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Biomedical subjects

C Gibson

Publications and source records attributed to C Gibson.

At least 37 records · Page 2Linked to original sources
PubMed1997

The adult Bullard laryngoscope in paediatric patients.

PURPOSE: The adult Bullard laryngoscope (BL) is effective in managing both normal and abnormal airways. Although its name implies use in the adult population, its size does not preclude its use in paediatric patients. Thus we evaluated whether the adult BL could be used in the paediatric population and whether its efficacy was related to age, weight, or height. METHODS: Fifty consecutive patients, between the ages of 1 and 10 years and scheduled for general anaesthesia, were examined. Exclusion criteria included obvious craniofacial abnormalities or indications for rapid sequence intubation. All patients had intravenous access secured before laryngoscopy. The laryngeal view, attempts at intubation, time to intubation and the reason for any difficulty with intubation were recorded. Correlation was then sought relating attempts and time to intubation with age, weight and height. RESULTS: Mean time to intubation was 38 +/- 13 sec. Multiple attempts occurred most frequently because of right aryepiglottic fold contact or anterior vocal cord contact. The latter appears to be unique to the adult BL use in the paediatric population. No relationship was found between the time to intubation and age, height, or weight. Four tracheas, all in patients < 38 mo, could not be intubated with the BL after four attempts. CONCLUSION: The adult BL appears to be an effective alternative tool in the management of the normal paediatric airway.

Adult↗
PubMed1997

Prophylactic antibiotic project.

This project evaluated the use of prophylactic antibiotics within two hours prior to selected surgical procedures. Even with knee arthroplasty, for which there is essentially universal agreement on the need for prophylactic antibiotics, there is room for improvement in antibiotic delivery. This is true both in the percent of patients receiving antibiotics and the timeliness of administration. Although there is some difference of opinion about the advisability of prophylactic antibiotics for certain procedures, the preponderance of recent literature advocates its use and this is a quality indicator evaluated by JCAHO.

Antibiotic Prophylaxis↗
PubMed1997

Pneumonia I and Pneumonia II Projects.

The need for timely and efficient treatment is assuming even greater significance, with pneumonia discharges increasing from 5,862 in 1992 to 7,870 in 1994. These two projects, involving a total of 13 hospitals, evaluated the timeliness of antibiotic administration for pneumonia patients. Baseline data revealed opportunities for improving process of care at all hospitals. After implementation of improvement plans, the majority of hospitals increased the percentage of patients receiving antibiotics within four hours of admission. This evaluation of the antibiotic delivery system can also be adapted to other diagnoses and medications.

Anti-Bacterial Agents↗
PubMed1996

Coexpression of the interleukin-13 and interleukin-4 genes correlates with their physical linkage in the cytokine gene cluster on human chromosome 5q23-31.

Interleukin-13 (IL-13) and IL-4 are cytokines produced by T cells that are encoded by the q23-31 region of human chromosome 5. To investigate the regulation of IL-13 gene expression by T cells, we isolated and sequenced the human IL-13 gene, analyzed its 5'-flanking region for potential transcriptional activation elements, and examined its expression in nontransformed T-lineage cell populations. The human IL-13 gene was located 12.5-kb upstream of the IL-4 gene and 2-kb downstream of a CpG island. The IL-13 gene 5' flank region included a segment with sequence homology to P elements of the IL-4 promoter involved in transcriptional activation in T cells. Mutation of the IL-13 P element site significantly reduced IL-13 promoter activity in response to T-cell activation. Oligonucleotides containing the IL-13 or IL-4 P element sites specifically bound the transcriptional activator protein, nuclear factor-activated T cells, preformed (NF-ATp), when incubated with nuclear protein extracts from activated T cells. Similar to IL-4, IL-13 mRNA expression was highest in T-cell populations enriched for cells that had previously been primed in vivo or in vitro, indicating that priming increases the expression of the IL-13 and IL-4 genes in a coordinate manner. Because the primed T cells contain higher levels of nuclear NF-ATp, capable of binding to P elements of the IL-4 and IL-13 promoters, than do freshly-isolated T cells, the NF-AT-binding P elements are attractive candidates to mediate the coordinate expression of these two cytokine genes.

Adult↗
PubMed1995

Hypomethylation of the interferon-gamma gene correlates with its expression by primary T-lineage cells.

