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Biomedical subjects

D Wong

Publications and source records attributed to D Wong.

323 records · Page 18Linked to original sources
PubMedDate not supplied

A survey of professional satisfaction among Canadian anesthesiologists.

PURPOSE: To assess overall job satisfaction among Canadian anesthesiologists and examine contributing factors. METHODS: A confidential postal survey of all active members of the Canadian Anesthesiologists Society was conducted in 1998. Demographics, anesthesia practice, overall job satisfaction, anesthetic assistance, and perceived surgeons' and public attitudes towards anesthesiologists were collected. RESULTS: Of 1659 surveys sent, 946 were returned (57% response rate). Seventy-five percent of the respondents were male and 25% female. Staff comprized 91%, residents 9%. The average working week was 59 +/- 11.9 hr. Seventy-five percent of respondents reported overall job satisfaction. Job satisfaction was associated with intellectual stimulation, good quality of care and interaction with patients. Dissatisfaction stemmed from treatment from the provincial government, hospital politics and long hours. Job satisfaction was associated with satisfaction with the level of operating room (OR) assistance, perceived high surgical regard and public image. Residents were more satisfied than staff anesthesiologists. Overall satisfaction was not affected by age, gender, region of practice, type of hospital or clinical work. CONCLUSIONS: Job satisfaction among anesthesiologists is significantly associated with intellectual stimulation, quality of care, interaction with the patients, treatment from the provincial government, hospital politics, working hours, OR assistance and perceived attitude of surgeons. Improving these contributing factors may lead to higher job satisfaction.

Adult↗
PubMedDate not supplied

Percutaneous ethanol injection of unresectable medium-to-large-sized hepatomas using a multipronged needle: efficacy and safety.

Fine needles with an end hole or multiple side holes have traditionally been used for percutaneous ethanol injection (PEI) of hepatomas. This study retrospectively evaluates the safety and efficacy of PEI of unresectable medium-to-large (3.5-9 cm) hepatomas using a multipronged needle and with conscious sedation. Twelve patients, eight men and four women (age 51-77 years; mean: 69) received PEI for hepatomas, mostly subcapsular or exophytic in location with average tumor size of 5.6 cm (range: 3.5-9.0 cm). Patients were consciously sedated and an 18G retractable multipronged needle (Quadrafuse needle; Rex Medical, Philadelphia, PA) was used for injection under real-time ultrasound guidance. By varying the length of the prongs and rotating the needle, the alcohol was widely distributed within the tumor. The progress of ablation was monitored by contrast-enhanced ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) after each weekly injection and within a month after the final (third) injection and 3 months thereafter. An average total of 63 mL (range: 20-154 ml) of alcohol was injected per patient in an average of 2.3 sessions. Contrast-enhanced CT, ultrasound, or MRI was used to determine the degree of necrosis. Complete necrosis was noted in eight patients (67%), near-complete necrosis (90-99%) in two (16.7%), and partial success (50-89%) in two (16.7%). Follow-up in the first 9 months showed local recurrence in two patients and new lesions in another. There was no mortality. One patient developed renal failure, liver failure, and localized perforation of the stomach. He responded to medical treatment and surgery was not required for the perforation. One patient had severe postprocedural abdominal pain and fever, and another had transient hyperbilirubinemia; both recovered with conservative treatment. PEI with a multipronged needle is a new, safe, and efficacious method in treating medium-to-large-sized hepatocellular carcinoma under conscious sedation. Its survival benefits require further investigations.

Administration, Cutaneous↗
PubMedDate not supplied

Positron emission tomography in cochlear implant and auditory brainstem implant recipients.

UNLABELLED: Positron emission tomography (PET) imaging was used to evaluate the brain's response to auditory stimulation, including speech. Five cases of adults illustrate the utility of PET to illuminate auditory processing with cochlear or brainstem implants. Subjects showed varying degrees of success in processing speech, which was reflected in the resulting PET images. Functional speech processing was associated with activation in areas classically associated with speech processing. In one patient who did not achieve functional speech processing, activation in frontal regions suggests that the subject used other cognitive strategies to assist auditory processing. LEARNING OUTCOMES: As a result of this activity, the participant will be introduced to the principles of PET and the application of this technology to deaf patients who have received an implanted auditory prosthesis.

