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Biomedical subjects

S M Green

Publications and source records attributed to S M Green.

At least 19 recordsLinked to original sources

Social patterns of food sharing in monogamous owl monkeys.

Captive owl monkeys (Aotus nancymaae, A. azarai) share food frequently within both families and pairs. In this study food sharing was observed in seven mated pairs and four families (i.e., four mated pairs and their offspring). Patterns of food sharing were examined with respect to age class, sex, and the presence or absence of dependent offspring. Within families, most food transfers were from adult males to developing offspring. Adult males and females transferred food to their mates in caged pairs as well as in family units. Food interactions between adults are as likely to result in food transfers as those between adults and offspring. This pattern of food sharing between mates in a monogamous species may serve both nutritional and social functions that differ from those in polygamous species.

Animals↗

Dynamic creep and mechanical characteristics of SmartSet GHV bone cement.

The restrained dynamic creep behaviour and mechanical properties of SmartSet GHV bone cement have been investigated at both room temperature and body temperature. It was found that the bone cement behaves significant differently at room temperature from that at body temperature. The test temperature had a strong effect on the creep performance of the bone cements with a higher creep rate observed at body temperature at each loading cycle. For both temperatures, two stages of creep were identified with a higher creep rate during early cycling followed by a steady state creep rate. The relationship between creep deformation and loading cycle can be expressed by a Hyperb 1 model. As a visco-elastic material, the sensitivity of bone cement to the temperature change was evident during mechanical testing. Compared to the mechanical strength at room temperature, a decreased value was demonstrated at body temperature. The bending modulus was very sensitive to the change in testing temperature, where a reduction of 52% was recorded. A significant reduction in compressive and bending strength, 31 and 23% were recorded respectively. The effect of temperature on bending strength was less apparent, where only 13% reduction was exhibited at body temperature compared to room temperature.

Bone Cements↗

Opsonization of polyethylene wear particles regulates macrophage and osteoblast responses in vitro.

The cellular reaction to wear debris may result in the failure of an artificial joint's fixation to the skeleton. The influence of debris opsinization on cell activity has received little attention. This study seeks to establish whether different proteinaceous culture environments may invoke variant cellular responses to debris challenge. Consideration of the zeta potential of a low density polyethylene particle group and an ex vitro ultrahigh molecular weight polyethylene particle group revealed that the nature of the protein adsorbants is related to the concentration of the proteins in solution. Furthermore, the composition of the adsorbed layer was shown to vary with the spectra of proteins in solution. In standard cell culture conditions zeta potential approached zero, indicating the high probability of particle agglomeration. Cell challenge studies with U937 macrophages showed that BSA and FCS protein adsorption mediated increased cell adhesion, while bovine IgG showed little change over control values. No changes in behavior of osteoblastic cells were observed in similar experiments.

Adsorption↗

Pre-heating of components in cemented total hip arthroplasty.

Fatigue fractures which originate at stress-concentrating voids located at the implant-cement interface are a potential cause of septic loosening of cemented femoral components. Heating of the component to 44 degrees C is known to reduce the porosity of the cement-prosthesis interface. The temperature of the cement-bone interface was recorded intra-operatively as 32.3 degrees C. A simulated femoral model was devised to study the effect of heating of the component on the implant-cement interface. Heating of the implant and vacuum mixing have a synergistic effect on the porosity of the implant-cement interface, and heating also reverses the gradients of microhardness in the mantle. Heating of the implant also reduces porosity at the interface depending on the temperature. A minimum difference in temperature between the implant and the bone of 3 degrees C was required to produce this effect. The optimal difference was 7 degrees C, representing a balance between maximal reduction of porosity and an increased risk of thermal injury. Using contemporary cementing techniques, heating the implant to 40 degrees C is recommended to produce an optimum effect.

Arthroplasty, Replacement, Hip↗

A preliminary hip joint simulator study of the migration of a cemented femoral stem.

A hip joint simulator that can be used to evaluate the outcome of the cemented total hip replacement has been designed, manufactured and evaluated. The simulator produces motion of a cemented hip construct in the extension/flexion plane, with a socket to rotate internal/externally. At the same time a dynamic loading cycle is applied to the construct. A validation test was performed on a cemented femoral stem within a novel composite femur. The study demonstrates the value of using a hip joint simulator to evaluate the outcome of the cemented hip construct. A complex migration pattern of the cemented hip prosthesis with respect to load cycling was observed, demonstrated in vitro comparable prosthesis migration behaviour, both the stem migration and migration patterns, to that found clinically.

