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Biomedical subjects

S R Brown

Publications and source records attributed to S R Brown.

At least 19 recordsLinked to original sources
PubMed2006

Identification of trait loci affecting white meat percentage and other growth and carcass traits in commercial broiler chickens.

White meat is the most economically valuable part of a broiler chicken. Increasing white meat relative to overall body size (white meat percentage, WM%) makes a broiler, gram for gram, a more valuable animal. However, accurately measuring WM% requires removing the bird from the breeding flock. Identification of markers for genomic regions associated with WM% would allow direct genetic selection on breeders. The objective of the current study was to identify genomic regions affecting WM% and other growth and carcass traits in an F2 cross between 2 commercial broiler lines that differed in WM%. Two commercial lines were crossed to generate 5 F1 half-sib families of each reciprocal cross type. One male from each family was crossed with 3 females from each of the other families within each reciprocal cross type. Seven F2 half-sib families, totaling 430 F2 individuals, were analyzed. Microsatellite markers (n = 73) on the 11 largest chromosomes were analyzed for associations with various growth and carcass traits by least squares interval mapping using line-cross, half-sib, combined, and parent of origin models. Sixty-eight QTL were identified at the 5% chromosome-wise level, including 6 QTL affecting WM%. Ten QTL reached 5% genome-wise significance, including 1 WM% QTL on Gga 2. The current study identified genomic regions harboring QTL affecting WM% and other carcass and growth traits, which may be useful for direct genetic selection, and also identified putative imprinted QTL in the chicken. The advantage of using multiple statistical models was evident because QTL were identified with the combined and parent of origin models that were not identified with the line-cross or half-sib models.

Animals↗
PubMed2005

Transverse verses midline incisions for abdominal surgery.

BACKGROUND: The choice of surgical incision in the abdomen is determined by access for surgery. It has been suggested that utilising a transverse or oblique rather than a midline incision may influence other parameters such as recovery and complication rates. However, there is little consensus in the literature as to whether a particular incision confers any advantage. OBJECTIVES: To determine whether a midline incision or a transverse incision (including oblique incision) confers any recovery advantage to the patient. SEARCH STRATEGY: Search terms included randomised trials containing combinations of the following: 'abdominal', 'incisions', 'horizontal', 'transverse', 'vertical', 'midline', and 'laparotomy'. SELECTION CRITERIA: All prospective randomised trials comparing midline with transverse incisions for abdominal surgery were included. Caesarian sections were excluded. DATA COLLECTION AND ANALYSIS: Two review authors assessed the methodological quality of potentially eligible trials and independently extracted data from the included trials. A wide range of outcome measures was considered. MAIN RESULTS: Due to differences in the method of assessment, the variability of data and the heterogeneity of the participant groups it was difficult to pool some of the outcome data. Despite these limitations, and potentially significant biases related to methodological quality, there was evidence to suggest that a transverse or oblique incision may be less painful and have less impact on pulmonary function than a midline incision, particularly in the early postoperative period. However, there was no difference seen in early or late postoperative complications between a transverse or oblique and a midline incision and recovery times were similar. AUTHORS' CONCLUSIONS: Both analgesia use and pulmonary compromise may be reduced with a transverse or oblique incision but this does not seem to be significant clinically as complication rates and recovery times are the same as with midline incision. The methodological and clinical diversity and the potential for bias in the included studies also mean that the results in favour of a transverse or oblique incision, particularly with regard to analgesic use, should be treated with caution. The optimal incision for abdominal surgery still remains the preference of the surgeon.

Humans↗
PubMed2005

The impact of injuries below the knee joint on the long-term functional outcome following polytrauma.

Previous studies have suggested that the lower-extremities are among the most frequently injured body regions in polytrauma patients and have a major impact on the functional recovery following polytrauma. In particular, injuries to the distal part of the lower-extremity appear to be associated with a poor functional outcome. Therefore, the goal of this study was to evaluate the impact of injuries below the knee joint on the long-term functional outcome following polytrauma. Three hundred eighty-nine polytrauma patients with associated lower-extremity fractures and a minimum follow-up of 10 years were included in this study. All patients were examined by a doctor, using a patient questionnaire and a standardised physical examination. Significantly, inferior outcomes were seen in patients with fractures below the knee joint as measured by the modified Karlström-Olerud score, Lysholm score, range of motion, weight bearing status, Hannover score for polytrauma outcome (HASPOC), SF-12, Tegner activity score, and inability to work (P < 0.05). Fractures below the knee joint have a significant impact on the functional recovery following polytrauma. We suggest that delayed treatment, thin soft tissue envelope below the knee joint, high-energy trauma, unfavorable blood supply, and complex fracture patterns contribute to these unfavorable outcomes.

