Search PubMed⌕ Search

Biomedical subjects

D P Jones

Publications and source records attributed to D P Jones.

At least 19 recordsLinked to original sources
PubMed2006

Filtering techniques for the removal of ventilator artefact in oesophageal pulse oximetry.

The oesophagus has been shown to be a reliable site for monitoring blood oxygen saturation (SpO(2)). However, the photoplethysmographic (PPG) signals from the lower oesophagus are frequently contaminated by a ventilator artefact making the estimation of SpO(2) impossible. A 776th order finite impulse response (FIR) filter and a 695th order interpolated finite impulse response (IFIR) filter were implemented to suppress the artefact. Both filters attenuated the ventilator artefact satisfactorily without distorting the morphology of the PPG when processing recorded data from ten cardiopulmonary bypass patients. The IFIR filter was the better since it conformed more closely to the desired filter specifications and allowed real-time processing. The average improvements in signal-to-noise ratio (SNR) achieved by the FIR and IFIR filters for the fundamental component of the red PPG signals with respect to the fundamental component of the artefact were 57.96 and 60.60 dB, respectively. The corresponding average improvements achieved by the FIR and IFIR filters for the infrared PPG signals were 54.83 and 60.96 dB, respectively. Both filters were also compared with their equivalent tenth order Butterworth filters. The average SNR improvements for the FIR and IFIR filters were significantly higher than those for the Butterworth filters.

Artifacts↗
PubMed2005

Evaluation of oesophageal reflectance pulse oximetry in major burns patients.

Pulse oximetry is being used in everyday clinical practice in anaesthesia utilising a peripheral probe. However, it may be unreliable in certain clinical situations such as hypothermia, hypovolemia, vasoconstriction and decreased cardiac output. Similar situations occur in burns patients and, more importantly, burns to extremities which limit the sites available for measurement of peripheral oxygen saturation (SpO(2)). To overcome these limitations, the oesophagus has been investigated as an alternative measurement site, as perfusion may be preferentially preserved centrally. A miniaturised reflectance oesophageal saturation (SpO(2)) probe has been constructed utilising infrared and red photodiodes and a photodetector. Our study was aimed at evaluating the reliability of oesophageal pulse oximetry in major burns patients. Seven adult patients (five males, two females) were studied. They were sedated and ventilated as part of their routine care. Measurable photoplethysmographic (PPG) traces and SpO(2) values were obtained in the oesophagus of all patients at a mean depth of 15.6+/-1.8 cm (measured from the lips). It was found that the oesophageal pulse oximeter results were in good agreement with oxygen saturation measurements obtained by a CO-oximeter. The mean (+/-S.D.) of the differences between the oesophageal oxygen saturation results and those from CO-oximetry was 0.50+/-0.69%. A Bland and Altman analysis showed that the bias and the limits of agreement between the oesophageal and commercial toe pulse oximeters were 0.4% and -3.6% to 4.6%, respectively. This study suggests that the oesophagus can be used as an alternative site for monitoring arterial blood oxygen saturation by pulse oximetry in burned patients.

Adult↗
PubMed2005

Alanylglutamine dipeptide and growth hormone maintain PepT1-mediated transport in oxidatively stressed Caco-2 cells.

Reactive oxygen species (ROS) produced by gut mucosal cells during conditions such as inflammatory bowel disease (IBD) may impair mucosal repair and nutrient transport/absorptive function. Absorption of di- and tripeptides in the small intestine and colon is mediated by the H(+)-dependent transporter PepT1, but effects of oxidative stress on di- and tripeptide transport are unknown. We assessed whether exposure to hydrogen peroxide (H(2)O(2)) influences dipeptide transport in human colonic epithelial (Caco-2) cells. Uptake of [(14)C]glycylsarcosine (Gly-Sar) was used to evaluate PepT1-mediated dipeptide transport. Exposure to 1-5 mmol/L H(2)O(2) for 24 h caused a dose-dependent decrease in Gly-Sar transport, which was associated with decreased PepT1 transport velocity (V(max)). Treatment with alanylglutamine (Ala-Gln) or growth hormone (GH) did not alter Caco-2 Gly-Sar transport in the absence of H(2)O(2). However, both Ala-Gln and GH prevented the decrease in dipeptide transport observed with 1 mmol/L H(2)O(2) treatment. Ala-Gln, but not GH, maintained cellular glutathione and prevented the decrease in PepT1 protein expression. Thus, these agents should be further investigated as potential therapies to improve absorption of small peptides in disorders associated with oxidative injury to the gut mucosa.

