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Biomedical subjects

B R Jones

Publications and source records attributed to B R Jones.

At least 19 recordsLinked to original sources
PubMed1992

Preliminary studies on congenital hypothyroidism in a family of Abyssinian cats.

Congenital hypothyroidism was diagnosed in related Abyssinian cats. The disease appeared to be inherited as an autosomal recessive trait with affected homozygotes showing signs of reduced growth rate, shorter stature with kitten-like features, constipation and goitre. Hypothyroidism was confirmed by demonstrating low basal serum thyroxine levels which failed to increase after intravenous administration of thyroid stimulating hormone or thyrotropic releasing hormone. The radioiodide uptake of the thyroid glands was normal but a high proportion of the accumulated radioiodide was discharged after the administration of sodium perchlorate. It is concluded that the affected cats had a primary dyshormonogenesis: an organification (peroxidase) defect.

Animals↗
PubMed1992

Recognition accuracy of current operating room alarms.

This prospective study was performed to determine whether anesthesia clinicians (i.e., both anesthesiologists and nurse anesthetists) can identify operating room alarms by their distinctive sounds and to identify factors related to alarm recognition accuracy. Nineteen alarms from 15 commonly used devices were recorded. These sounds were played, in a quiet room, to 44 anesthesia clinicians. The clinicians were asked to choose from a list the device that produced the alarm. After this recognition test, the clinicians rated the importance of each alarm and the frequency with which they heard it in the clinical situation. Clinicians correctly identified the alarm source 34% of the time. The recognition rate was higher for alarms rated as heard more frequently; however, alarms that were rated as more important were less likely to be correctly identified. Complexity of the sound did not influence accuracy of recognition. Most errors were attributed to similarities in sound or function, or both, among alarms. We conclude that anesthetists cannot reliably identify current operating room alarms by their distinctive sounds.

Anesthesiology↗
PubMed1991

Sensitivity of a disposable end-tidal carbon dioxide detector.

A small disposable carbon dioxide detector that can be used to provide evidence of correct endotracheal tube placement is now commercially available (FEF). The device contains an indicator that changes color when exposed to carbon dioxide. This study measured the lowest concentration of carbon dioxide causing a perceivable color change in the device. Ten volunteers were blinded to the concentrations of carbon dioxide in an airway circuit/lung model, and the minimal concentration of carbon dioxide that caused a perceivable color change was recorded. The mean minimum concentration required for detection of a color change was 0.54% (4.1 mm Hg) and ranged from 0.25 to 0.60% (1.9 to 4.6 mm Hg). We conclude that this device should produce a detectable color change even in patients with low end-tidal carbon dioxide, as might be observed during cardiopulmonary resuscitation.

Carbon Dioxide↗
PubMed1991

The onset of disuse-related potassium efflux to succinylcholine.

Disuse atrophy of skeletal muscle produces resistance to nondepolarizing relaxants and increased potassium efflux after the administration of succinylcholine. These changes appear to be due to development of perijunctional and/or extrajunctional receptors (up-regulation). In this study, the authors searched for the earliest detectable appearance of increased potassium efflux in beagles in whom disuse atrophy was simulated. Seven beagles underwent unilateral cast immobilization of a hind limb. Between 4 and 42 days, they periodically received succinylcholine 0.25 mg/kg while anesthetized with thiamylal and nitrous oxide. Sequential bilateral femoral venous samples showed that the casted limb did not manifest potassium release greater than the upper limit of normal (1 mEq/l) until cast immobilization periods of 14 days or longer. When this occurred, the increase in the potassium concentration in the femoral venous blood of the casted limb exceeded that from the noncasted limb by at least 0.7 mEq/l (P less than 0.01). The range for the onset of this response after casting was 14-42 days, the mean 27.2 days, and the standard deviation 9.8 days. These findings imply that up-regulation of skeletal muscle receptors, associated with exaggerated potassium efflux after administration of succinylcholine, is dependent on progressive development of extrajunctional receptors over surface membrane areas beyond the endplate.

Animals↗
PubMed1991

An experimental evaluation of castellated laryngofissure and bilateral arytenoid lateralisation for the relief of laryngeal paralysis in dogs.

