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Biomedical subjects

J Sim

Publications and source records attributed to J Sim.

At least 55 records · Page 3Linked to original sources
PubMed1998

Respect for autonomy: issues in neurological rehabilitation.

OBJECTIVE: To examine the ethical principle of respect for autonomy within the context of neurological rehabilitation. DISCUSSION: The nature of the principle of respect for autonomy is examined, and specific difficulties to which it may give rise in this area of practice are identified. These concern difficulties of communication with neurologically impaired patients, issues of competence related to patient decision-making, problems of consensus between patient and professional, and the role of the patient's family in the rehabilitation process. CONCLUSION: A number of strategies, based on a client-centred model of practice, are suggested which may counteract these difficulties and assist in respecting the patient's autonomy to the appropriate degree, while seeking to attain high-quality clinical outcomes.

Beneficence↗
PubMed1998

[Rheumatoid nodule diagnosed by thoracoscopy using flexible fiberoptic bronchoscope].

A 51-year-old man had been treated at a nearby hospital since 1993 for rheumatoid arthritis. Right pectoralgia developed in December 1994, and the patient consulted a nearby hospital, which detected right pleural effusion retention was pointed out on chest x-ray films. The patient was referred and admitted to our hospital. Rheumatic pleurisy was suspected because of a high serum rheumatoid factor(RF)level and high RF and high rheumatoid arthritis hemagglutination levels in the pleural effusion. However, due to a high adenosine deaminase level in the pleural effusion tuberculous pleurisy could not be ruled out. After drainage through a trocar catheter, the thoracic cavity was examined by thoracoscopy through the site of catheter insertion. As a result, sporadic bluish white nodular lesions were observed on the pleura. Granuloma formations presenting a palisade arrangement of giant cells were also observed, and pathologically diagnosed as rheumatoid nodules, thus providing the basis for a diagnosis of rheumatic pleurisy. Treatment with an increased dose of prednisolone achieved a rapid remission of the pleural effusion. Our experience underscored the usefulness of thoracoscopy as a means diagnosing of rheumatic pleurisy.

Anti-Inflammatory Agents↗
PubMed1997

Functional analysis of a conserved aspartate D218 in Cephalosporium acremonium isopenicillin N synthase.

Isopenicillin N synthase (IPNS) is instrumental in the catalytic conversion of a tripeptide precursor delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine to a bioactive intermediate isopenicillin N in the beta-lactam antibiotic biosynthetic pathway. It has recently been shown that this reaction is dependent on a conserved aspartate, D214, in a bacterial Streptomyces jumonjinensis IPNS. Thus, this study was carried out to provide the experimental evidence for the involvement of a similarly conserved aspartate residue, D218, in a fungal Cephalosporium acremonium IPNS (cIPNS). Initially, alteration of the aspartate residue to generate the mutant D218L cIPNS protein was achieved by site-directed mutagenesis. Subsequent enzyme assays indicated that the catalytic property of the mutant protein was lost, attesting to the need for the corresponding conserved aspartate to maintain IPNS functionality. It is also evident from the observed results that site-directed mutagenesis of this particular aspartate residue in cIPNS can affect its solubility. It is therefore important to take these potential changes into consideration when site-directed mutant proteins are analysed for catalytic function.

Acremonium↗
PubMed1997

Desensitization of the P2X(2) receptor controlled by alternative splicing.

P2X receptors are ion channels gated by extracellular ATP. We report here cloning of a P2X(2) receptor splice variant (P2X(2-2)) carrying a 207 bp deletion in the intracellular C-terminus and the analysis of the corresponding genomic structure of the P2X(2) gene. P2X(2-2) is as highly expressed as the original P2X(2) sequence in various tissues. ATP-activated currents mediated by heterologous expressed P2X(2) or P2X(2-2) receptors showed significant differences in desensitization time constants and steady-state currents in the continuous presence of ATP. These results imply functional differences between cells differentially expressing these P2X(2) isoforms.

Adenosine Triphosphate↗
PubMed1996

Attitudes and beliefs within the Sikh community regarding organ donation: a pilot study.

