Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Impact Of Suture Choice On Stricture Formation Following Repair Of Esophageal Atresia, Shawn D. St Peter, Patricia A. Valusek, Charles L. Snyder, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

Background/ Purpose: The most common complication following repair of esophageal atresia is anastomotic stricture. Despite strong opinions of pediatric surgeons regarding the type of suture used for the anastomosis, these opinions remain unsubstantiated by any data present in the literature. Therefore, we investigated the rate and severity of stricture formation relative to the suture size and material.
Materials & Methods: A retrospective analysis of our most recent 20-year experience with repair of esophageal atresia and tracheoesophageal fistula (EA/TEF) was performed. Stricture was defined as the need for dilation. Outcomes were analyzed based on absorbability, texture, and type of …

Accessibility Of Home Blood Pressure Monitors For Blind And Visually Impaired People, Mark M. Uslan, Darren M. Burton, Thomas E. Wilson, Steven Taylor, Bruce S. Chertow, Jack E. Terry

Physics Faculty Research

Background: The prevalence of hypertension comorbid with diabetes is a significant health care issue. Use of the home blood pressure monitor (HBPM) for aiding in the control of hypertension is noteworthy because of benefits that accrue from following a home measurement regimen. To be usable by blind and visually impaired patients, HBPMs must have speech output to convey all screen information, an easily readable visual display, identifiable controls that are easy to use, and an accessible user manual.

Methods: Data on the physical aspects and the features and functions of nine Food and Drug Administration-approved HBPMs (eight of which were …

Perioperative Management Of Pheochromocytoma: Anaesthetic Implications, Aliya Ahmed

Department of Anaesthesia

Pheochromocytoma is a catecholamine producing tumour that can cause severe hypertension and other systemic disturbances. The perioperative management of pheochromocytoma remains a complicated anaesthesia challenge requiring intensive preoperative preparation and vigilant intraoperative and postoperative care. In this article the perioperative management of pheochromocytoma is reviewed by first summarizing its pathophysiology, clinical aspects and diagnosis, then highlighting the preoperative optimization of the patient and finally describing the intraoperative and postoperative anaesthetic management in the light of the current information.

High Dietary Fat Intake Is Not Associated With High Levels Of Circulating Lipoproteins Or Total Cholesterol, C. Jayne Brahler, C. Wilson, Janine Baer

Physical Therapy Faculty Publications

The objective of this study was to determine the association between dietary intake of fats, waist to hip ratio (WHR), body mass index (BMI), and blood lipoproteins and total cholesterol (TC) using food frequency data in one group of apparently healthy, urban African American women and their daughters (n = 110). Subjects were fasted when blood was drawn, waist and hip circumferences and body weight and height were measured, and WHR and BMI were calculated.

Average daily total fat intakes were 91.46 g and 77.83 g for mothers and daughters, respectively, but average LDL levels of 104.4 g/L and 103.1 …

Anesthetic Deaths In A Developing Country, Mueenullah Khan, Fauzia A. Khan

Department of Anaesthesia

It is important to ascertain the contribution of anesthesia to perioperative mortality in order to enable improvement in the safety and quality of care. Scanty literature regarding anesthetic mortality from developing countries is available. We present data regarding anesthesia related mortality in a university hospital in a developing country. We reviewed all patient deaths occurring between 1992-2003 occurring within 24 hours of anesthesia, as part of departmental quality assurance activity. The aim of study was to identify any contributing factors associated with mortality, and to compare our data with similar studies from developed and developing countries. 111,289 cases were handled …

Tramadol Versus Nalbuphine In Total Intravenous Anaesthesia For Dilatation And Evacuation, Khalid Maudood Siddiqui, Ursula Chohan

Department of Anaesthesia

Objective: To compare the results of Tramadol with Nalbuphine for dilatation and evacuation with total intravenous anaesthesia technique.Methods: A total of 70 patients (35 in each group) were included in this prospective, double blind randomized study. Intravenous tramadol 1.5 mg/kg and nalbuphine 0.1 mg/kg were compared in total intravenous anaesthesia (TIVA) using a propofol infusion in patients undergoing dilatation and evacuation (D and E). Changes in haemodynamic variables greater than 20% from the base line values were noted.Results: There was no difference found in haemodynamic parameters. There was statistically significant difference found (p < 0.05) in postoperative recovery between the two groups.CONCLUSION: Quality of analgesia was better in nalbuphine group but both drugs provide suitable analgesic supplementation to TIVA.

