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Biomedical subjects

Andrew J Marshall

Publications and source records attributed to Andrew J Marshall.

12 recordsLinked to original sources
PubMed2007

Use of limestone karst forests by Bornean orangutans (Pongo pygmaeus morio) in the Sangkulirang peninsula, east Kalimantan, Indonesia.

The Indonesian province of East Kalimantan is home to some of the largest remaining contiguous tracts of lowland Dipterocarp forest on the island of Borneo. Nest surveys recently conducted in these forests indicated the presence of a substantial population of Eastern Bornean orangutans (Pongo pygmaeus morio) in the Berau and East Kutai regencies in the northern half of the province. The Sangkulirang Peninsula contains extensive limestone karst forests in close proximity to the lowland Dipterocarp forests inhabited by orangutans in these regencies. Orangutans have been sighted in these limestone karst forests, but the importance of this forest type for orangutans has been unclear. Therefore, we conducted 49 km of nest surveys in limestone karst forest to obtain the first quantitative estimates of orangutan densities in this habitat, and walked 28 km of surveys in nearby lowland Dipterocarp forests for comparison. We also gathered basic ecological data along our transects in an attempt to identify correlates of orangutan abundance across these habitat types. Undisturbed limestone karst forests showed the lowest orangutan densities (147 nests/km(2), 0.82 indiv/km(2)), disturbed limestone forests had intermediate densities (301 nests/km(2), 1.40 indiv/km(2)), and undisturbed lowland Dipterocarp forests contained the highest density (987 nests/km(2), 5.25 indiv/km(2)), significantly more than the undisturbed limestone karst forests. This difference was not correlated with variation in liana abundance, fig stem density, or stump density (an index of forest disturbance). Therefore, other factors, such as the relatively low tree species diversity of limestone karst forests, may explain why orangutans appear to avoid these areas. We conclude that limestone karst forests are of low relevance for safeguarding the future of orangutans in East Kalimantan.

Animals↗
PubMed2005

A model for studying epithelial attachment and morphology at the interface between skin and percutaneous devices.

Percutaneous devices are indispensable in modern medicine, yet complications from their use result in significant morbidity, mortality, and cost. Bacterial biofilm at the device exit site accounts for most infections in short-term devices. We hypothesize that advanced biomaterials can be developed that facilitate attachment of skin cells to percutaneous devices, forming a seal to preclude bacterial invasion. To study the skin/biomaterial interface systematically, we first identified biomaterials with physical properties compatible with histological processing of skin. Second, we developed an organ culture system to study skin response to implants. Organ cultures implanted with porous poly(2-hydroxyethyl methacrylate) [poly(HEMA)] or polytetrafluoroethylene (PTFE) could easily be evaluated histologically with preservation of the skin/biomaterial interface. Epithelial cells migrated down the cut edges of the biomaterial in a pattern seen in marsupialization of percutaneous devices in vivo. This in vitro model maintains skin viability and allows histologic evaluation of the skin/biomaterial interface, making this a useful, inexpensive test-bed for studies of epidermal attachment to modified biomaterials.

Administration, Cutaneous↗
PubMed2005

Urinary testosterone levels of wild male bonobos (Pan paniscus) in the Lomako Forest, Democratic Republic of Congo.

We collected urine samples from seven male bonobos (Pan paniscus) in the Eyengo community, Lomako Forest, Democratic Republic of Congo, and assayed them for testosterone (T). T levels averaged 525 pmol/mg Cr in adult males, and 309 pmol/mg Cr in subadult males. We collected hormonal and behavioral data during a period of relative social instability following the recent arrival of two immigrant males. In concordance with predictions derived from the challenge hypothesis [Wingfield et al., American Naturalist 136:829-846, 1990], which relates T to levels of reproductive aggression, the alpha male had the highest circulating levels of T. When we removed the two recent immigrant males from the analysis, there was a significant positive correlation between T levels and dominance rank for the long-term resident males (n=5, P=0.001, r2=0.98). These are the first data on T levels in wild bonobos, and the results suggest that further study of the relationship between T levels and social context in this species could inform current models relating hormones and aggression in wild apes.

