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Biomedical subjects

I S Jones

Publications and source records attributed to I S Jones.

At least 19 recordsLinked to original sources
PubMed1995

Rehabilitation of a child with partial unilateral cryptophthalmos and multiple congenital anomalies.

PURPOSE: This paper describes the surgical rehabilitation of a child with craniofacial anomalies, unilateral syndactyly, and partial unilateral cryptophthalmos associated with inferior colobomata of the iris and optic nerve and agenesis of the inferior rectus and inferior oblique muscles. The clinical presentation of cryptophthalmos is described. METHODS: The medical literature since the original description of cryptophthalmos in 1872 was reviewed to define patterns of inheritance and the incidence of associated anomalies. RESULTS: Including this patient, 149 case reports of cryptophthalmos were identified. In two families transmission from parent to child suggests dominant inheritance. None of the five dominant cases had any other anomalies, and all had bilateral complete cryptophthalmos. The incidence of cryptophthalmos in the remaining families is consistent with autosomal recessive inheritance. This group includes patients with bilateral, unilateral, and partial cryptophthalmos. Other anomalies are common, including those of the ear and nose, limbs, genitourinary system, and mouth and palate. Mortality in the perinatal period is associated with renal agenesis, laryngeal atresia, and pulmonary hypoplasia. CONCLUSIONS: Cryptophthalmos is a rare congenital anomaly with two patterns of inheritance.

Abnormalities, Multiple↗
PubMed1995

Laparoscopic assisted vaginal hysterectomy: an audit plus a word of caution.

Laparoscopic assisted vaginal hysterectomy (LAVH) performed in 109 cases has been reviewed. In this series the mean operative time was 89 minutes and mean inpatient hospitalization was 3.7 days. Throughout the review, 6 patients were considered to have major complications and each is discussed. The association of previous caesarean section and bladder damage is noted. LAVH widens the indications available for vaginal hysterectomy in younger women in whom the abdominal approach would previously be indicated, but extra caution is advised when this technique is first introduced to a gynaecological service.

Adult↗
PubMed1995

The effect of passenger load on unstable vehicles in fatal, untripped rollover crashes.

Consumers may be unaware of the risk of rollover crashes posed by passenger loads in vehicles with poor roll stability. This analysis demonstrates that certain sports utility vehicles and small pickup trucks have designs that are so unstable that the weight of the passengers in the vehicle affects its propensity to roll over. This effect occurs even though the weight of the loaded vehicle is less than the manufacturer's gross vehicle weight rating. The risk of a fatal, "untripped" rollover crash in vehicles with low roll stability is increased as each passenger is added to the vehicle load.

Accidents, Traffic↗
PubMed1994

Quality assurance applied to laparoscopically assisted vaginal hysterectomy: a pilot study.

The aim of this quality assurance pilot study was to compare and contrast aspects of hysterectomy for benign conditions using different surgical techniques. Laparoscopically assisted vaginal hysterectomy was compared with abdominal hysterectomy in a private practice setting and was then compared with Browne and Frazer's study of vaginal hysterectomy. Laparoscopic hysterectomy was found to be more costly than abdominal hysterectomy but clients had a reduced hospital stay and earlier return to full activities. The cost of disposable instruments was a major concern and the rationale for their use is questioned. The outcomes and resource allocation implications of the alternatives are considered.

Adult↗
PubMed1992

Radiation retinopathy: electron microscopy of retina and optic nerve.

A 4 1/2 year old female was treated for embryonal rhabdomyosarcoma of the left orbit in 1975 with radiation (59.5 Gy in 5 weeks), followed by chemotherapy. An electroretinogram (ERG) in March, 1988 revealed cone responses 3% of normal and no rod responses in the left eye, and normal responses in the right eye. The eye was enucleated in April 1988. In the fovea no choroidocapillaris was seen at the intact Bruch's membrane, and the pigment epithelium was preserved only in small patches. No photoreceptor cells were seen in the areas devoid of pigment epithelial cells. The parafoveal and peripheral (30 degrees eccentricity) retina was better preserved. The thickness of the layer of rods and cones and of Henle's fiber layer was reduced. Very few outer segments were present. Macrophages had invaded the retinal tissue in moderate numbers. The retinal vessels were ensheathed by several layers of collagen fibrils. The spatial densities of pigment epithelial, cone, rod, and bipolar cells had been reduced. The optic nerve contained a total number of 1,022,000 nerve fibers.

Child, Preschool↗
PubMed1991

Sodium and volume dysregulation after apparently normal pregnancy is suggested by abnormal levels of atrial natriuretic peptide, renin and aldosterone.

