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PubMedDate not supplied

Use of a nurse extender role in the rehabilitation setting.

In an effort to meet the increasing demand for bedside caregivers, nurse extender programs have proliferated over the past 2 years throughout the country. Standards for their job descriptions, however, are as varied as the number of programs. At Braintree Hospital, a great deal of time and effort has been spent to develop a program that is managed and supervised by registered nurses and that supports the appropriate delegation of tasks that do not require the skill of a professional nurse. Merker and Burkhart (1990) supported the use of a nurse extender to enhance the delivery of patient care and suggested that nursing administrators need to assess the current environment, define a strategy for the use of nurse extenders, and then implement that strategy. They also noted that because all healthcare facilities differ, it is important that each facility design its own program to meet its individual needs.

Clinical Competence↗

PubMed2004

Improving the accuracy of the spatial discretization in finite-difference electrochemical kinetic simulations, by means of the extended Numerov method.

The fourth-order accurate, three-point finite-difference Numerov spatial discretization provides accurate and efficient solutions to the time-dependent governing differential equations of electrochemical kinetics in one-dimensional space geometry, when the equations contain first time derivatives of the solution, second spatial derivatives, and homogeneous reaction terms only. However, the original Numerov discretization is not applicable when the governing equations involve first spatial derivative terms. To overcome this limitation, an appropriately extended Numerov discretization is required. We examine the utility of one of such extensions, first described by Chawla. Relevant discrete formulae are outlined for systems of linear governing equations involving first derivative terms, and applied to five representative example models of electrochemical transient experiments. The extended Numerov discretization proves to have an accuracy and efficiency comparable to the original Numerov scheme, and its accuracy is typically up to four orders of magnitude higher, compared to the conventional, second-order accurate spatial discretization, commonly used in electrochemistry. This results in a considerable improvement of efficiency. Therefore, the application of the extended Numerov discretization to the electrochemical kinetic simulations can be fully recommended.

Journal Article↗

PubMed2006

Evaluation of the protonation thermochemistry obtained by the extended kinetic method.

An evaluation of the results obtained by the extended kinetic method for a series of representative bases is presented here. Analysis of the original experimental data is conducted using the orthogonal distance regression (ODR) statistical treatment. A comparison with the proton affinities and protonation entropies obtained from variable temperature equilibrium constant measurements demonstrate deviations, which may be ascribed to random and systematic errors. Considerable random errors are associated with the extended kinetic method if the number of reference bases and the range of effective temperatures are too low. It is also confirmed that large systematic errors on proton affinities and protonation entropies are obtained when large protonation entropy is associated with the considered system. It is, however, encouraging to note that the gas phase basicities obtained by the extended kinetic method are generally comparable to that obtained by other methods within a few kJ/mol.

Journal Article↗

PubMed1982

Extended Hildebrand solubility approach and the log linear solubility equation.

The log linear solubility equation, log S = log Sw + sigma f, was studied in relationship to the extended Hildebrand solubility approach. It is shown that the log linear form may be derived beginning with the extended Hildebrand approach. The log linear expression gives a good linear fit for semipolar drugs in a number of water-cosolvent mixtures. It is particularly successful when the solubility parameter, delta 1, of the cosolvent is 3 or more solubility parameter units larger than the solubility parameter, delta 2, of the drug. When the cosolvent tends to solvate the drug strongly, the log linear function may even hold where the solubility parameters of the drug and cosolvent are similar. It appears, however, not to be applicable to nonpolar cosolvent systems. An interfacial model for the solubility of drugs in polar mixed solvents is based on sigma, a parameter that also figures prominently in the log linear solubility equation. When used to describe mixed solvent systems, the interfacial model applies in the region of the solubility profile (solubility versus solvent composition) where the log linear relationships hold. The extended Hildebrand solubility approach is applicable over a wide range of cosolvent composition in mixed systems from nonpolar organic solvents to water.

Aminobenzoates↗

PubMed1985

Extended Hildebrand solubility approach: sulfonamides in binary and ternary solvents.