Adult↗
PubMed2004

A randomised controlled trial of transverse skin crease vs. vertical midline incision for right hemicolectomy.

BACKGROUND: A transverse skin crease incision for right hemicolectomy may result in more rapid recovery than traditional vertical midline incision. This hypothesis was tested with a prospective randomised trial. METHODS: Patients from 2 centres undergoing right hemicolectomy were randomised to received a midline or transverse incision. Incision lengths were sufficient to enable unrestricted resection of the right colon. Patients and carers were blinded to the incisions using strategically placed dressings. Analgesia and oral intake were controlled by the patient. Operative details and recovery parameters were compared. RESULTS: A total of 28 patients were randomised. Demographic data and tumour characteristics of the two treatment groups were similar. The transverse incision group had a slightly shorter median wound (10 cm vs. 11 cm, p<0.05). Operative time, analgesia requirements, recovery parameters (time to discharge, 6.5 vs. 6.5 days) and frequency of complications were otherwise comparable. CONCLUSIONS: A transverse skin crease incision for right hemicolectomy results in a slightly smaller wound but no other advantages were demonstrated compared with a traditional vertical midline incision.

Adult↗
PubMed2003

The correlation between ion beam/material interactions and practical FIB specimen preparation.

The focused ion beam (FIB) tool has been successfully used as both a stand alone analytical instrument and a means to prepare specimens for subsequent analysis by SEM, TEM, SIMS, XPS, and AUGER. In this work, special emphasis is given to TEM specimen preparation by the FIB lift-out technique. The fundamental ion/solid interactions that govern the FIB milling process are examined and discussed with respect to the preparation of electron transparent membranes. TRIM, a Monte Carlo simulation code, is used to physically model variables that influence FIB sputtering behavior. The results of such computer generated models are compared with empirical observations in a number of materials processed with an FEI 611 FIB workstation. The roles of incident ion attack angle, beam current, trench geometry, raster pattern, and target-material-dependent removal rates are considered. These interrelationships are used to explain observed phenomena and predict expected milling behaviors, thus increasing the potential for the FIB to be used more efficiently with reproducible results.

Computer Simulation↗
PubMed2002

Comparison between midline incision and limited right skin crease incision for right-sided colonic cancers.

We compared the postoperative recovery parameters between patients undergoing curative surgery for right-sided colonic carcinoma using a limited skin crease incision and a traditional midline incision. A retrospective study was carried out analyzing clinical records and histopathological reports for all patients operated in one colorectal surgical unit for cancer of the right colon over a 2-year period. Palliative procedures were excluded. We analyzed demographic details, operative data (length of incision and time of operation), recovery parameters (time to parenteral analgesia, time to first oral fluid intake, time to first solid meal, time to discharge) and oncological parameters (lymph node harvest and resection margins). A total of 123 patients were analyzed, 61 with a midline incision and 62 with a skin crease incision. Demographic and tumour data (number of lymph nodes resected and resection margins) as well as postoperative complications were similar between the two groups. Wound length was significantly longer in the midline incision group (median, 20 cm vs. 10 cm; p<0.0005), as was the duration of surgery (median, 60 min vs. 45 min; p0.0005). With regard to postoperative recovery, the skin crease incision group had a significantly quicker return of bowel function ( p<0.0005), shorter time to oral fluid ( p<0.001) and solid food ( p<0.0005) intake, and shorter hospital stay ( p<0.0005) than the midline incision group. There was no statistically significant difference between the two groups concerning postoperative narcotic requirements. In conclusion, the limited skin crease approach for right colon cancer resection is technically feasible and safe. It can achieve the same standards of tumour resection and clearance as the vertical midline approach while reducing postoperative recovery.

Adenocarcinoma↗
PubMed2001

Efficacy of moxidectin 2 per cent gel against naturally acquired strongyle infections in horses, with particular reference to larval cyathostomes.

