126
|
Goggins JA, Hiltner A, Jones PK, Jones RD. Relationship between arterial thrombosis and neutralization of a polyethylene ionomer. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 1993; 27:627-37. [PMID: 8314815 DOI: 10.1002/jbm.820270510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The influence of three levels of sodium neutralization of an ethylene/methacrylic acid copolymer on in vivo blood compatibility was studied in a canine arterial model. Effects due to sample fabrication methods (thermal pressing versus solution casting) were also monitored. Sodium content, sodium release, hydrogen dissociation, and localization of anionic groups were noted. Polymer surface energy, surface morphology, water uptake, and thermal properties were characterized. Material characterization and in vivo implantation disclose the following: 1) Thermal pressing generated oxidation degradation products that decreased in vivo blood compatibility. Solution-cast samples adhered and activated fewer blood elements. 2) Platelets and leukocytes were sensitive to differences in shear rate in the carotid and femoral arteries, with the femoral site tending toward higher shear, more platelet deposition and fewer leukocytes. 3) The surface properties of the polyethylene control, 0% Na, and 50% Na samples tended to be similar. These properties were different from the 100% Na sample. The 100% Na ionomer was more hydrophilic, had a higher polar component for its surface energy, and was unique in exhibiting discrete ionic clusters 1-10 microns in diameter on its surface. 4) These differences were manifested in vivo by platelet activation and thrombus development on the polyethylene, 0% Na, and 50% Na implants, while the 100% Na implant surfaces were predominantly covered by singly adherent, unactivated platelets. 5) It is proposed that the improvement in biocompatibility for the 100% Na ionomer is due to the cluster development in the neutralized methacrylic component and that either directly, or through appropriate protein adsorption and/or conformational adjustment to the cluster regions, platelets are not activated and do not initiate the coagulation mechanism.
Collapse
|
127
|
Jones RD, Chan K, Roulson CJ, Brown AG, Smith ID, Mya GH. Pharmacokinetics of flumazenil and midazolam. Br J Anaesth 1993; 70:286-92. [PMID: 8471371 DOI: 10.1093/bja/70.3.286] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We have studied simultaneously the pharmacokinetics of flumazenil and midazolam in 12 healthy Chinese children, aged 5-9 yr, undergoing circumcision. Two hours before operation each patient received midazolam 0.5 mg kg-1 orally for premedication and 0.5 mg kg-1 i.v. during induction. Six minutes after cessation of anaesthesia, a bolus of flumazenil 10 micrograms kg-1 was given i.v., followed by an infusion of flumazenil at 5 micrograms kg-1 min-1 which was maintained until the child could identify himself. Midazolam data were consistent with a three-compartment model with a mean (SD) elimination half-life of 107 (30) min, total body clearance of 15.4 (3.2) ml min-1 kg-1 and apparent volume of distribution at steady state of 1.9 (0.6) litre kg-1. Flumazenil data were best interpreted by a monoexponential function, with a mean terminal elimination half-life of 35.3 (13.8) min, a total plasma clearance of 20.6 (6.9) ml min-1 kg-1 and apparent volume of distribution at steady state of 1.0 (0.2) litre kg-1. No unchanged midazolam was detected in the 24-h urine sample, but 5.8-13.8% of the flumazenil dose was recovered unchanged. At the time of self identification, 4.5 (1.4) min after flumazenil administration, the mean plasma concentrations of midazolam and flumazenil were 163.1 (43.7) and 29.9 (16.1) ng ml-1, respectively.
Collapse
|
128
|
Jones RD, Reid R, Balakrishnan G, Barrett A. Multifocal synchronous osteosarcoma: the Scottish Bone Tumour Registry experience. MEDICAL AND PEDIATRIC ONCOLOGY 1993; 21:111-6. [PMID: 8433676 DOI: 10.1002/mpo.2950210206] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We report 3 cases of multifocal synchronous osteosarcoma constituting 1% of osteosarcoma cases in the Scottish Bone Tumour Registry over 30 years. All were children and had a median age of 10 years. They all presented with multiple bony lesions in the absence of demonstrable pulmonary metastases. Treatment was with palliative radiotherapy in two and combination chemotherapy and radiotherapy in the most recent case. Survival was poor in all cases, with a median of 7 months. A proposal is made for genetic studies in future cases to help elucidate the origin of these tumours. The multicentric and metastatic hypotheses are discussed.
