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Biomedical subjects

M L Jones

Publications and source records attributed to M L Jones.

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

The Ability Program: improving statewide access to assistive technology for adults with disabilities.

In 1995, the Kate B. Reynolds Charitable Trust awarded $2.4 million to support the Ability Program, a statewide initiative to improve awareness of and access to assistive technology for adult North Carolinians with disabilities. This coordinated effort resulted in 11 funded projects, each using a different approach to deliver assistive technology to persons in rural communities. An overall management, technical assistance, and evaluation program ensured coordinated use of the Trust's funds. This paper describes the development and implementation of the Ability Program in North Carolina, accomplishments of program grantees, and results of a comprehensive program evaluation system used to document process and outcome measures. After 2 years of operation, the type and extent of assistive technology services for adults with disabilities in North Carolina increased as a result of the Ability Program.

Activities of Daily Living↗
PubMed1998

Orthodontic reconstruction in a victim of murder.

Accurate comparison of ante-mortem photographs and the skull of a deceased person is dependent upon suitable superimposition techniques and a post-mortem dentition which is comparable to the situation obtaining in the individual at the time of death. The skull featuring in this case presented with a missing upper lateral incisor, lost after death, and the occlusion was studied enabling a replacement tooth to be provided and positioned as in life. Although no dental records were available, good quality photographs of a putative identity were compared by electronic superimposition and the restored occlusal characteristics of the skull were shown to accurately match the photographs of one possible victim. This evidence resulted in positive identification by a Coroner. This case illustrates the importance of seeking specialist clinical advice in forensic dental cases.

Adolescent↗
PubMed1998

An evaluation of the biomechanical response of the tooth and periodontium to orthodontic forces in adolescent and adult subjects.

This study was designed to quantify the magnitude of tooth mobility in adolescents and adults, and to investigate the differences in the biomechanical response of tooth and periodontium to orthodontic forces. The initial displacement of the maxillary central incisor was measured in 50 adolescent and fifty adult patients and the biomechanical properties of the periodontium were examined using the finite element method (FEM) and supporting experimental data. The magnitude of tooth mobility was significantly greater in the adolescent group than in the adult group. By integrating the differences in tooth mobility in both subject groups with analytical tooth displacements, the Young's modulus of the periodontal ligament (PDL) was demonstrated to be greater in the adults than in the adolescent subjects. The differing biomechanical properties of the PDL in adults were demonstrated to result in almost equivalent or somewhat increased stress levels in the PDL in adult subjects. It is suggested that this might produce a reduction in the biological response of the PDL and thus lead to a delay in tooth movement in adults.

Adolescent↗
PubMed1998

An organization-wide approach for an effective communication system, Part 1.

This two-part series provides a cogent discussion of designing and implementing an effective communication system, with a committee structure based on the Joint Commission on Accreditation of Health Care Organizations (JCAHO) functions. Part one includes the development and design using a systems approach. Part two, which will be published in the April 1998 issue of JONA, will address the evaluation of outcomes and implications of this communication system. The experiential learning gained from this process is illustrated by the analysis of themes that surfaced during the implementation.

Communication↗
PubMed1998

An organization-wide approach for an effective communication system, Part 2.

This is the second article in a two-part series that describes an organization's approach to designing, implementing, and evaluating a communication system. Part 1 of this series, published in the March 1998 issue, focused on the design and implementation of this system. This article addresses the evaluation of outcomes related to identified goals to improve communication flow and decision making on multiple levels and to promote accountability for clinical and operational performance. Implementation strategies involving change management, emergence of issues with related implications, and planned evolution of this system also are discussed for ongoing organizational performance improvement.

Hospital Bed Capacity, 500 and over↗
PubMed1998

An evaluation of a noninvasive method of assessing alveolar bone levels in an experimental model of cleft lip and palate.

OBJECTIVE: The purpose of this study was to evaluate an ultrasound mucous-membrane-thickness-measuring device as a noninvasive, nonionizing alternative to radiography in the assessment of alveolar bone grafting. DESIGN: This was a prospective experimental study on porcine cadaver models. METHOD: An ultrasound technique (Krupp SDM) was assessed ex vivo on three specially developed porcine cadaver models in comparison to radiography and ridge-mapping. Direct measurement of the mucosal thickness provided a standard for comparison. In each model, 30 measurement sites were identified for comparison of the techniques. RESULTS: All measurement techniques demonstrated clinically acceptable reproducibility. Of the clinical measurement techniques, radiography proved to be the most reliable, showing a small, nonsignificant statistical difference from direct measurement. Both the ultrasound technique and ridge-mapping showed significant tendencies to underestimate mucosal thickness that became greater with increasing mucosal thickness. At sites where mucosal thickness was less than 6 mm, the ultrasound technique underestimated mucosal thickness by 0.6 mm on average. At sites where mucosal thickness exceeded 6 mm, ultrasonic artifacts rendered the ultrasound technique unreliable. CONCLUSION: The ultrasound technique could prove to be a useful clinical adjunct to radiography in the assessment of alveolar bone grafts, but in this particular application, care should be taken when using it to assess deeper alveolar defects.