Biological Transport↗
PubMed2003

Evaluation of oesophageal pulse oximetry in patients undergoing cardiothoracic surgery.

Pulse oximetry probes placed peripherally may fail to give accurate values of blood oxygen saturation when the peripheral circulation is poor. Because central blood flow may be preferentially preserved, we investigated the oesophagus as an alternative monitoring site. A reflectance blood oxygen saturation probe was developed and evaluated in 49 patients undergoing cardiothoracic surgery. The oesophageal pulse oximeter results were in good agreement with oxygen saturation measurements obtained by a blood gas analyser, a CO-oximeter and a commercial finger pulse oximeter. The median (IQR [range]) difference between the oesophageal oxygen saturation results and those from blood gas analysis were 0.00 (-0.30 to 0.30 [-4.47 to 2.60]), and between the oesophageal oxygen saturation results and those from CO-oximetry were 0.75 (0.30 to 1.20 [-1.80 to 1.80]). Bland-Altman analysis showed that the bias and the limits of agreement between the oesophageal and finger pulse oximeters were -0.3% and -3.3 to 2.7%, respectively. In five (10.2%) patients, the finger pulse oximeter failed for at least 10 min, whereas the oesophageal readings remained reliable. The results suggest that the oesophagus may be used as an alternative monitoring site for pulse oximetry even in patients with compromised peripheral perfusion.

Adult↗
PubMed2002

Assessment of photoplethysmographic signals for the determination of splanchnic oxygen saturation in humans.

The need for a clinically applicable method of detecting splanchnic hypoxia has led to experimental animal studies which indicated the usefulness of intestinal pulse oximetry. Pulse oximetry relies on detection of photoplethysmographic signals. Before developing a pulse oximeter for the measurement of organ oxygen saturation peri-operatively, we designed a system based on a reflectance photoplethysmographic probe to investigate photoplethysmographic signals from human viscera (bowel, liver, and kidney). Recordings were obtained simultaneously from the abdominal viscera and the finger using identical probes. The probe was held sequentially for up to 2 min on the surface of viscera of 12 patients during routine laparotomy. Measurable splanchnic photoplethysmographic signals were recorded for the first time in humans. There were no statistically significant differences between photoplethysmographic amplitudes from viscera and those from the finger. Our results indicate the feasibility of pulse oximetry for the measurement of visceral oxygenation in humans.

Adult↗
PubMed2002

Investigation of oesophageal photoplethysmographic signals and blood oxygen saturation measurements in cardiothoracic surgery patients.

Pulse oximeter probes attached to the finger may fail to estimate blood oxygen saturation (SpO2) in patients with compromised peripheral perfusion (e.g. hypothermic cardiopulmonary bypass surgery). The measurement of SpO2 from a central organ such as the oesophagus is suggested as an alternative to overcome this problem. A reflectance oesophageal pulse oximeter probe and a processing system implemented in LabVIEW were developed. The system was evaluated in clinical measurements on 50 cardiothoracic surgery patients. Oesophageal photoplethysmographic (PPG) signals with large amplitudes and high signal-to-noise ratios were measured from various depths within the oesophagus from all the cardiothoracic patients. The oesophageal PPG amplitudes from these patients were in good agreement with previous oesophageal PPG amplitude measurements from healthy anaesthetized patients. The oesophageal pulse oximeter SpO2 results agreed well with the estimated arterial oxygen saturation (SaO2) values inferred from the oxygen tension obtained by blood gas analysis. The mean (+/- SD) of the differences between the oesophageal pulse oximeter SpO2 readings and those from blood gas analysis was 0.02 +/- 0.88%. Also, the oesophageal pulse oximeter was found to be reliable and accurate in five cases of poor peripheral perfusion when a commercial finger pulse oximeter probe failed to estimate oxygen saturation values for at least 10 min. These results suggest that the arterial blood circulation to the oesophagus is less subject to vasoconstriction and decreased PPG amplitudes than are the peripheral sites used for pulse oximetry such as the finger. It is concluded that oesophageal SPO2 monitoring may be of clinical value.

