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Biomedical subjects

G Gibbons

Publications and source records attributed to G Gibbons.

At least 19 recordsLinked to original sources
PubMed2000

Dockings slashed.

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Animal Welfare↗
PubMed2000

Fibro-fatty nodules and low back pain. The back mouse masquerade.

BACKGROUND: Few useful interventions exist for patients with persistent low back pain. We suggest that a fibro-fatty nodule ("back mouse") may be an identifiable and treatable cause of this and other types of pain. METHODS: We describe 2 patients with painful nodules in the lower back and lateral iliac crest areas. In both cases, the signs and symptoms were unusual and presented at locations distant from the nodule. One patient complained of severe acute lower abdominal pain, and the other had been treated for chronic recurrent trochanteric bursitis for several years. RESULTS: In both patients, symptoms appeared to be relieved by multiple injection of the nodule. DISCUSSION: There is agreement that back mice exist. Referred pain from the nodules might explain the distant symptoms and signs in these cases. Multiple puncture may be an effective treatment because it lessens the tension of a fibro-fatty nodule. CONCLUSIONS: Randomized trials on this subject are needed. In the meantime, physicians should keep back mice in mind when presented with atypical and unaccountable symptoms in the lower abdomen, inguinal region, or legs.

Bursitis↗
PubMed1999

Describing what chaplains do in hospitals.

Reports on a research project that describes the unique activities in which chaplains engage as they provide pastoral care and counseling and spiritual direction to patients in a large, acute tertiary referral medical center in Melbourne, Australia. Analyzes 57,704 entries which described what hospital chaplains do when interacting with patients over a period of five and one-half years. Identifies as the core activities "promoting spiritual transcending" (57.6% of all entries), "promoting spiritual intactness" (36.1% of all entries) and "enacting ministry" (6.2% of all entries).

Australia↗
PubMed1999

Diabetic versus nondiabetic limb-threatening ischemia: outcome of percutaneous iliac intervention.

OBJECTIVE: The purpose of this study was to compare the effectiveness of iliac angioplasty and outcomes in diabetic patients and nondiabetic patients with limb-threatening ischemia. MATERIALS AND METHODS: Records of 91 consecutive patients with limb-threatening ischemia (rest pain, nonhealing ulceration, or gangrene) who, during a 6-year period, underwent iliac angioplasty of hemodynamically significant lesions were reviewed. Stents were placed in patients with suboptimal findings at angioplasty. Sixty-eight (75%) of the 91 patients were diabetic. Life table analysis and log-rank significance tests were used to compare rates of primary iliac artery patency, primary and secondary graft patency, limb salvage, and survival in diabetic patients versus nondiabetic patients. RESULTS: One hundred seven iliac lesions were treated with percutaneous angioplasty. Ten iliac stents were placed because of suboptimal results at angioplasty. The mean time of follow-up was 20 months (range, 2-62 months). Sixty-eight patients (75%) underwent peripheral reconstruction. Outcomes were comparable in both patient groups for primary iliac patencies at 4 years (diabetic patients, 85%; nondiabetic patients, 76%; p = .5), primary and secondary graft patencies at 4 years (diabetic patients, 65% and 73%, respectively; nondiabetic patients, 74% and 100%, respectively; p = .7 and .19, respectively), 4-year limb-salvage rates (diabetic patients, 93%; nondiabetic patients, 79%; p = .07). Major complications of angioplasty occurred in four patients (4.4%). CONCLUSION: Outcomes of iliac angioplasty and limb-salvage rates were comparable for diabetic patients and nondiabetic patients who underwent current methods of iliac angioplasty and infrainguinal reconstruction.

Aged↗
PubMed1997

Thrombolysis of infrapopliteal bypass grafts: efficacy and underlying angiographic pathology.

OBJECTIVE: The purpose of this study was to determine retrospectively the effectiveness of thrombolysis of occluded infrapopliteal bypass grafts and to identify factors affecting success. MATERIALS AND METHODS: The records of 52 consecutive patients (52 grafts) who underwent selective urokinase thrombolysis of grafts to the pedal or tibial arteries were reviewed. The need for subsequent surgery and the influence of diabetes on outcome were analyzed. RESULTS: There were 43 vein and nine Goretex (W-L Gore, Flagstaff, AZ) and vein composite grafts inserting into tibial and peroneal arteries (n = 28) or pedal arteries (n = 24). Mean time of follow-up was 19 months. All grafts were entered, and technical success was achieved in 73% of patients. Twenty-six patients required some form of graft revision. Overall patency at 30 days was 76%. Thirty-day limb-salvage and mortality rates were 82% and 4%, respectively. No significant difference was found in 1-yr outcomes between diabetic and nondiabetic patients or between pedal and tibial grafts. Major complications occurred in eight patients (15%). CONCLUSION: Thrombolysis of occluded grafts that insert into the pedal or tibial vessels was as effective as thrombolysis of more proximal grafts and native arterial thrombolysis, which have reported 30-day limb-salvage rates that range between 80% and 90%. Diabetes and grafting to foot vessels did not adversely affect response to thrombolysis. Surgery was often required to correct an underlying lesion revealed by thrombolysis. Despite the small size of the arteries to which the grafts were anastomosed, selective thrombolysis of occluded infrapopliteal bypass grafts proved to be an effective procedure.

