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Biomedical subjects

N J Barton

Publications and source records attributed to N J Barton.

At least 37 records · Page 2Linked to original sources
PubMed1994

Scintigraphy in the evaluation of the "clinical" scaphoid fracture.

In a prospective study we performed bone scans on 84 patients who had sustained a wrist injury and in whom a scaphoid fracture was clinically suspected but could not be confirmed on the original set of five routine "scaphoid view" radiographs. In 40 patients the bone scan was normal and in 25 there was increased uptake in areas other than the scaphoid. In 19 there was localized increased uptake in the scaphoid bone. In seven of these a scaphoid fracture was subsequently demonstrated on repeat radiographs (five cases) or a CT scan (two cases). In the remaining 12 no fracture could be demonstrated.

Carpal Bones↗
PubMed1994

Excision of the trapezium for osteoarthritis at the base of the thumb.

We have assessed the results of 34 simple excisions of the trapezium, with no additional soft-tissue procedures, in 30 patients. At a median follow-up of five years (2 to 22), 16 thumbs (47%) were completely painfree and a further 10 (29%) were slightly painful after use. Nineteen thumbs (56%) had no functional disability, but thumb-pinch strength was reduced by about 20%. No patient had painful degeneration at the scaphotrapezial pseudarthrosis.

Adult↗
PubMed1993

The Kapandji procedure for post-traumatic problems.

The Kapandji procedure was performed on 14 patients who presented with chronic pain at the distal radioulnar joint, limited forearm rotation or poor grip after an injury involving the distal radioulnar joint. Ten patients were able to resume their original occupation and leisure activities. Some complained of mild aching after heavy use. Postoperatively, grip strength on the affected side was, on average, 84 per cent that of the opposite side. Forearm rotation in the affected arm averaged 129 degrees before operation and 170 degrees afterwards, compared with 171 degrees on the normal side, while wrist flexion-extension averaged 129 degrees preoperatively, 126 degrees postoperatively and 148 degrees on the normal side. Four patients had less satisfactory results because of pain and a feeling of insecurity due to an unstable proximal ulna. However, two of these had severe residual problems in relation to the initial forearm component of the injury, the symptoms from which were difficult to separate from the distal radioulnar injury. Although the Kapandji procedure can yield excellent results, it is difficult to predict which patients will suffer from an unstable ulna.

Adolescent↗
PubMed1993

Nonunion of fractures of the scaphoid tuberosity.

Fracture of the tuberosity of the scaphoid is common and usually heals without incident because of the good blood supply. We report four cases of nonunion of this fracture. Three of them were symptomatic and two required operative treatment.

Adult↗
PubMed1992

The natural history of undiagnosed wrist pain in young women. A long-term follow-up.

43 young women with undiagnosed wrist pain were followed up for a median of 13 years (range 3 to 19). 26% were now free of pain and 35% had improved; 30% were unchanged and 9% were worse. Overall, 40% were still significantly troubled. There was no evidence that those patients suffered or had suffered from emotional or psychiatric disturbance which might have been responsible for the pain. Only three patients had developed ganglia.

Adolescent↗
PubMed1991

Hand injuries in cricketers.

55 patients with 64 injuries of the hand sustained while playing cricket were reviewed, 46 clinically. Most of the injuries were during fielding. The peripheral digits were most frequently involved and joint injuries predominated. Though the majority of the patients had a satisfactory functional outcome, some admitted to occasional pain and persistence of swelling and/or minor deformity. The most serious injuries were eleven fractures of the base of the middle phalanx with dislocation of the P.I.P. joint.

Adolescent↗
PubMed1991

Need the thumb be immobilised in scaphoid fractures? A randomised prospective trial.

Immobilisation of the thumb is widely believed to be important in the management of fractures of the carpal scaphoid. To assess the need for this, we randomly allocated 392 fresh fractures for treatment by either a forearm gauntlet (Colles') cast, leaving the thumb free, or by a conventional 'scaphoid' plaster incorporating the thumb as far as its interphalangeal joint. In the 292 fractures which were followed for six months, the incidence of nonunion was independent of the type of cast used.

Adolescent↗
PubMed1991

Coccidiosis in common wombats (Vombatus ursinus).

Eimeria arundeli is a widespread coccidian parasite of the common wombat (Vombatus ursinus), and has been considered to be nonpathogenic. We describe disease in two captive juvenile wombats ascribed to infection with E. arundeli. One animal had diarrhea, the second had mucoid soft feces and lost weight over several weeks prior to death. Masses of coccidial gametocytes in hypertrophic cells in the lamina propria distended villi, causing grossly visible raised pale thickened regions over extensive areas of the mucosa of the small intestine in both animals. Neutrophils infiltrated affected mucosa, and there was an inflammatory exudate into the intestinal lumen in case one. In case two, neutrophils infiltrated the lamina propria of villi focally, crypts were distended by necrotic debris, and epithelium on villi was extremely attenuated. No bacterial pathogens were isolated from lung and intestine in case one; case two was not cultured. Oocysts consistent with E. arundeli were present in large numbers in floatations of diarrheic feces in both cases.