Adult↗
PubMed2001

Rotenone-induced G2/M cell cycle arrest and apoptosis in a human B lymphoma cell line PW.

Concentrations of rotenone (ROT) that block electron flow through mitochondrial complex I (100 nM) did not significantly alter either cell viability or the growth of PW cells. However, 10- to 50-fold higher concentrations (1-5 microM) were found to induce a dose-dependent cell cycle arrest predominantly at the G2/M stage of the cycle and apoptosis. Apoptosis was dependent on the cell cycle arrest, since apoptosis but not the G2/M arrest was prevented with the broad spectrum caspase inhibitor zVADfmk. Biochemical features of apoptosis included mitochondrial cytochrome c release, reactive oxygen species generation, and the activation of procaspase 3. Thus, ROT inhibition of mitochondrial electron transport may be insufficient to induce apoptosis in PW cells. Instead, apoptosis in these cells occurs as a consequence of disruption of the cell cycle and is only indirectly dependent upon mitochondrial electron transport.

Amino Acid Chloromethyl Ketones↗
PubMed2001

Passive sampler for measurements of atmospheric nitric acid vapor (HNO3) concentrations.

Nitric acid (HNO3) vapor is an important nitrogenous air pollutant responsible for increasing saturation of forests with nitrogen and direct injury to plants. The USDA Forest Service and University of California researchers have developed a simple and inexpensive passive sampler for monitoring air concentrations of HNO3. Nitric acid is selectively absorbed on 47-mm Nylasorb nylon filters with no interference from particulate NO3-. Concentrations determined with the passive samplers closely corresponded with those measured with the co-located honeycomb annular denuder systems. The PVC protective caps of standardized dimensions protect nylon filters from rain and wind and allow for reliable measurements of ambient HNO3 concentrations. The described samplers have been successfully used in Sequoia National Park, the San Bernardino Mountains, and on Mammoth Mountain in California.

Air Pollution↗
PubMed2001

Regulation of glutathione redox status in lung and liver by conditioning regimens and keratinocyte growth factor in murine allogeneic bone marrow transplantation.

BACKGROUND: Reactive oxygen species (ROS) and glutathione (GSH) depletion contribute to organ injury after bone marrow transplantation (BMT). Keratinocyte growth factor (KGF) ameliorates graft-versus-host disease (GVHD)-associated organ injury in murine BMT models. METHODS: B10.BR mice received total body irradiation (TBI; day -1) +/- cyclophosphamide (Cy; 120 mg/kg/day i.p., days -3 and -2), then were transplanted on day 0 with C57BL/6 bone marrow + spleen cells as a source of GVHD-causing T cells. KGF (5 mg/kg/day subcutaneously [s.c.]) or saline was given on days -6, -5, and -4. Lung and liver GSH and oxidized GSH disulfide (GSSG) levels were measured on days 0 and 5 and glutathione redox potential (Eh) calculated. Organ malondialdehyde (MDA) was determined on day 5 as an index of ROS-mediated lipid peroxidation. RESULTS: In lung, TBI+BMT oxidized GSH Eh and increased MDA. Cy further oxidized lung GSH Eh. In liver, neither BMT regimen altered GSH redox status or MDA. KGF prevented the decrease in lung GSH after TBI+Cy and decreased lung MDA after both TBI and TBI+Cy. KGF increased liver GSH levels and GSH Eh after TBI and GSH Eh after TBI+Cy. CONCLUSIONS: In murine allogeneic BMT, TBI oxidizes the lung GSH redox pool and Cy exacerbates this response by 5 days post-BMT. In contrast, liver GSH redox status is maintained under these experimental conditions. KGF treatment attenuates the Cy-induced decrease in lung GSH, decreases post-BMT lung lipid peroxidation, and improves liver GSH redox indices. KGF may have a therapeutic role to prevent or attenuate GSH depletion and ROS-mediated organ injury in BMT.

Animals↗
PubMed2001

Role of mitochondrial dysfunction in S-(1,2-dichlorovinyl)-l-cysteine-induced apoptosis.

