linea alba sutured with the simple continuous or inverted cruciate pattern. CLINICAL RELEVANCE: These results justify the use of the simple continuous pattern over the cruciate pattern for ventral midline closure in llamas because of the ease of placement and speed.

Abdominal Muscles↗

Preclinical evaluation of manganese carbonate particles for magnetic resonance imaging of the liver.

RATIONALE AND OBJECTIVES: We characterized the physical, biological, and imaging properties of a manganese (Mn) carbonate particle suspension, a contrast agent for hepatic magnetic resonance (MR) imaging. METHODS: Mn carbonate suspensions were produced by controlled precipitation and characterized using light microscopy, transmission electron microscopy, and in vitro relaxivity studies. Efficacy of the agent was studied in normal and tumor-bearing rats using T1-weighted MR imaging. RESULTS: Following intravenous injection of Mn carbonate particles at doses ranging from 10 to 100 mumol Mn/kg, peak hepatic contrast enhancement of approximately 35% occurred from about 125 min until the termination of the MR imaging studies that varied from 125 to 305 min. Lesion conspicuity was increased because of relative intensity differences between normal liver and tumor. Data also showed that Mn carbonate particles dissolved on delivery to the liver, allowing Mn to interact with intrahepatic macromolecular complexes to provide positive contrast enhancement. CONCLUSION: Mn carbonate particles produce significant and sustained hepatic enhancement and should improve detection of small or isointense liver lesions.

Analysis of Variance↗

Evaluation of meniscal tears: fast spin-echo versus conventional spin-echo magnetic resonance imaging.

RATIONALE AND OBJECTIVES: We compared the performance of fast spin-echo (FSE) with conventional spin-echo (CSE) magnetic resonance (MR) imaging sequences in the detection of meniscal tears. METHODS: Seventy-three patients underwent MR examination of the knee for suspected internal derangement. Each patient was scanned with a CSE sequence and one of two FSE sequences. The primary difference between the two FSE sequences consisted of the echo train length (ETL). Thirty-seven patients (group 1) were scanned with the FSE I sequence (ETL = 8), and 36 patients (group 2) were scanned with the FSE II sequence (ETL = 4). Menisci were graded as torn or not torn on the basis of their MR appearance. The sequences were compared with each other and with the surgical findings in 31 patients who underwent arthroscopy. RESULTS: In group 1, there was a significant discrepancy between the CSE and FSE I techniques (p = .006). The FSE I sequence detected only 11 of 19 surgically proven torn menisci as opposed to 18 of 19 detected with the CSE sequence. The FSE II sequence performed significantly better in group 2, with an accuracy equal to that of the CSE sequence. CONCLUSION: FSE sequences are extremely technique dependent with regard to detecting meniscal tears and should not replace CSE sequences in this setting until further studies are performed to optimize the technique.

Adolescent↗

Prognostic models and the propensity score.

Subjects in observational studies of exposure effects have not been randomized to exposure groups and may therefore differ systematically with regard to variables related to exposure and/or outcome. To obtain unbiased estimates and tests of exposure effects one needs to adjust for these variables. A common method is adjustment via a parametric model incorporating all known prognostic variables. Rosenbaum and Rubin propose adjustment by the conditional exposure probability given a set of covariates which they call the propensity score. They show that, at any value of the propensity score, covariates are on average balanced between exposure groups. Thus matching on the propensity score leads to unbiased estimators and tests of exposure effect. However, the validity of the method depends on knowing the exposure probability. This quantity is usually not known in observational studies and needs to be estimated.

Bias↗

Iodinated nanoparticles for indirect computed tomography lymphography of the craniocervical and thoracic lymph nodes in normal dogs.

RATIONALE AND OBJECTIVES: We evaluated the imaging characteristics of an interstitially or intraperitoneally delivered iodinated particulate contrast agent for computed tomography (CT) lymphography of the craniocervical and thoracic lymph nodes. METHODS: We injected 2-4 ml of 15% wt/vol iodinated nanoparticle suspension subcutaneously, submucosally, or intraperitoneally in eight normal dogs. CT and plain radiographic images were obtained prior to contrast administration and 4 hr, 24 hr, and 7 days after injection. Correlation was made to detailed postmortem assessment. RESULTS: CT images showed enhancement of regional nodes draining injection sites. Mean attenuation of opacified nodes was 313 +/- 297 (mean +/- standard deviation), 536 +/- 453, and 492 +/- 372 Hounsfield units at 4 hr, 24 hr, and 7 days postinjection, respectively. Lymph node opacification on CT images correlated well with node location found at postmortem. CONCLUSION: Craniocervical and thoracic lymph nodes can be effectively opacified from interstitial or intraperitoneal delivery of this iodinated nanoparticulate contrast agent.

