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Biomedical subjects

B J Hunt

Publications and source records attributed to B J Hunt.

At least 127 records · Page 7Linked to original sources
PubMed1992

Alterations in the in vivo torque-velocity relationship after Achilles tendon rupture. Further evidence of speed-specific impairment.

The torque-velocity relationship of the ankle plantar flexors was determined in 31 patients recovering from Achilles tendon rupture. Isokinetic torque measurements were made at speeds of 0 to 240 degrees.s-1 at 24 degrees.s-1 intervals. Measurements of instantaneous torque were made at joint angles corresponding to neutral and 10 degrees plantar flexion. In 17 patients treated surgically, there was little difference between the injured and the uninjured leg. In contrast, patients who were treated by casting exhibited major differences between the injured and uninjured legs. This difference became amplified when torque values at 10 degrees plantar flexion were compared. Additionally, the differences between the injured and uninjured legs were not uniform. The differences in torque were greatest at slow test speeds and least at fast test speeds. Comparisons of the injured surgical and injured nonsurgical legs demonstrated that the surgical group had significantly greater torque. This difference was also speed specific. These findings demonstrate that both groups exhibited speed-specific impairment with the loss of muscle strength being greatest at slow speeds. Also, the degree of impairment was dependent on the ankle position at which torque was measured. Surgical treatment provides better functional results as observed by the torque-velocity relationship.

Achilles Tendon↗
PubMed1991

Modifying perioperative blood loss.

Fears about the risks of disease transmission through the transfusion of homologous blood, as well as problems with blood supply and cost have increased the interest in reducing perioperative bleeding. This article discusses the causes of non-surgical perioperative bleeding and attempts to reduce perioperative bleeding with pharmacological agents. There is particular emphasis on the effects of cardiopulmonary bypass on haemostasis as the majority of studies have been conducted in this area. The agents discussed include the use of fibrin sealants, antiplatelet agents such as dipyridamole and prostacyclin analogues, antifibrinolytics and the effects of desmopressin and aprotinin. Currently high dose aprotinin would appear to be the most efficacious method of reducing perioperative bleeding in cardiac surgery, although a full risk benefit analysis is not yet possible. The effectiveness of aprotinin and tranexamic acid in reducing the 'oozing' seen in any surgical patient suggests the contribution of fibrinolysis in causing perioperative bleeding has not been fully evaluated. More research is required in this actively growing area.

Hemorrhage↗
PubMed1990

Unusual lymphoproliferative oropharyngeal lesions in heart and heart-lung transplant recipients.

Three unusual cases of oropharyngeal lympho-proliferative lesions were seen in recipients of heart and heart-lung transplants. Two caused acute upper respiratory obstruction necessitating urgent ENT intervention. All patients were receiving immunosuppressive drugs including cyclosporin. The two obstructive cases were adenotonsillar enlargement in a 6-year-old, and a tumour of the tonsil and tongue base with cervical lymph node enlargement in a 32-year-old male. Both were caused by Epstein-Barr Virus-associated lymphoproliferative disorder. The third patient, a 32-year-old female, had a presumed low grade T-cell lymphoma that regressed spontaneously. Histopathological diagnosis of these lympho-proliferative disorders after transplantation usually requires immunocytochemistry to distinguish polyclonal proliferative disorders from true lymphoma. Polyclonal lymphoproliferative disorders after transplantation do not usually require aggressive cytoreductive therapy, but respond to simple measures such as the reduction of immunosuppression.

Adult↗
PubMed1989

Creatine kinase activity in sickle cell disease.

Creatine kinase activity was measured in 28 patients in the steady state of sickle cell disease and ranged from 4-45 IU/l, comparable with that found in healthy adult caucasians. Creatine kinase activity was also measured in 14 patients admitted consecutively for the treatment of vaso-occlusive sickle cell crises. Creatine kinase activity remained within the normal range in eight of these 14 patients throughout their admission; none had muscle pain or a chest syndrome. In the remaining six, three with muscle pain and three with a chest syndrome, increased activity was found on one or more days. A further 17 patients with vaso-occlusive sickle cell crises, associated with muscle pain, were studied. Creatine kinase activity was significantly raised in all 17, the mean creatine kinase activity for men was 578.8 IU/l and 210.6 IU/l for women, with the highest values (up to 1790 IU/l) found in those who had exercised before admission. Measurement of creatine kinase activity may therefore be a useful marker of muscle perturbation due to sickling.

Adolescent↗
PubMed1988

Induction of red blood cell destruction by graft-derived antibodies after minor ABO-mismatched heart and lung transplantation.

Heart-lung transplantation (HLT) unlike other solid-organ transplants involves transplantation of a large amount of lymphoid tissue; hence there is considerable potential for graft-versus-host reaction if there is an antigen mismatch between donor and recipient. Due to the shortage of suitable donors, minor ABO-mismatched HLT (group O organs given to A, B, or AB recipients) are performed. Of 84 consecutive HLT at Harefield Hospital, nine fully ABO-matched and nine ABO-mismatched HLT were studied. Six minor ABO-mismatched HLT patients had evidence of immune destruction of recipient's red cells. Haemolysis started from days 4-12 and lasted for a mean of 13 days; in four cases transfusion support was necessary. ABO antibodies incompatible with the recipient ABO antigens, but compatible with the donor, were found in the serum and red cell eluates of these patients. In two cases, these antibodies were detected for over one year after transplantation. These changes were not seen in the fully ABO-matched controls. Our findings suggest that donor-derived lymphocytes from group O organs continue to produce anti-A and/or anti-B after transplantation, and if the recipient is group A, B, or AB, mount a secondary immune response following antigenic stimulation by the recipient's differing ABO antigens. The specific transfusion management of these patients is discussed.

ABO Blood-Group System↗
PubMed1987

The significance of pancytopenia in miliary tuberculosis.

Patients with miliary tuberculosis accompanied by a pancytopenia rarely survive their disease. If the peripheral blood picture does recover it has been taken as an indication that there is no underlying haematological disease, and so re-examination of the bone marrow is not performed. A case is described where resolution of the pancytopenia occurred but a persisting haematological disease remained. Aspects of haematological disease associated with tuberculosis are discussed.

Aged↗
PubMed1981

The role of vertebral angiography in the investigation of third nerve palsy.

The association between intracranial aneurysm and third nerve palsy in a series of fifty patients presenting to this unit over a six year period has been studied. All aneurysms causing a third nerve palsy were found to be in the anterior circulation and all were adequately demonstrated by carotid angiography alone. None of the thirty cases of posterior circulation aneurysm was associated with a third nerve palsy. Vertebral angiography carries a higher risk of serious complications than carotid angiography. We feel that the added risk of vertebral angiography is not justified for the investigation of an isolated third nerve palsy.

Carotid Artery, Internal↗