Collapse
|
129
|
Jones RD. Tips for successful all-ceramic restorations. TRENDS & TECHNIQUES IN THE CONTEMPORARY DENTAL LABORATORY 1992; 9:37-40. [PMID: 1303586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
130
|
Jones RD, White JM. Rapid Class II molar correction with an open-coil jig. JOURNAL OF CLINICAL ORTHODONTICS : JCO 1992; 26:661-4. [PMID: 1298748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
131
|
Jones RD, Lawson AD, Gunawardene WM, Roulson CJ, Brown AG, Smith ID. An evaluation of prolonged oximetric data acquisition. Anaesth Intensive Care 1992; 20:303-7. [PMID: 1524168 DOI: 10.1177/0310057x9202000304] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Data derived from pulse oximetry has inherent limitations, one of which is artifactual desaturation caused by patient movement. Perioperative patterns of oxygen desaturation were studied for a mean duration of 67 hours in eight young patients following corrective spinal surgery. Pulse oximetry data were relayed to a computer using Satmaster, a program which permits storage, retrieval, signal evaluation and statistical analysis of oximetry data. Desaturation episodes were mild, of short duration and their infrequent occurrence was not increased during intravenous morphine infusion. Retrospective identification of contemporaneous artifactual changes in signal amplitude permitted the removal of artifactual desaturations from our statistical data analysis. This decreased the average time desaturated from 5.4% (220 minutes) to 4.2% (162 minutes) of the monitored period representing a 25% reduction in absolute incidence and a 35% reduction in episodic incidence of desaturation. Acquired data should be validated and inferences drawn from non-validated data must be assessed with caution.
Collapse
|
132
|
Jones RD, Baynes RE, Nimitz CT. Nonsteroidal anti-inflammatory drug toxicosis in dogs and cats: 240 cases (1989-1990). J Am Vet Med Assoc 1992; 201:475-7. [PMID: 1506258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A search of medical records at the Georgia Animal Poison Information Center over a 19-month period revealed 240 cases of dog and cat exposure to nonsteroidal anti-inflammatory drugs (NSAID). The most common NSAID consumed were ibuprofen, acetaminophen, aspirin, and indomethacin. The most common clinical signs of toxicosis were vomiting and diarrhea, CNS depression, and circulatory manifestations. Pets are at risk from NSAID toxicosis through administration by the owners or accidental consumption of improperly stored drugs.
Collapse
|
133
|
Jones RD, Brown AG, Roulson CJ, Smith ID, Chan SC. The upgraded Finapres 2300e. A clinical evaluation of a continuous noninvasive blood pressure monitor. Anaesthesia 1992; 47:701-5. [PMID: 1519723 DOI: 10.1111/j.1365-2044.1992.tb02396.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Measurements from the upgraded Finapres 2300e continuous noninvasive blood pressure monitor, the Finapres 2300 and Colin oscillometric noninvasive blood pressure monitor were compared with invasive arterial line blood pressure readings. Fifteen young Chinese patients undergoing elective spinal surgery of more than 2 h duration had contemporaneous blood pressure measurements digitally recorded every minute. Data were analysed using methods described by Bland and Altman to assess agreement of noninvasive devices with an arterial line. Results showed that although the Finapres 2300e was significantly more accurate than the Finapres 2300 and Colin noninvasive blood pressure monitors it could not be recommended as a substitute for continuous arterial line blood pressure monitoring. Both Finapres devices demonstrated reductions in accuracy related to time (drift) and over-read diastolic and mean pressures by 5-8 mmHg throughout the range of mean arterial line pressures (bias). The Colin was consistently less accurate than the Finapress monitors and performed worst at low mean arterial line pressures.
Collapse
|
134
|
Thompson FN, Jones RD, Stuedemann JA, Mizinga KM, Smith CK. Effect of metoclopramide on luteinizing hormone secretion in postpartum anestrous cows. Am J Vet Res 1992; 53:727-30. [PMID: 1524297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The effect of metoclopramide (MC), a dopamine antagonist on luteinizing hormone (LH), was examined in anestrous primaparous cows. Metoclopramide has been found to be beneficial in overcoming fescue toxicosis; increasing LH secretion stimulates return to ovulatory function after parturition. Consequently, if MC had negative effect on LH secretion, it would indicate that administration of MC to reproducing animals might be limited. Of 14 postpartum (47 to 66 days) cows, 7 were given MC (4 mg/kg of body weight, IV), and 7 served as controls. Blood was obtained via jugular cannulas at 15-minute intervals for 8 hours; MC was given at the end of the first hour, and gonadotropin-releasing hormone (GnRH, 7 mg/kg), was given IV at the end of hour 7 as a challenge stimulus for LH secretion. Prior to GnRH administration, MC did not have significant effect on LH secretion, as judged by mean serum LH concentration, LH pulse frequency, and LH pulse amplitude. Administration of MC resulted in greater (P less than 0.05) LH response to GnRH, indicating enhanced secretory ability when the pituitary gland was challenged. Serum prolactin concentration was increased (P less than 0.01) by MC administration. Therefore, MC did not have adverse effect on LH secretion in postpartum cows.
