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B D Gelb

Publications and source records attributed to B D Gelb.

72 records · Page 4Linked to original sources
PubMed1992

Characterization of human genomic yeast artificial chromosome inserts containing hexokinase 1 coding information on chromosome 10.

Hexokinase 1 (HK1) is one of four mammalian HK isoenzymes and maps to human chromosome 10. Two yeast artificial chromosomes (YACs) were identified in the Washington University human YAC library using polymerase chain reaction (PCR) primers designed with knowledge of the human HK1 cDNA sequence. YAC B129B12 is 120 kb in length and maps entirely to chromosome 10. YAC A159D5 is 400 kb in length and appears to have resulted from a recombination of chromosome 10 with non-chromosome 10 material. We report these YACs as potential resources for those interested in HK1 gene organization and mapping, as well as those desiring additional genomic information and markers on chromosome 10.

Animals↗
PubMed1992

Designing health promotion programs by watching the market.

More health care providers and payors are beginning to see health promotion programs as a significant tool for attracting patients, reducing costs, or both. To help design programs that take into account the values and lifestyles of the target group, naturalistic observation can be useful. The authors illustrate the approach in a study of pipeline workers that provided input for the design of nutrition and smoking cessation programs.

Cancer Care Facilities↗
PubMed1992

Large employers and their coalitions: exploring a hospital constituency.

Hospitals may increasingly find large employers banding together in coalitions. Based on focus group data, insights from one coalition and a sample of its members are offered as an aid in understanding the circumstances under which such coalitions and their members resemble other "industrial buyers" and the circumstances under which they represent an adversarial constituency for hospital administrators. These data suggest that the cost of care and the trend of cost increases dominate the thinking of benefits managers; that these managers believe many corporations will work with fewer, more carefully selected providers in the future, and that therefore employee choices will be further restricted; and that the relationship between large employers or employer coalitions and hospitals depends on the employer's role and the provider's marketing orientation.

Administrative Personnel↗
PubMed1991

San Luis Valley recombinant chromosome 8 and tetralogy of Fallot: a review of chromosome 8 anomalies and congenital heart disease.

Tetralogy of Fallot, the most common cyanotic heart defect, has not been closely associated with a specific chromosome defect. The San Luis Valley Recombinant Chromosome 8 [SLV Rec(8)] syndrome is strongly associated with congenital heart disease, particularly tetralogy of Fallot. This article reviews SLV Rec(8) syndrome and other chromosome 8 aberrations to suggest locations for cardiogenic genes. SLV Rec(8) [rec(8),dup q,inv(8)(p23q22)] syndrome has been found in Hispanic families in the southwestern United States. Congenital heart disease is found in 93.3% of SLV Rec(8) individuals (n = 45), with tetralogy of Fallot constituting 40.5% of all lesions and conotruncal defects, 55.6%. These frequencies exceed the incidence of tetralogy of Fallot (10%) and conotruncal defects (20%) among all children with heart defects (P less than 0.003 for both). Review of patients with deletion 8p (n = 13) showed heart defects in 84.6% with 27.3% being conotruncal defects. Among duplication 8q patients (n = 20), 45% had heart defects with conotruncal defects constituting 44%. Neither group differed significantly from expected in its incidence of conotruncal defects. Among patients with mosaic trisomy 8 (n = 47), 12 had heart abnormalities including one conotruncal defect. Among 3 patients with other rec(8) chromosomes, one had a ventricular septal defect. The cause of heart defects in SLV Rec(8) cannot be assigned to either the deletion of 8p or the duplication of 8q. The lack of an association between other chromosome 8 abnormalities and tetralogy of Fallot suggests that genes at the SLV Rec(8) breakpoints or an interaction between genes on both arms of chromosome 8 are important.

Chromosome Aberrations↗
PubMed1991

Protein kinase activity of rat brain hexokinase.

Hexokinase 1 (HK1) purified from rat brain exhibits protein kinase activity, including autophosphorylation and phosphorylation of histone H2A. This protein kinase activity is observed only in the absence of the HK1 carbohydrate substrate, glucose. Analysis of the ATP-binding domains of the mammalian HK1 protein sequences shows significant homology with other mammalian protein kinases.

