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Biomedical subjects

J R Holmes

Publications and source records attributed to J R Holmes.

At least 19 recordsLinked to original sources

Marginal fit of castable ceramic crowns.

The objective of this study was to measure marginal fit of castable ceramic versus gold crowns. Full veneer gold and ceramic crowns were made on Ivorine dies. Crowns were cemented, embedded, sectioned faciolingually and mesiodistally, and photographed for measurement of absolute marginal discrepancies (cavosurface angle to casting margin) to evaluate fit. Results revealed no statistically significant differences in fit among four locations around the margins of either ceramic or gold crowns. There was no statistically significant difference in the combined absolute marginal discrepancy (fit) between ceramic and gold crowns. The variance of the combined absolute marginal discrepancy (fit) of the ceramic crowns was significantly different than that of the gold crowns (p = 0.01 level). The standard deviation (variability) of the gold crowns was more than twice that of the ceramic crowns. Randomized block ANOVA demonstrated statistically significant differences among individual gold crown specimens, but none among individual ceramic crown specimens.

Analysis of Variance

Reactivity-based hydrocarbon controls: scientific issues and potential regulatory applications.

The California Air Resources Board and the South Coast Air Quality Management District hosted a conference on April 8-9, 1991 to examine the scientific issues associated with reactivity-based hydrocarbon controls, and to identify the obstacles to potential regulatory applications. Owing to residual uncertainties in the underlying science, and the complex emission measurement capabilities required for enforcement, a general consensus emerged on the need for further research before application of reactivity-based controls. A number of recommendations were made for research on the remaining scientific, enforcement, and policy issues, many of which have led to cooperative efforts initiated since the conference.

Air Pollutants, Occupational

Measurement of cardiac dimensions with two-dimensional echocardiography in the living horse.

Two-dimensional echocardiography (2DE) was performed on 22 unsedated Thoroughbred and part Thoroughbred horses weighing between 411 and 650 kg to establish normal reference values for 2DE measurements. Animals stood during examinations performed with a 3.5 MHz mechanical sector transducer using various transducer positions and tomographic planes. Right ventricular diameter (RVD), ventricular septal thickness (VSTh), aortic diameter (AoD), area of the chordal lumen of the left ventricle (CTA), left ventricular diameter (LVD) and left atrial diameter (LAD) were determined at ventricular end-diastole (Ed) and/or end-systole (Es). Fractional shortening (FS) of the left ventricle and end-systolic left atrial to aortic ratio (LAD-Es:AoD-Es) also were calculated. Echocardiographic data were related to body weight by linear regression analysis. Intra-observer variability was checked in five horses by measuring each parameter during each of 10 consecutive cardiac cycles. The 2DE data were compared with M-mode values in published reports. In the 18 horses whose weight did not exceed 551 kg, repeatable recordings of good quality were obtained, and 2DE measurements could be made using intra-cardiac reference points. Increasing body weight proved to impose substantial limitations on measurements taken with the available machine and transducer. This problem might be overcome by using probes of lower frequency or equipment with higher quality image display at greater depth. The following parameters correlated significantly to body weight: VSTh-Es (r = 0.69; P less than 0.01). AoD-Es (r = 0.64; P less than 0.01) and CTA-Es (r = 0.84; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Anatomical validation of two-dimensional echocardiography in the horse.

This study was performed on 15 horses to validate the cardiac anatomy as imaged with two dimensional echocardiography (2DE) and to determine the accuracy of intracardiac measurements. 2DE images were recorded in five horses in life with a Diasonics DRF100 ultrasound system and a 3.5 MHz transducer in different tomographic planes. After slaughter, the hearts were fixed in 10 per cent formalin. To compare in vivo and in vitro results, the specimens were suspended in a water-filled tank and 2DE images were made using the same transducer positions as in life. In vitro 2DE and autopsy measurements of the same planes and parameters were also taken on a further 10 hearts, and the results were statistically compared. The in vivo 2DE images corresponded well with both in vitro 2DE recordings and anatomical sections. Repeatable imaging of each tomographic plane was possible on the post mortem hearts using intracardiac reference points. Comparison of parameters measured during in vitro 2DE and autopsy demonstrated a significant correlation between all 2DE and autopsy data (r: 0.879 to 0.926; P less than 0.001). Repeated 2DE measurements of each parameter showed a good reproducibility with coefficients of variation (CV%) varying between 4.6 to 10.6 per cent. The results suggest that 2DE is a reliable method for accurate anatomical evaluation of the equine heart and show the potential application of quantitative two dimensional echocardiography in the living horse.

