Biomedical subjects
Publications and source records attributed to J Parks.
In this model, peer review takes place in the setting of a professional practice model and focuses on staff development, compliance with standards of care and annual performance appraisal. The roles of group facilitators and the nurse manager are outlined. A discussion of the problems and benefits of peer review is presented.
Previous work suggested a deficiency in the terminal complex of the mitochondrial electron transport chain, cytochrome c oxidase (COX), in platelet mitochondria of Alzheimer's disease (AD) patients. The present study extends this observation to AD brain mitochondria through assay of electron transport chain activities in mitochondria isolated from autopsied brain samples from AD patients (n = 9) and from controls with and without known neurologic disease (n = 8). AD brain mitochondria demonstrated a generalized depression of activity of all electron transport chain complexes. This depression was most marked in COX activity (p < 0.001). Concentrations of cytochromes b, c1, and aa3 were similar in AD and controls. The electron transport chain is defective in AD brain, and the defect centers about COX.
A new technique for eliminating or reducing glabellar frown lines and forehead creases with a small (3- to 5-cm) incision, KTP (potassium [K]-titanyl-phosphate) laser (Laserscope), and endoscope (Karl Storz) has been performed on 62 patients over the last 18 months. This endolaser technique takes advantage of the unique properties of the frequency-doubled Nd:Yag (neodymium:yttrium aluminum garnet) (KTP) laser coupled with an optimized quartz contact probe. It enables the surgeon to incise or excise the procerus, corrugator, and frontalis muscles, with little or no bleeding, at a distance from a small incision immediately behind the hairline. This small incision frontal lift has been as effective as the standard forehead lift in rejuvenation of the upper face, avoiding the paresthesias, scalp itch, headaches, periorbital ecchymosis, and hair loss that are common sequelae of the forehead lift. Recovery time has been markedly reduced.
Thirty physically abused women were randomly selected from the population of a local women's shelter and evaluated by psychiatric interview and psychiatric rating scales. High prevalences of major depression disorder (37%) and PTSD (47%) were determined. Furthermore, these disorders were found to be positively associated. These results suggest the need for immediate availability of psychiatric services at such shelters along with further study of their populations and possible intervention strategies.
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Despite anatomic and physiologic changes that predispose to stone formation, nephrolithiasis in pregnancy remains an uncommon occurrence. Stones occur more frequently in multiparas, during the later stages of gestation, and without a difference in laterality. Correct diagnosis can be confusing. Ultrasound has become a primary diagnostic tool and limited excretory urograms are only recommended for complicated cases. Conservative management can result in spontaneous passage of most stones. When necessary, cystoscopy or surgery can be done safely. Preexisting stone disease is associated with an increased incidence of urinary tract infections in pregnancy. Renal colic often precipitates premature labor. Most drugs used to treat stone disease are contraindicated in gestation. Increased quantities of known inhibitors of stone formation are present in gestation and may explain why the incidence of stones is not increased in this hypercalciuric state.
Four consecutive trials involving a computer activity were presented to 110 students categorized as Type A+, A-, B+, or B- personalities. A fifth trial presented the same computer activity with controls in reversed position, and Type A groups had more difficulty than Type B groups.
In this procedure hemoglobin is converted to its reduced form and the magnitude of the zero-order spectral shift of the reduced hemoglobin peak at 430 nm to the carboxyhemoglobin peak at 418 nm is determined by second-derivative spectrum analysis. The method is simple, straightforward to set up, and rapid. A result may be obtained within 15 min of receiving the sample. It is sufficiently sensitive to differentiate carboxyhemoglobin concentration in the blood of smokers and nonsmokers.
Thiamine deficiency causes Wernicke's encephalopathy, although the precise mechanism is unknown. We used a low-thiamine diet in conjunction with a thiamine analog, pyrithiamine, as a model of severe thiamine deficiency in rats. We investigated the function of intact, coupled mitochondria isolated from both brain and liver. State 4 respiration did not change in the thiamine-deficient animals. Brain state 3 rates fell in thiamine-deficient animals when pyruvate/malate, alpha-ketoglutarate, or glutamate were used as substrate. Liver state 3 rates were depressed only when pyruvate/malate was substrate. Activities of brain and liver pyruvate dehydrogenase complex and alpha-ketoglutarate dehydrogenase complex were depressed in the thiamine-deficient group. We conclude that the mitochondrial abnormalities resulting from thiamine deficiency are secondary to depression of thiamine-mediated enzyme activity, rather than from a putative role of thiamine in chemiosmotic coupling, and that the resulting abnormalities in ATP synthesis and perhaps in glutamate catabolism result in the irreversible neurologic defect seen in this disease.