To determine the potential role of methylation in the regulation of interferon-gamma (IFN-gamma) gene transcription by T cells, primary T-lineage cell populations were analyzed for the extent of methylation of three CpG sites within or near transcriptional activator elements in the 5' flank and first intron of the human IFN-gamma gene. A striking correlation was observed between the capacity of the IFN-gamma gene to be expressed and the degree of hypomethylation. The IFN-gamma gene was virtually completely methylated at all sites in thymocytes, neonatal T cells, and adult CD45RAhiCD45R0lo (antigenically naive) CD4 T cells, cell types that all have a low or undetectable capacity to express the IFN-gamma gene. In contrast, there was substantial hypomethylation in T-lineage cell types with relatively high capacities to express the IFN-gamma gene, including adult CD8 T cells and adult CD45RAloCD45R0hi (memory/effector) CD4 T cells. These results suggest that hypomethylation of the IFN-gamma genetic locus may be an important determinant of IFN-gamma gene expression in vivo by T-lineage cells.

Age Factors↗
PubMed1995

Regulation of host cell recognition in Streptococcus pyogenes.

Protein F, a fibronectin-binding protein, and the M protein of Streptococcus pyogenes both play important roles in directing adherence to different populations of host cells in the skin. Expression of both proteins is regulated in response to alterations in atmosphere. Transcriptional control of mry, a positive-acting regulator of expression of the gene which encodes the M protein (emm) in response, to elevated levels of CO2, is a mechanism for control of emm expression in response to atmosphere. Expression of protein F is controlled at the level of transcription in response to the concentration of O2, and its expression is stimulated in the presence of superoxide. Further support for a role of superoxide in regulation of prtF expression comes from the observation that an S. pyogenes mutant which contains an insertionally inactivated gene for superoxide dismutase (sod) becomes hypersensitive to superoxide and will express prtF constitutively. A second strain also demonstrates constitutive expression of prtF but contains a functional sod. Complementation analyses in this strain using a prtF allele cloned from a regulating host and a novel method for shuttle mutagenesis which utilized the transposon mini-gamma delta have been used to identify rofA, a positive-acting regulator of prtF expression. A model for the role of the surface proteins, F and M and their regulatory genes mry and rofA in streptococcal infections of the skin will be discussed.

Antigens, Bacterial↗
PubMed1994

Sterilisation of implantable devices.

The pathogenesis and rates of infection associated with the use of a wide variety of implantable devices are described. The multi-factorial nature of post-operative periprosthetic infection is outlined and the role of sterilisation of devices is explained. The resistance of bacterial spores is highlighted as a problem and a full description is given of the processes of sterilisation by heat, steam, ethylene oxide, low temperature steam and formaldehyde, ionising radiation and liquid glutaraldehyde. Sterility assurance and validation are discussed in the context of biological indicators and physical/chemical indicators. Adverse effects upon the material composition of devices and problems of process control are listed. Finally, possible optimisations of the ethylene oxide process and their potential significance to the field of sterilisation of implants is explored.

Biocompatible Materials↗
PubMed1992

A survey of nuclear cardiological practice in Great Britain. The British Nuclear Cardiology Group.

There is little information on the practice of nuclear cardiology in Great Britain. On behalf of the British Nuclear Cardiology Group in October 1988 we sent a postal questionnaire to 143 hospitals with nuclear medicine facilities (at least 70% of such hospitals). Sixty nine replies were received (48%), of which 23 (33%) were from teaching hospitals and 46 (39%) non-teaching. In these hospitals 147,904 isotope investigations were performed annually (mean 2311 per centre) of which 17,298 (12%) (mean 254 per centre) were cardiac studies. Of these, 59% were equilibrium radionuclide ventriculograms, 14% first pass ventriculograms, and 27% thallium-201 scans. Rest studies were performed more commonly by radiographers or technicians (63%) than by doctors (20%), but doctors were more commonly involved in stress studies (48%). Radiologists reported the studies more often (28%) than they performed them (6%). Methods of acquisition and analysis were varied and, for instance, the lower limit of normal left ventricular ejection fraction ranged from 35% to 75% (mean 49%). For thallium imaging 42% of centres used dipyridamole in some patients and 24% used tomography. These data show that nuclear cardiology techniques are used much less frequently in Great Britain than in countries such as the United States and Germany, that the ratio of blood pool to myocardial perfusion imaging is much higher than elsewhere, and that methods are poorly standardised. They may provide the impetus to improve the service and serve as a baseline for future surveys.

Cardiology↗
PubMed1991

Structure and expression of the bovine amelogenin gene.