Outcomes Of Peginterferon Alfa-2a And Ribavirin Combination Therapy In A Resident-Initiated, Multidisciplinary, Hepatitis C Clinic, Nicole M. Agostino Do, Erini Vasiliadis Do, K Nadeem Ahmed Md, Suzanne J. Templer Do, Edward R. Norris Md, Fapa, Fapm, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Joseph L. Yozviak Do, Facp

Department of Medicine

No abstract provided.

Development Of A Blood Test For The Detection Of Cutaneous Malignant Melanoma, Rebecca Slattery

Theses : Honours

Cutaneous Malignant Melanoma is a highly aggressive form of skin cancer that has a tendency to metastasise. In its early stages, the 5-year survival rate of patients is greater than 90% following surgical excision of an in situ tumour. However, following metastasis of the tumour, the 5-year survival rate declines to 5-35%. Due to the correlation between metastasis and declining survival, studies have attempted to identify potential metastasis as early as possible. Molecular markers of melanoma cells in the peripheral blood of CMM patients have been investigated, as the invasion of tumour cells into the blood is one of the …

Using Pareto Fronts To Evaluate Polyp Detection Algorithms For Ct Colonography, Adam Huang, Jiang Li, Ronald M. Summers, Nicholas Petrick, Amy K. Hara

Electrical & Computer Engineering Faculty Publications

We evaluate and improve an existing curvature-based region growing algorithm for colonic polyp detection for our CT colonography (CTC) computer-aided detection (CAD) system by using Pareto fronts. The performance of a polyp detection algorithm involves two conflicting objectives, minimizing both false negative (FN) and false positive (FP) detection rates. This problem does not produce a single optimal solution but a set of solutions known as a Pareto front. Any solution in a Pareto front can only outperform other solutions in one of the two competing objectives. Using evolutionary algorithms to find the Pareto fronts for multi-objective optimization problems has been …

Validating Pareto Optimal Operation Parameters Of Polyp Detection Algorithms For Ct Colonography, Jiang Li, Adam Huang, Nicholas Petrick, Jianhua Yao, Ronald M. Summers, Maryellen L. Giger (Ed.), Nico Karssemeijer (Ed.)

Electrical & Computer Engineering Faculty Publications

We evaluated a Pareto front-based multi-objective evolutionary algorithm for optimizing our CT colonography (CTC) computer-aided detection (CAD) system. The system identifies colonic polyps based on curvature and volumetric based features, where a set of thresholds for these features was optimized by the evolutionary algorithm. We utilized a two-fold cross-validation (CV) method to test if the optimized thresholds can be generalized to new data sets. We performed the CV method on 133 patients; each patient had a prone and a supine scan. There were 103 colonoscopically confirmed polyps resulting in 188 positive detections in CTC reading from either the prone or …

Gastroesophageal Reflux Disease And Fundoplication In Infants And Children, Shawn D. St Peter, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

Gastroesophageal reflux disease (GERD) can be one of the most distressing conditions developing at different ages in infants and children. The disease itself is a complex process along with ongoing dynamic anatomic and physiologic changes occurring during normal development. Therefore among referring physicians, considerations regarding the role of surgery for GERD in children varies widely depending on individual experiences in managing these patients. These varied opinions result in discrepancies in the operative experience with fundoplication among pediatric surgeons. It is unclear how much of the current opinions stem from published evidence, particularly with regard to the safety and efficacy of …

Pancreatic Operations In Children, An Institutional Experience And Review Of Literature, Varun Puri, Lisa Martin, Shawn D. St Peter, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

Pancreatic operations are not commonly performed in the pediatric age group. Tumors, chronic pancreatitis, trauma and hyperinsulinemic hypoglycemia are the main diseases leading to pancreatic resections in children. Excluding patients with acute pancreatitis and pseudocysts, over the last 5 years we have performed operations in 11 children for pancreaticoduodenal pathology. The diagnoses encountered were tumors or tumor like conditions (four), angiodysplasia (one), chronic pancreatitis (one), traumatic pancreatic transection (three), traumatic pseudocyst, and neonatal hyperinsulinemic hypoglycemia (one). Operations performed were: pancreaticoduodenectomy (PD) in three patients, subtotal or distal pancreatectomy in six patients, distal pancreaticojejunostomy with oversewing of the proximal pancreatic duct …