The extended Hildebrand solubility approach is used to estimate the solubility of sulfonamides in binary and ternary solvent systems. The solubility of sulfisomidine in the binary solvent, dioxane-water, shows a bell-shaped profile with a solubility maximum well above the ideal solubility of the drug. This is attributed to solvation of the drug with the dioxane-water solvent, and indicates that the solute-solvent interaction energy (W) is larger than the geometric mean (delta 1 delta 2) of regular solution theory. The solubilities of sulfadiazine, sulfisomidine, sulfathiazole, and sulfamethoxazole were determined in mixtures of dimethylacetamide, glycerol, and water, and the solubility profiles were well reproduced by use of the extended Hildebrand solubility approach. Since the solubility parameter (delta 1 = 11) of the solvent (dimethylacetamide) was approximately equal to the solubility parameters of the sulfonamides, and because of the powerful solvating power of dimethylacetamide, the solubility profiles did not exhibit peaks as observed for sulfisomidine in dioxane-water. When sulfisomidine was dissolved in a ternary mixture, i.e., butyl acetate (delta 1 = 8.5), dimethylacetamide (delta 1 congruent to 11), and methanol (delta 1 = 14.5), a spike was produced in the solubility profile at the solubility parameter of dimethylacetamide. This sharply peaked profile suggests that the two branches be treated as separate solubility curves, which are then independently well reproduced by the extended Hildebrand solubility approach. None of the four sulfonamides yielded log-linear relationships in the ternary mixtures.

Acetamides↗

PubMed2005

Extended multiorgan resection for T4 gastric carcinoma: 25-year experience.

BACKGROUND AND OBJECTIVES: In locally advanced gastric carcinoma infiltrating adjacent organs, an extended resection including invaded organs is required to improve the prognosis. We retrospectively analyzed our experience with extended multiorgan resection (EMR) in patients with advanced gastric cancer. METHODS: Between December 1979 and April 2004, 65 patients were resected for extended gastric carcinoma macroscopically invading other organs. Various clinicopathologic factors influencing early and late results were evaluated. Survival rates were calculated according to the Kaplan-Meier method. Prognostic factors were evaluated by univariate and multivariate analysis. RESULTS: The majority of patients (61.5%) did receive a R0 curative resection. In 52 (80%) of the 65 presumed T4 cancers, histologic final analysis confirmed invasion. Postoperative morbidity and mortality was 27.7% and 12.3%, respectively. Actuarial 5-year overall survival (OS) rate was 21.8%. It was significantly better in R0 versus R+ (30.6% vs. 0%, P = 0.001). Multivariate analysis identified curative resection as the strongest predictor of survival (P = 0.002). CONCLUSIONS: Patients with locally advanced gastric carcinoma invading adjacent organs can benefit from aggressive surgical treatment with acceptable morbidity and mortality. However, curative resection is mandatory to improve prognosis.

Adult↗

PubMed2006

An extended power of cluster detection tests.

Several tests have been proposed to detect spatial disease clustering without prior information on their locations. In order to compare the performance of these tests, most authors employ the usual power, i.e. the rejection probability of the null hypothesis of no clustering due to various reasons. However, the usual power is not always appropriate for evaluating the cluster detection tests since their purpose is to both reject the null hypothesis and identify the cluster areas accurately. In this paper, we propose an extended power of the cluster detection tests, which includes the usual power as a special case. Further, we define the profile of the extended power, which can be expected to play an important role in the evaluation and comparison of several cluster detection tests. The proposed extended power and its profile are demonstrated by two tests--Kulldorff's circular spatial scan statistic and a flexible spatial scan statistic proposed by Tango and Takahashi.

Cluster Analysis↗

PubMed1994

Coexistence of folded and extended conformations of a tripeptide containing alpha, alpha -di-n-propylglycine in crystals.

The crystal structure of the tripeptide Boc-Leu-Dpg-Val-OMe (Dpg, alpha, alpha -di-n-propylglycine) reveals the coexistence of two distinct backbone conformations. In molecule A the Dpg residue adopts a fully extended conformation (phi = 76.0 degrees, psi = 180.0 degrees) while in molecule B a left handed helical conformation (phi = 62.8 degrees, psi = 39.6 degrees) is observed. Molecule B adopts a folded structure corresponding to a highly distorted Type II beta-turn conformation, which lacks an intramolecular 4 -> 1 hydrogen bond. In contrast, molecule A has an open, extended conformation. The results demonstrate that both fully extended and helical conformations are energetically accessible to the Dpg residue.

Models, Molecular↗

PubMed2000

Mass cultured human fibroblasts overexpressing hTERT encounter a growth crisis following an extended period of proliferation.