Animals

Left ventricular volume determination in the horse by two-dimensional echocardiography: an in vitro study.

This study was designed to evaluate the accuracy of two-dimensional echocardiography (2DE) in determining the left ventricular volume (LVV) of the horse in vitro. After examining the shape of the left ventricular silicon rubber casts of four equine hearts, two modified Simpson's rule methods (Model A and Model B) as combinations of conical shapes and one biplane area-length method as a single cone (Model C) were chosen for volume calculations. One long axis and three short axis planes were used for linear and area 2DE measurements, respectively. The ventricular length (L) was calculated from the chordal length (CL) by using a linear regression equation (L = 5.54 + 1.83 CL) obtained by anatomical measurement of these two parameters on 40 normal hearts. The LVV was calculated in 15 formalin-fixed hearts from 2DE measurements with the three geometric models. Left ventricular casts were then made using silicon rubber, and their volumes were determined by water displacement. The calculated volumes were plotted against cast volumes with linear regression analysis. All calculated LVVs correlated well with the cast LVVs (R = 0.921 to 0.957; P less than 0.001). The highest correlation was provided by Model A which best represented the shape of the left ventricle. This model consisted of a truncated cone bordered by the area at the level of the mitral valve and by the area at the level of the chordae tendineae, plus a cone the base of which was the area at the level of the papillary muscles. The results demonstrate the applicability of 2DE for equine LVV determinations in vitro, similar to other species.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Intraoperative positioning for arthrodesis of the hip with the double beanbag technique.

The double beanbag technique allows the surgeon to select the position of the lower limb before an arthrodesis of the hip. During the procedure, the surgeon can freely manipulate the limb, confident that it can be replaced in the exact position that was chosen for the arthrodesis. The technique is not cumbersome, and only commonly available equipment is needed. For the method to be effective, there must be enough residual motion of the hip to allow positioning and preparation of the skin. Also, rigid internal fixation must be used to maintain the selected position of arthrodesis at the conclusion of the operation.

Arthrodesis

Considerations in measurement of marginal fit.

The terminology describing "fit" and the techniques used for measuring fit vary considerably in the literature. Although fit can be most easily defined in terms of "misfit," there are many different locations between a tooth and a restoration where the measurements can be made. In this work, the measurements of misfit at different locations are geometrically related to each other and defined as internal gap, marginal gap, vertical marginal discrepancy, horizontal marginal discrepancy, overextended margin, underextended margin, absolute marginal discrepancy, and seating discrepancy. The significance and difference in magnitude of different locations are presented. The best alternative is perhaps the absolute marginal discrepancy, which would always be the largest measurement of error at the margin and would reflect the total misfit at that point.

Dental Cavity Preparation

Equine syncope.

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Animals

Norwalk virus outbreak at a college campus.

An epidemic of nonbacterial gastroenteritis affected nearly 100 students at a college campus in Jefferson County, Alabama. The outbreak closely resembled food poisoning, since there was a rapid occurrence of multiple cases within a short period. Vomiting occurred in 79% and diarrhea in 64%; fever was uncommon. We found a significant association between the illness and the eating of lettuce at a meal one day before the outbreak began. Paired serologic specimens showed evidence of Norwalk virus infection. Twenty acutely ill students had leukocytosis (mean WBC 12,780/cu mm) and lymphopenia--a pattern that may be characteristic of Norwalk virus gastroenteritis. Outbreaks of Norwalk virus infection as well as other nonbacterial gastroenteritis may closely mimic epidemics caused by more familiar foodborne pathogens such as staphylococci.

Alabama

Paroxysmal atrial fibrillation in racehorses.

The paper describes five cases of atrial fibrillation detected after racing. In four of them, the arrhythmia disappeared spontaneously within 24 h and they were regarded as paroxysmal in type. In the fifth case, which won its race, the arrhythmia persisted for at least 45 h after racing. It was therefore regarded as an example of persistent atrial fibrillation. It was then treated with quinidine sulphate which restored sinus rhythm. It would seem that paroxysmal atrial fibrillation may be a cause of sudden decrease in racing performance.

Animals

Milrinone in congestive heart failure: observations on ambulatory ventricular arrhythmias.