In order to define further the mechanisms responsible for tooth amelogenin heterogeneity, seven bovine amelogenin cDNAs were sequenced. On the basis of these sequences, five of the cDNAs could be grouped into one class which differed appreciably in sequence from the second group of two cDNAs. Two overlapping bovine genomic clones were then isolated and shown by sequencing to contain six exons encoding the entire consensus sequence of the class I cDNA. Southern blot analysis of DNA from male and female animals using class I or class II specific oligonucleotide probes suggested that the class I gene sequence was located on the X chromosome while the class II sequence was located on the Y chromosome. Therefore, these results also suggest that the genes on the X and Y chromosomes are both transcribed. Furthermore, the results are consistent with alternative splicing of the class I primary transcript as a potential mechanism for generating amelogenin heterogeneity.

Amelogenin↗
PubMed1990

Psychosocial rehabilitation: the role of the psychiatric nurse.

The roles and functions of Nurses working in Rehabilitation Psychiatry are varied and complex, new challenges are arising out of historical and emerging contexts. This paper explores problems faced by the Psychiatric Nurse and explains some of the functions and roles that contribute to the rehabilitation process.

Humans↗
PubMed1989

Easily assembled digital data acquisition system for the analytical ultracentrifuge.

A system for the acquisition of digital data from the analytical ultracentrifuge which uses a commercially available data acquisition board, a standard IBM compatible personal computer (PC), and an interface circuit has been developed. The system uses the signal from the standard Beckman scanner. Preliminary analysis and data reduction are performed at the PC within minutes of data acquisition using simple commercially available software, and final data fitting is performed with a mainframe computer. Procedures are described which allow approach to equilibrium to be followed and attainment of equilibrium to be demonstrated. Data density of approximately 200 points per millimeter column height (approximately 500 points per 100 microliters of sample) allows the use of short columns and hence short run times. Only 2 min are required to collect a complete scan, which is recorded in a format suitable for direct analysis by standard spreadsheet software. This allows multiple sequential scans to be quickly recorded at equilibrium and averaged to reduce noise prior to analysis. The combination of characteristics allows molecular weight determinations to be performed relatively quickly with only a few micrograms of protein. The system is inexpensive and easy to assemble given the centrifuge and a PC.

Computer Systems↗
PubMed1989

Enhancement of the kinetics of the aeration of ethylene oxide sterilized polymers using microwave radiation.

Ethylene oxide (EO) is used extensively to sterilize medical supplies that are heat sensitive. EO residues in materials post sterilization can present a hazard to patients at the point of use. Protracted aeration (i.e. degassing) times are necessary post sterilization to reduce EO residues to an accepted level. The sorption of EO into polyvinylchloride was found to be an active process given that at sorption equilibrium (i.e. when the net flow of diffusant into the host material has reduced to zero) the number of molecules of EO per unit volume was greater in PVC than in its external environment. The diffusion coefficient (D) was concentration (c) dependent and the relationship which best describes this dependence was D(c) alpha ln c. The diffusion of EO was dramatically accelerated (as evidenced by a time saving in degassing of up to 400%) if microwave heating (2.45 GHz) was used instead of conventional heating for the same macroscopic temperature. The values of activation energy for diffusion were obtained from the respective Arrhenius plots of diffusion coefficient versus inverse temperature for each process. In general, even small reductions in activation energy can greatly increase the specific rate of reaction. The relative efficacy of microwaves in eliminating EO residues as evidenced by this data occurs as a result of microwaves reducing the activation energy for diffusion by almost a factor of two. The relative efficiency of microwave desorption compared to conventional aeration offers considerable gains in the cost-effectiveness of gas sterilization since it will permit a much greater throughput of material, thereby obviating the need for excessively large inventories of equipment.

Air↗
PubMed1989

Computerized model for accurate determination of ethylene oxide diffusion in sterilized medical supplies.

A computerized numerical model is described which is shown to be more generally applicable than analytical methods in the determination of ethylene oxide diffusion in polymeric material. Diffusion coefficients of ethylene oxide in poly(vinyl chloride) were determined from the rates of desorption both for conventional aeration with warm air and for microwave-assisted desorption and found to be concentration dependent. The model takes account of device geometry and concentration dependence of diffusion coefficient and its predictions are in agreement with experimental results for desorption. The model is also used to simulate the whole sterilization process with a view to a planned diminution of EO residuals after sterilization.

Biocompatible Materials↗