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Biomedical subjects

R Sharpe

Publications and source records attributed to R Sharpe.

At least 19 recordsLinked to original sources

Duplex ultrasound scanning is reliable in the detection of endoleak following endovascular aneurysm repair.

OBJECTIVE: To investigate the value of duplex ultrasound scanning (DUSS) in the routine follow up of patients following EVAR. METHODS: Imaging was reviewed for 310 consecutive patients undergoing EVAR at a single centre. Concurrent ultrasound and CT scans were defined as having occurred within 6 months of each other. There were 244 paired concurrent DUSS and CT scans which were used for further analysis. These modalities were compared with respect to sensitivity, specificity, positive and negative predictive values and level of agreement (by Kappa statistics) using CT as the 'gold standard'. RESULTS: DUSS failed to detect a number of endoleaks which were seen on CT and the sensitivity of this test was therefore poor (67%). However, the specificity of DUSS compared more favourably with a value of 91%. Positive predictive values ranged from 33-100% but negative predictive values were more reliable with values of 91-100% at all time points post operatively. There were no type I leaks, or endoleaks requiring intervention which were missed on DUSS. Overall, there was a 'fair' level of agreement between the two imaging modalities using Kappa statistics. CONCLUSION: Although DUSS is not as sensitive as CT scanning in the detection of endoleak, no leaks requiring intervention were missed on DUSS in this study. DUSS is much cheaper than CT and avoids high doses of radiation. DUSS therefore remains a valuable method of follow up after EVAR and can reduce the need for repeated CT scans.

Aneurysm↗

The pathology of devil facial tumor disease (DFTD) in Tasmanian Devils (Sarcophilus harrisii).

A disfiguring and debilitating neoplastic condition known as devil facial tumor disease (DFTD) has been discovered in wild Tasmanian Devils (Sarcophilus harrisii) across 51% of its natural range, with population declines of up to 80% in some areas (C. Hawkins, personal communication). Between 2001 and 2004, 91 cases were examined. The tumors presented as large, solid, soft tissue masses usually with flattened, centrally ulcerated, and exudative surfaces. They were typically multicentric, appearing first in the oral, face, or neck regions. Histologically, the tumors were composed of circumscribed to infiltrative nodular aggregates of round to spindle-shaped cells, often within a pseudocapsule and divided into lobules by delicate fibrous septae. They were locally aggressive and metastasized in 65% of cases. There was minimal cytologic differentiation among the tumor cell population under light and electron microscopic examination. The results indicate DFTD to be an undifferentiated soft tissue neoplasm.

Animals↗

Optimization of the projection screen in a display system for minimal access surgery.

BACKGROUND: The operative image for minimal access surgery currently is displayed on a monitor located outside the sterile field. It is ergonomically advantageous to locate the image adjacent to the surgeon's hands by projection onto a sterile screen, but there has been no research into the optimal screen material. METHODS: Several screen materials were compared for image resolution, brightness, variation of brightness with viewing angle, and image artifact. RESULTS: Glossy materials perform poorly, whereas finely grained surfaces improve image clarity. Excessive roughness and incomplete opacity limit the image resolution. Conventional screen fabrics are unsuitable in this application. Ambient lighting and projector brightness affect image contrast, but a correct choice of material can address this. Practical issues such as moisture absorbency and ease of sterilization are considered. CONCLUSIONS: Potential screen materials were rejected because of excessive glare, poor resolution, and image artifact. Finely textured surfaces (e.g., polystyrene sheeting) provide an acceptable screen.

Artifacts↗

Neutropenic enterocolitis: a rare presenting complication of acute leukemia.

Neutropenic enterocolitis is a necrotizing inflammatory process with intramural infection that occurs predominantly in neutropenic patients. This syndrome is most frequently observed after chemotherapy for hematologic and solid tissue malignancies, but it can also be observed in a number of other clinical settings as well. Neutropenic enterocolitis can be a rare presenting complication of acute leukemia. We report a case of acute lymphoblastic leukemia that presented with abdominal pain due to neutropenic enterocolitis. The diagnostic and treatment challenges associated with this manner of presentation are discussed.

Adult↗

Male reproductive health and environmental xenoestrogens.