Collapse
|
135
|
Jones RD, Chan K, Andrew LJ, Lawson AD, Wong P. Comparative pharmacokinetics of propofol in Chinese adults and children. METHODS AND FINDINGS IN EXPERIMENTAL AND CLINICAL PHARMACOLOGY 1992; 14:41-7. [PMID: 1619968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The pharmacokinetics of propofol were studied in 14 healthy young male Chinese adults, aged 18-38 years, undergoing minor orthopedic surgery. All patients who received a single bolus dose of propofol 2.5 mg/kg were paralyzed with atracurium and mechanically ventilated. Anesthesia was maintained with 67% nitrous oxide plus 1-2% isoflurane in oxygen with alfentanil 5 micrograms/kg intravenously as a bolus injection. Blood concentrations of propofol over the subsequent 24 hours were measured using high pressure liquid chromatography with fluorimetric detection. Data were consistently described by a three compartment model but analysis revealed two significantly different blood propofol concentration-time profiles (p less than 0.05). Five patients, designated "fast" metabolizers, demonstrated a mean elimination half-life which was shorter than that described in Chinese children, while their total body clearance was similar. Nine other patients, designated "slow" metabolizers, had a longer mean elimination half-life and slower total body clearance than those in elderly Caucasian patients. This may be suggestive of propofol metabolism at some extra-hepatic site in some patients, while other patients demonstrate marked lipophilicitic constraint of the drug by the deep compartment.
Collapse
|
136
|
Jones RD, Donaldson IM, Timmings PL. Impairment of high-contrast visual acuity in Parkinson's disease. Mov Disord 1992; 7:232-8. [PMID: 1620141 DOI: 10.1002/mds.870070308] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Several studies have shown that the visual system is affected in Parkinson's disease (PD) with reduced contrast sensitivity, low-contrast acuity, and flicker sensitivity, as well as altered electroretinograms (ERGs) and pattern visual evoked potentials (VEPs). Apparently, however, no study has yet specifically determined whether visual acuity to high-contrast stimuli is impaired in PD. Visual acuity was measured in a group of 16 patients with PD, both on and off drugs (for 24 h), and 16 age- and sex-matched normal control subjects. Acuity was impaired in the PD group both on standard Snellen chart and on a screen in a computerized test of visual resolution. The degree of impairment was 24 and 25%, respectively, in the two tests. The PD patients had marginally better acuity on both tests while receiving drugs, but the differences were not significant. The difference between the two groups was consistent with impaired resolution and could not be accounted for by any perceptual dysfunction that may also have been present in the PD group. Conversely, however, impaired acuity may be implicated in studies that have reported mild deficits of visuospatial/visuoperceptual function in PD. Reduced acuity appears to be a subtle sequela of dopaminergic deficiency in the visual system.
Collapse
|
137
|
Jones RD, Bowen JM. Determination of metoclopramide in the serum and urine of cattle. VETERINARY AND HUMAN TOXICOLOGY 1991; 33:551-3. [PMID: 1808828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Metoclopramide, a dopamine-2 agent, has been shown to be useful in the antagonism of fescue toxicosis in grazing steers. The determination of this drug is described for the purpose of pharmacokinetic study and consideration of potential delivery devices to combat this economically significant condition.
Collapse
|
138
|
Anderson SW, Damasio H, Jones RD, Tranel D. Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. J Clin Exp Neuropsychol 1991; 13:909-22. [PMID: 1779030 DOI: 10.1080/01688639108405107] [Citation(s) in RCA: 370] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We examined the sensitivity and specificity of the Wisconsin Card Sorting Test (WCST) as a measure of frontal lobe damage in 91 subjects with stable focal brain lesions. Anatomical information about the location and extent of brain damage was obtained from MR and CT transparencies. No significant differences in WCST performance were found between subjects with frontal vs. nonfrontal damage. Some subjects with extensive frontal lobe damage performed well on the WCST, and some subjects with damage outside of the frontal lobes failed. The optimal cutoff scores for discriminating frontal from nonfrontal subjects correctly classified only 62% of the subjects. Further analysis of WCST performances associated with damage to various subregions of the frontal lobes also failed to reveal any reliable relationships. These findings indicate that performance on the WCST cannot be interpreted in isolation as an index of frontal lobe damage.
