Brain stem abscess with direct extension through the internal auditory canal.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
J R Steele
Publications and source records attributed to J R Steele.
Effects of chronic anterior cruciate ligament deficiency on muscle activation patterns during an abrupt deceleration task.
OBJECTIVE: This study examined the influence of chronic anterior cruciate ligament deficiency on muscle activation patterns displayed during abrupt deceleration, relative to timing of tibiofemoral shear forces (Fs) generated during the task. DESIGN: Experimental data were collected for both limbs of 11 chronic functional anterior cruciate ligament deficient subjects and 11 matched controls. METHODS: Electromyographic, high speed film and ground reaction force data were sampled as subjects landed in single-limb stance on a force platform after receiving a chest level pass and decelerating abruptly. Temporal characteristics of each muscle burst relative to initial foot-ground contact were derived and Fs were calculated from net joint reaction forces and the patellar tendon force occasioned by the net moments and inertial forces predicted about the knee. RESULTS: Compared to controls, anterior cruciate ligament deficient subjects displayed a delay in hamstring activation so that peak hamstring activity was more synchronous with initial contact and with the high Fs which occurred after initial contact. CONCLUSIONS: It was concluded the delayed hamstring activation was an adaptation developed to enable peak muscle activity to better coincide with the high anterior Fs, thereby stabilizing the injured limb against a giving-way episode via increased joint compression and posterior tibial drawer.
Adult↗
Transrectal versus transvaginal abscess drainage: survey of patient tolerance and effect on activities of daily living.
PURPOSE: To evaluate patient perception of pain related to transrectal and transvaginal drainage and the catheter's effect on activities of daily living. MATERIALS AND METHODS: From July 1993 to August 1997, 22 male and 40 female patients (mean age, 41 years; age range, 4-80 years) underwent transrectal or transvaginal aspiration or drainage. Fifty-seven drainages were performed. In a follow-up survey, patients were asked to score pain experienced during the procedure and afterward on a scale of 1-10 and to rate the effect of the catheter on their activities of daily living. RESULTS: Twenty-two patients participated in the telephone survey. For those able to recall the insertion procedure, the mean pain score was 3.2 for transrectal and 5.9 for transvaginal drainage. Mean indwelling catheter pain was 1.6 for transrectal and 4.8 for transvaginal drainage. Pain after removal was 1.4 for transrectal and 2.3 for transvaginal drainage. Only one patient with a transrectal catheter reported severe limitation (bowel movement), with no reports of any serious effect on urinating, bathing, sitting, or walking. Transvaginally placed catheters caused marked limitation in all categories and were more painful than transrectal catheters (P < .05). CONCLUSION: Of the transrectal and transvaginal approaches, transrectal is better tolerated.
Abdominal Abscess↗
Breast motion and sports brassiere design. Implications for future research.
Exercise usually results in a large displacement of the breasts, often leading to breast pain. Although breast pain is a common concern of exercising females, little research has been conducted in the area of breast pain. It has been suggested that a cause of breast pain is excessive breast motion. As the female breast does not contain strong intrinsic structural support, this breast motion is difficult to reduce. It is suggested that the primary anatomical support for the breast is the Cooper's ligaments; however, their true functional properties are unknown. Because of the lack of internal breast support it has been suggested that the skin covering the breast may also act as a support structure for the breast, but this has not been quantified. In an attempt to reduce breast motion, external breast supports (brassieres) have been developed. This article discusses components of current sports brassieres with implications for future research required to improve brassiere design and performance.
Biomechanical Phenomena↗
Household-shoe wearing and purchasing habits. A survey of people aged 65 years and older.
A mail survey was conducted to assess the types of household footwear currently being worn by a random sample of independently living men and women aged 65 years and older as well as their needs related to the purchase and wearing of household footwear. Questionnaires were completed by 128 people. The greatest number of respondents wore slippers all day around the home, purchasing these shoes because of their convenience and comfort. Respondents were not willing to purchase expensive shoes for household wear and infrequently replaced them, despite the fact that such footwear was worn for extended periods each day. It was concluded that further research is required to design a household shoe that fits well and accommodates a variety of foot pathologies typical of the elderly foot; the shoe should be comfortable, relatively inexpensive, and safe for typical household surfaces.
Aged↗
A kinematic and kinetic analysis of the sit-to-stand transfer using an ejector chair: implications for elderly rheumatoid arthritic patients.