Milrinone is a potent non-catecholamine, non-glycoside inotropic agent that can improve hemodynamic performance and functional capacity in patients with severe congestive heart failure. However, the potential effect of chronic inotropic stimulation on ventricular arrhythmias in patients with heart failure requires evaluation. We compared 24-hour ambulatory ECGs before and 2 to 4 weeks after initiation of chronic milrinone therapy in 20 patients with severe congestive heart failure (mean cardiac index 1.79 +/- 0.43 L/min/m2). A greater than tenfold increase in simple ventricular premature complex (VPC) density, a greater than tenfold increase in complex VPC form density, or an increase from 0 to greater than 5 episodes per 24 hours of any complex VPC form occurred in 35% (7 of 20) of patients. A greater than tenfold reduction in simple VPC density was noted in 5% (1 of 20), while 60% (12 of 20) of the study group had no significant change in ventricular arrhythmia profile on milrinone. The hemodynamic and functional response to milrinone, as well as entry hemodynamic profiles, were unrelated to the change in frequency or complexity of ventricular arrhythmias during therapy. Thus, milrinone therapy in congestive heart failure may be associated with the development of VPC complexity and with a significantly increased density of complex VPC forms.

Administration, Oral

The dowelklip: a device for dowel pin placement.

While no system of dowel pin placement satisfies all the desired requirements in every situation, the dowelklip is an original design that meets most of the requirements for many routine treatment procedures. For dentists who do not do a large enough volume of fixed restorative procedures to justify the expense of complex die positioning systems but are dissatisfied with sticky wax and match sticks, the dowelklip offers an alternative approach.

Denture Design

Observations on seven cases of mitral insufficiency in the horse.

Observations on seven cases of mitral insufficiency are described. Three of the horses had recent histories of cardiac failure and formed a separate group in which there were marked haemodynamic changes which varied in relation to heart rate but were associated with pulmonary hypertension, elevated right ventricular pressure and low peak left ventricular pressure. In the other four horses the heart appeared to be compensating at rest but to be unable to cope with severe exertion. On auscultation, a widespread pansystolic murmur and a prominent third heart sound were characteristic of the left ventricular volume overload. Microscopic changes were found in one left papillary muscle. The possibility that changes in the position of the papillary muscles consequent upon left ventricular dilatation may lead to or exaggerate mitral valve eversion is discussed.

Animals

Phonocardiography in the horse: 1. The intracardiac phonocardiogram.

Using microtransducers, the intracardiac phonocardiogram was recorded in 8 horses from the right heart and in 6 of them also on the left side. All 4 heart sounds were recorded but not in all sites. Their timing was related to pressure events. Systolic ejection murmurs were recorded in both the pulmonary artery and the aorta. Diastolic murmurs were recorded in 2 horses with aortic regurgitation, with maximum amplitude in the left ventricle. The findings were similar to those reported in man and agree with some of the recent concepts on heart sound production.

Animals

Phonocardiography in the horse: 2. The relationship of the external phonocardiogram to intracardiac pressure and sound.

The paper describes observations during individual cardiac cycles on the changing pressures and sounds recorded from the various chambers of the heart and aorta, related to phonocardiograms from an external microphone hand-held over the cardiac area. The majority of the first sound appears to arise from the left side of the heart after the AV valves have closed and the second sound is a consequence of sudden deceleration of blood against already closed semilunar valves. Systolic murmurs at the aortic root may be benign from increased flow and turbulence at the peak of ejection but these may not be recorded externally.

Animals

Assessment of myocardial function in the horse. 1. Theoretical and technical considerations.

The paper discusses the various parameters which are currently used in attempts to assess the contractile efficiency of the myocardium in various species. These procedures depend upon accurate recording of intracavity pressure. The response of a catheter-mounted microtransducer compared with a fluid-filled catheter manometer system is illustrated to show the advantage of the former in providing a true representation of pressure changes.

Animals

Assessment of myocardial function in the horse. 2. Experimental findings in resting horses.

The paper describes observations on 8 horses at rest using catheter-mounted microtransducers to record intracavity pressures. In 5 of them records were obtained from both left and right sides and in 3 horses from the right heart only. Twelve indices were measured. Variations in left ventricular end-diastolic pressure seemed to influence the results on many of the parameters. It is suggested that left ventricular end-diastolic pressure itself may be a useful guide to left ventricular functional efficiency but more work is necessary to further evaluate these indices as possible measures of myocardial function in the horse.

Animals