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Biomedical subjects

P W Brand

Publications and source records attributed to P W Brand.

At least 19 recordsLinked to original sources
PubMed2006

Pressure sore--the problem.

The problem is that when the surface of the body is denervated, it is liable to break down from a number of widely different mechanical stresses. The obvious common factor of denervation or loss of sensation has allowed many workers to assume that loss of nerves is the most significant element in the aetiology of these pressure sores. Hence, the term 'trophic' ulcer, which suggests that some trophic, or nourishing, element is missing from tissues which are not supported by intact nerves. The nature of this trophic factor is not understood and therefore its influence is difficult to measure and still more difficult to control. We have found that a more fruitful approach to the problem is to concentrate upon the biology and the mechanics of the breakdown of normal surface tissues, and then see if it is very different from the biology and mechanics of the breakdown of denervated tissues.

Animals↗
PubMed1997

A personal revolution in the development of clubfoot correction.

This article presents the author's experience of having worked in London, England, under Denis Browne, whose method of treating equinovarus in the newborn involved manipulation of the baby feet until full correction had been achieved at the very first visit. The feet were then strapped to the sole plates of the Denis Browne splint, which ensured that the baby's normal kicking action maintained mobility at the subtalar joints and also a basic plantigrade posture. When he transferred to India, the author found a large population of children who had been born with talipes equinovarus, but who had never had treatment. He worked at obtaining correction without strong manipulation, using serial plaster casting followed by Denis Browne's splints. His personal reactions to the problems and the merits of the two methods forms the subject of this article.

Casts, Surgical↗
PubMed1991

Correlation of physiological cross-sectional areas of muscle and tendon.

Muscle physiological cross-sectional area, as defined and measured by dividing the volume of the muscle by its fibre length, is proportional to the maximum strength of the muscle. It is one of the important parameters when considering muscle mechanics in sports science and, clinically in tendon transfer procedures. This study reports that tendon cross-sectional area correlated well with the physiological cross-sectional area of associated muscles.

Adult↗
PubMed1989

Spatial variations of the 3 micron emission features within UV-excited nebulae: photochemical evolution of interstellar polycyclic aromatic hydrocarbons.

We have obtained 3 microns spectra at several positions in the Orion Bar region and in the "Red Rectangle," the nebula surrounding HD 44179. The recently discovered weak emission features at 3.40, 3.46, 3.51, and 3.57 microns (2940, 2890, 2850, and 2800 cm-1) are prominent in the Orion Bar region. The 3.40 microns and 3.51 microns features increases in intensity relative to the dominant 3.29 microns (3040 cm-1) feature when going from the ionized to the neutral zone across the Orion Bar. However, only a weak and rather broad 3.40 microns feature is present at the position of HD 44179. These spectra demonstrate that some of the 3 microns emission components vary independently of each other and in a systematic way within UV-excited nebulae. This spatial variation is discussed in terms of the UV excitation and photochemical evolution of polycyclic aromatic hydrocarbons and related molecular structures. The spatial behavior of the weak emission features can be understood qualitatively in terms of hot bands of the CH stretch and overtones and combination bands of other fundamental vibrations in simple PAHs. An explanation in terms of emission by molecular sidegroups attached to the PAHs is less straightforward, particularly in the case of the Red Rectangle and other evolved mass-losing objects. We estimate PAH sizes of 20-50 carbon atoms based on the susceptibility of PAHs to destruction by the far ultraviolet fields present in the Orion Bar and the Red Rectangle; the size range is similar to independent estimates made previously.

Astronomical Phenomena↗
PubMed1988

Biomechanics of tendon transfers.

There are just two variables that define the mechanical qualities of each muscle. One is its potential for generating tension, and the other is the distance through which tension can be exerted. Tension capability can be increased in a muscle by exercise. There is no way to increase potential for excursion except by reattaching a muscle at surgery with extra length and tension, at the risk of involuntary contractions during healing that may result in avulsion. Single muscle may control several joints in series but cannot selectively vary the torque delivered at each. Therefore, when working against distal opposing forces, it is necessary to have separate muscles to add torque to proximal joints; or it may be advisable to reduce the number of joints to be controlled by fusing one or more of them, or sometimes by depending on tenodesis or other passive support.

Biomechanical Phenomena↗
PubMed1987

Bone loss in limbs with decreased or absent sensation: ten year follow-up of the hands in leprosy.

Three hundred and sixty-seven patients with insensitive hands have been studied by correlating radiologic findings with occupational and medical history in order to better define causal factors in bone resorption. This study indicates that nonspecific infection and trauma are the reasons for bone resorption in 98% of cases. The role of intermittent pressure seems to be in soft tissue breakdown, which then allows bone to become infected. Bone resorption can be arrested at any stage of the disease by appropriate therapy of splinting and control of infection.

Bone Resorption↗
PubMed1987

A standard for dorsal-plantar and lateral radiographic projections of the feet.

Several attempts have been made to persuade physicians to establish standardized projections of foot radiographs. However, standards have not been widely accepted. Further advancement toward quantification of deformity and surgical criteria is delayed due to a lack of universally accepted technique. Procedures for obtaining two precise projections of the foot are described.

Body Weight↗
PubMed1985

Median nerve function after tendon transfer for ulnar paralysis.

This is a long term follow-up study of the median nerves of 128 leprosy patients who originally had pure ulnar palsy for which they had tendon transfers to correct claw hand. Of the thirty-one cases in which the carpal tunnel was not used as a pathway for tendon grafts, 16% developed median palsy in the subsequent years. Of the ninety-seven cases in which tendon grafts were passed through the carpal tunnel, 7% developed a transient median nerve palsy and 11% developed permanent median palsy. None of the median nerve palsies developed during the weeks or months of post-operative re-education or observation, but were noted at follow-up visits months or years later. It is concluded that the use of the carpal tunnel did not significantly affect the status of those high-risk median nerves in cases of leprosy.

Follow-Up Studies↗
PubMed1981

Relative tension and potential excursion of muscles in the forearm and hand.

Muscle strength varies enormously from person to person and even from time to time, but the ratio of strength from muscle within the same limb varies much less. The mass or volume of a muscle is proportional to its work capacity, and the fiber length of a muscle is proportional to its potential excursion. By dividing the fiber length into the volume of each muscle, the cross-sectional area of the muscle was determined, and a list of relative tension capacities of forearm and hand muscles was prepared. Although based on a small number of specimens, this list has the first data on forearm and hand muscles which should be of practical use in planning the operation of tendon transfer.

Biomechanical Phenomena↗
PubMed1979

Management of the insensitive limb.

The limb or part of a limb that becomes insensitive often is destroyed or must be amputated. This is largely due not to intrinsic weakness of the limb but to damage from external forces that would normally be avoided by the person experiencing a warning pain. When the lack of pain sensation can be compensated for, the insensitive limb need not become damaged. Techniques for protecting the insensitive foot and hand are presented.

Foot↗