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Biomedical subjects

A Young

Publications and source records attributed to A Young.

At least 307 records · Page 17Linked to original sources
PubMed1984

A new spinal brace for use in Duchenne muscular dystrophy.

Nine boys with Duchenne muscular dystrophy, chairbound but without scoliosis, were fitted with a recently developed brace of metal and moulded medium-density polyethylene, the modified Calot brace. Each was also fitted with a wrap-around, moulded leather jacket. Each brace held the relaxed lumbar spine in an angle of lordosis similar to that achieved by a brief active effort to sit erect without a brace. Over-all, they proved equally acceptable to patients and carers. The modified Calot brace caused substantially less restriction of pulmonary function and so may be preferable to the moulded leather jacket.

Braces↗
PubMed1984

The relative isometric strength of type I and type II muscle fibres in the human quadriceps.

In isometric contractions, the type II fibres of animal muscle may have a greater specific strength than the type I fibres. This paper reports two retrospective analyses of the influence of fibre-type composition on the ratio of the voluntary isometric strength of the quadriceps to its cross-sectional area at mid-thigh. In 15 normal quadriceps, the ratio of the muscle's strength to its cross-sectional area was weakly correlated with the percentage contribution of type II fibres to a biopsy from the lateral mass of the muscle (r = 0.55, P less than 0.05). Linear regression suggested that type II fibres might have about three times the specific strength of type I fibres. Measurements of the atrophied quadriceps of 11 patients with unilateral knee injury/immobilization were standardized by comparison with the contralateral muscles. Strength/cross-sectional area was again correlated with the percentage area as type II fibres (r = 0.62, P less than 0.05). The data suggested that type II fibres might have about twice the specific strength of type I fibres. Despite the wide confidence limits of each of the analyses, they agree that, in isometric contractions, the type II fibres of the human quadriceps seem stronger, for their cross-sectional area, than the type I fibers.

Adolescent↗
PubMed1984

Plasma creatine kinase after the marathon--a diagnostic dilemma.

The mechanism of the protein leak from exercised muscle remains obscure, but may be related to depletion of intracellular high-energy phosphate and/or to mechanical disruption. The high levels of creatine kinase (CK) and other muscle proteins found in plasma for several days after marathon running, especially downhill running, are due to protein efflux from skeletal muscle. There is no evidence that marathon running damages the healthy, well-perfused myocardium, despite the fact that the plasma levels of total creatine kinase (CK), the isoenzyme CK-MB, CK-MB/total CK (%), myoglobin, aspartate transaminase, lactate dehydrogenase and tropomyosin may be the same as after myocardial infarction. These indices must be interpreted with the greatest caution when found in anyone who habitually undertakes strenuous exercise, especially if they have done so within the previous week.

Blood Proteins↗
PubMed1984

Carbon dioxide as a lighter-than-urine contrast medium for percutaneous nephrostomy.

Carbon dioxide was used either alone or in combination with standard triiodinated contrast media in 32 patients who underwent percutaneous nephrostomy. Carbon dioxide was used to opacify the posterior calyces, which are the uppermost structures in the kidney of the prone or prone-oblique patient. Carbon dioxide is usually injected in small amounts (20-40 cm3), although clinical and laboratory data indicate that it can be used as the only medium in large amounts with complete safety. There were no complications.

Adult↗
PubMed1983

The relevance of traditional medical cultures to modern primary health care.

This paper attempts to identify forms of traditional medicine which have the greatest potential for advancing primary health care goals. It begins by differentiating traditional medical systems into types, according to the kinds of medical knowledge which they depend on for preventing, diagnosing, and treating sickness. Emphasis is given to the facts that some traditional systems concentrate on producing varieties of pathophysiological knowledge, while others focus on forms of etiological knowledge; and that some traditional systems accumulate the medical knowledge which they produce, while others diffuse and fragment it. These differences give clues to a medical tradition's abstract potential for achieving three distinct, and only sometimes linked, ends: curing disease, healing illness, and enhancing the productivity of official primary health care programs. To make these clues concrete, it is also necessary to know something about the different ways in which traditional medical beliefs and practices are embedded, together with modern (cosmopolitan) medicine, in actual patterns of resort. The remainder of the paper assesses the relevance, for advancing primary health care goals, of particular classes of traditional healers--e.g. herbalists, midwives, bonesetters--and technologies within different types of medical systems. Four possibilities are described; integration, complementarity, rivalry and intercalation.

