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Scott Johnson

Publications and source records attributed to Scott Johnson.

17 recordsLinked to original sources
PubMed2006

Gender disparities in the live kidney donor evaluation process.

BACKGROUND: Females are live kidney donors more often than males. We examined the pool of potential donors to determine at what point in the donor evaluation process this gender disparity develops. METHODS: We selected patients who underwent blood typing as potential live kidney donors for recipients being evaluated for transplantation at our center between January 2000 and January 2004. We reviewed patient records to determine when in the evaluation process elimination occurred: ABO incompatible, positive cross-match, no medical workup, medical workup incomplete, medical contraindication, social contraindication, recipient too sick or dead, approved but did not donate, or donated. RESULTS: A total of 506 potential donors (55% female, 45% male) were evaluated. Males and females were equally likely to get through each step of the evaluation and be approved for donation. Overall, females were significantly more likely to donate than males. However, when approved donors are divided into those who were evaluated during the open nephrectomy (ON) era versus the laparoscopic nephrectomy (LN) era, the gender disparity among donors was present only in the ON era. In the ON era, there were 54 donors, 37 females and 17 males (P=0.004), whereas in the LN era, there were 61 donors, 32 females and 29 males (P=NS). CONCLUSION: Among potential donors approved for donation, females have been significantly more likely to donate than males. The introduction of LN at our center was associated with a decrease in the gender difference in kidney donation.

Female↗
PubMed2006

Separation incidence of protaper rotary instruments: a large cohort clinical evaluation.

Separation is a potential risk when using any instrument in the root canal system. Presently, there are no large clinical studies investigating the separation incidence of the ProTaper rotary file system or the number of times a ProTaper rotary file can be safely used. The purpose of this study was to determine if the number of uses affects the separation incidence of ProTaper rotary instruments. 4652 consecutively treated root canals were performed in an endodontic group practice over a 17-month period. Both the separation incidence and the number of uses were tracked for each file. The overall rate of instrument fracture in this study was 2.4% with no significant differences over the first four uses. The results of this study indicate that ProTaper rotary files may be safely reused at least four times. The size of the rotary file, among other factors, will determine how many times a particular file should be used.

Dental Alloys↗
PubMed2006

Impact of a lung transplantation donor-management protocol on lung donation and recipient outcomes.

RATIONALE: One of the limitations associated with lung transplantation is the lack of available organs. OBJECTIVE: To determine whether a lung donor-management protocol could increase the number of lungs for transplantation without affecting the survival rates of the recipients. METHODS: We implemented the San Antonio Lung Transplant protocol for managing potential lung donors according to modifications of standard criteria for donor selection and strategies for donor management. We then compared information gathered during a 4-yr period, during which the protocol was used with information gathered during a 4-yr period before protocol implementation. Primary outcome measures were the procurement rate of lungs and the 30-d and 1-yr survival rates of recipients. MAIN RESULTS: We reviewed data from 711 potential lung donors. The mean rate of lung procurement was significantly higher (p < 0.0001) during the protocol period (25.5%) than during the pre-protocol period (11.5%), with an estimated risk ratio of 2.2 in favor of the protocol period. More patients received transplants during the protocol period (n = 121) than during the pre-protocol period (n = 53; p < 0.0001). Of 98 actual lung donors during the protocol period, 53 (54%) had initially been considered poor donors; these donors provided 64 (53%) of the 121 lung transplants. The type of donor was not associated with significant differences in recipients' 30-d and 1-yr survival rates or any clinical measures of adequate graft function. CONCLUSIONS: The protocol was associated with a significant increase in the number of lung donors and transplant procedures without compromising pulmonary function, length of stay, or survival of the recipients.

Adult↗
PubMed2006

Clinical results of an organ procurement organization effort to increase utilization of donors after cardiac death.

BACKGROUND: To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to minimize cold ischemia times and encourage adoption of DCD protocols at transplant centers. RESULTS: In one OPO, eight centers initiated DCD programs in 11 hospitals. A total of 52 DCD donors were procured, increasing from four in 1999 to 21 in 2003. Eleven donors had care withdrawn in the operating room, whereas 41 had care withdrawn in the ICU. In all, 91 patients received renal transplants from these 52 donors (12 kidneys discarded, one double transplant), whereas 5 patients received liver transplants. One-, two-, and three-year kidney graft survival rates were 90%, 90%, and 82%, respectively. Fifty-five percent of patients needed at least one session of hemodialysis postoperatively. Mean recipient hospital length of stay was 11.1+/-6 days. Mean creatinine levels at 3, 6, 12, and 24 months were 1.65, 1.40, 1.41, and 1.40, respectively. CONCLUSIONS: DCD donors can be an important source of donor organs and provide excellent overall outcomes. Regional cooperation and a prospectively considered allocation and distribution system are important considerations in stimulating DCD programs.