During the process of immortalization, at least two mortality checkpoints, M1 and M2, must be bypassed. Cells that have bypassed M1 (senescence) have an extended life span, but are not necessarily immortal. Recent studies have shown that ectopic expression of the catalytic subunit of telomerase (hTERT) enables normal human cells to bypass senescence (M1) and oncogene transformed cells to avert crisis (M2) and become immortal. However, it is unclear whether hTERT expression is sufficient for normal human fibroblasts to overcome both M1 and M2 and become immortal. We have investigated the role of telomerase in immortalization by maintaining mass cultures of hTERT-transduced primary human fetal lung fibroblasts (MRC-5 cells) for very long periods of time (more than 2 years). In the present studies, up to 70% of MRC-5 cells were transduced with retroviral vectors that express hTERT. hTERT-transduced cells exhibited high levels of telomerase activity, elongation of telomeres, and proliferation beyond senescence. However, after proliferating for more than 36 population doublings (PDLs) beyond senescence, the overall growth rate of hTERT-expressing cells declined. During theses periods of reduced growth, hTERT-transduced MRC-5 cells exhibited features typical of cells in crisis, including an increased rate of cell death and polyploidy. In some instances, very late passage cells acquired a senescence-like phenotype characterized by arrest in the G1 phase of the cell cycle and greatly reduced DNA synthesis. At the onset of crisis, hTERT-transduced cells expressed high levels of telomerase and had very long telomeres, ranging up to 30 kb. Not all cells succumbed to crisis and, consequently, some cultures have proliferated beyond 240 PDLs, while another culture appears to be permanently arrested at 160 PDLs. Late passage MRC-5 cells, including postcrisis cells, displayed no signs of malignant transformation. Our results are consistent with the model in which telomerase and telomere elongation greatly extends cellular life span without inducing malignant changes. However, these investigations also indicate that hTERT-expressing cells may undergo crisis following an extended life span and that immortality is not the universal outcome of hTERT expression in normal diploid fibroblasts.

Blotting, Southern↗

PubMed1994

Genomic organization and expressed sequences of the mouse extended H-2K region.

The mouse major histocompatibility complex (MHC) has long been of great interest to many biologists because of not only its critical role in the immune system, but also its association with at least three embryonic lethal genes. Here, we present an analysis of the mouse extended H-2K region using YAC technology. Six new expressed sequences were identified, demonstrating that the high gene density previously described continues. Restriction mapping of a YAC clone extending proximal of the MHC region defined a CpG-rich region located up to 320 kb away from H-2K. The absence of any CpG-rich region for a distance spanning approximately 200 kb near the YAC's proximal end suggests that the high gene density probably diminishes at a distance of 360 kb away from H-2K. The description of genomic organization of both H-2K and the extended H-2K region provides insight into the characteristics of this whole region with respect to gene diversity and density.

Animals↗

PubMed1996

Extended glycoprotein structure of the seven domains in human carcinoembryonic antigen by X-ray and neutron solution scattering and an automated curve fitting procedure: implications for cellular adhesion.

Carcinoembryonic antigen (CEA) is one of the most widely used cell-surface tumour markers for tumour monitoring and for targeting by antibodies. It is heavily glycosylated (50% carbohydrate) and a monomer is constructed from one V-type and six C2-type fold domains of the immunoglobulin superfamily. The solution arrangement at low resolution of the seven domains in CEA cleaved from its membrane anchor was determined by X-ray and neutron scattering. Guinier analyses showed that the X-ray radius of gyration RG of CEA was 8.0 nm. The length of CEA was 27 to 33 nm, and is consistent with an extended arrangement of seven domains. The X-ray cross-sectional radius of gyration RXS was 2.1 nm, and is consistent with extended carbohydrate structures in CEA. The neutron data gave CEA a relative molecular mass of 150,000, in agreement with a value of 152,500 from composition data, and validated the X-ray analyses. The CEA scattering curves were analysed using an automated computer modelling procedure based on the crystal structure of CD2. The V-type and C2-type domains in CD2 were separated, and the C2-type domain was duplicated five times to create a linear seven-domain starting model for CEA. A total of 28 complex-type oligosaccharide chains in extended conformations were added to this model. By fixing the six interdomain orientations to be the same, three-parameter searches of the rotational orientations between the seven domains gave 4056 possible CEA models. The best curve fits from these corresponded to a family of zig-zag models. The long axis of each domain was set at 160(+/-25) degrees relative to its neighbour, and the two perpendicular axes were orientated at 10(+/-30) degrees and -5(+/-35) degrees. Interestingly, the curve fit from this model is within error of that calculated from a CEA model generated directly from the CD2 crystal structure by the superposition of adjacent domains. Zig-zag models of this type imply that the protein face of the GFCC' beta-sheet in neighbouring CEA domains lie on alternate sides of the CEA structure. Such a model has implications for the adhesion interactions between CEA molecules on adjacent cells or for the antibody targeting of CEA.