The aim of this study was to compare the efficacy of 2 surgical procedures for providing an adequate laryngeal airway in dogs after surgically induced laryngeal paralysis. The laryngeal function of 10 healthy, adult experimental dogs was assessed by clinical examination, laryngoscopy, arterial blood gas measurement and analysis of tidal breathing flow-volume loops before, and after, bilateral recurrent laryngeal neurectomy. A castellated laryngofissure with vocal fold resection was done on 5 dogs and bilateral arytenoid cartilage lateralisation performed on the remaining 5 dogs. Six weeks later, the laryngeal function of the 10 dogs was reassessed, before the dogs were killed and a necropsy performed. The visible changes in laryngeal structure were recorded. Both surgical procedures alleviated some of the airway obstruction caused by the bilateral recurrent laryngeal neurectomy, but bilateral arytenoid cartilage lateralisation produced more consistent clinical improvement, a wider rima glottidis, increased inspiratory air flow and a significant increase in post-operative arterial oxygen tension.

Animals↗
PubMed1991

Strength of continuous spinal catheters.

Several commercially available catheters are currently marketed for continuous intrathecal use. Initial studies using continuous spinal catheters have reported several occurrences of retained fragments after removal of the catheter. Accordingly, we measured the break strength of five commercially available catheters. The TFX/Rusch 28- and 32-gauge continuous spinal catheters required 3.18 and 1.92 lb to break, respectively. The Kendall 28-gauge, the Preferred Medical Products 24-gauge, and the 24-gauge Burron catheters averaged 1.22, 1.97, and 3.55 lb to break, respectively. We also tested a commonly used Burron 20-gauge catheter, which is marketed for epidural use, and found it had an average break strength of 6.35 lb. The tested values obtained for the TFX/Rusch catheters were lower than the break strength values supplied by the manufacturers. The authors conclude that the break strength of spinal catheters is one-third to one-half that found for a typical epidural catheter.

Anesthesia, Spinal↗
PubMed1990

Recognition accuracy with a voice-recognition system designed for anesthesia record keeping.

We tested on three occasions, with anesthetists as subjects, the accuracy of two voice-recognition systems designed for anesthetic record keeping. Initially, a prototype system was tested (10 subjects); several years later the resulting commercial system was tested in a quiet environment (11 subjects) and in noisy operating rooms (10 subjects). For each test an anesthetist first trained the system to recognize his or her voice by reading aloud a list of common anesthetic terms. To determine recognition accuracy, the percentage of words recognized correctly by the computer, each subject repeated the vocabulary words ten times. Although accuracy was similar during the three tests, it was slightly higher with the laboratory test (mean percent of words recognized correctly, 96.5%; range of accuracy for individual anesthetists, 91.6 to 98.8%) than with the prototype test (95.9%; range, 89.1 to 99.6%). Accuracy was lowest with the operating room test (95.3%; range, 87.8 to 98.4%). Twenty-four words caused particular difficulty during the laboratory test and were eliminated from the vocabulary of the subsequent operating room test. Omitting these 24 words from the laboratory vocabulary list allowed a more nearly direct comparison with the results from the operating room list; recognition accuracy improved in the former to 97.5% (range, 92.1 to 98.9%). Two anesthetists--one each from the laboratory and operating room tests--performed poorly, and eliminating their scores changed the respective overall scores to 98.2% (range, 96.7 to 98.9%) and 96.5% (range, 94.3 to 98.4%). Thus, the corrected difference between the laboratory accuracy and the operating room accuracy was 1.7%.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1990

The pathology of an inherited hyperlipoproteinaemia of cats.

The gross and histological features of congenital lipoprotein lipase deficiency are described in eight cats. The main histological features could be directly related to the presence of the chylomicronaemia. They consisted of lipid accumulation within clear vacuoles or ceroid accumulation within residual bodies in parenchymatous organs such as the liver, spleen, lymph nodes, kidney and adrenal gland. Xanthomata were seen in various sites, probably arising either from frank haemorrhage or the leakage of lipid-rich plasma perivascularly. As in human lipoprotein lipase deficiency there was no evidence of the formation of atherosclerotic plaques. Focal degenerative changes were, however, present within arteries and this may indicate blood vessel weakness and explain the tendency to haemorrhage and xanthomata/granulomata formation. The degeneration and fibrous replacement of glomeruli and nephrons possibly arises from pressure necrosis of adjacent xanthomata and alterations in renal blood flow.

Animals↗
PubMed1990

Characterization of a lipoprotein lipase class III type defect in hypertriglyceridemic cats.

