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Biomedical subjects

J Bingham

Publications and source records attributed to J Bingham.

At least 37 records · Page 2Linked to original sources
PubMed2000

Biliary complications associated with laparoscopic cholecystectomy: analysis of common misconceptions

AIMS: General surgeons often express the view that the majority of biliary complications following laparoscopic cholecystectomy are caused by trainee surgeons; complications occur most often in the presence of difficult anatomy or pathology; biliary injuries occur more proximally in the biliary tree than at open cholecystectomy; most injuries are recognized at the time of surgery; and most complications can be managed non-operatively. The aim of this study was to determine if these views are substantiated in clinical practice. METHODS: Thirty consecutive patients were referred to a specialist hepatobiliary unit over a 7-year period with biliary complications following laparoscopic cholecystectomy. The mode of presentation, management and outcome of these patients were analysed. RESULTS: In 21 cases the initial operator was a consultant. Four of the 30 complications occurred in the presence of an anatomical variation or unusually difficult pathology. Only patients in whom a previous attempt at repair had been made had injuries at or proximal to the bile duct confluence; the only two deaths occurred in this group. Only 41 per cent of injuries were detected at the time of surgery and 89 per cent required further surgical intervention, hepaticojejunostomy being the most common procedure performed (75 per cent). CONCLUSIONS: The majority of bile duct injuries are not caused by trainees, do not occur because of unusual anatomy or pathology, do not occur in the proximal biliary tree, are not recognized at the time of the initial operation and often require major reconstructive procedures for their management.

Journal Article↗
PubMed2000

Visualizing large hierarchical clusters in hyperbolic space.

SUMMARY: HyperTree is an application to visualize and navigate large trees in hyperbolic space. It includes color-coding, search mechanisms and navigational aids, as well as focus+context viewing, allowing enormous trees to fit within the fixed space of a computer screen or printed page.

Animals↗
PubMed2000

Evaluation of (18)fluorodeoxyglucose positron emission tomography ((18)FDG PET) in the detection of malignant peripheral nerve sheath tumours arising from within plexiform neurofibromas in neurofibromatosis 1.

OBJECTIVES: The ability of (18)fluorodeoxyglucose positron emission tomography ((18)FDG PET) to detect malignant change in plexiform neurofibromas from patients with neurofibromatosis 1 (NF1) was evaluated. METHODS: Eighteen NF1 patients who presented with pain, increase in size, or neurological deficit associated with a plexiform neurofibroma were assessed. Magnetic resonance imaging determined the site and extent of the lesion. Qualitative(18)FDG PET was performed and the standard uptake value (SUV) measured the regional glucose metabolism. Histological confirmation of the diagnosis was obtained in 10 patients. RESULTS: Twenty three plexiform neurofibromas were detected in 18 patients. Seven malignant peripheral nerve sheath tumours, four high grade and three low grade tumours, occurred in five patients. In one patient the clinical and radiological characteristics of the tumour suggested malignancy, but histology was inconclusive. Fifteen benign plexiform neurofibromas were identified in 12 patients and these findings were confirmed histologically in five lesions from four patients. Ten plexiform neurofibromas occurring in eight patients were considered benign on(18)FDG PET and the patients did not undergo surgery. They remained stable or their symptoms improved on clinical follow up (median 9 months). The results of qualitative (18)FDG PET were interpreted as indicating that 13 plexiform neurofibromas were benign and 10 were malignant. No malignant tumours were classified as benign, but two benign tumours were reported as malignant. The SUV was calculated for 20 tumours and was significantly higher in five malignant tumours 5.4 (SD 2.4), than in 15 benign tumours 1.54 (SD 0.7), p=0.002. There was an overlap between benign and malignant tumours in the SUV range 2.7-3.3. CONCLUSIONS: (18)FDG PET is helpful in determining malignant change in plexiform neurofibromas in NF1. Increased separation between benign and malignant lesions could be obtained by calculating the SUV at about 200 minutes after injection of (18)FDG, when the peak activity concentration is obtained in malignant tumours.

Adolescent↗
PubMed2000

Biliary complications associated with laparoscopic cholecystectomy--an analysis of common misconceptions.

BACKGROUND: Several views are expressed by surgeons on biliary complications following laparoscopic cholecystectomy as follow: most are caused by trainees; complications occur in the presence of difficult anatomy/pathology; injuries occur more proximally than at open cholecystectomy; most injuries are recognised immediately and most can be managed non-operatively. The aim of our study was to determine if these views are substantiated in clinical practice. METHODS: The mode of presentation, management and outcome of thirty-two patients referred to a hepatobiliary unit over a seven year period were analysed. RESULTS: In 72% of cases the initial operator was a consultant. Five of the 32 complications (16%) occurred in the presence of difficult anatomy/pathology. Two patients had proximal biliary tree injuries, the only mortalities (two) occurring in this group. Only 41% of injuries were detected immediately; 87% required surgical intervention, hepaticojejunostomy being the most common procedure performed (75%). CONCLUSION: Our study shows that the majority of bile duct injuries are not caused by trainees, do not occur because of unusual anatomy/pathology, do not occur in the proximal biliary tree and are not recognised at the time of operation. Most injuries ultimately require major reconstructive surgery for definitive management.

