Biomedical subjects
G Gardner
Publications and source records attributed to G Gardner.
Tuning fork tests in modern otology.
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The automated analysis of urinary oestrogens during pregnancy.
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"Disaggregation" of phytochrome in vitro-a consequence of proteolysis.
The relationship between a large molecular weight (9S) and a small molecular weight (4.5S, 60,000 molecular weight) species of phytochrome was examined to determine if the larger species was an aggregate of the smaller. Alterations of pH, salt concentration, or phytochrome concentration did not cause any observable formation of the large form from the small form. However, in partially purified phytochrome extracts from Secale cereale L. and Avena sativa L., the large form was converted to the small form over time at 4 C in the dark. This breakdown was inhibitable by the protease inhibitor phenylmethanesulfonyl fluoride. When highly purified large molecular weight rye phytochrome was incubated with a neutral protease isolated from etiolated oat shoots, the large phytochrome was converted to the small form without qualitative visible absorbancy changes. The effect of the oat protease could be mimicked by a wide variety of commercial endopeptidases, including trypsin. Examination of the trypsin-induced breakdown on sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that as the size of the photoreversible unit changes from large to small, the size of its constituent polypeptide chains is reduced from 120,000 to 62,000 molecular weight. These experiments provide evidence that the endogenous breakdown observed in extracts is a result of contaminant protease and, consequently, that the small molecular weight species of phytochrome is an artifact due to proteolysis.
Mastoid obliteration using homograft bone. Preliminary report.
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Tuning forks in modern otology.
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Middle cranial fossa approach to acoustic tumor surgery.
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Other tumors of the cerebellopontine angle.
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Glomus Tumor: Diagnosis and Management.
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CO2 laser stapedotomy: is it practical?
The argon laser has been described as an instrument capable of performing stapedotomy for otosclerosis. Because of the possibility of cost ineffectiveness and damage to the saccule using the argon laser, this study was undertaken to ascertain the possibility of using the CO2 laser for stapedotomy. the operation was done on seven cats, and the resulting histopathologic findings were studied. Stapedotomy was also performed with the CO2 laser on human cadaver temporal bones to measure temperature changes in the vestibule and to develop guidelines for the laser's use in humans. The authors' results indicated that the CO2 laser can be used effectively and safely in cats and should be considered for human use.
Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: I. Psychiatric diagnoses and functional disability.
OBJECTIVE: Recent studies of the relationship between fibromyalgia and psychiatric disorders have yielded conflicting findings, and many of these inconsistencies seem to result from methodological differences. METHOD: We compared 36 patients with fibromyalgia and 33 patients with rheumatoid arthritis from a tertiary care clinic using physician-administered, structured psychiatric interviews and self-reported measures of illness appraisal, coping, and functional disability. RESULTS: Patients with fibromyalgia had significantly higher lifetime prevalence rates of mood and anxiety disorders, as well as higher mean numbers of medically unexplained physical symptoms across several organ systems. Ninety percent of the patients with fibromyalgia had a prior psychiatric diagnosis compared with less than half of the patients with rheumatoid arthritis. CONCLUSIONS: Despite the absence of organic pathology, the patients with fibromyalgia had equal or greater functional disability and were less well adapted to their illness. Although the pathophysiology of fibromyalgia remains unclear, co-morbid psychiatric disorders and functional disability remain an important focus of treatment in this population.
Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect.
