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Biomedical subjects

D J Beard

Publications and source records attributed to D J Beard.

At least 37 records · Page 2Linked to original sources
PubMed2001

Hamstrings vs. patella tendon for anterior cruciate ligament reconstruction: a randomised controlled trial.

A randomised controlled trial was performed to evaluate early outcome for two types of anterior cruciate ligament reconstruction. Sixty patients undergoing cruciate reconstruction were randomized into two groups. Group PT underwent reconstruction using a patella tendon autograft, whereas Group (SG) had a semitendinosus/gracilis autograft (SG). IKDC, Lysholm, and Tegner scores, KT1000 values and muscle strength were recorded pre-operatively, at 6 months and 1 year follow up. The functional scores, activity level, muscle strength and anterior tibial translation improved in both groups. No significant difference between groups was found for any measurement at 6 months and 1 year despite adequate study power. The study indicates that the 1 year results for either technique are equally favourable.

Analysis of Variance↗
PubMed2001

Reconstruction does not reduce tibial translation in the cruciate-deficient knee an in vivo study.

We have assessed the effectiveness of reconstruction of the anterior cruciate ligament (ACL) in reducing functional tibial translation (TT). The gait of 11 ACL-deficient patients was studied using Vicon equipment before and after surgery. Measurements of the angle between the patellar tendon and the long axis of the tibia were obtained in order to calculate TT in the sagittal plane relative to the uninjured limb during standing and walking. Before surgery, patients did not show abnormal TT on the injured side, but after surgery significant anterior TT was found in the operated limb for every parameter of gait. Abnormal anterior TT occurring during activity does not seem to be reduced by reconstruction; rather, it increases. It may be that the increased translation results from relaxation of excess contraction of the hamstring muscles, since compensatory muscle activity no longer is required in a reconstructed knee. The reduction of TT may not be an appropriate objective in surgery on the ACL.

Adult↗
PubMed2000

Sensorimotor changes after anterior cruciate ligament reconstruction.

The restoration of joint stability is unlikely to be dependent on passive properties of the joint alone, yet the effect of anterior cruciate ligament reconstructive surgery on the sensorimotor system largely remains unexplored. This study evaluated whether surgical reconstruction of the ligament had any effect on one indicator of sensorimotor function, hamstring contraction latency, which previously has been shown to be related to function. Twenty-five patients with unilateral chronic anterior cruciate ligament deficiency had measures of hamstring contraction latency obtained before and after (3 and 6 months) reconstruction. After surgery, the contraction latency difference was found to improve significantly (decrease) in patients who had a preexisting deficit. The mechanism for alteration in response time remains unclear, but an observed relationship between contraction latency and tibial translation supports a mechanical basis for the findings. It was concluded the sensorimotor changes associated with surgical reconstruction of the cruciate ligament may help to restore joint stability. The study highlights the need to appreciate sensorimotor consequences of cruciate ligament surgery.

Adult↗
PubMed1998

Home or supervised rehabilitation following anterior cruciate ligament reconstruction: a randomized controlled trial.

Rehabilitation following anterior cruciate ligament (ACL) reconstruction is varied. Patients are usually prescribed an independent home exercise program, although some patients may attend physical therapy for additional supervised exercise. It is not known whether additional supervised exercise provides any further benefit. The purpose of this study was to compare efficacy for two types of rehabilitation following ACL reconstruction. A randomized controlled trial of 31 ACL-reconstructed patients was used to test the hypothesis that a home program plus supervised rehabilitation (Group S) is more effective than a home program (Group H) alone. Function, activity level, anterior tibial translation, and muscle strength were measured preoperatively and at 3 and 6 months postoperatively. Improvement of function, activity level, muscle strength, and anterior tibial translation was evident in both groups, but no significant differences were found between groups even though the sample size was sufficient to detect small treatment effects. It was concluded that supervised exercise, in addition to a home program, has minimal extra benefit for patients who have undergone ACL reconstruction.

