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Biomedical subjects

R Kerr

Publications and source records attributed to R Kerr.

At least 19 recordsLinked to original sources
PubMed1992

Fine-needle aspiration biopsy for the measurement of hepatic iron concentration.

The potential application of fine-needle aspiration liver biopsy in the documentation of hepatic iron overload has been assessed in iron-loaded rats. Fine-needle aspiration and standard liver biopsy specimens were obtained from three groups of animals supplemented with oral and parenteral iron for 2 to 6 mo. The mean dry weights of standard and fine-needle biopsy specimens were 7.41 +/- 0.77 (+/- S.E.M.) and 0.57 +/- 0.54 mg, respectively. Hepatic iron in fine-needle aspiration biopsy specimens correlated significantly with hepatic iron in standard liver biopsy specimens as measured by biochemical determination, computerized image analysis and histological grading (r greater than 0.9, p less than 0.001). In conclusion, we have shown that fine-needle aspiration biopsy of the liver can obtain sufficient tissue for biochemical measurement of the hepatic iron concentration in an animal model of iron overload. The clinical applications of fine-needle aspiration liver biopsy in human beings with iron overload is currently being investigated.

Analysis of Variance↗
PubMed1992

Magnetic resonance imaging of tendon and ligament abnormalities: Part II. Pelvis and lower extremities.

Magnetic resonance imaging (MRI) has provided an ideal means, unmatched by other preexisting modalities, of examining musculoskeletal abnormalities, particularly those involving tendons and ligaments in the lower extremities. Lack of motion artifact, convenience of application of surface coil, and absence of overlying structures have made the lower extremities ideally suited to MRI. In addition, the abundance of adjacent adipose tissue provides a superb contrast background. Although evaluation of trauma remains the most common reason for MRI examination, many other conditions may also affect tendons and ligaments. As in other soft-tissue, chondral, and osteochondral lesions, MRI provides exquisite details of abnormalities in these structures. Part II of this review systematically reviews the abnormalities of tendons and ligaments in the pelvis and lower extremities.

Adolescent↗
PubMed1992

Magnetic resonance imaging of tendon and ligament abnormalities: Part I. Spine and upper extremities.

Magnetic resonance imaging (MRI) has proven to be an ideal technique for evaluating tendons and ligaments, which, because of their fibrous structure, have a low signal intensity on all sequences. Trauma and a wide variety of other conditions cause aberrations in the normal appearance of these structures, ranging from minor alterations in shape, size, appearance, and continuity to various changes in signal intensity within the tendon, tendon sheath, and ligament on different sequences. The purpose of this paper is to review MRI findings in patients with abnormalities of tendons and ligaments in the spine and upper extremities.

Aged↗
PubMed1992

Adenosine modulation of calcium currents in postganglionic neurones of avian cultured ciliary ganglia.

1. Calcium currents in postganglionic neurones of cultured 7- to 10-day embryonic avian ciliary ganglia were analyzed under whole-cell voltage-clamp and their modulation by 2-chloroadenosine determined. 2. In the presence of tetrodotoxin (200 nM) in the medium to block the Na+ current and CsCl (105 mM) in the patch-clamp electrode to block the K+ current, two different components of the calcium currents (transient and sustained) were identified on the basis of their voltage-dependent kinetics as well as their sensitivity to the dihydropyridine agonist Bay K 8644 and antagonist nifedipine. 3. The sustained current inactivated very slowly (tau greater than 1000 ms; for test potentials from -20 mV to +40 mV) but was reactivated at a holding potential (Vh) of -40 mV. The current was increased on average over 50% by 1 microM of Bay K 8644 at a test potential of 0 mV and decreased over 35% by 1 microM of nifedipine. 4. The transient current inactivated slowly (tau less than 200 ms; for test potentials from -20 mV to +40 mV), and could be completely reactivated at a Vh of -80 mV. This current was unaffected by Bay K 8644 (1 microM) but reduced on average by 8% with nifedipine (1 microM). 5. The sustained and transient currents were decreased more than 70% by 5 microM of omega-conotoxin and decreased more than 50% by 250 microM verapamil. 6. 2-Chloroadenosine (1 microM) decreased the transient current by over 50% and the sustained current by less than 10%. In the presence of nifedipine (1 microM), 2-chloroadenosine decreased the transient current by over 30% and the remaining sustained current by 35%.In the presence of 8-phenyltheophylline (10 microM), 2-chloroadenosine no longer decreased either the transient or sustained currents but did have a slight potentiating effect on both the transient and sustained currents.7. These observations of the effects of 2-chloroadenosine on the transient and sustained currents are discussed in relation to the different calcium channel types at preganglionic nerve terminals.