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We found primary hyperparathyroidism in 56 of 1,132 consecutive patients with nephrolithiasis. We describe 48 of these patients who have undergone curative parathyroidectomy. Thirty of the 48 patients had extremely mild hypercalcemia (serum calcium level, 10.15 to 10.95 mg/dL), often accompanied by very substantial hypercalciuria. Stone disease was of equal severity in these 30 patients and in the 18 with more pronounced hypercalcemia (serum calcium level above 11 mg/dL). In all 48 patients, recurrent stone formation was virtually abolished by parathyroidectomy.
Considerable investigation has been devoted to the gastric dilatation-torsion complex. An adequate explanation of its cause has yet to be made, or a means of prevention described. We do know of its highly lethal nature, especially if not aggressively treated, of the high incidence of recurrence, and of the associated pathophysiology. As surgeons, we must approach the patient in an aggressive systematic manner. Decompression and patient stabilization must be achieved prior to definitive surgical management. The surgery planned must correct the obvious pathologic state and include procedures designed to prevent recurrence of this condition. The tube gastrostomy technique promotes gastric fixation by dense adhesion bands exceeding that attainable by gastropexy alone. The procedure is easy to perform, requires little surgical time, and does not appear to be discomforting to the patient. In addition, the tube gastrostomy acts as a convenient decompressive pathway during the postoperative period, circumventing gastric intubation or pharyngostomy tube placement should distention occur.
1. During in vitro incubation of liposomes or unilamellar vesicles prepared from egg-yolk or rat-liver phosphatidylcholine with human, monkey or rat plasma the phospholipid becomes associated with a high molecular weight protein-containing component. 2. The phosphatidylcholine . protein complex thus formed co-chromatographs with high-density lipoprotein on Ultrogel AcA34 and has the same immunoelectrophoretic properties as this lipoprotein. 3. Release of the phosphatidylcholine from liposomes was also observed when liposomes were incubated with pure monkey high-density lipoproteins. Under those conditions some transfer of protein from the lipoprotein to the liposomes was observed as well. 4. The observed release of phospholipid from the liposomes is a one-way process, as the specific radioactivity of liposome-associated phosphatidylcholine remained constant during incubation with plasma. 5. It is concluded that either the lipoprotein particle takes up additional phospholipid or that a new complex is formed from protein constituents of the lipoprotein and the liposomal phosphatidylcholine. 6. Massive release of entrapped 125I-labeled albumin from the liposome during incubation with plasma suggests that the observed release of phosphatidylcholine from the liposomes has a highly destructive influence on the liposomal structure. 7. Our results are discussed with special reference to the use of liposomes as intravenous carriers of drugs and enzymes.
The response to administered adrenocorticotropin (ACTH, Cortrosyn) of 26 heterozygotes (parents of children with adrenal 21-hydroxylase deficiency) and of 14 controls are compared. The mean plasma levels of 4-pregnene-3, 20-dione-17, 21-diol (17-OH progesterone) were significantly greater in the heterozygotes 60 minutes (p less than 0.02) and 90 minutes (p less than 0.05) after stimulation with Cortrosyn than in controls. There is, however, considerable overlap. The results would indicate a partial enzyme deficiency in the parents of diseased subjects. There was no significant difference in the response of plasma cortisol.
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Lymphocyte-dependent antobody (LDA) from the blood of a patient with choriocarcinoma was characterized in an allogeneic in vitro system. The antibody reacted with specific traget cells, including cells from the patient's husband. Antibody-coated traget cells were damaged by normal lymphocytes from man and other species. Neither cytotoxic, complement-dependent antibody nor sensitized cytotoxic lymphocytes were found in the patient. LDA activity was associated with IgG gamma-globulin by G-200 Sephadex filtration, electrophoretic mobility, and reactivity with anti-IgG, but there was no activity associated with IgM immunoglobulin. Sera from 14 of 16 normal donors lacked detectable LDA activity, and only low levels were found in sera from the other two donors.