Biomedical subjects
R Clinton
Publications and source records attributed to R Clinton.
Is routine roentgenography needed after closed tube thoracostomy removal?
BACKGROUND: Efficacy of chest radiograph protocol after tube thoracostomy tube (CT) removal. METHODS: Retrospective review (July of 1995 to July of 1996) of 141 patients with CT followed throughout their hospitalization. Excluded patients died (23 patients) or had thoracotomy (13 patients) before CT removal. RESULTS: A total of 105 patients had 113 CT removed (mean age, 36.9 years; Injury Severity Score = 23.4; CT duration, 5.0 days). Protocol chest radiographs were performed on average at 7.9 and 22.1 hours. Recurrent pneumothorax (RHPTX = new interpleural air) occurring in 12 patients (11%) and persistent pneumothorax (PHPTX = same volume of interpleural air) occurring in 13 patients (12%) caused no clinical problems and were treated without tube replacement. Three patients had symptoms after removal; none had RHPTX. Two patients had clinical signs; one reaccumulated a hemothorax requiring CT replacement, the other improved without replacement. CONCLUSIONS: Clinically significant RHPTX/PHPTX after CT removal is infrequent. Signs not symptoms detect CT removal complications. At our institution, chest radiographs are obtained in a delayed manner from protocol and offer no benefit over clinical assessment.
Adaptation of human enteric coronavirus to growth in cell lines.
BACKGROUND: The existence of human enteric coronavirus (HEC) has been debated since its first description in stool by electron microscopy (EM) in 1975. Needed to resolve the issue is its cultivation in readily available cell lines. OBJECTIVES: To grow HEC in cell lines. To describe its characteristics and to differentiate it from other human and animal coronaviruses. STUDY DESIGN: Originally grown in human fetal intestinal organ culture, HEC was passed in J774 cells (a mouse macrophage cell line) and C6/36 cells (a mosquito cell line). Its cytopathic effect (CPE) and pattern of immunofluorescence were described. Its appearance was ascertained by negative staining and transmission EM. Its structural proteins were delineated by polyacrylamide gel electrophoresis (PAGE) and Western blotting (WB). The antigenic character of the virus was determined by immunofluorescence and WB. Agglutination with mouse erythrocytes was performed. RESULTS: In J774 cells, HEC induced the formation of giant cells and small syncytia. Immunofluorescence in both J774 and C6/36 cells was limited to the cytoplasm. Studies with transmission EM revealed the virus to have the typical appearance of other coronaviruses, to be 80-120 nm in diameter, and to bud into cysternae of the endoplasmic reticulum. By PAGE and WB, its major protein has an average molecular weight (MW) of 41 kilodaltons (kDa). Two other proteins had MWs of 190 and 24 kDa. By immunofluorescence and WB, HEC is antigenically distinct from human coronaviruses 0C43 and 229E and mouse hepatitis virus (A59 strain). Preparations of HEC did not agglutinate mouse erythrocytes. CONCLUSION: We conclude that HEC is a human coronavirus that is antigenically unrelated to 0C43 and 229E viruses. Growth of HEC in readily available cell lines should aid in elucidating its role as a pathogen in human diarrheal illnesses.
[Sagittal splitting of the ascending mandibular ramus. Prevention of injury to the lower dental pedicle].
The authors report a technique of sagittal split osteotomy of the ramus, which varies from accepted techniques, and permits maintenance of integrity of the neurovascular bundle and, at the same time, good visibility of the developing split. 78 cases of this technique are reviewed.
A histological study of the carrageenan-induced granuloma in the rat lung.
Intralobular injection of 0.17 ml of 2% carrageenan, through a ventral slit in the trachea of rats, induced localised areas of inflammation with a high survival rate. This inflammation was characterised by immediate polymorphonuclear leucocyte (PMN) infiltration into the interstitial and alveolar spaces followed in 4 days by replacement of the PMNs by carrageenan-containing macrophages. Between days 10 to 70, the macrophages rapidly increased in size and accumulated numerous large vacuoles which stained for the presence of carrageenan. Several macrophages were so large that they each filled an entire alveolar space. From days 70 to 205, the macrophage appearance was unchanged except that the staining of their carrageenan-containing vacuoles was less metachromatic with toluidine blue. Fibrosis was first noted at day 205 and consisted of several small granulomas located near large airways and blood vessels. These granulomas had a central area filled with macrophages and a peripheral zone consisting of fibroblasts, new collagen, scattered macrophages and blood vessels. The morphology of the macrophages remained essentially unchanged from days 205 to 500 but by day 500, the macrophages were found only in numerous pockets within the inflamed lobe. They still stained positive for the presence of carrageenan at day 500. The extreme longevity of these macrophages and the lack of significant fibrosis may be due to the "un-naturalness", indigestibility, and low toxicity of the irritant, carrageenan. In addition, their size and numerous vacuoles may have inhibited their movement and subsequent removal from the lung. The paucity of significant fibrosis may be due to the lack or inhibition of a "fibroblast stimulating factor" released by the macrophages or possibly the collagen was degraded as soon as it was synthesised. This carrageenan-induced inflammation is a very suitable for the study of alveolar macrophages but appears to be inappropriate for the study of pulmonary fibrosis.
School hearing and vision screening-referrals.
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