Activities of Daily Living↗
PubMed1997

The population of users of upper limb prostheses attending the Oxford Limb Fitting Service.

There is no central database that records the changing provision of prostheses in the United Kingdom. Experience suggests there have been some shifts in the population, particularly in the past decade. Because the detailed records of these changes are contained in the patients' medical records it is difficult to assess the substance of these data except on an individual basis; the larger picture the sifting of a centre's or many centres' data. This paper describes the analysis of one such set of records at the Oxford Limb Fitting Centre. It relates the profile of the population that attends the centre to the general population, and compares the information with that obtainable from other sources. The possible causes for the findings are discussed.

Adolescent↗
PubMed1995

General pharmacology of [2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3- dihydro-1H-pyrrolizine-5-yl]-acetic acid in experimental animals.

[2,2-Dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3-dihydro-1H-pyrrolizine-5- yl]-acetic acid (ML 3000) is a newly synthesized compound with analgesic, antipyretic and anti-inflammatory activity. The general pharmacological effects of ML 3000 following oral administration were investigated in experimental animals. The results showed that with regard to the CNS, ML 3000 did not affect behaviour in the Irwin test, locomotor activity or hexobarbital-induced sleep at doses of 30, 100 and 300 mg/kg. ML 3000, at a single dose of 100 mg/kg administered intraduodenally, had no notable effect on the cardiovascular system or respiration in anaesthestised rats and dogs nor on neuromuscular function in anaesthetised cats. No evidence of gastric damage or disturbance of peristalsis was observed following oral administration of ML 3000. In vitro, ML 3000 evoked a weak spasmogenic response in the guinea-pig ileum with a dose-related inhibition of acetylcholine, histamine and barium chloride-induced responses. A small transient reduction in urine volume was observed after the highest dose accompanied by decreases in electrolyte excretion at doses of 100 and 300 mg/kg in rats. The results demonstrate that ML 3000 has no notable general pharmacological effects under the experimental conditions reported.

Acetates↗
PubMed1994

Reflex hamstring contraction latency in anterior cruciate ligament deficiency.

Decreased dynamic stability of the knee joint associated with functional disability is a feature of anterior cruciate ligament deficiency (ACLD). The purposes of this study were to examine the between-limbs difference in reflex contraction latency of the hamstring muscles in patients with unilateral ACLD and to investigate its relationship with instability and function. Fifty patients with arthroscopically diagnosed unilateral ACLD were measured bilaterally for reflex hamstring contraction latency (RHCL), and 20 normal volunteers were similarly tested. The subjects were measured in a position of single-limb full weight-bearing with the knee flexed 30 degrees. An anteriorly directed shear force was applied to the tibia, and surface electromyographs (EMGs) recorded the activity of the hamstrings in response to the applied force. The latency of contraction was defined as the time from initial tibial movement, identified by accelerometry, to the onset of increased hamstring EMG activity. Both legs were tested and a between-limbs difference was computed. A significant difference in RHCL was found between the limb with ACLD and the control limb. The mean RHCL of the limb with ACLD was nearly double that of the unaffected limb, for a significant mean between-limbs difference (p < 0.05). The mean between-limbs difference for the control subjects was not statistically significant. The conclusion is that patients with ACLD have an increased RHCL of the injured leg. As the RHCL is dependent on proprioceptive activity around the joint, it can be used as a measure of proprioceptive ability. The loss of the neurophysiological protective reflex involving the anterior cruciate ligament and hamstrings in patients with ACLD is likely to be a contributory factor in the decreased joint stability experienced by these patients.

Adult↗
PubMed1994

Proprioception enhancement for anterior cruciate ligament deficiency. A prospective randomised trial of two physiotherapy regimes.