Collapse
|
139
|
Costello SA, Jones RD, Barrett A. The effect of scheduling in children undergoing prophylactic cranial irradiation for acute lymphoblastic leukaemia. Radiother Oncol 1991; 22:56-9. [PMID: 1947213 DOI: 10.1016/0167-8140(91)90069-s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Control of central nervous system (CNS) disease and overall survival have been analysed in a group of 829 children with leukaemia entered into the UKALL VIII trial to determine whether scheduling of the cranial irradiation is of prognostic significance. We show that short gaps in treatment do not influence prognosis and that current radiotherapy practice need not be modified.
Collapse
|
140
|
Tsui SL, Chan CS, Chan AS, Wong SJ, Lam CS, Jones RD. Postoperative analgesia for oesophageal surgery: a comparison of three analgesic regimens. Anaesth Intensive Care 1991; 19:329-37. [PMID: 1767898 DOI: 10.1177/0310057x9101900303] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sixty-four patients undergoing oesophageal surgery were randomly allocated to receive either a continuous lumbar epidural infusion of morphine or fentanyl, or, intramuscular morphine for postoperative analgesia. There was no statistical difference in analgesic requirements between the patients who underwent a thoracotomy for their procedure (n = 50) and those who did not (n = 14), as assessed by the total dose of opioid administered, visual analogue scale (VAS) and pain score (PS) comparison. However, by these criteria, epidural morphine infusion provided the most satisfactory analgesia (P less than 0.05). Despite the variable quality of analgesia achieved with the three regimens, the postoperative lung function tests were similar for all groups, and we conclude that routine lung function tests are not an appropriate method of comparing analgesic efficacy. Prophylactic administration of loratadine to 15% of our patients was not shown to be effective in diminishing the incidence of pruritus.
Collapse
|
141
|
Jones RD, Lawson AD, Andrew LJ, Gunawardene WM, Bacon-Shone J. Antagonism of the hypnotic effect of midazolam in children: a randomized, double-blind study of placebo and flumazenil administered after midazolam-induced anaesthesia. Br J Anaesth 1991; 66:660-6. [PMID: 2064881 DOI: 10.1093/bja/66.6.660] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In a randomized, double-blind study, we administered placebo and flumazenil to 40 healthy Chinese boys, aged 3-12 yr, undergoing circumcision. The children received midazolam 0.5 mg kg-1 orally for premedication and 0.5 mg kg-1 i.v. during induction. After operation the patients were given 0.1 ml kg-1 of a blinded solution followed by 0.05 ml kg-1 min-1 until either they awoke or the 10-ml ampoule of solution was empty. Efficacy of antagonism of midazolam was assessed by times to eye opening and self identification, modified Steward coma scale, a post-box toy completion-time ratio and qualitatively by an independent observer. The difference between flumazenil and placebo was both clinically and statistically different in the first 2 h. Children receiving flumazenil awoke approximately four times faster and identified themselves nearly three times sooner; 65% of this group could complete the post-box toy at 10 min, compared with none of the placebo group. There were no cases of resedation, but one child did not awaken for 30 min after i.v. administration of flumazenil 1.0 mg. The mean total dose of flumazenil administered was 0.024 (SD 0.019) mg kg-1. Flumazenil rapidly antagonized midazolam-induced hypnosis in children and was associated with minimal change in cardiorespiratory variables.
Collapse
|
142
|
Tsui SL, Chan CS, Chan AS, Wong SJ, Lam CS, Jones RD. A comparison of two-lung high frequency positive pressure ventilation and one-lung ventilation plus 5 cm H2O non-ventilated lung CPAP, in patients undergoing anaesthesia for oesophagectomy. Anaesth Intensive Care 1991; 19:205-12. [PMID: 2069240 DOI: 10.1177/0310057x9101900209] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A randomised prospective controlled study was conducted during a one-year period on patients scheduled for oesophagectomy via a right thoracotomy approach. Twenty-two patients received one-lung ventilation (OLV group) and twenty patients received high frequency positive pressure ventilation (HFPPV group). Episodic hypoxaemia (SaO2 less than 90% for greater than 30 seconds, FiO2 1.0) occurred in eleven patients in the OLV group and six patients in the HFPPV group. No patient in the HFPPV group had a severe desaturation episode (SaO2 less than 80%, FiO2 1.0) compared with nine patients in the OLV group (P less than 0.05). The mean peak inspiratory pressure and average mean airway pressure were significantly lower in the HFPPV group 28.8 (SD 7.7) and 7.2 (SD 2.4) cm H2O respectively, compared with the OLV group, 40.0 (SD 9.9) and 11.9 (SD 4.9) cm H2O (P less than 0.05). Two-lung high frequency positive pressure ventilation has some advantages over one-lung ventilation during the thoracotomy phase of oesophagectomy because it is easy to administer, does not significantly compromise the surgical exposure and is associated with fewer severe undesirable physiological disturbances.