Diagnosis↗
PubMed1983

Variations in the pattern of muscle innervation by the L5 and S1 nerve roots.

Evidence based on electrical studies is presented for the standard and anomalous patterns of innervation of muscles supplied by the fifth lumbar and first sacral nerve roots. Although considerable controversy still exists, previous work in this field suggests that the L5 nerve root supplies tibialis anterior, extensor hallucis longus, extensor digitorum brevis, and the lateral head of gastrocnemius, while the S1 nerve root innervates the medial head of gastrocnemius, soleus, and abductor hallucis. In order to confirm the reliability of this data, the L5 and S1 nerve roots of 50 patients were electrically stimulated during surgery, and distally evoked responses in the relevant muscles were recorded, using surface electrodes. The results confirm the essential reliability of the proposed table of segmental innervation and also demonstrate that most muscles have a dual innervation, with one nerve root being dominant. However, eight patients (16%) exhibited a marked departure from the normal pattern. For example, it is clear that on occasion the extensor digitorum brevis and the lateral head of gastrocnemius can be supplied by S1 and the soleus and medial head of gastrocnemius can be supplied by L5. In a prospective study of 100 patients presenting with clinical evidence of lumbosacral nerve root entrapment, the level of nerve root involvement, as predicted by electromyography, was compared with the operative findings. Correct preoperative nerve root localization was achieved in 84%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

The effect of high-resistance training on the strength and cross-sectional area of the human quadriceps.

Seventeen volunteers performed unilateral strength-training of the quadriceps with high-resistance, low-repetition, dynamic exercise, thrice weekly for an average of 5 weeks. Both before and after the training period, bilateral measurements were made of isometric quadriceps strength, quadriceps cross-sectional area (by ultrasound scanning), and thigh circumference. There were no significant changes in the untrained thighs. The trained quadriceps increased their isometric strength by more than they changed their cross-sectional area (mean increments = 15% and 6% respectively). Quadriceps hypertrophy was underestimated by measurements of thigh circumference and could not be predicted from them. We conclude that studies of localized muscle growth require direct measurements of the size of the muscle(s) concerned. Nevertheless, these may still underestimate the improvements in strength produced by high-resistance training.

Adult↗
PubMed1983

'Exercise medicine': the knowledge and beliefs of final-year medical students in the United Kingdom.

It is becoming increasingly important that all doctors should have a good understanding of all the medical aspects of exercise. A questionnaire survey of final-year, British, medical students has demonstrated widespread acceptance that regular exercise is conducive to good health. Nevertheless, there were important deficiencies in the students' knowledge of the physiology of exercise and of physical training, and in their knowledge of the prevention and management of sports injuries. It is recommended that undergraduate education (and examinations) should put a greater emphasis on the medical aspects of exercise.

Athletic Injuries↗
PubMed1983

Evidence for an association between rheumatoid arthritis and autoimmune endocrine disease.

Evidence is presented for the first time of a significantly increased prevalence of type 1 (insulin-dependent) diabetes in the close relatives of patients with rheumatoid arthritis. Thirty-nine (13%) of 295 patients with classical or definite rheumatoid arthritis had a first or second degree relative with type 1 diabetes and 38 (13%) had a close relative with autoimmune thyroid disease. These findings could be compatible with a possible common genetically determined mechanism of susceptibility to both diseases.

Adult↗
PubMed1983

Prospective study of the radiological changes in hands, feet, and cervical spine in adult rheumatoid disease.

Annual radiographs of hands, feet, and cervical spine were taken in 100 patients with rheumatoid arthritis from the first year of disease for a mean follow-up period of 9.5 years. Seventy-six patients developed peripheral erosive disease and 54 developed rheumatoid changes of the cervical spine, of whom 34 (63%) had subluxations. The severity of rheumatoid neck damage correlated strongly with the severity of peripheral erosive disease (p = 0.002). Cervical subluxation was more likely to occur in patients with erosions of the hands and feet which deteriorated progressively with time (p = 0.018). The timing and severity of cervical subluxation coincided with the progression of peripheral erosive disease in 26 of these 34 patients (76.5%). The other 8 patients with cervical subluxation (23.5%) had none or only mild peripheral erosions, but their subluxations did not progress with time. There were 9 patients with marked cervical subluxations which deteriorated relentlessly, and they all also had severe progressive erosive disease of the hands and feet. One of these patients developed a cervical myelopathy, and 2 other patients with normal neurological signs had upper cervical fusions performed for severe occipital headache. This small group of rheumatoid patients who are at risk of developing cervical myelopathy cannot be predicted with certainty, but can be selected out at an early stage by performing regular radiographs of hands, feet, and cervical spine.

