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Biomedical subjects

S H Johnson

Publications and source records attributed to S H Johnson.

At least 19 recordsLinked to original sources
PubMed1992

Wayfinding on foot from information in retinal, not optical, flow.

People find their way through cluttered environments with ease and without injury. How do they do it? Two approaches to wayfinding are considered: Differential motion parallax (DMP) is a retinal motion invariant of near and far objects moving against fixation; the information in optical flow (IOF) is a radial pattern of vectors, relying on decomposition of retinal flow. Evidence is presented that DMP guides wayfinding during natural gait, accounting for errors as well as correct responses. Evidence against IOF is also presented, and a space-time aliasing artifact that can contaminate IOF displays is explored. Finally, DMP and IOF are separated, showing they can yield different results in different environments. Thus, it is concluded that (a) DMP and IOF are different, (b) DMP and not IOF is used for wayfinding, (c) moving observers do not usually decompose retinal flow, and (d) optical flow may be a mathematical fiction with no psychological reality.

Adult↗
PubMed1992

Getting your research published: adapting the thesis style.

Writing a research report is similar to the research experience; both are processes with many distinct steps. Break your research project into parts and write about key accomplishments as you complete each milestone in the project.

Academic Dissertations as Topic↗
PubMed1992

Strengthening your case study approach.

A well-written case study has an important place in nursing literature because it describes new problems and techniques in clinical practice and helps identify researchable clinical questions. Do not be deceived into thinking that the case study manuscript is easy to write, because it is not. But, with the application of a few guidelines, the case study can be fun to write, exciting to edit, and enjoyable to read.

Medical Records↗
PubMed1992

Fluorine-18-antimyosin monoclonal antibody fragments: preliminary investigations in a canine myocardial infarct model.

The purpose of this study was to determine in a canine model whether selective myocardial infarct uptake of 18F-labeled antimyosin monoclonal antibody fragments could be achieved in a time frame compatible with the short half-life of this nuclide. Antimyosin monoclonal antibody fragments were labeled with 18F using a succinimidyl [18F]fluorobenzylamine ester acylation agent. Six dogs had myocardial infarction induced by coronary artery occlusion and were reperfused prior to the intravenous administration of 0.6-4.7 mCi of 18F-labeled F(ab')2 (two dogs) or Fab (four dogs). Analysis of tissues obtained 2-4 hr after antibody administration revealed infarct:normal myocardium uptake ratios as high as 14-21:1 for F(ab')2 and 9-12:1 for Fab. Even with Fab, however, prolonged 18F activity in the blood pool interfered with delineation of infarcts by PET imaging. In one dog, perfusion imaging with [13N]ammonia before antimyosin administration was performed, and regions of normal and ischemic myocardium were determined. With these regions of interest, infarct:normal myocardium uptake ratios calculated from the 18F-labeled Fab images increased from 1.5:1 at 1 hr to 4.0:1 at 5 hr. We conclude that 18F-labeled antimyosin fragments may be of value for hot-spot imaging of damaged myocardium with PET; however, blood-pool subtraction techniques will probably be required.

Animals↗
PubMed1992

Outlining: the key to an organized manuscript.

Faced by a blank sheet of paper and justifiable uncertainty about editorial review board approval, a nurse-author setting out to write an article should, before all, remember that ideas can be conveyed well in writing only if they are organized. The traditional "school-room" outlining methods may be replaced by one of the three approaches to manuscript organization that are described in this article. These approaches are tailored to the mental working habits of various categories of writers.

Humans↗
PubMed1991

Prediction of death and myocardial infarction by radionuclide angiocardiography in patients with suspected coronary artery disease.

The prognostic value of radionuclide angiocardiography was examined in patients with suspected coronary artery disease. Nine hundred and eight patients who underwent rest and exercise radionuclide angiocardiography without subsequent cardiac catheterization were followed for a median of 4.6 years. Fifty-two cardiovascular deaths and 28 nonfatal myocardial infarctions occurred during the follow-up period. Thirty-nine radionuclide angiocardiographic and clinical variables were analyzed in association with the end points of cardiovascular death, total cardiac events and death from all causes using the Cox proportional hazards model and Kaplan-Meier survival estimates. Univariable analysis identified the exercise ejection fraction as the best predictor of cardiovascular death (chi-square = 82), total cardiac events (chi-square = 84) and death from all causes (chi-square = 66). A small subset of patients (n = 45) with an exercise ejection fraction less than 0.35 were at high risk for future cardiac events, whereas most patients (n = 776) had an exercise ejection fraction greater than or equal to 0.50 and a low probability of a subsequent event. Three variables--the exercise ejection fraction, the exercise change in heart rate, and gender--contained independent prognostic information determined by multivariable analysis. The exercise ejection fraction was the strongest independent predictor (p less than 0.0001) for every end point. The measurement of ventricular function during exercise provides important independent prognostic information in patients with suspected coronary artery disease. Radionuclide angiocardiography successfully identifies patients requiring invasive assessment, and the low probability of cardiac events in patients with good exercise ventricular function obviates the need for interventional therapy.

