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Biomedical subjects

G King

Publications and source records attributed to G King.

At least 55 records · Page 3Linked to original sources
PubMed1999

In vivo real-time analysis of intraperitoneal radiolabeled tumor cell movement during laparoscopy.

PURPOSE: A porcine model has been developed to allow the real-time imaging of radiolabeled tumor cell movement throughout the peritoneal cavity, both at rest and during carbon dioxide insufflation. METHODS: Fifteen 30-kg domestic white female pigs were used. Under anesthesia, 15 to 20 million radiolabeled human colorectal tumor cells (LIM1215) were introduced into the peritoneal cavity under laparoscopic vision into the pelvis. Radiolabeled tumor cell movement was examined by using a 25-cm-diameter, low-energy mobile gamma camera with high resolution collimator. Tumor cell movement and distribution during two hours without insufflation was examined in four pigs. Then tumor cell movement and distribution during two hours with CO2 insufflation was examined in four pigs. In a further four pigs, tumor cells were then mixed with blood and injected into the peritoneal cavity and the effect of no insufflation vs. insufflation was noted. A further three pigs were examined with manipulation of the intra-abdominal contents after injection of LIM1215 cells into the peritoneal cavity. Venting insufflating CO2 was filtered for tumor cells. RESULTS: Widespread intraperitoneal distribution of tumor cells from the pelvis was identified both with CO2 insufflation of the peritoneal cavity and without insufflation. Tumor cells dispersed throughout the peritoneal cavity at a slower rate without carbon dioxide insufflation. There was a differential rate of tumor cell movement to the left upper quadrant and right upper quadrant with insufflation and without insufflation. Blood within the peritoneal cavity and an extended contact of the laparoscopic trocars with the peritoneal cavity in this setting increased contamination of the trocars and trocar sites with tumor cells. Tumor cells were identified on laparoscopic instruments in all experiments. No evidence of aerosolization of tumor cells was found. CONCLUSION: Tumor cells move throughout the peritoneal cavity both at rest and during CO2 insufflation. The pattern of tumor cell dispersion differs with CO2 insufflation. The presence of blood and extended contact of trocars with peritoneal contents are a major factor in trocar and trocar site tumor cell contamination.

Animals↗
PubMed1999

Measuring outcomes in children's rehabilitation: a decision protocol.

OBJECTIVE: To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. DESIGN: A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. SETTING: A children's rehabilitation center in a city of 50,000. PARTICIPANTS: All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. INTERVENTION: Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. OUTCOME MEASURES: Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). RESULTS: Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change. CONCLUSIONS: The "All About Outcomes" software is clinically useful. Further research should evaluate whether using the software affects the use of outcome measures in clinical practice.

Child↗
PubMed1999

Cigarette smoking among native and foreign-born African Americans.

PURPOSE: To examine differences in current smoking status and the number of cigarettes consumed daily between foreign and native-born African Americans, and the impact of demographic and socioeconomic status (SES) factors on smoking behavior. METHODS: Data were obtained from combining the 1990-1994 National Health Interview Surveys and consisted of 16,738 U.S. born and foreign-born African Americans between 18 and 64 years of age. The statistical analysis included cross-tabulations and weighted multiple logistic regression (MLR) using the Statistical Packages for the Social Sciences (SPSS) and the Survey Data Analysis (SUDAAN) computer programs. RESULTS: Adjusted MLR analysis revealed that native-born African Americans were more likely (odds ratio (OR) = 2.7, p < 0.001) to be current smokers than foreign-born blacks. Within the native-born group, smoking prevalence decreased with increasing education and income, but these associations were not found for foreign-born blacks. Women in both groups were less likely than men to be current smokers. Statistically significant differences were not found between the two groups in the number of cigarettes smoked per day. CONCLUSIONS: This analysis of nativity and smoking behavior further demonstrates the social diversity among African Americans and suggests the differential impact of social and cultural factors on smoking behavior within racially classified social groups. In areas where there are substantial numbers of foreign-born blacks, researchers should consider differentiating smoking status by nativity. Though differences in smoking prevalence were apparent for native and foreign-born American Americans, prevention and cessation programs are needed for both groups.