Arthritis, Rheumatoid↗
PubMed1983

Stridor and parkinsonism.

A patient is described with idiopathic Parkinson's disease and severe laryngeal stridor. Other than urinary frequency and urgency, not uncommon in this condition, and postoperative levodopa-sensitive postural hypotension, there were no features of generalized autonomic failure. The laryngeal stridor responded to levodopa therapy, and we are not aware that this has been reported previously.

Aged↗
PubMed1983

'Osmosin' in rheumatoid arthritis: interim results.

The interim results of an on-going trial in patients with active rheumatoid arthritis are reported. The findings from 17 patients so far treated and followed-up for 4 to 6 weeks suggest that 'Osmosin' (105 mg sodium indomethacin trihydrate), given once daily for the first 2 weeks and twice daily thereafter, is effective in reducing the inflammatory activity of joint disease, as assessed by visual analogue and 5-point semantic severity scales. Analysis showed that there was a strong association between the assessments on the two scales and this was stronger if patients were not conditioned by being allowed to see their previous visual analogue scale assessment.

Arthritis, Rheumatoid↗
PubMed1983

Rethinking ideology.

Rethinking the relationship between medicine and ideology means investigating the origins of the efficacy of ideological knowledge. Only after this investigation is completed is it possible to advance claims about dominance and hegemony. In order to rethink ideology, it is useful to divide the field into three levels of analysis: the level of ideological knowledge, where manifold and contradictory facts and meanings are produced and come to occupy the consciousness of the individual; the level of ideological discourse, where ideological knowledge is organized into trajectories of dominant facts and meanings; and the level of ideological process, where discourses are given authority and, sometimes, incorporated into ideological hegemonies. However, such an investigation requires that we reject certain preconceptions about "rationality." In the sovereign sense in which empiricist writers use this term, it has the effect of hiding the origins of ideological knowledge by desocializing its mode of production. Correctly understood, rationality is only one element within a socially determined and embedded rationalization process through which dominant facts and meanings are produced. Only by distinguishing between rationality (an aspect of mind) and rationalization (a social process) is it possible to clarify the relationship between ideology, medicine, and science.

Cognition↗
PubMed1983

Expression of differentiation markers by chick embryo neuroretinal cells in vivo and in culture.

Several markers of chick neuroretinal differentiation were monitored in vivo and in culture. All increase markedly between 7 and 20 days of embryonic development in vivo. In vitro, endogenous GABA levels decrease almost immediately, while other neuronal markers increase as in vivo for 2 to 5 days before declining (choline acetyltransferase, acetyl cholinesterase, glutamic acid decarboxylase). Neuronal cell surface markers (binding sites for tetanus toxin, alpha-bungarotoxin, muscimol), however, reach maximal levels only after 8 days in vitro. Glial markers such as carbonic anhydrase and hydrocortisone-induced glutamine synthetase activities are also expressed only transiently in culture.

Acetylcholinesterase↗
PubMed1983

Rehabilitation of patients with pulmonary disease.

Rehabilitation is not a type of treatment: it is the condition of optimal function, or the achievement of that condition. Pulmonary rehabilitation is simply a function-orientated approach to the clinical management of the patient with chest disease. It starts with the best available conventional treatment and then proceeds with any modality which might enhance the patient's level of physical, mental, or social function. The emphasis in this review has been on measures to increase exercise capacity, in particular, possible mechanisms whereby exercise training may benefit the patient with chronic airflow obstruction. It is hoped that the comments will lead to further studies in this area, and encourage doctors to think beyond the mere treatment of chest disease, to the attainment of the best possible level of function despite the presence of chest disease.

Breathing Exercises↗