PubMed Health⌕ Search

Biomedical subjects

J R Govan

Publications and source records attributed to J R Govan.

At least 73 records · Page 4Linked to original sources
PubMed1990

Long term continuous domiciliary oxygen therapy by transtracheal catheter.

Long term continuous oxygen therapy improves prognosis in patients with hypoxaemic chronic airflow limitation. Transtracheal delivery of oxygen permits adequate oxygenation of such patients at lower flow rates than are required for delivery by nasal cannulas, thus increasing the time for which portable oxygen cylinders can be used and improving the efficacy of domiciliary oxygen concentrators in patients with refractory hypoxaemia. In a study of the long term acceptability and risks of transtracheal oxygen in 37 patients, with a total follow up of 595 patient-months, most patients reported symptomatic benefit and four have used transtracheal oxygen successfully for more than four years. Problems have included surgical emphysema (4 patients), catheter fracture (9), local infection (34), and catheter dislodgement (21); but these have been relatively infrequent and in general have not caused important clinical problems. Transtracheal oxygen therapy was discontinued in 10 patients before death for various reasons, including infection (2 patients), catheter fracture (1), and surgical emphysema (1). Accumulation of mucus balls has not been a problem. It is concluded that transtracheal oxygen therapy is a safe and acceptable alternative to nasal cannulas in well motivated patients with hypoxaemia due to chronic airflow limitation who are keen to pursue an active life.

Aged↗
PubMed1989

Fecal isolation of Pseudomonas aeruginosa from patients with cystic fibrosis.

Fecal isolation of Pseudomonas aeruginosa was observed in 8 of 10 patients with cystic fibrosis who at the time of sampling also exhibited colonization of the respiratory tract. In contrast, P. aeruginosa cells were isolated at low frequency (9.1%) from the stools of 44 patients with cystic fibrosis with no previous history of chronic colonization. The results of this study suggest that the gastrointestinal tract is not a significant chronic reservoir of P. aeruginosa prior to pulmonary colonization.

Adolescent↗
PubMed1988

A fatal transfusion reaction associated with blood contaminated with Pseudomonas fluorescens.

A fatal transfusion reaction due to contamination of platelet-depleted whole blood with Pseudomonas fluorescens is reported. Routine sterility testing on blood products and environmental microbiological monitoring suggested no source for the contaminating organism, as has been the case for the majority of reported incidents of this type. The value of routine sterility testing in the prevention and investigation of such incidents is discussed.

Aged↗
PubMed1986

Long term transtracheal oxygen delivery through microcatheter in patients with hypoxaemia due to chronic obstructive airways disease.

Transtracheal administration of oxygen is a new technique for long term treatment. Twenty patients with hypoxaemia due to chronic obstructive airways disease were studied while receiving oxygen through a microcatheter inserted percutaneously into the trachea. By bypassing most of the dead space and avoiding oxygen wastage at the face this method of delivery reduced oxygen requirements by roughly half compared with delivery through nasal cannulas, thus reducing costs and facilitating portable treatment. Twelve of these patients continued to use the system for up to 13 months in preference to using nasal cannulas. Two important complications were a staphylococcal infection and a fractured catheter. Transtracheal oxygen reduced breathlessness and helped patients with routine daily activities. Transtracheal administration of oxygen is a practical method of treatment which may have an important role in rehabilitating patients with chronic lung disease.

Aged↗
PubMed1986

In vivo significance of bacteriocins and bacteriocin receptors.

Bacteriocins are protein or protein-complex antibiotics produced by a wide variety of bacterial species. By conventional definition, bacteriocins differ from most other antibiotics in that the producer strain is immune to the action of its own bacteriocin and the inhibitory activity of individual bacteriocins is directed only to bacteria which are closely related to the strains which produce them. Bacteriocin production is regulated by plasmid or chromosomal elements and bacteriocin activity is initiated by adsorption of bacteriocin to specific outer membrane receptors on susceptible cells. In Darwinian terms, production of bacteriocin by a bacterial strain, within a particular ecological niche, could be considered advantageous by ensuring elimination of other closely related, and thus competitive, bacteria. In contrast, conservation of bacteriocin receptors appears suicidal if their only function is to initiate cell death. The paper will illustrate the ubiquity of bacteriocins and discuss evidence for their in vivo function in terms of bacterial survival. Evidence will also be presented to indicate that bacteriocin receptors in Escherichia coli and Pseudomonas aeruginosa have important alternative physiological functions in outer-membrane mediated nutrient uptake, particularly with respect to bacterial iron metabolism.

Bacteriocins↗
PubMed1986

Pseudomonas aeruginosa and cystic fibrosis: unusual bacterial adaptation and pathogenesis.

Pseudomonas aeruginosa is an adaptable, saprophytic bacterium with the potential to cause a variety of opportunistic infections in compromised hosts. In patients with cystic fibrosis, chronic pulmonary colonization with mucoid alginate-producing mutants of P. aeruginosa is a major cause of morbidity and mortality and is an interesting example of microbial adaptation and host-bacterium interaction.

Adaptation, Physiological↗
PubMed1985

Typing of Pseudomonas cepacia by bacteriocin susceptibility and production.