Collapse
|
143
|
Jones RD, Clarkson DG, Symonds RP, McNee SG. An iridium-192 applicator for the treatment of stomal recurrence following tracheostomy for subglottic carcinoma. Br J Radiol 1991; 64:270-1. [PMID: 2021800 DOI: 10.1259/0007-1285-64-759-270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
144
|
Docker A, Jones RD, Thomas PG, Benn T. Byssinosis in the cotton waste industry. THE JOURNAL OF THE SOCIETY OF OCCUPATIONAL MEDICINE 1991; 41:129-32. [PMID: 1921343 DOI: 10.1093/occmed/41.3.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A cross-sectional survey was carried out on 772 workers in 27 mills in the North of England involved in the processing of cotton waste. The overall prevalence of byssinosis as defined by Schilling's criteria was 9.8 per cent with 5.4 per cent having grades 2 and 3. The prevalence in workers who had only ever had cotton waste exposure (5 per cent) was significantly less than for those who had mixed waste and raw cotton exposure. There was no clear relationship between prevalence of byssinosis and years of exposure or dust levels.
Collapse
|
145
|
Anderson MH, Jones RD, Cooper J, Smith SJ, Elliott DS, Ritsch H, Zoller P. Variance and spectra of fluorescence-intensity fluctuations from two-level atoms in a phase-diffusing field. PHYSICAL REVIEW. A, ATOMIC, MOLECULAR, AND OPTICAL PHYSICS 1990; 42:6690-6703. [PMID: 9903969 DOI: 10.1103/physreva.42.6690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
|
146
|
Abstract
The pharmacokinetics of propofol were studied in 12 healthy Chinese children, aged 4-12 yr, undergoing circumcision under inhalation anaesthesia. All patients received a single i.v. bolus dose of propofol 2.5 mg kg-1 and blood concentrations of propofol over the subsequent 24 h were measured using high pressure liquid chromatography with fluorimetric detection. Data were consistent with a three-compartment model with a mean (SEM) elimination half-life of 209 (29) min and total body clearance of 40.4 (3.6) ml min-1 kg-1. The mean (SEM) apparent volume of distribution at steady state was 5.0 (2.7) litre kg-1 and volume of the central compartment was 0.6 (0.1) litre kg-1. The mean (SEM) ratio of k12:k21 was 1.4 (0.2), suggesting that, after injection of a single bolus dose in children, propofol is distributed rapidly to the shallow compartment. The mean ratio of k31:k10 suggests that lipophilicity constrains return of the drug to the central compartment.
Collapse
|
147
|
Jones RD, Donaldson IM, Parkin PJ, Coppage SA. Impairment and recovery profiles of sensory-motor function following stroke: single-case graphical analysis techniques. INTERNATIONAL DISABILITY STUDIES 1990; 12:141-8. [PMID: 2103566 DOI: 10.3109/03790799009166606] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Graphical analysis procedures have been developed to improve interpretation of sensory-motor tests from individual subjects following acute brain damage. The procedures have been applied to 11 unilateral stroke patients assessed serially over 12 months on a computerized quantitative sensory-motor test battery of which grip strength, arm speed, and tracking have been chosen for illustrative purposes. The results indicate that four graphs are necessary to fully demonstrate neurologic impairment and recovery of each sensory-motor function, although fewer graphs would be satisfactory in some applications. Such analyses have proven valuable in the display of serial performance of individual patients but demonstration of impairment and recovery is much more difficult than for group analyses.
