PubMed Health⌕ Search

Biomedical subjects

M Bowden

Publications and source records attributed to M Bowden.

At least 19 recordsLinked to original sources

Comparison of an automated thrombolytic predictive instrument to both diagnostic software and an expert cardiologist for diagnosis of an ST elevation acute myocardial infarction.

Because the electrocardiograms (ECGs) of patients with symptoms suggesting an acute thrombotic coronary occlusion are typically read by physicians relatively inexperienced in this skill, it is important to develop automated decision support. A Thrombolytic Predictive Instrument (TPI) is now available along with the standard diagnostic software in a commercially available electrocardiograph. This study evaluates the performance of the predictive software in comparison to both an expert cardiologist and standard diagnostic software. True sensitivity and specificity cannot be determined because acute coronary angiography was not performed. The specificities determined by this study were excellent (98% and 99%), and the sensitivities were very good (72% and 78%). These results that the TPI will be only rarely applied to patients who do not indeed have an acute coronary thrombosis. However, the reasons for even this small number of presumably falsely TPI positive patients should be determined and analyzed. It is unlikely that alterations of the thresholds for TPI activation will significantly improve on this very good level of sensitivity, without prohibitively decreasing specificity.

Clinical Competence↗

Modified bar superstructure for an implant-retained orbital prosthesis.

The success of a bar superstructure for an orbital prosthesis may be compromised by the placement and angulation of implants. The following technique describes a modification to a bar superstructure that provided the advantages of convenience, security, and consistent positioning even though one implant was lost and the angulation of implants limited accuracy.

Eye, Artificial↗

A comparative study of monoclonal gammopathies and immunoglobulin levels in Japanese and United States elderly.

OBJECTIVE: To define the prevalence of monoclonal immunoglobulin (Ig) proteins and quantitative serum immunoglobulin levels in elderly Japanese in comparison with elderly Caucasians as possible factors related to the reported lower incidence of multiple myeloma in elderly Japanese than in elderly Caucasians. DESIGN: Survey study SETTING: Community Center in Yokohama, Japan and Retirement Community in the United States. PARTICIPANTS: Convenience sample of community-dwelling elderly subjects (age 63-95) presenting for health screening examinations in each setting. Frozen serum samples were obtained from routine screening from 146 consecutive Japanese subjects and 111 US subjects. INTERVENTION: None MEASUREMENTS: Presence of monoclonal immunoglobulin protein determined by serum protein electrophoresis and immunofixation and quantitative Ig by laser nephelometry. RESULTS: Four (2.7%) of the Japanese cohort had monoclonal gammopathies compared with 11 (10%) of the American cohort. Two of the monoclonal gammopathies were IgG Kappa and two were IgG Lambda. No cases of multiple monoclonal gammopathy were identified in the Japanese group, compared with 25% of the monoclonal gammopathies in the American group. The mean quantitative serum IgG level for the Japanese group was 1,685 +/- 520 mg/dL versus 1,118 +/- 402 mg/dL for the American group; mean quantitative IgA levels were 283 +/- 116 mg/dL versus 226 +/- 116 mg/dL (P < 0.001). Albumin levels were normal in both populations, suggesting that there was not an increase in occult inflammatory disorders in the Japanese population. CONCLUSION: The low prevalence of monoclonal gammopathy in elderly Japanese is consistent with the reported lower frequency of multiple myeloma. The reason for the higher quantitative immunoglobulin levels in this population is unclear. Further cross-cultural investigation is warranted to explore the genetic influences on altered immune regulation with aging.

Age Factors↗

Identification of pathological mineral deposits by Raman microscopy.

Raman microscopy--the analysis of scattered photons after excitation--is well established in non-biological sciences for the identification of crystals. It shows promise in biological (clinical) specimens also, as demonstrated here in studies of synovial fluid, synovium, and gouty tophus, selected for their known content of sodium urate and calcium pyrophosphate crystals.

Aged↗