Cementation↗

Creep behavior comparison of CMW1 and palacos R-40 clinical bone cements.

The restrained dynamic creep behaviors of two clinical bone cements, Palacos R-40 and CMW1 have been investigated at room temperature and body temperature. It was found that the two cements demonstrated significantly different creep deformations, with Palacos R-40 bone cement demonstrating higher creep strain than CMW1 bone cement at each loading cycle. For both cements, two stages of creep were identified with a higher creep rate during early cycling followed by a steady-state creep rate. The test temperature had a strong effect on the creep performance of the bone cements with higher creep rate observed at body temperature. The relationship between creep deformation and loading cycles can be expressed by single logarithmic model. The SEM examinations revealed that CMW1 bone cement is more sensitive to defects within the specimen especially to the defects at the edges of the specimen than Palacos R-40 bone cement. However, in the absence of micro-cracks or defects within the inner surface layer, the dynamic loading (at less than 10.6 MPa) is unlikely to produce micro-cracks in the CMW1 bone cement. The different behaviors between the two bone cements may be attributed to differences in chemical compositions and molecular weight distributions.

Journal Article↗

Immunohistochemical localization of trichloroacylated protein adducts in tetrachloroethene-treated mice.

Tetrachloroethene (PCE), a common industrial solvent and environmental contaminant, is primarily used in the dry-cleaning industry. The toxicity of PCE has been linked to vision disorders, renal and hepatic cancer, and autoimmune diseases. Although the mechanism of toxicity is not fully understood, PCE forms trichloroacylated protein adducts in tissues where toxicity is known to occur. These adducts may be responsible for toxicity by altering the function of cellular proteins. Using Western blot analysis, formation of trichloroacylated protein adducts has been reported. To determine the localization of the adducts in a specific zone of a tissue, immunohistochemical staining was used in the study. An antiserum to trichloroacylated proteins was raised in rabbits and its specificity was established by enzyme-linked immunosorbent assay (ELISA). Female MRL-lpr/lpr and MRL +/+ mice were treated with PCE using a single 5-mmol/kg dose over 24 h or on every fourth day for 6 wk (total 20 doses). Formation of trichloroacylated protein adducts was observed in the liver, and localized to the centrilobular zones. Intensity and circumference of the staining around the central vein were much greater in subchronically treated mice than in acutely treated mice. No immunochemical reactivity was observed in any of the other tissues examined. This study shows that hepatic trichloroacylated protein adducts are localized in a region of the liver where PCE-mediated toxicity is known to occur. Immunohistochemical localization of these adducts and its association with PCE-induced toxicity support the contention that adducts may contribute to toxicity.

Acylation↗

Ketamine sedation for pediatric gastroenterology procedures.

BACKGROUND: Although the dissociative sedative ketamine is used commonly for pediatric procedural sedation in other settings, the safety of this agent in pediatric gastroenterology is not well-studied. A 5-year experience with ketamine sedation for pediatric gastroenterology procedures was reviewed to document the safety profile of this agent and to identify predictors of laryngospasm during esophagogastroduodenoscopy (EGD). METHODS: The study was a retrospective consecutive case series of children receiving ketamine administered by pediatric gastroenterologists skilled in basic airway management to facilitate pediatric gastrointestinal procedures during a 5-year period. Patient's records were reviewed to determine indication, dosage, adverse effects, drugs, inadequate sedation, and recovery time for each sedation. A multiple logistic regression analysis was performed to identify predictors of laryngospasm during EGD. Outcome measures were descriptive features of sedation, including adverse effects and predictors of laryngospasm during EGD. RESULTS: During the study period pediatric gastroenterologists administered ketamine 636 times, primarily for EGD (86%) and primarily by the intravenous route (98%). The median loading dose and total dose were 1.00 mg/kg and 1.34 mg/kg, respectively. Inadequate sedation was noted in seven (1.1%) procedures. Adverse effects included transient laryngospasm (8.2%), emesis (4.1%), recovery agitation (2.4%), partial airway obstruction (1.3%), apnea and respiratory depression (0.5%), and excessive salivation (0.3%). There were no adverse outcomes attributable to ketamine. Nearly half (46%) the subjects had severe underlying illness (American Society of Anesthesiologists (ASA] class > or =3). All instances of laryngospasm occurred during EGD (9.5% incidence), and the only independent predictor of laryngospasm in this sample was decreasing age. The incidence of laryngospasm was 13.9% in preschool-aged (< or =6 years) children and was 3.6% in school-aged (>6 years) children (difference 10.3%, 95% confidence intervals 5.5-14.9%). No dose relationship was noted with laryngospasm, and the risk did not increase with underlying illness. CONCLUSION: Pediatric gastroenterologists skilled in ketamine administration and basic airway management can effectively administer this drug to facilitate gastrointestinal procedures. Transient laryngospasm occurred in 9.5% of children receiving ketamine for EGD, and its incidence was greater in preschool than in school-aged children.