2-Chloroadenosine↗
PubMed1992

Hematopoietic bone marrow hyperplasia: high prevalence on MR images of the knee in asymptomatic marathon runners.

In a prior study of marathon runners, we noticed that MR scans of the knee frequently showed hyperplasia of red (i.e., hematopoietic) bone marrow. Because the frequency of this finding in various populations is unknown, the purpose of this study was to determine the relative prevalences of hematopoietic bone marrow hyperplasia on MR examinations of the knees of healthy volunteers (n = 74), patients with symptoms of knee disorders (n = 54), and asymptomatic marathon runners (n = 23). The prevalence of hematopoietic bone marrow hyperplasia was 3% (2/74) for the healthy volunteers, 15% (8/54) for the patients, and 43% (10/23) for the marathon runners. The difference in prevalence between each of the three groups was statistically significant at p less than .05 in each case with hematopoietic bone marrow hyperplasia, the distal femur was the only area affected, while the epiphysis and proximal tibia were uninvolved. This pattern of affected bone marrow with hyperplasia of the hematopoietic marrow may be useful for the differential diagnosis. We postulate that the high prevalence of hematopoietic bone marrow hyperplasia in marathon runners may develop as a response to "sports anemia", which is commonly found in highly conditioned, aerobically trained athletes. Furthermore, this is considered to be a normal variant when found in the pattern described here.

Bone Marrow↗
PubMed1992

Knowledge and motor performance.

Traditionally, motor skill acquisition has implied that the performance of a given individual on a particular skill is dependent on the amount of prior practice of that skill. However, concepts such as schema theory, or kinetic formulae, or the strategic allocation of resources imply that, even when practising specific skills, performers gain knowledge about their own motor performance which can be used or applied to related or novel situations. An attempt was made to relate the performance of a complex psychomotor task to differing levels of motor skill expertise or knowledge (athlete and nonathlete). 20 subjects performed (1600 responses) on a novel pursuit or tracking task. Analysis indicated that the athletes performed significantly better. Their main advantage appeared to be more in their ability to control and produce fast, accurate movements than in their decision-making. Accepting Henry and Rogers' 1960 proposition that there is no such thing as a general motor ability or coordination factor does not imply that the only alternative is for all motor skills to be specific. It is argued that the differences in the present study arose from the athletes' greater knowledge (schema, kinetic formulae) related to their understanding of their own motor capabilities.

Adult↗
PubMed1992

Fluid resuscitation in traumatic hemorrhagic shock.

Fluid resuscitation from traumatic hemorrhagic shock is a critical component of therapy for the critically injured patient. Therapy is aimed at restoring hemodynamic stability and oxygen delivery to tissues. The route and rate of fluid infusion, the temperature of the fluid infused, the type of asanguineous fluids chosen, and the timing of red cell transfusion may all impact substantially on the patient outcome. Complications of fluid therapy, especially edema, may be related to the choice of fluid infused. Identification of hypovolemia and methods to monitor tissue are important aspects of patient care.

Animals↗
PubMed1991

Adenosine modulation of potassium currents in postganglionic neurones of cultured avian ciliary ganglia.

1. Potassium currents in cultured postganglionic neurones of avian ciliary ganglia were analysed under whole-cell voltage clamp and their modulation by adenosine determined. 2. In the presence of tetrodotoxin (200 nM), and with moderate holding potentials (Vh = -40 mV), the steady-state current-voltage (I/V) curve was N-shaped over the range from -70 mV to +155 mV. CsCl (1 M) blocked the current, indicating that it was carried by K+. If Ca2+ influx was blocked by CdCl2 (500 microM) then the outward current was reduced and the N-shaped I-V curve lost, indicating the presence of a calcium-activated potassium current (IK(Ca)); the remaining current, due to the delayed rectifier (IK), increased with depolarization up to about a conductance of 10 nS near + 50 mV. This IK was 50% activated at about +20 mV and 50% inactivated at about -50 mV. Adenosine (10 microM) had similar affects on the N-shaped I/V curve as did CdCl2, indicating that it blocked IK(Ca). However, adenosine had little affect on the steady-state current in the presence of CdCl, indicating that it did not much affect IK. 3. In the presence of tetrodotoxin (200 nM), a large inward current occurred for large hyperpolarizations from a Vh = -50 mV. This inward rectifying current (IIR) had a reversal potential near EK and showed 50% activation at about -130 mV. Adenosine (10 microM) reduced IIR, by as much as 50% at large hyperpolarizations beyond -80 mV. 4. Relaxations of the outward current on hyperpolarization from Vh = -30mV were blocked by carbachol (10 microM), had a reversal potential near EK, and an I/V curve typical of 1M currents. These currents were little affected by adenosine (10 microM). 5. A fast transient outward current, due to depolarizing pulses from a large Vh = -110mV was observed in the presence of tetrodotoxin (200 nM). This had the characteristics of an IA current as it could be blocked with 4-aminopyridine (5 mM) and was 50% activated at about -20 mV and 50% inactivated at about -94 mV. The IA current was reduced by 42% at a depolarization of -20 mV by adenosine (10 microM). 6. Many neurones possessed a fast transient outward current that was blocked by tetrodotoxin (200nM). This current could be blocked with 4-aminopyridine (5mM); it therefore has the characteristics of a sodium-activated potassium current ('K(Na)). This IK(Na) was unaffected by adenosine (1O microM). 7. These results are discussed in relation to the role of adenosine in blocking Ca2 + channels and thereby modifying calcium-dependent components of K+ currents.