Brain↗
PubMedDate not supplied

T3N0 rectal cancer: results following sharp mesorectal excision and no adjuvant therapy.

Adjuvant chemoradiation therapy following resection of T3N0 rectal cancer is recommended in order to reduce the incidence of local recurrence and improve survival. However, recent experience with rectal cancer resection utilizing sharp dissection and total mesorectal excision has resulted in a reduction in local recurrence rates to as low as 5% without adjuvant treatment. The purpose of this study was to determine if rectal cancer resection utilizing sharp mesorectal excision alone is adequate treatment for local control of T3N0 rectal cancer. Between July 1986 and December 1993, 95 patients with T3N0M0 rectal cancer underwent resection with sharp mesorectal excision and did not receive any adjuvant therapy. Various prognostic factors were analyzed for their association with local recurrence and survival. Seventy-nine patients had a low anterior resection, 10 of whom had a coloanal anastomosis, and 16 had an abdominoperineal resection. The median follow-up was 53.3 months. Six patients had local recurrence, 12 had distant recurrence, and three had local and distant recurrences. The overall local recurrence rate was 9% crude and 12% 5-year actuarial. The overall crude recurrence rate was 22%. The 5-year disease-specific survival rate was 86.6% with an overall survival of 75%. Postoperative complications occurred in 18 patients (19%). Five patients (6%) had a documented anastomotic leak. Perioperative mortality was 3%. No technical factors, including type of resection (low anterior vs. abdominoperineal), location of tumor, or extent of resection margin, were significant for determining local recurrence. The only histopathologic marker significant for determining local recurrence was lymphatic invasion (P <0.04). Sharp mesorectal excision with low anterior resection or abdominoperineal resection for T3N0M0 rectal cancer results in a local recurrence rate of less than 10% without the use of adjuvant therapy. Therefore, in select patients with T3N0M0 rectal cancer, the standard use of adjuvant therapy for local control may not be justified.

Aged↗
PubMedDate not supplied

The development of a database for payment card embossing machines.

In order to meet increasing operational demands involving the forensic examination of payment cards, a software program was created to enable the cards to be linked by identifying characteristics found on characters embossed on their plastic surfaces. In doing so, a database was developed, reducing an otherwise insurmountable task into an orderly and efficient process. Counterfeit cards as well as altered genuine cards, from across Canada, can be accurately correlated and linked to the specific embossing machines responsible for their production.

Commerce↗
PubMedDate not supplied

A labetalol metabolite with analytical characteristics resembling amphetamines.

A metabolite of labetalol that is responsible for previous reports of false-positive assays for amphetamines by thin-layer chromatography and immunoassay has been identified. The compound, 3-amino-1-phenylbutane (APB), an oxidative metabolite of labetalol, was initially identified in a patient's urine by gas chromatography-mass spectrometry and confirmed by analysis of the pure material. Gas chromatography showed a single major peak with relative retention time indistinguishable from that of methamphetamine, both underivatized and as the pentafluoropropionyl derivative. By classical thin-layer chromatography, APB migrated identically to methamphetamine but showed ninhydrin color development characteristic of amphetamine. APB was shown to cross-react approximately 2% with the Abbott TDx amphetamine/methamphetamine II kit, 10% with the Syva EMIT d.a.u. polyclonal amphetamine class kit, and 3% with the Syva EMIT d.a.u. monoclonal amphetamine kit. This degree of cross-reactivity is sufficient to cause false-positive immunoassays when cutoffs of 300 ng/mL are used.

Aged↗
PubMedDate not supplied

The contrasting influence of chronic nicotine intake on gastrin and gastric acid secretion.

