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Biomedical subjects

D Huber

Publications and source records attributed to D Huber.

At least 19 recordsLinked to original sources
PubMed2000

Occludin modulates transepithelial migration of neutrophils.

Neutrophils cross epithelial sheets to reach inflamed mucosal surfaces by migrating along the paracellular route. To avoid breakdown of the epithelial barrier, this process requires coordinated opening and closing of tight junctions, the most apical intercellular junctions in epithelia. To determine the function of epithelial tight junction proteins in this process, we analyzed neutrophil migration across monolayers formed by stably transfected epithelial cells expressing wild-type and mutant occludin, a membrane protein of tight junctions with four transmembrane domains and both termini in the cytosol. We found that expression of mutants with a modified N-terminal cytoplasmic domain up-regulated migration, whereas deletion of the C-terminal cytoplasmic domain did not have an effect. The N-terminal cytosolic domain was also found to be important for the linear arrangement of occludin within tight junctions but not for the permeability barrier. Moreover, expression of mutant occludin bearing a mutation in one of the two extracellular domains inhibited neutrophil migration. The effects of transfected occludin mutants on neutrophil migration did not correlate with their effects on selective paracellular permeability and transepithelial electrical resistance. Hence, specific domains and functional properties of occludin modulate transepithelial migration of neutrophils.

Actins↗
PubMed1999

[Keratoconus screening with wave-front parameters based on topography height data].

BACKGROUND: The image-forming properties of a keratoconus eye are degraded even in the early stage of this disease. The purpose of this study was to develop keratoconus detection scheme based on topography height data independent of the currently used system which avoids the disadvantages of detection algorithms currently used in clinical practice. PATIENTS AND METHODS: Eighty-eight patients with keratoconus (46 with mild and 42 with severe clinical signs) and a control group of 40 normal subjects were included in this study. A decomposition of corneal topography height data into orthogonal Zernike polynomials was performed using the commercially available corneal topographer TMS-1. Expansion coefficients of the different groups were compared to evaluate significant differences. Elevated terms were used to detect the disease. The statistical significance of this detection scheme was compared to those given by the keratoconus detection software of the TMS-1. From the elevated Zernike terms a neural network was constructed and optimized for dividing keratoconus patients and normal controls. RESULTS: Some low-order Zernike coefficients with a radial order n < 8 were found to be elevated in patients with keratoconus and were used to define a new detection algorithm. This index performed at least as well (sensitivity in mild/severe keratoconus 93.4%/100% with a specificity of 100%) as keratoconus detection schemes based on the Klyce-Maeda and the Rabinowitz-Klyce indices as well as the I-S value and the Surface Asymmetry Index SAI in our study population. CONCLUSIONS: Zernike decomposition of corneal topography height data allows a definition of an exact and robust algorithm for detection of keratoconus. It avoids the drawbacks of refractive power based definitions and is independent on the individual topographer design.

Adolescent↗
PubMed1998

Family nursing practice in public health: Finland and Utah.

This exploratory study of family nursing practice in public health care was conducted in Finland and Utah. Staff nurses were interviewed in focus groups and asked to describe their practice of family nursing, the factors promoting and restraining practice, and the impact of the changes in health care delivery on practice. Thirty-six Finnish and 30 Utah nurses participated. Pressure to do more activities with fewer nurses and resources, changes in family problems, and skill level of the nurses were common themes. However, differences were evident. Finnish public health nurses used emotional support and information to help families empower themselves to use resources and to strengthen their family unit. Utah nurses focused first on individual level goals and then family cohesion and health. Nurse-initiated referrals and direct physical care were the primary intervention strategies of Utah nurses. Unlike the U.S. health care system, access for all in maternal and child health care and school health allowed Finnish nurses to develop long-term relationships with families, thus advancing family nursing practice. This study identifies several potential variables for further study particularly related to the organization of health care and nurse-family relationships.

Adult↗
PubMed1998

Altered instantaneous and calcium-modulated oscillatory PTH secretion patterns in patients with secondary hyperparathyroidism.