Adolescent↗
PubMed1999

Detection of immunoglobulin light chain mRNA by in situ hybridisation using biotinylated tyramine signal amplification.

A highly sensitive method for the light microscopic in situ hybridisation of immunoglobulin light chain mRNA in formalin fixed, paraffin wax embedded sections is reported. This method is based on signal amplification using horseradish peroxidase catalysed deposition of biotinylated tyramine at the sites of hybridisation. kappa and lambda light chain immunoglobulin mRNA in situ hybridisation was performed with fluorescein isothiocyanate conjugated oligonucleotide probe cocktails. The hybridisation signal was detected using a biotinylated tyramine signal amplification procedure with streptavidinbiotin-horseradish peroxidase complex as the final layer. Peroxidase was demonstrated using 3,3'-diaminobenzidine. The biotinylated tyramine signal amplification method resulted in the sensitive detection of immunonoglobulin light chain mRNA, with the whole procedure being completed in one day. Moreover, the use of peroxidase as the final reporter molecule also allowed haemamatoxylin to be used as counterstain, thereby permitting the evaluation of cellular morphology.

Biotinylation↗
PubMed1998

Multiparameter flow cytometric analysis of polymorphonuclear leucocytes in whole blood from patients with adult rapidly progressive periodontitis reveals low expression of the adhesion molecule L-selectin (Cd62L).

Numerous studies of polymorphonuclear leucocyte (PMN) function in patients with adult periodontitis, including rapidly progressive periodontitis, have yielded conflicting findings, perhaps because most of the assays were performed on PMNs that had been separated from whole blood by a variety of procedures. To avoid the problems associated with in vitro analysis of isolated cells, PMN function and antigen expression in live whole unmanipulated blood of eight patients with rapidly progressive periodontitis were compared with those of age-, race-, and sex-matched controls. Using multiparameter flow cytometry, a) L-selectin (CD62L) expression, b) cell size, and c) respiratory burst activity were measured in PMNs in whole blood immediately ex vivo and during incubation with Porphyromonas gingivalis and Staphylococcus aureus. By comparison with PMNs from the control group, PMNs from the patient group expressed significantly lower levels of CD62L and had an increased size before stimulation. PMNs from both groups produced respiratory bursts similar to those of the two bacteria, but in both groups the responses to S. aureus were significantly greater than those to P. gingivalis. The significantly reduced expression of the adhesion molecule CD62L on PMNs in the patient group may lead to reduced tethering of neutrophils at sites of inflammation and may partly explain the susceptibility of these individuals to recurrent and severe periodontal infections.

Adult↗
PubMed1998

From inside out. Microperforation of the gallbladder during laparoscopic surgery may liberate mucosal cells.

BACKGROUND: Port-side recurrence after laparoscopic surgery on known and unsuspected gastrointestinal malignancies has been reported. The mechanisms of this type of metastatic spread are poorly understood. For in situ malignancies, microperforation of the viscus by laparoscopic instruments may liberate cells to facilitate malignant cell movement. METHODS: Twenty-three patients undergoing laparoscopic cholecystectomy for benign disease were prospectively studied. The laparoscopic fundal grasper was washed with sterile saline at the start and conclusion of surgery. These washings were examined for the presence of mucosal cells as evidence that gallbladder perforation occurred during the operation. RESULTS: No mucosal cells were seen from washings at the start of surgery. Thirteen cases (56%) of perforation or attempted choledochogram were recorded during surgery. Four of these 13 washings contained mucosal cells. One washing was positive for mucosal cells in the absence of perforation or attempted choledochogram. CONCLUSIONS: Microperforation of the gallbladder by laparoscopic instruments occurs during laparoscopic cholecystectomy.

Cholecystectomy, Laparoscopic↗
PubMed1998

The relationship between hetero-oligomer formation and function of the topological specificity domain of the Escherichia coli MinE protein.