Adenosine↗
PubMed1991

Medial dislocation of the biceps brachii tendon: appearance at MR imaging.

Abnormalities of the long tendon of the biceps brachii muscle commonly accompany other lesions about the shoulder, especially rotator cuff rupture, and are a frequent cause of a painful shoulder. The spectrum of abnormalities associated with medial displacement of the biceps tendon seen at magnetic resonance (MR) imaging was reviewed in six patients. MR imaging was performed on a 1.5-T system with use of a dedicated surface coil. The findings at MR imaging were correlated with those at surgery. Two types of medial displacement of the biceps tendon were identified. More frequently observed was a defect in the subscapularis apparatus that allowed intraarticular entrapment of the biceps tendon. Less commonly observed was incomplete dislocation, with the biceps tendon lying between a partially disrupted subscapularis tendon. MR imaging enabled accurate identification of medial dislocation of the biceps tendon and entrapment of the tendon within the glenohumeral joint. MR imaging also demonstrated the associated disruption of the subscapularis tendon that must be present to allow the biceps tendon access to the joint space.

Aged↗
PubMed1991

Alterations in the supraspinatus tendon at MR imaging: correlation with histopathologic findings in cadavers.

To determine the histopathologic correlates of alterations in the rotator cuff at magnetic resonance (MR) imaging, 13 cadaveric shoulders (in subjects aged 26-83 years at the time of death) underwent MR imaging in the coronal oblique plane at 1.5 T with proton-density- and T2-weighted spin-echo sequences. Areas corresponding to sites of MR imaging alterations were then examined histologically. Increased signal intensity on proton-density-weighted images (without further increased signal intensity on T2-weighted images) and an indistinct margin at the articular side of the supraspinatus tendon corresponded to eosinophilic, fibrillar, and mucoid degeneration and scarring. Areas of increased signal intensity on T2-weighted images were associated with severe degeneration and disruption of the supraspinatus tendon. Although other authors have suggested that certain MR findings are indicative of tendinitis, the histologic data in this study were not those of active inflammation but rather tendon degeneration.

Adult↗
PubMed1991

Do asymptomatic marathon runners have an increased prevalence of meniscal abnormalities? An MR study of the knee in 23 volunteers.

Excessive repetitive musculoskeletal loads and stresses associated with intense physical activity may lead to deterioration of the menisci of the knee. Therefore, MR imaging was performed on the knees of 23 asymptomatic marathon runners (eight men, 15 women; average age, 40 years; average number of years training, 10; average training distance per week, 41 miles) to determine the prevalence of meniscal signal abnormalities. None of the runners had previous knee injuries or surgery and each of them regularly competes in 26-mile, 50-mile, or 100-mile marathon races. T1-weighted coronal MR images and proton density-weighted and T2-weighted sagittal images were obtained with a 1.5-T MR system and a transmit/receive extremity coil. The medial and lateral menisci were divided into four portions, or horns, and a total of 92 horns were evaluated (i.e., four horns per knee: medial posterior, medial anterior, lateral posterior, and lateral anterior). Two meniscal horns (2%) had grade 3 signal (grade 3 indicates a meniscal tear), 12 (13%) had grade 2 signal, 29 (32%) had grade 1 signal (grades 1 and 2 are indicative of meniscal degeneration), and 49 (53%) had grade 0 signal (grade 0 is normal). Overall, the prevalence of meniscal tears was 9% (two meniscal tears found in 23 runners). This is lower than the prevalence of MR signal abnormalities indicative of meniscal tears reported for asymptomatic, nonrunner athletes (20% of 20 athletes) and for asymptomatic nonathletes (16% of 74 subjects). Fifty-three percent of the meniscal horns of the nonrunner athletes had grade 1 or 2 signal, indicative of meniscal degeneration. Our results indicate that the prevalence of meniscal tears in marathon runners is no higher than the prevalence reported for sedentary persons, and the runners have the same amount of meniscal degeneration as do nonrunner athletes.

