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Biomedical subjects

F Morris

Publications and source records attributed to F Morris.

At least 37 records · Page 2Linked to original sources

High dose-rate microselectron molds in the treatment of skin tumors.

PURPOSE: The feasibility of high dose rate iridium afterloaded molds in the treatment of skin tumors. METHODS AND MATERIALS: Expanded silicone rubber and bronchial applicator tubes were used in the construction of various molds. The number of tubes used and the separation between them depends on the size and area to be treated. Source dwell position and time are set to follow Paterson-Parker rules. Single plane expanded silicone rubber molds between 15 X 15 mm and 60 X 70 mm were used in 120 different sites, and of the others, seven were perspex double molds, two were cylindrical applicators, and one was a partially shielded intranasal applicator. One hundred and thirty lesions of various site and histology were treated in all. After exclusion of treatments that were combined with either external beam or chemotherapy, 106 lesions (76 patients) were evaluated. RESULTS: Full response was obtained in all but four basal cell carcinomas. The acute reaction ranged from moist desquamation (27 sites) to erythema only. Follow-up at 5 or more months revealed no changes whatever in 47 sites; 53 showed an excellent cosmetic outcome, although slight changes in pigmentation or minimal atrophy was demonstrable and 6 sites became noticeably atrophic with patchy pigmentation. For 9.6 months of average follow-up time, no recurrences have been observed. CONCLUSION: The high-dose-rate iridium-loaded skin applicators offer the possibility of improved therapeutic ratio in the treatment of superficial skin tumors. With the availability of a high-dose-rate afterloader this technique is simple and straightforward.

Aged↗

Surface composition of orthopaedic implant metals regulates cell attachment, spreading, and cytoskeletal organization of primary human osteoblasts in vitro.

The nature of orthopaedic implant surfaces affects the interaction between bone and the implant. To analyze this interaction at a cellular level, this study examined the early phase of cell adhesion to implant surfaces. Using an in vitro model, the cell adhesion of primary human osteoblasts cultured on Ti6A14V (Ti), CoCrMo (CC), and tissue culture polystyrene (PS) was characterized. The osteoblasts were found to adhere in greater numbers to Ti compared with PS and CC during a 12 hour period. Other cellular characteristics related to cell adhesion, such as cell spreading, cytoskeletal organization, and focal contact formation, were also examined. Osteoblasts cultured on Ti were significantly larger, and spread better, compared with those on PS and CC. Also, the rate of cytoskeletal reorganization was enhanced on Ti. Focal contacts remained peripherally located in cells on Ti and CC as cytoskeletal reorganization proceeded. However, for cells on PS, the focal contacts quickly became dispersed along actin filaments. There was no difference between surfaces in the number of cells forming focal contacts, although the cells used a larger percentage of their membrane to attach to CC. These data suggest that osteoblast attachment to Ti is greater because cell spreading and cytoskeletal organization are enhanced. Furthermore, the mechanisms of osteoblast attachment to the underlying substrate may be significantly different between biometals and tissue culture plastic. Substrate specific information regarding the characteristics and mechanisms of cell adhesion may be helpful in the design of implants to optimize bone growth at the interface.

Alloys↗

The injured motor cycle messenger.

Injured motor cycle messengers make up a small but significant proportion of the young injured attending Central London accident and emergency (A&E) departments. The study confirms that the pattern of their injuries is similar to other injured urban motor cyclists, and discusses the background of the injured, in terms of experience and training, highlighting the frequency of injury and possible predisposing factors. A total of 116 injured motor cycle messengers attending two Central London A&E departments over a 10-month period were studied. Thirteen per cent sustained sufficiently serious injuries to necessitate admission, the rest were treated as out-patients for lesser injuries. The mean age was 23. Only 18% had received any formal training and 31% were in possession of a provisional driving license only. Fifty-eight per cent had been employed as a messenger for less than 3 months, yet two-thirds of them had sustained a previous injury whilst a messenger. The apparent absence of supervision of this potentially dangerous occupation is emphasized. In view of the repeated injuries sustained by many of these vulnerable young men, it is suggested that those responsible for their treatment might, in addition to their therapeutic role, give suitable guidance that might prevent re-attendance with further injuries.

Accidents, Occupational↗

Impact of HIV infection on mycobacterial disease.

The current epidemic of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome has resulted in a worldwide resurgence of tuberculosis. In the United States, the number of new cases of tuberculosis has increased in the past five years, leading to a cumulative excess of about 15,000 cases. The clinical and epidemiologic picture of tuberculosis in AIDS patients differs drastically from the standard presentation of tuberculosis cases in HIV-negative patients. The diagnosis and management of tuberculosis, particularly atypical mycobacterial infections, present a challenge in HIV-infected patients. Prevention of the transmission of disease is a major concern. Since atypical mycobacterial infection and disease pose a greater management challenge, this article summarizes diagnosis and treatment of atypical mycobacterial infection in HIV-positive patients.

Adult↗

Do head-restraints protect the neck from whiplash injuries?

Over an 11-month period a study was made of all patients presenting to an accident and emergency department who had sustained whiplash as a result of rear-bumper impacts. The patients were analysed with respect to the presence of head-restraints in their vehicles. A significant increase in the incidence of whiplash was found in patients whose vehicles did not have head-restraints fitted. Legislation requiring all passenger cars to have head-restraints fitted as standard would have a major impact in reducing the number of whiplash injuries sustained in rear bumper impacts.

