Medicine and Health Sciences Commons^™

Conjugated Bilirubin Measurement Re-Examined: A New 'Approach'., Aidan Kelleher

Theses

Conjugated bilirubin is an important but difficult metabolite to measure accurately, elevated levels of conjugated bilirubin in the serum are indicative of obstructive jaundice and therefore can be used to discriminate this disorder from other forms of unconjugated hyper bilirubinaemia.

The Atomic Force Microscope In The Elucidation Of Leukocyte Abnormality, Derbrenn O'Connor

Theses

The aim of this project was to investigate the novel use of the atomic force microscope (AFM) as a technique in the elucidation of leukocyte abnormality. To this end, comparative AFM imaging and elasticity studies were performed on normal and myeloid leukaemic leukocytes.

Initially, an evaluation of techniques for the isolation of specific leukocyte (e.g. lymphocytes, granulocytes, etc.) populations from whole blood or leukocyte concentrates, was carried out. It was found that a silanised glass surface failed to select and immobilise a leukocyte population. However, centrifugation of whole blood in an Isopaque-ficoll gradient solution yielded a viable mixed leukocyte population …

Affinity Chromatography: A Review Of Clinical Applications, David S. Hage

David Hage Publications

Affinity chromatography is a type of liquid chromatography that makes use of biological-like interactions for the separation and specific analysis of sample components. This review describes the basic principles of affinity chromatography and examines its use in the testing of clinical samples, with an emphasis on HPLCbased methods. Some traditional applications of this approach include the use of boronate, lectin, protein A or protein G, and immunoaffinity supports for the direct quantification of solutes. Newer techniques that use antibody-based columns for on- or off-line sample extraction are examined in detail, as are methods that use affinity chromatography in combination with …

Establishing Norms For A Mexican Group Using Ricketts, Steiner And Arnett Analyses, Mauricio Gonzalez Balut

Loma Linda University Electronic Theses, Dissertations & Projects

Most existing cephalometric analyses are based on norms for the Caucasian population. Therefore, they cannot be properly applied for Mexican or Hispanic patients. Ethnic variations in the normal positions of the maxilla and mandible influence and alter the diagnosis and treatment plan for each of the different type of malocclusions. Previous studies have addressed the difference between the Caucasian norms and the Hispanic norms, this indicates the variety of their skeletal, dental and facial features.

It is the purpose of this study to establish specific cephalometric standards for the native Mexican group, using the Steiner and Ricketts analyses along with …

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Posttransplant Recoarctation Of The Aorta: A Twelve Year Experience., Girish S. Shirali, C E. Cephus, M A. Kuhn, K K. Ogata, L K. Vander Dussen, R E. Chinnock, N F. Mulla, J K. Johnston, L L. Bailey, S R. Gundry, A J. Razzouk, R L. Larsen

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation.

BACKGROUND: Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta.

METHODS: This was a retrospective review of all children (ageyears) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the …

Evaluation Of The Role Of Fructosamine As An Indicator Of Diabetic Control, Katherine Hooley

Theses

Diabetes mellitus, a common metabolic disease, is characterised by excess circulating glucose concentrations. Such a hyperglycaemic status provides the stimulus for irreversible glycation (non-enzymatically post-translational) of structural and functional proteins. Protein glycation, although a cause of complication (neuropathy, micro/macrovascular disease), provides a time-averaged index of diabetes status and control. In particular, glycated plasma proteins analysis, i.e., the fructosamine assay, has received favourable response due to its speed, simplicity, low cost, and ease of automation. However, lack of standardisation and a universally-accepted calibrant has limited technical and subsequent clinical confidence in fructosamine analysis. In response, a comprehensive technical evaluation (including novel …

Development Of A Differential Assay To Selectively Measure Α-Amylase Isoenzymes., Miriam O'Connor

Theses

α-Amylase is a heterogeneous polypeptide, primarily found in the Salivary and Pancreatic glands, giving rise to two isoenzymes, namely Salivary- and Pancreatic-type Amylases. Total α-Amylase activity measurements are routinely carried out in hospital laboratories to aid in the diagnosis of diseases of the pancreas and in the investigation of pancreatic function in patients with severe abdominal pains. With the development and wide availability of modem chromogenic oligosaccharide substrates specific for Amylase, assays have become more sensitive, rapid and easier to use.

