Search PubMed⌕ Search

Biomedical subjects

J S Huntley

Publications and source records attributed to J S Huntley.

At least 19 recordsLinked to original sources
PubMed2007

Grip strength and forearm circumference in a healthy population.

Two hundred and fifty subjects were recruited. Age, sex, hand preference and anthropometric measurements were recorded for each subject. Grip strength was measured using a Jamar hydraulic dynamometer. Multiple regression analyses were performed. One hundred and seventy two subjects were men and 78 were women. Twenty-six subjects were left hand dominant. Hand grip strength was greatest for the 35 to 44 year old group for both sexes. Grip strength was consistently greater for men than women. Contralateral grip strength predicted maximum grip strength for both sexes. Forearm circumference predicted maximum hand grip strength for men. Although there was a large range of forearm circumferences in the population, there was little difference between sides for each subject (100% less than 2 cm). The demonstrated relationships between: (i) contralateral grip strengths and (ii) grip strength and forearm circumference lead us to suggest that for certain pathologies, a difference in forearm circumference greater than 2 cm may lend credence to a measurement of diminished grip strength.

Adolescent↗
PubMed2005

Use of non-degenerate human osteochondral tissue and confocal laser scanning microscopy for the study of chondrocyte death at cartilage surgery.

Although autologous osteochondral grafting has been widely applied in humans, most in vitro work has been on animal models. The aims of this study were to: (i) elaborate a full thickness human femoral condylar model using discard material from knee arthroplasty resections, and (ii) use this model to assess chondrocyte viability in response to surgical trauma. Homogeneous regions of human lateral femoral condyle bone-cartilage were procured from knee arthroplasty resections. These were graded prospectively, firstly by visual inspection, and then by confocal laser scanning microscopy (CLSM). Samples were subjected to tests of tissue hydration, including analysis of water content and swelling after excision from underlying bone. Surgical cuts were made in explants that were macroscopically and microscopically normal (i.e. Grade 0). Associated margins of death were assessed from both transverse and surface perspectives. Thirty-nine samples were obtained from anterior and distal femoral cuts (16 knees from 13 patients) for (1) macroscopic grading, (2) microscopic analysis, (3) analyses of water content as cut and on re-equilibration after excision from bone. Thirteen were Grade 0 on macroscopic viewing--however one showed fibrillation on microscopy and was therefore reassigned Grade 1. Grade 0 tissue had a water content of 73.8+/-0.38%, in agreement with control values from the literature. Tissues of Grades 2 and 3 were significantly (P=0.03, and P=0.004) more hydrated (76.0+/-0.59%, 76.7+/-0.99%) than Grade 0 tissue. Grade 0 tissue from the anterior cut did not swell significantly following excision from subchondral bone. However Grade 0 tissue from the distal cut showed a small but statistically significant (P=0.019) increase in water content (1.68+/-0.39%) following excision. With increasing grade there was increased tendency to swell off the bone (P<0.0001). Transverse imaging showed that the Acufex MP surgical harvester caused a greater margin of cell death (211+/-18.3 microm) in the superficial zone (SZ) than the mid-zone (50.5+/-13.6 microm; P=0.022), or SZ death from a scalpel cut (33.0+/-8.5 microm; P=0.0009). Similarly, in unfixed samples viewed from the surface perspective, the margin of death for the surgical harvester (277+/-7.2 microm) was significantly (P<0.0001) greater than that for the scalpel (38.8+/-7.2 microm). If macroscopically and microscopically non-degenerate, then human lateral femoral condylar cartilage from the anterior cut of knee resections has normal biophysical parameters (water content and lack of swelling on excision). The surgical harvester (Acufex), used in human osteochondral grafting, caused a substantial margin of cell death at the periphery of the graft, and the SZ appeared to be especially vulnerable. This effect may be important in terms of limiting the reparative capacity of the SZ. The harmful effect on viability is likely to impede lateral repair which is fundamental to subsequent structural and functional integrity.

Adult↗
PubMed2005

Cutting-edge design to improve cell viability in osteochondral grafts.

INTRODUCTION: Autologous osteochondral grafting is in widespread use for focal defects of articular cartilage. There is major concern over the nature of the tissue bridging graft elements and graft/recipient cartilage. Chondrocyte viability is thought to be an important determinant of the quality of repair. The aim of the current study was to compare the zone of death for osteochondral grafts harvested with the commercially available Acufex, and an osteotome with a specially designed cutting-edge. MATERIALS/METHODS: The circular osteotomes were the Acufex 4.5mm MP (Smith & Nephew) and the Lissimore, which has a different cutting-tip geometry and sharpness. These implements were used to harvest osteochondral plugs from macroscopically non-degenerate human lateral condyle explants obtained from the anterior femoral cuts of knee replacement surgery. Confocal laser scanning microscopy with vital staining was used to quantify the zone of marginal chondrocyte death for the entire perimeter of the plugs. RESULTS: The increase in cartilage plug diameter (reference the osteotome minimal internal diameter) was significantly greater for the Acufex (Mann-Whitney; n=5; P=0.0079), with the diameter (mm) increasing by 0.49+/-0.03 (10.9%), compared with 0.16+/-0.02 (3.3%) for the Lissimore. Osteochondral plugs had a significantly (Mann-Whitney; n=5; P=0.0079) lower mean margin of cell death with the Lissimore osteotome (117.8+/-8.97 microm) than the Acufex MP (315.3+/-5.90 microm). CONCLUSIONS: Cutting-tip profile is an important factor in determining the extent of marginal death in circular osteochondral grafts. We have designed and assessed an alternative cutting-tip, which caused significantly less marginal death than the commercially available Acufex. We conclude that there is scope for improvement of osteochondral harvest techniques.