Biliary Tract Diseases↗
PubMed1999

The protein kinases of Caenorhabditis elegans: a model for signal transduction in multicellular organisms.

Caenorhabditis elegans should soon be the first multicellular organism whose complete genomic sequence has been determined. This achievement provides a unique opportunity for a comprehensive assessment of the signal transduction molecules required for the existence of a multicellular animal. Although the worm C. elegans may not much resemble humans, the molecules that regulate signal transduction in these two organisms prove to be quite similar. We focus here on the content and diversity of protein kinases present in worms, together with an assessment of other classes of proteins that regulate protein phosphorylation. By systematic analysis of the 19,099 predicted C. elegans proteins, and thorough analysis of the finished and unfinished genomic sequences, we have identified 411 full length protein kinases and 21 partial kinase fragments. We also describe 82 additional proteins that are predicted to be structurally similar to conventional protein kinases even though they share minimal primary sequence identity. Finally, the richness of phosphorylation-dependent signaling pathways in worms is further supported with the identification of 185 protein phosphatases and 128 phosphoprotein-binding domains (SH2, PTB, STYX, SBF, 14-3-3, FHA, and WW) in the worm genome.

Animals↗
PubMed1999

Efficacy of SAG-2 oral rabies vaccine in two species of jackal (Canis adustus and Canis mesomelas).

Trials were carried out to test the efficacy of SAG-2 oral rabies vaccine in two species of jackals, namely the side-striped jackal (C. adustus) and the black-backed jackal (C. mesomelas). The first trial tested the efficacy of SAG-2 when given by direct oral administration at doses of 6.5 and 7.5 log10 median tissue culture infectious doses (TCID50). One side-striped jackal which had received the higher dose did not seroconvert and succumbed to challenge, while all other jackals seroconverted and resisted a lethal challenge. The second trial tested the efficacy in side-striped jackals only of the SAG-2 vaccine when given within chicken head baits. A volume of 1.8 ml of vaccine fluid with titers of 7.0 or 8.0 log10 TCID50/ml were placed into blisters which were stapled under the skin of the chicken heads. All jackals (5/5) which received 8.0 log10 TCID50/ml and 3 of 5 which received 7.0 log10 TCID50/ml seroconverted and resisted lethal challenge. A third trial tested the rate of vaccine virus titer loss in chicken head baits placed under field conditions. Titer loss was marked in baits which were not protected from direct sunshine, whereas under vegetation cover approximately log10 TCID50/ml was lost every 3 days. Hence, it was concluded that a bait vaccine virus titer of 8.0 log10 TCID50/ml will be sufficient to immunize wild jackal populations if enough baits can be consumed by jackals within 3 days. This conclusion needs to be tested through the use of oral vaccine in field trials.

Administration, Oral↗
PubMed1999

Telemedicine and cardiopulmonary resuscitation: the value of video-link and telephone instruction to a mock bystander.

We evaluated cardiopulmonary resuscitation (CPR) performed by persons with no previous experience on a resuscitation dummy. Subjects were randomized into four groups, one of which had no instruction. The other three groups were instructed for 3 min in mock CPR by a supervisor using a telephone, a video-link, or directly in person. They were compared with a group which had had previous CPR training. The main outcome measures were the number of correct ventilations, chest compressions and compressions with correct hand position. Video-link instruction was associated with significantly higher median scores for all three outcome measurements (P < 0.05), whereas telephone instruction and previous CPR training were associated with higher scores on only one, namely ventilations (P < 0.05). Video-link instruction was comparable with direct observer instruction. There was no significant difference between previously trained subjects and the intervention groups. Video-link instruction can produce significant improvements in the quality of CPR in mock resuscitations for persons with no resuscitation training.

Adult↗
PubMed1999

The epidemiology of rabies in Zimbabwe. 1. Rabies in dogs (Canis familiaris).

