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Biomedical subjects

J B Scott

Publications and source records attributed to J B Scott.

At least 19 recordsLinked to original sources
PubMed2005

A laboratory and clinical evaluation of single-use instruments for tonsil and adenoid surgery.

OBJECTIVES: To compare the quality and consistency of single-use adenotonsillectomy instruments available in the UK with reusable instruments and examine their performance in a clinical setting. DESIGN: A laboratory assessment of each reusable instrument created a detailed specification for the respective single-use equivalent. A surveillance system monitored the performance of a selected set of specified single-use instruments. SETTING: Single-use instruments were withdrawn shortly after their introduction in 2001. Persisting concerns from the Spongiform Encephalopathy Advisory Committee led to an investigation into the feasibility of continuing to use such instruments. MAIN OUTCOME MEASURES: The numbers of instruments from each set judged as unacceptable or as good as the original. The number and cause of instrument failure during clinical surveillance. RESULTS: Between 40% and 93% of the instruments on each set were as good as the original and between 0% and 40% of the instruments were unacceptable from six sets of steel and one set of polymer instruments. 4151 procedures were monitored between 1 February 2003 and 31 March 2004 using a total of 41 376 instruments. Problems were reported with 335 (0.8%) instruments, 46% attributable to instrument design, 14% to poor design control and 13% to instruments escaping quality control systems. Following correction of the faults, between 1 January 2004 and 31 March 2004 the problem rate fell to 0.4%. CONCLUSIONS: High quality single-use instruments for tonsil and adenoid surgery are available in the UK. Some companies offered inferior instruments not fit for their purpose. The procurement, introduction and subsequent clinical approval of single-use instruments requires a radically different approach to that currently applied to the purchase of reusable surgical equipment. Careful monitoring of their introduction is essential.

Adenoidectomy↗
PubMed1999

Surgical treatment and long-term outcome of ferrets with bilateral adrenal tumors or adrenal hyperplasia: 56 cases (1994-1997).

OBJECTIVE: To determine signalment, clinical signs, concurrent diseases, response to surgical treatment, and long-term outcome of ferrets with bilateral adrenal tumors or adrenal hyperplasia. DESIGN: Retrospective study. ANIMALS: 56 ferrets with bilateral adrenal tumors or adrenal hyperplasia confirmed histologically following subtotal bilateral adrenalectomy. PROCEDURE: Medical records of all ferrets with bilateral adrenal tumors or hyperplasia examined between 1994 and 1997 were reviewed. Ferrets underwent a subtotal bilateral adrenalectomy or a unilateral adrenalectomy initially, followed by a unilateral subtotal adrenalectomy when tumors or hyperplasia later developed on the contralateral adrenal gland. A long-term follow-up of a minimum of 18 months after final adrenal gland surgery was obtained by examination of medical records and follow-up telephone conversations. RESULTS: Clinical signs of hyperadrenocorticism included bilaterally symmetric alopecia, return to male sexual behavior in castrated male ferrets, or swollen vulva in spayed female ferrets. Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy (or unilateral adrenalectomy followed by contralateral unilateral subtotal adrenalectomy) was effective with a mortality rate of < 2%. Only 3 (5%) ferrets required glucocorticoid or mineralocorticoid replacement following subtotal bilateral adrenalectomy. Recurrence after bilateral adrenalectomy was 15% with a mean long-term follow-up period of 30 months. CONCLUSIONS AND CLINICAL RELEVANCE: Bilaterally symmetric alopecia, return to male sexual behavior in castrated male ferrets, or swollen vulva in spayed female ferrets are indicative of adrenal tumors or adrenal hyperplasia in ferrets. Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy is effective, with a low rate of complications and postoperative recurrence rate.

Adrenal Gland Neoplasms↗
PubMed1999

Improved efficacy of calculus removal in furcations using ultrasonic diamond-coated inserts.

