Cytodiagnosis in bronchial carcinoma.
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Bronchoscopy↗
Biomedical subjects
M Walton
Publications and source records attributed to M Walton.
Absorbable and metal interference screws: comparison of graft security during healing.
Anterior cruciate ligament replacement was performed on 71 sheep to compare graft security using a titanium or an absorbable polyglyconate interference screw (Acufex, Mansfield, MA) to hold the bone-patellar tendon-bone autograft. Early self mobilization was followed later by retrieval of most specimens up to 12 weeks. No grafts failed in vivo or migrated within the bone tunnel. Failure strengths of femur-graft-tibia preparations held by absorbable screws were lower initially but at no time were they statistically different to those held by metal screws. By 4 weeks, fibrous union between the graft tendon and tunnel wall led to no difference in failure strength if the screw was present or removed before measurement. Histologically, ossific incorporation of the graft bone was not evident until 6 weeks. A mild tissue reaction occurred around the absorbable screw. In the 2 12-month specimens, the polyglyconate had been largely replaced by fibrous tissue. Overall, the absorbable screw performed to a level comparable to the metal screw.
Absorbable Implants↗
Post-suspension hypotension is attenuated in Sprague-Dawley rats by prostacyclin synthase inhibition.
Cardiovascular deconditioning, sometimes manifested in astronauts during standing postflight, may be related to the impairment of autonomic function and/or excessive production of endothelium-dependent relaxing factors. In the present study, we examined the cardiovascular responses to 7-day 30 degrees tail-suspension and a subsequent 6-h post-suspension period in conscious male Sprague-Dawley rats to determine the role of prostacyclin in the observed post-suspension reduction in mean arterial pressure (MAP). The specific prostacyclin synthase inhibitor U-51605 (0.3 mg/kg), or saline, was administered intravenously prior to release from suspension and at 2 and 4 h post-suspension. During 7 days of suspension, MAP did not change, however, there was a post-suspension reduction in MAP which was associated with significant increases in plasma prostacyclin and nitric oxide. U-51605 attenuated the observed post-suspension hypotension and reduced plasma prostacyclin levels, but not nitric oxide levels. The baroreflex sensitivity for heart rate was modified by U-51605: increased MAP threshold and effective MAP range. Thus, the post-suspension reduction in mean arterial pressure may be due to overproduction of prostacyclin and/or other endothelium-dependent relaxing factors and alteration in baroreflex activity.
Animals↗
Nonabsorbable versus absorbable suture anchors for open Bankart repair. A prospective, randomized comparison.
Suture anchors facilitate the surgical repair of capsuloligamentous structures to bone. Bioabsorbable suture anchors, which obviate potential pitfalls in the periarticular use of permanent implants, have recently become available. We randomly assigned 40 patients to undergo modified Bankart shoulder repairs with either nonabsorbable or absorbable suture anchors. The patients had a history of recurrent traumatic anterior instability that had not improved with nonoperative management. The average patient age was 22 years (range, 17 to 46), and the average preoperative Rowe score was 47 points in the nonabsorbable anchor group and 47 points in the absorbable anchor group. Average postoperative Rowe scores were 96 and 93 points, respectively. There was one failed result in the nonabsorbable anchor group and two in the absorbable anchor group. No statistically significant subjective or objective differences were found at an average of 25 months postoperatively. Our results reveal that, in this application, bioabsorbable suture anchors are a viable option for the repair of soft tissue to bone.
Adolescent↗
Caring for patients with enterocutaneous fistulae.
Fistulae are distressing for both patients and staff. The management of fistulae presents a challenge to the nurse in terms of providing care for the psychological and physiological needs of the patient. This article describes the causes of fistulae and examines the nursing priorities and how to achieve them.
Body Image↗
Apoptosis, neurotrophic factors and neurodegeneration.