1. Plasma atrial natriuretic peptide (ANP), renin activity, aldosterone, sodium, potassium and serum total protein and albumin during and after 14 normal pregnancies were compared with age-matched controls. 2. None developed toxaemia and all delivered healthy babies. 3. During pregnancy, plasma renin activity and aldosterone were significantly (P less than 0.01) higher and potassium, total protein and albumin significantly lowew (P less than 0.01) than in controls, while ANP was not different from the control level. 4. At 6-13 weeks postpartum, a significant (P less than 0.01) suppression of renin and aldosterone was accompanied by significant (P less than 0.01) elevation of atrial natriuretic peptide when compared with controls. 5. The hormonal changes are consistent with 'effective plasma volume' reduction during pregnancy and persistent volume expansion after pregnancy, perhaps due to a renal glomerular lesion sustained late in pregnancy. In contrast, levels of potassium, total protein and albumin are consistent with haemodilution during pregnancy and its correction postpartum. 6. Measurements available in seven women 40-120 weeks postpartum showed normal renin and aldosterone levels in most, but ANP was still elevated. 7. Pregnancy may have a protracted effect on volume regulation.

Adult↗
PubMed1989

Defective equipment and tractor-trailer crash involvement.

The role of defective equipment in large truck crashes on interstate highways in Washington State was investigated using a case-control study design. For each large truck involved in a crash, three trucks were randomly selected from the traffic stream at the same time and place as the crash, but one week later both crash and comparison trucks were inspected by Commercial Vehicle Enforcement officers of the Washington State Patrol. The effects of truck equipment condition, truck operating characteristics (carrier type, carrier operation, and truck load), and driver characteristics (driver age, hours of driving) on crash involvement were analyzed by comparing their relative frequency among crash-involved and comparison sample tractor-trailers. A logistic regression model was used to estimate the adjusted odds ratio for each factor. Overall, 77% of tractor-trailers in crashes and 66% of those not involved in crashes had defective equipment warranting a citation. Forty-one percent in crashes had defective equipment warranting taking the truck out of service, and 31% not in crashes had these defects. Brake defects were the most common type and were found in 56% of tractor-trailers in crashes; steering equipment defects were found in 21%. The relative risk of crash involvement for trucks with brake defects was about one and one-half times that for trucks without brake defects. For trucks with steering defects, the relative risk of crash involvement was at least twice that for trucks with steering defects, the relative risk of crash involvement was at least twice that for trucks without defects, and the risk increased substantially for trucks with out-of-service steering defects.

Accidents, Traffic↗
PubMed1989

Trauma triage: vehicle damage as an estimate of injury severity.

Field triage of injured patients has the objective of rapid identification of that 5-10% with injuries serious enough to pose a risk to life. The process requires not only the identification of patients with abnormal physiology, but also those whose physiology is normal despite the fact that significant anatomic injury may exist. This paper defines relationships by which vehicle damage information available at the accident may augment the physiologic measures used for triage decisions. Vehicle velocity changes of 20 m.p.h. or more in direct frontal collisions, 22 m.p.h. or more in offset frontal collisions, and 15 m.p.h. or more in side impacts captured 90% of the patients with Injury Severity Scores of 16 or greater. The amount of vehicle damage observed with these velocity changes was found to be 20 inches of crush in direct frontal collisions, 28 inches of crush in offset frontal collisions, and 15 inches of damage in side impacts. Incorporating these findings into triage of trauma patients who exhibit normal vital signs at the accident scene may provide a more structured basis for field triage.

Accidents, Traffic↗
PubMed1988

Predicting injury risk with "New Car Assessment Program" crashworthiness ratings.

The relationship between crashworthiness ratings produced by the National Highway Traffic Safety Administration's (NHTSA's) New Car Assessment Program (NCAP) and the risk of incapacitating injury or death for drivers who are involved in single-car, fixed-object, frontal collisions was examined. The results are based on 6,405 such crashes from the Motor Vehicle Traffic Accident file of the Texas Department of Highways and Public Transportation. The risk of injury was modeled using logistic regression taking into account the NCAP test results for each individual model of car and the intervening effects of car mass, age of the driver, restraint use, and crash severity. Three measures of anthropometric dummy response, Head Injury Criterion (HIC), Chest Deceleration (CD), and femur load were used to indicate vehicle crash test performance. The results show that there is a significant relationship between the results of the NCAP tests and the risk of serious injury or death in actual single-car frontal accidents. In terms of overall injury, chest deceleration was a better predictor than the Head Injury Criterion. For restrained drivers, crash severity, driver age, and chest deceleration were significant parameters for predicting risk of serious injury or death; the risk of injury decreased as chest deceleration decreased. The results were similar for unrestrained drivers although vehicle mass and femur load were also significant factors in the model. The risk of overall injury decreased as chest deceleration decreased but appeared to decrease as femur load increased.