Animals↗

Neuropathology of intracranial arteriovenous malformations following conventional radiation therapy.

Conventional fractionated radiation therapy was used in 15 patients to treat arteriovenous malformations (AVMs) of the brain deemed inoperable or incompletely obliterated using endovascular or surgical techniques. The AVMs measured from 0.8 to 85 cm3 (mean 28.2 cm3; median 24 cm3). Angiography in 12 patients 1-21 years following radiation therapy demonstrated no significant change in 7, slight reduction in 2, near complete obliteration in 1, and complete obliteration in 2. Magnetic resonance imaging further demonstrated apparent obliteration in one other case. Three irradiated AVMs were available for pathological examination following fatal recurrent hemorrhage after 21 years in case 1 and following surgery after 5 years in cases 2 and 3. Doses of 20 and 45 Gy were delivered to the area of the AVM in 10 and 15 fractions with a 6-MV linear accelerator in case 1 and in cases 2 and 3, respectively. A blinded histopathological comparison was made of the latter cases and three AVMs removed at surgery that were not previously irradiated and that were comparable in size, number of arterial feeders, and location within the brain. Segmental hyalinization of some blood vessels was seen in both irradiated and nonirradiated cases. The single postmortem specimen showed extensive thrombosis but a patent nidus. The findings are in keeping with the clinical impression that conventional fractionated radiation therapy fails to alter the natural history of cerebral AVMs. The favorable outcome of radiosurgery on small- to medium-sized AVMs appears attributable to the shorter duration of therapy using relatively high-dose prescriptions to the nidus.

Adult↗

Enantioselective enzymatic biotransformation of 2'-deoxy-3'-thiacytidine (BCH 189) monitored by capillary electrophoresis.

Concentrations of the enantiomers of 2'-deoxy-3'-thiacytidine (BCH 189) have been monitored during enantiospecific biotransformation catalyzed by cytidine deaminase. This enzymatic reaction is monitored by capillary electrophoresis (CE) over a 51-h time period. The use of dimethyl-beta-cyclodextrin as a chiral electrolyte additive in a pH 2.3 phosphate buffer system gives enantiomeric separation with results for peak efficiencies, resolution, and analysis time of the order of 25,000 plates, > 1.5 and 30 min, respectively. The features of the CE method are compared with those of the previously favored chiral HPLC method.

Antiviral Agents↗

Tempo sensitivity in auditory sequences: evidence for a multiple-look model.

Differential thresholds for tempi (with interonset intervals ranging from 100 to 1,500 msec) were measured using an adaptive 2IFC paradigm for several types of auditory sequences. In Experiment 1, the number of intervals in an isochronous sequence was varied to compare the sensitivity for single intervals with that for sequences of two to six intervals. Mean relative just noticeable differences (JNDs) decreased as the number of intervals increased (single intervals = 6%, two intervals = 4%, four intervals = 3.2%, six intervals = 3%) and were optimal at intermediate tempi for both sequences and single intervals (as low as 1.5% in the range between 300 and 800 msec). In Experiment 2, the sensitivity for different types of irregular sequences was studied. Globally, JNDs for irregular sequences were of an intermediate level between that observed for single intervals and that observed for regular sequences. However, the closer a sequence was to regularity, the lower its relative JND. Experiment 3 demonstrated that musicians were more sensitive than nonmusicians to changes in tempo, and this was true for single intervals and for regular and irregular sequences, demonstrating the role of training on these abilities. The results are discussed in terms of possible underlying mechanisms, in particular those providing a mental representation of the mean and dispersion of successive interval durations.

Acoustic Stimulation↗

Reproduction of musical rhythms by children, adult musicians, and adult nonmusicians.