The effects of chronic nicotine treatment on gastric acid secretion stimulated by subcutaneous injection of pentagastrin, as well as on serum gastrin levels and the stomach parietal cell population, were examined. Rats drank a solution of nicotine 25 micrograms/mL tap water for periods of 10, 30 or 45 days. Pentagastrin increased the gastric secretory volume and acid output in pylorus-ligated control animals that drank tap water. Animals given nicotine in their drinking water for 10, 30 or 45 days showed increased basal gastric secretion and acid output. Pentagastrin produced maximum stimulatory effects at lower dose levels of 50 micrograms/kg in the 10-day treatment group and 25 micrograms/kg in the 30- or 45-day treatment groups; however, the maximum responses to pentagastrin in all nicotine-treated batches were comparable to those of their corresponding controls. Serum gastrin levels remained unchanged from the 10th day of nicotine treatment, whereas the levels in the control animals continued to rise with age. Nicotine 25 micrograms/mL drinking water given for 10, 30 or 45 days caused no significant changes in the parietal cell population, mucosal surface area or mucosal thickness. These findings are consistent with the idea that chronic nicotine administration, for at least 10 days, will lead to increased muscarinic receptor sensitivity; basal acid secretion is consequently elevated, and this in turn may depress gastrin secretion.

Animals↗
PubMedDate not supplied

Microbial flora on doctors' white coats.

OBJECTIVE: To determine the level and type of microbial contamination present on the white coats of doctors in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting. DESIGN: Cross sectional survey of the bacterial contamination of white coats in a general hospital. SETTING: East Birmingham Hospital, an urban general hospital with 800 beds. SUBJECTS: 100 doctors of different grades and specialties. RESULTS: The cuffs and pockets of the coats were the most highly contaminated areas. The level of bacterial contamination did not vary with the length of time a coat had been in use, but it increased with the degree of usage by the individual doctor. Staphylococcus aureus was isolated from a quarter of the coats examined, more commonly from those belonging to doctors in surgical specialties than medical specialties. Pathogenic Gram negative bacilli and other pathogenic bacteria were not isolated. CONCLUSIONS: White coats are a potential source of cross infection, especially in surgical areas. Scrupulous hand washing should be observed before and after attending patients and it may be advisable to remove the white coat and put on a plastic apron before examining wounds. There is little microbiological reason for recommending a more frequent change of white coat than once a week, nor for excluding the wearing of white coats in non-clinical areas.

Bacteria↗
PubMedDate not supplied

Histamine levels in middle ear effusions.

The presence of histamine in 131 middle ear effusions was determined by the fluorometric assay technique. This potent mediator of inflammation was found in significant amounts in most of the samples, suggesting that it may play an important role in the pathogenesis of otitis media with effusion. It is postulated that mast cells located in the lamina propria of the tympanic mucoperiosteum are triggered to degranulate and release histamine by anaphylatoxin derived from activation of the complement system.

Adolescent↗
PubMedDate not supplied

Central venous access devices in children.

Central venous access devices are used with increasing frequency in children with chronic illnesses that require long-term parenteral treatment. Nurses are often responsible for taking care of the device and teaching the family home maintenance.

Cardiac Tamponade↗
PubMedDate not supplied

The enhanced transfer of drug-resistant genes in NIH-3T3 cells transformed by the EJras oncogene.

The spontaneous transfer of drug resistance genes has been shown to take place between cultured mammalian NIH-3T3 cells and occurs with a hierarchy of transfer efficiencies, transformed cells being more efficient than non-transformed cells. This experiment was accomplished by co-cultivating two NIH-3T3 sublines, each transfected by standard plasmid methods with a different drug resistance gene, subjecting the mixed population to double selection by adding both drugs to the mixed cell culture, and isolating single cells which were resistant to both drugs. The genes used were the neo gene and gpt gene which conferred resistance to the drugs G418 and mycophenolic acid, respectively. DNA analysis confirmed the presence of both resistance genes in the cells which were resistant to both drugs. The mechanism of this gene transfer was by cell fusion rather than by chromosomal DNA uptake. The efficiency of gene transfer, as indicated by the number of double-resistant colonies standardized by number of cells cultured, was much higher between two sublines of cells transformed by the EJras oncogene than between one transformed and one non-transformed subline, which in turn was higher than between two non-transformed sublines. The higher efficiency of gene transfer between the transformed cells also occurred when these cells were injected into nude mice, thus demonstrating that the same process occurred in vivo. It would appear that drug resistance genes may be transferred spontaneously in cultured mammalian cells by cell fusion, and that transformed cells have a higher efficiency of gene transfer compared to non-transformed cells.

Animals↗