Adult↗
PubMed2006

Predictors of immunity after a major serogroup W-135 meningococcal disease epidemic, Burkina Faso, 2002.

BACKGROUND: The African meningitis belt undergoes recurrent epidemics caused by Neisseria meningitidis serogroup A. During 2002, Burkina Faso documented the first large serogroup W-135 (NmW-135) meningococcal disease epidemic. To understand the emergence of NmW-135, we investigated meningococcal carriage and immunity. METHODS: Immediately after Burkina Faso's epidemic, we conducted a cross-sectional survey of meningococcal carriage and seroprevalence in an epidemic and a nonepidemic district. We identified predictors of elevated NmW-135 serum bactericidal activity (SBA), a functional correlate of protection, using multivariate logistic regression. RESULTS: The NmW-135 carriage rate was 25.2% in the epidemic district and 3.4% in the nonepidemic district (P<.0001). Compared with residents of the nonepidemic district, those of the epidemic district had higher geometric mean titers of NmW-135 SBA (P<.0001). NmW-135 SBA titers>or=1:8, an estimated protective threshold, were observed in 60.4% and 34.0% of residents of the epidemic and nonepidemic district, respectively (P=.0002). In a multivariate model, current NmW-135 carriage, age, and residence in the epidemic district were independent predictors of having an NmW-135 SBA titer>or=1:8. CONCLUSIONS: Extensive NmW-135 carriage and transmission in the epidemic area caused residents to acquire natural immunity. Serial carriage and seroprevalence surveys could establish the duration of immunity in the population. The persistent circulation of NmW-135 underscores the potential for periodic NmW-135 epidemics in Africa.

Adolescent↗
PubMed2006

Curriculum development: the venous thromboembolism quality improvement resource room.

BACKGROUND: The role of the hospitalist has evolved over the last decade, with hospitalists increasingly being asked to lead systems-based initiatives to improve the quality of inpatient care. The educational strategy of the Society of Hospital Medicine (SHM) includes development of practice-based resources to support hospitalist-led improvement in clinically important measures of hospital care quality. OBJECTIVE: To develop a resource at the SHM Web site to present quality improvement (QI) principles for systems-based care in the hospital and to help individual hospitalists improve specific patient outcomes. DESIGN: The SHM defined the role of the hospitalist in QI, performed an assessment of the educational needs of hospitalists, and executed a Web-based educational strategy to address these needs. The organization identified the most common cause of preventable inpatient deaths, hospital-acquired venous thromboembolism (VTE), and prioritized the need to improve prophylaxis. RESULTS: This new resource at the SHM Web site presents principles for conducting QI in the hospital. To enable learning that is practice based, the VTE Quality Improvement Resource Room (QI RR) features Ask the Expert, an interactive discussion community, and an original Improvement Workbook, a downloadable project outline and tutorial that hospitalists can use to guide and document steps in an effort aimed at reducing hospital-acquired VTE. CONCLUSIONS: This QI resource serves as a template for the development of subsequent hospital-based resources. User feedback will refine the QI RR and its format so that similar offerings can target other significant inpatient problems. Additional research is needed to evaluate learning and the clinical impact of this quality improvement resource on hospital performance measures and patient outcomes.

Curriculum↗
PubMed2006

Dynamic targeting image-guided radiotherapy.

Volumetric imaging and planning for 3-dimensional (3D) conformal radiotherapy and intensity-modulated radiotherapy (IMRT) have highlighted the need to the oncology community to better understand the geometric uncertainties inherent in the radiotherapy delivery process, including setup error (interfraction) as well as organ motion during treatment (intrafraction). This has ushered in the development of emerging technologies and clinical processes, collectively referred to as image-guided radiotherapy (IGRT). The goal of IGRT is to provide the tools needed to manage both inter- and intrafraction motion to improve the accuracy of treatment delivery. Like IMRT, IGRT is a process involving all steps in the radiotherapy treatment process, including patient immobilization, computed tomography (CT) simulation, treatment planning, plan verification, patient setup verification and correction, delivery, and quality assurance. The technology and capability of the Dynamic Targeting IGRT system developed by Varian Medical Systems is presented. The core of this system is a Clinac or Trilogy accelerator equipped with a gantry-mounted imaging system known as the On-Board Imager (OBI). This includes a kilovoltage (kV) x-ray source, an amorphous silicon kV digital image detector, and 2 robotic arms that independently position the kV source and imager orthogonal to the treatment beam. A similar robotic arm positions the PortalVision megavoltage (MV) portal digital image detector, allowing both to be used in concert. The system is designed to support a variety of imaging modalities. The following applications and how they fit in the overall clinical process are described: kV and MV planar radiographic imaging for patient repositioning, kV volumetric cone beam CT imaging for patient repositioning, and kV planar fluoroscopic imaging for gating verification. Achieving image-guided motion management throughout the radiation oncology process requires not just a single product, but a suite of integrated products to manipulate all patient data, including images, efficiently and effectively.