The epidemiology of rabies in dogs in Zimbabwe is described using data from 1950, when rabies was re-introduced after a 37-year absence, to 1996. Dogs constituted 45.7% of all laboratory-confirmed rabies cases and were the species most frequently diagnosed with the disease. Slightly more cases were diagnosed from June to November than in other months. From 1950 to the early 1980s, most dog cases were recorded from commercial farming areas, but since the early 1980s most have been recorded from communal (subsistence farming) areas. This change appears to be due to improved surveillance in communal areas and not to any change in the prevalence of rabies. Dog rabies therefore appears to be maintained mainly in communal area dog populations, particularly the large communal area blocks. Urban rabies was not important except in the city of Mutare. Where dog rabies prevalence was high, the disease was cyclic with periods between peak prevalence ranging from 4-7 years. Dog rabies cases were, on the whole, independent of jackal rabies and rabies in other carnivores. There was a significant negative relationship between the annual number of rabies vaccine doses administered nationally to dogs and the annual number of dog rabies cases lagged by one year, indicating that the past levels of immunisation coverage have had a significant effect on the number of rabies cases. However, dog vaccination coverage has clearly not been adequate to prevent the regular occurrence of rabies in dogs.

Animals↗
PubMed1999

The epidemiology of rabies in Zimbabwe. 2. Rabies in jackals (Canis adustus and Canis mesomelas).

The epidemiology of rabies in Canis adustus (the side-striped jackal) and Canis mesomelas (the black-backed jackal) in Zimbabwe is described using data collected from 1950-1996. Cases in the two species made up 25.2% of all confirmed cases, second only to domestic dogs. Since the species of jackal cases was not recorded on rabies submission forms, the country was divided into areas according to species dominance and jackal cases were assigned to either C. adustus or C. mesomelas dominant zones or a sympatric zone where the relative status of the species is not known. Jackal rabies in both species is maintained in the commercial farming sector. Jackal rabies in the C. adustus zone occurs as dense epidemics, which begin at a single focus and spread centrifugally. The foci were initiated by rabid dogs, but once initiated the epidemic is maintained by C. adustus independently of other species. The extent of outbreaks in the C. adustus zone was limited by geographical (landuse type and jackal species interface) boundaries. Jackal rabies in C. adustus zones showed two seasonal peaks with the main peak occurring during late summer and the second peak during winter. In the C. mesomelas zone jackal rabies was more sparse but it occurred during most years. C. mesomelas is also able to maintain rabies independently of other species, although the epidemiology of the disease in this species is unclear. Transmission of rabies cycles between the two jackal species zones does not appear to occur as epidemics terminate when crossing the C. adustus and C. mesomelas interface boundaries.

Age Distribution↗
PubMed1999

Presence of antibodies to canine distemper virus, canine parvovirus and canine adenovirus type 1 in free-ranging jackals (Canis adustus and Canis mesomelas) in Zimbabwe.

A survey of free-ranging jackals (Canis adustus and Canis mesomelas) in Zimbabwe was conducted to determine the prevalence of serum antibodies to canine distemper virus (CDV), canine parvovirus (CPV) and canine adenovirus type 1 (CAV-1). Sera from 16 Canis adustus and 22 Canis mesomelas were collected from 1990 to 1993 from various regions of Zimbabwe and assayed by means of immunofluorescent techniques. Seroprevalence in C. adustus and C. mesomelas respectively were 50% and 63.6% for CDV, 12.5% and 18.2% for CPV and 37.5 and 9.1 for CAV-1. These results demonstrate that jackals are infected with these viruses and may act as reservoirs of them, although their susceptibility to the viruses is not known.

Adenoviruses, Canine↗
PubMed1998

The Genome Sequence DataBase (GSDB): improving data quality and data access.

In 1997 the primary focus of the Genome Sequence DataBase (GSDB; www. ncgr.org/gsdb ) located at the National Center for Genome Resources was to improve data quality and accessibility. Efforts to increase the quality of data within the database included two major projects; one to identify and remove all vector contamination from sequences in the database and one to create premier sequence sets (including both alignments and discontiguous sequences). Data accessibility was improved during the course of the last year in several ways. First, a graphical database sequence viewer was made available to researchers. Second, an update process was implemented for the web-based query tool, Maestro. Third, a web-based tool, Excerpt, was developed to retrieve selected regions of any sequence in the database. And lastly, a GSDB flatfile that contains annotation unique to GSDB (e.g., sequence analysis and alignment data) was developed. Additionally, the GSDB web site provides a tool for the detection of matrix attachment regions (MARs), which can be used to identify regions of high coding potential. The ultimate goal of this work is to make GSDB a more useful resource for genomic comparison studies and gene level studies by improving data quality and by providing data access capabilities that are consistent with the needs of both types of studies.

Base Sequence↗
PubMed1998

Mokola virus infection: description of recent South African cases and a review of the virus epidemiology.

