Seeing the light in day surgery.
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Adaptation, Psychological↗
Biomedical subjects
A Lowe
Publications and source records attributed to A Lowe.
Stent revascularization for atherosclerotic renal artery stenosis. 1-year clinical follow-up.
Patients who had undergone stent revascularization of renal artery stenosis for poorly controlled hypertension, preservation of renal function, or both were monitored to assess the procedure's effect upon subsequent renal function and blood pressure control. At 1-year follow-up, systolic and diastolic blood pressures had significantly decreased (166 +/- 26 to 156 +/- 25 mmHg and 86 +/- 14 to 80 +/- 13 mmHg, respectively; P < 0.05), and creatinine levels decreased or remained stable in approximately two thirds of the patients. Renal artery stent revascularization appears to have a beneficial effect upon blood pressure control and a nondeleterious effect upon renal function in the majority of patients.
Aged↗
The beta3-adrenergic receptor in the obesity and diabetes prone rhesus monkey is very similar to human and contains arginine at codon 64.
The beta3-adrenergic receptor (ADRbeta3) is a seven-membrane spanning, G-protein linked receptor expressed in brown adipose tissue in rodents, and visceral adipose tissue in humans. Stimulation of the receptor by norepinephrine leads to lipolysis and thermogenesis. In rodent models of obesity and diabetes, administration of beta3-agonists results in weight loss and improved glucose tolerance. Studies indicate that the pharmacological properties of the ADRbeta3 differ markedly between rodents and humans, making generalizations of rodent studies to humans difficult. We hypothesized that the obesity and diabetes prone rhesus monkey (Macaca mulatta) would provide an excellent animal model to study the role of the ADRbeta3 in the development of obesity and diabetes as well as for assessment of the therapeutic efficacy of beta3-agonists. We sequenced the entire coding region of the rhesus ADRbeta3 gene. Like humans, the rhesus ADRbeta3 has two exons. There is 89% amino acid (aa) identity between human and rhesus compared to 82% aa identity between human and mouse. A single base deletion results in divergence of the intracellular carboxy terminus accounting for 26 of the 45 aa changes and 10 additional aa. Of the 15 rhesus monkeys studied, all were homozygous for Arg64. In humans, Arg64 (rather than Trp) is associated with increased body mass index, insulin resistance, and an earlier onset of type II diabetes mellitus. We conclude that the rhesus ADRbeta3 is more similar to the human ADRbeta3 than to the rodent ADRbeta3 suggesting that this primate model may be more appropriate for physiologic and therapeutic studies of the ADRbeta3 axis, and that Arg64 may influence susceptibility in this species to obesity, insulin resistance, and type II diabetes.
Amino Acid Sequence↗
[Clinical monitoring. A method for quality control].
Clinical monitoring approximates the quality control standards that have been developed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and utilizes clinical indicators to measure the relative quality of the health care given. This method can be used to compare the quality of desired care against actual day by day care. To demonstrate how it can be applied, an example of clinical monitoring performed in a U.S. hospital is presented.
Humans↗
The role of the operating room nurses in the treatment of necrotizing fasciitis.
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Adult↗
Measuring outcomes: a nursing report card.
Balancing quality health care with the pressures of managed care and restructuring requires monitoring and measuring outcomes. The "nursing report card" organizes data in an informative manner, allowing nursing's contributions to patient outcomes to be assessed and reported to all customers in an ongoing fashion.
Humans↗
The vesicle-associated membrane protein family of proteins in rat pancreatic and parotid acinar cells.
BACKGROUND & AIMS: The vesicle-associated membrane protein (VAMP) family of proteins may play an important role in regulating enzyme secretion from pancreatic and parotid acini. The purpose of this study was to characterize the isoforms produced in pancreatic and parotid acini and determine their subcellular locations. METHODS: Using a battery of specific antisera and recombinant tetanus toxin light chain (which cleaves VAMP-2 and cellubrevin), the presence of each VAMP molecule in the acini was determined by immunoblotting of subcellular membrane fractions; their localization was determined by confocal immunofluorescence microscopy and immunogold electron microscopy. RESULTS: Both VAMP-2 and cellubrevin were present on both the zymogen granule membrane and plasma membrane. VAMP-1 was not present in the acinar cell but was found in the nerve endings innervating the acini. As expected, pancreatic acinar VAMP-2 and cellubrevin were sensitive to cleavage by recombinant tetanus toxin. CONCLUSIONS: VAMP-2 and cellubrevin may play integral roles in exocytosis of the pancreatic and parotid acinar cells, whereas VAMP-1 is restricted to nerves that innervate the acini and may function to modulate exocrine activity.
Animals↗
Severe autosomal dominant hypertension and brachydactyly in a unique Turkish kindred maps to human chromosome 12.