The efficacy of moxidectin 2 per cent equine gel against naturally acquired strongyle infections was assessed in 18 ponies which had grazed on contaminated pasture before being housed for eight weeks. Twenty-four hours before the treatment, two randomly selected ponies were euthanased and their worm burdens were determined. Eight of the remaining 16 ponies were treated with moxidectin 2 per cent gel while the other eight were given a placebo gel. Eight weeks later the 16 animals were necropsied and their worm burdens established. A 100 per cent efficacy was recorded against adult and lumenal L4 cyathostomes and adult Strongylus and Triodontophorus species. Digest recoveries of larval cyathostomes indicated a 90.8 per cent (P<0.002) reduction in early L3 and a 99.9 per cent (P<0.001) reduction in developing stages. There was a reduction in faecal egg output of between 96 and 100 per cent in the treated animals compared with the controls.

Animals↗
PubMed2001

Biofeedback avoids surgery in patients with slow-transit constipation: report of four cases.

Biofeedback is established treatment for intractable constipation in patients with an element of pelvic floor dysfunction. In those with intractable slow-transit constipation and normal pelvic floor function, colectomy is usually recommended. We report four patients with isolated slow-transit constipation who benefited from biofeedback and avoided surgery. All four patients were extensively investigated for pelvic floor dysfunction before undergoing a standard biofeedback course of four outpatient sessions. All improved in terms of bowel frequency, laxative use, bloating, straining, and lifestyle. Improvement has been maintained for a median of nine (range, 5-12) months without the requirement for further treatment. Biofeedback represents a safe and inexpensive treatment for these patients and may avoid surgery in a significant proportion.

Adult↗
PubMed2001

Consecutive series of laparoscopic-assisted vs. minilaparotomy restorative proctocolectomies.

PURPOSE: Compared with open restorative proctocolectomy, laparoscopic procedures may reduce postoperative recovery times and give a more cosmetically acceptable scar, but operative time may be prolonged. We describe a minilaparotomy technique for restorative proctocolectomy and compare recovery parameters with a laparoscopic procedure. METHODS: A consecutive series of patients undergoing laparoscopic-assisted restorative proctocolectomy were compared with a subsequent consecutive series of patients undergoing a minilaparotomy procedure. This method incorporates a suprapubic incision. Mobilization of the colon is performed in the usual manner with visualization of less accessible areas made possible by using an illuminated St. Mark's retractor. Operative and recovery parameters were analyzed for each group retrospectively. RESULTS: Twenty-five patients were compared (12 in the laparoscopic group). Wound length was significantly longer in the open group (median, 14 vs. 8.5 cm; P < 0.01), but operative times were shorter (median, 120 vs. 150 minutes; P < 0.01). There were no differences in any of the recovery parameters analyzed, including analgesic requirements, time to ileostomy function, first fluid intake, time to solid diet, length of hospital stay, and complications. CONCLUSION: The only advantage of a laparoscopic-assisted procedure over a minilaparotomy technique was the size of the wound. The minilaparotomy restorative proctocolectomy achieves the same postoperative recovery parameters and has a shorter operative time. This technique is recommended for surgeons less experienced in laparoscopy.

Adenomatous Polyposis Coli↗
PubMed2001

A prospective randomised study of drains in infra-peritoneal rectal anastomoses.

Although increasing evidence suggests that prophylactic drainage after intra-peritoneal colorectal anastomoses is unnecessary, drains for infra-peritoneal rectal anastomoses, where the leak rate is higher, are widely employed still. The aim of this study was to assess the effect of prophylactic drainage after anastomosis below the peritoneal reflection. All patients attending one specialist unit over an 8-month period for elective rectal cancer resection with an infra-peritoneal anastomosis were randomised to drainage or no drainage. The incidence of anastomotic leak and complications specific to the drain as well as other complications were compared. Fifty-nine patients were analysed (31 with drain). Twenty-five of the drained and 16 of the no-drain patients had a defunctioning stoma (p=ns). The groups were comparable for demographic data, operation and anastomotic height from the anal verge. There were three leaks (10%) in the drain group and five leaks (18%) in the no-drain group (p=ns). There were 2 (7%) patients in each group with a clinical leak. There were no specific drain complications and the incidence of other complications was similar in both groups. In conclusion, this study supports the contention that there is no difference in morbidity with or without the use of a drain for infra-peritoneal anastomoses.