OBJECTIVE: Two recent reports have found associations between fibromyalgia and sexual victimization, but had methodologic characteristics that limited their interpretation. METHOD: We compared 36 patients with fibromyalgia and 33 patients with rheumatoid arthritis by using structured interviews for sexual, physical, and emotional victimization histories, as well as dimensional self-report measures of victimization severity. RESULTS: Compared with the patients with rheumatoid arthritis, those with fibromyalgia had significantly higher lifetime prevalence rates of all forms of victimization, both adult and childhood, as well as combinations of adult and childhood trauma. Although childhood maltreatment was found to be a general risk factor for fibromyalgia, particular forms of maltreatment (eg, sexual abuse per se) did not have specific effects. Experiences of physical assault in adulthood, however, showed a strong and specific relationship with unexplained pain. Trauma severity was correlated significantly with measures of physical disability, psychiatric distress, illness adjustment, personality, and quality of sleep in patients with fibromyalgia but not in those with rheumatoid arthritis. CONCLUSIONS: Fibromyalgia seems to be associated with increased risk of victimization, particularly adult physical abuse. Sexual, physical, and emotional trauma may be important factors in the development and maintenance of this disorder and its associated disability in many patients.
The interrelationships between antidiuretic hormone, adenyl cyclase, tissue cyclic AMP and diffusional water permeability.
1. Physiological concentrations of antidiuretic hormone increase diffusional water permeability but not measurable cyclic AMP content in the isolated papilla of the rat's kidney. 2. Theophylline (6 mM) increases diffusional water permeability and cyclic AMP content in the isolated papilla of the rat's kidney. 3. The increase in water permeability is detected with 5 muunits.ml-1 of ADH and is maximal with 50 muunits.ml-1. The same maximum was achieved with 6 mM theophylline. 4. Cyclic AMP and dibutyryl cyclic AMP both increase water permeability, but to a lesser extent than theophylline or ADH. 5. In the presence of theophylline, ADH causes a dose related generation of tissue cyclic AMP up to a dose of 2,000,000 muunits.ml-1. 6. Adenyl cyclase is increasingly activated by ADH up to doses of 2,000,000 muunits.ml-1. 7. These results suggest that while ADH activates the adenyl cyclase system and changes water permeability there are sufficient disparities to cast doubt on an exclusive role for cyclic AMP as the second messenger.
Hearing preservation in unilateral acoustic neuroma surgery.
This paper reviews the principal English literature on hearing preservation in unilateral acoustic neuroma surgery. Seventeen case reports and 13 surgical series are included. In addition, we report ten cases of our own, two with successful hearing preservation. The purpose of this report is to study feasibility, success rate, and associated problems. Previous reports have been compared in terms of criteria that we have selected. A classification system similar to Silverstein's is used. The total number of cases under review is 621, with 221 reported successes. Cases limited to those having a unilateral acoustic neuroma, with valid supportive audiometry, were 394, with 131 successes. The approximate overall rate of success is 33%. There are five cases of hearing preservation with unilateral acoustic neuromas 3 cm or larger when supporting audiometric data are available, the largest being "4-5 centimeters." Problems included mixing of unilateral acoustic neuromas with other types of tumors and failure to include comprehensive data, particularly audiometry. We conclude 1) that hearing preservation is a reasonable goal in unilateral acoustic neuroma surgery, although the number of available candidates is relatively small and 2) that intelligent selection of patients and high quality surgical technique are the keys to success.
Endolymphatic sac shunt operation in Meniere's disease.
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Handover: the collective narrative of nursing practice.
This paper examines the practice of handover in a large metropolitan hospital. It shows that the handover is a significant site at which to examine how tensions and imperatives derived from the traditional institutional position and role of the nurse are played out in contradiction with emergent professionalism. It identifies handover dimensions and focuses discussion on how the collective narrative of the handover serves to construct patient identities as well as ensure solidarity and cohesion among nurses.
The silence and the silencing of the nurse's voice: a reading of patient progress notes.
Content analysis of text offers a method for exploring experiences which usually remain unquestioned and unexamined. In this paper the authors analyse a set of patient progress notes by re-framing them as a narrative account of a significant event in the experience of a patient, her family and attending health care workers. Examination of these notes provides insights into aspects of clinical practice which are usually dealt with at a taken-for-granted level. An interpretation of previously unexamined therapeutic practices within the social and political context of institutional health care is offered.