Dentsply Cavitron Diamond Inserts provide improved efficacy in removing calculus from furcations. A total of 60 extracted human mandibular molar teeth had artificial calculus applied to the furcations, then were randomly treated with either sharp universal Gracey curettes (HAND), a plain ultrasonic TFI-10 tip in a cavitron instrument (CAV), or one of 2 diamond-coated cavitron instruments (TFI-10 fine-grit (FIN) and TFI-10 medium-grit (MED)) When the time needed to completely clean the furcations was evaluated, MED was the fastest, followed by FIN, CAV, and HAND, respectively. All of the powered instruments were faster than hand curettes with regard to effective in vitro calculus removal in furcations. The use of these types of instruments would reduce the time required to perform periodontal surgery and might improve regenerative therapy.

Dental Calculus↗
PubMed1998

Multi-center clinical evaluation of combination anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) as a bone replacement graft material in human periodontal osseous defects. 6-month results.

A synthetic cell-binding peptide (P-15) combined with anorganic bovine-derived hydroxyapatite bone matrix (ABM) was compared to demineralized freeze-dried bone allograft (DFDBA) and open flap debridement (DEBR) in human periodontal osseous defects in a controlled, monitored, multi-center trial. Following appropriate initial preparation procedures, flap surgery with defect and root debridement was performed. Three osseous defects per patient were treated randomly with one of three procedures after surgical preparation. Appropriate periodontal maintenance schedules were followed, and at 6 to 7 months re-entry flap surgery was performed for documentation and finalization of treatment. Analysis of variation (ANOVA) and t test analyses of patient mean values from 31 patients revealed that the combination ABM/P-15 grafts demonstrated significantly better mean defect fill of 2.8 +/- 1.2 mm (72.3%) versus a mean defect fill of 2.0 +/- 1.4 mm (51.4%) for defects treated with DFDBA (P <0.05) and a mean defect fill of 1.5 +/- 1.3 mm (40.3%) (P <0.05) for defects treated with DEBR. Other hard tissue findings showed similar clinically superior results with the use of ABM/P-15. Relative defect fill results showed 87% positive (50% to 100% defect fill) responses with ABM/P-15, 58% positive responses with DFDBA, and 41% positive responses with DEBR. There were 8 to 9 times more failures (minimal response) with DFDBA and DEBR (26% to 29% frequency) than with ABM/P-15. Soft tissue findings showed no significant differences among treatments except for greater clinical attachment level gain with ABM/P-15 compared to DEBR. These results suggest that the use of the P-15 synthetic cell-binding peptide combined with ABM yields better clinical results than either DFDBA or DEBR. Further studies are needed to determine the relative roles of the ABM and/or the P-15 in these improved results.

Adult↗
PubMed1997

Clinical evaluation of the speed and effectiveness of subgingival calculus removal on single-rooted teeth with diamond-coated ultrasonic tips.

Several studies have found incomplete calculus removal during periodontal treatment with traditional hand curets, sonic, and ultrasonic instruments. This study evaluated the speed and effectiveness of subgingival calculus removal with new diamond-coated ultrasonic tips on single-rooted teeth. Single session subgingival scaling and root planing was performed on 80 teeth with 5 to 12 mm probing depths in 15 patients. Each patient provided groups of 4 teeth that were randomly treated with either hand curets (HAND); standard smooth ultrasonic tip (US); or fine grit (FINDIAM) or medium grit (MEDDIAM) diamond-coated ultrasonic tips. The time taken to reach the therapeutic endpoint of a clean, smooth root surface in a defined region on each tooth with each instrument by the 3 therapists with differing experience levels was recorded. The teeth were then atraumatically extracted, stored in a surfactant, photographed at 10X, and the percent of calculus present in the area of the pocket or on a comparable control surface calculated by histometric point counting. ANOVA and paired t tests showed that mean percent remaining calculus on treated versus control surfaces was HAND 4.6 +/- 5.3 versus 57.5 +/- 28.2, US 4.7 +/- 6.4 versus 54.4 +/- 25.9, FINDIAM 4.3 +/- 5.2 versus 37.5 +/- 22.1, and MEDDIAM 3.4 +/- 4.2 versus 50.7 +/- 20.1, respectively (all P < 0.01). The mean time in seconds to reach the clinical endpoint ranged from HAND 289 +/- 193, US 194 +/- 67, FINDIAM 167 +/- 71, to MEDDIAM 147 +/- 92. All powered instruments were significantly faster than HAND (P < 0.05), but did not differ from each other. On a 0 = "smooth" to 3 = "rough" scale, most often HAND resulted in "smooth" surfaces (10/20), the powered tips of all types "slight" surface roughness (10/20 each), and US the most "moderate" roughness (7/20). There were no differences in percent calculus remaining, surface roughness, or time spent among the 3 treating clinicians despite their varying experience levels. The results of this study showed that percent calculus remaining was <5% with all the instruments given time ad libitum on a given root surface. Root roughness was generally slightly greater with all 3 powered tips. All of the powered instruments took significantly less time than the HAND. Both DIAM tips took less time than US. Diamond-coated ultrasonic tips appeared to be much more efficient than HAND or US in removing calculus in moderate-deep probing depths on single-rooted teeth in vivo.