Humans↗
PubMed2006

Relationship of water status to vegetative growth and leaf gas exchange of peach (Prunus persica) trees on different rootstocks.

We investigated relationships between tree water status, vegetative growth and leaf gas exchange of peach trees growing on different rootstocks under field conditions. Tree water status was manipulated by partially covering (0, approximately 30 and approximately 60%) the tree canopies on individual days and then evaluating the effects of tree water status on vegetative growth and leaf gas exchange. Early morning stem water potentials were approximately -0.4 MPa for trees in all treatments, but mean midday values ranged from -1.1 to -1.7 MPa depending on rootstock and canopy coverage treatment. Relative shoot extension growth rate, leaf conductance, transpiration rate and net CO2 exchange rate differed significantly among trees in the different rootstocks and canopy coverage treatments. Shoot extension growth rate, leaf conductance, leaf transpiration rate and leaf net CO2 exchange rate were linearly correlated with midday stem water potential. These relationships were independent of the rootstock and canopy coverage treatments, indicating that tree water relations are probably directly involved in the mechanism that imparts vegetative growth control by selected peach rootstocks.

Carbon Dioxide↗
PubMed2006

Hydraulic conductance characteristics of peach (Prunus persica) trees on different rootstocks are related to biomass production and distribution.

We investigated hydraulic conductance characteristics and associated dry matter production and distribution of peach trees grafted on different rootstocks growing in the field. A single scion genotype was grown on a low ('K146-43'), an intermediate ('Hiawatha') and a high ('Nemaguard') vigor rootstock. 'K146-43' and 'Hiawatha' rootstocks had 27 and 52% lower mean leaf-specific hydraulic conductances, respectively, than the more vigorous 'Nemaguard' rootstock. Tree growth rates and patterns of biomass distribution varied significantly among rootstocks. Mean dry mass relative growth rates of trees on 'K146-43' and 'Nemaguard' were 66 and 75%, respectively, of the rates of trees on 'Nemaguard', and the scion to rootstock dry mass ratios of trees on 'K146-43' and 'Hiawatha' were 63 and 82%, respectively, of the ratio of trees on 'Nemaguard'. Thus, differences in dry matter distribution between the scion and rootstock, which may be a compensatory response to the differences in leaf specific hydraulic conductance among rootstocks, appeared to be related to differences in growth rates. Correspondingly, there was a positive linear relationship between the scion to rootstock dry mass ratio and the rootstock to scion hydraulic conductance ratio when conductance was normalized for dry mass. This study confirms that rootstock effects on tree water relations and vegetative growth potential result, at least in part, from differences in tree hydraulic conductance associated with specific peach rootstocks.

Biomass↗
PubMed2005

A 5 yr clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars.

An examination of 5616 endodontically treated and retreated maxillary first and second molars was made in an attempt to determine the percentage of MB2 canals that could be located routinely, and evaluate if there were any significant differences between initial treatments and retreatments. The teeth examined were 3578 first molars and 2038 second molars treated consecutively over a 5-yr period by six endodontists. Overall the MB2 canal was found in 2133 (60%) first molars, and 712 (35%) second molars. The incidence of a MB2 canal in first molar retreatments was 66% compared to a 58% incidence in initial treatments. Whereas in second molars the retreatment incidence was 40% compared to 34% in initial treatments. The significant difference in the incidence of a MB2 canal between initial treatments and retreatments suggests that failure to find and treat existing MB2 canals will decrease the long-term prognosis.

Chi-Square Distribution↗
PubMed2005

Effects of long-term storage on plasmid stability in Bacillus anthracis.

The plasmid profiles of 619 cultures of Bacillus anthracis which had been isolated and stored between 1954 and 1989 were analyzed using the Laboratory Response Network real-time PCR assay targeting a chromosomal marker and both virulence plasmids (pXO1 and pXO2). The cultures were stored at ambient temperature on tryptic soy agar slants overlaid with mineral oil. When data were stratified by decade, there was a decreasing linear trend in the proportion of strains containing both plasmids with increased storage time (P < 0.001). There was no significant difference in the proportion of strains containing only pXO1 or strains containing only pXO2 (P = 0.25), but there was a statistical interdependence between the two plasmids (P = 0.004). Loss of viability of B. anthracis cultures stored on agar slants is also discussed.

