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Biomedical subjects

R Handley

Publications and source records attributed to R Handley.

At least 19 recordsLinked to original sources
PubMed2000

The use of interlocked 'customised' blade plates in the treatment of metaphyseal fractures in patients with poor bone stock.

Balanced and stable fixation in metaphyseal fractures and nonunion can be difficult because of osteoporosis, disuse osteopenia, comminution, joint proximity or malignant infiltration. Five patients with nonunion and four with comminuted or pathological acute fractures of metaphyseal areas of the tibia or humerus were treated with a 'customized' interlocked blade plate. The plates are standard AO dynamic compression plates of a suitable length that are bent to an acute angle in an industrial vice and 'interlocked'. The nine patients with a mean age of 62.2 years (range 30-91) were followed up for a mean of 7.2 months. At follow-up all fractures had healed with a single complication of subacromial impingement in a patient with a proximal humeral fracture.

Adult↗
PubMed1998

'Clearance' of cervical spine injury in the obtunded patient.

The need to exclude cervical spine injury ('clearance') in an obtunded patient poses a dilemma. The purpose of this study was to find out the current practices for tackling this situation around the country. A questionnaire was sent to all Intensive Care Units who accept injured patients. There is a great diversity in the management and investigation of these patients. There is clearly a need for a recognised protocol for dealing with this difficult situation. Such a protocol is suggested.

Cervical Vertebrae↗
PubMed1997

Novel Chemiluminescent Substrate and Probe Systems for the Identification of CFDeltaF508 Genotypes.

Background: Chemiluminescence detection systems are rapidly gaining popularity as safer alternatives to isotopic methods in molecular diagnostics with equal sensitivity and specificity. In addition, they offer versatility of detection because of the availability of different haptens for labeling the probes, the antihapten antibodies conjugated with either alkaline phosphatase (AP) or horseradish peroxidase (HRP), and their respective chemiluminescent substrates. A novel dual chemiluminescent substrate (AP and HRP based) and probe systems to distinguish genotypes of cystic fibrosis DeltaF(508) mutation are described. Methods and Results: Two methodologies have been formulated to identify positively the genotypes of the cystic fibrosis DeltaF(508) mutation. In method 1, a pair of oligonucleotides designed to anneal to the fanking regions of DeltaF(508) mutation are differentially labeled with the hapten biotin or fluorescein and ligated using the template DNA of wild-type (N/N), heterozygous (N/DeltaF(508)), and homozygous (DeltaF(508)/DeltaF(508)) genotypes. The ligated product containing both labels is detected by first binding with avidin-HRP and anti-fluorescein-AP followed by reaction with the dual substrate. As expected, the ligation products are detected only in n/DeltaF(508) and DeltaF(508)/DeltaF(508) genotypes but not in N/N, where the ligation is precluded by the presence of three intervening nucleotides. In method 2, the three genotypes are hybridized on a membrane simultaneously with uniquely labeled (biotin or digoxigenin) oligonucleotides each designed to bind either the normal or the mutant allele. On treatment with HRP- and AP-conjugated antibodies followed by reaction with the dual substrate, only the band from N/DeltaF(508) genotype emitted a strong signal because of the binding of both oligonucleotides. Conclusions: The ligation and hybridization methods in conjunction with the dual substrate can detect and differentiate the genotypes with the DeltaF(508) mutation. These formats may be valuable for distinguishing normal individuals from carriers in population screening and fetuses that are heterozygous, from those that are homozygous for cystic fibrosis DeltaF(508) in prenatal and neonatal diagnosis.

Journal Article↗
PubMed1988

Deferred treatment for prostate cancer.

The clinical outcome of 278 prostate cancer patients managed by a deferred treatment policy was analysed retrospectively. Following TURP or biopsy, all patients were asymptomatic and deemed suitable for management by a deferred treatment policy, i.e. hormone therapy or other forms of treatment were only initiated if and when symptomatic progression occurred. The overall 5-year survival rate was 30%; 18% of patients died from other causes without needing treatment for their prostate cancer; 11% were alive and untreated after 5 years' follow-up; 17% died from prostate cancer without further treatment. Poor tumour grade, anaemia, metastatic disease, a short history, presentation with retention, and a raised serum creatinine at presentation were associated with a poor prognosis.

Aged↗
PubMed1986

Expressed emotion: from predictive index to clinical construct.

Expressed emotion, a measure of family attitudes toward psychiatric patients that is predictive of relapse, has attracted renewed attention recently as interest in the chronic psychiatric patient has widened. The authors review the development of the concept and the limits of its meaning. In seeking the core clinical construct underlying the expressed emotion variable, the authors also review recent studies of the relationship of expressed emotion to family interaction patterns, physiological arousal states, precipitants of relapse, and parental personality style. While family intervention studies are necessary to demonstrate that expressed emotion influences outcome in psychiatric patients, methodological limitations in currently available studies leave this issue unresolved.

Adolescent↗
PubMed1982

The development and in vitro evaluation of acrylic strips and dialysis tubing for local drug delivery.