Apoptosis is an active process of cell death characterized by distinct morphological features, and is often the end result of a genetic programme of events, i.e. programmed cell death (PCD). There is growing evidence supporting a role for apoptosis in some neurodegenerative diseases. This conclusion is based on DNA fragmentation studies and findings of increased levels of pro-apoptotic genes in human brain and in in vivo and in vitro model systems. Additionally, there is some evidence for a loss of neurotrophin support in neurodegenerative diseases. In Alzheimer's disease, in particular, there is strong evidence from human brain studies, transgenic models and in vitro models to suggest that the mode of nerve cell death is apoptotic. In this review we describe the evidence implicating apoptosis in neurodegenerative diseases with a particular emphasis on Alzheimer's disease.
Alzheimer Disease↗
A preoperative protocol for the prevention of infection in children with tunnelled right atrial catheters.
The use of central venous lines has come to be widely accepted by children with cancer and their families. However, attendant infection is a cause of considerable morbidity. Coagulase-negative staphylococci, the predominant aerobic species on the skin, are now the commonest cause of catheter-related bacteremia. We introduced a protocol to reduce the colonization of the skin at the catheter insertion site. Antiseptic skin scrubs, with 4% chlorhexidine gluconate, were performed on the neck and anterior chest the night before and again on the morning of the surgical procedure. A single dose of cephalothin (or vancomycin for penicillin-allergic patients) was administered IV immediately before the operation. Compared to the 12 month period prior to initiation of this protocol, the rate of infections (occurring within 30 days of catheter placement) in the 3.5 year period of intervention dropped from 8 to 4.9 per 1,000 catheter days. The proportion of infections that were staphylococcal was reduced from 93 to 63% and the proportion of non-ports removed within 30 days of placement fell from 45 to 0%. Despite these changes, the major contribution to improved infection control appeared to be the use of an increased proportion of ports (a rise from <10 to almost 60%).
Administration, Topical↗
Autotransfusion systems (ATS).
Due to the large number of patients undergoing cardiac surgical procedures and the subsequent increase in demand for blood volume replacement, the use of autotransfusion is increasing in the postoperative setting. In a study conducted by Roche and Stengel it was estimated that the country's blood resources could be depleted by these surgical procedures. The use of autotransfusion offers a viable solution for this problem. Studies suggest that with autotransfusion, bank blood requirements may decrease as much as 50 percent. The ready availability and economic advantages associated with autotransfusion may also ensure continued use of systems of this type. It has been the authors' experience thus far that both systems presented have been safe and effective when used in postoperative management of the cardiac surgical patient.
Blood Transfusion, Autologous↗
Staff appraisal: trying to do better.
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Employee Performance Appraisal↗
The effects of long-term administration of ethane-1-hydroxy-1, 1-diphosphonate on osteoarthrosis and heterotopic ossification in the mouse knee joint.
Ethane-1-hydroxy-1, 1-diphosphonate (EHDP) was administered weekly for up to 15 months in either a high (50 mg/kg body weight) or low (5 mg/kg body weight) dose to the males of an inbred strain of mouse (SRT/ORT) which suffers from a high incidence of osteoarthrosis of the knee joint accompanied by extensive periarticular soft-tissue metaplasia forming cartilage and bone. The diphosphonate had two effects. In both doses it caused a reduction in the level of bone resorption. In high doses it caused a partial inhibition of mineralization resulting in the deposition of uncalcified osteoid. The diphosphonate did not influence the incidence or severity of the articular degeneration. The development of periarticular sort-tissue metaplasia was not halted by the EHDP although its form was slightly modified in the high dose. In both treated groups the proximal end of the tibia developed into an abnormal club shape as a result of interference with the normal turnover of bony spicules in the metaphyses. High-dose mice given 85Strontium as a tracer for calcium had much lower radioactivity in their bones than did the low dose and control mice.
Aged↗
Making the right choice. Interview by Laurence Dopson.
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Community Health Nursing↗