The relative contributions of increased parathyroid cell mass and altered control mechanisms of parathyroid hormone (PTH) secretion in secondary hyperparathyroidism are still controversial. In this study, endogenous pulsatile PTH secretion was analyzed by the multiparameter deconvolution technique to differentiate alterations in cell mass-dependent (PTH burst mass) and regulation-dependent (frequency, synchrony, calcium responsiveness) PTH release in uremic patients. PTH concentration versus time profiles were obtained in 13 uremic and 16 healthy adults under baseline conditions and during acute hypo- and hypercalcemia. Plasma PTH half-life was increased in patients compared with control subjects (4.7+/-1.9 versus 2.6+/-0.1 min, P < 0.005). The baseline PTH secretion rate was elevated eightfold in the patients as a result of an increased PTH mass secreted per burst (17.1+/-4.7 versus 2.0+/-0.4 pM, P = 0.0001), higher burst frequency (8.0+/-0.3 versus 6.8+/-0.3 h(-1), P < 0.01), and a higher tonic secretion rate (343+/-99 versus 30+/-4 pM/h, P = 0.0001). Acute hypocalcemia elicited an immediate, frequency- and amplitude-mediated selective increase in the pulsatile secretory component, which was fractionally weaker in patients (+595%) than control subjects (+1755%, P < 0.001). The acceleration and the amplification of PTH bursts were 35 and 60% lower in the patient group. Acute hypercalcemia suppressed total PTH secretion by 79% in control subjects but only by 63% in patients (P < 0.002). PTH burst frequency was reduced during hypercalcemia by 30% in control subjects, but remained unchanged in patients. In conclusion, uremic hyperparathyroidism is mediated by a marked increase in glandular secretion, but also by reduced PTH elimination. The increased spontaneous PTH burst frequency and the blunted responsiveness to changes in Ca2+ indicate partial uncoupling of hyperplastic parathyroid glands from the physiologic regulatory mechanisms that direct pulsatile PTH release.

Adolescent↗
PubMed1998

1,25(OH)2-vitamin D3 reduces spontaneous and hypocalcemia-stimulated pulsatile component of parathyroid hormone secretion.

To investigate the effects of 1,25(OH)2-vitamin D3 (1,25(OH)2D3) on pulsatile parathyroid hormone (PTH) release, minute-to-minute intact PTH secretion was examined in nine healthy adults under baseline conditions and during hypocalcemia (sodium citrate clamp) before and after 5 d of oral 1,25(OH)2D3 treatment (1 microgram/d). In addition, acute effects of 1,25(OH)2D3 were examined by a single intravenous bolus of 2 micrograms of 1,25(OH)2D3. Pulsatile and tonic PTH secretion rates were calculated by the multiparameter deconvolution technique. During baseline, 68% of circulating PTH was attributable to tonic, and 32% to pulsatile, secretion. During induction of hypocalcemia, a selective increase in pulsatile secretion (+1100%), mediated by a combined increase in burst frequency and burst mass, was observed. During the subsequent steady-state hypocalcemic period, burst frequency and mass decreased and tonic secretion increased to 3 times the baseline level. Intravenous 1,25(OH)2D3 did not affect the temporal pattern of PTH secretion. In contrast, oral 1,25(OH)2D3 decreased baseline plasma PTH by 30% without a detectable change in Ca2+. This suppression was accounted for mainly by a decrease in PTH burst frequency. During hypocalcemia induction, a significantly lower (30%) increase in burst mass occurred compared with the pretreatment study. During steady-state hypocalcemia, PTH burst mass (-45%) and pulsatile (-50%) and total (-35%) secretion rate were lower than before treatment. In conclusion, acute hypocalcemia selectively increases pulsatile PTH release by stimulating both burst frequency and mass via a Ca2+ rate-sensitive mechanism. Oral 1,25-(OH)2D3 suppresses pulsatile baseline PTH release and reduces the pulsatile secretory capacity of the parathyroids during a hypocalcemic stimulus.

Administration, Oral↗
PubMed1998

Dolphin morbilliviral infection from the Mediterranean Sea did not spread into the Adriatic Sea.

In July of 1990, a mass mortality of striped dolphins due to morbillivirus infection had begun in the western Mediterranean. By 1992, the infection had spread to the eastern Mediterranean and the Aegean Sea. Other dolphin species in the Mediterranean were not found to have died due to this infection, although it is possible for many species of marine mammals to be infected. In 1994, it was published that morbillivirus infection had caused Atlantic bottlenose dolphin mortality in the USA. Although striped dolphins are not residents of the Adriatic Sea, it was hypothesised that the infection could have spread from them to Adriatic bottlenose dolphins. From October 1990 through April 1997, 16 dolphin carcasses found along the Croatian Adriatic coast were examined. Tissues were examined by light microscopy for syncytia and inclusion bodies, histopathologic lesions characteristic of dolphin morbillivirus infection, and by detection of morbilliviral RNA by a reverse transcriptase polymerase chain reaction (RT-PCR). No signs of morbillivirus infection were found in the examined animals. It was concluded that this infection had not spread to dolphins of the Adriatic Sea up until that date.