Finding genes that cause human hypertension is not straightforward, since the determinants of blood pressure in primary hypertension are multifactorial. One approach to identifying relevant genes is to elucidate rare forms of monogenic hypertension. A relevant mutation may provide a rational starting point from which to analyse the pathophysiology of a condition affecting 20% of the world's population. In 1973 a family with autosomal dominantly inherited brachydactyly and severe hypertension, where the two traits cosegregated completely, was described. We have now re-examined this kindred, and localized the hypertension and brachydactyly locus to chromosome 12p in a region defined by markers D12S364 and D12S87. As the renin-angiotensin-system and sympathetic nervous system respond normally in this form of hypertension, the condition resembles essential hypertension. This feature distinguishes this form of hypertension from glucocorticoid remediable aldosteronism and Liddle's syndrome, which are salt-sensitive forms of monogenic hypertension with very low plasma renin activity. We suggest that identification of the gene involved in hypertension and brachydactyly and its mutation will be of great relevance in elucidating new mechanisms leading to blood pressure elevation.
Adult↗
Cultural aspects of African American eating patterns.
The high mortality from diet-related diseases among African Americans strongly suggests a need to adopt diets lower in total fat, saturated fat and salt and higher in fiber. However, such changes would be contrary to some traditional African American cultural practices. Focus group interviews were used to explore cultural aspects of eating patterns among low- and middle-income African Americans recruited from an urban community in Pennsylvania. In total, 21 males and 32 females, aged 13-65+ years were recruited using a networking technique. Participants identified eating practices commonly attributed to African Americans and felt that these were largely independent of socioeconomic status. They were uncertain about links between African American eating patterns and African origins but clear about influences of slavery and economic disadvantage. The perception that African American food patterns were characteristically adaptive to external conditions, suggest that, for effective dietary change in African American communities, changes in the food availability will need to precede or take place in parallel with changes recommended to individuals. Cultural attitudes about where and with whom food is eaten emerged as being equivalent in importance to attitudes about specific foods. These findings emphasize the importance of continued efforts to identify ways to increase the relevance of cultural context and meanings in dietary counseling so that health and nutrition interventions are anchored in values as perceived, in this case, by African Americans.
Adolescent↗
Reducing variation in patient care. Nursing responds to capitation.
As managed care and capitation methods of payment become more common to hospitals, a strategy to improve quality and reduce costs is introduced in response to these new pressures. Nursing leaders must take the initiative and respond to these changes by reducing the variations in patient care. The author describes seven initiatives undertaken by the nursing leaders of The St. Joseph Healthcare System in Albuquerque. New Mexico during a 3-year period. The success of these initiatives and their universal application is discussed.
Capitation Fee↗
The discontent of the nineties--one nurse's perspective.
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Delivery of Health Care↗
Bond strength, interfacial characterization, and fracture surface analysis for a new stress-breaking bonding agent.
Three commercial dentin bonding systems were analyzed by tensile bond testing, area analysis of fractured surfaces, and SEM analysis of the tooth-resin interfaces. Tensile bond strengths in megapascals(SD) were Tenure-Marathon V ([T-M]; 8.86[3.02]), new system with low-viscosity resin ([K-LVR-P]; 6.50[2.01]), and new system without low-viscosity resin ([K-P] = 7.28[1.75]), which were significantly greater than Scotch-bond 2-P50 ([SB-P50]; 3.96[1.02]). Gaps that ranged up to 5.6 microns (mean for the group) were observed around most of the restorations at dentin surfaces and less so at enamel surfaces, where some of the restorations remained free of gaps. The gaps near the dentin margin were significantly smaller for K-LVR-P than for SB-P50. The tensile test revealed mixed failure modes in all systems, and in the cross sections of class V restorations, the gaps were confined to the dentin-resin junction.
Analysis of Variance↗
Oral appliances for the treatment of snoring and obstructive sleep apnea: a review.
This paper, which has been reviewed and approved by the Board of Directors of the American Sleep Disorders Association, provides the background for the Standards of Practice Committee's parameters for the practice of sleep medicine in North America. The 21 publications selected for this review describe 320 patients treated with oral appliances for snoring and obstructive sleep apnea. The appliances modify the upper airway by changing the posture of the mandible and tongue. Despite considerable variation in the design of these appliances, the clinical effects are remarkably consistent. Snoring is improved and often eliminated in almost all patients who use oral appliances. Obstructive sleep apnea improves in the majority of patients; the mean apnea-hypopnea index (AHI) in this group of patients was reduced from 47 to 19. Approximately half of treated patients achieved an AHI of < 10; however, as many as 40% of those treated were left with significantly elevated AHIs. Improvement in sleep quality and sleepiness reflects the effect on breathing. Limited follow-up data indicate that oral discomfort is a common but tolerable side effect, that dental and mandibular complications appear to be uncommon and that long-term compliance varies from 50% to 100% of patients. Comparison of the risk and benefit of oral appliance therapy with the other available treatments suggests that oral appliances present a useful alternative to continuous positive airway pressure (CPAP), especially for patients with simple snoring and patients with obstructive sleep apnea who cannot tolerate CPAP therapy.
Evaluation Studies as Topic↗
The lower pathway operon for benzoate catabolism in biphenyl-utilizing Pseudomonas sp. strain IC and the nucleotide sequence of the bphE gene for catechol 2,3-dioxygenase.