MinE is an oligomeric protein that, in conjunction with other Min proteins, is required for the proper placement of the cell division site of Escherichia coli. We have examined the self-association properties of MinE by analytical ultracentrifugation and by studies of hetero-oligomer formation in non-denaturing polyacrylamide gels. The self-association properties of purified MinE predict that cytoplasmic MinE is likely to exist as a mixture of monomers and dimers. Consistent with this prediction, the C-terminal MinE22-88 fragment forms hetero-oligomers with MinE+ when the proteins are co-expressed. In contrast, the MinE36-88 fragment does not form MinE+/MinE36-88 hetero-oligomers, although MinE36-88 affects the topological specificity of septum placement as shown by its ability to induce minicell formation when co-expressed with MinE+ in wild-type cells. Therefore, hetero-oligomer formation is not necessary for the induction of minicelling by expression of MinE36-88 in wild-type cells. The interference with normal septal placement is ascribed to competition between MinE36-88 and the corresponding domain in the complete MinE protein for a component required for the topological specificity of septal placement.

Antibodies↗
PubMed1998

Tumour cell movement during heating and humidification of insufflating CO2: an in vitro model.

BACKGROUND: Intra-operative hypothermia and port-site recurrence have been associated with laparoscopic surgery. Heating and humidification of insufflating CO2 may protect against laparoscopy-associated hypothermia. However, the effect of heated, humidified CO2 upon tumour cell movement is unknown. METHODS: Twenty-four in vitro studies that used 4-L plastic bottles were performed. Thirteen million human colorectal cancer cells were placed in each bottle. Twelve studies used dry room temperature CO2 for insufflation: the remaining 12 used heated, humidified CO2 as the insufflating gas. Both groups were subdivided into bottles with leaks around the trocars and with airtight sealing around the trocars. Two trocars and a laparoscopic grasper were used. The exiting insufflating gas was filtered and examined for the presence of cells. Laparoscopic instruments agitated the contents of the bottles. The instruments and trocars were washed. These washings were examined for the presence of cells. RESULTS: Heated, humidified CO2 insufflation was able to maintain a warmer and more humid environment within the bottles when compared with dry room-temperature CO2. No cells were detected on the gas filters. Tumour cells were found on 12 out of 12 instruments and 11 out of 12 trocars with dry CO2 insufflation. Tumour cells were found on 8 out of 12 instruments and 7 out of 12 trocars with heated humidified CO2 insufflation. The only statistically significant difference in tumour cell spread to trocars was found between heating and humidification when no leak was present, and heating and humidification with leak present, and dry insufflation with no leak present (P = 0.015, Fisher's two-tailed exact test). CONCLUSIONS: Heating and humidifying CO2 during in vitro laparoscopy does not increase the aerosolization of tumour cells when compared with dry CO2. However, the use of heated and humidified gas with airtight seals around the trocars in vitro may lessen cell deposition on trocars.

Carbon Dioxide↗
PubMed1998

Treatment of patent ductus arteriosus by placement of two intravascular embolisation coils in a puppy.

A 14-week-old border collie with a history of exercise intolerance was confirmed to have a patent ductus arteriosus (PDA) from colour flow Doppler echocardiography. Under general anaesthesia, angiography was performed to gauge accurately the width of the ductus, and then two intravascular embolisation coils were introduced into the ductus via percutaneous catheterisation of the femoral vein. The coils were both 8 mm in diameter, each with four loops. This led to an immediate disappearance of the murmur. Some slight residual flow was detected at the time of the procedure by angiography, but by 10 days postoperatively there was no PDA flow detectable. The time taken to complete the procedure was 55 minutes, with a total fluoroscopy time of 15 minutes. Placement of intravascular embolisation coils represents a viable alternative to traditional surgical methods of ductus closure.

Animals↗
PubMed1998

Absence of lysozyme (muramidase) in the intestinal Paneth cells of newborn infants with necrotising enterocolitis.

AIM: To determine immunocytochemically whether preterm and newborn infants with necrotising enterocolitis (NEC) show differences in numbers of lysozyme positive Paneth cells compared with normal controls, and to relate the findings to the possibility that lysozyme deficiency may facilitate the bacterial infections thought to be associated with this condition. METHODS: Tissues from 10 infants with NEC and from 11 matched controls were sectioned and stained immunocytochemically for lysozyme. Differences in the numbers of Paneth cells and degree of lysozyme positivity in the tissues were assessed. RESULTS: Tissues from NEC patients showed no, or very few, lysozyme positive Paneth cells, whereas controls showed strong positive staining. CONCLUSIONS: A deficiency or developmental defect in Paneth cells, resulting in an absence of lysozyme, may render the intestine more susceptible to bacterial infection, allowing organisms to adhere and translocate across the mucosa. Such enhancement of infection may contribute to the pathogenesis of NEC.

