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Biomedical subjects

D C Brown

Publications and source records attributed to D C Brown.

196 records · Page 11Linked to original sources
PubMedDate not supplied

Energy metabolism during male human puberty. II. Use of testicular size in predictive equations for basal metabolic rate.

This study tests the hypothesis that equations to predict basal metabolic rate (BMR) of adolescent boys may be made more accurate by using a measure of pubertal maturity (testicular volume, TV). Eighty-six male volunteers aged 11.8-13.7 years were studied. There was a wide range of pubertal development within the subject group, ranging from mean TV of 3 to 22.5 ml. BMR was found to correlate more highly with TV (r = 0.519) than height (r = 0.425) or age (r = 0.272). BMR predicted using the World Health Organization equations (based on height and weight) were significantly higher than measured BMR in early pubertal boys (TV < or = 4 ml, BMR (measured) = 5.04 +/- 0.17, BMR (predicted) = 6.14 +/- 0.15 MJ/day, p < 0.001, Student's t-test). The results provide evidence that measurement of testicular volume may increase the accuracy of equations for the prediction of BMR of adolescent boys.

Adolescent↗
PubMedDate not supplied

Dural tail adjacent to acoustic neuroma: MR features.

There have been several reports describing the presence of a dural tail on enhanced MR as being specific for or suggestive of meningioma. It has also been stated that it is a specific diagnostic sign in distinguishing meningioma from acoustic neuroma. We report a case of a dural tail in an acoustic neuroma.

Contrast Media↗
PubMedDate not supplied

Short arm plaster cast for distal pediatric forearm fractures.

Ten years' clinical experience with below-elbow plaster cast treatment of distal one third pediatric forearm fractures was subjected to an independent retrospective radiographic review. In the study population of 761 fractures, no significant displacement occurred while the forearm remained in plaster. The average angulation change was 4.5 degrees (SD +/- 2.2 degrees). In each angulation change > 5 degrees, poor cast molding was evident, as reflected by a high "cast index" (p < 0.01). Although this technique is technically demanding, excellent results are obtained in all distal pediatric forearm fractures if proper cast molding is used.

Casts, Surgical↗
PubMedDate not supplied

Oxytocin content of the cerebrospinal fluid of dogs and its relationship to pain induced by spinal cord compression.

OBJECTIVES: To determine whether oxytocin exists in the cerebrospinal fluid (CSF) of dogs and whether the amount of oxytocin in the CSF of dogs with neck or back pain caused by spinal cord compression is significantly different than that in the CSF of clinically normal dogs. STUDY DESIGN: Prospective controlled study. ANIMAL POPULATION: A total of 15 purpose-bred beagles and 17 client-owned dogs. METHODS: CSF was collected by needle puncture of the cerebellar medullary cistern after induction of general anesthesia. Oxytocin levels within the samples were determined through radioimmunoassay. RESULTS: Dogs with spinal cord compression had significantly more oxytocin in their CSF than the clinically normal dogs (13.76 +/- 2.0 pg/mL and 3.61 +/- 0.63 pg/mL, respectively; P < .0001). Dogs with chronic signs (>7 days) had significantly more oxytocin in their CSF than dogs with acute signs (<7 days) (21.60 +/- 0.86 pg/mL and 6.80 +/- 0.81 pg/mL, respectively; P < .0001). Both acutely and chronically affected dogs had significantly more oxytocin in their CSF than the controls (P < .005 and P < .0001 respectively). CONCLUSIONS: Dogs with neck and back pain caused by spinal cord compression have significantly more oxytocin in their CSF than clinically normal dogs. Dogs with chronic clinical signs have significantly more oxytocin in their CSF than dogs with acute clinical signs. CLINICAL RELEVANCE: In humans, intrathecal injection of oxytocin is effective in treating low back pain for up to 5 hours. Intrathecal oxytocin may be a logical choice for perioperative analgesia in dogs undergoing myelography because the intrathecal space is accessed for injection of contrast agent.

Animals↗
PubMedDate not supplied

The effects of perioperative hypothermia and the duration of anesthesia on postoperative wound infection rate in clean wounds: a retrospective study.