Recruiting And Retaining Gps And Patients In Intervention Studies: The Deps-Gp Project As A Case Study, M Williamson, J Pirkis, J Pfaff, O Tyson, Moira Sim, N Kerse, N Lautenschlager, N Stocks, O Almeida

Research outputs pre 2011

Background: Recruiting and retaining GPs for research can prove difficult, and may result in sub-optimal patient participation where GPs are required to recruit patients. Low participation rates may affect the validity of research. This paper describes a multi-faceted approach to maximise participation of GPs and their patients in intervention studies, using an Australian randomised controlled trial of a depression/suicidality management intervention as a case study. The paper aims to outline experiences that may be of interest to others considering engaging GPs and/or their patients in primary care studies. Methods: A case study approach is used to describe strategies for: (a) …

Anaesthesia For Interventional Neuroradiology, Aliya Ahmed

Department of Anaesthesia

There have been rapid and significant advances in diagnostic and interventional radiology, including interventional neuroradiology, in recent years. Many intracranial vascular pathologies are being successfully managed by endovascular interventional neuroradiology techniques. These techniques include procedures like embolization of vascular tumours and arterio-venous malformations, coiling of cerebral aneurysms. etc. The support of anaesthesia team is requested for these therapeutic endovascular neuroradiological procedures. The main aims of the anaesthesiologist during any interventional neuroradiology procedure are provision of a physiologically stable and immobile patient, alteration of arterial blood pressure as necessary, and appropriate and timely management of complications. Provision of anaesthesia in remote …

Adenoviral Mediated Gene Transfer Into The Dog Brain In Vivo, Marianela Candolfi, Kurt Kroeger, Elizabeth Pluhar, Chunyan Liu, Carlos Barcia, Josee Bergeron, Mariana Puntel, James Curtin, Elizabeth Mcniel, Andrew Freese, John Ohlfest, Peter Moore, William Kuoy, Pedro Lowenstein, Maria Castro

Articles

OBJECTIVE: Glioblastoma multiforme (GBM) is a devastating brain tumor for which there is no cure. Adenoviral-mediated transfer of conditional cytotoxic (herpes simplex virus [HSV] 1-derived thymidine kinase [TK]) and immunostimulatory (Fms-like tyrosine kinase 3 ligand [Flt3L]) transgenes elicited immune-mediated long-term survival in a syngeneic intracranial GBM model in rodents. However, the lack of a large GBM animal model makes it difficult to predict the outcome of therapies in humans. Dogs develop spontaneous GBM that closely resemble the human disease; therefore, they constitute an excellent large animal model. We assayed the transduction efficiency of adenoviral vectors (Ads) encoding beta-galactosidase (betaGal), TK, …

Biomechanical Testing Of Two-Level Cervical Disc Arthroplasty, Laura J. Gilmour

Theses and Dissertations (ETD)

In vitro biomechanical studies comparing two-level cervical disc arthroplasty with two-level fusion were completed using an established cadaveric cervical spine model. Three conditions were tested: non-instrumented, instrumented with two-level fusion (C5-C6 and C6-C7), and instrumented with two-level arthroplasty (C5-C6, C6-C7) using the Prestige Low-Profile (Medtronic Sofamor Danek, Memphis TN) or ProDisc-C (Synthes Spine, West Chester PA) prosthetic disc. Specimens were tested non-destructively in physiologic flexion-extension, lateral bending, and axial rotation to an end-limit load of 3-Nm or 45o rotation. Rotations at the superior, implanted, and inferior motion segment units (MSU) of the instrumented conditions were normalized to the non-instrumented condition …

A Computer Simulation Model Of The Human Head-Neck Musculoskeletal System, Jun Yan

Theses and Dissertations (ETD)

Objective. The objective of this research was to develop a muscle-driven biomechanical model of the human head-neck system that could be used to simulate neck movements under muscle control. This model can further be modified to enable input from an external stimulus, such as EMG data.

