Corticosterone and methylation of noradrenaline in vitro.
Explore the source record for details and available documents.
Animals↗
Biomedical subjects
J Crowe
Publications and source records attributed to J Crowe.
A method for the qualitative demonstration and quantitative estimation of esterases in the ox adrenal medulla.
Explore the source record for details and available documents.
Acetylesterase↗
Hydraulic compression of mice to 166 atmospheres.
Hydraulic uniform compression elicited tremors, uncoordinated limb movements, and tonic convulsions in liquid-breathing mice at pressures ranging from 50 to 100 atmospheres. Such abnormal muscular activity was observed neither in control animals nor in mice caudally to a spinal transection. Uniform compression of isolated preparations of mouse muscle in saline failed to contract at pressures up to 200 atmospheres.
Animals↗
Increased duodenal DMT-1 expression and unchanged HFE mRNA levels in HFE-associated hereditary hemochromatosis and iron deficiency.
HFE-associated hereditary hemochromatosis is characterized by imbalances of iron homeostasis and alterations in intestinal iron absorption. The identification of the HFE gene and the apical iron transporter divalent metal transporter-1, DMT-1, provide a direct method to address the mechanisms of iron overload in this disease. The aim of this study was to evaluate the regulation of duodenal HFE and DMT-1 gene expression in HFE-associated hereditary hemochromatosis. Small bowel biopsies and serum iron indices were obtained from a total of 33 patients. The study population comprised 13 patients with hereditary hemochromatosis (C282Y homozygous), 10 patients with iron deficiency anemia, and 10 apparently healthy controls, all of whom were genotyped for the two common mutations in the HFE gene (C282Y and H63D). Total RNA was isolated from tissue and amplified via RT-PCR for HFE, DMT-1, and the internal control GAPDH. DMT-1 protein expression was additionally assessed by immunohistochemistry. Levels of HFE mRNA did not differ significantly between patient groups (P = 0.09), specifically between C282Y homozygotes and iron deficiency anemic patients, when compared to controls (P = 0.09, P = 0.9, respectively). In contrast, DMT-1 mRNA levels were at least twofold greater in patients with hereditary hemochromatosis and iron deficiency anemia when compared to controls (P = 0.02, P = 0.01, respectively). Heightened DMT-1 protein expression correlated with mRNA levels in all patients. Loss of HFE function in hereditary hemochromatosis is not derived from inhibition of its gene expression. DMT-1 expression in C282Y homozygote subjects is consistent with the hypothesis of a "paradoxical" duodenal iron deficiency in hereditary hemochromatosis. The observed twofold upregulation of the DMT-1 is consistent with the slow but steady increase in body iron stores observed in those presenting with clinical features of hereditary hemochromatosis.
Cation Transport Proteins↗
Management of Barrett's oesophagus in 2001 in Ireland.
BACKGROUND: Endoscopic surveillance of patients with Barrett's oesophagus is recommended to detect early carcinoma. The practice patterns of endoscopists since the publication of more recent management guidelines remain unknown. METHODS: All endoscopists (n=68) in the Irish Medical Directory and their trainees were sent a postal questionnaire on Barrett's surveillance. RESULTS: Fifty-five per cent (30/54) perform surveillance on all patients with Barrett's oesophagus and 38% on selected patients. In patients with no dysplasia, repeat endoscopy was more commonly practiced annually (28/54) than every two to three years (23/54). Surgeons were more likely to perform surveillance annually than gastroenterologists (75% vs 40%). Only 26% of endoscopists took four-quadrant biopsies every 2 cm. Intervention was recommended by a majority (28/54) of endoscopists in a patient with high grade dysplasia. A majority of respondents (47/54) would have surveillance if they were found to have Barrett's oesophagus. CONCLUSION: Most endoscopists in Ireland do not adhere to recent guidelines in their management of Barrett's oesophagus. Surgical endoscopists perform surveillance more frequently than their medical colleagues.
Barrett Esophagus↗
The role of surgery and laser ablation in oesophageal carcinoma.