The current shortage of organs for transplantation is a matter of considerable concern in the United Kingdom (U.K.). Whilst issues of histocompatibility create particular problems in this respect for the Asian population in the U.K., it is sometimes suggested that there is also a resistance to the idea of organ transplantation among this community. To explore this issue, a small-scale interview study was conducted in Coventry among members of the Sikh community. A judgemental sample of 22 individuals, from different strata of the local Sikh community, were interviewed either in one-to-one interviews or in a focus group. These interviews had two broad aims: to determine the prevailing attitudes towards organ transplantation, and to gauge the impact and acceptability of the current Department of Health campaign literature. It was found that, whilst there were a number of misgivings to do with notions of mutilation and reincarnation, and anxieties as to technical or clinical aspects of the transplantation process, the prevailing view was supportive of transplantation, and organ donation was seen as a highly appropriate means of exhibiting the altruistic tradition within Sikhism. Such barriers that exist to the idea of transplantation seem to have more to do with knowledge and understanding than with cultural or religious factors. Concerning the campaign literature, informants identified a number of shortcomings, and indicated ways in which the impact of the leaflets and posters might be enhanced. Although the generalizability of these findings is limited, and despite possible threats to the validity of the data collected, this study has produced findings with significant implications for future policy in this area.

Ethnicity↗
PubMed1996

The admission of Asian patients to intensive therapy units and its implications for kidney donation: a preliminary report from Coventry, UK.

OBJECTIVE: To determine the relative admission rates of Asian and non-Asian patients to intensive therapy units (ITUs) in Coventry and to explore the implications of these rates for the transplantation of organs to Asian people. DESIGN: Examination of 1991 census data and a retrospective review of ITU admissions books. Data were collected on ethnic background, presenting diagnosis, and clinical outcome for each admission. SETTING: The three ITUs in Coventry. PATIENTS: All admissions to the ITUs from 1990-93 inclusive. RESULTS: Asian patients were admitted to ITUs disproportionately to their numbers in the Coventry population. Members of the Asian community were less than half as likely to be admitted to an ITU (p < 0.001) and more likely to die while there (p = 0.007) than members of the non-Asian population in Coventry. The proportions of patients referred to the transplant unit and the rates of subsequent donation do not seem to differ significantly for Asian and non-Asian patients (p = 0.26 in both cases). CONCLUSIONS: There are clear implications for the availability of cadaveric kidney transplantation to Asian patients, given that few kidneys from non-Asian donors are histocompatible with Asian recipients. Indeed, in Asians, promotion of living related donation may be more effective in countering the organ shortfall than efforts to increase consent to cadaveric transplantation. However, it may be valuable to investigate any patterns of morbidity or social or cultural factors that might explain the initial low admissions rates to ITUs for Asian patients.

Asia↗
PubMed1995

Use of denaturing gradient electrophoresis to determine the distributions of polymorphisms in entire genes in natural populations.

We show here that the method of genomic denaturing gradient electrophoresis (gDGGE) can be used to examine any gene that has been previously cloned and sequenced, and to detect and approximately localize within the gene the majority of its polymorphisms. By using pooled-DNA gDGGE, many different samples can be scanned on a single gel. Further, the patterns on the gels and results from sequencing of some of the alleles shows that a variety of different kinds of polymorphism, ranging from single base changes to more substantial allelic differences, can be distinguished. The extramacrochaetae (emc) gene of Drosophila melanogaster exhibits no polymorphism in its ORF that can be detected by this method, although a rearrangement polymorphism was detected in the 3' downstream region of the gene. The suppressor-of-hairless (Su(H)) gene of D. melanogaster, however, exhibits a variety of polymorphisms in its ORF. Some are small deletions or insertions in a glutamine-rich part of the gene product that would not have been detectable by ordinary screening methods. Many of the polymorphisms detected in this preliminary survey are likely to have an impact on the function of the Su(H) gene product.

