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Biomedical subjects

C L Graham

Publications and source records attributed to C L Graham.

At least 19 recordsLinked to original sources

The human RGL (RalGDS-like) gene: cloning, expression analysis and genomic organization.

Ral GDP dissociation stimulator (RalGDS) and its family members RGL, RLF and RGL2 are involved in Ras and Ral signaling pathways as downstream effector proteins. Here we report the precise localization and cloning of two forms of human RGL gene differing at the amino terminus. Transcript A, cloned from liver cDNA libraries has the same amino terminus as the mouse RGL, whereas transcript B cloned from brain has a substitution of 45 amino acids for the first nine amino acids. At the genomic level, exon 1 of transcript A is replaced by two alternative exons (1B1 and 1B2) in transcript B. Both forms share exons 2 through 18. The human RGL protein shares 94% amino acid identity with the mouse protein. Northern blot analysis shows that human RGL is expressed in a wide variety of tissues with strong expression being seen in the heart, brain, kidney, spleen and testis.

Amino Acid Sequence↗

Conceptual learning processes in physical therapy students.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate processes used by students in developing conceptual knowledge in physical therapy. SUBJECTS: The subjects were 10 first-year physical therapist students enrolled in a professional Master of Physical Therapy degree program. METHODS: Qualitative methods were used to collect data during a 15-week kinesiology course. Data were collected using open-ended interviews, observation, and journals kept by the students throughout the course. RESULTS: Several major themes emerged, including use of discussion, use of visualization, and use of experience by the students as they learned concepts in kinesiology. CONCLUSION AND DISCUSSION: The type of learning processes used by students in this study may be enhanced by educational methods such as collaboration and group learning, situated cognition and use of authentic contexts, cognitive apprenticeship, and whole-part-whole learning. Further research is needed to explore the relationship between student learning processes and teaching methods used in physical therapy education.

Adult↗

Stability of ondansetron hydrochloride injection in extemporaneously prepared oral solutions.

The stability of ondansetron hydrochloride in extemporaneously prepared oral solutions containing orange juice, cola, or cherry syrup was determined. Solutions were prepared by adding ondansetron hydrochloride to orange juice, cola, or cherry syrup to produce ondansetron concentrations of 0.267 and 0.067 mg/mL in orange juice or cola and 0.533 mg/mL in cherry syrup. The ondansetron concentration in orange juice and cola solutions was assayed at the time of preparation and at 30 minutes and one hour. The cherry syrup solution was stored at both 3-5 and 25-27 degrees C, with the ondansetron concentration being determined at the time of preparation and daily for seven days. All the solutions were prepared in triplicate. Ondansetron concentrations were measured by stability-indicating high-performance liquid chromatography. At each time interval, the mean ondansetron concentration remained > or = 97% of the initial measurement for all solutions. The appearance and color of the solutions did not change. Ondansetron hydrochloride was stable for at least one hour in orange juice or cola and at least seven days in cherry syrup.

Administration, Oral↗

Ondansetron: a novel antiemetic agent.

Ondansetron hydrochloride is a new serotonin receptor antagonist that is effective in preventing emesis associated with cancer chemotherapy. The antiemetic effect appears to be exerted through a peripheral vagal blocking within the gastrointestinal tract, as well as an inhibitory effect within the chemoreceptor trigger zone (CTZ). Plasma concentrations of ondansetron peak 1 hour after an oral dose, and the tablet has an absolute bioavailability of 59%. Ondansetron undergoes extensive hepatic oxidative metabolism in the liver. The half-life of ondansetron is 3.5 hours in healthy volunteers; elderly patients have a slightly reduced clearance, and pediatric patients have increased clearance. Although less than 10% of ondansetron is recovered unchanged in the urine, most metabolites are eliminated by this route. The recommended dose of ondansetron is 0.15 mg/kg for three doses on the day of chemotherapy (30 minutes before chemotherapy and 4 and 8 hours afterward). An alternative regimen includes a single-day dose of 32 mg IV in adult patients before chemotherapy. The efficacy of ondansetron therapy for delayed emesis has not been determined. Ondansetron has proven to be appropriate as a single agent or as an addition to standard antiemetic therapy (ie, corticosteroids, benzodiazepines, neurotransmitter blockers) in preventing and treating acute chemotherapy-induced emesis (CIE). Initial results of clinical trials in prevention of radiotherapy-induced emesis and anesthesia-induced emesis appear positive. Ondansetron is well tolerated, with few adverse events (eg, headache, sedation).

Antineoplastic Agents↗

Stability of ondansetron in large-volume parenteral solutions.

OBJECTIVE: To determine the stability of ondansetron hydrochloride in large-volume parenteral solutions under four storage and time-period conditions. DESIGN/METHOD: Ondansetron was added to each of the following commercially available solutions to make final concentrations of approximately 24 and 96 micrograms/mL: NaCl 0.9%, D5W, and lactated Ringer's solution. SETTING: University analytical laboratory. MAIN OUTCOME MEASURES: Each solution was studied at both concentrations under the following conditions: (1) 1 day refrigerated, 2 days room temperature; (2) 7 days refrigerated, 2 days room temperature; (3) 14 days refrigerated, 2 days room temperature; and (4) 14 days room temperature. All solutions were exposed to fluorescent light when under room temperature conditions and were studied in triplicate. Ondansetron concentrations of samples were obtained periodically throughout each storage/time condition via a specific, stability-indicating HPLC method. RESULTS: A clinically significant loss of concentration was defined as greater than 10 percent decrease from the initial concentration. In all solutions and at both concentrations studied, the mean ondansetron concentration was greater than or equal to 90 percent under all storage and time conditions. CONCLUSIONS: Ondansetron can be stored and administered in these solutions without loss of potency.

