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Biomedical subjects

J Christie

Publications and source records attributed to J Christie.

At least 73 records · Page 4Linked to original sources
PubMed1991

Subconjunctival high dose plasminogen activator in rabbit filtration surgery.

The primary cause of failure in glaucoma filtration surgery is fibroblastic proliferation and subconjunctival fibrosis at the bleb site resulting in decreased aqueous flow. We evaluated New Zealand white rabbits in a masked, placebo controlled pilot study to determine the potential reduction of episcleral fibrosis at the surgical bleb site utilizing 0.3 mls of: balanced salt solution (n = 11); an inert gel delivery vehicle (n = 13); the gel delivery vehicle with incorporated recombinant tissue plasminogen activator (tpa; n = 14), 1 mg/ml. Statistical analysis of computer assisted area measurements from multiple histologic sections demonstrated a significant decrease in episcleral fibrosis in the t-PA group as compared to the two other groups (p less than 0.05). Results from the t-PA group did not demonstrate an effect on intraocular pressure. There was no clinical evidence of toxicity or healing complications in the t-PA group.

Animals↗
PubMed1991

Locked intramedullary nailing of open tibial fractures.

We report the use of Grosse-Kempf reamed intramedullary nailing in the treatment of 41 Gustilo type II and III open tibial fractures. The union times and infection rates were similar to those previously reported for similar fractures treated by external skeletal fixation, but the incidence of malunion was less and fewer required bone grafting. The role of exchange nailing is discussed and a treatment protocol is presented for the management of delayed union and nonunion.

Adolescent↗
PubMed1990

Reduced plasma oestrogen stimulated neurophysin and delayed response to oestrogen challenge in Alzheimer's disease.

Plasma concentrations of oestrogen stimulated neurophysin (ESN) were reduced in 28 patients with Alzheimer's disease (AD) compared with 14 age-matched controls, 16 patients with other presenile dementias and 12 patients with major depressive disorder. The ESN response to oestrogen challenge was delayed in 10 AD patients compared with 7 age-matched controls. Reduced basal and oestrogen stimulated plasma ESN may be related to impaired responsiveness of the hypothalamo-neurohypophysial neurons and/or a reduction in the amount of pituitary ESN available for release. Plasma ESN measurements may be of value for excluding the diagnosis of AD in patients with dementia who present before the age of 65.

Administration, Oral↗
PubMed1990

Novel exercise protocol suitable for use on a treadmill or a bicycle ergometer.

Many exercise protocols are in use in clinical cardiology, but no single test is applicable to the wide range of patients' exercise capacity. A new protocol was devised that starts at a low workload and increases by 15% of the previous workload every minute. This is the first protocol to be based on exponential rather than linear increments in workload. The new protocol (standardised exponential exercise protocol, STEEP) is suitable for use on either a treadmill or a bicycle ergometer. This protocol was compared with standard protocols in 30 healthy male volunteers, each of whom performed four exercise tests: the STEEP treadmill and bicycle protocols, a modified Bruce treadmill protocol, and a 20 W/min bicycle protocol. During the two STEEP tests the subjects' oxygen consumption rose gradually and exponentially and there was close agreement between the bicycle and the treadmill protocols. A higher proportion of subjects completed the treadmill than the bicycle protocol. Submaximal heart rates were slightly higher during the bicycle test. The STEEP protocol took less time than the modified Bruce treadmill protocol, which tended to produce plateaux in oxygen consumption during the early stages. The 20 W/min bicycle protocol does not take account of subjects' body weight and consequently produced large intersubject variability in oxygen consumption. The STEEP protocol can be used on either a treadmill or a bicycle ergometer and it should be suitable for a wide range of patients.

Adult↗
PubMed1990

Compartment pressures after intramedullary nailing of the tibia.

Intracompartmental pressures of 66 patients with 67 tibial fractures treated by intramedullary nailing were monitored. There was no difference in the pressures recorded between the different Tscherne fracture types, between open and closed fractures, between low energy and high energy injuries or between fractures dealt with early and those not treated until more than 24 hours after injury. The overall incidence of acute compartment syndrome was 1.5%. No patient developed any sequelae of compartment syndrome. We conclude that intramedullary nailing does not increase the incidence of acute compartment syndrome in tibial fractures and that delay does not reduce the risk of raised compartment pressures.

Adolescent↗
PubMed1990

Closed intramedullary tibial nailing. Its use in closed and type I open fractures.

We present the results of using the Grosse-Kempf interlocking nail in the management of 125 closed and type I open tibial fractures. The mean time to union was 16.7 weeks and no fracture required bone grafting. Mobilisation of the patient and the range of joint movement were better than with other methods of treating tibial fractures. There was a 1.6% incidence of infection; 40.8% of patients had knee pain and 26.4% needed to have the nail removed. Other complaints were minor. We suggest that closed intramedullary nailing with an interlocking nail system is an excellent method of treating closed and type I open tibial fractures.

Adolescent↗
PubMed1990

External fixation for type III open tibial fractures.

An analysis of 51 type III open tibial fractures treated by external skeletal fixation is presented. The fractures are subdivided according to the classification of Gustilo, Mendoza and Williams (1984) into types IIIa, IIIb and IIIc. The different prognoses of these fracture subtypes is examined. The use of the Hoffmann and Hughes external fixators in the management of type III open tibial fractures is presented and it is suggested that the prognosis is independent of the type of fixator used.