Differential Amylase Isoenzyme assays ware developed to distinguish isoenzyme levels. Several methods were developed for isoenzyme determination. Of these. …

Development Of An Elisa Method For The Measurement Of Cd44 Expression In Human Serum, Ciara Hurley

Theses

CD44 is a cell surface glycoprotein (mol. wt. =85-95 kDa) which has been implicated in lymphocyte-HEV interactions and the process of lymphocyte homing. CD44 is a complex glycoprotein which undergoes extensive alternative splicing to generate various CD44 isoforms. CD44 functions include the delivery of an activation signal to T-cells, binding to hyaluronate, mediation of lymphocyte homing, and the spread of metastatic cells. CD44 has been particularly implicated in the dissemination of non- Hodgkin's lymphoma and as such may serve as a useful prognostic marker of disease progression. CD44 measurement in serum may provide a rapid, inexpensive and relatively non-invasive prognostic …

Methicillin Resistant Staphylococcus Aureus (Mrsa): Molecular Detection And Dna Fingerprinting, Leslie Cotter

Theses

Throughout the 1990s, the incidence of methicillin-resistant Staphylococcus aureus has increased in many health care areas including acute and chronic care facilities, outpatient clinics and in the community. Once introduced into a health care environment, this nosocomial pathogen can spread rapidly and as MRSA are resistant to multiple antibiotics, treatment is often difficult. Therefore effective infection control measures are required to prevent cross-infection and further spread of endemic strains.

In this study, a sensitive and specific triplex-PCR assay was designed for MRSA detection, wherein three genes, the methicillin resistance gene (mecA). femA and the extracellular thermonuclease gene (rmc) were simultaneously …

Development Of An Atomic Force Microscopic Immunosensor For The Ferritin Antigen, Brendan O'Connell

Theses

The adsorption conditions for a range of different immunoreactants to both polystyrene and ultrasmooth silanised silicon surfaces are optimised. The conditions studied were concentration of protein, time and temperature of incubation, pH, molarity and ionic strength of the buffer. The anti-ferritin surface was selected as our model system. This immunosensor was used to develop and evaluate a millispot ELISA for ferritin. The millispot ferritin ELISA developed utilises a sample volume of 6pl and a sample incubation time of 10 minutes. Precision and accuracy studies show the assay to have a dynamic assay range of 7.8-lOOng/ml ferritin. The millispot ELISA detected …

Development And Validation Of Flow-Injection (Continuous-Flow) Elisa Techniques., Declan Gerard Spillane

Theses

A flow-through enzyme-linked immunosorbent assay was developed based on affinity chromatography using the determination of ferritin in serum as a model system. In this method, samples and standards are introduced to separate columns containing immobilised anti-ferritin antibody, and antigen bound by solid-phase antibody is subsequently detected using an anti-ferritin-alkaline phosphatase conjugate. To detect immobilised label, p-nitrophenyl phosphate is added and product is developed in the column at room temperature. Following elution of product from the column, the absorbance is measured and the columns are regenerated using a low pH elution. The final developed system requires approximately 1.5 h for the …

Development And Validation Of An Improved Ultrasensitive Assay For Cardiac Troponin I (Ctni), William G. Blake

Theses

Cardiac troponin I (cTnl) has been reported to be a highly specific marker for myocardial injury. In patients suffering from acute coronary syndromes, a sensitive serum marker which is closely related to the extent of myocardial damage which provides prognostic data and which can be measured rapidly is desirable. In this thesis a “sandwich” enzyme immunoassay was developed to measure cTnI. The developed assay was reproducible with the inter assay precision ranging from 4.8-14% and the intra assay precision ranging from 3.1-9.5%. The limit of detection of the assay was calculated as 0.385 ng/ml. The upper reference range (non-parametric 95% …