Adolescent↗

Do published guidelines predict pneumonia in children presenting to an urban ED?

OBJECTIVES: In 1997, a Canadian task force published evidence-based guidelines for diagnosing pediatric pneumonia, concluding that the absence of each of four signs (ie, respiratory distress, tachypnea, crackles, and decreased breath sounds) accurately excludes pneumonia. The study was performed to evaluate the accuracy of these guidelines in predicting pneumonia in young children. METHODS: This was an observational study conducted over a 4-month period at an urban emergency department with 80,000 annual visits, approximately 20% of which were children < or =5 years old. Consecutive children < or =5 years old who underwent chest radiography were enrolled. Prior to ordering radiographs, treating physicians were required to enter specific patient signs and symptoms into a computerized database. World Health Organization criteria were used to define tachypnea. Sensitivity, specificity, and predictive values of the task force guidelines in predicting pneumonia were calculated. RESULTS: Three hundred twenty-nine children, including 67 (20%) with pneumonia, were enrolled. Guidelines were 45% sensitive (95% confidence interval (CI) = 33-58) and 66% specific (95% CI = 60-72) for diagnosing pneumonia. Positive and negative predictive values were 25% (95% CI = 18-34) and 82% (95% CI = 77-87), respectively. CONCLUSION: Previously published evidence-based guidelines for excluding pediatric pneumonia were found unreliable in this study.

Child, Preschool↗

Ketamine sedation for pediatric critical care procedures.

OBJECTIVES: To describe our experience using ketamine sedation to facilitate pediatric critical care procedures, and to document the safety profile of ketamine in this setting. DESIGN: Retrospective consecutive case series. SETTING: Pediatric intensive care unit of a tertiary children's hospital. PATIENTS: Children receiving ketamine for procedural sedation over a 5-year period. INTERVENTIONS: We reviewed patient records to determine indication, dosing, adverse events, inadequate sedation, and recovery time for each sedation. OUTCOME MEASURES: Descriptive features of sedation including adverse events. RESULTS: During the study period, children in our pediatric intensive care unit received ketamine at total of 442 times to facilitate a wide variety of critical care procedures, most commonly central line placement, esophagogastroduodenoscopy, and wound debridement. Most study children had substantial underlying illness (ASA > or = 3 in 88%; ASA > or = 4 in 39%). Inadequate sedation was noted in only nine (2%) procedures. Adverse effects included transient laryngospasm (n = 9), transient partial airway obstruction (n = 5), apnea with bradycardia (n = 1), emesis during the procedure (n = 2), emesis during recovery (n = 9), mild recovery agitation (n = 10), moderate-to-severe recovery agitation (n = 1), and excessive salivation (n = 4). There were no adverse outcomes attributable to ketamine. CONCLUSION: Pediatric intensivists skilled in ketamine administration can safely and effectively administer this drug to facilitate critical care procedures. Despite the ill nature of our patient sample, adverse effects were uncommon.

Adolescent↗

Iatrogenic cardiopulmonary arrest during pediatric sedation with meperidine, promethazine, and chlorpromazine.

The pediatric sedative combination of meperidine, promethazine, and chlorpromazine (MPC) has been widely used for more than 40 years. Despite its relatively poor efficacy and questionable safety profile, many emergency departments (EDs) continue to stock specially formulated mixtures of these three agents. We report a case of iatrogenic cardiac arrest in a 2-month-old infant in whom a consulting resident administered too much MPC (10 times the expected dose) by the wrong route (intravenous instead of intramuscular). The child was successfully resuscitated with no apparent neurologic deficit. Subsequently, we have removed MPC entirely from our ED and instituted a policy restricting ED procedural sedation privileges to emergency physicians. We urge other EDs to do likewise.