Between January 1990 and December 1994 oesophagectomy was carried out in 42 patients and comparison made with 38 who had palliative laser therapy. Apart from six patients referred after being unresectable at surgical exploration there were no agreed selection criteria, although the laser patients were in general older (mean 64 V 73 year) with a higher proportion of cardiorespiratory co-morbidity (14 per cent V 18 per cent). Lateral margins were involved in 14 per cent of known palliative resections with 50 per cent having positive nodes. The mean operating time was three hours and two chest drains inserted electively were removed after 3.6 days with mean drainage of 817 ml. The mean ICU stay was 5.4 days and 3 had radiological leaks; all but one settled conservatively. The 90 day mortality was 11.9 per cent for surgery and 34 per cent for laser patients. Twenty-three patients (61 per cent) required further courses of laser-therapy for benign anastomotic stenosis. Including the initial treatment of both groups 6.0 procedures per patient year were required in the laser groups compared with 1.1 for surgery. The 1, 2 and 3 year survival was 60 per cent, 31 per cent, 39 per cent for surgery compared with 24 per cent, 8 per cent, 3 per cent for laser--12 surgical patients are still alive and well at mean of 29 months (range 16-68). Surgery where possible with acceptable morbidity and mortality offers good palliation and long-term survival is possible; selection criteria for palliation only need to be defined.
Adult↗
The celtic coincidence--the frequency and clinical characterisation of hereditary haemochromatosis in patients with coeliac disease.
BACKGROUND: Hereditary Haemochromatosis (HH) and Coeliac disease (CD) are common disorders in Northern European populations, particularly the Irish population. AIMS: To investigate whether there was increased frequency of the two common HFE gene mutations, C282Y and H63D, associated with HH amongst a cohort of CD patients, and to determine the penetrance of the HH associated genotypes in this cohort. METHODS: HFE genotypes of a cohort of CD patients were determined using standard PCR techniques. HFE allele frequencies were compared to those of a previously reported, ethnically similar, cohort of 800 neonates, using Fishers exact test. Patients with HH-associated genotypes were subsequently evaluated. RESULTS: The C282Y and H63D allele frequencies, 24/222 (11%) and 28/222 (13%) respectively, in the CD patients were similar to those of the neonatal group, 171/1600 (11%) and 242/1600 (15%). Eight patients had HH-associated genotypes, of which two demonstrated biochemical evidence of iron overload. CONCLUSION: The HFE mutations associated with Hereditary Haemochromatosis are not more common in Irish CD patients.
Celiac Disease↗
Transjugular liver biopsy: assessment of safety and efficacy of the Quick-Core biopsy needle.
BACKGROUND: We assessed the safety and efficacy of transjugular liver biopsy with the Quick-Core biopsy needle. METHODS: Fifty consecutive patients with liver failure and contraindications to percutaneous liver biopsy were referred for transjugular liver biopsy. Eighteen (36%) patients had thrombocytopenia (platelet range = 44-92/microL, mean = 66/microL), 31 (62%) patients had elevated prothrombin times (international normalized ratio range = 1.3-3, mean = 1.6), and 19 (38%) patients had ascites. The Cook Quick-Core biopsy needle was used. RESULTS: Average procedure time was 30 min. Transjugular access to the hepatic veins was successful in 49 of 50 cases. A transfemoral approach was used in one patient. Tissue specimens were satisfactory for histologic diagnosis in all cases. Established cirrhosis was present in 37 (74%) patients. The mean number of cores was 2.2 (range = 1-3). The mean number of portal triads per core was 10.4 (range = 6-20). There were no procedure-related complications. CONCLUSION: Transjugular liver biopsy with the Quick-Core biopsy needle is safe and effective in patients in whom the percutaneous route is contraindicated by coagulopathy or ascites.
Biopsy, Needle↗
Juvenile hemochromatosis due to G320V/Q116X compound heterozygosity of hemojuvelin in an Irish patient.