Amino Acid Sequence↗
PubMed1991

Mammalian hexokinase 1: evolutionary conservation and structure to function analysis.

We have amplified and sequenced the complete coding region of bovine hexokinase isoenzyme 1 (HK1) from brain RNA with PCR primers selected for sequence conservation. The sequence information was analyzed to evaluate the evolutionary and structure-function relationships among the mammalian and yeast HK isoenzymes. Structure to function analysis identified an unduplicated, invariant N-terminal domain involved in HK1 outer mitochondrial membrane targeting, as well as putative carbohydrate and nucleotide-binding sites in the regulatory and catalytic halves of HK1 essential to enzyme function. The ATP-binding site in the catalytic half of the HK1 protein resembles nucleotide-binding regions from protein kinases, with the single amino acid replacement (lysine to glutamate) in the ATP-binding site of the amino half explaining the loss of HK1 catalytic function in the regulatory domain. Sequence comparisons suggest that the 50-kDa mammalian and yeast glucokinases arose separately in evolution. In addition to providing valuable phylogenetic and structure-function insights, this work provides an efficient strategy for rapid cloning and sequencing of the coding regions for other HKs and related proteins.

Amino Acid Sequence↗
PubMed1991

Scenarios: a planning tool for health care organizations.

An organization's strategic planners require an understanding of future developments in the environment in which their decisions will be made. However, there is increasing recognition that there is no single predetermined "future." Therefore, the use of alternative future scenarios can be helpful. Scenario construction is a technique for combining possible environmental developments in a systematic way to help managers assess the potential consequences of alternative decisions. This article discusses the scenario technique and shows, as an example, its application to one organization in the health care field.

Decision Making, Organizational↗
PubMed1991

Does greater usage of a health plan reduce satisfaction?

As health care providers assess the future of managed care, the satisfaction of individual purchasers becomes an important issue. Do they become disenchanted after heavier use of managed care plans--and if so, does that contrast with purchasers of indemnity plans? The authors explore such issues.

Analysis of Variance↗
PubMed1990

Noninvasive discrimination of right atrial ectopic tachycardia from sinus tachycardia in "dilated cardiomyopathy".

Right atrial ectopic tachycardia (RAET) with secondary cardiac dysfunction can be difficult to differentiate from primary dilated cardiomyopathy (CMP) with sinus tachycardia. In an attempt to separate RAET from CMP by noninvasive testing, routine surface electrocardiograms (EGGs), 24-hour ambulatory ECGs (Holter monitors), and echocardiograms of patients with RAET (n = 34) and CMP (n = 33) were reviewed. RAET atrial rates were significantly faster than CMP rates on the resting ECG and on Holter monitoring; 12 of 33 patients with RAET had resting ECG rates greater than 150% of predicted normal values for age but none of 32 patients with CMPs had resting ECG rates in this range. Mean P wave axis in the horizontal plane was more posterior in patients with RAET and was less than 0 degrees (negative in lead V2) in 8 of 29 patients with RAET but in 1 of 33 patients with CMP. Second-degree atrioventricular (AV) block was observed in 12 of 33 patients with RAET but in none of 33 with CMP. Shortening fraction less than 10% was found in 13 of 33 individuals with CMP but in only 1 of 27 with RAET. We conclude that noninvasive studies can help identify RAET among patients with poor functioning hearts and right atrial tachycardia.

Cardiomyopathy, Dilated↗
PubMed1990

Prevalence of additional cardiovascular anomalies in patients referred for transcatheter closure of patent ductus arteriosus.

