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Biomedical subjects

R Fish

Publications and source records attributed to R Fish.

36 records · Page 2Linked to original sources
PubMed1997

An interleukin 5 mutant distinguishes between two functional responses in human eosinophils.

Interleukin 5 (IL-5) is the key cytokine involved in regulating the production and many of the specialized functions of mature eosinophils including priming, adhesion, and survival. We have generated a point mutant of human IL-5, IL-5 (E12K), which is devoid of agonist activity in both a TF-1 cell proliferation assay and a human eosinophil adhesion assay. However, IL-5 (E12K) is a potent and specific antagonist of both these IL-5-dependent functional responses. In both receptor binding and cross-linking studies the wild-type and IL-5 (E12K) mutant exhibit virtually identical properties. This mutant protein was unable to stimulate tyrosine phosphorylation in human eosinophils, and blocked the phosphorylation stimulated by IL-5. In contrast, IL-5 (E12K) is a full agonist in a human eosinophil survival assay, although with reduced potency compared to the wild-type protein. This IL-5 mutant enables us to clearly distinguish between two IL-5-dependent functional responses and reveals distinct mechanisms of receptor/cellular activation.

Cells, Cultured↗
PubMed1997

Mode of onset of malignant ventricular arrhythmias in idiopathic ventricular fibrillation.

INTRODUCTION: The mode of onset of malignant ventricular arrhythmias (ventricular tachycardia [VT] or ventricular fibrillation [VF]) has been well described in patients with organic heart disease and in patients with the long QT syndromes. Less is known about the mode of onset of VF in patients with out-of-hospital VF who have no evidence of organic heart disease or identifiable etiology. METHODS AND RESULTS: We reviewed the ECGs of all our patients with idiopathic VF. Documentation of the onset of spontaneous arrhythmias was available for 22 VF episodes in 9 patients (6 men and 3 women; age 41 +/- 16 years). In all instances, spontaneous VF followed a rapid polymorphic VT, which was initiated by premature ventricular complexes (PVCs) with very short coupling intervals. The PVC initiating VF had a coupling interval of 302 +/- 52 msec and a prematurity index of 0.4 +/- 0.07. These PVCs occurred within 40 msec of the peak of the preceding T wave. Pause-dependent arrhythmias were never observed. CONCLUSION: Cardiac arrest among patients with idiopathic VF has a very distinctive mode of onset. Documentation of a polymorphic VT that is not pause dependent is of diagnostic value.

Adult↗
PubMed1996

Reduction of urinary basic fibroblast growth factor using pentosan polysulphate sodium.

OBJECTIVE: To evaluate the use of pentosan polysulphate sodium (PPS) to reduce the level of urinary basic fibroblast growth factor (bFGF). PATIENTS AND METHODS: Forty-one patients with a clam enterocystoplasty were randomized to receive either 200 mg three times daily of oral PPS (n = 21) or placebo (n = 20) for 6 weeks. Three patients acted as a cross-over study. Urinary bFGF was measured before and after treatment and the degree of symptomatic benefit assessed using a questionnaire. RESULTS: There was no reduction in bFGF in the patients receiving placebo (P = 0.235) but there was a statistically significant reduction in bFGF (P = 0.0251) in the patients receiving PPS, most of whom were symptomatically improved, especially with regard to mucus production. CONCLUSION: PPS may have a role in reducing urinary bFGF in patients with bladder tumours or following an enterocystoplasty and also in improving the quality of life of patients with a clam enterocystoplasty.

Adolescent↗
PubMed1996

Elevated levels of basic fibroblast growth factor in the urine of clam enterocystoplasty patients.

PURPOSE: We determined whether basic fibroblast growth factor is elevated in the urine of patients who have undergone clam ileocystoplasty. MATERIALS AND METHODS: An immunoassay technique was used to measure urinary basic fibroblast growth factor in 50 patients equally divided between those with and without neuropathy who had undergone clam enterocystoplasty. The results were compared with urinary basic fibroblast growth factor concentrations from 25 healthy age and sex matched volunteers. RESULTS: There is a highly significant elevation of urinary basic fibroblast growth factor in clam enterocystoplasty patients compared to controls, which is not related to the presence or absence of infection. There is no difference between those with and without neuropathy. CONCLUSIONS: Elevated levels of basic fibroblast growth factor are an important consideration in the malignant potential of the clam procedure.

Adolescent↗
PubMed1982

Biochemical aids to the staging of breast cancer.

Up to fifteen plasma proteins were measured before treatment in 249 women presenting with lumps in the breast. Concentrations showed considerable overlap between the various clinical stages, and were often normal even in metastatic disease. A discriminant function is proposed, based on measurement of C-reactive protein, beta 2-microglobulin, carcinoembryonic antigen and ferritin and calculation of a score for each subject. High-risk scores resulted for all 18 patients with Stage 4 (i.e., metastatic) disease, and the number of Stage 1 patients attaining high scores was consistent with the reported incidence of development of metastases in such a group. Follow-up studies are in progress.