Adult↗
PubMed1995

Clinical comparison of desired versus actual amount of surgical crown lengthening.

The actual length of clinically exposed tooth structure between planned restoration margin and alveolar crest ("biologic width") obtained during surgical crown elongation procedures was compared to the textbook goal of 3.0 mm. Sixteen (16) patients with 21 teeth requiring surgical crown lengthening for restoration placement participated. Oral hygiene instructions were given and optimal plaque control was mandatory. At each clinician's discretion, surgical techniques consisted of either gingivectomy or an apically positioned flap with and without osseous resection. Utilizing a reference stent, measurements were obtained at the facial, mesial-facial, lingual, and distal-lingual of the treated teeth both before and after osseous reduction. Parameters evaluated were gingival margin position, probing depth, mucogingival junction position, alveolar crest location, mobility, plaque index, and gingival index. These measurements were again recorded 8 weeks after surgery with the exception of alveolar crest. Statistical analysis with the paired t-test and linear correlation showed no significant change from baseline or among operators with varying experience in any of these parameters. Overall the results showed that the default objective of 3 mm between planned restoration margin and alveolar crest was not routinely achieved (mean 2.4 +/- 1.4 mm). The post-treatment distance from the planned restoration margin to the alveolar crest was greatest at the facial aspect of the teeth (mean 2.6 +/- 1.2 mm) and least at the distal-lingual (mean 2.2 +/- 1.7 mm). In addition, although more experienced periodontists removed a larger amount of bone, the amount of root surface exposed was still short of the initially desired biologic width.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed1994

Effectiveness of injectable filler materials for smoothing wrinkle lines and depressed scars.

Both synthetic and biological materials have been used for smoothing wrinkle lines and depressed scars. Injectable fillers provide a convenient and easy alternative to surgical methods to treat dermal defects. Optimally, injectable fillers augmenting dermal tissue should exhibit properties similar to the dermal collagen network, providing a stable matrix for long-term correction but also being subject to the dynamic changes that occur to dermal tissue during the aging processes. At present, only biological materials are available on a commercial basis, although a number of synthetic injectables are being evaluated in clinical trials. The long-term effectiveness of most commercial materials has been limited prompting questions about the cost-benefits of such treatment. In this regard, the effectiveness of the injectable fillers, particularly of biological materials, will be discussed as will the difficulties involved in determining the expected result (effectiveness) for specific materials and in providing methods of measuring effectiveness.

Adipose Tissue↗
PubMed1984

Effect of equilibration zones on stability, uniformity, and homogeneity profiles of vapors and aerosols in the ADG nose-only inhalation exposure system.