Many sequential events, musical rhythms in particular, can be described by a hierarchical structure, with lower order events recursively combining to form higher levels. This study investigated factors influencing the ease of reproduction of short musical rhythms that reflect various organizational principles. For adults and children, reproduction was better for rhythms with the following characteristics: (1) binary rather than ternary subdivision, (2) two rather than three different durations, (3) the ability to be segmented into two shorter rhythms of identical duration, and (4) intensity accents on important hierarchical positions. These findings suggest that a prototypical temporal structure--that is, a regular beat with binary subdivisions--is functional in childhood. The ability to process complex hierarchical structure appeared to be influenced more by musical training than by passive acculturation.

Adult↗

Effects of the 21-aminosteroid U-74389G on ischemia and reperfusion injury of the ascending colon in horses.

Sixteen horses were allotted at random to 3 groups: vehicle only; low dosage (vehicle and 3 mg of U-74389G/kg of body weight); high dosage (vehicle and 10 mg of U-74389G/kg). These solutions were given prior to reperfusion. The ascending colon was subjected to 2 hours of ischemia followed by 2 hours of reperfusion. Before, during, and after ischemia, full-thickness colonic tissue biopsy specimens were obtained for measurement of malondealdehyde (MDA) concentration and myeloperoxidase activity and for morphologic evaluation. Although increases were not significant, MDA concentration and myeloperoxidase activity increased during ischemia and reperfusion. Administration of U-74389G did not have significant effects on MDA concentration and myeloperoxidase activity. However, the lower dosage tended (P = 0.08) to reduce myeloperoxidase activity at 30 and 60 minutes of reperfusion. In horses of the vehicle-only group, ischemia induced a decrease in mucosal surface area that was continued into the reperfusion period (P < or = 0.05). Administration of U-74389G at both dosages (3 and 10 mg/kg) prevented the reperfusion-induced reduction in mucosal surface area, which was significant at 60 minutes (high dosage; P = 0.05) and 90 minutes (low and high dosages; P = 0.02). After initial reduction in horses of all groups, mucosal volume increased for the initial 60 minutes of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

Immersion events in residential swimming pools. Evidence for an experience effect.

BACKGROUND: --Drowning and near-drowning in residential swimming pools are leading causes of morbidity and mortality for young children. We tested the hypothesis that the period immediately after a pool is acquired is a time of high risk for these events. This study was also designed to provide population-based data on swimming pool immersion events, regardless of severity. METHODS: --We conducted a mail survey of a probability sample of Sacramento County, California, households with in-ground swimming pools in January 1988; 80% of eligible subjects responded. Onset of exposure to a pool was defined as the month in which (1) the responding household had a pool installed, or (2) the responding household first occupied a residence with a pool. Exposures began in 1959 through 1987. RESULTS: --The home swimming pool immersion event rate was 11 per 1000 pool-years. The rate per 1000 pool-years was higher for the first 6 months of exposure than thereafter (0 to 6 months, 44; 7 to 24 months, 14; greater than 24 months, seven), but 77% of events occurred outside the high-risk period. For households whose exposures began in 1984 through 1987, the immersion event rate was 51 per 1000 pool-years overall and 123 per 1000 pool-years for the first 6 months of pool exposure; these increases probably represent underreporting of earlier events. In this group, 48% of events occurred outside the high-risk period. The family swimming pool accounted for 91% of immersion events at the respondents' homes. CONCLUSIONS: --The residential swimming pool is an important hazard for pool-owning households. The first 6 months of exposure constitute a high-risk period, but many immersion events occur later. Pool drowning prevention programs may focus on newly acquired swimming pools and their owners but should be as broad as possible to maximize their effectiveness.

California↗

The epidemiology of seatbelt-associated injuries.

This study examined the frequency of spine and abdominal injuries to motor vehicle occupant crash victims, the relationship between the two types of injuries, and the association with restraint use. There were 303 motor vehicle occupants treated at a regional trauma center for spine and/or abdominal injuries over a 5-year period. Patients with Chance-type fractures of the lumbar spine were much more likely to be rear seat passengers and to be using a lap belt than were patients with other types of spinal injuries. Similarly, patients with hollow viscus injuries were more likely to be rear seat passengers and to be lap belted than were patients with injuries to the spleen, liver, pancreas, or kidneys. Nearly two thirds of the lumbar Chance-type fractures were associated with hollow viscus injuries, including six of seven children. This increased risk of Chance-type fractures and hollow viscus injuries was associated with increased use of lap-belt seat restraints in the population.

Abdominal Injuries↗

The inability of young children to reproduce intensity differences in musical rhythms.