Animals↗
PubMed1997

Nursing Management Minimum Data Set (NMMDS).

The Nursing Management Minimum Data Set (NMMDS) is the research-based management data set that meets the nurse executives need for a specific nursing management data capture system that will produce accurate, reliable, and useful data for decision making. The authors update the development of the NMMDS and discuss the 17 NMMDS across-settings elements. Also discussed are the applications of the NMMDS to clinical practice and some ways in which the NMMDS can benefit both nurses and patient/client care.

Continuity of Patient Care↗
PubMed1997

Effects of sex, age, capturing method, and season on serum chemistry values of brown bears in Croatia.

Sixty seven serum samples collected from 43 European brown bears (Ursus arctos) from Croatia were tested for < or = 31 serum chemistry parameters. Results were grouped and compared by bears origin (method of capture), sex, age, mass, and season sampled. Greatest differences were found between captive and free-living bears, and minor differences were found when sex, age, mass, or season of sampling were compared. Creatine kinase was significantly different among three categories of bears with the highest mean value of 924 IU/l in snare captured free-living bears compared to 67.8 IU/l in captive ones. Results of these tests provide reference values for European brown bears.

Age Determination by Teeth↗
PubMed1996

Colour duplex ultrasonography versus angiography in the diagnosis of lower-extremity arterial disease.

Colour duplex scanning is reported to be an accurate non-invasive tool for the diagnosis of lower-extremity arterial disease. The authors at the South Coast Vascular Laboratory have conducted a prospective audit to determine the efficacy of colour duplex scanning in a vascular surgical practice. The aims of this prospective trial were to compare the accuracy of colour duplex scanning with intra-arterial digital subtraction angiography (DSA) in the localization and classification of aortoiliac and femoropopliteal artery disease. Ninety-one lower limbs in 50 patients were evaluated independently by colour duplex scanning and DSA. The lower-limb vasculature was divided into eight segments: infrarenal aorta, common iliac artery, external iliac artery, common femoral artery, proximal, middle and lower thirds of the combined length of the superficial femoral and above-knee popliteal artery, and lastly the below-knee popliteal artery. A total of 558 arterial segments were examined. The Kappa value of duplex scanning compared with 'gold standard' DSA was 0.57. For detecting haemodynamically significant arterial lesions of > 50% reduction in diameter, duplex scanning had a sensitivity of 75%, specificity of 90%, positive predictive value of 77% and negative predictive value of 89% compared with DSA. The level of accuracy obtained does not support the use of duplex as a sole method of investigation for lower-extremity arterial disease in the authors' case. However, the high negative predictive value of colour duplex may be useful in excluding haemodynamically significant disease. This study emphasizes the importance of prospective auditing to determine individual accuracy with duplex examination for arterial disease, and enables clinical decision making to be based on tests with a known accuracy.

Angiography, Digital Subtraction↗
PubMed1996

Outcomes of an adjunct executive appointment for faculty.

The Council on Graduate Education for Administration in Nursing (CGEAN) was established to further develop and improve graduate education for administration in nursing. The Council seeks to identify the nature and direction of education for administration in nursing in various healthcare systems, providing guidelines for programs offering administration. A major goal of CGEAN is facilitating dialogue between nursing service administrators and graduate level educators who are engaged in teaching and research related to administration in nursing. This column, sponsored by the members of the Council, analyzes and responds to position statements and trends related to the delivery of health services and graduate education for administrators in nursing.

Education, Nursing↗
PubMed1995

Colour-coded duplex ultrasonography in selection of patients for transluminal angioplasty.