A commercially available, inexpensive, nose-only exposure chamber was modified to include removable equilibration zones, and the effect of these zones on chamber performance was determined. Since limited performance data were available concerning this unit, a more extensive characterization was performed. EPA limit concentrations (greater than or equal to 5 mg/liter) of toluene vapor or corn oil aerosol, and relatively low concentrations of uranine aerosol (less than or equal to 50 micrograms/liter) were produced by standard techniques. The presence or absence of equilibration zones did not affect the stability or uniformity of toluene vapor atmospheres, with the coefficient of variation (CV) not exceeding 3.33% in all experiments. In contrast, the presence of two equilibration zones was found to progressively enhance the uniformity of the inhalable test aerosols in the animal exposure zone (CV less than or equal to 3.16%). Matrix sampling revealed that in both uranine and corn oil experiments, the center matrix point concentration was consistently lower than samples taken in the actual animal breathing zone. Equilibration zones markedly reduced the difference between breathing zone and center point concentrations. These performance data indicated that the modified ADG nose-only exposure system performed exceptionally well with the materials that were studied. Results were comparable to those describing whole-body chamber performance. The ready availability of this inexpensive prototype lends itself to standardization of techniques between laboratories.

Aerosols↗
PubMed1983

Effects of brain hypoxia on pulmonary hemodynamics.

The effects of acute brain hypoxia on pulmonary hemodynamics were investigated in anesthetized dogs with the vagus and carotid sinus nerves intact and cut. Following ligation of collateral vessels, brain hypoxia was induced by pumping arterial blood through a ventilated extracorporeal lung to the external carotid arteries for 5 min. In the intact-nerve group brain hypoxia caused no change in pulmonary and systemic vascular pressures and resistances. In the cut-nerve group brain hypoxia caused an increase in mean pulmonary artery, left atrial, pulmonary artery pulse, and mean aortic pressures. Cardiac output, dP/dt, central blood volume, and total peripheral resistance increased but pulmonary vascular resistance and lung extravascular thermal volume were unchanged. It is concluded that acute brain hypoxia does not increase pulmonary vascular resistance but may increase pulmonary blood volume resulting from increased left ventricular afterload.

Animals↗
PubMed1983

Effects of histamine on lung water and hemodynamics after beta-blockade.

The effects of 90 min intravenous histamine (10 micrograms base . kg-1 . min-1) with and without beta (propranolol)-receptor blockade on lung water and hemodynamics were studied. In anesthetized dogs cold 3% saline was used as the indicator to determine cardiac index, central blood volume, and lung extravascular thermal volume. Propranolol alone decreased stroke volume and cardiac index but increased central blood volume, total peripheral resistance, and mean pulmonary arterial and pulmonary arterial wedge pressures. Pulmonary vascular resistance, mean arterial pressure, and lung extravascular thermal volume were not changed. Histamine with propranolol further reduced stroke volume and cardiac index, whereas mean pulmonary arterial and pulmonary arterial wedge pressures returned to control values. Mean arterial pressure, central blood volume, and total peripheral resistance decreased, pulmonary vascular resistance increased, and lung extravascular thermal volume remained unchanged. In all experiments postmortem extravascular lung water-to-dry weight ratio was unchanged. We conclude that histamine does not increase lung water content and that beta-receptor blockade does not modify this response.

Adrenergic beta-Antagonists↗
PubMed1982

Local vasoactivity of oxygen and carbon dioxide in the right coronary circulation of the dog and pig.

1. Eight mongrel dogs were anaesthetized with sodium thiamylal and chloralose-urethane, ventilated, vagotomized and heparinized. Five Poland-China pigs were anaesthetized with sodium thiamylal and nitrous oxide, ventilated, vagotomized and heparinized. 2. Extracorporeal perfusion of the right coronary artery at constant pressure (100 mmHg) was instituted. A lung from a donor animal was interposed in the coronary perfusion circuit to effect changes in CO2 and O2 tensions in the coronary arterial blood while systemic blood gases were maintained at normal levels. 3. Local hypoxia (PO2 range 17-22 mmHg) produced a 25-75% decrease in coronary vascular resistance (P less than 0.05) and a 0-24% (not significant) decrease in right ventricular dP/dt. 4. Local changes in PCO2 over the range 8-105 mmHg were associated with a 17-58% decrease in coronary vascular resistance (P less than 0.05), a 19-24% decrease in right ventricular dP/dt (P less than 0.05) with no change in right ventricular end-diastolic pressure, and a 1-18% (not significant) decrease in heart rate. 5. These studies suggest that local decreases in O2 or increases in CO2 tensions produce decreases in right coronary vascular resistance that are in the opposite direction to those that would be expected from the observed changes in heart rate and contractility (two primary determinants of myocardial oxygen consumption). 6. These data support the hypothesis that CO2 and O2 are locally vasoactive in the coronary circulation.

