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Biomedical subjects

J D Hutchison

Publications and source records attributed to J D Hutchison.

At least 19 recordsLinked to original sources
PubMed2004

Sir John Struthers MD FRCS Edin LLD Glasg: anatomist, zoologist and pioneer in medical education.

Sir John Struthers (1823--1899), a past president of the Royal College of Surgeons of Edinburgh and Regius Professor of Anatomy at the University of Aberdeen, was an accomplished scientist and medical educator. Much of his career was spent in shaping the medical curriculum of the nineteenth century. He was a strong proponent of a sound basic science education as preparation for a career in medicine, but was also central in developing more formal clinical teaching for medical students. His interest in comparative anatomy and evolution has provided a rich legacy of human and zoological specimens that remain of value in everyday teaching. Much of his work on educational theory and the place of basic sciences in the medical curriculum remains relevant to this day, and is of particular interest given the ongoing debate regarding the place of the basic medical sciences in the undergraduate medical curriculum

Anatomy, Comparative↗
PubMed2003

Disturbance of pro-inflammatory cytokines in post-traumatic psychopathology.

BACKGROUND: Post-traumatic psychopathology (PTP) is important to the orthopaedic surgeon as it may complicate the recovery from musculoskeletal injury. PTP is associated with a disturbance of the hypothalamic-pituitary-adrenal axis, and may lead to impaired healing. We have investigated the relationship between PTP and pro-inflammatory markers of the metabolic response to trauma. MATERIALS AND METHODS: A prospective cohort study of 82 patients with musculoskeletal injuries, correlating development of psychopathology (measured by general health questionnaire) and pro-inflammatory markers (CRP, IL-6, sIL-6r, TNF-alpha) two and six months after their injury. RESULTS: Psychological disturbance was found in 39% of patients at two months and 18% at six months. This disturbance was associated with significantly increased levels of IL-6 at two months and of sIL-6r and TNF-alpha at six months. CRP levels were not related to the development of PTP. CONCLUSIONS: The relationship between PTP and disturbances of pro-inflammatory markers needs further exploration, but may explain in part the impaired functional recovery when musculoskeletal trauma is complicated by psychological disturbance.

Accidents, Traffic↗
PubMed2001

Osteoarthritis as a systemic disorder including stromal cell differentiation and lipid metabolism.

For many years articular cartilage has been the focus of research aimed at improving understanding of and treatment for osteoarthritis. Although much is known about the tissue, research has had little success in elucidating the pathogenesis of generalised osteoarthritis. A new hypothesis is required. Substantial changes in many tissues, including bone, muscle, ligaments, and joint capsule, as well as cartilage, are increasingly recognised in this disease, and not all these changes are localised to the affected joints. There is also a well established link with obesity. These observations, the common origins of the mesenchymal cells that maintain these tissues, and the possible role of neuroendocrine factors that can regulate bone mass, result in the hypothesis that systemic factors that include altered lipid metabolism could explain the diversity of physiological changes in generalised osteoarthritis. If proven, this hypothesis could have important implications for a new approach to pharmacological intervention in the early stages of the disease.

Adipocytes↗
PubMed2001

C-reactive protein and interleukin 6 receptor in post-traumatic stress disorder: a pilot study.

BACKGROUND: it has been reported that psychological stress in humans is associated with a derangement of biological homeostasis. This pilot study aimed to examine the inflammatory response to post-traumatic stress disorder (PTSD) through measurements of the serum levels of the receptor to interleukin 6 (sIL-6r) and C-reactive protein (CRP), in relation to measures of psychological disturbance. METHODS: 15 patients with established PTSD and eight control patients with musculoskeletal injuries were studied at least three months after their index trauma. All completed revised impact of events scale (RIES), Davidson's trauma scale (DTS) and the general health questionnaire (GHQ), and gave blood samples that were assayed for CRP and sIL-6r. Statistical analysis was by the Mann-Whitney U-Wilcoxon rank sum tests. RESULTS: positive relationships were found between sIL-6r and the RIES intrusion score (P=0.026), and between CRP and DTS intrusion scores (P=0.016), GHQ depression (P=0.028), and RIES intrusion (P=0.044) in the case group. DISCUSSION: we have demonstrated a relationship between post-traumatic psychological and biological disturbance, which provides the basis for further research on the effects of psychological disturbance on physical recovery after injury.

Adolescent↗
PubMed2001

Association between COLIA1 Sp1 alleles and femoral neck geometry.