Bacterial Infections↗
PubMed1998

Social heterogeneity in smoking among African Americans.

OBJECTIVES: This study assessed the effects of sociodemographic variables on the smoking behavior of African Americans. METHODS: Data for 14,397 African-American respondents (18-64 years old) to the National Health Interview Survey in the years 1990 through 1993 were examined in multivariate models. RESULTS: Age was the strongest predictor of smoking, and men were at least 1.75 times as likely as women to be smokers (P < .001). CONCLUSIONS: The Year 2000 goal of an 18% prevalence rate among African-American adults may not be attained without major community interventions focusing on male and middle-aged African Americans.

Adolescent↗
PubMed1998

Partial regression in primary carcinoma of the lung: does it occur?

AIMS: To study immunohistochemically a group of 28 primary lung cancers which demonstrated histological features reminiscent of those characteristic of regression in malignant melanoma, to determine the phenotype of their immune cell infiltrates. METHODS AND RESULTS: Using a standard s-ABC immunoperoxidase method then quantification by the Leica Q500 MC image analyser, the cellular infiltrate in these tumours, when compared to 67 control cases, showed excess CD3 + T lymphocytes (P < 0.007), with an increase in CD4:CD8 ratio and increased CD68 + macrophages (P = 0.00001). CD57 + natural killer cells and S100 + Langerhans cells were also increased, but not quite significantly (P = 0.048 and P = 0.072, respectively). CONCLUSIONS: This immunophenotype resembles that shown in regressing skin malignancies and suggests a similar process occurring in lung cancer. Regressing lung cancers are associated with a better prognosis than matched controls (P = 0.0034), some showed radiological evidence of growth retardation and the group had an excess of the large cell undifferentiated histological type.

Antigens, CD↗
PubMed1998

Cigarette smoking in Connecticut: home and workplace exposure.

Estimates of smoking prevalence, environmental tobacco smoke exposure patterns, and the effect of sociodemographic variables were obtained from a telephone survey of 596 randomly selected adults in Connecticut, aged 18 or older. Results of this study indicate that 21.5% of respondents smoked cigarettes, and the smoking prevalence of men was almost twice the rate of women. Smokers were disproportionately represented in lower education, income, and occupational status categories. Approximately 60% of respondents stated they do not allow smoking in their homes. Environmental tobacco smoke exposure in the home was inversely related to age, (OR = .12, P < .01) and education (OR = .23, P < .05). Persons employed in crafts, trades, or general labor occupations were three times (P = .01) more likely to work in places which allowed smoking. Although Connecticut ranks among the top 10 states with the lowest cigarette smoking prevalence rates, continued antismoking efforts targeting lower socioeconomic groups will likely further reduce smoking and environmental tobacco smoke among adults and children.

Adolescent↗
PubMed1998

Birth weight of US biracial (black-white) infants: regional differences.

OBJECTIVE: The study examined the prevalence of low birth weight among biracial infants of black and white parents, by region of the United States. METHODS: Using the national linked live birth-death infant file for 1991, low birth weight (<2,500 g) was examined among 50,980 biracial singleton infants according to parental race (black mother-white father vs. white mother-black father). RESULTS: Nationally, the rate of low birth weight was 31% higher in the black mother-white father group (8.4%) than in the white mother-black father group (6.4%). The difference was smaller in the Northeast, reflecting a high rate (9.8%) for biracial infants of Puerto-Rican white mothers. The difference in the West was larger (75%), due to both a high rate in the black mother-white father group (9.1%) and a low rate for the white mother-black father group (5.2%), and persisted after controlling for parental education and a variety of maternal risk factors. CONCLUSIONS: Further studies are needed to identify the maternal factors involved in the regional differences in the prevalence of low birth weight among biracial infants.

Adult↗