Amino Acid Sequence↗

PubMed1994

A quantum-mechanical study of the chain-length dependent stability of the extended and 3(10)-helix conformations in dehydroalanine oligopeptides.

A quantum-chemical study of the chain-length dependent stability of the extended, 2-ribbon and 3(10)-helix conformations in dehydroalanine (delta Ala) oligopeptides has been performed by using both semiempirical AM1 and ab initio 4-31G methodologies. The validity of both methods in the study of the conformational properties of delta Ala oligopeptides was tested first on the dipeptide. The results of this test showed that 4-31G and AM1 calculations are in good agreement with 6-31G* calculations and experimental data. In order to monitor the conformational conversions, delta Ala oligopeptides comprising two to six residues were constructed. Molecular geometries were fully optimized using AM1, and the final conformations were verified to be minima by analysis of the corresponding second-derivative matrices. Conformational studies revealed that the 3(10)-helix is stabilized with respect to the 2(7)-ribbon when the number of residues is three or four, at the AM1 and ab initio 4-31G level respectively, while the extended form is the most stable in all the calculations performed. On the other hand, if a linear behaviour is assumed for longer chains, our calculations show a trend that would predict a conversion from extended form to 3(10)-helix in oligopeptides with around six (ab initio 4-31G) or eight (AM1) delta Ala residues. In order to explain these conformational changes, the cooperative effects for the different conformers were investigated. Large cooperative energy effects were found for the 3(10)-helix conformation.

Alanine↗

PubMed1996

Resected acinar cell carcinoma of the pancreas with tumor thrombus extending into the main portal vein: report of a case.

The incidence of acinar cell carcinoma has been reported to be about 1% of all pancreatic neoplasms, and pancreatic cancer combined with tumor growth extending into the portal vein is a rare condition. We herein report a case of acinar cell carcinoma of the pancreas with a tumor thrombus extending into the main portal trunk. Preoperative imaging of the portal vein, consisting of computed tomography (CT), magnetic resonance imaging (MRI), and angiography, revealed an oval shadow defect in the main portal trunk along with an irregular mass in the pancreatic head. At operation, we confirmed a tumor thrombus extending from a tumor in the pancreatic head into the main portal trunk via the pancreatoduodenal veins. A pancreatoduodenectomy combined with partial resection of the portal vein was thus performed under a temporary portal vein shunt from the ileocecal vein to the umbilical vein. Immunohistochemical examination for alpha 1-antichimotrypsin and electron microscopic examination confirmed the diagnosis of acinar cell carcinoma of the pancreas with a tumor thrombus in the portal vein. Surgical excision combined with portal vein resection may therefore improve the prognosis of selected patients with portal tumor thrombus.

Carcinoma, Acinar Cell↗

PubMed1984

Linkage disequilibrium of HLA-SB1 with the HLA-A1, B8, DR3, SCO1 and of HLA-SB4 with the HLA-A26, Bw38, Dw10, DR4, SC21 extended haplotypes.

Homozygous typing cells from 13 normal HLA-A1, B8, Dw3, DR3 and five normal HLA-A26, Bw38, Dw10, DR4 individuals were typed for the following markers: HLA-SB, MB, MT; complement proteins BF, C2, C4A, C4B; and GLO. Ninety-one percent of A1, B8, Dw3, DR3 homozygous individuals (HI) tested were homozygous for BF*S, C2*C, C4A*QO, and C4B*1 (SCO1 complotype), which indicates that the SCO1 complotype is in linkage disequilibrium with the A1, B8, DR3 haplotype in randomly selected normal populations. Sixty-seven percent of HLA-A1, B8, Dw3, DR3, SCO1 positive HI also expressed SB1; since the frequency of SB1 in random Caucasian populations is 11.2%, this finding indicates that SB1 is in linkage disequilibrium with the A1, B8, DR3, SCO1 extended haplotype. All HI with the A26, Bw38, Dw10, DR4 haplotype were homozygous for both SC21 and SB4, suggesting that SC21 and SB4 should be included in the A26, Bw38, Dw10, DR4 extended haplotype. On the other hand, neither of the GLO markers were found in association with either haplotype. The results of this study indicate that HLA-SB is included in some extended haplotypes and may be important in these markers for diseases such as insulin-dependent diabetes mellitus. This study also demonstrated an apparent influence of HLA-SB on primary mixed lymphocyte culture (MLC) responses. The mean relative response of primary MLCs between individuals matched for HLA-A, B, D, DR, MB and MT but not SB was 40% of that for the MLCs with mismatched HLA-D, significantly higher than the MLCs matched for all HLA and complotypes.