Adult↗
PubMed1996

Expression of interleukin-6 in osteoarthritic chondrocytes and effects of fluid-induced shear on this expression in normal human chondrocytes in vitro.

This study tested the effect of fluid-induced shear on interleukin-6 expression in normal human articular chondrocytes in vitro. As determined by Northern blot analysis, interleukin-6 mRNA expression occurs in chondrocytes from osteoarthritic cartilage but not in normal chondrocytes. Applying fluid-induced shear stress to primary high density cultures of chondrocytes increased interleukin-6 mRNA signal 4-fold at 1 hour and 10 to 15-fold at 48 hours compared with unsheared control cultures. At 48 hours, fluid-induced shear stress increased interleukin-6 protein levels in the culture medium 9 to 10-fold compared with unsheared controls. mRNA signals for interleukin-1alpha, interleukin-1beta, and tumor necrosis factor-alpha in RNA from sheared or control chondrocytes were not detected by Northern blotting. Transforming growth factor-beta mRNA signal was detectable but was not affected by shear. In contrast, human lung fibroblasts (WI-38) responded to fluid-induced shear with increased signal for transforming growth factor-beta, but not interleukin-6, mRNA. Both cell types did respond to interleukin-1alpha with increased interleukin-6 mRNA signal. These data demonstrated that distortional forces, such as fluid-induced shear stress, alter interleukin-6 levels in normal chondrocytes in vitro and suggest that increased interleukin-6 expression in osteoarthritic cartilage may result, in part, from alterations in the mechanical loading of the tissue.

Adult↗
PubMed1996

Transient neutropenia: neutrophil distribution and replacement.

UNLABELLED: Radiolabeled polymorphonuclear (PMN) receptor-specific proteins or peptides lead the list of agents being evaluated for imaging inflammatory foci. Some of these agents induce transient neutropenia. This study was designed to quantify the degree of dose dependency of neutropenia, determine the duration of neutropenia, identify the organs in which these PMNs sequester and ascertain if these PMNs return to the circulation. METHODS: Rodent anti-PMN (Gr-1) MAb R86-BC5 (IgG-2a) and Balb/c mice served as the model, and PMN nonspecific ME 31.3 (IgG-2a) as a control. Circulating PMN number was determined several times, 30 min prior to and between 1 min and 120 hr after MAb administration. Iodine-125-MAbs provided quantification of circulating activity and tissue distribution as a function of time. RESULTS: Data showed the severity of neutropenia increased with the amount of MAb administered (> 95% PMNs lost after 150 micrograms versus < 85% after 10 micrograms). Moreover, the recovery time for PMN counts to reach the pretreatment level also increased in a dose-dependent manner (96 hr at 150 micrograms versus 4 hr at 10 micrograms and 2 hr at 2 micrograms). The blood activity, however, which declined quickly with the neutropenia, never rose again with PMN recovery. As a function of time, radioactivity in the study group decreased from all organs except from the liver and spleen, whereas in the control group, it decreased from all organs, including the liver and spleen (e.g., 4 hr liver, 29.4% decrease versus 91.2% decrease in the control group; and spleen, 15.5% decrease versus 63.6% decrease in control group). CONCLUSION: The degree and duration of neutropenia is dose-dependent. PMNs, lost from the circulation, sequester in the reticuloendothelial system, and do not return to circulation. Therefore, they are not available to image inflammatory foci. The PMN concentration is restored to a pretreatment level in a dose-dependent fashion, presumably by freshly released PMNs from bone marrow.

Animals↗
PubMed1995

The influence of race on the use of surgical procedures for treatment of peripheral vascular disease of the lower extremities.