Aged↗
PubMed2005

A users guide for reducing the pain of local anaesthetic administration.

Local anaesthetics (LAs) are used by medical practitioners in a number of clinical settings. The choice of agent and mode of administration is influenced by their experience, speciality and knowledge of the evidence base. Patients often express concern about the discomfort experienced during injection. Although short lived, the pain of LA administration in some patients is severe enough for them to decline future surgery. Methods to minimise the pain of LA administration relate to (1) the patient, (2) the LA, and (3) the injection technique (table 1). This article aims to provide a practical guide to doctors of all specialities who use LAs.

Anesthesia, Local↗
PubMed2005

C-reactive protein: a valuable acute investigation. A case of pneumococcal meningitis presenting as ankle pain.

A case is presented in which the decision to admit and treat an adult with musculoskeletal pain and pyrexia was based on her markedly raised c-reactive protein (CRP). At the time of admission she was apyrexial and the CRP was the only haematological investigation that was out of the normal range. She subsequently became precipitously septic with pneumococcal bacteraemia and meningitis. The CRP is an important investigation for emergency departments.

Acute Disease↗
PubMed2005

Chondrocyte death associated with human femoral osteochondral harvest as performed for mosaicplasty.

BACKGROUND: Autologous osteochondral transfer is an option for the treatment of articular defects. However, there are concerns about graft integration and the nature of the tissue forming the cartilage-cartilage bridge. Chondrocyte viability at graft and recipient edges is thought to be an important determinant of the quality of repair. The purpose of the present study was to evaluate early cell viability at the edges of osteochondral grafts from ex vivo human femoral condyles. METHODS: Fresh human tissue was obtained from eleven knees at the time of total knee arthroplasty for the treatment of osteoarthritis. Osteochondral cylinders were harvested with use of a 4.5-mm-diameter mosaicplasty osteotome from regions of the anterolateral aspect of the femoral condyle that were macroscopically nondegenerate and histologically nonfibrillated. Plugs were assessed for marginal cell viability by means of confocal laser scanning microscopy. RESULTS: The diameter of the cartilaginous portion of the osteochondral plugs was a mean (and standard error of the mean) of 4.84 +/- 0.12 mm (as determined on the basis of three plugs). This value was approximately 300 microm greater than the measured internal diameter of the osteotome. There was a substantial margin of superficial zone cell death (mean thickness, 382 +/- 68.2 microm), with >99% cell viability seen more centrally (as determined on the basis of five plugs). Demiplugs were created by splitting the mosaicplasty explants with a fresh number-11 scalpel blade. The margin of superficial zone cell death at the curved edge was significantly greater than that at the site of the scalpel cut (390.3 +/- 18.8 microm compared with 34.8 +/- 3.2 microm; p = 0.0286). Similar findings were observed when the cartilage alone was breached and the bone was left intact, with the margin of superficial zone cell death being significantly greater than that obtained in association with the straight scalpel incision (268 +/- 38.9 microm compared with 41.3 +/- 13.4 microm; p = 0.0286). The margin of superficial zone cell death showed no increase during the time-period between fifteen minutes and two hours after plug harvest. A mathematical approximation of the mosaicplasty region suggested that early cell death of this magnitude affects about one third of the superficial graft area. CONCLUSIONS: The results of the present study suggest that mosaicplasty, while capable of transposing viable hyaline cartilage, is associated with an extensive margin of cell death that is likely to compromise lateral integration and articular reconstruction.

Aged↗
PubMed2004

Informed consent and the JHO in Scotland.

AIM: To define the views of junior house-officers (JHOs) concerning consent for general surgical conditions. METHODS: Questionnaire-based descriptive study on two cohorts of JHOs, separated by 3 years of major national and local directives. RESULTS: From the JHO perspective: (i) there has been a shift away from the JHO being the main signatory, (ii) many JHOs (58% in 2000; 47% in 2003) feel unsupported with respect to obtaining consent, (iii) knowledge concerning any consultant/unit's complication rates was poor (<30%), (iv) knowledge concerning complication rates for several paradigm procedures was also poor, though it improved from 2000 to 2003, (v) there is no formal training in consent. CONCLUSIONS: Despite the JHO group of 2003 outperforming that of 2000, there is major scope for improvement from patient, legal, educational and risk-management perspectives.

Attitude to Health↗
PubMed2004

Castell coch.

Explore the source record for details and available documents.

Journal Article↗
PubMed2003

Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons.

To assess the reasons for and outcomes of referrals concerning the foreskin, 100 consecutive patients seen in paediatric clinics were followed to discharge. 18 referrals were for circumcision on religious grounds. Of the other 82, the main reason for referral was non-retractability or phimosis. At clinic, 24 (29%) of these were deemed normal for age, 31 (38%) were treated with topical steroid (successfully in 25), 9 (11%) were listed for preputioplasty, 7 (9%) were listed for adhesiolysis, 7 (9%) were listed for circumcision, and 4 were listed for other forms of surgery. 6 patients were identified as having balanitis xerotica obliterans (BXO), a condition that had not been suggested on referral. With the advent of new treatments for foreskin disorders, circumcision is decreasingly necessary. Knowledge of the natural history of the foreskin, and the use of topical steroids, could shift the management of paediatric foreskin problems from the hospital outpatient department to primary care. BXO is not sufficiently recognized as a form of phimosis that requires operation.

Administration, Topical↗