Genetic factors play an important role in the pathogenesis of osteoporosis by affecting bone mineral density and other predictors of osteoporotic fracture risk such as ultrasound properties of bone and skeletal geometry. We previously identified a polymorphism of a Sp1 binding site in the Collagen Type 1 Alpha 1 gene (COLIA1) that has been associated with reduced BMD and an increased risk of osteoporotic fractures in several populations. Here we looked for evidence of an association between COLIA1 Sp1 alleles and femoral neck geometry. The study group comprised 153 patients with hip fracture, and 183 normal subjects drawn at random from the local population. Femoral neck geometry was assessed by analysis of pelvic radiographs in the fracture patients and DXA scan printouts in the population-based subjects. The COLIA1 genotypes were detected by polymerase chain reaction and were in Hardy Weinberg equilibrium: "SS" = 222 (66%); "Ss" = 105 (31.3%); and "ss" = 9 (2.7%). There was no significant difference in hip axis length or femoral neck width between the genotype groups, but femoral neck-shaft angle was increased by about 2 degrees in the Ss/ss genotype groups (n = 114) when compared with SS homozygotes (n = 222) (P = 0.001). Previous studies have suggested that an increased femoral neck-shaft angle may increase the risk of hip fracture in the event of a sideways fall by influencing the forces that act on the femoral neck. The association COLIAI genotype and increased femoral neck angle noted here may therefore contribute to the BMD-independent increase in hip fracture risk noted in previous studies of individuals who carry the 's' allele.

Aged↗
PubMed1999

Optimizing the configuration of cement keyholes for acetabular fixation in total hip replacement using Taguchi experimental design.

Cement fixation of the acetabular component is increasingly recognized as a common site of loosening when hip replacements fail. Cement keyholes drilled into the acetabulum have been recommended to improve this fixation but little is known of the optimum positions or sizes of these holes. This study investigates the diameter, depth and number of keyholes to be drilled to maximize the failure torque in a model system. A Taguchi experimental design was used to identify the most significant factors and to predict the best configuration of keyholes within the constraints of the experimental test rig. One hole at each of the pubic, iliac and ischial sites, of 12 mm diameter and 6 mm depth, was found to be the optimum configuration. The failure torque was most strongly dependent on the hole diameter in the pubic region, decreased with increasing hole depth and was not sensitive to the number of holes.

Acetabulum↗
PubMed1997

Infection associated with the use of allograft bone from the north east Scotland Bone Bank.

To assess the rate of infection associated with use of banked allograft bone, the case records of patients receiving banked bone over one year were reviewed. The notes of patients undergoing autografting procedures during the same period were reviewed as controls. Eighty-two patients received 98 banked allograft femoral heads and there were 10 proven infections (12.2%). Fifty-seven patients had autograft procedures, with two cases of infection (3.5%). The results of bacteriological surveillance of grafts harvested during the same period were analysed; there was a discard rate due to bacterial contamination of 1.3%, and two patients received three contaminated grafts, one of these patients suffering a postoperative infection. The failure rate of procedures was 50% where there was postoperative infection and 4.2% where there was none. Procedures using banked allograft bone have a substantial infection risk, and this is associated with a much higher rate of failure of the procedure. Prospective audit of allograft use should be applied to reduce this risk.

Bone Banks↗
PubMed1997

Ipsilateral fractures of the proximal ulna and distal radius (Colles type).

A 43-year-old female fell backward outside her home while carrying a watering can. She sustained an ipsilateral fracture of the proximal ulna and distal radius (Colles fracture). The ulnar fracture was plated, and the Colles fracture was managed by closed reduction and percutaneous Kirschner wiring. The patient recovered without incident. This association of forearm fractures is unusual. Both fractures can be caused by a fall on the hand with the wrist in mid-extension and the elbow flexed, and they probably occurred in quick succession.

Accidental Falls↗
PubMed1996

Seasonal differences in biochemical parameters of bone remodelling.

AIMS: To compare bone remodelling parameters in late autumn and early spring in 20 post-menopausal women. METHODS: The parameters measured were serum osteocalcin and its apparent degree of carboxylation (measured by hydroxyapatite binding), total and bone specific alkaline phosphatase and urinary bone resorption markers, (pyridinoline and deoxypyridinoline). RESULTS: Serum osteocalcin concentrations were lower in autumn than in spring but the degree of carboxylation was similar. Total and bone specific alkaline phosphatase activities in serum were higher in autumn than in spring. These results support previous observations. However, notable and previously unreported changes in urinary bone resorption markers were observed. Pyridinoline concentrations were lower and deoxypyridinoline higher in autumn compared with spring. The ratio of pyridinoline:deoxypyridinoline was therefore very different between the seasons. CONCLUSIONS: The results clearly demonstrate that seasonal changes in these variables of bone remodelling must be taken into consideration when designing, reporting or analysing studies of bone metabolism in vivo.

Aged↗
PubMed1996

Antibiotic prophylaxis: theory and reality in orthopaedics.

Marked differences were found when prophylactic antibiotic regimens and accuracy of administration were compared in the orthopaedic trauma and elective surgery units of one city. Consultants carrying out elective, primary joint replacements advocated similar antibiotic policies. There was 100% compliance in correct prescription and over 99% in administration of antibiotic doses. An audit of eight surgeons who undertook emergency surgery on adult hip fractures found three different prophylactic antibiotic regimens and that half of the consultants wished no antibiotics to be given. Only 33% of the patients were prescribed the schedule that their consultant wished and there were frequent inaccuracies in dose administration. Of 48 doses prescribed, five were omitted and in addition, four were recorded as having been given although they were unprescribed. Whilst antibiotic prophylaxis is universally accepted and the drugs are prescribed and administered accurately in cases of elective joint arthroplasty, the converse is true for emergency hip surgery.