Alveolar Process↗
PubMed1997

Production of IL-5 and granulocyte-macrophage colony-stimulating factor by naive human mast cells activated by high-affinity IgE receptor ligation.

BACKGROUND: The late-phase allergic reaction is an eosinophilic inflammatory response that begins several hours after allergen exposure, may persist for 24 hours, and is an important pathogenic mechanism in allergic disease. OBJECTIVE: Cultured naive human mast cells were used to investigate whether mast cells are a direct source of the eosinophil-promoting cytokines IL-5, IL-3, and granulocyte-macrophage colony-stimulating factor (GM-CSF). METHODS: Naive human mast cells were derived from bone marrow mononuclear cells cultured in the presence of stem-cell factor. Cytokine message and protein production in response to high-affinity IgE receptor ligation of cultured mast cells were measured by semiquantitative polymerase chain reaction and ELISA, respectively. RESULTS: IL-5, IL-3, and GM-CSF messenger RNA increased within 2 hours of mast cell activation, with IL-5 and GM-CSF message remaining elevated for 24 hours, whereas IL-3 mRNA rapidly declined. IL-5 and GM-CSF protein were measurable 4 to 6 hours after stimulation and peaked by 24 and 12 hours, respectively. IL-3 protein was not detectable. CONCLUSION: These findings demonstrate that naive mast cells do not constitutively produce IL-5 or GM-CSF protein but are a major source of these eosinophilotropic cytokines on high-affinity IgE receptor ligation.

Base Sequence↗
PubMed1997

An analysis of the effects of ramp slope on people with mobility impairments.

A study was conducted to evaluate the usability of the range of ramp slopes allowed under the current ADA accessibility guidelines. One hundred seventy-one subjects of all ages and using different types of mobility aids traversed a 30-foot ramp varying in slope from 1:8 to 1:20. Data were recorded for pulse rate, energy expenditure, rate of travel, distance traveled, and the location of rest stops. Findings show that among all subjects only a few manual wheelchair users had difficulty traversing all 30 feet in ascent, even on slopes as steep as 1:8. Based on these results, changes to the technical requirements for ramp slope and length cannot be recommended at this time.

Adolescent↗
PubMed1997

Treatment strategies for lower third molars following orthodontic care.

To examine the extent to which orthodontists consider it appropriate to refer post-orthodontic patients for lower third molar treatment. The subjects were 10 orthodontists from hospital, specialist practice and community setting. Participants were presented with 15 case histories of orthodontic patients (including full records) and asked to state whether they would have referred the case to an oral surgeon for management of their third molars. Data were analysed using multi-kappa measure. Two-hundred-and-sixty-two decisions of 300 (88%) were not to refer cases for third molar management. Little consensus was seen between orthodontists on which post-orthodontic cases referral (kappa = 0.14). Some clinicians referred cases much more frequently than others (Kruskall-Wallis = 46.84, P < 0.001) and some clinicians referred much more frequently (Kruskall-Wallis = 85.57, P < 0.001). This group of orthodontists did not refer post-orthodontic cases for third molar management and little consensus was observed regarding which cases did warrant removal.

Adolescent↗
PubMed1997

Meeting the challenges of critical care obstetrics in today's health care system: collaborative education and practice strategies.

The transformation of health care in the United States necessitates developing creative strategies to provide quality and cost-effective care for the critically ill obstetric patient population. A discussion of the care of these patients is presented in a multidisciplinary framework, using a case study to illustrate the management process. The significance of contributions and collaboration of advanced practice nurses in perinatology and critical care in the care management of the critically ill obstetric patient is described. Such strategies as location of the patient and educational preparation for nurses caring for these complex patients are offered for consideration. Implications are described and recommendations are made for administrative and clinical practice.

Adult↗
PubMed1996

The role of P-selectin and ICAM-1 in acute lung injury as determined using blocking antibodies and mutant mice.

Cobra venom factor (CVF) induces lung injury through oxidant- and neutrophil-dependent mechanisms. Adhesion molecules, particularly L-selectin, P-selectin, CD11/CD18, and ICAM-1, are required for full expression of injury in rats. This study compared the roles of P-selectin and ICAM-1 using either mutant mice or blocking Abs. Mice deficient in either P-selectin, ICAM-1, or both adhesion molecules were compared with wild-type mice. Wild-type and single mutant mice were given Abs against murine P-selectin or ICAM-1. CVF was injected i.v., and neutrophil sequestration and extravascular albumin were measured 30 min later. Neither P-selectin, ICAM-1, nor P-selectin/ICAM-1 double mutants showed a reduction in neutrophil sequestration or lung injury when compared with wild-type mice. Anti-P-selectin Abs inhibited both sequestration and injury in wild-type mice by 57% and 60%, respectively, but had no effect in P-selectin mutants. Similar results were found using anti-ICAM-1 Ab in wild-type mice (78% inhibition of sequestration and 88% inhibition of injury) and ICAM-1 mutant mice (no reduction). These results suggest that the apparent role of these molecules in CVF-induced lung injury depends on the method used to block function. When studied using blocking Abs, both P-selectin and ICAM-1 were required for neutrophil sequestration and lung injury, while neither played a role singly or together when studied using mice with genetic deletions. Abs may inhibit neutrophil sequestration and lung injury through mechanisms other than simply adhesion blockade, or mutant mice may utilize alternative adhesion pathways.

