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Biomedical subjects

D K Clawson

Publications and source records attributed to D K Clawson.

At least 19 recordsLinked to original sources
PubMed1991

Structure of recombinant human rheumatoid arthritic synovial fluid phospholipase A2 at 2.2 A resolution.

Phospholipases A2 (PLA2s) may be grouped into distinct families of proteins that catalyse the hydrolysis of the 2-acyl bond of phospholipids and perform a variety of biological functions. The best characterized are the small (relative molecular mass approximately 14,000) calcium-dependent, secretory enzymes of diverse origin, such as pancreatic and venom PLA2s. The structures and functions of several PLA2s are known. Recently, high-resolution crystal structures of complexes of secretory PLA2s with phosphonate phospholipid analogues have provided information about the detailed stereochemistry of transition-state binding, confirming the proposed catalytic mechanism of esterolysis. By contrast, studies on mammalian nonpancreatic secretory PLA2s (s-PLA2s) have only recently begun; s-PLA2s are scarce in normal cells and tissues but large amounts are found in association with local and systemic inflammatory processes and tissue injury in animals and man. Such s-PLAs have been purified from rabbit and rat inflammatory exudate, from synovial fluid from patients with rheumatoid arthritis and from human platelets. Cloning and sequencing shows that the primary structure of the human s-PLA2 has about 37% homology with that of bovine pancreatic PLA2 and 44% homology with that of Crotalus atrox PLA2. The human s-PLA2 is an unusually basic protein, yet contains most of the highly conserved amino-acid residues and sequences characteristic of the PLA2s sequenced so far. Here we report the refined, three-dimensional crystal structure at 2.2 A resolution of recombinant human rheumatoid arthritic synovial fluid PLA2. This may aid the development of potent and specific inhibitors of this enzyme using structure-based design.

Arthritis, Rheumatoid↗
PubMed1990

The education of the physician.

Although the quality of U.S. medical care is at an all-time high, thanks largely to the education and training of American physicians, the nation is in a health care crisis, especially in rural areas and the inner cities. To meet this challenge, change in the education of physicians is required. An important reason for the present crisis is that the selection and education process has encouraged only science- and high-technology-oriented individuals to enter medicine, even though social and behavioral factors are the basis of a majority of today's medical problems. The author realizes that there is little motivation for frequently overburdened faculties and underfunded medical schools to undertake the needed changes; he describes various problems that challenge the existence of the health care system, including the increasing (and well-meaning) involvement in educational matters by legislators and bureaucrats. The author then explores various options for bringing about reform of physician education, including changes in premedical education, in the criteria used for identifying and admitting promising students, and in various aspects of medical education. Such reform could encourage some of the best, brightest, and more broadly educated students to enter the medical profession and could maintain high standards of physician education while fulfilling a public trust and meeting a public need.

Education, Medical, Undergraduate↗
PubMed1979

Medical schools and public health departments: a new alliance for progress.

For some time there has been concern regarding the future and relevance of both public health departments and departments of community medicine. Problems have developed as to how these agencies can be in the main stream of the health delivery system and maintain quality in service, research, and teaching. In this paper the authors describe an experimental health care delivery and teaching model, the health-department/medical-school affiliation. They analyze the conceptual basis for the affiliation and discuss the critical items in the affiliation agreement in the belief that such an arrangement could have an impact comparable with that which the medical-school/teaching-hospital affiliation had 40 years ago. The options opened by the new affiliation should serve to release the full potential of community medicine and public health in the United States.

Community Health Services↗
PubMed1977

Did you know?

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Hospital Administration↗
PubMed1976

Orthopedic manpower.

Key statistical information regarding Orthopedic Manpower is present to make orthopedists aware of the detailed information that is currently available. It is clear there is still insufficient data to justify radically altering the numbers or types of practices. Until the scope of orthopedic practice is more clearly defined and generally accepted (by orthopedists, other physicians, health professionals and the public) we must continue to monitor our activities and make adjustments through evolutionary changes rather than revolutionary regulations. Quite clearly there are segments of our country that are orthopedically underserved. Thus, it is vital that we seek new methods to encourage orthopedists to settle in these areas. Clearly, the simple production of more orthopedists in the traditional model will not answer the geographic maldistribution. With the tremendous scope of problems cared for by orthopedists, there does not appear to be an oversupply; however, we are headed in that direction. If we continue to rate operative procedures as the most significant and satisfying aspect of the practice, we certainly have enough, but they are not spread across the country in a uniform manner. Significant increases in numbers will be necessary if the orthopedist is to assume the role of general practitioner of the musculoskeletal system as well as a specialist for diagnosing and treating the more complicated musculoskeletal problems (whether by medical-surgical or physical-medical modalities). Should this be the case adjustments must be made in the selection process of orthopedic residents, in training programs, as well as estimates of the numbers of such specialists necessary for the future.

Allied Health Personnel↗
PubMed1975

The deep posterior compartmental syndrome of the leg.

Fourteen cases of deep posterior compartmental syndrome of the leg complicating lower-extremity trauma were analyzed. Caused by increased pressure within the deep posterior compartment, the syndrome was characterized by pain, plantar hypesthesia, weakness of toe flexion, pain on passive toe extension, and tenseness of the fascia between the tibia and the triceps surae in the distal medial part of the leg. Decompression of the compartment within twelve hours of the onset of the syndrome prevented permanent sequelae.

Adult↗
PubMed1970

Low back pain.

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Back Pain↗