The nephrotoxicity of trichloroethylene and dichloroacetylene has previously been linked to mitochondrial dysfunction induced by the metabolite S-(1,2-dichlorovinyl)-l-cysteine (DCVC). In this study, we examined whether key biochemical steps associated with mitochondria occur in DCVC-induced apoptosis in cultured porcine proximal tubular LLC-PK1 cells. DCVC caused a decrease in mitochondrial membrane potential (mt Delta Psi) beginning at 4 h and a release of cytochrome c into the cytoplasm at 6 h. Caspase-3-like activity was detected at 6 h and extensive DNA fragmentation was observed at 8 h. Decreases in cellular ATP were not evident until 8 h and later, even though electron microscopy showed that the mitochondria were extensively swollen. Aminooxyacetic acid (AOAA), an inhibitor of cysteine-conjugate beta-lyase, protected against mitochondrial changes and apoptosis. Overexpression of the antiapoptotic Bcl-2 protein desensitized LLC-PK1 cells to DCVC-induced apoptosis. These results support the interpretation that mitochondrial release of cyt c and cyt c-dependent activation of caspase-3 could have a central role in nephrotoxicity due to haloalkene-derived cysteine S-conjugates.

Aminooxyacetic Acid↗
PubMed2001

Fungal peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis.

We report the first case of peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis. He presented with gray-black proteinaceous material obstructing the lumen of his Tenckhoff catheter. Although the peritoneal fluid was cloudy, the patient suffered neither significant abdominal tenderness nor systemic symptoms. Catheter removal and treatment with amphotericin B allowed complete recovery and return to peritoneal dialysis within 7 days. Outdoor play in a wooded environment may have allowed contact of this saprophytic fungus with the child's indwelling catheter transfer set.

Amphotericin B↗
PubMed2001

Investigation of the human oesophagus as a new monitoring site for blood oxygen saturation.

Pulse oximeter probes placed peripherally may fail to give accurate values of arterial blood oxygen saturation (SpO2) when peripheral perfusion is poor. Since central blood flow may be preferentially preserved, the oesophagus was suggested as an alternative monitoring site. A reflectance oesophageal photoplethysmographic (PPG) probe and a multiplexed data acquisition system, operating simultaneously at two wavelengths and incorporating an external three-lead electrocardiogram (ECG) reference channel, has been developed. It has been used to investigate the suitability of the oesophagus as a possible monitoring site for SpO2 in cases of compromised peripheral perfusion. Oesophageal PPG signals and standard ECG traces were obtained from 16 anaesthetized patients and displayed on a laptop computer. Measurable PPG signals with high signal-to-noise ratios at both infrared and red wavelengths were obtained from all five oesophageal depths investigated. The maximum PPG amplitude occurred at 25 cm from the upper incisors in the mid-oesophagus. The measured pulse transit times (PTTs) to the oesophagus were consistent with previous measurements at peripheral sites and had a minimum value of 67 +/- 30 ms at a depth of 30 cm. There was broad agreement between the calculated values of oesophageal SpO2 and those from a commercial finger pulse oximeter.

Adult↗
PubMed2000

Radiation exposure during fluoroscopically assisted pedicle screw insertion in the lumbar spine.

STUDY DESIGN: An experimental model to assess radiation exposure during lumbar pedicle screw insertion. OBJECTIVES: To measure skin (patient) and scatter (surgeon) doses of radiation during lumbar spine fluoroscopy to assess safety of the procedure for both the surgeon and patient and determine best practice. SUMMARY OF BACKGROUND DATA: Fluoroscopy assists with accuracy of pedicle screw placement, yet the optimal technique of C-arm use and risk to both patient and operating room staff from radiation exposure are unknown. METHODS: Entry- and scatter-dose recordings were made using a digital dosimeter while screening an anthropomorphic phantom prone on a radiolucent operating table. The source was positioned both superiorly and inferiorly with the height varied in the latter orientation to create a working space under the C-arm. The senior author's fluoroscopy records were reviewed in 140 consecutive cases. RESULTS: In a series of 140 patients who underwent pedicle screw fixation, the fluoroscopy time was 1.4 minutes per case or 0.33 minutes per screw. In the source-superior position, the effective dose received by the patient was approximately 2.3 mSv per case. In the source-inferior position with a working space of 300 mm, the effective dose was 6.8 mSv. Scatter dose to the surgeon was higher in the source-superior position but was still less than 10% of recommended limits for the hand, thyroid, and eyes. CONCLUSIONS: The source-superior position is the preferred position for pedicle screw screening if a working space is required. Patient exposure is minimized, and surgeon dose is well within current recommendations.