Hemojuvelin (HJV) is a recently discovered gene responsible for 1q-linked juvenile hemochromatosis. The majority of mutations characterized in this gene are rare and private, except G320V, identified in patients from different countries. Here, we report the clinical features and the molecular study of a young Irish patient presenting with severe cardiac disease related to iron overload. We sequenced the coding region and the exon-intron boundaries of genes associated with juvenile hemochromatosis, HAMP and HJV encoding hepcidin and hemojuvelin respectively. Two heterozygous HJV mutations were identified: the G320V mutation and the new Q116X mutation that cause a premature stop codon in the protein. This finding increases the number of mutations identified in HJV gene and underlines that the G320V is a recurrent mutation, even in Northern Europe.
Adolescent↗
Practical tips on preparing for a JCAHO survey.
This article focuses on the role of the Nurse Manager and Staff Nurse in the Joint Commission for Accreditation of Healthcare Organizations survey process. We present practical tips to make the unit visits, interviews, and closed chart reviews easier and more meaningful. Emphasis is on meeting those standards that address use and documentation of the nursing process.
Accreditation↗
Goal attainment in a randomized controlled trial of rehabilitation after myocardial infarction.
PURPOSE: Goal setting is an established strategy in health behavior change programs although its usefulness remains uncertain. The authors investigate the validity of attainment of a patient-identified goal as an outcome measure in cardiac rehabilitation after myocardial infarction. METHODS: On entry into a randomized controlled trial of cardiac rehabilitation after an acute myocardial infarction, patients identified one activity that, if and when attained, would reflect their perception of a successful recovery. Patients reported whether they had attained their goal and the time of goal attainment. This was then related to trial outcomes that included generic and specific health-related quality of life and percent predicted exercise tolerance. RESULTS: Goals identified by 180 of the 201 (89.6%) patients, were attained by 51.5% at 8 weeks and by 86.5% at 12 months. At the end of the 8-week intervention, there was a substantial trend for fewer rehabilitation than usual care patients to have attained their identified goal (P < 0.06), although rehabilitation patients demonstrated greater improvement in specific health-related quality of life and exercise tolerance than usual care patients (P < 0.05). Among patients who identified a recreational physical activity goal (26.7%), significantly fewer (P < 0.007) rehabilitation than usual care patients had attained their goal at the end of the intervention with no differences in improvement in outcomes. CONCLUSIONS: Although improvement in outcomes was greater in rehabilitation patients than usual care patients at 8 weeks, goal attainment, particularly for the recreational physical activity goal, was greater among usual care patients. The validity of self-identified activity goal attainment as a measure of the efficacy of cardiac rehabilitation is unclear and might give misleading results.
Exercise Therapy↗
Non-invasive optical methods for the study of cerebral metabolism in the human newborn: a technique for the future?
Two of the major causes of death and disability in the preterm newborn of the developed nations are cerebral ischaemia and intraventricular haemorrhage. It is estimated that intraventricular haemorrhage develops in 40-50% of infants with a birthweight of 1500 g or less but precisely how many individuals are affected by haemorrhage, or how many cases of disability are antedated by cerebral ischaemia, is not known because of the lack of effective low-cost instruments for the continuous, or at least frequent, assessment of cerebral metabolic status in the high-risk individual. In the future, however, fibre-optic-based spectrophotometric techniques for the measurement of cerebral redox state may provide low-cost, portable instruments for the noninvasive assessment of cerebral metabolism during the intensive care of the neonate.
Brain↗
A randomized controlled trial of the effectiveness of exercise and/or alternating air mattress in the control of back pain after percutaneous transluminal coronary angioplasty.
OBJECTIVE: To determine whether an alternating air mattress, a specifically designed exercise program, or both were effective in alleviating back pain in patients after percutaneous transluminal coronary angioplasty (PTCA). DESIGN: 2 by 2 factorial, randomized control trial. SETTING: Intermediate cardiac care unit in a Canadian regional cardiac referral center. SUBJECTS: The sample included 100 subjects, X age 57.4 years, undergoing PTCA. INSTRUMENTS: 10 cm visual analog and Borg scales, both of which measured subjects' perception of pain. RESULTS: The combination of exercise and alternating air mattress is most effective in pain reduction (p = 0.012). CONCLUSION: The combination of exercise and alternating air mattress is more effective in alleviating back pain in patients after PTCA than conventional methods or exercise and alternating air mattress alone.
Adult↗