Biomedical subjects
D Kessler
Publications and source records attributed to D Kessler.
Prescription for change: an interview with FDA Commissioner Dr. David Kessler.
Dr David A. Kessler took over as Commissioner of the Food and Drug Administration in December 1990. Since then, he has initiated many changes to improve the structure and efficiency of the agency. In this interview, he describes some of the problems and challenges associated with the process of reviewing and approving new drugs.
Effect of strain on surface morphology in highly strained InGaAs films.
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Pyruvate-formate-lyase-deactivase and acetyl-CoA reductase activities of Escherichia coli reside on a polymeric protein particle encoded by adhE.
A 4.8 kb DNA-fragment was cloned and sequenced encompassing the structural gene of PFL-deactivase (2.7 kb) and 2 kb of the 5' flanking region that contains the elements for anaerobic induction. A mutant lacking deactivase was shown to require exogenous electron acceptors for anaerobic growth with glucose. This revealed the identity of PFL-deactivase with the alcohol and acetaldehyde dehydrogenases of E. coli. The multienzyme represents a homopolymeric protein (approximately 40 x 96 kDa) requiring Fe2+ for all functions.
Optimal pension funding with demographic instability and endogenous returns on investment.
"This paper tries to explore some optimal funding policies for pension systems in a general equilibrium setting where funding affects returns on investment and wages through its impact on capital formation. This is done in the context of irregular demographic evolutions such as those expected in developed countries for the next century. Particular attention is given to the intergenerational welfare criterion which is used for designing optimal policies.... We will first present the model for the pension system and the economy and discuss a general one-parameter form for the intergenerational utility function. We will then present the simulated optimal paths for different numerical specifications of the model and the utility function. The last section will show by how much a simpler policy with fixed transfers and purely individual funding can depart from optimal paths...."
Birth order, family size, and achievement: family structure and wage determination.
The influence of birth order and childhood family size on future achievement is discussed. Two major empirical findings are presented by the author. "First, neither birth order nor childhood family size significantly influences the level or growth rate of wages, a result that is consistent with previous research. Second, family size is both a statistically and economically significant determinant of women's employment status: women from small families work less than women from large families when they are young and more than women from large families when they are more mature." The geographical focus is on the United States.
X-linked mental retardation with bilateral clasped thumbs: report of another affected family.
A Sephardi Jewish family is reported in which the two brothers had mental retardation, lower limb spasticity and bilateral clasped thumbs anomaly. This X-linked recessive disorder has only been reported twice. We believe this syndrome comprises a distinct entity among the X-linked mental retardation syndromes.
Roughening phase transition in surface growth.
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Too much or too little science in sex selection techniques?
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[Forecasting the economic effects of the aging population].
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Low dose streptokinase for acute myocardial infarction in a community hospital.
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More on acute renal failure in the intensive care unit.
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Case-control study of men with suspected chronic idiopathic prostatitis.
We studied prospectively 50 asymptomatic men (24 men from infertile couples and 26 normal volunteers) with no history of genitourinary infection and 34 men referred for symptoms of chronic prostatitis. Both groups were evaluated by urethral and prostatic secretion cultures for Chlamydia trachomatis, 4-glass prostatic localization cultures for facultative aerobic bacteria (Ureaplasma urealyticum, Mycoplasma hominis and selected fungi) and counts of prostatic fluid leukocytes. The men with symptoms of prostatitis had more than 1,000 leukocytes per mm. in prostatic secretions more often than did controls (11 of 27 versus 0 of 44, p less than 0.001). The concentration of Ureaplasma urealyticum in prostatic secretions was 1 log higher in prostatic fluid localization cultures than in first voided urine in 0 of 30 patients versus 13 of 50 controls (p equals 0.0014). Chlamydia trachomatis was not isolated from any patient or control. No other significant differences were found between patients and controls. We did not identify an infectious cause of chronic nonbacterial prostatitis.
Use of extracorporeal supportive techniques as additional treatment for septic-induced multiple organ failure patients.
We compared retrospectively four similar groups of patients with multiple organ failure (MOF) due to sepsis. All of them were treated initially with conventional therapy, aprotinin as protease inhibitor and vitamin C with allopurinol as possible scavengers of oxygen-free radicals, were also added. After 24 h of no clinical progress, continuous arteriovenous hemofiltration (CAVH), CAVH/dialysis (CAVH/D), and sequential plasmafilter-dialysis with slow continuous hemofiltration (CAVHP/D) were respectively added to groups 2 (n = 14), 3 (n = 6), and 4 (n = 11). Mortality was 87% for group 1, 71% for group 2, 50% for group 3, and 36% for group 4. In the latter we were able to remove possible MOF-inducing mediators from the bloodstream, to give fluids without restriction (even in oliguric patients), and to improve removal of metabolic waste products. It is possible that these extracorporeal supports, associated with conventional therapy, and pharmacologic drugs such as protease inhibitors and possible scavengers of oxygen-free radicals, helped to reduce the mortality rate. We conclude that, although the number of study patients was too small to reach firm conclusions, the good results observed with CAVHP/D suggest clinical trials to assess the efficacy of this technique.
Superimposed high frequency ventilation with conventional mechanical ventilation.
A 73-year-old man with ARDS-multiple organ failure due to Chlamydia psittaci, was successively supported with conventional respiratory techniques. After 48 hours of no clinical improvement, HFV was superimposed to CMV in order to combine the advantages of each one. Since improvement has been seen in all ventilatory parameters, this method is suggested as another mode of ventilation for patients with refractory hypoxia and hypercarbia who do not respond to conventional respiratory care.
[Extracorporeal support technics in the treatment of multisystem failure. Our experience].
Mortality rate among patients with septic, oliguric, multiple organ failure is high. Conventional hemodialysis has often detrimental effects on critically ill patients. Continuous arteriovenous hemofiltration (CAVH), continuous arteriovenous hemodialysis (CAVH/D) and continuous arteriovenous hemodialysis associated with sequential plasmapheresis (CAVHP/D) could reduce mortality in septic (hypercatabolic, oliguric) ARDS induced MOF patients. These techniques are simple and can be managed without superspecialized personnel.
Dynamical scaling of the surface of finite-density ballistic aggregation.
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Extended axillary block (E. A. B.).
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