Biomedical subjects
Publications and source records attributed to M Lentz.
From January 1990 to November 1994, 23 patients with advanced pretreated lung carcinoma were enrolled into a phase II trial to test a new nitrosourea, cystemustine, given every 2 weeks at the dose of 60 mg/m(2) in a 15-minute IV infusion. All eligible patients were considered evaluable for response and toxicity (WHO criteria).
BACKGROUND: Gemcitabine has shown activity in patients with less chemosensitive solid tumors. Phase II screening of novel drugs is an accepted method with which to investigate new therapies in malignant mesothelioma. The European Organization for Research and Treatment of Cancer-Lung Cancer Cooperative Group has performed several sequential Phase II trials of new agents for the treatment of mesothelioma over the last 10 years. METHODS: Twenty-seven chemotherapy-naive patients with histologically proven malignant mesothelioma were treated with gemcitabine as a 30-minute intravenous administration of 1250 mg/m2 on Days 1, 8, and 15 of a 28-day cycle. Therapy continued for up to ten cycles unless disease progression or excessive toxicity mandated discontinuation. RESULTS: With a median relative dose intensity of 96%, toxicity was mild and neutropenia of > or = Grade 3 (according to National Cancer Institute criteria) occurred in 30% of patients, without episodes of febrile neutropenia. One case of hemolytic-uremic syndrome, most likely related to gemcitabine use, was observed. Overall, 2 objective responses were observed (response rate of 7%; 95% confidence interval, 1-24%). The median survival was 8 months. CONCLUSIONS: At the prescribed dosage and schedule, single agent gemcitabine appears to have limited activity in chemotherapy-naive patients with malignant pleural mesothelioma.
The purposes of this study were to (1) identify the clusters of symptoms women experience during the premenstruum, (2) assess the reliability of the symptom clusters as reported by a population-based sample and a sample of women with three perimenstrual symptom patterns, (3) compare the levels of severity for the symptom clusters across menstrual cycle phases and by symptom patterns (e.g., premenstrual syndrome [PMS] vs. low severity), and (4) estimate the stability of the symptom cluster rankings across three menstrual cycle phases. Data from a cross-sectional population-based sample and a comparative sample of women screened for low-severity (LS), PMS, and premenstrual magnification (PMM) symptom patterns were analyzed using factor analysis, correlation coefficients, multivariate analysis of variance, and reliability and stability coefficients. Four symptom clusters accounted for >40% of the variance: turmoil, fluid retention, somatic symptoms, and arousal symptoms. Alpha (alpha) levels were >.70 for turmoil and fluid retention. None of the symptom clusters had correlations with other factors that exceeded a levels for sample 2. Symptom cluster scores varied by cycle phase and group (LS, PMS, PMM). Arousal and somatic symptoms were the most stable of the symptom clusters across cycle phases, and fluid retention and turmoil symptoms were less stable.
The objective of this study was to compare ticarcillin/clavulanate given at 3.1 g every 6 hours with imipenem/cilistatin given at 500 mg every 6 hours for the treatment of infections associated with gangrenous or perforated appendicitis. One hundred thirty-seven patients were found to have gangrenous or perforated appendicitis and received the study medication for 3 to 5 days in a double-blinded, randomized manner. Clinical success was similar for the two treatment groups, 96.9 and 95.9 per cent in the ticarcillin/clavulanate and imipenem/cilistatin groups, respectively (P=0.99; 95% confidence interval for the difference was -5.6% to 7.6%). Bacteriologic success at the end of therapy was similar in the two groups, 100 and 98.4 per cent in the ticarcillin/clavulanate and imipenem/ cilistatin groups, respectively (P=0.99; 95% confidence interval for the difference was -1.8% to 4.7%). The occurrence of adverse events related to treatment was similar for the two groups (P=0.31) and led to study withdrawal for four patients (one with ticarcillin/clavulanate and three with imipenem/ cilistatin). Ticarcillin/clavulanate given at 3.1 g every 6 hours is as effective and as safe as imipenem/ cilistatin given at 500 mg every 6 hours for treatment of gangrenous or perforated appendicitis.