We performed a prospective, double-blind, randomised, clinical trial to investigate the efficacy of two regimes of rehabilitation for knees with anterior cruciate ligament deficiency (ACLD). Fifty ACLD patients were randomly allocated to one of two treatment groups: a programme of muscle strengthening (T) or a programme designed to enhance proprioception and improve hamstring contraction reflexes (P). An indirect measure of proprioception, the reflex hamstring contraction latency (RHCL), and a functional scoring system were used to record the status of the knee before and after the 12-week course of physiotherapy. Sagittal knee laxity was also measured. There was improvement in mean RHCL and in the mean functional score in both groups after treatment. The improvement in group P was significantly greater than that in group T. There was no significant change in joint laxity after treatment in either group. In both groups there was a positive correlation between improvement in RHCL and functional gain.

Adolescent↗
PubMed1993

Proprioception after rupture of the anterior cruciate ligament. An objective indication of the need for surgery?

Failure of conservative treatment is the usual indication for the reconstruction of a knee with deficiency of the anterior cruciate ligament (ACL) and this depends on subjective judgement. The ability of muscles to protect the subluxing joint by reflex contraction could provide an objective measurement. We have studied 30 patients with unilateral ACL deficiency by measuring the latency of reflex hamstring contraction. We found that the mean latency in the injured leg was nearly twice that in the unaffected limb (99 ms and 53 ms respectively). There was a significant correlation between the differential latency and the frequency of 'giving way' indicating that functional instability may be due, in part, to loss of proprioception. Measures of proprioception, including reflex hamstring latency, may be useful in providing an objective assessment of the efficacy of conservative treatment and the need for surgery.

Adult↗
PubMed1993

Pharmacological effects of cefclidin on the central nervous system.

The effects of cefclidin (CFCL), a novel antibacterial agent, on the central nervous system (CNS) were examined in a variety of animal models. The effects of cefazolin (CEZ) were also examined for comparative purposes. In the animal models used CFCL whilst having some effects at the doses examined, failed to show an overall consistent effect on the CNS. In contrast CEZ produced changes in the parameters measured which were generally consistent with a proconvulsant action.

Animals↗
PubMed1992

The interactions of neuropeptides with membrane model systems: a case study.

The interactions between the positively charged neuropeptides substance P (SP), bradykinin (BK), and zwitterionic Met-enkephalin (ME) neuropeptides, and negatively charged SDS and zwitterionic lysophosphatidylcholine (LPC) membrane model systems, have been investigated using one- and two-dimensional nmr experiments. Proton longitudinal relaxation studies were used to characterize these interactions as intrinsic or extrinsic. An extrinsic interaction are similar to those observed for extrinsic membrane proteins. An intrinsic interaction are similar to those observed for intrinsic membrane proteins, and would require that the hydrophobic residues penetrate or insert into the hydrophobic core of the membrane. The interactions between both SP and BK and SDS, based on nmr results, may be characterized as intrinsic, and the interaction between ME and SDS may be characterized as extrinsic. Two-dimensional nuclear Overhauser enhancement spectroscopy experiments proved the insertion of the phenylalanine residues on both SP and BK into the hydrophobic core of SDS micelles. The interaction between SP and BK with LPC based on nmr results are characterized as extrinsic, with the interaction between ME and SDS characterized as weakly intrinsic.

Bradykinin↗
PubMed1992

The use of UV-visible spectroscopy for the determination of hydrophobic interactions between neuropeptides and membrane model systems.

Ultraviolet-visible spectroscopy has been used as a rapid method to evaluate the hydrophobic interactions between a series of cationic and zwitterionic neuropeptides and dipeptides with the hydrophobic core of two membrane model systems; sodium dodecyl sulfate and lysophosphatidylcholine micelles. If a hydrophobic interaction occurs, a 1-nm bathochromic shift is observed in the uv-visible spectrum of the aromatic side chains when going from aqueous solution to a micellar solution. The aromatic residues of substance P, bradykinin, and Des-Arg9 bradykinin all exhibited the 1-nm bathochromic shift in the presence of sodium dodecyl sulfate while those of Met-enkephalin did not. The opposite effects were observed in the presence of lysophosphatidylcholine micelles.