Factors Which Influence Women's Decisions For Choice Of Primary Surgery For Stage I And Stage Ii Breast Cancer, Barbara Mastaglia

Theses : Honours

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive …

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

The Clastogenic Effects Of Cyclophosphamide And A Sixty Hertz Electromagnetic Field On Bone Marrow Cells Of Cd-1 Mice, Kevin K. Block

Dissertations

Extremely low frequency (ELF) electromagnetic fields (EMF) have been correlated with the induction of cancer in a number of epidemiological studies (Feychting and Ahlbom, 1993; T,m and Lee, 1994; London e t al. 1991; Lovely et al., 1994; Tomenius, 1986; Wertheimer and Leeper, 1979, 1982). Two hypothesis were tested in the present study. The first hypothesis tested was that exposure to a 7.3 G magnetic field for 24 hours would increase the frequency of clastogenic and/or mutagenic events in bone m arrow cells of mice. The second hypothesis tested was that exposure to a 7.3 G magnetic field for 24 …

A Pilot Study On The Short Term Effects Of The Herbst Appliance On The Glenoid Fossa, David A. Bennion

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this pilot study was to evaluate the initial effects of the Herbst appliance and determine through the use of common cephalometric radiographs that were optically enhanced and then digitally reproduced, if fossa migration is taking place. Fourteen, (6 male, 8 female), growing patients were treated by the same clinician for the correction of a Class II malocclusion using a modified Herbst appliance. Pretreatment (T₁) standard lateral cephalometric radiographs and post Herbst treatment (T_H) optically enhanced lateral cephalometric radiographs were taken. All radiographs were digitally captured and reproduced so 6 linear and 1 area …

A Cephalometric Study Of The Class Ii Correction Effects Of The Eureka Spring, Ernest L. Stromeyer

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of the Eureka Spring appliance, was investigated on 37 consecutively treated, non compliant, bilateral Class II malocclusions, requiring at least 3 mm or more of additional molar correction. The mean pretreatment age of this sample was 13.9 years. All patients were treated by a single clinician utilizing the Eureka Spring. Lateral cephalographs were taken at start of orthodontic treatment (T1), at insertion of Eureka Springs (T2), and at removal of the Eureka Springs (T3). The average treatment interval between T2 and T3 was 4 months. Class II correction occurred almost entirely by dentoalveolar movement, 33% in the maxilla …

Update - July 1997, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Practicing on Newly Dead Bodies
-- Life versus Death: The Ethical Imperative to Practice and Teach Using the Newly Dead
-- You Can't Always Get What You Want
-- MA in Clinical Ethics
-- MA in Clinical Ministry

Electromyography (Emg) Signal Classification By Artificial Neural Networks, Behnam Dashtipour

Electrical & Computer Engineering Theses & Dissertations

EMG signal processing is one of the active fields of biomedical signal processing. One unanswered question is how to determine whether a muscle is fatigued by analyzing the EMG signal. Fatigue detection could be useful in several different practical situations. There are several studies which show there are differences between EMG signal features before fatigue and after fatigue. Generally studies are based on an analytical analysis of the EMG signal instead of a quantitative analysis. In all previous studies in EMG signal processing for fatigue/nonfatigue detection, the result is that there exist some differences between the EMG signal before muscle …

Oral Cancer Screening, Damon Omar Watson

Honors Theses

Cancers of the oral cavity and pharynx have increased throughout the decades. Since oral cancer represents a small percentage of the total cancers in the United States, it is often overlooked. Though this is the case, the results of this cancer can be devastating. To address this issue, an Oral Cancer Screening was organized on August 14, 1996 at the West Michigan Cancer Center in Kalamazoo. This was a joint collaboration between the author, the West Michigan Cancer Center, and the Kalamazoo Valley Dental Society. This event allowed research to take place concerning the data obtained. Confidential results and information …

Bronchospasm/Desaturation Under Anaesthesia: Are They Signs Of Pneumothorax?, N A. Zubair, A Zaidi, R S. Kamal

Department of Anaesthesia

No abstract provided.