Accidents, Traffic↗

A study of the potential pharmacokinetic interaction of lisinopril and digoxin in normal volunteers.

1. The pharmacokinetics of single oral doses of 20 mg lisinopril and 0.25 mg digoxin, given alone and together, have been studied in 12 normal young male volunteers. 2. Peak serum conc of lisinopril occurred at 6 to 8 h and were slightly higher during combined treatment. Subsequent elimination proceeded moderately rapidly in both cases, concn declining to approx. 25% of peak values in 24 h. The AUC of lisinopril was similarly slightly higher during combined treatment. 3. After lisinopril alone, urinary elimination of unchanged lisinopril was 13% dose in 72 h, and after combined therapy was 17% dose. 4. Although there were no statistically significant differences in lisinopril pharmacokinetics during single or combined treatment, serum and urinary parameters suggest that bioavailability may be enhanced slightly during combined treatment. 5. Plasma concentrations of digoxin were slightly lower and urinary excretion slightly higher during combined treatment, the mean renal clearance being 20% higher.

Adult↗

Technetium-99m-pyrophosphate scintigraphy in patients with suspected acute myocardial infarction: impact of interobserver variability.

Technetium-99m-pyrophosphate (TcPYP) scintigraphy may have great value in patients with suspected acute myocardial infarction (AMI), but interobserver variability undoubtedly has adverse impact on predictive value. TcPYP scintigrams for 133 (80%) of 166 consecutive patients admitted for suspected AMI were interpreted independently by three experienced readers. Although there was complete agreement for 87 interpretations (65%), major discrepancies (i.e., at least one positive and one negative reading on the same scan) occurred for 28 scans (21%). To assess predictive accuracy, patients were categorized as follows: 36 had definite AMI manifest by new ECG Q waves and/or CK-MB evidence of AMI (group I), 56 were classified as possible AMI (group II), and 41 had AMI excluded (group III). Using only the definitive diagnostic categories (groups I and III), accuracy for each reader approximated 0.68, with no single reader being correct more often than any other.

Creatine Kinase↗

Developing and negotiating transfer agreements in allied health.

The Kentucky Council on Higher Education has developed a statewide articulated system for allied health education. The articulated system permits entry and exit of prepared professionals at a variety of levels. The six disciplinary clusters included in the system are clinical laboratory sciences, dental auxiliaries, dietetics/nutrition, rehabilitation therapies, radiological sciences, and respiratory therapy. Competency-based education was used as the theoretical framework for developing and negotiating transfer agreements. Types of agreements included the block credit transfer agreement and the course specific transfer agreement. Agreements were negotiated between education systems and between specific programs/institutions. To date, approximately 30 transfer agreements have been negotiated. The process for negotiating transfer agreements included the following sequence: identify programs, develop a theoretical articulation model, rank order transfer agreements, determine the type of agreement, review respective curricula, determine the existing amount of transferable coursework, draft a pre-articulation agreement, schedule a meeting between faculty and administrators to discuss the agreement, and secure authorizing signatures on the final transfer agreement. Facilitators and barriers to negotiating agreements are discussed and recommendations offered for others who may be interested in developing transfer agreements.

Allied Health Personnel↗

Routine serum enzyme tests in the diagnosis of acute myocardial infarction. Cost-effectiveness.

To determine the cost-effectiveness of routine use of serial SGOT, lactic dehydrogenase (LDH), and LDH isoenzyme determinations in patients with suspected acute myocardial infarction (AMI), 166 consecutive patients admitted to a coronary care unit were prospectively identified and clinical findings analyzed independently using predetermined criteria. Based on chest pain characteristics, ECG, and creatine kinase--MB (CK-MB) results, patients were placed in categories of definite AMI (31%), possible AMI (34%), or AMI excluded (36%). The SGOT and/or LDH patterns were considered positive (ie, suggestive of AMI) in 82% of the patients with definite AMI but only confirmed CK-MB results. Positive SGOT/LDH results yielded new clinically relevant information in only 14 patients (8%). Total charges for SGOT/LDH determinations in these 166 patients totaled $10,938 or approximately $780 for each additional clinically important positive result. When serial ECG and CK-MB results are available, routine serial SGOT/LDH determinations are not justified.

Adult↗

Systemic sarcoidosis and electrocardiographic conduction abnormalities. Electrophysiologic evaluation of two patients.

Two patients with long histories of sarcoidosis had progression of conduction abnormalities to heart block and severe bradycardia. Conduction system involvement was trifascicular in both patients, though evidence for left ventricular functional impairment was otherwise lacking. Sudden death is seen more commonly in patients with sarcoidosis who have diffuse myocardial involvement, while conduction abnormalities can occur with relatively localized disease.

Arrhythmias, Cardiac↗

An electron microscopic India ink technique for demonstrating capsules on microorganisms: studies with Streptococcus pneumoniae, Staphylococcus aureus, and Neisseria gonorrhoeae.

A technique using India ink in electron microscopic preparations was used to study bacterial capsules. Capsules were demonstrated on Streptococcus pneumoniae and Staphylococcus aureus (strain M and the Smith diffuse variant) from in vitro cultures. Two types of false capsules were observed on Neisseria gonorrhoeae grown in vitro or obtained from human urethral exudates. No true capsules were definitively identified on gonococci from these sources. The technique described does not require the use of specific anticapsular antibody or specific polysaccharide stains and permits the detection of artifacts that may, by the use of light microscopic methods, be misinterpreted as capsules.

Antigens, Bacterial↗