Summary of background data. Utilizing computer aided design (CAD) and dynamic simulation software programs, the Joint Implant Biomechanics Laboratory at The University of Tennessee Health Science Center developed a virtual model of the human cervical spine to simulate the in vitro biomechanical experiments. This in vitro model did not include any muscle …

Guidelines And Standards For Performance Of A Pediatric Echocardiogram: A Report From The Task Force Of The Pediatric Council Of The American Society Of Echocardiography., Wyman W. Lai, Tal Geva, Girish S. Shirali, Peter C. Frommelt, Richard A. Humes, Michael M. Brook, Ricardo H. Pignatelli, Jack Rychik, Pediatric Council Of The American Society Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Variability In Selecting Lateral Cephalometric Landmarks In Two Cbct Image Modes, Dana Nguyen

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to determine the variability of lateral cephalometric landmark selection in two cone beam computed tomography (CBCT) lateral cephalometric simulations: 1) a mean projection image (MPI) and 2) a serial sagittal slice image (SSSI).

Methods: A MPI is a two-dimensional (2D) image obtained from the NewTom 3G^TM CBCT that resembles the conventional lateral cephalogram. A SSSI is a 2D image also obtained from CBCT data, but is created by superimposing a series of selected thin sagittal slices containing the required cephalometric landmarks. This study compared the Ricketts and Steiner analysis of the MPI …

Estimation Of Blood Loss During Caesarean Section: An Audit, Fauzia A. Khan, Mueenullah Khan, Asif Ali, Ursula Chohan

Department of Anaesthesia

Objective: To evaluate the blood ordering practice and blood transfusion for Caesarean sections at our institution and to compare the estimated blood loss between anaesthetists and obstetricians.Methods: A review of 126 patients undergoing both elective and emergency Caesarean section was undertaken in 2002. Information collected included the number of blood units cross-matched preoperatively, type of surgery (emergency or elective), type of anaesthesia, parity of the patient, estimated blood loss by both anaesthetists and obstetricians, intraoperative and postoperative transfusion within 48 hours and pre and post operative haemoglobin (Hb) and haemocrit (Hct).Results: A total of 215 units were cross-matched for 126 …

Single Molecule Detection Systems And Methods, John G. K. Williams, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

A micofluidic system is provided that includes a substrate, a first microchannel disposed in the substrate for providing a reactant to a reaction zone, a second microchannel disposed in the substrate, the third microchannel providing fluid communication between the first and second microchannels. The system also typically includes first and second electrodes, positioned at opposite ends of the second microchannel, for providing an electric field within the second microchannel. In operation, when the reactant is in the reaction zone, a reaction product is produced having a net electric charge different from the electric of the reactant.

Open Versus Laparoscopic Pyloromyotomy For Pyloric Stenosis: A Prospective, Randomized Trial., Shawn D. St Peter, G W. Holcomb Iii, Casey M. Calkins, J Patrick Murphy, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pyloric stenosis, the most common surgical condition of infants, is treated by longitudinal myotomy of the pylorus. Comparative studies to date between open and laparoscopic pyloromyotomy have been retrospective and report conflicting results. To scientifically compare the 2 techniques, we conducted the first large prospective, randomized trial between the 2 approaches.

METHODS: After obtaining IRB approval, subjects with ultrasound-proven pyloric stenosis were randomized to either open or laparoscopic pyloromyotomy. Postoperative pain management, feeding schedule, and discharge criteria were identical for both groups. Operating time, postoperative emesis, analgesia requirements, time to full feeding, length of hospitalization after operation, and complications …

One Year Experience Of Mri Under General Anaesthesia, Shahla Siddiqui

Department of Anaesthesia

A case series over one year of our experience of using Propofol and Laryngeal mask airway (LMA) in children under 10 years of age undergoing MRI under general anaesthesia is presented. All paediatric patients under the age of ten attending out-patient department were included in the case series starting from January 1st, 2004 till December 31st, 2004. All patients underwent general anaesthesia using Propofol / LMA technique as described in detail in communication below. A total of 78 children were included; the only patient requiring intubation was the youngest: a neonate of 1 day who had a large orbital mass. …

Viral Hemorrhagic Fever - An Icu Perspective, Asghar Ali, Shahla Siddiqui

Department of Anaesthesia

No abstract provided.