Pseudomonas sp. strain IC is able to grow on biphenyl, 3-methylbiphenyl and 4-methylbiphenyl. These are converted to benzoate and the corresponding methylbenzoates. The lower pathway genes for the catabolism of the benzoates were cloned on a 22 kb HindIII fragment. Hybridization with gene-specific probes from the meta pathways of other catabolic plasmids showed that the gene order was identical to that of the operons carrying the same function from TOL plasmids. The nucleotide sequence of a 1241 bp region carrying the whole of the bphE gene (for a catechol 2,3-dioxygenase) and the 5' end of the downstream bphG gene (for 2-hydroxy semialdehyde dehydrogenase) was determined. Both genes showed a high degree of homology with genes encoding isofunctional proteins from other Pseudomonas strains. The upper pathway genes for the conversion of biphenyl to benzoate have also been cloned but no linkage with the lower pathway operon has been detected. Pseudomonas strain IC contains a large plasmid pWW110 (> 200 kb) and there are indications that this plasmid carries the bph genes.
Amino Acid Sequence↗
A histidine decarboxylase-like mRNA is involved in tomato fruit ripening.
DNA sequencing of a tomato ripening-related cDNA, TOM 92, revealed an open reading frame with homology to several pyridoxal 5'-phosphate histidine decarboxylases, containing the conserved amino acid residues known to bind pyridoxal phosphate and alpha-fluoromethylhistidine, an inhibitor of enzyme activity. TOM 92 mRNA accumulated during early fruit ripening and then declined. Fruit of the ripening-impaired tomato mutant, ripening inhibitor (rin), did not accumulate TOM 92 mRNA, and its accumulation was not restored by treatment of fruit with ethylene. The TOM 92 mRNA was not detected in tomato leaves and unripe fruit.
Amino Acid Sequence↗
cDNA cloning and characterisation of novel ripening-related mRNAs with altered patterns of accumulation in the ripening inhibitor (rin) tomato ripening mutant.
A cDNA library produced from mRNA isolated from the pericarp of wild-type tomato fruit (Lycopersicon esculentum Mill. cv Ailsa Craig) at the first visible sign of fruit ripening was differentially screened to identify clones whose homologous mRNAs were present at reduced levels in fruit of the tomato ripening mutant, ripening inhibitor,rin. Five clones were isolated (pERT 1, 10, 13, 14, 15). Accumulation of mRNA homologous to each of these clones increased during the ripening of wild-type fruit and showed reduced accumulation in ripening rin fruit. The levels of three of them (homologous to ERT 1, 13 and 14) were increased by ethylene treatment of the mutant fruit. A further clone, ERT 16 was identified for a mRNA present at a high level in both normal and mutant fruit at early stages of ripening. Database searches revealed no significant homology to the DNA sequence of ERT 14 and 15; however, DNA and derived amino acid sequence of ERT 1 both contain regions of homology with several reported UDP-glucosyl and glucuronosyl transferases (UDPGT) and with a conserved UDPGT motif. A derived amino acid sequence from the ERT 10 cDNA contains a perfect match to a consensus sequence present in a number of dehydrogenases. The ERT 13 DNA sequence has homology with an mRNA present during potato tuberisation. The presence of these mRNAs in tomato fruit is unreported and their role in ripening is unknown. The ERT 16 DNA sequence has homology with a ripening/stress-related cDNA isolated from tomato fruit pericarp.
Amino Acid Sequence↗
Laser lithotripsy. Patient care, staff education.
The high cost of laser equipment and the required specialization of staff members make extension of laser lithotripsy to every hospital impractical. At present, in Ontario, laser lithotripsy is available only in Toronto and Kingston, and ESWL is available only in Toronto and London. Laser lithotripsy is a viable alternative to invasive surgical treatment of urinary calculi that are resistant to ESWL. For the suitable candidate, laser lithotripsy is a welcome alternative to an extensive surgical procedure and recovery period. Hospitalization is reduced significantly, and patients can return to work after the calculus and residue have been passed. Patients can be managed safely and effectively, resulting in reduced morbidity and mortality and reduced cost in time and expense to the patient and hospital.
Equipment Safety↗
Single amino acid codon changes detected in louping ill virus antibody-resistant mutants with reduced neurovirulence.
Seven mutant viruses were derived from a Scottish strain of louping ill virus using a virus envelope-specific neutralizing monoclonal antibody. None of the mutants was neutralized and immunofluorescence microscopy confirmed that they did not bind to this antibody. Four mutants showed reduced mouse neurovirulence compared with parent virus and two mutants failed to induce protective immune responses in mice challenged with virulent tick-borne encephalitis virus. The mutants with the lowest virulence showed poor or undetectable haemagglutinating activity. The nucleotide sequence of the envelope glycoprotein gene of each of the seven mutants was determined and the deduced amino acid sequence was compared with parent virus. For each mutant, only a single amino acid codon change was detected and all the amino acid substitutions occurred within amino acid positions 308 to 311. A change from the amino acid aspartate to asparagine at amino acid position 308, which represented a potential glycosylation site, was the most effective substitution in reducing mouse neurovirulence. The results demonstrate the importance of critical sites within the envelope glycoprotein as determinants of virus virulence.
Animals↗