Blood Proteins↗
PubMedDate not supplied

Hospital mergers: legal and personal implications for emergency physicians.

In east central Illinois over the last three years, three hospitals in which the authors were contracted as emergency physicians have been in various stages of merger with nearby hospitals. In all, six hospitals will be merged into three "medical centers." This is a basis of experience to be shared with other emergency physicians, as consolidation of health care facilities seems to be a wave of the future due to financial constraints of the health care setting. Lessons to be learned from these experiences involve many issues, including work contract, malpractice insurance payment, physician and nurse staffing, and public information problems.

Antitrust Laws↗
PubMedDate not supplied

Physicians should be expert witnesses.

Physicians have a responsibility to society, their peers, and patients to participate in malpractice litigation in a manner that ensures that medical malpractice cases are properly evaluated. Physicians are reluctant to involve themselves as expert witnesses in medical malpractice litigation because of not wanting to further any malpractice suits, mistrust of attorneys and misconceptions about expert witnesses and the legal system in general. The expert witness should be an impartial practicing physician who can select those suits that should or should not be filed and identify which parties were negligent in each case. If impartial physicians do not evaluate cases for attorneys, other more partisan and less objective physicians will.

Expert Testimony↗
PubMedDate not supplied

Review of medical negligence cases: an essential part of residency programs.

Residency programs routinely review cases involving "morbidity and mortality." It would be a valuable experience to similarly review medical malpractice cases and the associated testimony by medical experts. When available, the cases reviewed in residency programs would be those in which faculty members at the same institution had testified. The faculty member in such cases would be intimately familiar with the case and able to share the knowledge necessary to take part in the legal process. This case review process would expose residents to the legal realities of medical practice, provide a forum for peer review of legal testimony by experts, and show residents how to participate in the legal system should the need arise.

Emergency Medicine↗
PubMedDate not supplied

Electric shock, Part I: Physics and pathophysiology.

Electric shock causes injury and death through a variety of mechanisms. The proper treatment of a patient with electric shock depends upon the nature of the injuries sustained. The primary electric injuries to be expected depend in large part on the type of electric energy source, the amount and duration of current flow, and the parts of the body affected. Secondary injury can be caused by trauma associated with the electric accident such as falls and explosions.

Burns, Electric↗
PubMedDate not supplied

Electric shock, Part II: Nature and mechanisms of injury.

Virtually every part of the body can be injured by electric current. The extent of injury to any given tissue will depend on many factors, including the nature of the tissue and the amount and duration of the electric current. In addition, cardiac and respiratory arrest can be induced by a number of mechanisms with little or no immediate tissue damage. Burns can be caused by the heating of tissue by electric current and by other mechanisms. Secondary trauma may result from falls, explosions, and other events initiated by electric forces. Nervous tissue has the least resistance to current flow and is thus more easily damaged. Part II in this 3-part series will discuss nervous tissue damage first, followed by discussions of damage to tissues of increasingly greater electric resistance. These are blood vessels, muscle, skin, and bone. Less common injuries are discussed last.

Blood Vessels↗
PubMedDate not supplied

Electric shock, Part III: Deliberately applied electric shocks and the treatment of electric injuries.

Earlier parts of this series have discussed the physics, pathophysiology, and nature of electric injury. This part will discuss deliberately applied electric shocks and the treatment of electric injuries. Electric shocks are deliberately applied to persons during electroshock therapy and with stun guns, shock batons, and electric cattle prods. Electric injuries, whether a complication of deliberate electric shock or due to accidental injury, should be treated to preserve cardiac and respiratory function and to prevent further tissue damage. Safe extrication at the scene, rapid triage, and emergency medical treatment are discussed.

Electric Injuries↗
PubMedDate not supplied

The HELLP syndrome: case report and review of the literature.

A pregnant patient with a chief complaint of chest pain was found to have many characteristic findings of the HELLP syndrome. A number of pregnancy-related conditions have in common various degrees of hypertension, proteinuria, edema, hemolysis, elevated liver enzymes, and low platelets. Emergency physicians should search for clinical and laboratory signs of these conditions when evaluating ill pregnant patients.

Adult↗
PubMedDate not supplied

The standard of care.

The professional standard of care has historically been defined in terms of the practice of reasonable, prudent physicians. In court, physicians are needed in most cases to testify as to what is the standard of practice and to verify the relevance of published materials that may be presented as being descriptive of the standard of care. Proposed standards have been published by many organizations and institutions. The medical literature also serves as a source of information concerning medical practices. Court cases may be decided in a way that suggests that the usual practices of physicians are inadequate.

Expert Testimony↗