Outcomes Associated With A Home Care Telehealth Intervention, Faith Hopp, Peter Woodbridge, Usha Subramanian, Laurel Copeland, David Smith, Julie Lowery

Social Work Faculty Publications

To determine whether adding telehealth technology to traditional home care services increases health-related quality of life (HRQOL) and home care satisfaction, and decreases resource utilization among home care patients. This trial included 37 home care patients receiving services in a Veterans Affairs medical center, randomized into intervention and control groups. Outcome measures included patient satisfaction and HRQOL at baseline and 6-month follow- up, and the use of inpatient and outpatient services before and during the 6-month study period. Intervention group patients reported greater improvement in the mental health component of HRQOL, (t = 2.27; df = 15; p = …

Factors That Influence The Blood Flow Response Of Skin To Electrical Stimulation, Abdul-Majeed Raja Al-Malty

Loma Linda University Electronic Theses, Dissertations & Projects

Female reproductive hormones, aging, global heating and local heating are factors affecting skin blood flow (SBF), but their effect on electrical stimulation (ES) has never been examined until the present investigation. To investigate female reproductive hormones, nine women (age= 25.6±3.5 years) with a normal menstrual cycle (MC) underwent ES in thermoneutral (25°±0.5°C) and warm environments (35°±0.5°C). To investigate aging, ES was applied on active young (n=15, age=32.1±8.3 years) and old (n=8, 64.5±6.2 years) groups in thermoneutral and warm environments. To investigate the effect of global and local heating, groups of 15 and 18 subjects (age= 18-40 years) experienced ES under …

Bone Morphogenic Protein Induced Repair Of The Premaxillary Cleft, Rick J. Rawson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to evaluate the bony augmentation of premaxillary clefts in humans using recombinant bone morphogenic protein (rhBMP-2) in a collagen sponge carrier. 12 patients with unilateral cleft alveolar ridges were evaluated pre- and 4 months postoperatively. 10 patients were repaired with rhBMP-2 while two others were grafted with anterior iliac crest particulate marrow cancellous bone (PMCB). Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and pre/post operative volume ratios.

A pre/post operative volume ratio for patients repaired with rhBMP-2 ranged from 24.1% to 90.6% with a mean of …

Preliminary Results For A Monocular Marker-Free Gait Measurement System, Jane Courtney, Annraoi Depaor

Articles

This paper presents results from a novel monocular marker-free gait measurement system. The system was designed for physical and occupational therapists to monitor the progress of patients through therapy. It is based on a novel human motion capture method derived from model-based tracking. Testing is performed on two monocular, sagittal-view, sample gait videos – one with both the environment and the subject’s appearance and movement restricted and one in a natural environment with unrestricted clothing and motion. Results of the modelling, tracking and analysis stages are presented along with standard gait graphs and parameters.

Desulfovibrio Desulfuricans G20 Tetraheme Cytochrome Structure At 1.5 A˚ And Cytochrome Interaction With Metal Complexes, Mrunalini Pattarkine, J J. Tanner, C A. Bottoms, Y H. Lee, Judy D. Wall

Faculty Works

The structure of the type I tetraheme cytochrome c3 from Desulfovibrio desulfuricans G20 was determined to 1.5 A˚ by X-ray crystallography. In addition to the oxidized form, the structure of the molybdate-bound form of the protein was determined from oxidized crystals soaked in sodium molybdate. Only small structural shifts were obtained with metal binding, consistent with the remarkable structural stability of this protein. In vitro experiments with pure cytochrome showed that molybdate could oxidize the reduced cytochrome, although not as rapidly as U(VI) present as uranyl acetate. Alterations in the overall conformation and thermostability of the metal-oxidized protein were investigated …

Forensic Nursing: Death Investigation, Lauren Palazzo

Senior Honors Projects

Forensic Nursing is a fairly new exciting nursing specialty. Television shows such as CSI portray forensic nurses and investigators in a less than realistic manner. Forensic nursing and investigation are exciting fields to specialize in, but the role of the forensic nurse and investigator are often misunderstood. For my project I wrote a research paper on forensic nursing, joined the international association of Forensic nurses, attended the international conference in washington dc and set in on a few meetings with a board, including lawyers, represenatives from the rape crisis center, clinical managers from W&I ED, nurses, NP’s, etc. in discussing …