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Biomedical subjects

M Gibbons

Publications and source records attributed to M Gibbons.

At least 19 recordsLinked to original sources
PubMed2003

A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial.

Before proceeding to longer-term studies, we have studied the early clinical results of a new mobile-bearing total knee prosthesis in comparison with an established fixed-bearing device. Patients requiring bilateral knee replacement consented to have their operations under one anaesthetic using one of each prosthesis. They also agreed to accept the random choice of knee (right or left) and to remain ignorant as to which side had which implant. Outcomes were measured using the American Knee Society Score (AKSS), the Oxford Knee Score (OKS), and determination of the range of movement and pain scores before and at one year after operation. Preoperatively, there was no systematic difference between the right and left knees. One patient died in the perioperative period and one mobile-bearing prosthesis required early revision for dislocation of the meniscal component. At one year the mean AKSS, OKS and pain scores for the new device were slightly better (p < 0.025) than those for the fixed-bearing device. There was no difference in the range of movement. We believe that this is the first controlled, blinded trial to compare early function of a new knee prosthesis with that of a standard implant. It demonstrates a small but significant clinical advantage for the mobile-bearing design.

Aged↗
PubMed2003

The role of the popliteofibular ligament and the tendon of popliteus in providing stability in the human knee.

Techniques for the selective cutting of ligaments in cadaver knees defined the static contributions of the posterolateral structures to external rotation, varus rotation and posterior tibial translation from 0 degrees to 120 degrees of flexion under defined loading conditions. Sectioning of the popliteofibular ligament (PFL) (group 1) produced no significant changes in the limits of the knee movement studied. Sectioning of the PFL and the popliteus tendon (femoral attachment, group 2) produced an increase of only 5 degrees to 6 degrees in external rotation from flexion of 30 degrees to 120 degrees (p < 0.001). Even when other ligaments were sectioned first (group 3), the maximum effect of the PFL was negligible. Our findings show that the popliteus muscle-tendon-ligament complex, lateral collateral ligament, and posterolateral capsular structures function as a unit. No individual structure alone is the primary restraint for the movements studied. Operative reconstruction should address all of the posterolateral structures, since restoration of only a portion may result in residual instability.

Aged↗
PubMed2000

Decreased nuclear factor-kappaB DNA binding activity following permanent focal cerebral ischaemia in the rat.

Many factors implicated in the pathogenesis of cerebral ischaemia such as glutamate, tumour necrosis factor and interleukin-1 have also been shown to activate nuclear factor-kappaB (NF-kappaB). In the present study we have investigated NF-kappaB activity at various times following permanent focal cerebral ischaemia in rats using immunohistochemistry, western blotting and electrophoretic mobility shift assay (EMSA). Three hours following middle cerebral artery occlusion nuclear translocation of NF-kappaB was detected using immunohistochemical and western blotting techniques. This was reflected in a trend towards increased NF-kappaB binding activity (EMSA) in the ischaemic cortex compared to histologically normal tissue. In contrast however, from 6 to 48 h post-occlusion nuclear translocation and NF-kappaB binding activity was decreased in the ischaemic cortex. Decreased NF-kappaB binding activity detected in degenerating neurones, suggests that decreased NF-kappaB activity may exacerbate ischaemia induced neuronal cell death.

Animals↗
PubMed1999

Science's new social contract with society.

Under the prevailing contract between science and society, science has been expected to produce 'reliable' knowledge, provided merely that it communicates its discoveries to society. A new contract must now ensure that scientific knowledge is 'socially robust', and that its production is seen by society to be both transparent and participative.

Science↗
PubMed1999

An encyclopedia of mouse genes.