Collapse
|
148
|
Woods BM, Jones RD. Environmental control systems in a spinal injuries unit: a review of 10 years' experience. INTERNATIONAL DISABILITY STUDIES 1990; 12:137-40. [PMID: 2103565 DOI: 10.3109/03790799009166605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In 1979 a 30-bed spinal injuries unit was opened at Burwood Hospital in Christchurch, New Zealand. The design of the building included built-in environmental control facilities for tetraplegic patients. This paper outlines 10 years of experience with environmental controls in a hospital setting, and discusses some of the problems encountered. Special mention is made of ease of setting up equipment, patient interface switches, patient acceptance, and a major upgrade and modification of the original control system. Although not utilized as much as originally anticipated, a definite need for environmental controls with the spinal injuries unit has become firmly established.
Collapse
|
149
|
Hodgson JT, Jones RD. Mortality of a cohort of tin miners 1941-86. BRITISH JOURNAL OF INDUSTRIAL MEDICINE 1990; 47:665-76. [PMID: 2223659 PMCID: PMC1012024 DOI: 10.1136/oem.47.10.665] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The mortality patterns of United Kingdom tin miners were examined in relation to calendar period and duration of underground work with particular attention to lung cancer and exposure to radon. Subjects were all men who had worked for at least one year between 1941 and 1984 at one of two United Kingdom tin mines and for whom a complete work history could be constructed from mine records. Standardised mortality ratios (SMRs) were calculated using national (England and Wales) rates. The pattern of SMRs in relation to potential explanatory variables was analysed using Poisson regression methods. Mortalities from lung cancer and silicosis (including silicotuberculosis) were significantly raised and showed a significant relation with duration of underground work (mortality from stomach cancer was raised in both underground and surface workers, but not significantly). Excess mortality from silica related disease declined steeply from 35% among workers first exposed before 1920 to 1% among those first exposed after 1950. Thirteen surface workers with known exposure to arsenic had high rates of lung and stomach cancer. The SMR for lung cancer showed a consistent pattern in relation to duration of underground exposure, rising from 83 (observed/expected = 8/9.6) for surface workers (without exposure to arsenic) to 447 (15/3.4) for workers with more than 30 years underground exposure. Examination of the SMR for lung cancer by total underground exposure, age, and time since last exposure gave rise to a model for the expression of risk which depends only on total exposure and time since exposure. The fitted model implies that the effect of exposure to radon in a given year has no effect on risk for 10 years, then rapidly rises to a maximum from which the excess risk then declines, halving every 4.3 years. There were no direct measurements of historic radon levels. A conservative estimate based on measurements taken since 1969 by the National Radiological Protection Board and the Mines and Quarries Inspectorate is that the annual dose to an underground worker was about 10 working level months (WLM). Given this assumption, the risk/exposure slope implied by the present data, and the model fitted to it, was somewhat lower than that given in the fourth Committee on the Biological Effects of Ionisation Radiation (BEIR IV) report (about 40% lower for lifetime exposures). The present data also imply different risks depending on the age at exposure, with relatively higher lifetime risks for exposure at older ages, and relatively lower risks for exposures at younger ages. In conclusion, there was a clear relation between exposure to radon and death from lung cancer. The relative risk of lung cancer due to exposure to radon was not constant in cessation of exposure. The lifetime excess risk of lung cancer implied by these data for 40 years exposure at the current statutory limit of four WLM a year starting at age 20, was about 8% (79 excess deaths per 1000 exposed), assuming average smoking habits among the exposed workers. Control of dust concentrations in the mines has substantially reduced--and may have eliminated--direct mortality from silica related disease.
Collapse
|
150
|
Jones RD, Symonds RP, Habeshaw T, Watson ER, Laurie J, Lamont DW. A comparison of remote afterloading and manually inserted caesium in the treatment of carcinoma of cervix. Clin Oncol (R Coll Radiol) 1990; 2:193-8. [PMID: 2261414 DOI: 10.1016/s0936-6555(05)80167-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Between 1982 and 1985, 240 patients with carcinoma of cervix were treated by radical radiotherapy, 140 using the selectron at the Royal Beatson Memorial Hospital (RBMH) and 100 with conventional caesium at the Western Infirmary. To allow for the increased dose rate to point A (1.2-1.4 Gy/h) during selectron treatment the overall intracavity dose was reduced by a mean value of 25%. Local recurrence rates were similar: 15% (selectron) against 14% (conventional). Three-year survival with local control was somewhat worse in the selectron group (77% against 81%) mainly because of an increased frequency of metastatic disease with local control (19.3% against 12.0%. The use of remote afterloading has not increased late morbidity (15.7% selectron, 15.0% conventional). The introduction of the selectron has brought about a marked reduction in staff radiation exposure. At the RBMH the mean recorded dose to nurses fell from 19 mSv in 1981 to 2.4 mSv in 1985.
Collapse
|