OBJECTIVE: To determine the effects of hypothermia and duration of anesthesia on the infection rate in clean wounds in dogs and cats. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Seven hundred seventy-seven dogs and cats undergoing clean surgical procedures. METHODS: Records of animals prospectively evaluated for postoperative wound infection were retrospectively evaluated for the prevalence of perioperative hypothermia. Body temperatures during the perioperative period and the duration of surgery and anesthesia were recorded. Data were analyzed to identify differences between animals with infected and uninfected wounds and multiple logistic regression modeling was used to evaluate the independent contribution of risk factors to the incidence of postoperative wound infection. RESULTS: No statistically significant differences were found in the analysis of temperature data between animals with infected and uninfected wounds. Duration of anesthesia was significantly greater in animals with wound infections (P = .01). Multiple logistic regression modeling identified duration of anesthesia as a risk factor for postoperative wound infection independent of the duration of surgery. CONCLUSIONS: In animals with clean surgical wounds, mild perioperative hypothermia is not a significant risk factor for postoperative wound infection. The duration of anesthesia, however, is a significant risk factor independent of the duration of surgery. CLINICAL RELEVANCE: To decrease the incidence of postoperative wound infection, the duration of anesthesia should be minimized. Surgical time, as well as the time required for ancillary diagnostic tests while under anesthesia should, therefore, be kept to a reasonable minimum.

Anesthesia↗
PubMedDate not supplied

New drug therapy for kidney stones: a review of cellulose sodium phosphate, acetohydroxamic acid, and potassium citrate.

Kidney stones have an overall incidence of two to three percent in western countries. In many patients, the disease process is difficult to control and recurrence rates are high: 20 to 50 percent over the subsequent ten years. The pathogenesis and standard methods of treatment for the five major types of stones (i.e., calcium oxalate, struvite, calcium phosphate, uric acid, and cystine) are reviewed. Three new drugs are reviewed in the context of their roles in the selective treatment of kidney stones. Cellulose sodium phosphate (Calcibind) is a nonabsorbable ion-exchange resin with a limited indication for the treatment of calcium stones associated with absorptive hypercalciuria Type I. Acetohydroxamic acid (Lithostat) is an urease-inhibitor that is indicated as adjunctive therapy in patients with chronic urea-splitting urinary tract infections and struvite stones. Potassium citrate (Urocit) is an investigational agent that has clinical efficacy in patients with calcium oxalate and calcium phosphate stones who are hypocitraturic. In addition, potassium citrate is an alkalinizing agent that can be used in patients with uric acid stones.

Adult↗
PubMedDate not supplied

Posterior chamber phakic intraocular lens for hyperopia.

PURPOSE: A Phase I U.S. FDA clinical study of a plate haptic posterior chamber phakic intraocular lens (STAAR Surgical Implantable Contact Lens) for treatment of hyperopia was conducted at 4 sites in the United States. The purpose of this report is to assess the short-term safety and efficacy. METHODS: Ten patients with hyperopia between +2.50 and +10.875 D were implanted in one eye each with the posterior chamber plate phakic intraocular lens and were examined at baseline and 1 day, 1 week, 1, 3, and 6 months after surgery. Mean baseline hyperopia was +6.63 D. RESULTS: At 6 months postoperatively, 7 of 10 eyes (70%) had an uncorrected visual acuity of 20/20 or better and 10 of 10 (100%) had 20/40 or better. Eight of ten eyes (80%) had a spectacle-corrected visual acuity within 1 line of baseline; the other two eyes (20%) had an improvement of 3 lines. Mean 6-month postoperative spherical equivalent refraction was +0.20 +/- 0.61D (range, -0.50 to +1.50 D), a reduction of 6.025 D from baseline. Eight of 10 eyes (80%) were within +/-0.50 D of emmetropia, 9 eyes (90%) were within +/-1.00 D, and all eyes (100%) were within +/-1.50 D. No operative or postoperative complications or adverse reactions were observed. CONCLUSIONS: Results support the short-term safety, efficacy, and predictability of the STAAR Surgical Implantable Contact Lens (plate haptic posterior chamber phakic intraocular lens) in the treatment of hyperopia.

Adult↗
PubMedDate not supplied

An integrated model for measuring management performance.