Age Factors↗
PubMed2004

Dilatation of the aorta in pure, severe, bicuspid aortic valve stenosis.

BACKGROUND: Aortic complications are more frequent after bicuspid aortic valve (BAV) replacement (AVR), than tricuspid aortic valve replacement. We studied the size of the proximal thoracic aorta in patients with BAV undergoing AVR for pure, severe aortic stenosis, looking for dilatation in comparison with patients with a matched tricuspid aortic valve (TAV) and normograms of aortic size. METHODS: Aortic root and ascending aortic diameter measurements were taken at 3 levels, from electrocardiographic-gated multidetector row computed tomograms, in 28 patients with pure, severe aortic stenosis before AVR. The patients were divided in 2 groups (BAV, n = 10; TAV, n = 18). Patients with greater than mild aortic regurgitation or who were scheduled for aortic root replacement were excluded. RESULTS: Although patients in the BAV group were younger (P <.0001) and less likely to have hypertension (P <.005), their aortic diameters were larger than those of patients in the TAV group at all levels measured (aortic sinus, 41.1 +/- 8.1 mm vs 33.8 +/- 3.3 mm; sino-tubular junction, 39.0 +/- 7.8 mm vs 31.1 +/- 3.8 mm; right pulmonary artery level, 42.8 +/- 7.1 mm vs 33.7 +/- 4.3 mm; P <.005 for all). Whereas 60% (6/10) of patients in the BAV group had >/=1 aortic diameter measurements greater than the 95th age-adjusted percentile, 0% (0/18) of patients in the TAV group did. CONCLUSIONS: Patients with BAV undergoing AVR with pure, severe aortic stenosis commonly have moderate dilatation of the thoracic aorta, whereas matched patients with a TAV do not. This finding may contribute to the increased frequency of aortic complications seen in follow up of patients with a BAV after AVR.

Aged↗
PubMed2004

Pacemaker diagnostics to determine treatment and outcome in sick sinus syndrome with paroxysmal atrial fibrillation.

Sequential analysis of pacemaker diagnostics has been used to help manage the treatment and pacemaker program in patients who have sick sinus syndrome with documented paroxysmal atrial fibrillation. One hundred consecutive patients were followed for an average of 18 months. Knowledge of the atrial fibrillation burden led to major changes in medical management for half of the patients and changes to pacemaker programming for all. At the end of the study, 48 patients were free of arrhythmia with pacing although 14 required antiarrhythmic medication. We advocate using pacemaker diagnostics to improve patient management.

Aged↗
PubMed2003

Thoracic aorta at multi-detector row CT: motion artifact with various reconstruction windows.

The authors assessed motion artifact of the thoracic aorta in 25 patients who underwent multi-detector row computed tomography (CT) with retrospective electrocardiographic (ECG) gating. CT reconstructions centered at four phases of diastole were compared for five different levels of the thoracic aorta. A significant positive correlation was observed between heart rate and motion artifact (r = 0.72, P <.001). The optimal reconstruction phase varied between patients, and this was directly related to heart rate. For patients with a heart rate of 70 beats per minute, the reconstruction phase centered at 75% of the R-R interval had the significantly least motion artifact (P =.004). Conversely, the optimal reconstruction phase for patients with heart rates above 70 beats per minute was centered at 50% of the R-R interval (P =.09).

Aorta, Thoracic↗
PubMed2003

Calcified patent ductus arteriosus diagnosed following aortic valve replacement.

A 71-year-old woman underwent aortic valve replacement for severe, symptomatic aortic stenosis. The left ventricle filled rapidly when the left ventricular vent was switched off and postoperatively she was slow to recover with bilateral pleural effusions. These findings prompted early reinvestigation, initially with echocardiography and subsequently with multi-detector row computed tomography. Using a retrospectively electrocardiographic-gated acquisition, adapted from a noninvasive coronary angiography protocol, a calcified, persistently patent ductus arteriosus was identified as the cause for her perioperative and postoperative condition. The defect has since been closed successfully using a transcatheter technique.