Animals↗
PubMed1990

A long-range restriction map between the alpha-globin complex and a marker closely linked to the polycystic kidney disease 1 (PKD1) locus.

Two polymorphic loci and two additional probes that map close to CMM65, which is tightly linked to the polycystic kidney disease 1 (PKD1) locus in chromosome band 16p13.3, are described. These new probes were isolated from a library that was enriched by preparative pulsed-field gel electrophoresis (PFGE) for sequences from a 320-kb NotI fragment that includes CMM65. Through the use of a panel of somatic cell hybrids and PFGE, the new polymorphic loci, PNL56S and NKISP1, were localized within 60 kb and approximately 250 kb distal to CMM65, respectively. A long-range restriction map linking these new probes and the distal markers EKMDA2, CMM103, and alpha-globin was constructed. These latter probes have been localized to regions approximately 900 kb, 1.2 Mb, and 1.9 Mb distal to CMM65, respectively. The entire region was found to be unusually rich in CpG dinucleotides. The new polymorphic probes and the long-range map will aid both the search for the PKD1 locus and the detailed characterization of this distal region of 16p.

Animals↗
PubMed1990

The efficacy of a controlled-release albendazole capsule in suppressing nematode burdens in sheep.

An experiment was undertaken between July and November 1985 in East Gippsland, Victoria, to determine the efficacy of an intra-ruminal controlled-release albendazole capsule against naturally acquired worm burdens and larval challenge in Merino hoggets. Two groups of 20 sheep, one group untreated, the other dosed with a capsule were grazed together; 5 sheep from each group were slaughtered for total worm counts 30 and 101 d after capsules were administered. Serum anthelmintic concentrations, faecal egg counts and body weights were monitored. Most capsules were exhausted within 91 d of administration. During the estimated 80 d for which they remained active the capsules were highly effective against the benzimidazole-susceptible worm populations. Faecal egg counts were reduced to zero and total worm populations were reduced by over 97% 30 d after administration. By 101 d egg counts were increasing and worm counts indicated that sheep were becoming reinfected. Sheep treated with the capsules grew faster than those not treated.

Albendazole↗
PubMed1990

Suspected scaphoid fractures. The value of radiographs.

Twenty observers reported independently on the presence or absence of a fracture of the scaphoid on 60 sets of radiographs; these included initial and 2- to 3-week views in patients in whom the outcome was known, normal scaphoids and random copies of these. Analysis of variance of the accuracy of observations revealed that the 2- to 3-week radiographs did not improve diagnostic ability and that this was independent of the experience or seniority of the observer. For normal radiographs, 20% of the observations reported a fracture. Reproducibility of opinion improved with experience but this did not help with accuracy. Radiographs without accurate clinical observation should not determine the management of the suspected scaphoid fracture.

Carpal Bones↗
PubMed1990

Identification of a locus which shows no genetic recombination with the autosomal dominant polycystic kidney disease gene on chromosome 16.

The major site for mutations leading to autosomal dominant polycystic kidney disease (ADPKD) is at the PKD1 locus, previously mapped to 16p13. Three additional probes have now been mapped within an existing array of genetic markers flanking this locus. One of these, CMM65b (D16S84), shows no recombination with PKD1 in 201 informative meioses. The others, Fr3-42 (D16S21) and EKMDA2 (D16S83), are shown to be the closest telomeric flanking markers. Somatic cell hybrids containing derivative chromosome 16s were used to construct a physical map of the region. Cosmid overlap cloning of the D16S84 region allowed a t(16;1) translocation breakpoint to be mapped at the molecular level, orientating the extended D16S84 locus with respect to the chromosome. The new markers and physical map described here provide an improved framework for attempts to clone the PKD1 region and to identify polycystic kidney disease mutations.

Animals↗
PubMed1990

Clinical features and molecular analysis of the alpha thalassemia/mental retardation syndromes. I. Cases due to deletions involving chromosome band 16p13.3.

We describe eight patients who have alpha thalassemia which cannot be accounted for by the Mendelian inheritance of abnormal alpha globin genes. Apart from the hematologic abnormality, the other universal clinical finding is mild to moderate mental handicap; there is also a broad spectrum of associated dysmorphic features. Initial analysis of the alpha globin gene complex (which maps to chromosome band 16p13.3), demonstrated that the alpha thalassemia results from failure of the patient to inherit an alpha globin allele from one of the parents. Using a combined molecular and cytogenetic approach, we have extended this analysis to show that all of these patients have 16p deletions which are variable in extent but limited to the terminal band 16p13.3; in at least four cases the deletion results from unbalanced chromosome translocation, and hence aneuploidy of a second chromosome is also present. The relatively nonspecific clinical phenotype contrasts with the other currently known microdeletion syndromes; this may reflect ascertainment bias in the recognition of such syndromes. This work represents the first step in the characterization of a new microdeletion syndrome that is probably underdiagnosed at present.

Adolescent↗