Transluminal angioplasty can be used to relieve symptomatic lower extremity arterial disease with minimal morbidity. This prospective study compares the accuracy of colour-coded duplex ultrasonography with intra-arterial digital subtraction angiography in selection of femoro-popliteal lesions for angioplasty. Isolated, short (< 6 cm) and haemodynamically significant stenosis (> 50% reduction in diameter) were considered for angioplasty. Colour-duplex selection and exclusion was in agreement with angiography in 68 out of 86 lower limbs (79%). The sensitivity, specificity, positive and negative predictive value of colour duplex compared with angiography yielded values of 60.9, 87.5, 60.9 and 85.7%, respectively. The discrepancy between colour duplex and digital subtraction angiography can be partly explained by the tendency of duplex to underestimate the severity and length of disease. It is concluded that colour-coded duplex can be used as a screening tool for lower extremity arterial disease to select appropriate lesions for endovascular procedures. The accuracy of duplex in the present study was not perfect and the decision for further intervention should be based on clinical grounds.

Angiography, Digital Subtraction↗
PubMed1994

Immunocytochemical localization of Ca(2+)-dependent protease from Allomyces arbuscula.

The Ca(2+)-dependent protease antisera and the purified specific antibodies from Allomyces arbuscula have shown very specific recognition when blotted against the total protein extract or the purified 43-40 kDa Ca(2+)-dependent protease from this aquatic fungus. By immunoblotting and immunofluorescence techniques using specific antibodies, we have shown that the enzyme activity is developmentally regulated and is related to the presence of antigen and not to any specific inhibitor. The immunofluorescence was absent in zoospores but appeared in polarized forms in germinating spores. In elongating hyphae the protease was mainly localized along the cytoplasmic membrane and in the cytoplasm, with predominance at the apex.

Blotting, Western↗
PubMed1994

Mitochondrial DNA sequence divergence among some west European brown bear (Ursus arctos L.) populations. Lessons for conservation.

We used the polymerase chain reaction and nucleotide sequencing to study mitochondrial DNA (mtDNA) genetic variability of brown bears (Ursus arctos) belonging to some western European populations. Demographic decline and isolation have apparently shaped genetic variability within and between populations. Small relict bear populations were apparently monomorphic and fixed for different mtDNA haplotypes. Genetic relationships among mtDNA haplotypes suggested the existence of a phylogeographic structure. We discuss the possible roles of historical and demographic factors in determining the observed genetic patterns. The low genetically effective size of the studied brown bear populations points to risks of continuing future loss of gene diversity and increase in inbreeding. Artificial gene flow through restocking could alleviate inbreeding depression in small isolated brown bear populations, and mtDNA phylogeographic relationships may provide a framework for their genetic management.

Animals↗
PubMed1994

Day-only admission for varicose vein surgery.

Day-only admissions for surgery are strongly encouraged, in an effort to keep costs down. Varicose vein surgery has been considered too major for day-only management despite the fact that there have been studies from overseas showing that it can be done with a morbidity comparable to inpatient surgery. The morbidity of day-only surgery for varicose veins (both long and short saphenous procedures) was assessed and compared with the results of inpatient surgery. Patients were also asked whether they were satisfied with the surgery being done this way. There were 165 consecutive patients available for study, 64 day-only and 101 inpatient. All patients attending Shellharbour Hospital. Shellharbour, had surgery done as day-only (as it was a morning list and allowed adequate time for recovery). Patients attending Bulli Hospital, Bulli, had surgery done as an inpatient (afternoon list). All surgery was performed by one surgeon. There was no difference (Chi-squared) in the age distribution (mean 48 years for day-only, 51 years for inpatient) or sex proportion in either group (Chi-squared test of proportions with continuity correction). Assessment of the results was done by review of the surgeon's notes, as well as telephone interviews for day-only subjects. The complication rate in both groups was similar. Wound problems represented the main complication with an incidence of 10.5% in each group. There was one deep venous thrombosis (DVT) in each group (diagnosed by duplex scan). Response to the telephone interview suggested that most patients were happy to have the surgery done as a day-only procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

GI nursing: the community health aspect.

Much of the research and literature regarding gastrointestinal nursing addresses concerns of clients in the hospital or outpatient setting. This article focuses on a larger clientele, the well elderly aggregate in the community. Implementation of the nursing process with participants of a local senior center indicated the need for a gastrointestinal education program. A GI health program with a long-range goal of reducing the number of deaths caused by colon cancer was developed and presented. The goal of the program was to educate individuals about colon cancer and the importance of early detection. In this article, the authors describe the application of the nursing process with a well elderly population and the results of that experience for the client and for the GI nurse in the community.

Aged↗