Adult↗
PubMed2001

Stapled mucosectomy for acute thrombosed circumferentially prolapsed piles: a prospective randomized comparison with conventional haemorrhoidectomy.

OBJECTIVE: Stapled mucosectomy has been developed as an alternative to conventional haemorrhoidectomy for the elective treatment of haemorrhoids, but has not been assessed in the emergency setting. The aim of this study was to compare this technique with a conventional procedure for acute thrombosed circumferential prolapsed haemorrhoids. PATIENTS AND METHODS: A prospective randomized comparison of conventional Milligan-Morgan haemorrhoidectomy and stapled mucosectomy was carried out on 35 consecutive patients presenting with acute thrombosed circumferential prolapsed haemorrhoids. Operative data, postoperative stay, pain assessment and persistent symptoms were compared at discharge and at 2 week and 6 week review. Additionally at 6 week review the time to return to work was recorded and an endoanal ultrasound was carried out. RESULTS: Thirty patients were randomized and followed up for six weeks. Although postoperative stay and in-hospital analgesia were the same, patients from the stapled group reported significantly more pain at discharge. However, by 2 weeks the conventional group reported significantly higher pain scores particularly on passing stool. By this stage over half the stapled group patients reported no pain at all. More patients in the conventional group complained of persistent symptoms of pain, bleeding and discharge at 2 week and 6 week review with 20% requiring readmission compared with none in the stapled group. The median return to work was significantly shorter for the stapled group (14 days vs 28 days, P < 0.05). Although all patients claimed to be continent, two patients from each group had ultrasonic evidence of internal sphincter damage. CONCLUSION: Stapled mucosectomy for acute thrombosed circumferential piles is feasible and may result in less pain, a more rapid resolution of symptoms and an earlier return to work compared with a conventional procedure.

Clinical Trial↗
PubMed2000

Preservation of rectal function after low anterior resection with formation of a neorectum.

Recent advances in surgery have enabled low rectal cancers to be resected, while at the same time restoring bowel continuity and preserving the anal sphincter. Although a permanent stoma is avoided and the operation is oncologically sound, function may be compromised. Many patients with a straight coloanal anstomosis suffer from urgency, incontinence, and bowel frequency-the so-called anterior resection syndrome. Over the last 15 years, surgical developments have aimed at improving function after restoration of bowel continuity, essentially by creating a neorectum. The best known and most widely practiced operation involves formation of a colonic J-pouch. The physiological and functional outcomes of the colonic J-pouch are discussed, along with controversies surrounding construction. Although a J-pouch improves some aspects of function, the results are not perfect. Alternatives to the colonic J-pouch are appraised, indicating future areas of development.

Anastomosis, Surgical↗
PubMed2000

Tip-of-the-tongue phenomena: an introductory phenomenological analysis.

The issue of meaningful yet unexpressed background-to language and to our experiences of the body-is one whose exploration is still in its infancy. There are various aspects of "invisible," implicit, or background experiences which have been investigated from the viewpoints of phenomenology, cognitive psychology, and linguistics. I will argue that James's concept of the phenomenon of fringes, as explicated by Gurwitsch, provides a structural framework from which to investigate and better understand ideas and concepts that are indeterminate, particularly those experienced in the sense of being sought-after. Johnson's conception of the image-schematic gestalt (ISG) provides an approach to bridging the descriptive gap between phenomenology and cognitive psychology. Starting from an analysis of the fringes, I will turn to a consideration of the tip-of-tongue (TOT) state, as a kind of feeling-of-knowing (FOK) state, from a variety of approaches, focusing mainly on cognitive psychology and phenomenology. I will then integrate a phenomenological analysis of these experiences, from the James/Gurwitsch structural viewpoint, with a cognitive/phenomenological analysis in terms of ISGs, and further integrate that with a cognitive/functional analysis of the relation between consciousness and retrieval, employing Anderson et al's theory of inhibitory mechanisms in cognition. This synthesis of these viewpoints will be employed to explore the thesis that the TOT state and similar experiences may relate to the gestalt nature of schemas, and that figure/ground and other contrast-enhancing structures may be both explanatory and descriptive characterizations of the field of consciousness.

Consciousness↗