Drug Stability↗

Managing information systems: still a CFO function.

This article represents the first in a series examining the information management needs, both now and in 1988, of hospital CFOs. Future articles will focus on the management concerns of CFOs in relation to information, their current and projected use of information management products for long-range, strategic planning, and criteria for systems design. All these articles are based on HFMA members' opinions as voiced in a recent national poll. In all, more than 600 CFOs and data processing professionals responded to a recent survey sponsored by HFMA, HBO & Company, and Amherst Associates.

Computers↗

CFOs see management issues shifting in health care.

This article represents the second in a series of articles examining the information management needs, both now and in 1988, of hospital CFOs. CFOs are being forced to become more business-like, and therefore, are finding the need for more and better information. With this information, they can better manage operating profit, accounts receivable, and changes in prospective payment. This series of articles is based on a recent national poll of HFMA members. In all, more than 600 CFOs and data processing professionals responded to the survey sponsored by HFMA, HBO & Company, and Amherst Associates. For a copy of complete survey findings, contact: Cam L. Graham, CPA, HBO & Company, 301 Perimeter Center North, Atlanta, GA 30346.

Attitude of Health Personnel↗

Congenital hypothyroidism in a dog due to an iodide organification defect.

A 10-month-old dwarfed male pup born of large-breed parents with normal stature had congenital goiter. Hypothyroidism due to failure to form organic iodine was diagnosed based on low serum thyroxine and triiodothyronine assays, radiographic findings in the epiphyses, and an abnormal perchlorate discharge test. Replacement of thyroid hormone resulted in more than 450% increase in body weight and a 600% increase in shoulder height over an 8-month period of treatment. A relapse in mental and physical condition occurred when hormone replacement therapy was later withdrawn. Postmortem findings are described.

Animals↗

Adrenocortical suppression in cats given megestrol acetate.

Megestrol acetate was given orally to 8 cats at a dose of 2.5 mg every other day for 2 weeks and to 8 cats at a dose of 5.0 mg every day for 2 weeks. Four cats were designated nontreated controls. Pre-ACTH-stimulated plasma concentrations of cortisol (hydrocortisone) and ACTH-stimulated cortisol and tolerance to large-dose glucose infusion (IV) were determined on each of the 20 cats given megestrol acetate. Cats were restrained with acepromazine maleate and ketamine hydrochloride during blood sample collection and large-dose glucose infusion. Adrenocortical function and tolerance to large-dose glucose infusion were reevaluated for 4 weeks--after 1st and 2nd weeks of megestrol acetate treatment of the treated groups, and after 1st and 2nd weeks when treatment was stopped (ie, experiment weeks 3 and 4). Each week a cat from the control group and 2 cats from the 2 treated groups were selected to determine the changes occurring during the experiment for that week; after collection of plasma samples, each week's 5 selected cats were euthanatized and necropsied. Significant impairment of adrenocortical function and alteration of adrenocortical morphology occurred with both treated groups. The most severe adrenocortical alterations occurred in the cats 1 week after megestrol acetate was no longer given (ie, experiment week 3). Megestrol acetate-induced adrenocortical suppression contributed to the death of 1 cat. It was concluded that if stress occurs to cats on treatment or soon after treatment with megestrol acetate, glucocorticoids should be supplemented. The effects of megestrol acetate on glucose tolerance were overshadowed by the unforeseen intolerance caused by chemical restraint with acepromazine maleate and ketamine hydrochloride.

Adrenal Cortex↗

Adrenocortical suppression in dogs on daily and alternate-day prednisone administration.

Three groups of eight normal dogs each were orally given prednisone at doses of 0.22 mg/kg of body weight/day, 0.55 mg/kg/day, or 1.1 mg/kg on alternate mornings. Four dogs served as nontreated controls. Samples were obtained from members of each group to determine baseline serum cortisol and ACTH-stimulated cortisol values and histologic features in the lateral thoracic skin before prednisone administration, and after 1, 2, 3, and 4 weeks of administration. Some animals from each group were necropsied after 1, 2, 3, and 4 weeks of prednisone administration. Each course of prednisone administration resulted in adrenocortical atrophy and hypofunction, but adrenocortical suppression was less severe and slower in onset in the group given prednisone on alternate days. Extra-adrenal effects observed were atrophy of the skin and focal, fatty change of the liver. These changes were most evident in dogs given daily pharmacologic doses of prednisone (0.55 mg/kg/day). Fewer extra-adrenal effects were observed in dogs given alternate-day therapy. There were no extra-adrenal lesions in the dogs given equivalent glucocorticoid replacement doses (0.22 mg/kg/day).

Administration, Oral↗