OBJECTIVE: To assess whether rates of amputation and leg-sparing surgery for peripheral vascular disease of the lower extremities differ between African-American and white patients. DESIGN: Retrospective cohort study using Medicare claims data for 1989 and 1990. SETTING: A total of 3313 hospitals in the United States. PATIENTS: Random sample of 19,236 Medicare Part A enrollees who underwent amputation and/or leg-sparing surgery for peripheral vascular disease. MAIN OUTCOME MEASURES: Adjusted odds of toe and/or foot amputation, below-knee amputation, above-knee amputation, lower extremity arterial vascularization, and percutaneous transluminal angioplasty for African American relative to whites, controlling for case-mix, region, and hospital characteristics. RESULTS: African-American patients were significantly more likely than white patients to undergo above-knee, below-knee, and toe and/or foot amputation and significantly less likely to undergo lower-extremity arterial revascularization and percutaneous transluminal angioplasty. These associations occurred for diabetic patients and nondiabetic patients but were more pronounced among patients who did not have diabetes. CONCLUSIONS: Potential explanations include unmeasured factors such as severity of disease and the technical expertise available at hospitals or other factors such as lack of compliance with medical treatment and race-specific treatment decisions by providers. Whatever the cause, interventions aimed toward reducing the number of amputations among African Americans are needed. Further work is required to determine where such interventions should be targeted.

Black or African American↗
PubMed1995

Effects of fluid-induced shear on articular chondrocyte morphology and metabolism in vitro.

This study tested the effects of fluid-induced shear on high density monolayer cultures of adult articular chondrocytes. Fluid-induced shear (1.6 Pa) was applied by cone viscometer to normal human and bovine articular chondrocytes for periods of 24, 48, and 72 hours. At 48 and 72 hours, fluid-induced shear caused individual chondrocytes to elongate and align tangential to the direction of cone rotation. Fluid-induced shear stimulated glycosaminoglycan synthesis by 2-fold (p < 0.05) and increased the length of newly synthesized chains in human and bovine chondrocytes. In human chondrocytes, the hydrodynamic size of newly synthesized proteoglycans also was increased. After 48 hours of fluid-induced shear, the release of prostaglandin E2 from the chondrocytes was increased 10 to 20-fold. In human chondrocytes, mRNA signal levels for tissue inhibitor of metalloproteinase increased 9-fold in response to shear compared with the controls. In contrast, mRNA signal levels for the neutral metalloproteinases, collagenase, stromelysin, and 72 kD gelatinase, did not show such major changes. This study demonstrated that articular chondrocyte metabolism responds directly to physical stimulation in vitro and suggests that mechanical loading may directly influence cartilage homeostasis in vivo.

Aged↗
PubMed1994

Lipid metabolism.

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Cholesterol↗
PubMed1994

Influence of biological response modifiers: measurement of tumor blood flow and temperature.

Human recombinant interferon-alpha-2b (IFN) is known to inhibit growth of both normal and tumor cells and to stimulate immune effector cell function. We have previously shown that IFN and other biological response modifiers augment accumulation of radiolabeled antibodies in tumors. This investigation demonstrates that 30 min post i.m. administration of IFN significantly (p < 0.01) enhances tumor perfusion in tumor-bearing mice and persists for a much longer time than in normal tissue, which, in part, may contribute to the enhanced tumor uptake of radiolabeled monoclonal antibodies within 1.5 h of their administration. Histological examinations of tumors obtained from animals receiving IFN 72 h previously did not show changes in inflammatory cells. Our investigation shows that laser Doppler flowmetry and color Doppler imaging can provide an excellent means of measuring tumor perfusion changes in small living animals where radioactive tracers cannot be used.

Animals↗
PubMed1993

Chromatin texture features in hematoxylin and eosin-stained prostate tissue.

A pilot study was undertaken to determine the expression of certain nuclear features in prostatic lesions. Twenty cases, 5 of hyperplasia and 5 each of carcinoma, Mostofi grades I-III, were selected as a training set, and an additional 20 cases were used as a test set, including 5 cases of hyperplasia and 5 cases each in Mostofi grades I-III. Images of hematoxylin and eosin-stained, 4-microns paraffin sections were obtained with a JVC BY-110 three-color camera and digitized by an IBM personal computer with a Matrox MVP-AT/NP imaging board. Thirty nuclei for each case from the training set, for a total of 600 nuclei, and 10 nuclei for each case from the test set, for a total of 200 nuclei, were analyzed by quantitative cytometric software on a SUN 3/60 workstation. A linear discriminant model was used for statistical analysis. One hundred percent of the hyperplasia group, 98% of the low grade group, 92% of the medium grade group and 82% of the high grade group were classified correctly in the test set with an overall success rate of 93%. Statistically significant chromatin texture features included heterogeneity, condensation, margination, run length nonuniformity, long run emphasis, gray level nonuniformity and inertia. Area, roundness and staining intensity (total extinction) were also significant. The results with standard hematoxylin and eosin-stained tissue sections were similar to those previously obtained with Feulgen-stained material. These results indicate that routine hematoxylin and eosin-stained material offers consistent diagnostic clues.

Chromatin↗