A Patient Management Program: The Evaluation Of A Combined Pre-Admission And Early Discharge Program, Lorna Rogers

Theses: Doctorates and Masters

The purpose of this descriptive study was to describe the evaluation of a 'Patient Management Program'. This managed care type of program combined a Pre-Admission Clinic and an Early Discharge Program. It was established as a twelve month pilot program at a major Western Australian public teaching hospital in January 1995. It aimed to provide a more efficient health service by replacing part of elective surgical patients' inpatient care with outpatient services. The first component of the Program was the Pre-Admission Clinic, which allowed patients to undergo pre-operative assessment and testing prior to admission to hospital, thus facilitating same day …

Monitoring Of Oxygen Saturation During And After Endoscopy, George Paul Van Lawick

Theses : Honours

Fibreoptic endoscopy is a common and relatively safe diagnostic and therapeutic procedure used to examine the gastrointestinal tract. Previous research has established that oxygen desaturation is common among patients undergoing endoscopy and is one of the few complications which may arise during, and after the procedure. Oxygen saturation (Sa0₂) is a measurement of the percentage of oxygen carried by the haemoglobin and can be measured noninvasively and accurately using a pulse oximeter. Oxygen desaturation is generally described as Sa0₂ levels at or below 90%. Currently there are no clear guidelines for the duration of Sa0₂ monitoring …

Update - December 1996, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Bioehtics Endowment Honors Jack and Margaret Provonsha
-- Partial Birth Abortion: Ethical Issues
-- Partial Birth Abortion: Mandates, Methods, and Morality
-- Partial Birth Abortion Dialogue

Clustered Microcalcification Detection Using Optimized Difference Of Gaussians, Edward M. Ochoa

Theses and Dissertations

The objective of this thesis is to design an automated microcalcification detection system to be used as an aid in radiologic mammogram interpretation. This research proposes the following methodology for clustered microcalcification detection. First, preprocess the digitized film mammogram to reduce digitization noise. Second, spatially filter the image with a difference of Gaussians (DoG) kernel. To detect potential microcalcifications, segment the filtered image using global and local thresholding. Next, cluster and index these detections into regions of interest (ROIs). Identify ROIs on the digitized image (or hardcopy printout) for final radiologic diagnosis.

Pain Levels And Rating Of Perceived Exertion Of People With Herniated Lumbar Disc While Walking In Two Environments, Brenda L. Cunningham-Boerger

Masters Theses

The purpose of the study was to investigate if walking in water is an effective substitute for walking on land as an aerobic exercise for people with herniated lumbar disc. The study involved the dependent variables o f perceived pain levels (PPL) and ratings o f perceived exertion (RPE). Independent variables were walking condition and work intensity. Land walking was performed on a treadmill; water walking was performed in an indoor pool 4.5 ft deep and 90*F. Work was set at four different intensities, based on the formula for predicting maximum heart rate (MHR), 220 minus age. The graded work …

Experience With Larangeal Mask Airway In Pakistani Patients, F A. Khan, M A. Afzal, R S. Kamal

Department of Anaesthesia

One hundred and thirty seven adult patients undergoing peripheral surgery were studied regarding ease of larangeal mask airway (LMA) insertion, airway maintenance during surgery and complication encountered during insertion, maintenance and in the postoperative period. In a majority (84%) of patients, the airway was positioned correctly at the first attempt, 3% patients had mild laryngospasm at insertion and in 85% a good airway was obtained. No airway related problems were encountered intraoperatively. Two percent patients had laryngospasm on removal of LMA. Postoperatively, the complaint of sore throat and uvular trauma was seen in 4% cases.

Update - October 1996, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Is Organ Reanimation a Better Mousetrap?
-- Reanimation of Dead Hearts
-- Reanimation Dialogue
-- James W. Walters publishes second book on ethics and aging

Pregnancy Induced Hypertension--Anaesthetic Considerations, N A. Zubair

Department of Anaesthesia

No abstract provided.