Twelve elderly female rheumatoid arthritis patients (mean age = 65.5 +/- 8.6 yr) were assessed rising from an instrumented Eser Ejector chair under four conditions: high seat (540 mm), low seat (450 mm), with and without the ejector mechanism operating. Sagittal plane motion, ground reaction forces, and vertical chair arm rest forces were recorded during each trial with the signals synchronised at initial subject head movement. When rising from a high seat, subjects displayed significantly (p < 0.05) greater time to seat off; greater trunk, knee and ankle angles at seat off; increased ankle angular displacement; decreased knee angular displacement; and decreased total net and normalised arm rest forces compared to rising from a low seat. When rising using the ejector mechanism, time to seat off and trunk and knee angle at seat off significantly increased, whereas trunk and knee angular displacement, and total net and normalised arm rest forces significantly decreased compared to rising unassisted. Regardless of seat height or ejector mechanism use, there were no significant differences in the peak, or time to peak horizontal velocity of the subjects' total body centre of mass, or net knee and ankle moments. It was concluded that increased seat height and use of the ejector mechanism facilitated sit-to-stand transfers performed by elderly female rheumatoid arthritic patients. However, using the ejector chair may be preferred by these patients compared to merely raising seat height because it does not necessitate the use of a footstool, a possible obstacle contributing to falls.
Activities of Daily Living↗
Reproducibility of knee laxity assessment results using the dynamic cruciate tester.
The purpose of the study was to examine reproducibility of knee laxity measurements obtained using the Dynamic Cruciate Tester (DCT) from day-to-day, set-to-set, and trial-to-trial. In Part I, peak anterior tibial translation (ATT) was assessed for 1 anterior cruciate ligament (ACL) deficient and 16 control subjects during two sets of three active trials (maximal isometric quadriceps contractions) and three passive trials (240 N load) conducted over four consecutive days. In Part II, peak ATT was recorded for 12 chronic ACL deficient subjects during one set of five active and five passive trials within one day. Results were analysed using mixed repeated measures ANOVA designs with intraclass reliability coefficients (ICC) calculated from the ANOVA results. There were no significant differences in the mean peak ATT results among the four tests days or between the two test sets conducted within a day, with ICC ranging from R1 = 0.939 to 0.980. It was concluded peak ATT measurements obtained using the DCT were reproducible from day-to-day and set-to-set. A significant main effect of trial was found on both active (F(2,32) = 13.93; p < 0.001) and passive (F(2,32) = 57.21; p < 0.001) peak ATT results. It was therefore recommended a full pretrial should be conducted before knee laxity assessment using the DCT to ensure reproducible results.
Adult↗
Foot-care awareness. A survey of persons aged 65 years and older.
The authors conducted a mail survey that examined foot problems, rates of utilization of foot-health services, and the perception of foot problems as medical conditions in a sample of people aged 65 years and older who lived independently. Although 71% of the 128 respondents reported suffering from foot problems, only 39% had consulted medical personnel about their feet, and only 26% identified their foot pathologies as medical conditions. More female than male respondents experienced foot problems and had visited medical personnel about their feet. Increased education of older individuals about their foot-care requirements, as well as increased access to podiatric medical services, is recommended.
Aged↗
Biomechanics of the sprint start.
Many variables have been studied pertaining to the block sprint start. Research suggests that the adoption of a medium block spacing is preferred, with front and rear knee angles in the set position approximating 90 and 130 degrees, respectively, with the hips held moderately high. The sprinter must be capable of developing a high force rate combined with a high maximum force, especially in the horizontal direction. This ability to create high force underlies other important indicators of starting performance such as minimum block clearance time, maximum block leaving velocity and maximum block leaving acceleration. Once the sprinter has projected him/herself from the blocks at a low angle (40 to 45 degrees) relative to the ground, the following 2 post-block steps should occur with the total body centre of gravity ahead of the contacting foot at foot strike to minimise potential horizontal braking forces.
Biomechanical Phenomena↗
An injury profile of elite ironman competitors.