Amino Acid Sequence↗
PubMed1985

Comparative effects of an antiviral drug, inosiplex, and diphosphonates in Paget's disease of bone.

The effects of the antiviral agent, inosiplex, were assessed in four patients with Paget's disease of bone. Treatment for 6 months did not suppress disease activity as judged by serum alkaline phosphatase and hydroxyprolinuria, and viral inclusions persisted in the one patient from whom a bone biopsy was taken. These results contrasted markedly with the suppressive effects of diphosphonate treatment in these same patients.

Alkaline Phosphatase↗
PubMed1985

Treatment of malignant hypercalcaemia with clodronate.

We have assessed the effects of clodronate (dichloromethylene diphosphonate; Cl2MDP 0.8-3.2g daily by mouth for up to 3 months) in 17 episodes of hypercalcaemia and osteolysis due to carcinoma. Clodronate reduced serum calcium in 14 episodes and bone resorption in all patients. These remained suppressed for the duration of treatment, but recurred promptly when treatment was stopped. Clodronate may be a useful measure for controlling hypercalcaemia and osteolysis in patients with carcinoma.

Adult↗
PubMed1985

Abnormal vitamin D metabolism in Paget's disease of bone.

We have studied several biochemical indices of bone turnover and vitamin D metabolism in 32 untreated patients with Paget's disease and in 32 age-matched control subjects. patients with Paget's disease, as expected, were characterized by high bone turnover, as judged by alkaline phosphatase and urinary excretion of hydorxyproline. Serum values of 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) and the ratio of 24,25(OH)2D3 to 25-OHD were significantly lower in patients than in control subjects. Serum concentrations of 1,25(OH)2D3 were normal in Paget's disease. The distribution of values for 24,25(OH)2D3 was log normal. On the basis of the normal range computed from control subjects, patients were divided into those with low or normal values for 24,25(OH)2D3. Disease activity, as judged by biochemical indices was significantly higher in the patients with the lower values of 24,25(OH)2D3. We conclude that Paget's disease is characterized by low circulating concentrations of 24,25(OH)2D3, particularly in patients with more extensive or severe disease.

24,25-Dihydroxyvitamin D 3↗
PubMed1985

The physical dependence liabilities of oxybutynin and morphine in rats.

The anticholinergic/antispasmodic agent oxybutynin does not induce physical dependence in rats when administered by oral gavage twice daily for 40 days; nor did challenge with naloxone precipitate withdrawal signs in these (oxybutynin-treated) animals. In contrast, morphine treatment resulted in a high degree of physical dependence as evidenced by the withdrawal signs noted after treatment was halted. Challenge with naloxone also induced severe withdrawal signs in morphine-treated rats. Withdrawal signs characterised by squealing, teeth chattering and "wet-dog" shakes were seen in one from five morphine-treated rats challenged with oxybutynin.

Animals↗
PubMed1983

Drug treatment of primary hyperparathyroidism: use of clodronate disodium.

Clodronate disodium (dichloromethylene diphosphonate), a specific inhibitor of bone resorption, was given by mouth (1.0-3.2 g daily) to nine patients with primary hyperparathyroidism for two to 32 weeks so that its clinical and metabolic effects could be evaluated. Bone resorption decreased in all patients as judged by a fall in the fasting urinary calcium to creatinine and hydroxyproline to creatinine ratios. Serum calcium concentration was increased in all patients before treatment and fell in response to treatment to values near the upper end of the normal range. Hypercalcaemia and hypercalciuria recurred when treatment was stopped. In three patients treated for longer than 19 weeks clodronate failed to sustain the reduction in serum calcium concentration but the concentration remained below pretreatment values. These results suggest that clodronate may be of use in the medical management of primary hyperparathyroidism, particularly in patients in whom suppression of bone disease is desirable before surgery or in whom surgery is contraindicated.

Aged↗