The purpose of this investigation was to compare self-reported sleep quality and psychological distress, as well as somnographic sleep and physiological stress arousal, in women recruited from the community with self-reported medically diagnosed fibromyalgia (FM) to women without somatic symptoms. Eleven midlife women with FM, when compared to 11 asymptomatic women, reported poorer sleep quality and higher SCL-90 psychological distress scores. Women with FM also had more early night transitional sleep (stage 1) (p < 0.01), more sleep stage changes (p < 0.03) and a higher sleep fragmentation index (p < 0.03), but did not differ in alpha-EEG-NREM activity (a marker believed to accompany FM). No physiological stress arousal differences were evident. Less stable sleep in the early night supports a postulate that nighttime hormone (e.g., growth hormone) disturbance is an etiologic factor but, contrary to several literature assertions, alpha-EEG-NREM activity sleep does not appear to be a specific marker of FM. Further study of mechanisms is needed to guide treatment options.
The purpose of this study was to compare women over 40 years of age with premenstrual syndrome (PMS) to women with a low-severity (LS) symptom pattern with respect to physiologic indicators of stress arousal and response, stress hormone arousal, stressful life circumstances, anger, self- and social control, and interpersonal sensitivity. Women with PMS experienced more negative life events, more difficulty with anger, and more concerns about self- and social control, than women with an LS pattern. These experiences were coupled with increased physiologic arousal and stress responses (skin conductance and muscle tension levels) and relatively higher norepinephrine levels than for women with an LS pattern, but with dampened cardiovascular responses to stressors. As they age, women with a PMS symptom pattern demonstrate persistent differences in stress arousal and response from women with an LS pattern.
The slogan of an increase in external stimuli is seen as a characteristic of the diverse processes of modernization in the German Empire. A study of Theodor Lessing's "Anti-noise Society" (1908-1914) showed how the individual experienced auditory stimuli andd how these stimuli were understood and digested. Apart from the writings of Lessing, the Society's mouthpiece "Anti-rowdy. The Right to Quietness" was analysed hermeneutically and with respect to questions of social history. The combination of this analysis with the relevant medical results and discussions in specialist literature (question of nervousness; occupational medicine) have shown that the use of an expression like "increase in stimuli" is justified when urban life before World War I is to be characterised. It is, however, only an abstract collective term under which diverse forms of practical knowledge, different ways of giving meaning to this psychosocial phenomenon, and even willful disregard for it as a relevant contemporary issue are subsumed - just as with noise as an environmental problem.
The results of the American Association of Critical-Care Nurses Demonstration Project support the contention that high quality critical care nursing can be provided to patients at a reasonable cost. In addition, the data refute the notion that elements influenced by nurses--supplies and nursing care--are the most costly portion of the total hospital charge.
E1 is the largest open reading frame (ORF) of bovine papillomavirus type 1 (BPV-1) and is highly conserved among all papillomaviruses, maintaining its size, amino acid composition, and location in the viral genome with respect to other early genes. Multiple viral replication functions have been mapped to the E1 ORF of BPV-1, and evidence suggested that more than one protein was encoded by this ORF. We previously identified a small protein (M) whose gene consists of two exons, one encoded by the 5' end of the E1 ORF. We show here that a 68-kilodalton (kDa) phosphoprotein made from the E1 ORF can be detected in BPV-1-transformed cells, and we present evidence that this protein is encoded by sequences colinear with the entire E1 ORF. The full-length E1 protein immunoprecipitated from virally transformed cells and identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis comigrates with a protein expressed from a recombinant DNA construct capable of producing only the complete E1 protein. In addition, two different antisera directed against polypeptides encoded from either the 3' or the 5' end of the E1 ORF both recognize the full-length E1 product. A mutation converting the first methionine codon in the ORF to an isoleucine codon abolishes BPV-1 plasmid replication and E1 protein production. Consistent with the notion that this methionine codon is the start site for E1, a mutant with a termination codon placed after the splice donor at nucleotide 1235 in E1 produces a truncated protein with the molecular mass predicted from the primary sequence as well as the previously identified M protein. When visualized by immunostaining, the E1 protein expressed in COS cells is localized to the cell nucleus. A high degree of similarity exists between the BPV-1 E1 protein and polyomavirus and simian virus 40 large-T antigens in regions of the T antigens that bind ATP. We show by ATP affinity labeling that the E1 protein produced in COS cells binds ATP and that this activity is abolished by a point mutation which converts the codon for proline 434 to serine. Furthermore, this mutation renders the viral genome defective for DNA replication, suggesting that the ATP-binding activity of E1 is necessary for its putative role in viral DNA replication.(ABSTRACT TRUNCATED AT 400 WORDS)
The American Association of Critical-Care Nurses developed a Demonstration Project to document fiscal costs and patient care effectiveness of critical care nursing in a unit characterized by valued organizational attributes. Data were collected by interview, observation, and written surveys from 42 nurses, 68 physicians, and 192 patient admissions. Decentralized administration, participatory management, high rate of CCRN certification, all-registered nurse staff, and high nurse-physician collaboration were present. Organizational and clinical outcomes were positive: high satisfaction, low turnover, low mortality ratio, no new complications, high patient satisfaction. The proportion of charges for nursing-controlled factors was low compared with proportion of total stay spent in the unit. Aspects of structure, process, and outcome can be measured simultaneously in critical care; these measurements indicate that positive organizational and clinical outcomes coexist with valued aspects of the organizational environment.