Aged↗
PubMed2003

Morphologic assessment of patent ductus arteriosus in adults using retrospectively ECG-gated multidetector CT.

OBJECTIVE: Noninvasive imaging of a persistently patent ductus arteriosus in adults remains a challenge. Bearing in mind the excellent spatial resolution provided by multidetector CT (MDCT), we postulated that MDCT might be used to evaluate this anatomic defect. We sought to show that MDCT can depict in detail patent ductus arteriosus in adults and allow determination of the size of the duct, degree of calcification, and morphologic classification. CONCLUSION: MDCT represents a novel method of noninvasively assessing patent ductus arteriosus in adults that provides detailed anatomic information. Comparison with invasive angiographic findings is needed to validate the technique of sizing of ducts using MDCT.

Adult↗
PubMed2003

Terminal right heart failure due to complex congenital cardiac disease successfully managed by home peritoneal drainage.

A man, aged 32, who had undergone surgical correction of complex congenital cardiac disease, had chronic severe right heart failure. Increasing reliance on diuretics led to deteriorating renal function, and he was rejected as a candidate for cardiac transplantation. By inserting a Tenckhoff catheter, and training him to drain his ascites at home, we achieved a dramatic improvement in both his cardiac and renal function. As far as we can ascertain, this is the first time this technique has been used for such a patient. We discuss the mechanisms of improvement, and suggest that other such patients with congenital cardiac disease might benefit from similar management.

Adult↗
PubMed2002

Quadricuspid aortic valves.

Quadricuspid aortic valves (QAV) are a rare but well recognized cause of significant aortic regurgitation. The first case was found reported in 1862. Since then there have been 110 reported cases of QAV and we report 4 more. Previously, these were diagnosed at the time of surgery or postmortem examination. With advances in echocardiography, including harmonic imaging, and also the advent of transesophageal echocardiography, more cases are being diagnosed prior to surgery. We describe four more cases, three diagnosed preoperatively and one at the time of surgery, and then review the previously reported cases. Of the 114 cases reported, 46 had the aortic valve replaced, most commonly in the 5th and 6th decade of life. Hurwitz and Roberts classified quadricuspid valves according to the size of the leaflets. It has previously been believed that QAVs with four equal sized leaflets were less likely to develop significant aortic regurgitation; however, on review of the available cases, this would not appear to be the case. The preoperative diagnosis of QAVs is important as they can be associated with abnormally placed coronary ostium. Of the 114 cases reported, there are 10 reports of abnormally placed ostia. There has been at least one reported case of death occurring because of obstruction of an abnormally placed right coronary ostium by a prosthetic aortic valve.

Adult↗
PubMedDate not supplied

Characterization of an in vitro model for evaluating the interface between skin and percutaneous biomaterials.

Percutaneous devices play an essential role in medicine; however, they are often associated with a significant risk of infection. One approach to circumvent infection would be to heal the wound around the devices by promoting skin cell attachment. We used two in vitro assay models to evaluate cutaneous response to poly(2-hydoxyethyl methacrylate) (poly(HEMA)). One approach was to use a cell adhesion assay to test the effects of surface modification of poly(HEMA), and the second used an organ culture system of newborn foreskin biopsies implanted with porous poly(HEMA) rods (20 microm pores) to evaluate the skin/poly(HEMA) interface. Surface modification of poly(HEMA) using 1,1'-carbonyldiimidazole (CDI) enhanced keratinocyte, fibroblast, and endothelial cell adhesion. Keratinocytes in the organ culture model not only remained functionally and structurally viable as observed by immunohistochemistry and electron microscopy, but migrated into the pores of CDI-modified poly(HEMA) rods. No biointegration was seen in the non-CDI-modified poly(HEMA). Laminin 5 immunostaining was seen along the poly(HEMA)/skin interface in a pattern resembling the junctional epithelium of the tooth, the unique natural interface between the skin and tooth that serves as a barrier to bacteria. In vitro systematic evaluation of biomaterials for use in animal implant studies is both cost effective and time efficient.

Aged↗