An injury questionnaire was administered to the 30 elite ironman competitors (mean age = 25.7 +/- 4.6 yrs) participating in a commercially sponsored seven race national series. Responses provided retrospective data from the preceding three years indicating the type, location, frequency, cause and severity of injuries sustained by ironmen, and associated these injuries with particular race components (run, swim, board, ski). Twenty self-reported questionnaires were returned for analysis that described a total of 67 injuries incurred by 19 subjects. Results indicated the following: (i) the most frequently injured body parts were the knee (n = 18) and shoulder (n = 14) with the lower extremity accounting for 55% of all injuries reported; (ii) knee, shin and calf injuries had a significant association with the run component and upper extremity injuries had a significant association with the swim component; (iii) running was perceived to be the most injurious race component in terms of the frequency and severity of injury; (iv) overtraining was perceived to be the main cause of injury; (v) tendinitis was perceived to be the main type of injury; (vi) athletes adjusted their training mode to accommodate injury so that total training volume could be maintained; and (vii) injury did not result in withdrawal from competition. Further research investigating the techniques used in the ironman event and their relationship to injury is recommended.
Adult↗
Effect of torso position on arthrometric assessment of anterior knee laxity.
The purpose of the study was to examine the effect of changes in torso position on arthrometric assessment of knee laxity. Anterior tibial translation (ATT) of 12 control and 12 ACL deficient subjects was assessed using a Dynamic Cruciate Tester during five maximal isometric knee extensions and five passive tests (240 N load) on the right and left knee in each of three torso positions: vertical, reclined, and supine. Electromyographic activity of rectus femoris, vastus lateralis, biceps femoris, and semimembranosus were sampled during arthrometric assessment. Results indicated there was no significant difference in mean ATT as a function of torso position. However, subjects demonstrated significantly greater hamstring activity when seated vertically compared to reclined or supine and significantly greater hamstring activity when reclined compared to supine.
Journal Article↗
Effect of work station design on sitting posture in young children.
The purpose of the study was to compare muscular activity levels and sitting posture displayed by 10 children (mean age = 4.7 years) when performing tracing tasks while seated at a traditional work station (level desk top, 5 degrees backward sloping seat) and at an ergonomically designed work station (15 degrees sloping desk top, 15 degrees forward sloping seat). EMG profiles of latissimus dorsi (LD), erector spine (ES), and superior trapezius (ST) were sampled using Medi-trace disposable surface electrodes for 10 min on the non-dominant side. Muscle activity was sampled (1000 Hz) every 2 min for 5000 ms while the subjects performed the tracing tasks at each station. Raw EMG signals of the five trials for each muscle were processed by removing signal offset, full-wave rectification, and integration. The subjects' posture was monitored from a lateral view using a Panasonic VHS video camera while the children were seated at each work station. Neck flexion angle and the angle between the torso and thigh (hip angle) were manually sampled from the video images each 1 min as an indication of the posture adopted by the subjects during the tracing tasks. Use of t-tests for dependent means indicated that there was no significant difference in either mean ES or ST muscle activity as a function of work station design. However, subjects demonstrated significantly less LD activity when seated at the ergonomic work station (mean = 20.9 V ms) compared with the traditional work station (mean = 24.4 V ms, t = -2.88, p = 0.018).(ABSTRACT TRUNCATED AT 250 WORDS)
Child, Preschool↗
Traumatic anterior dislocation of the hip: spectrum of plain film and CT findings.
Traumatic anterior dislocation of the hip represents 11% of all hip dislocations and is classified into superior and inferior types [1]. Whereas inferior anterior hip dislocation is easily recognized on an anteroposterior radiograph of the pelvis, the radiographic appearance of superior anterior hip dislocation is less straightforward, often leading to an initial misdiagnosis of posterior hip dislocation. Misdiagnosis of the direction (anterior versus posterior) of a hip dislocation can result in failed closed reduction or an improper surgical approach to open reduction. In addition, recognition of associated impaction fractures is important, as patients with this finding have a greater tendency to develop traumatic arthritis [2, 3]. This pictorial essay, which is based on our experience with 20 cases of anterior hip dislocation, including five of the rare superior type, illustrates the spectrum of radiographic findings and distinguishing features associated with anterior hip dislocation.
Adult↗
A three-dimensional representation of an athletic female knee joint using magnetic resonance imaging.