This study reports on the development of drug containing acrylic strips for delivering antimicrobial agents and compares the in vitro release pattern with dialysis tubing. Polyethylmethacrylic strips of suitable dimensions containing 10 to 50% chlorhexidine acetate, 40% metronidazole and 40% tetracycline were prepared. Daily release of the incorporated drugs into 1 ml aliquots was measured spectrophotometrically over a 14 day period. Similarly the release of chlorhexidine gluconate from various lengths of patent and heat sealed dialysis tubing was recorded for 4 days. At 30%, 40% and 50% admixtures the acrylic strips released chlorhexidine up to the 14 day period and a parallel bioassay confirmed the maintenance of antibacterial activity to this time. At the same admixture the release of metronidazole was greater than chlorhexidine and tetracycline. All drugs were released at high levels on day 1 followed by a marked fall in release by day 2 and progressive fall thereafter. The release from tubing was almost total within 24 hours and was independent of sealing the ends. The strips appear to have potential for prolonged drug delivery to periodontal pockets. Preliminary clinical use revealed no patient acceptability problems and alterations in subgingival flora were produced.

Chlorhexidine↗
PubMed1981

The effects of drug and water incorporation upon some physical properties of cold cured acrylic.

The addition of drugs to the cold cured acrylics has been demonstrated to variably affect their mechanical properties. This study investigated the effects, to the mechanical properties of a cold cured denture base material, of the addition of drugs and water. Chlorhexidine acetate was incorporated into the denture reline material at 10% w/w in the polymer phase of the material. Specimens also contained 10, 20, or 30% water w/w in the monomer phase of the material with or without the drug. The hardness of the specimens decreased with the addition of water to drug containing or drug-free specimens. Furthermore, there was a significant reduction in the modulus of elasticity of the material with the addition of drugs and water or water alone, which was progressive as the amount of water increased. The load at fracture was similarly reduced as the water incorporation increased. The results demonstrated the considerable effects drug and water incorporation had upon the material. However, this would not negate the use of the material in the oral cavity in the reline or rebase situation employing existing prostheses. Moreover, the reduction in material strength may have the advantage of progressive loss of material with a resulting improved release pattern of the contained drug.

Chemical Phenomena↗
PubMed1981

The effects of the incorporation of chlorhexidine acetate on some physical properties of polymerized and plasticized acrylics.

The effects on the water uptake and weight loss of the incorporation of chlorhexidine acetate in heat cured acrylic and an acrylic gel soft liner was determined. Hardness and transverse bend measurement were similarly made for admixtures to heat and cold cured acrylics. Following soaking in water for 87 days the heat cured test specimens demonstrated an initial weight gain followed by a progressive loss, the soft liner test specimens however all showed weight gains. Drying back specimens to constant weight revealed significantly greater weight losses in test compared to control specimens for both the cured acrylic and gel liner. However these weight losses were less than the chlorhexidine content for 5 and 10% admixtures. Hardness and moduli of elasticity measurements were significantly reduced for heat and cold cured acrylics containing chlorhexidine. The property changes observed in the materials would be consistent with the pattern of incorporation of chlorhexidine into the matrix. However, these do not negate the carriage of medicaments in these materials for prolonged delivery within the oral cavity, if employed as rebase or reline materials in existing prostheses.

Acrylates↗
PubMed1968

Uptake of Carrier-free Cs by Ramalina reticulata.

The uptake of carrier-free (137)Cs by Ramalina reticulata Kremp. does not appear to be directly linked to metabolism. The results indicate the presence of a barrier to entry of (137)Cs. The barrier is stabilized by Ca ions. Removal of Ca by pretreatment of the tissue in monovalent salt solutions increases the uptake of (137)Cs. Uptake under anaerobiosis is also greater than normal, but in this case, Ca displaced from the barrier membrane is not lost from the tissue and normal permeability is rapidly re-established when aerobic conditions are restored. Under anaerobiosis Ca(2+) increases damage to the respiratory mechanism presumably by increasing retention of toxic products.

Journal Article↗
PubMed1966

Potassium Loss and Changes in the Fine Structure of Corn Root Tips Induced by H-ion.

The effects of H, Ca, and anaerobiosis upon loss of K to ambient solutions, upon changes in the fine structure, and upon the respiration of corn root tissue were studied. In the pH range 5.5 to 8.0 losses of K decreased with decreasing H concentration. Ca reduced K loss greatly in the lower part of the pH range but with increasing pH the effect of Ca declined. Losses of K under N(2) were much greater than those measured under air but the same effects of H and Ca were found. The effect of phosphate upon K loss was found to depend upon pH, temperature and the state of development of the tissue.In pure H(2)O or dilute HCl no obvious derangement of the fine structure of meristematic cells was found to occur in 3 hours above pH 4.4 except attenuation of the groundplasm. At pH 4.4 and below, serious injury was found. The presence of CaCl(2) or NaCl in the treatment solution greatly ameliorated the effect of H, CaCl(2) being effective at minute concentration (0.01 meq per liter). NaH(2)PO(4) was without any great effect. Anaerobiosis at neutral pH produced severe tissue damage.In contrast to anaerobic treatments, aerobic treatments (pH 5.8) resulting in large losses of K were not accompanied by any diminution of the respiratory rate.

Journal Article↗