Lipoprotein lipase (LPL) is an important enzyme involved in triacylglycerol metabolism in plasma. We have characterized the deficiency in LPL activity in hypertriglyceridemic cats. Pre- and postheparin plasma contain a similar high level of LPL mass, which has no enzymatic activity. This indicates that the cats produce an abnormal LPL protein which is inactive and fails to bind to the endothelium. This phenomenon is similar to the Class III type defect characterized in human LPL deficiency. Molecular analyses indicate that there is no major structural rearrangement in the LPL gene, and that the mRNA and protein products are normal with respect to size and quantity. These cats present unique animal model for human LPL deficiency.

Animals↗
PubMed1989

The ultrastructural pathology of five lipoprotein lipase-deficient cats.

The ultrastructural pathology of cats suffering from familial lipoprotein lipase deficiency is described. There were large numbers of lipid vacuoles within hepatocytes, epithelial cells of the proximal convoluted tubule of kidney and macrophages of the liver, spleen and lymph node. The older cats tended to have larger quantities of ceroid within hepatocytes and macrophages, and all stages of development of ceroid were observed. Chylomicron emboli were seen within the glomerular capillaries and interlobular blood vessels. There was podocyte foot fusion and thickening of basement membranes of glomeruli, Bowman's capsule and some proximal convoluted tubules, similar to that seen in diabetes mellitus. These changes represent a non-specific reaction of the kidney to noxious insults such as hypoxia caused by emboli. Transformation of smooth muscle cells from a contractile to a synthetic state was seen in the splenic trabeculae and, to a lesser extent, in blood vessels. Dilatations of the nuclear membrane of the lymphocytes were noted, the significance of which is unknown.

Animals↗
PubMed1989

The influence of fresh gas flow and inspiratory/expiratory ratio on tidal volume and arterial CO2 tension in mechanically ventilated surgical patients.

The relative importance of fresh gas flow and inspiratory/expiratory ratio in determining delivered tidal volume and PaCO2 was studied in anesthetized adult patients ventilated with a fixed ventilator bellows volume. The fresh gas flows studied were 2, 6, and 10 L/min, and inspiratory/expiratory ratio was either 1:2 or 1:4.5. Bellows volume and respiratory rate were held constant throughout the study. At the lowest fresh gas flow and smallest inspiratory/expiratory ratio, PaCO2 was 43 +/- 2 mm Hg. The PaCO2 decreased progressively and significantly with each increase in fresh gas flow during ventilation with either inspiratory/expiratory ratio setting. PaCO2 averaged 30 +/- 3 during ventilation with the highest fresh gas flow and largest inspiratory/expiratory ratio. As fresh gas flow increased, PaCO2 and tidal volume changed to a significantly greater degree in response to changes in inspiratory/expiratory ratio. These data demonstrate that altering either fresh gas flow or inspiratory/expiratory ratio can produce clinically significant perturbations in PaCO2 and tidal volume during anesthesia. These perturbations occur even if bellows volume is held constant. Furthermore, changes in inspiratory/expiratory ratio will affect these parameters to a greater degree as fresh gas flow is increased.

Adult↗
PubMed1989

A comparison of platinized grooved electrode performance with ring-tip electrodes.

One of the determinants of the capture threshold of an endocardial pacing lead is the configuration of the electrode tip. To evaluate whether micro- and macroporous electrodes have better initial and chronic thresholds than nonporous electrodes, acute and chronic capture thresholds, stimulation impedance and sensing thresholds were determined in 22 patients in whom a ventricular ring-tip electrode and a unipolar, dual chamber pacemaker with bidirectional telemetry had been implanted. These values were compared to those obtained from 25 patients receiving an electrode constructed with a platinized groove surface at the time of implant of an identical pulse generator. The ventricular capture threshold at implant was 0.7 V +/- 0.3 at 0.6 msec pulse width for both groups. The capture threshold was significantly greater in the ring tip electrode group at follow-up periods of 1 month (1.1 V +/- 0.5 vs 1.6 V +/- 0.6, P less than 0.008), 4 months (1.0 V +/- 0.2 vs 1.7 V +/- 0.8, P less than 0.002), and 10 months (1.2 V +/- 0.4 vs 1.7 V +/- 0.5, P less than 0.04) following implantation. The stimulation impedance at the time of implantation was lower in the ring-tip electrode group (530 ohms vs 603 ohms, P less than 0.03), but thereafter no significant difference was seen between the two groups. The acute and chronic sensing thresholds were similar in both groups. While the microporous electrode had significantly lower chronic capture thresholds, the magnitude of this difference is small, and probably clinically inconsequential.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