Bone Screws↗
PubMed2000

Biomarkers of oxidative stress study: are plasma antioxidants markers of CCl(4) poisoning?

Antioxidants in the blood plasma of rats were measured as part of a comprehensive, multilaboratory validation study searching for noninvasive biomarkers of oxidative stress. For this initial study an animal model of CCl(4) poisoning was studied. The time (2, 7, and 16 h) and dose (120 and 1200 mg/kg, intraperitoneally)-dependent effects of CCl(4) on plasma levels of alpha-tocopherol, coenzyme Q (CoQ), ascorbic acid, glutathione (GSH and GSSG), uric acid, and total antioxidant capacity were investigated to determine whether the oxidative effects of CCl(4) would result in losses of antioxidants from plasma. Concentrations of alpha-tocopherol and CoQ were decreased in CCl(4)-treated rats. Because of concomitant decreases in cholesterol and triglycerides, it was impossible to dissociate oxidation of alpha-tocopherol and the loss of CoQ from generalized lipid changes, due to liver damage. Ascorbic acid levels were higher with treatment at the earliest time point; the ratio of GSH to GSSG generally declined, and uric acid remained unchanged. Total antioxidant capacity showed no significant change except for 16 h after the high dose, when it was increased. These results suggest that plasma changes caused by liver malfunction and rupture of liver cells together with a decrease in plasma lipids do not permit an unambiguous interpretation of the results and impede detection of any potential changes in the antioxidant status of the plasma.

Animals↗
PubMed2000

Redox state of glutathione in human plasma.

Thiol and disulfide forms of glutathione (GSH) and cysteine (Cys) were measured in plasma from 24 healthy individuals aged 25-35 and redox potential values (E(h)) for thiol/disulfide couples were calculated using the Nernst equation. Although the concentration of GSH (2.8 +/- 0.9 microM) was much greater than that of GSSG (0.14 +/- 0.04 microM), the redox potential of the GSSG/2GSH pool (-137 +/- 9 mV) was considerably more oxidized than values for tissues and cultured cells (-185 to -258 mV). This indicates that a rapid oxidation of GSH occurs upon release into plasma. The difference in values between individuals was remarkably small, suggesting that the rates of reduction and oxidation in the plasma are closely balanced to maintain this redox potential. The redox potential for the Cys and cystine (CySS) pool (-80 +/- 9 mV) was 57 mV more oxidized, showing that the GSSG/2GSH and the CySS/2Cys pools are not in redox equilibrium in the plasma. Potentials for thiol/disulfide couples involving CysGly were intermediate between the values for these couples. Regression analyses showed that the redox potentials for the different thiol/disulfide couples within individuals were correlated, with the E(h) for CySS-mono-Gly/(Cys. CysGly) providing the best correlation with other low molecular weight pools as well as protein disulfides of GSH, CysGly and Cys. These results suggest that E(h) values for GSSG/2GSH and CySS-mono-Gly/(Cys. CysGly) may provide useful means to quantitatively express the oxidant/antioxidant balance in clinical and epidemiologic studies.

Adult↗
PubMed2000

Erroneous concerns about child sexual abuse.

AIM: To assess the incidence and nature of concerns about sexual abuse, with particular reference to erroneous concerns of sexual abuse made by children. METHODS: A review of case notes of all child sexual abuse reports to the Denver Department of Social Services over 12 months. Cases were put into four groups: substantiated, not sexual abuse, inconclusive and erroneous accounts by children. RESULTS: 551 cases were reviewed. Forty-three percent were substantiated, 21% were inconclusive and 34% were not considered to be abuse cases. There were 14 (2.5%) erroneous concerns emanating from children. They comprised three cases of allegations made in collusion with a parent, three cases where an innocent event was misinterpreted as sexual abuse and eight cases (1.5%) of false allegations of sexual abuse. CONCLUSION: Erroneous concern of sexual abuse from children are uncommon. The four categories of concern in this study, in contrast to the simple classification of substantiated and unsubstantiated, provide a means of encouraging open minded assessments of the typical concerns which a child protection agency receives.

Adolescent↗