A model of organizational performance measurement that compels attention to the proper balance among quality, cost, and access; takes into account patient perceptions; produces clear targets for continual quality improvement (CQI); yields easily understood graphical displays; and captures health care organizations in simultaneous operation across the functions of cost, quality, and access was designed for the 22 medical treatment facilities of the Strategic Air Command. Such a tool provides practitioners, payers, and patients a range of information--from systemwide, facility, clinical service, and practitioner-specific insights on current performance to resource forecasts and easily understood targets for CQI. This case study shows that integrated performance modeling may be useful in examining many health management and reform issues.

Data Collection↗
PubMedDate not supplied

Appendiceal mucocoele: a case report and review of the literature.

Mucocoele of the appendix denotes an obstructive dilatation of the appendiceal lumen due to abnormal accumulation of mucus, which may be related to a variety of pathological conditions. This may be the outcome of various processes. Most important for the surgeon, however, are the mucocoeles that are caused by mucinous cystadenomas and cystadenocarcinomas. In the latter case, a possible rupture of the mucocoele, either spontaneous or accidental, during surgery may result in the clinical condition of pseudomyxoma peritonei, a spread of malignant cells throughout the entire peritoneal cavity in the form of multiple mucinous deposits. It is therefore important both to identify the disease preoperatively and to plan a careful resection to remove the mass. We report one case and present the clinical and diagnostic aspects of this disease.

Aged↗
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The relationship of isotopic bone imaging findings to prognosis in Legg-Perthes disease.

A significant association was observed between the size of the radioactive uptake defect on bone image and the end-result (Mose) in 34 hips of children with early Legg-Perthes disease. A correlation between the size of the bone-image defect and radiographic prognostic criteria, Catterall classification and extent of subchondral fissure was also observed in 27 early Legg-Perthes cases. Bone imaging is recommended for suspected Legg-Perthes patients, not only to establish the diagnosis but to assess the stage of disease and to determine prognosis.

Child↗
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Duplication of the pituitary gland as shown by MR.

Duplication of the pituitary gland is a rare malformation. The authors describe a patient with features of the median cleft face syndrome (hypertelorism, V-shaped hairline, and developmental delay) who exhibited duplication of the pituitary gland and diffuse thickening of the hypothalamus (hypothalamic hamartoma) as shown by MR. The embryology of the developing pituitary gland and pathogenesis of pituitary duplication are discussed.

Child, Preschool↗
PubMedDate not supplied

Sturge-Weber syndrome: cranial MR imaging with Gd-DTPA.

PURPOSE: To study the role of Gd-DTPA in cranial MR of patients with Sturge-Weber syndrome. METHODS AND MATERIALS: Seven patients with Sturge-Weber syndrome, ages 3 months to 36 years, were evaluated with unenhanced and contrast-enhanced (Gd-DTPA) MR imaging. Correlation was made to cranial CT in five patients. RESULTS: MR findings included (in decreasing frequency): pial angiomatosis, cerebral atrophy, decrease in cortical veins, enlargement of deep veins, enlargement of choroid plexus, and parenchymal calcification. Contrast MR imaging was essential in diagnosis in four cases in which cranial CT, unenhanced MR, or angiography was normal or demonstrated nonspecific abnormalities. Pial angiomatosis with adjacent cerebral atrophy were the only consistent radiographic abnormalities. CONCLUSION: In all patients, contrast MR demonstrated the radiographic spectrum of central nervous system abnormalities in Sturge-Weber syndrome to a greater degree than unenhanced MR or CT and may represent the method of diagnosis in these patients. Demonstration of the pial angioma on contrast MR should be considered the most important criterion for the radiographic diagnosis of Sturge-Weber syndrome.

Adolescent↗
PubMedDate not supplied

Recurrence after Achilles tendon lengthening in cerebral palsy.

We performed a retrospective review of all hemiplegic and diplegic cerebral palsy (CP) patients who had tendo-Achillis lengthening by open Z-plasty between 1974 and 1985. Fifty-seven patients with 77 heelcord lengthening were followed approximately 10 years. Our postoperative regimen did not routinely include bracing and physiotherapy, but our recurrence rates of 18 and 41% for diplegic and hemiplegic patients, respectively, are comparable to those reported in the literature. Children aged > or = 6 years at initial operation did not have recurrence. Diplegic patients who were operated on before age 4 years or patients who had longitudinal incisions had statistically significantly higher recurrence rates.

Achilles Tendon↗