Intense interest in knee joint mechanics has resulted in the development of numerous models to predict forces acting at the knee. However, few models have accounted for the unique geometric characteristics of the knee joint's articular surfaces when predicting the mechanical response of the joint. The purpose of this study was to stimulate accurately the complex geometric characteristics of the tibiofemoral joint for input into a finite element model representing the knee joint of athletic females. The right knee of an athletic female with no history of knee joint trauma was imaged using a 0.5 T magnetic resonance imaging (MRI) unit. Twelve cross-sectional slices of the knee were scanned in each of three orthogonal planes (coronal, sagittal and axial) at slice intervals of 6 mm, 7 m, and 8 mm respectively. A scan plan (two coronal images and an axial image) was also generated to enable calculation of the orthogonal scans with respect to one another. Select anatomical reference points representing cancellous and compact bone, major ligament attachment areas, and articular cartilage of the distal femur and proximal tibia were digitized from the processed shadowgraphs. The processed digitized data were input into a computer graphics program which was the pre- and post-processing software for the finite element analysis package. Contours of the cancellous and compact bone of the tibial and femoral condyles were generated using beta and cubic spline curves. Bezier quadratic and cubic polynomials were used to reconstruct the tibial and femoral shafts.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Biomechanical factors affecting performance in netball. Implications for improving performance and injury reduction.
Despite netball having one of the largest number of participants of any team game within the Commonwealth there has been limited research conducted which biomechanically analysed skills of the game. However, information presented from biomechanical analyses of skills can provide coaches with the necessary theoretical basis to teach netball fundamentals to junior players. Biomechanical information can also be used to refine the existing techniques of experienced netball players so they may achieve optimal technical performance of game skills while minimising the potential for injury. Changes to footwork rules and to the material properties of court surfaces and footwear could reduce stress placed on the musculoskeletal system. However, the factor which influences musculoskeletal stress to the greatest extent is a player's landing technique. Thus, the first concern for all netball coaches must be to teach all players to land correctly. The magnitude and rate of loading of the high vertical and horizontal ground reaction forces generated when players execute abrupt landings in netball are reduced more effectively by encouraging players to throw higher passes, requiring the receiver to jump upward to catch the ball. However, to maximise the reduction in stress placed on the musculoskeletal system on landing, players should be encouraged to land with the foot neutrally aligned (not abducted or adducted), ensure adequate hip and knee flexion, and reduce the foot-hip displacement by eliminating an exaggerated 'striding out' position often adopted by netball players. Apart from landing techniques, the only netball skill that has been objectively analysed is goal shooting. To improve shooting accuracy players should demonstrate greater flexion of the knees and shooting elbow when preparing to shoot, sufficient but not excessive hyperextension of the hand to stabilise the ball, minimisation of trunk, arm and forearm movements during the shooting action in favour of increased hand motion, greater release height and greater release velocity. If the potential for injury from poorly executed skills in netball is to be minimised, further research is required to identify the most efficient methods of performing all skills involved in the game, including pivoting, rebounding, defensive movement patterns, and attacking movement strategies.
Athletic Injuries↗
Transient diffuse computed tomographic scan enhancement in multifocal seizures.
Previous reports have documented transient angiographic and nucleotide brain scan abnormalities in patients with focal seizures. We describe transient diffuse cortical computed tomographic scan enhancement in a 1-year-old infant with repetitive multifocal seizures. Similar scan abnormalities may be seen in certain asphyxiated infants and occasionally in victims of child abuse. The implications of these findings are discussed.
Electroencephalography↗
Brainstem evaluation with CT cisternography.
Seventy-eight positive contrast computed tomography (CT) cisternograms were reviewed to assess the normal anatomy of the brainstem and its surrounding cisterns. Normal brainstem and cisternal anatomy was found to be constant and symmetrical. The review included six patients with brainstem gliomas and five patients with extraaxial masses. In these patients CT cisternography accurately identified mass formation and permitted the confident distinction of extraaxial from intra-axial masses. CT cisternography is a safe and accurate method for evaluating the anterior compartment of the posterior fossa. This procedure is particularly applicable to those cases where conventional CT yields insufficient diagnostic information.
Adolescent↗
Computed tomography of the pancreas: the use of intravenous contast to define the dorsal surface of the pancreas.
After a non-selective review of 80 abdominal CT examinations, it was found that the use of intravenous contrast markedly improves the recognition of the superior mesenteric vein and the splenic vein. These veins lie adjacent to the posterior surface of the pancreas. When the pancreas is poorly seen due to inadequate retroperitoneal fat, when pancreatic size is borderline, or when pancreatic ductal obstruction is suspected on scans prior to intravenous contrast administration, the use of contrast may resolve the uncertainty.
Abdominal Neoplasms↗