Complement System Proteins↗

PubMed1994

An extended-release formulation of methotrexate for subcutaneous administration.

Methotrexate is a cell-cycle phase-specific antimetabolite that requires prolonged exposure for optimal efficacy. However, the in vivo half-life is short, and repeated administrations are required for optimal efficacy. Methotrexate was encapsulated into a lipid-based drug-delivery system to create an extended-release formulation (Depo/methotrexate) for subcutaneous administration. Pharmacokinetics and efficacy studies were done in BDF1 mice. Depo/methotrexate increased the methotrexate plasma half-life by a factor of 190, from 0.53 to 100 h. Plasma peak levels of the encapsulated drug were 120-fold lower than those of unencapsulated methotrexate, whereas the AUCs (areas under the concentration-time curve) were similar. As a consequence of the extended drug release, the single-dose potency of methotrexate against the L1210 leukemia model was increased by a factor of about 130 without producing significant changes in the therapeutic index. In conclusion, Depo/methotrexate appears to have potential usefulness as an extended-release formulation of methotrexate.

Animals↗

PubMed1981

The albino locus and locomotor behavior in the mouse: studies using extended test intervals.

The influence of albinism upon initial activity in novel surroundings was examined using coisogenic and congenic lines of mice. In comparison with those of previous studies, an extended test interval was used, and this modification produced significant main and interaction effects of the c locus upon activity for both lines. The present findings confirm and extend those of previous studies upon the depressant effects of albinism based upon coisogenic lines, and extend the findings to congenic lines as well.

Albinism↗

PubMed1986

Detection of TRH extended peptides in rat hypothalamus using an antibody raised to pGluHisProGlyLys.

An antibody was raised to the synthetic pentapeptide pGluHisProGlyLys which, in radioimmunoassay (RIA), could detect the pentapeptide at a level of 10 fmole per tube and exhibited less than 0.5 per cent cross reactivity with a series of related peptides. The RIA was used to demonstrate the presence of C-terminally extended forms of thyrotropin releasing hormone (TRH) in rat hypothalamus. After extraction, the endogenous peptides were resolved by gel exclusion chromatography and TRH-extended peptides were revealed by trypsin digestion to release the pentapeptide. The TRH extended peptides occurred in substantial quantity, approximately 11 pmoles/g, indicating that only partial processing of the gene duplicated prohormone takes place.

Animals↗

PubMed1996

Proprioception in the nearly extended knee. Measurements of position and movement in healthy individuals and in symptomatic anterior cruciate ligament injured patients.

Proprioception of the knee was measured in 19 healthy individuals to evaluate whether there were any differences between extension and flexion movements from two different starting positions. The threshold before detecting a passive movement, visual estimation on a protractor of a passive change in position (30 degrees angular change) and active reproduction of the same angular change were registered. The reference population was tested twice to study normal variation and reproducibility, followed by the evaluation of 20 patients with chronic, symptomatic and unilateral anterior cruciate ligament (ACL)-deficient knees. In the normal population no differences were found between the right and the left leg, men and women, or measurements made at the first and at the second test occasion. The thresholds from a starting position of 20 degrees were lower for extension than for flexion. When comparing the thresholds for extension between the 20 degrees and the 40 degrees starting position, lower values were found in the more extended position. The thresholds for flexion were lower from the 40 degrees starting position than from the 20 degrees starting position. The active reproduction of an angular change of 30 degrees was more accurate during flexion (30 degrees-60 degrees) than during extension (60 degrees-30 degrees). There were no differences in the reproduction tests or in thresholds from the 40 degrees starting position between the patients and the normal group, but the patients had higher thresholds from the 20 degrees starting position, in movements towards both extension 1.0 degree (range 0.5 degree-12.0 degrees) and flexion 1.5 degrees (range 0.5 degree-10.0 degrees) than the normal group 0.75 degree (range 0.5 degree-2.25 degrees) (P = 0.01) and 1.0 degree (range 0.5 degree-3.0 degrees) (P = 0.06), respectively. Thus, information of passive movements in the nearly extended knee position was more sensitive towards extension than towards flexion in threshold tests and the sensitivity improved closer to full extension, which implies a logical joint protective purpose. In this nearly extended knee position, which is the basis for most weight-bearing activities, patients with symptomatic ACL-deficient knees had an impaired awareness in detecting a passive movement. There were no differences in the more flexed position or in the reproduction tests between the patients and the normal group, and reproduction tests in the present form seem less appropriate to use in the evaluation of ACL injuries.

Adult↗