Five cases of Mokola virus, a lyssavirus related to rabies, are described. The cases occurred in cats from the East London, Pinetown and Pietermaritzburg areas of South Africa from February 1996 to February 1998. Each of the cats was suspected of being rabid and their brains were submitted for laboratory confirmation. Four of the cases were positive, but with atypical fluorescence, and 1 was negative. Mokola virus infection was identified by anti-lyssavirus nucleocapsid monoclonal antibody typing. As in rabies cases, the predominant clinical signs were of unusual behaviour. Aggression was present, but only during handling. Four of the 5 cats had been vaccinated for rabies, which is consistent with other studies that show that rabies vaccination does not appear to protect against Mokola virus. Since Mokola may be confused with rabies, the incidence of Mokola virus may be more common in Africa than is currently reported. As human infections may be fatal, the emergence of this virus is a potential threat to public health.

Animals↗
PubMed1998

A nucleotide-specific polymerase chain reaction assay to differentiate rabies virus biotypes in South Africa.

Antigenic and nucleotide sequence analyses have shown that two distinct biotypes of rabies virus are circulating in South Africa. One of these typically infects members of the family Canidae, while the other comprises a heterogeneous group of apparently indigenous viruses, infecting members of the Viverridae family. In recent times, it has become evident that a considerable amount of cross-infection may occur and the manifestation of viverrid rabies in non-viverrid animals in particular appears to have become more commonplace. Consequently, the need to rapidly distinguish between rabies virus biotypes has become increasingly important in efforts to monitor the epidemiology of rabies in the southern African region. In this study, a nested polymerase chain reaction (PCR) assay was developed to distinguish between these two groups of rabies viruses. Consensus oligonucleotides were used to amplify the cytoplasmic domain of the rabies virus glycoprotein and the adjacent intergenic region. The resultant amplicon was subsequently used as template in second round heminested PCR in the presence of type-specific primers, thereby successfully generating amplicons of characteristic size for each biotype.

Animals↗
PubMed1998

Cancer pain management. Improving knowledge and patient care.

OBJECTIVE: A pain management project was designed to assess the effectiveness of a multifaceted intervention for improving GPs' knowledge of cancer pain management. Two hypotheses were tested: that the intervention would influence GPs' knowledge in the area of cancer pain management; that information would be gathered to assist in the production of educational material. METHOD: The project involved assessment of GP knowledge, feedback and discussion at project officer visits, mailings and participation in developing guidelines. RESULTS: All participants who completed the second round of visits were glad they had participated in the program. A discussion of the information topics covered is included. CONCLUSION: Increasing GPs' knowledge of the management of symptoms is only one of many factors that influence their prescribing patterns. In cancer pain management lack of knowledge is a significant contributor to unnecessary patient suffering. We have been able to demonstrate the success of a multifaceted intervention in improving the knowledge of cancer pain management by GPs. Although not measured directly, it is hoped that this will lead to improved quality of life for patients cared for by these practitioners.

Australia↗
PubMed1998

Evaluation of a cancer pain education program for general practitioners.

OBJECTIVE: To evaluate a cancer pain education program. METHOD: Participants in the program completed an evaluation form covering various aspects of the program's design. RESULTS: All participants who completed the program were glad that they had done so. The most and least useful aspects are included in the article. Participants were satisfied with the program and eager to participate in similar ones. CONCLUSION: The education program was both successful at improving participants' knowledge of cancer pain management and provided in a manner acceptable to the participants. Ideas for future similar projects are included.

Australia↗
PubMed1997

Innocuity studies of SAG-2 oral rabies vaccine in various Zimbabwean wild non-target species.

The SAG-2 modified live rabies vaccine was tested for innocuity when administered by the oral route in several potential wild non-target bait-consuming species, as follows: ten chacma baboons (Papio ursinus), six African civets (Civettictis civetta), six slender mongooses (Galerella sanguinea), six honey badgers (Mellivora capensis), six large-spotted genets (Genetta tigrina), 39 multi-mammate mice (Mastomys natalensis), 26 bushveld gerbils (Tatera leucogaster) and six pied crows (Corvus albus). At least 9.0 log10 median tissue culture infectious doses (TCID50), given in a volume of 1 ml, was administered orally to each of the animals, except the rodents which received 8.0 log10 TCID50, given in 0.1 ml. All the animals were observed for not < 90 days for signs of vaccine-induced rabies. Most of the species were also tested for vaccine virus replication in the oral cavity and persistent virus infection in the brain, salivary gland and tonsil. None of the animals died of rabies and no persistent infection was found. Rabies virus which was pathologically and serotypically indistinguishable from the vaccinal strain was isolated from the saliva of one genet 1 day after vaccine administration. From this study it was concluded that SAG-2 rabies vaccine would be safe for use in most situations where oral vaccination campaigns for jackals are required in Zimbabwe.

Administration, Oral↗