A musical rhythm can be described in terms of both its temporal and its dynamic structure. However, although 6-year-old children are able to perceive and reproduce simple temporal structures, even 8-year-olds rarely reproduce intensity differences. Four experiments on the perception and reproduction of musical rhythms by 5- to 8-year-old children demonstrate that even though dynamic structure is clearly dominated by its temporal support, intensity differences play a role in reinforcing the temporal structure. The inability of children to reproduce intensity differences appears to be due neither to an inability to control the intensity of their tap responses nor to the fact that they cannot perceive such changes in intensity. Rather, the results seem best interpreted in terms of the allocation of attentional resources. With simple stimulus material (Experiments 1-3), the children focused on temporal information, and only when the processing of temporal information was mastered did they have "enough attention left" to direct it to intensity differences (Experiment 2). With more complex orchestral music (Experiment 4), attention was primarily allocated to the dynamic structure.

Attention↗

Magnetic resonance imaging of acute occlusive intestinal ischemia.

The mortality of acute superior mesenteric artery occlusion and mesenteric infarction remains high, in part because of the failure to identify the patients with the disorder. A reliable noninvasive diagnostic study may facilitate earlier definitive diagnosis and therapy. Proton magnetic resonance imaging may offer a noninvasive diagnostic alternative. We examined this possibility by using an experimental rabbit model of acute superior mesenteric artery occlusion in this study. Animals were scanned 1 hour after the ischemic insult. Relative intestinal wall signal intensity was increased in experimental (ischemic) animals when compared to sham operated controls on T2-weighted (4.35 +/- 0.5 vs 2.57 +/- 0.31, p less than 0.02) and proton spin density-weighted images (2.1 +/- 0.2 vs 1.4 +/- 0.21, p less than 0.05). Significant increases in image intensity were found on T2-weighted and proton spin density images when compared to control animals. Differences between groups could be further highlighted after the administration of a paramagnetic contrast agent gadolinium diethyltriamine pentacetic acid on T1-weighted images. The data from this preliminary study demonstrate that proton magnetic resonance imaging may be used to discriminate between ischemic and nonischemic small intestine. This noninvasive tool may someday become clinically useful to enhance our diagnostic capabilities when a diagnosis of acute superior mesenteric artery occlusion is being entertained.

Animals↗

Innovations in emergency medical services systems.

This article roughly follows the chronology of an EMS call and discusses innovations in prehospital care, including epidemiology and prevention; precall management (system status management and flexible response); intervention during the call (emergency medicine dispatch); finding the scene; and communications.

Computers↗

A psychological pulse train: how young children use this cognitive framework to structure simple rhythms.

This paper examines the reproduction of both regular rhythms and irregular sequences by 5- and 7-year-old children, concentrating on the important role played by their organization around a pulse train. It is shown that: (a) the closer rhythms are to a regular beat the easier they are to reproduce and the greater are the improvements with age; (b) memory capacity is limited by the number of pulses around which the rhythm is organized rather than by the number of elements it contains; (c) all the children's productions contain two interval lengths that are in a ratio close to 1:2 and arranged in preferential sequences which we have called "stereotypes"; (d) arrhythmic sequences can only be reproduced if the intervals undergo a systematic distortion towards regularity. These results are interpreted in relation to a pulse-train hypothesis which states that on hearing a rhythm an "internal clock" or "time base" is evoked around which the rhythm is structured.

Attention↗

Parental attitudes and practices toward children as pedestrians.

Community programs to reduce the toll from pedestrian injuries in childhood must include parents as a key element. This study, consisting of a survey questionnaire, was undertaken to provide information concerning current parent attitudes and practices that could be used to guide prevention programs. The survey consisted of 2464 questionnaires from parents of children in grades kindergarten to four in a suburban school district. Although 94% of parents did not believe that 5- to 6-year-old children can reliably cross streets alone, one third of parents allowed kindergarten-aged children to cross residential streets alone and first-grade children to walk alone to school. The presence of speeding traffic or the lack of safe places to walk did not influence parents in limiting their children's crossings. Few (17%) parents believed that children should be taught not to cross alone; one half of parents, including 41% of parents of kindergarten-aged children believed that children should be taught to cross busy streets without traffic lights. According to results of the study, parent expectations for their children's pedestrian skills may be inappropriate and may be a fruitful target for injury-prevention programs.

Accidents, Traffic↗