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Biomedical subjects

J M Gibson

Publications and source records attributed to J M Gibson.

159 records · Page 9Linked to original sources

Repeated corticosteroid injections into knee joints.

The effect of intra-articular injections of corticosteroids repeated over a period extending from four to 15 years on the radiological appearances of knee joints affected by rheumatoid arthritis and osteoarthritis has been studied. In 65 cases, the X-ray films of 15 showed no deterioration, 38 showed minimal or moderate deterioration, 10 showed marked deterioration and only 2 showed gross deterioration. The results do not support the contention that repeated intra-articular injections of corticosteroids will inevitably lead to rapid joint destruction. The authors are of the opinion that intraarticular injections of corticosteroids, if used judiciously, have an important part to play in the management of chronic arthritis.

Adrenal Cortex Hormones↗

Diversity of coding profiles of mechanoreceptors in glabrous skin of kittens.

We examined stimulul-response (S-R) profiles of 35 single mechanoreceptive afferent units having small receptive fields in glabrous forepaw skin of 24 anesthetized domestic kittens. Single unit activity was recorded with tungsten microelectrodes from cervical dorsal root ganglia. The study was designed to be as quantitatively descriptive as possible. We indented each unit's receptive field with a broad battery of simple, carefully controlled stimuli whose major parameters, including amplitude, velocity, acceleration, duration, and interstimulus interval were systematically varied. Stimuli were delivered by a small probe driven by a feedback-controlled axial displacement generator. Single unit discharge data were analyzed by a variety of direct and derived measures including dot patterns, peristimulus histograms, instantaneous and mean instantaneous firing rates, tuning curves, thresholds for amplitude and velocity, adaptation rates, dynamic and static sensitivities, and others. We found that with respect to any of the S-R transactions examined, the properties of our sample of units were continuously and broadly distributed. Any one unit might exhibit either a slow or rapid rate of adaptation, or might superficially appear to preferentially code a single stimulus parameter such as amplitude or velocity. But when the entire range of responsiveness of units to the entire stimulus battery was surveyed by a variety of analytic techniques, we were unable to find any justifiable basis for designation of discrete categories of S-R profiles. Intermediate response types were always found, and in general, all units were both broadly tuned and capable of responding to integrals of several stimulus parameters, our data argue against the usefulness of evaluating a unit's S-R coding capabilities by means of a limited ste of stimulation of response analysis procedures.

Adaptation, Physiological↗

A psychoneural model of visual contrast.

A typical set of visual contrast data can be described by a function which relates brightness responses to the luminance stimulus provided by a target that is viewed against an illuminated surround. This brightness-luminance function is represented by a psychoneural visual-contrast model having two channels, one corresponding to the brightness of the target and the other to the brightness of the surround. The principal ascending and descending pathways in each channel are represented by a submodel which is equivalent to the intensity-perception model described by MacKay. The interaction between the channels, which accounts for the perception of contrast, takes the form of nonlinear lateral inhibition. Brightness responses calculated with the use of the psychoneural contrast model correspond very closely to the data upon which the brightness-luminance function is based.

Light↗

The effect of treatment on eye-head coordination in Parkinson's disease.

Eye-head movements to target steps of amplitude 3.75 degrees to 30 degrees were analyzed in 9 untreated patients with idiopathic Parkinson's disease. Testing was performed before and after the introduction of a dopamimetic drug (L-dopa or bromocriptine) and compared with 9 normal controls. The patients showed a significantly greater scatter of mean head latencies prior to treatment, although their mean latencies were not significantly prolonged. When compared to controls, the patients' head movements were of reduced peak velocity and gain. Treatment resulted in an improvement of gain but not velocity. Analysis of the frequency of gaze types showed no significant effect of treatment.

Aged↗

A 'fail-safe' screening programme for diabetic retinopathy.

OBJECTIVE: To improve screening for diabetic retinopathy in a hospital diabetic clinic through the use of the audit process. DESIGN: Comparison of an existing system of screening for diabetic retinopathy (a specialist optometrist using ophthalmoscopy alone) with a new system in which a specialist optometrist examined retinal Polaroid photographs taken through pharmacologically dilated pupils and combined this with ophthalmoscopy in all cases except when the photographs were perfect and definitely showed no retinopathy. In this new system, the optometrist could discuss cases of uncertainty with a diabetes physician while the patient was still in the clinic with eyes dilated. SETTING: Inner city hospital diabetes clinic. SUBJECTS: 289 hospital diabetic clinic patients not already attending an ophthalmologist; a consecutive series of 144 such patients for the first audit, 145 for the repeat audit. MAIN OUTCOME MEASURES: Assessment of each screening system against a gold standard. For the first audit this was agreement by two of four diabetes physicians, who combined examination of the photographs with the findings from dilated ophthalmoscopy, on the classification of the retinae of each patient, guided by standard European criteria. For the second audit, the gold standard was enhanced by discussing the photographs and findings of all patients with an independent ophthalmologist. For patients requiring referral, a second ophthalmologist also commented on the case. RESULTS: The addition of retinal photography to universal pupil dilatation, and the availability of diabetes physician backup to discuss cases of uncertainty, greatly increased the optometrists' detection rate. Sensitivities for the first (ophthalmoscopy only) and second (ophthalmoscopy plus photography plus diabetologist back-up) audits were, respectively, 71.4% vs 100% for sight-threatening retinopathy, 33% vs 100% for retinopathy requiring six-month review, and 40.3% vs 97.2% for any retinopathy (p = 0.002). CONCLUSIONS: Optometrists specialising in diabetic retinopathy using Polaroid retinal photography and ophthalmoscopy, both through dilated pupils, backed up by experienced diabetologists to discuss cases of uncertainty, could form the basis of a retinopathy screening service that accurately identifies and categorises retinopathy and does not miss sight-threatening cases.

Diabetic Retinopathy↗