Bacillus anthracis↗
PubMed2003

Rapid onset of protection following vaccination of calves with multivalent vaccines containing modified-live or modified-live and killed BHV-1 is associated with virus-specific interferon gamma production.

The objective of this study was to determine the effect of vaccination with commercially-available multivalent vaccines containing either modified-live (MLV) bovine herpesvirus-1 (BHV-1) (Bovishield) or MLV plus killed (MLV + K) BHV-1 (Reliant Plus) on protection against challenge at 5 days after a single vaccination. An additional objective was to determine whether cell-mediated immunity as measured by virus-specific interferon gamma (IFN-gamma) production by peripheral blood mononuclear cells (PBMC) was associated with any early protection induced by vaccination. Clinical signs, serum neutralizing (SN) titers, and nasal virus isolation (VI) titers were also measured. The 12-16-week-old dairy cross-calves seronegative for antibodies to BHV-1 were vaccinated with a multivalent vaccine containing MLV BHV-1 (n = 19), a multivalent vaccine containing MLV + K BHV-1 (n = 19), or a control multivalent vaccine not containing BHV-1 (n = 10) on day 0 and challenged intranasally on day 5. PBMC were isolated on days 0, 3, 5, 8, 10, 14 and 19. PBMC were incubated in vitro with spent media, live BHV-1, or heat-inactivated BHV-1 for 72 h. Supernatants were assayed for bovine IFN-gamma by ELISA. Bovine herpesvirus-1-specific IFN-gamma production was expressed as percent of the kit positive control, with value for spent media subtracted. Clinical signs were monitored daily. Serum VN titers were measured on days 0-5 and 19. Nasal VI titer was measured every other day from days 5 to 19. Interferon gamma production was higher on day 5, and was significantly increased post-challenge, in both vaccine groups compared to controls. There was no difference between vaccine groups on any day. There was no significant difference in SN titer among groups on any day. Virus isolation titer was significantly higher in controls on days 6 and 8 compared to both vaccine groups. Temperatures were significantly higher and nasal discharge was present more often post-challenge in controls compared to vaccine groups. Vaccination 5 days prior to challenge with commercially-available vaccine containing MLV or MLV + K BHV-1 was associated with increased BHV-1-specific IFN-gamma production, decreased viral shedding, lower temperatures and less nasal discharge post-challenge. Cell mediated immune responses as measured by IFN-gamma production are stimulated rapidly following BHV-1 vaccination of calves.

Animals↗
PubMed2003

Incoherent imaging using continuous wave ultrasound. A preliminary study using bovine intervertebral discs.

As an object rotates with respect to a stationary planar ultrasonic beam, the scattering centres within the object return echoes that are Doppler-shifted in frequency by amounts depending on the velocities of the individual scatterers. The backscattered echo amplitude at any particular frequency is the line integral of the scattered radiation at the cross-range corresponding to that frequency. The amplitude as a function of frequency can be interpreted as a tomographic projection. A tomographic reconstruction algorithm can produce an image of the distribution of scattering centres in the insonified object from these projections. This paper describes the development and characterisation of a microscanner to investigate the approach of using continuous wave ultrasound for three-dimensional cross-sectional imaging. The results of preliminary tissue investigation, conducted using bovine coccygeal intervertebral discs, are described. The radial imaging resolution improves as the Doppler frequency resolution improves but the circumferential resolution degrades proportionally. As the number of projections increases, there is a finite increase in image quality. Two- and three-dimensional images of the intervertebral disc reveal an alternate light and dark banding pattern that is characteristic of the laminar structure of the annulus fibrosus.

Algorithms↗
PubMed2002

Clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars.

An examination of 1873 conventionally treated and retreated maxillary first and second molars was made in an attempt to determine the percentage of second mesiobuccal (MB2) canals that could be located routinely and evaluate if there were any significant differences between initial treatments and retreatments. The teeth examined were 1193 first molars and 680 second molars treated consecutively over a 2-yr period by five endodontists. Overall the MB2 canal was found in 724 (61%) first molars and 245 (36%) second molars. The incidence of a MB2 canal in first molar retreatments was 67% compared to a 59% incidence in initial treatments. Whereas in second molars, the retreatment incidence was 44% compared with 35% in initial treatments. The significant difference in the incidence of a MB2 canal between initial treatments and retreatments suggests that failure to find and treat existing MB2 canals will decrease the long-term prognosis.

Chi-Square Distribution↗