Adult↗
PubMed1991

Tendon injuries of the lower extremity: magnetic resonance assessment.

MR is rapidly establishing itself as a premiere imaging modality for the assessment of musculoskeletal trauma. Its utility in the evaluation of the menisci and ligaments of the knee is well known, but there is far less known about the use of MR for evaluation of the tendons. MR, by virtue of its unmatched soft tissue resolution capability, can determine not only the contour of an affected tendon, but the tendon sheath and internal signal alterations that accompany tendonitis, partial and complete ruptures. Injuries to the Achilles tendon are well known to the athlete and the imager alike; however, abnormalities of the posterior tibial tendon, peroneal tendon, and flexor hallucis longus also result in significant clinical symptoms, as well as imaging abnormalities.

Athletic Injuries↗
PubMed1991

Echinococcal infestation of the spine in North America.

Taenia echinococcal infestation, a parasitic disease rarely seen in the United States, occurred in a 62-year-old man. Bone is involved in about 1% of all cases, and of these cases, the spine is involved in about 50%. Preoperative identification is difficult because of lack of characteristic radiographic features. Successful management is also problematic because of the difficulty of preoperative diagnosis, the invasive nature of the bony involvement, and the variable anaphylactic reaction to the cyst fluid antigen. The diagnosis must be entertained in the differential diagnosis of benign spinal neoplasms especially when dealing with patients from endemic areas.

Echinococcosis↗
PubMed1991

Biliary obstruction secondary to shrapnel.

Foreign bodies of the biliary tree represent infrequent causes of obstructive jaundice. We report a patient who developed biliary obstruction from metal shrapnel, 44 yr after a war injury. From our review of the literature, the syndrome of shrapnel-induced obstructive jaundice may occur many years after the initial injury. In the majority of patients, the missile lodges in the liver parenchyma, and migrates to the common bile duct. Complications from this injury include cholangitis, pancreatitis, and liver abscesses. As demonstrated by this case, computed tomography scan and endoscopic retrograde cholangio-pancreatogram may reliably detect this infrequent occurrence. With the development of therapeutic biliary procedures, many foreign bodies can be removed endoscopically. Thus, one should consider shrapnel-induced biliary obstruction in those patients with obstructive jaundice and prior combat injury.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1990

Nonballistic coincident timing.

A nonballistic coincident timing task was used to assess to what extent retarded subjects could use spatial and temporal information to plan their movements. Subjects did not just respond to events but appeared able to modify/plan their responses, given sufficient time.

Adolescent↗
PubMed1990

Trauma to the foot.

Minor trauma to the foot may cause stress fracture, avulsion fracture or ligamentous and tendon injury. Plain radiographs are frequently normal. Radionuclide bone scan is a sensitive detector of early bone injury. A stress fracture may develop focal uptake or diffuse uptake throughout the bone involved. MR imaging is the most sensitive means of evaluating injury to the soft tissues. Acute edema, partial tear, complete tear, and chronic tendinitis have distinct features on T1- and T2-weighted images. Major trauma occurs most commonly as a result of falls from heights and from motor-vehicle accidents. Plain films are useful in the initial evaluation of the extent of trauma. CT is particularly useful in evaluating calcaneal fractures that involve the subtalar joint. Both MR imaging and CT scans are useful in detecting injured or entrapped tendons associated with fracture-dislocations.

Foot Injuries↗
PubMed1990

Magnetic resonance imaging of foot and ankle trauma.

MRI is a useful diagnostic tool in the assessment of traumatic lesions of the foot and ankle. It is especially useful in demonstrating acute and chronic tendon and ligament injuries. Subtle fractures, including osteochondral, nondisplaced, and stress fractures, are well shown with MRI but may be difficult to detect on radiographs. A bone scan may also be used to detect these fractures; however, with MRI the fracture extent may be determined. MRI is also useful in diagnosing complication of trauma, such as ischemic necrosis and bone and soft-tissue infections.

Ankle Injuries↗