Adult↗
PubMed1991

Safety and efficacy of sonicated albumin microspheres in perfusion and vein graft patency assessments.

This study was designed to identify a concentration of sonicated albumin microspheres that is safe, useful in determining graft patency, and provides an estimate of regional myocardial perfusion. The study included 8 patients between 50 and 72 years of age who were undergoing coronary artery bypass grafting. All patients were hemodynamically stable with left ventricular ejection fractions greater than or equal to 0.35. None had congestive heart failure or myocardial infarction within 4 months prior to the study. All had normal baseline neurologic and renal functions, and none had experienced allergic reactions to blood products or contrast dyes. A standard median sternotomy was performed for exposure of the heart at surgery, and saphenous veins were harvested and used for grafting. Intraoperative epicardial echocardiography (EE), always in the left ventricle short-axis at midpapillary level, was performed before and after grafting to determine regional myocardial wall motion. Sonicated albumin microspheres were prepared and injected into a single vein graft using an 18-gauge needle; 20 x 10(6), 100 x 10(6), and 200 x 10(6) microspheres were injected into the first graft sequentially. All other vein grafts were injected once with the dose that gave optimal contrast enhancement in the initial graft studied. In each patient, a minimum of 3 and maximum of 5 injections were performed, and graft perfusion was studied using EE. Graft flow, blood pressure, and electrocardiographic (ECG) measurements were continuously monitored, with a final EE performed after weaning the patient off cardiopulmonary bypass to assess wall motion. Preliminary results showed that no patient had adverse effects during or after the study and all remained hemodynamically stable.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Effects of internal mammary artery dissection on phrenic nerve perfusion and function.

The effects of left internal mammary artery (LIMA) dissection and distal division on phrenic nerve perfusion and function were examined in an adult swine model. Phrenic nerve perfusion was determined by left atrial injection of radioactively labeled microspheres. Phrenic nerve function was determined by measuring nerve and diaphragm potentials evoked by bilateral phrenic nerve stimulation. In the first group of animals (n = 9), the LIMA was dissected with ligation of all its branches. Left phrenic nerve perfusion and function decreased after LIMA dissection in every animal studied, whereas only minimal changes were observed on the right. Sixty minutes after LIMA dissection, left phrenic nerve mean perfusion decreased 71%. Left phrenic nerve and left diaphragm mean action potential amplitudes decreased 54% and 80%, respectively. In the second group of animals (n = 4), the LIMA dissection was performed without division of the pericardiacophrenic artery, a small proximal branch of the internal mammary artery that supplies the phrenic nerve. Sixty minutes after LIMA dissection, left phrenic nerve perfusion had decreased by 21% from control values, with a corresponding decrease in left phrenic nerve and diaphragm mean action potential amplitudes of 19% and 23%, respectively. These results indicate that LIMA dissection with division of all its branches in this model is associated with a significant impairment in left phrenic nerve perfusion and function and suggests a causal relationship. These results may also explain the apparent increased phrenic nerve cold sensitivity and increased incidence of phrenic nerve dysfunction associated with LIMA grafting.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1991

Neodymium:YAG laser damage to UV-absorbing poly(methyl methacrylate) and UV-absorbing MMA-HEMA-EGDMA polymer intraocular lens materials.

MemoryLenses and UV-poly(methyl methacrylate) intraocular lenses, which served as controls, were individually exposed to twenty 5 mJ shots of the Nd:YAG laser focused onto the posterior surface while placed in a sterile holder containing 5 ml of saline. The MemoryLens is a new foldable intraocular lens (IOL) manufactured from a polymer consisting of methyl methacrylate (MMA), 2-hydroxyethyl methacrylate (HEMA), and ethylene glycol dimethyacrylate (EGDMA) with a UV absorber. Damage to the lenses was assessed by scanning electron microscopy. Cytotoxicity tests designed to detect potentially toxic substances released during laser damage were conducted with the saline solution by incubating it with mouse fibroblasts. Additional tests of the saline solution were conducted by high performance liquid chromatography and spectrophotometry. Damage induced by the Nd:YAG laser to the UV-poly(methyl methacrylate) IOLs was similar to that reported by other authors. Damage to the MemoryLens appeared less severe and showed no radial stress cracking. Cytotoxicity tests were negative for both types of IOLs. High performance liquid chromatography tests were negative for residual monomers (MMA, HEMA, EGDMA) and spectrophotometry did not reveal residual UV absorber.