The significance of Pseudomonas cepacia as an opportunistic pathogen in immunocompromised patients has become increasingly recognized. Particularly disturbing is its increased incidence, reported by several North American centers, in respiratory tract cultures from patients with cystic fibrosis. Epidemiological studies of P. cepacia have been hampered by a lack of typing methods. In this paper we report the development of a typing scheme based on bacteriocin production and susceptibility. For bacteriocin production, test isolates of P. cepacia were rapidly applied to the surfaces of agar plates with a multiple inoculator. After incubation of these test isolates for 5.5 h and their exposure to chloroform, indicator strains were applied in agar overlays without prior removal of the test strain growth. After 18 h of incubation, inhibition zones caused by bacteriocin activity were recognized. A similar procedure was used to examine the bacteriocin susceptibility of the test strain. The bacteriocin type of the test strain was defined based on its bacteriocin production as judged by zones of inhibition against a set of eight indicator strains and by susceptibility or resistance of the test strain to bacteriocin produced by six producer strains. Of 373 strains of P. cepacia, 95.2% were typed into a total of 44 type combinations. Bacteriocin typing provided a suitable procedure for epidemiological studies of colonization or infection by P. cepacia. The technique described in this paper was simple to perform, gave a result within 24 h, provided good strain discrimination, and was suitable for clinical, environmental, and phytopathogenic strains.

Bacteriocins↗
PubMed1984

Chromosomal loci associated with antibiotic hypersensitivity in pulmonary isolates of Pseudomonas aeruginosa.

492a and 492c were two strains of Pseudomonas aeruginosa isolated from the sputum of a patient with cystic fibrosis. The strains were closely related but expressed different antibiograms. 492c was hypersensitive (10-100 times more sensitive than 492a) to the beta-lactam antibiotics carbenicillin, methicillin, flucloxacillin, mecillinam and cefuroxime and the non-beta-lactam, nalidixic acid. 492c also showed enhanced sensitivity (4-8 times more sensitive than 492a) to chloramphenicol, trimethoprim and novobiocin. 492a and PAO8 expressed similar levels of antibiotic resistance, except for trimethoprim, to which 492a was five times more sensitive than PAO8. Two genes associated with antibiotic hypersensitivity were mapped in the 30 min region of the chromosome, by means of R68.45-mediated plate matings between a Leu - mutant of 492c and PAO8, followed by transductional analysis using phage F116L. The first of these genes, blsA1, was closely linked to nalB, and in a PAO background, was associated with hypersensitivity to the beta-lactams and a moderate increase in sensitivity to chloramphenicol, trimethoprim, nalidixic acid and novobiocin. A further increase in sensitivity to the latter three antibiotics was associated with the second gene, tpsA1, which mapped between ser-3 and hisV. This gene could also be transferred to PAO from 492a, thus 492c could have arisen from 492a in vivo following a single chromosomal mutation at the blsA locus. Isolation of a blsA mutant of PAO969 provided further evidence for this theory.

Anti-Bacterial Agents↗
PubMed1984

Revised pyocin typing method for Pseudomonas aeruginosa.

In the Gillies and Govan method of pyocin typing for Pseudomonas aeruginosa a cross-streaking technique was used, and 105 main types and 25 subtypes were identified by the patterns of inhibition observed on 13 indicator strains. Disadvantages of the technique included the need to remove test strain growth before application of the indicator strains, the 48-h period needed to obtain a result, and the inability to reliably type mucoid P. aeruginosa. Recent studies have enabled us to overcome these disadvantages and significantly improve the speed and application of pyocin typing. Our revised technique utilizes the same 13 indicator strains which are already used internationally. Test strains were rapidly applied to the surface of agar plates with a multiple inoculator. After incubation for 6 h and exposure to chloroform, the indicator strains were applied in agar overlays without prior removal of the test strain growth. After 18 h of incubation, the pyocin type was recognized by inhibition of particular indicator strains. Additionally, the activity of particulate (R and F) and nonparticulate (S) pyocins could be distinguished on the basis of inhibition zone size, which thus allowed further discrimination. The revised technique allows typing within 24 h, increases the number of identifiable types, and can be used to type mucoid strains.

Bacteriocins↗
PubMed1981

Isolation of alginate-producing mutants of Pseudomonas fluorescens, Pseudomonas putida and Pseudomonas mendocina.

Spontaneous alginate-producing (muc) variants were isolated from strains of Pseudomonas fluorescens, P. putida and P. mendocina at a frequency of 1 in 10(8) by selecting for carbenicillin resistance. The infrared spectrum of the bacterial exopolysaccharide was typical of an acetylated alginate similar to that previously described in Azotobacter vinelandii and in mucoid variants of P. aeruginosa. Mucoid variants were not isolated from P. stutzeri, P. pseudoalcaligenes, P. testosteroni, P. diminuta, P. acidovorans, P. cepacia or P. maltophilia.

Alginates↗
PubMed1980

Alginate synthesis in mucoid Pseudomonas aeruginosa: a chromosomal locus involved in control.

Mucoid variants of Pseudomonas aeruginosa isolated in vitro or in vivo could be classified into two phenotypic groups based on whether alginate was produced on a chemically defined medium. Mucoid strains yielded lowe recombination frequencies than the non-mucoid parent when used as donors in FP2-mediated plate matings. The mucoid characteristic (muc) was co-inherited by a proportion of recombinants selected for the inheritance of chromosomal markers his-5075+ or cys-5605+. The results of further experiments using either a mucoid recipient or a mucoid donor carrying plasmid R68.45 suggested that the control of alginate production in P. aeruginosa involves at least one chromosomal locus.

Alginates↗