Animals↗
PubMed1982

Central blood volume and lung extravascular thermal volume in dogs with dirofilariasis.

Central blood volume, lung extravascular thermal volume, cardiac output, and pulmonary and systemic vascular pressures were measured in clinically normal and heartworm-infected dogs. Central blood volume and cardiac output were significantly (P less than 0.05) decreased in heartworm-infected dogs compared with the in normal dogs. Pulmonary vascular resistance, total peripheral resistance, mean pulmonary artery, pulmonary artery wedge, and pulse pressures were significantly increased in heartworm-infected dogs compared with that in normal dogs. Significant differences between normal and heartworm-infected dogs were not found in lung extravascular thermal volume, pulmonary extravascular tissue weight, or extravascular lung water to extravascular dry-weight ratio. Lung extravascular thermal volume overestimated gravimetric pulmonary extravascular tissue weight by approximately 16%. A significant correlation (R = 0.83) existed between pulmonary extravascular tissue weight and lung extravascular thermal volume for all dogs.

Animals↗
PubMed1981

Vascular response of the chicken hindlimb to vasoactive agents, asphyxia, and exercise.

Previous studies in live chickens have measured heart rate, blood pressure, and cardiac output during drug administration or asphyxia and made assumptions concerning the peripheral vasculature. The present study employs a constant-flow, isolated hindlimb perfusion technique to measure directly changes in skeletal muscle vascular resistance induced either by local intra-arterial (i.a.) bolus, or continuous i.a. infusion, of various vasoactive substances. Prostaglandin E1 (0.5 microgram, bolus) produced arteriolar vasodilation lasting 10 min, as indicated by a fall ian perfusion pressure. Bolus injection of histamine (10 microgram diphosphate) or adenosine (5 and 10 microgram) produced vasodilation of less than 2-min duration. Theophylline infusion (5 microM infused at 1 mL/min, i.a.) blocked the effect of adenosine. Norepinephrine (1 microgram) produced vasoconstriction which was reduced 60% by systemic alpha-adrenergic blockade with phenoxybenzamine (7.5-10 mg/kg). Tracheal occlusion produced intense vasoconstriction which was reduced 70% by alpha-adrenergic blockade. Electrical stimulation of the peripheral end of the cut sciatic nerve (6 Hz) produced an immediate vasodilation lasting several minutes.

Acetylcholine↗
PubMed1981

Vascular and hematologic effects of hemorrhage in the chicken.

Chickens have been reported to have a rate of posthemorrhagic fluid mobilization twice that of mammals and lack a phase of shock irreversible to transfusion. In the present study we measured several hemodynamic and hematologic parameters in chickens subjected to sustained hemorrhagic hypotension. Total peripheral resistance was unaffected or fell slightly and skeletal muscle vascular resistance judged from changes in gastrocnemius resistance was not affected by hemorrhage. Blood compositional changes included a progressive hyperkalemia, hyperglycemia, and hemodilution as evidenced by linear falls in hematocrit, hemoglobin, and plasma total protein concentration. Plasma sodium and osmolality were unchanged, as were arterial pH and oxygen tension; however, there was a fall in carbon dioxide tension. These studies demonstrate that fluid mobilization in the chicken after hemorrhage does not require an increase in precapillary resistance and suggest that, because the chicken does not exhibit intense precapillary constriction, it is spared some of the deleterious effects of inadequate tissue perfusion. Thus, the findings tend to incriminate the peripheral action of the sympathetic nervous system as a major contributor to the development of irreversibility in other species.

Acid-Base Equilibrium↗