Animals↗
PubMed1991

Exercise radionuclide angiocardiography predicts cardiac death in patients with coronary artery disease.

The purpose of this investigation was to document the relative importance of three clinical and three radionuclide variables for prediction of cardiac death in a consecutive group of patients evaluated for coronary artery disease. During a 6 1/2-year period, beginning in January 1978, 2,042 consecutive patients underwent radionuclide angiocardiography, with a clinical diagnosis of coronary artery disease, at Duke University Medical Center. A subgroup of 318 patients who underwent surgical myocardial revascularization near the time of initial study were excluded from later analysis. Clinical follow-up information was complete in a group of 1,663 patients who did not undergo interventional therapy. The 141 cardiac deaths in these 1,663 patients were the study end point. Cox proportional hazards models analyzed the prognostic information contained in three clinical variables (pain type, age, and sex) and three radionuclide angiocardiogram variables (exercise ejection fraction, resting end-diastolic volume, and change in heart rate with exercise). One-variable models confirmed the prognostic importance of each of these six variables. A multivariable model in which all six variables were used showed clinical variables to contain only 5% and the radionuclide variables 95% of the prognostic information. The exercise ejection fraction was the single most important variable, which alone contained 85% of the total information in the model. Curves relating probability of no cardiac death to the exercise ejection fraction identified a value of 0.50 as an inflection point. Patients with exercise ejection fractions below 0.50 demonstrate a probability of cardiac death that increases as the ejection fraction decreases.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1990

Intraoperative perfusion contrast echocardiography. Initial experience during coronary artery bypass grafting.

Intraoperative evaluation of the effectiveness of myocardial revascularization has been limited by an inability to assess regional myocardial perfusion. Microbubbles of sonicated diatrizoate sodium and diatrizoate meglumine (Renografin) have been an effective echocardiographic contrast agent and have been employed clinically during cardiac catheterization. This recent development in contrast-enhanced two-dimensional echocardiography permits real-time imaging of transmural myocardial blood flow but has not been evaluated in the operating room. This study represents the initial surgical application of this directed technique and was designed to evaluate the safety and efficacy of intraoperative perfusion contrast echocardiography in assessing the results of coronary artery bypass grafting. Twenty men with significant coronary artery disease ranging in age from 49 to 73 years were studied. Direct contrast agent injection into completed saphenous vein bypass grafts caused the myocardium supplied by each graft to be well delineated and provided a tomographic view of contrast distribution. The enhanced region was well correlated with the size and distribution of the native vessel. Rapid contrast washout (less than 20 seconds) indicated satisfactory regional perfusion. Contrast echocardiography prolonged the operation less than 10 minutes and did not result in any perioperative complications.

Aged↗
PubMed1979

Cecil urethroplasty with concurrent scrotoplasty for repair of hypospadias.

During 13 years about 8 per cent of 234 patients operated upon for hypospadias presented surgical problems of reconstruction of the urethra from the urethral meatus proximal to the penoscrotal junction. These cases commonly are referred to as perineal or penoscrotal hypospadias. The problem occurs when the urethral groove fails to develop adequately and the scrotal folds have failed to rotate caudally. This hypospadias is in contrast to penoscrotal or distal hypospadias, when the urethral groove is developed but fusion is incomplete. In these patients the Cecil procedure has been used but modified to extend the urethra from behind the penoscrotal junction to the glans at the second stage of the urethroplasty. The modification consists of rotating the scrotum caudally from its high location. The tension and acute angulation that contributed to frequent complications previously associated with such attempts have been avoided and results are satisfactory.

Humans↗
PubMed1978

Etiologic considerations in penoscrotal hypospadias repair.

Superficial location of fivrous bands causing chordee in patients with penoscrotal hypospadias has been demonstrated by microscopic and gross photographs. Our technique to manage this problem is similar to that described by Allen and Spence and by King for distal hypospadias and has been used in 120 patients. The technique involves the repair of the embryologic penile defect by advancing the closure of the urethral groove and transposing the scrotum to its appropriate caudal position. The repair is applicable in patients with failure of fusion rather than failure of the development of the urethral groove as in perineal hypospadias.

Child↗
PubMed1978

Absence of an effect of timolol on the pupil.

Timolol, a relatively new beta-adrenergic blocker which has been found to lower the intraocular pressure in man, has not been observed to have any side effects upon the visual system. This study utilized pupillography to determine the effect of conjunctival instillation of 0.5% timolol ophthalmic solution upon pupillary size and reaction. No clinically significant effect was observed, but a statistically significant decrease in the amplitude of redilation of the pupil was found in the eye that received timolol.

Conjunctiva↗