The laboratory mouse is the premier model system for studies of mammalian development due to the powerful classical genetic analysis possible (see also the Jackson Laboratory web site, http://www.jax.org/) and the ever-expanding collection of molecular tools. To enhance the utility of the mouse system, we initiated a program to generate a large database of expressed sequence tags (ESTs) that can provide rapid access to genes. Of particular significance was the possibility that cDNA libraries could be prepared from very early stages of development, a situation unrealized in human EST projects. We report here the development of a comprehensive database of ESTs for the mouse. The project, initiated in March 1996, has focused on 5' end sequences from directionally cloned, oligo-dT primed cDNA libraries. As of 23 October 1998, 352,040 sequences had been generated, annotated and deposited in dbEST, where they comprised 93% of the total ESTs available for mouse. EST data are versatile and have been applied to gene identification, comparative sequence analysis, comparative gene mapping and candidate disease gene identification, genome sequence annotation, microarray development and the development of gene-based map resources.

Animals↗
PubMed1995

Complications of nailing in closed tibial fractures.

Reamed intramedullary nailing was used to treat 102 closed tibial shaft fractures. Although a high rate of union was achieved (98%), we noted a higher incidence of complications than previously reported. Thirty-five (37%) patients exhibited one or more components of malunion. In 17 (18%) patients, further operative procedures were required to achieve union or to correct malalignment. New, postoperative peroneal nerve lesions were found in 19 (19%) patients, of which four (4%) failed to resolve. Acute compartment syndrome, requiring fasciotomy, developed in seven (7%) cases after surgery. Two patients developed an atrophic nonunion. In spite of these complications, the overall results were good and we continue to recommend this method of treatment for the displaced, unstable tibial shaft fracture.

Adolescent↗
PubMed1995

Urinary problems after formation of a Mitrofanoff stoma.

1. Bladder irrigation reduces occlusion of drains with clots and debris, thus protecting anastomoses. 2. Leakage from anastomoses is an acknowledged problem postoperatively but resolves spontaneously in the majority of cases. 3. To establish urinary continence a good fluid intake is essential, bladder capacity must be developed, intermittent catheterisation taught and excessive mucus production eliminated. 4. The risk of urinary tract infections can be minimised by drinking cranberry juice, prophylactic antibiotic therapy and a good intermittent catheterisation technique. A degree of bacteria is inevitable and not always significant.

Fluid Therapy↗
PubMed1994

Childhood sexual abuse.

Childhood sexual abuse is a common problem. Patients with subacute and nonacute injuries may be treated in the physician's office. Patients with acute injuries are usually best managed in an emergency department where forensic testing can be performed efficiently. Physicians need to know how to appropriately interview children with signs of acute and subacute trauma. The physical examination should be thorough, nontraumatic and well documented. Evidence of inflammation, infection, and acute or healed trauma should be sought. Attention should be paid to sexually transmitted diseases, pregnancy prevention and mental health needs. Coordination with child welfare services, mental health professionals and law enforcement officers is often indicated. Awareness of the various presentations of sexual abuse and familiarity with normal and abnormal genital findings are necessary for the initial evaluation of these children.

Child↗
PubMed1984

Total body composition by dual-photon (153Gd) absorptiometry.

The lean-fat composition (%FATR) of soft tissue and the mineral mass of the skeleton were determined in vivo using dual-photon (153Gd) absorptiometry (dose under 2 mrem). A rectilinear raster scan was made over the entire body in 18 subjects (14 female, 4 male). Single-photon absorptiometry (125I) measured bone mineral content on the radius. Percentage fat (%FATD) was determined in the same subjects using body density (from underwater weighing with correction for residual lung volume). Lean body mass (LBM) was determined using both %FATR and %FATD. Percentage fat from absorptiometry and from underwater density were correlated (r = 0.87). The deviation of %FATD from %FATR was due to the amount of skeletal mineral as a percentage of the LBM (r = 0.90). Therefore, skeletal variability, even in normal subjects, where mineral ranges only from 4 to 8% of the LBM, essentially precludes use of body density as a composition indicator unless skeletal mass is measured. Anthropometry (fatfolds and weight) predicted %FATR and LBM at least as well as did underwater density. The predictive error of %FATR from fatfolds was 5% while the predictive error in predicting LBM from anthropometry was 2 to 3 kg (3%).

Adipose Tissue↗
PubMed1970

Relationship between science and technology.

Do economic advances spring directly from fundamental scientific discoveries? The early history of the transistor suggests that the situation is not nearly so simple as this.

Journal Article↗