Adolescent↗
PubMed1988

Undisplaced fracture of the neck of the femur: results of treatment of 100 patients treated by single Watson-Jones nail fixation.

In a review of 100 patients with clinical and radiological evidence of undisplaced Garden stage I and II fractures of the neck of the femur treated by fixation with a single Watson-Jones nail, the early mortality was 4 per cent and in 93 cases with complete radiological data important displacement of the fracture during surgery occurred on one occasion. Of 72 patients with a mean follow-up of 22.6 months (range 3-83 months) 68 patients (94.4 per cent) achieved union and non-union occurred in 4 patients (5.6 per cent) all of whom required further surgery. In 40 patients with united fractures with a minimum follow-up of 2 years (mean 41.2 months; range 24-83 months) the overall incidence of avascular changes was 22.5 per cent; three patients required revisional surgery for late segmental collapse and a further six patients had avascular changes with minimal symptoms. Single nail fixation is a safe reliable procedure and there appears to be little indication for multiple fixation or compression devices for this fracture.

Adult↗
PubMed1988

Angina pectoris during exercise--relationship to coronary anatomy and myocardial function.

We studied 34 patients with proven coronary heart disease to determine whether the presence or absence of angina pectoris during exercise testing was associated with greater disease, ST segment depression or fall in left ventricular ejection fraction. Angina pectoris was the limiting symptom in 19 and fatigue/breathlessness in 15 patients. Exercise time [421(31) vs. 455(64) s], ST depression [1.4(0.3) vs. 1.1(0.3)mm], fall in left ventricular ejection fraction [13(2) vs. 12(2)] and coronary score and fall in left ventricular ejection fraction [15(2) vs. 8(3), P less than 0.02]. The degree of ST segment depression correlated with the coronary score (r = 0.6) and fall in left ventricular ejection fraction (r = 0.5). ST segment depression but not angina pectoris during exercise predicted the extent of disease and its functional consequences.

Angina Pectoris↗
PubMed1988

Fixation of displaced subcapital femoral fractures. Compression screw fixation versus double divergent pins.

One hundred and twenty-seven consecutive patients with displaced subcapital fractures of the femoral neck (Garden Grade III or IV) all under 80 years of age and independently mobile, were randomly allocated to fixation with either double divergent pins or a single sliding screw-plate device. The incidence of non-union and infection in the sliding screw-plate group was significantly higher, and we believe that when internal fixation is considered appropriate multiple pinning should be used. Mobility after treatment was disappointing in about half of the patients, and we feel that internal fixation can only be justified in patients who are physiologically well preserved and who maintain a high level of activity.

Adult↗
PubMed1988

Intramedullary locking nails in the management of femoral shaft fractures.

Intramedullary locking nails have proved to be of considerable advantage when treating complex, comminuted or segmental femoral shaft fractures. We have reviewed 117 patients with 120 femoral shaft fractures treated with the Strasbourg device. These included 20 compound fractures, 13 pathological fractures and two non-unions. Rehabilitation and union rates have been very satisfactory and there have been no serious infections in the series. Comminution of the proximal femur has occurred in six patients and there have been three femoral neck fractures, but all of these have healed without further complications.

Adolescent↗
PubMed1987

Determination of stroke volume and cardiac output during exercise: comparison of two-dimensional and Doppler echocardiography, Fick oximetry, and thermodilution.

Simultaneous estimates of cardiac output were made during graded upright maximal exercise in 10 male subjects by means of Doppler velocity spectrum of ascending aortic flow, apical two-dimensional echocardiograms, thermodilution, and Fick oximetry. In 15 subjects, aortic annular and root diameters were measured during similar exercise from parasternal two-dimensional echocardiograms. The linear correlation between Doppler, two-dimensional echocardiography, and the invasive estimates ranged from r = .78 to r = .92. Both echocardiographic techniques were able to predict changes in invasive flow estimates with reasonable accuracy. Two-dimensional echocardiographic flow estimates underestimated invasive values by about 60%. The accuracy of Doppler flow estimates varied with the method of estimating aortic cross-sectional area. Greatest accuracy was obtained with areas calculated from diameters measured at the aortic value anulus with the leading edge-to-leading edge method of measurement. Correlation coefficients comparing Doppler and thermodilution flow estimates were generally higher (r = .75 to .96, mean .86) for individuals than for the group, but accuracy of the Doppler estimates in single subjects was quite variable. Aortic diameters did not increase from rest to moderate levels of upright exercise. A 3% to 5% increase in resting aortic diameter was noted in the upright posture as compared with the supine. Doppler flow estimates were obtained in all subjects to maximal exertion but in only a minority of subjects with two-dimensional echocardiography or thermodilution. Thus two-dimensional and Doppler echocardiography offer a noninvasive means of estimating cardiac output during vigorous exercise. The Doppler technique is technically more suitable to the study of exercise than two-dimensional echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Business management in agricultural practices.

Veterinarians tend to look upon themselves as professionals first, and as businessmen either second or not at all. This was the main conclusion of a study of 10 livestock practices mainly in the Lakelands area. The study attempts to show that by ignoring standard marketing and accounting procedures, they are wasting an opportunity to improve their financial efficiency and the quality of service they provide. Both these qualities will become more and more important in an increasingly competitive world, it says.

Agriculture↗