Adult↗
PubMed1995

Measurement of lower limb blood flow in patients with neurogenic claudication using positron emission tomography.

STUDY DESIGN: Ten subjects (seven with neurogenic claudication and three control subjects) underwent examination of lower limb muscle blood flow before and after exercise using positron emission tomography. OBJECTIVES: To investigate the hypothesis that lower limb muscle ischemia was the origin of symptoms in neurogenic claudication. BACKGROUND: Patients with neurogenic claudication secondary to spinal stenosis experience lower limb discomfort after exercise similar to that of ischemic claudication. However, they do not have clinical evidence of peripheral vascular disease. The authors postulated that the lower limb discomfort in patients with neurogenic claudication may arise from muscle ischemia due to inadequate dilatation of arterioles in response to exercise, this itself arising secondary to sympathetic dysfunction due to spinal stenosis. METHOD: Using O15-labeled water and positron emission tomography measured thigh and leg muscle blood flow response to exercise bilaterally in seven patients with unilateral neurogenic claudication and three control subjects were measured. RESULTS: The average values obtained for mid-thigh and mid-calf muscle perfusion at rest were 2.57 ml/min/100 g tissue (2.23-3.90) and 2.39 ml/min/100 g tissue (2.03-3.46), respectively. The average values obtained from mid-thigh and mid-calf perfusion after exercise were 4.41 ml/min/100 g tissue (2.8-6.0) and 4.87 ml/min/100 g (2.2-11.7). We found no difference in muscle perfusion between symptomatic and asymptomatic limbs in this group of patients. CONCLUSION: These studies suggest that muscle ischemia is not the origin of symptoms in most patients with neurogenic claudication.

Adult↗
PubMed1995

Carboxylation of osteocalcin in post-menopausal osteoporotic women following vitamin K and D supplementation.

The effect of vitamin supplements on bone metabolism indices in patients with osteoporosis has received scant attention in the literature. Over a 2-week period, vitamin supplements of K and K+D were given to 20 post-menopausal osteoporotic women with previous Colles fractures. Osteoporosis was confirmed by bone mass measurements that demonstrated that broadband ultrasound attenuation (os calcis) was almost as discriminatory as dual energy X-ray absorptiometry (spine and hip) in Colles fracture patients compared with matched controls. Vitamin K corrected the carboxylation defect in osteocalcin and while less marked 4 weeks later, the improvement was still detectable. The result after K+D was similar. The level of carboxylation became the same as in premenopausal women. Total osteocalcin level (bound) osteocalcin. While there was vitamin K correctable undercarboxylation of osteocalcin, simultaneously there was no evidence of undercarboxylation of prothrombin.

Absorptiometry, Photon↗
PubMed1994

Glucose translocation and metabolism in the rat jejunum perfused in once-through mode in vitro.

Simultaneous once-through luminal and vascular perfusions with glucose of rat jejunum in vitro were used in an attempt to resolve conflicting reports on glucose metabolism in jejuna perfused in once-through mode in vivo and in recirculation mode in vitro. Results include: (a) respiration rates during each perfusion, (b) CO2 production from absorbed glucose, (c) absolute rates of glucose absorption from the lumen into the epithelium, (d) absolute rates of glucose translocation from lumen to vascular bed, (e) absolute rates of lactate excretion into the two perfusion media, (f) recoveries of absorbed glucose, (g) the distribution of radioactivity among translocated glucose and its metabolites. About 50% of the total lactate originates in the glucose extracted from the vascular medium during concomitant absorption and translocation of luminal glucose. The results suggest what further experiments need to be done. Results from recirculation perfusions in vitro cannot contest or confirm the results quoted from experiments conducted with once-through perfusions in vivo.

Animals↗
PubMed1994

Collagen organization in the crural interosseous membrane and its relationship to fibular osteotomy.

The organization of collagen fibres in the crural interosseous membrane was measured using X-ray diffraction. The fibres were found to be highly aligned and steeply angled in a distal direction from tibia to fibula with a mean angle of 13 degrees. This organization will lead to a very stiff, ligament-like structure which will transmit forces to the tibia generated by the muscles attached to the fibula. It also suggests an optimum site for a fibular osteotomy about 4 cm distal to the tibial fracture site.

Aged↗
PubMed1991

Lactate is not a major product of glucose metabolism in the respiring jejunum perfused in the recirculation mode in vitro.

Yields of lactate from glucose absorbed from the luminal medium and extracted concurrently from the vascular medium of the perfused rat jejunum in vitro were half those previously reported from comparable glucose concentrations in the recirculated perfusion media. These low yields were obtained by maintaining perfusion medium flow rates and pressures pharmacologically at values found in vivo; permitting normal peristalsis; and restoring the depleted glyceric acid-2,3-bisphosphate and reduced deformability of out-dated blood-bank erythrocytes to normal physiological values before they were added to the vascular perfusion medium and equilibrated at 37 degrees C with air/CO2. Respiration rates are recorded for the first time in each perfusion experiment. A substantial fraction of glucose consumed in this and all earlier recirculation perfusion experiments in vitro has still to be accounted for.

Animals↗