Male reproductive health has deteriorated in many countries during the last few decades. In the 1990s, declining semen quality has been reported from Belgium, Denmark, France, and Great Britain. The incidence of testicular cancer has increased during the same time incidences of hypospadias and cryptorchidism also appear to be increasing. Similar reproductive problems occur in many wildlife species. There are marked geographic differences in the prevalence of male reproductive disorders. While the reasons for these differences are currently unknown, both clinical and laboratory research suggest that the adverse changes may be inter-related and have a common origin in fetal life or childhood. Exposure of the male fetus to supranormal levels of estrogens, such as diethlylstilbestrol, can result in the above-mentioned reproductive defects. The growing number of reports demonstrating that common environmental contaminants and natural factors possess estrogenic activity presents the working hypothesis that the adverse trends in male reproductive health may be, at least in part, associated with exposure to estrogenic or other hormonally active (e.g., antiandrogenic) environmental chemicals during fetal and childhood development. An extensive research program is needed to understand the extent of the problem, its underlying etiology, and the development of a strategy for prevention and intervention.

Animals↗

Tissue shortage.

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Animal Experimentation↗

The Draize test--motivations for change.

The use of animals in research and testing is an issue of increasing public concern, with many people convinced that it is unjust to expose any sentient and unconsenting individual to suffering, or risk of suffering, when the only potential benefit would be to others. Such ethical considerations make the introduction of alternative forms of research and testing an urgent priority. In the case of the Draize eye irritancy test, however, scientific considerations superimpose ethical motivations for change, because the procedure is also unsatisfactory on scientific grounds. After concerted pressure from animal welfare groups throughout the world, several laboratories are now investigating humane and more scientific replacements for this test, with encouraging results. Some of the techniques being used have long been available, even before the introduction of the Draize test itself in 1944. This shows what could be achieved today, in other areas of animal testing, assuming the necessary imagination, motivation and resources. Focusing the scientific mind on alternative methodologies is expected not only to benefit science and the animals, but to protect the public more reliably as well.

Animal Testing Alternatives↗

Intraoperative evoked potentials recorded in man directly from dorsal roots and spinal cord.

Direct spinal cord surface recordings of evoked spinal cord potentials have been made in 26 patients during neurosurgical procedures for intractable pain. Monopolar recordings at the dorsal root entry zone after peripheral nerve stimulation have been made at multiple levels for segmental localization and to monitor the state of the afferent path and dorsal horn. Dorsal root and dorsal column conduction has been tested on diseased and intact sides. Normal afferent conduction velocity was found to have an overall mean of 61.33 m/sec for cervicothoracic and lumbosacral peripheral nerves, and 50 m/sec for the dorsal columns. The normal mean amplitude for the slow negative wave (N1) recorded at the root entry was 52.54 muV, while that for the dorsal column conducted response recorded within 4 cm of the stimulus point on the dorsal columns was 347.5 muV. Several different placements of stimulating and recording electrodes are described, as well as their application. An interpretation of the resulting data is proposed.

Adult↗

Methionine enkephalin and isosteric analogues. Part II.: Receptor conformation of methionine enkephalin.

Biological activities are reported for two different types of analogues of methionine enkephalin. Cyclic analogues, bridged between the amino- and carboxy- terminals of the parent peptide, are inactive. In contrast, significant levels of activity are displayed by linear isosterically modified analogues in which the Tyr1-Gly2 peptide bond is replaced by either -CH2NH- or -CH2CH2-. Similar replacements of the Gly2-Gly3 peptide bond yield compounds with much reduced potency. These modifications serve as useful probes of the receptor conformation. Based on these findings, a model is proposed for interaction between enkephalin and its receptor.

Animals↗

Methionine enkephalin and isosteric analogues. I. Synthesis on a phenolic resin support.

An efficient synthesis of methionine enkephalin using a phenolic resin support is described. Analogues modified at their C-termini, such as peptide acids, amides, methyl esters and compounds formed by their reduction, were prepared conveniently from common peptide phenyl ester resins. The resin was used in the synthesis of complex isosterically modified analogues designed to investigate the role of peptide backbone plays in receptor interaction. Free hexapeptide phenyl ester resins underwent intramolecular aminolysis liberating the corresponding cyclic peptides.

Amino Acid Sequence↗