Catheter closure of the patent ductus arteriosus is now a reality. The purpose of this study was to establish the prevalence of associated cardiovascular defects and the accuracy of echocardiography in patients referred for transvenous ductal closure. This study reviewed 146 patients seen from 1981 to 1988: 126 with only a patent ductus arteriosus (Group I) and 20 with additional cardiovascular anomalies (Group II). Groups I and II did not differ significantly in age, gender or physical examination except for the presence of a continuous murmur (Group I 100% versus Group II 80%, p less than 0.001). A left patent ductus arteriosus was visualized by two-dimensional echocardiography in 96% of patients and was evident by Doppler study in 100%. A patent ductus arteriosus was not seen in six patients including a patient who was found to have only a collateral network from the aorta to the main pulmonary artery. The 12 patients with noncardiovascular abnormalities such as Down's syndrome were more likely than the overall group to have additional cardiovascular anomalies (6 of 12, p = 0.001). The cardiovascular anomalies encountered were varied. Eight of the 20 patients with such anomalies had only a restrictive ventricular septal defect in addition to the patent ductus arteriosus. Significant anomalies found at catheterization included two thoracic arteriovenous malformations and an isolated right carotid artery draining into the right pulmonary artery by way of a right ductus arteriosus. This study indicates that echocardiography is an effective diagnostic technique in this patient group. A thorough cardiac catheterization with angiography should be performed before implantation of a ductal device.

Child, Preschool↗
PubMed1989

Telephoned appointment-scheduling by a physician's office: does it work?

Are phone calls reminding patients of recall appointments a worthwhile marketing tool? Evidence from a dermatologist's practice suggests that, though patients find the calls acceptable, such calls do not increase the short-term revenue of a practice. They do, however, appear to increase the likelihood that a patient will return.

Appointments and Schedules↗
PubMed1987

Physicians and hospital decision making: a two-stage technique for improvement.

A research technique that combines qualitative and quantitative stages can be useful in eliciting issues of importance to physicians and then in calculating the relative priority they place on each issue. The technique described here, physician focus groups plus conjoint analysis, has been used successfully in the health care setting. It offers opportunities for decision makers in any health care institution to "listen" to what physicians have to contribute.

Decision Making, Organizational↗
PubMedDate not supplied

Neurologic complications of heart transplantation in children.

Neurologic complications can add significant morbidity to otherwise successful orthotopic heart transplantations in children. Complications have been reported to occur in up to 50% of children undergoing heart transplantation. The purpose of this study was to identify the prevalence and outcome of neurologic complications of heart transplantation in children. We reviewed all children who received orthotopic heart transplantation at Texas Children's Hospital from November 1984 to November 1990. Twenty-two patients (ages, 3 weeks to 17 years; mean, 8.5 years) underwent heart transplantation using cardiopulmonary bypass with moderate hypothermia. For analysis, we compared results during the first 3 years of our experience, 1984 through 1987 (group 1), to 1987 through 1990 (group 2). Survival was 45% (5 of 11 patients) for group 1 and 73% (8 of 11 patients) for group 2. A neurologic complication was defined as a change in the neurologic examination and/or status. Neurologic complications included seizures (6 of 22 patients), strokes (3 of 22 patients), unresponsiveness (3 of 22 patients), and change in mental status (2 of 22 patients). Early (within 2 weeks after operation) neurologic complications occurred in 45% (10 of 22 patients), were persistent (sequelae lasting more than 4 months) in 27% (6 of 22 patients), and resulted in death in 9% (2 of 22 patients). Late (after 2 weeks after operation) neurologic complications occurred in 23% (5 of 22 patients), were persistent in 9% (2 of 22 patients), and have occurred in only two survivors. Neurologic factors were not responsible for the cause of death in group 2. No neurologic complications (early or late) were seen in 1 of 11 patients in group 1 as compared with 7 of 11 patients in group 2 (p < 0.015). Serious neurologic morbidity decreased between the two groups after preoperative cyclosporine was avoided and postoperative hypertension was controlled. All survivors are functioning at age-appropriate levels. Although neurologic complications may be frequent, long-term neurologic disability in survivors is rare.

Adolescent↗
PubMedDate not supplied

Pseudoconduction of atrial flutter of a recipient atrium.

A nine-year-old girl had an episode of atrial flutter and a nonsustained wide QRS tachycardia during her initial hospitalization after orthotopic heart transplantation. Evaluation of her ECG and telemetric tracing revealed atrial flutter of the recipient atrium and sinus rhythm of the donor atrium. The wide QRS tachycardia was an accelerated ventricular rhythm that was also found on subsequent 24-hour ambulatory ECG monitoring. Timely recognition of recipient atrial arrhythmias prevents inappropriate clinical intervention.

Atrial Flutter↗