Chlorpromazine↗

Crystal structure of Staphylococcus aureus tyrosyl-tRNA synthetase in complex with a class of potent and specific inhibitors.

SB-219383 and its analogues are a class of potent and specific inhibitors of bacterial tyrosyl-tRNA synthetases. Crystal structures of these inhibitors have been solved in complex with the tyrosyl-tRNA synthetase from Staphylococcus aureus, the bacterium that is largely responsible for hospital-acquired infections. The full-length enzyme yielded crystals that diffracted to 2.8 A resolution, but a truncated version of the enzyme allowed the resolution to be extended to 2.2 A. These inhibitors not only occupy the known substrate binding sites in unique ways, but also reveal a butyl binding pocket. It was reported that the Bacillus stearothermophilus TyrRS T51P mutant has much increased catalytic activity. The S. aureus enzyme happens to have a proline at position 51. Therefore, our structures may contribute to the understanding of the catalytic mechanism and provide the structural basis for designing novel antimicrobial agents.

Amino Acid Sequence↗

Some failure modes of four clinical bone cements.

The fracture or failure behaviours of four commercial acrylic-based bone cements have been examined in tensile, bending and compression modes, and their mechanical properties are reviewed. It was found that Palacos R-40 bone cement had high radiopaque agent concentration, with high surface hardness. It exhibited a much lower bending strength and bending modulus compared with the other three bone cements (CMW1, CMW2000 and Simplex P). The textures of tensile fracture surfaces produced were similar for the four bone cements studied. The fracture surface was fragmented by crevices, which developed through the matrix and around large undissolved polymethylmethacrylate (PMMA) beads. Three bands with different features existed on the bending fracture surfaces, with an abrupt transition between them. It appears that the agglomerates of zirconium dioxide particles are implicated in Palacos R-40 bone cement fracture surface. The examination of compressive failed specimens revealed that a 'yielded crack band' existed across the transverse section. Plastic deformation resulted in the PMMA beads being squashed in the longitudinal direction and dilated in the transverse direction.

Biomechanical Phenomena↗

The wear of metal-on-metal total hip prostheses measured in a hip simulator.

New generation metal-on-metal prostheses have been introduced to try and overcome the problem of osteolysis often attributed to the wear particles of the polyethylene component of conventional metal-on-ultra-high molecular weight polyethylene (UHMWPE) joints. The wear rates of four metal-on-metal joints (two different clearances) were assessed along with that of a conventional metal-on-UHMWPE joint. Friction measurements of the metal-on-metal joints were taken before and after the wear test and compared. Two distinct wear phases were discernible for all the metal-on-metal joints: an initial wear phase up to 0.5 x 10(6) cycles and then a lower steady state wear phase. The steady state wear rate of the 22 microm radial clearance metal-on-metal joint was lower than that for the 40 microm radial clearance joint, although this difference was not found to be significant (p > 0.15). The wear rates for all the joints tested were consistent with other simulator studies. The friction factors produced by each joint were found to decrease significantly after wear testing (p < 0.05).

Biocompatible Materials↗

Analysis and purification of nucleic acids by ion-pair reversed-phase high-performance liquid chromatography.

Sizing of DNA fragments is a routine analysis traditionally performed on agarose or polyacrylamide gels. Electrophoretic analysis is labor-intensive with only limited potential for automation. Recovery of DNA fragments from gels is cumbersome. We present data on automated, size-based separation of DNA fragments by ion-pair reversed-phase high performance liquid chromatography (IP RP HPLC) - DNA chromatography - on the WAVE DNA Fragment Analysis System with the DNASep cartridge. This system is suitable for accurate and rapid sizing of double-stranded (ds) DNA fragments from 50 to ca. 2000 base pairs (bp). Fluorescently labeled DNA fragments are compatible with the technology. Length-dependent separation of dsDNA fragments is sequence independent and retention times are highly reproducible. The resolving capabilities of DNA chromatography are illustrated by the analysis of multiple DNA size markers. Resolved dsDNA fragments are easily collected and are suitable for downstream applications such as sequencing and cloning. DNA chromatography under denaturing conditions with fluorescently labeled DNA fragments offers a means for the separation and purification of individual strands of dsDNA. Analysis of DNA fragments on the WAVE System is highly automated and requires minimal manual intervention. DNA chromatography offers a reliable and automated alternative to gel electrophoresis for the analysis of DNA fragments.

Automation↗