Accident Prevention↗
PubMed1988

Crash involvement of large trucks by configuration: a case-control study.

For a two-year period, large truck crashes on the interstate system in Washington State were investigated using a case-control method. For each large truck involved in a crash, three trucks were randomly selected for inspection from the traffic stream at the same time and place as the crash but one week later. The effects of truck and driver characteristics on crashes were assessed by comparing their relative frequency among the crash-involved and comparison sample trucks. Double trailer trucks were consistently overinvolved in crashes by a factor of two to three in both single and multiple vehicle crashes. Single unit trucks pulling trailers also were overinvolved. Doubles also had a higher frequency of jackknifing compared to tractor-trailers. The substantial overinvolvement of doubles in crashes was found regardless of driver age, hours of driving, cargo weight, or type of fleet. Younger drivers, long hours of driving, and operating empty trucks were also associated with higher crash involvement.

Accidents, Traffic↗
PubMed1984

Levamisole as adjuvant to chemotherapy of ovarian cancer. Results of a randomized trial and 4-year follow-up.

The results of a randomized trial, stratified according to age and stage of disease, in 140 patients with ovarian cancer are presented. The drug, levamisole, or a placebo was given as adjuvant to cytotoxic chemotherapy for 12 months after maximal surgical reduction of tumor. Because of severe side effects, levamisole treatment was discontinued in 8 of 69 patients (marked neutropenia in 5, severe skin rashes in 3). There were no significant differences in the survival curve and mean duration of survival between levamisole-treated and placebo-treated groups during the 4 years of follow-up, except for patients with Stage II disease. Among these latter patients, the survival rate became progressively much lower in the levamisole-treated group and the difference reached statistical significance after the second year of follow-up (P less than 0.01). In view of the inconclusive evidence that levamisole provides a beneficial effect (in fact, there is concern of a deleterious effect) and the serious side effects, the drug should not be used in patients with ovarian cancer.

Adjuvants, Immunologic↗
PubMed1984

A prospective study of 413 consecutive car occupants with chest injuries.

A 3-year prospective study of road traffic accidents was performed in Oxfordshire by a combined team of surgeons and engineers. This liaison permitted the identification of injury sources and allowed the accurate comparison of injuries with collision severity. This was measured using the velocity change of the occupant's vehicle during the impact and was calculated using the CRASH 2 computer programme. It was shown that the pattern of chest injury varied with the direction of impact and the severity was related to the velocity change. Seatbelt use resulted in a reduction in injury severity and also modified the pattern of injuries sustained.

Accidents, Traffic↗
PubMed1984

Sister chromatid exchange induced by X-irradiation of retinoblastoma lymphocytes.

Lymphocyte cultures were employed to assess the degree of spontaneous and induced chromosomal fragility in retinoblastoma. Sister chromatid exchange (SCEs) were scored in metaphases. Three unilateral, three bilateral, eleven family members and controls were studied. Retinoblastoma (RB) lymphocytes did not exhibit increased spontaneous fragility. X-irradiation (25-200 rad) did not significantly increase SCE in unilateral retinoblastoma lymphocytes when compared with controls (P greater than 0.50). However, bilaterally affected subjects and three unaffected relatives demonstrated a statistically significant increase in SCE (P less than 0.01). In conclusion, hereditary retinoblastoma lymphocytes appear more radiosensitive than sporadic retinoblastoma, perhaps, reflecting the increased second malignancies in germinal mutation retinoblastoma. In addition, the analysis of radiation-induced SCE in peripheral blood lymphocytes of RB patients and family members may provide a valuable tool increasing the accuracy of genetic counseling for this disorder. Additional studies of RB patients and families are needed to assess the relevance of this approach to genetic counseling.

Adolescent↗
PubMed1983

Ocular and oculodermal melanocytosis associated with uveal melanoma.

Fifteen patients with ocular or oculodermal melanocytosis were found after reviewing 1210 cases of histologically proven uveal melanomas. The melanoma in each of these patients developed in the eye affected with ocular or oculodermal melanocytosis and not in the unaffected eye. In the one case of bilateral involvement with oculodermal melanocytosis, the patient developed the melanoma in the eye more affected with melanocytosis. In the only case of partial ocular melanocytosis, the melanoma developed in a sector of the eye affected with melanocytosis. A comparison of the prevalence of ocular or oculodermal melanocytosis in patients with uveal melanoma with the prevalence of ocular or oculodermal melanocytosis in the general population, implies that there is an increased incidence of uveal melanomas in patients with ocular or oculodermal melanocytosis.

Adolescent↗