Animals↗
PubMed1995

Optimizing conditions for the growth of Lactobacillus casei YIT 9018 in tryptone-yeast extract-glucose medium by using response surface methodology.

This study was undertaken to find optimum conditions of tryptone, yeast extract, glucose, Tween 80, and incubation temperature for the growth of Lactobacillus casei YIT 9018 and to assess the effects of these factors by use of response surface methodology. A central composite design was used as an experimental design for allocation of treatment combinations. A second-order polynomial regression model, which was used at first for analysis of the experiment, had a significant lack of fit. Therefore, cubic and quartic terms were incorporated into the regression model through variable selection procedures. Effects involving incubation temperature, yeast extract, glucose, and tryptone were significant, whereas the only significant effect involving Tween 80 was the interaction effect between temperature and Tween 80. It turned out that growth of L. casei YIT 9018 was most strongly affected by the incubation temperature. Estimated optimum conditions of the factors for growth of L. casei YIT 9018 are as follows: tryptone, 3.04%; yeast extract, 0.892%; glucose, 1.58%; Tween 80, 0%; incubation temperature, 35 degrees C.

Bacteriological Techniques↗
PubMed1995

Moral rights and the ethics of nursing.

This paper explores the nature of rights, and their implications for the ethics of nursing. A right is seen as an entitlement which is justified on moral and/or legal grounds, and which may take the form of a right of action or a right of recipience, or both; in either case, correlative duties are generally imposed on others. Some of the conflicts which can occur among two or more conflicting rights are examined through three hypothetical scenarios, and approaches to their resolution are suggested. The question of whether nurses, as nurses, possess rights is then considered, and it is suggested that they do not. In conclusion, it is argued that, if rights are to be a helpful concept, they must be carefully defined and analysed, and their relationship to one another, and to duties, must be clarified.

Beneficence↗
PubMed1994

Molecular mechanisms of resistance to heat and oxidative damage.

Spore heat resistance can be predicted within reasonable limits from knowledge of optimal growth temperature of the sporeformer, the temperature of sporulation, water content of the spore protoplast, cortex size, total mineralization and specific mineralization. The molecular mechanisms by which dehydration and mineralization act to stabilize spores against heat damage are unknown. A major need for further progress is to identify the principal targets for lethal damage. In this review the hypothesis was explored that heat killing may be related to oxidative killing. The proposed common denominator for the two is the formation of radicals able to react with, and irreversibly damage, spore polymers such as proteins or DNA.

Hot Temperature↗
PubMed1993

Measurement validity in physical therapy research.

This article considers the role of measurement validity within physical therapy research. The concept of measurement validity is identified as a component of internal validity, and it is differentiated from the notion of reliability; these concepts are related to systematic and random sources of error, respectively. Using examples from physical therapy and rehabilitation, four main types of validity are reviewed: face validity, criterion-related validity, content validity, and construct validity. The differing implications of these types of validity for quantitative and qualitative research are discussed. Three principal areas of concern are then addressed, based on a critical discussion of selected examples from the literature. First, it is argued that validity is often poorly distinguished from the allied concept of reliability and that purported claims for validity often only demonstrate reliability. Second, it is claimed that validity is too often neglected in favor of reliability, and specific examples relating to gait analysis are put forward to support this argument. Third, some of the methodological difficulties that may occur when attempts are made to demonstrate validity are considered. The article concludes with a plea for a closer focus on the issue of measurement validity within physical therapy research.

Bias↗
PubMed1993

Sports medicine: some ethical issues.

The ethical aspects of sports medicine have hitherto received little scrutiny, in contrast to its legal implications, which have recently been subject to much greater discussion. However, the differences that are apparent between sports medicine and 'mainstream' areas of clinical practice can shed new light on a number of the central issues within health-care ethics. By means of hypothetical case studies, this paper seeks to examine some of these issues within a sports medicine context. Specific attention will be paid to the concepts of autonomy and paternalism, issues to do with truthfulness, and the question of conflicting professional loyalties. It is suggested that the ethics of sports medicine warrant further and more detailed examination.

Adolescent↗