Women between the ages of 40 and 59 years were classified as pre-, peri-, and postmenopausal, with and without hot flash symptoms, for comparison of somnographic sleep variables. Few differences in sleep variables were noted between the groups. However, peri- and postmenopausal women experiencing hot flashes (symptomatic) tended to have lower sleep efficiencies than those not experiencing hot flashes. As well, rapid-eye-movement (REM) latency was longer (p less than 0.05) in the symptomatic women (means = 94.2 min) than in the nonsymptomatic women (means = 71.4 min). Although an age difference existed between the menopausal status groups, it was less than a decade and a main group effect for sleep efficiency and REM latency was seen while controlling for age and/or depression.
Monoclonal antibodies were raised against Swarm rat chondrosarcoma link protein 2. Two of the resultant hybridomas (9/30/6-A-1 and 9/30/8-A-4) were used in structural analyses of the link proteins. The 9/30/6-A-1 monoclonal antibody recognized an epitope which was only present on rat chondrosarcoma link protein 2. This epitope was absent in rat chondrosarcoma link protein 3 obtained after trypsin or clostripain treatment of rat chondrosarcoma proteoglycan aggregate, indicating that proteolytic digestion either removed or modified the epitope. Contrasting this, the 9/30/8-A-4 monoclonal antibody recognized an epitope present in link protein(s) 1, 2, or 3 isolated from cartilage of several animal species (rat, bovine, human, and chicken). Rat chondrosarcoma link protein 2 was digested with Staphylococcus aureus V8 protease, and the resulting peptides were fractionated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and subjected to immunolocation analyses. The 9/30/6-A-1 and 9/30/8-A-4 monoclonal antibodies recognized epitopes in two different halves of the link protein molecule. The 9/30/8-A-4 monoclonal antibody was used to identify proteolytic cleavage peptides common to the individual link proteins (1, 2, or 3) purified from cartilage proteoglycans of several animal species. Digestion of rat chondrosarcoma link protein 2 with endoglycosidase H or alpha-mannosidase increased its electrophoretic mobility to that of link protein 3 and removed or altered the determinant recognized by the 9/30/6-A-1 monoclonal antibody, indicating that a high-mannose oligosaccharide chain was part of the antigenic determinant. The 9/30/8-A-4 monoclonal recognition of epitope was unaffected by endo- or exoglycosidase treatment. Endo- and exoglycosidase treatment of bovine nasal cartilage link proteins also altered their electrophoretic mobility, indicating that high-mannose oligosaccharide structures on the various link proteins (1, 2, or 3) accounted for the microheterogeneity observed in sodium dodecyl sulfate-polyacrylamide gels.
Although activity is a normal state of the human body, a variety of orthopedic conditions may necessitate some degree of immobilization. Major deconditioning changes in the cardiovascular system and musculoskeletal system have been identified. The deconditioning changes affecting the cardiovascular system are decreased venous flow, decreased orthostatic tolerance, and decreased work capacity. The deconditioning changes associated with the musculoskeletal system are bone demineralization, altered joint function, and loss of muscle mass, strength, and tone. Possible nursing interventions and their rationales for use with the identified deconditioning changes have been explored. The general goal of any intervention is to minimize the deconditioning that occurs with immobilization.
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