Animals↗
PubMed1996

A computerised method of monitoring and assessing undergraduate clinical activity.

This article describes the development and use of an electronic data acquisition system for monitoring and assessing the clinical activity of undergraduate dental students. The advantages of such a system over a paper-based one is that it can generate reports quickly and easily, showing the variety of clinical experience gained by the undergraduates and an assessment of the level of skill displayed. It also relieves academic staff of the tedious, repetitive task of collecting and collating data by hand.

Clinical Competence↗
PubMed1996

Role for macrophage inflammatory protein-2 in lipopolysaccharide-induced lung injury in rats.

Macrophage inflammatory protein-2 (MIP-2) is a C-X-C chemokine that possesses chemotactic activity for neutrophils. Rat MIP-2 was cloned and expressed as a 7.9-kDa peptide that exhibited dose-dependent neutrophil chemotactic activity at concentrations from 10 to 250 nM. Rabbit polyclonal Ab to the 7.9-kDa peptide showed reactivity by western blot analysis and suppressed its in vitro chemotactic activity. Cross-desensitization chemotaxis experiments suggested that the chemotactic responses elicited by MIP-2 and the related chemokine, cytokine-induced neutrophil chemoattractant, may be mediated through a common receptor. Also, chemotactic responses to human GRO-alpha were blocked by exposure of human neutrophils to either GRO-alpha or rat MIP-2, suggesting conservation of this receptor-mediated response. After LPS instillation into rat lung, mRNA for MIP-2 was up-regulated in a time-dependent manner, peaking at 6 h. MIP-2 protein was detected in bronchoalveolar lavage fluids of these animals and a significant amount of chemotactic activity present in these fluids was attributed to MIP-2. On the basis of intrapulmonary instillation of Ab to MIP-2, neutrophil accumulation in lungs after airway instillation of LPS was found to be MIP-2-dependent. These data indicate that MIP-2 plays a significant role in LPS-induced inflammatory response in rat lungs and is required for the full recruitment of neutrophils.

Animals↗
PubMed1996

High-affinity inhibitors of dihydrofolate reductase: antimicrobial and anticancer activities of 7,8-dialkyl-1,3-diaminopyrrolo[3,2-f]quinazolines with small molecular size.

A series of 7,8-dialkylpyrrolo[3,2-f]quinazolines were prepared as inhibitors of dihydrofolate reductase (DHFR). On the basis of an apparent inverse relationship between compound size and antifungal activity, the compounds were designed to be relatively small and compact. Inhibitor design was aided by GRID analysis of the three-dimensional structure of Candida albicans DHFR, which suggested that relatively small, branched alkyl groups at the 7- and 8-positions of the pyrroloquinazoline ring system would provide optimal interactions with a hydrophobic region of the protein. The compounds were potent inhibitors of fungal and human DHFR, with K(i) values as low as 7.1 and 0.1 pM, respectively, and were highly active against C. albicans and an array of tumor cell lines. In contrast to known lipophilic inhibitors of DHFR such as trimetrexate and piritrexim, members of this series of pyrroloquinazolines were not susceptible to P-glycoprotein-mediated multidrug resistance and also showed significant distribution into lung and brain tissue. The compounds were active in lung and brain tumor models and displayed in vivo activity against Pneumocystis carinii and C. albicans.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1996

Regulatory effects of endogenous interleukin-1 receptor antagonist protein in immunoglobulin G immune complex-induced lung injury.

IL-1 receptor antagonist (IL-1Ra) has regulatory effects on IL-1 activity both in vitro and in vivo. In the IgG immune complex model of lung injury in rats, exogenously administered human IL-1Ra suppressed neutrophil recruitment and ensuing lung injury. In this study, we sought to determine if endogenous rat IL-1Ra might regulate this lung-inflammatory response. By Northern blot analysis of lung mRNA and Western analysis of bronchoalveolar lavage (BAL) fluids, rat IL-1Ra expression was found to increase during development of inflammation in IgG immune complex-mediated alveolitis. By immunostaining, alveolar macrophages and recruited neutrophils were the apparent sources of IL-1Ra. In vivo blocking of endogenous IL-1Ra resulted in a 53% increase in lung vascular permeability and a 180% increase in BAL fluid neutrophils. In companion studies, a significant increase in IL-1beta was found, whereas no significant change in TNF-alpha activity was observed. Whereas the in vivo regulatory effects of IL-1R appear to be limited to IL-1beta, IL-10 regulates both IL-1beta and TNF-alpha in this model, reflected by a 48% increase in BAL IL-1beta in rats treated with anti-IL-10. These findings suggest that IL-1Ra is an intrinsic regulator of inflammatory injury after deposition of IgG immune complexes and that it regulates production of IL-1beta.

Alveolitis, Extrinsic Allergic↗