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Biomedical subjects

K M Clarke

Publications and source records attributed to K M Clarke.

5 recordsLinked to original sources

Intestine submucosa and polypropylene mesh for abdominal wall repair in dogs.

Continuing investigations of abdominal body wall reconstruction materials suggest that unacceptable implant complications continue and that the ideal material has not yet been found. This pilot study compared xenogeneic (porcine) small intestine submucosa (SIS) with polypropylene mesh (PPM) for repair of created partial-thickness (six dogs) and full-thickness (six dogs) abdominal wall defects. Postoperative clinical evaluation of all dogs showed no evidence of implant failure. Dogs were euthanized at 1, 2, and 4 months after surgery. The SIS implants were completely replaced by host tissue at 4 months as determined by immunohistochemistry. The resultant repair was well-organized, smooth, dense collagenous connective tissue that was well incorporated into the adjacent fascia and skeletal muscle fiber bundles. In the full-thickness defect dogs, omentum covered a significantly larger portion of PPM (P = 0.001) and was more firmly attached to PPM (P = 0.0001) compared to SIS/connective tissue repair. We conclude that xenogeneic SIS can be used as an abdominal body wall repair material in the dog and warrants further investigations.

Abdominal Muscles↗

Change processes in a creation of meaning event.

Creation of meaning events are in-therapy change episodes that occur when a patient seeks to understand the meaning of an emotional experience. A performance model of this task was developed in an earlier study. The present study was conducted to determine which client performance components distinguish successful from unsuccessful creation of meaning episodes. Measures of referential activity were also applied to the events and uncovered important features of the therapist intervention that accompanied successful meaning making. The implications of these results for psychotherapy are discussed.

Adult↗

Burn area measurement by computerized planimetry.

A microcomputer system was developed which allows the user to draw the contour of a burn on a diagram on the computer screen. The per cent body surface area is then determined by direct area measurement by the computer. A total of 148 weekly burn diagrams ranging from 1% to 71% (mean, 23.7%) body surface area burn in 59 patients were analyzed using this system. Excellent correlation between the computer system and the manual Lund and Browder chart method (correlation coefficient, 0.962; p less than 0.0001) was obtained. Computerized planimetry provides a rapid, simple method of recording data and calculating total per cent burn which compares well with the manual Lund and Browder diagram.

Burns↗

The pathophysiology of the anterior tibial compartment syndrome: an experimental investigation.

In an experimental study in dogs of the anterior tibial compartment syndrome, three measurements were taken before, during, and following raising pressure in the compartment: blood flow, muscle function, and peroneal nerve conduction. If fasciotomy was performed within 4 hours, peroneal nerve conduction velocity always returned to normal regardless of amount of pressure or length of time pressure was applied; if performed after 12 hours peroneal nerve conduction velocity did not return to normal at any pressure or time condition, suggesting that irreversible damage to the nerve had occurred. Blood flow, as measured by rate of clearance of Xe133, always returned to normal within 2 hours of fasciotomy regardless of the time postinjury or amount of pressure applied. Muscle function (CPK and LDH) did not always return to baseline with fasciotomy and in some instances the absolute values were higher after fasciotomy. Further clinical studies using these measurements are recommended.

Animals↗

Comparison of intra-articular and epidural morphine for analgesia following stifle arthrotomy in dogs.

We prospectively studied 18 dogs that presented for exploratory stifle arthrotomy, with or without meniscectomy, and lateral extracapsular stabilization as a result of cranial cruciate ligament rupture. Dogs were premedicated with acepromazine, induced with thiopental, and maintained with halothane in oxygen. Preoperatively, dogs were assigned to one of three groups. Group 1 (n = 6) received intra-articular morphine (0.1 mg/kg diluted in 1 mL/10 kg body weight of saline) and epidural saline (1 mL/5 kg body weight saline plus the volume of saline representing 0.1 mg/kg of morphine). Group 2 (n = 6) received intra-articular saline (1 mL/10 kg body weight of saline plus the volume of saline representing 0.1 mg/kg of morphine) and epidural saline (1 mL/5 kg body weight saline plus the volume of saline representing 0.1 mg/kg of morphine). Group 3 (n = 6) received intra-articular saline (1 mL/10 kg body weight of saline plus the volume of saline representing 0.1 mg/kg of morphine) and epidural morphine (0.1 mg/kg of morphine diluted in 1 mL/5 kg body weight saline). The efficacy of each analgesia regimen was evaluated for 6 hours postoperatively with a pain score based on subjective and objective variables. Serum cortisol and blood glucose concentrations were measured. Butorphanol was used to provide analgesia as needed based on a predetermined maximum pain score. Supplemental analgesics were required postoperatively every 2 to 3 hours for 6 hours in all dogs that did not initially receive analgesics (group 2). Pain scores were significantly lower in dogs administered morphine intra-articularly (group 1) and epidurally (group 3) at 30 minutes and 30, 120, and 360 minutes, respectively, compared with dogs that did not initially receive analgesics (group 2). One dog in group 1 and one dog in group 3 required supplemental analgesia with butorphanol. There was no difference between analgesia produced by intra-articular morphine compared with that of epidural morphine. Side effects after intra-articular or epidural morphine were not observed. Intra-articular administration of morphine can produce effective analgesia in dogs comparable with that produced by epidural administration of morphine.

Analgesia↗