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PubMed1991

Medical ethics reflected in codes of ethics: the Hippocratic Oath and the 1980 AMA code compared.

The Hippocratic Oath and 1980 Code of Ethics of the American Medical Association (AMA) are compared to evaluate the nature of the relationship between students and teachers of medicine and the ethical injunctions that guide practice and make up the essence of the Hippocratic Oath. Such injunctions include the need to take care that harm is not done, to maintain confidentiality, and to avoid acts leading to death. The AMA code is analyzed from the perspective of its injunctions to give competent and compassionate care, to follow the law, to be responsible for guarding patients against incompetent physicians, and to assure that patient care is based on principles of compassion and skill. The centrality of trust in the relationship between patient and doctor as a crucial value in defining a profession is emphasized.

American Medical Association↗

PubMed1995

Diving patterns of ama divers of Hegura Island, Japan.

Daily diving patterns, especially depth-time profiles, were continuously recorded during the entire work shift in four cachido and four funado divers of Hegura Island, Japan. All Hegura divers (cachido and funado alike) were female and habitually wore wet suits. Cachidos dive free and unassisted from a boat or float, whereas funado divers are assisted by weighted descent and during the ascent by being pulled by a partner into a boat on the water surface. Both funado and cachido divers spent 250-280 min/day on the sea at their diving locations; the actual diving time was 100-120 min. The divers made 90-120 dives/day to a depth of 13-22 m, each dive lasting approximately 60 s, considerably longer and deeper than those observed and recorded previously in ama divers in the Chiba and Miura regions. These dive profiles are similar to those reported by Paulev in which he observed apparent signs of decompression sickness when the subject dived to a depth of 15-20 m 100 times in 5 h. The average bottom time for each dive of Hegura funados was 23.6 s which is approximately 10 s longer than that of Korean female ama. The rate of ascent in the funado divers was 1.5 m/s, which is nearly twice that of the cachido divers (0.8 m/s). The dive frequency of Hegura funados (109 dives/day) was greater than the Chiba male funados (23 dives/day). Accordingly, cumulative bottom time of Hegura funado was 48 min/day, whereas that of Chiba funado was 17 min/day.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1997

GAPS (AMA Guidelines for Adolescent Preventive Services). Where are the gaps?

The AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale is a major breakthrough in the evolution of preventive health services in general and of adolescent preventive services in particular. GAPS is a comprehensive guide for adolescent health professionals that contains several pioneering elements. These elements include (1) providing a framework for the organization and content of "well-adolescent care," (2) offering guidance for parents and families as an essential part of adolescent health care, and (3) dealing with a wide range of adolescent health problems, with an appropriate focus on the behavioral, emotional, and developmental aspects.

Adolescent↗

PubMed1997

Number of sexual partners and health lifestyle of adolescents. Use of the AMA Guidelines for Adolescent Preventive Services to address a basic research question.

OBJECTIVE: To expand understanding of the behavioral epidemiology of an important sexually transmitted disease risk factor within a clinical framework of the AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale. DESIGN: Cross-sectional analysis of the fourth year of a longitudinal study of adolescent health behavior. SETTING: High schools in a single major urban school district. PARTICIPANTS: Nine hundred and forty-six white, African American, and Hispanic sexually active adolescents. MAIN OUTCOME MEASURES: Number of sexual partners in previous year and other health-risk and health-protective behaviors. Measures are operationalized according to guidelines for adolescent preventive services recommendations. RESULTS: Adolescents with 3 or more sexual partners annually were more involved with potentially health-harming behaviors such as illicit substance use and less involved with potentially health-protective behaviors such as seat belt use. These relationships were independent of sex, ethnic group, or socioeconomic status. CONCLUSIONS: The number of sexual partners may be considered part of a larger pattern of adolescent health-risk and health-protective behaviors. The guidelines may provide a useful framework for clinical assessment of these patterns as part of a routine health care visit of adolescent patients.

Adolescent↗

PubMed1978

Internal-external control and withdrawal AMA from an alcohol rehabilitation program.

Male and female alcoholics who were participating in an in-patient rehabilitation program were given the Rotter internal-external control scale in order to determine whether there were differences between those who leave against medical advice vs. those who complete treatment. It was anticipated that AMA patients would have significantly higher scores than completers. The hypothesis was given some support for males (p less than .06) and was not supported for females. Males and younger patients also were more inclined to leave against medical advice.

Adult↗

PubMed1990

Comprehensive two-dimensional gel protein databases offer a global approach to the analysis of human cells: the transformed amnion cells (AMA) master database and its link to genome DNA sequence data.

A total of 3430 polypeptides (2592 cellular; 838 secreted) from transformed human amnion cells (AMA) labeled with [35S]methionine were separated and recorded using computer-aided two-dimensional (2-D) gel electrophoresis. A master 2-D gel database of cellular protein information that includes both qualitative and quantitative annotations has been established. The protein numbers in this database differ from those reported in an earlier version (Celis et al. Leukemia 1988, 2,561-602) as a result of changes in the scanning hardware. The reported information includes: percentage of total radioactivity recovered from the gels (based on quantitations of polypeptides labeled with a mixture of 16 14C-amino acids), protein name (including credit to investigators that aided identification), antibody against protein, cellular localization, (nuclear, 40S hnRNP, 20S snRNP U5, proteasomes, endoplasmic reticulum, mitochondria, Golgi, ribosomes, intermediate filaments, microfilaments and microtubules), levels in fetal human tissues, partial protein sequences (containing information on 48 human proteins microsequenced so far), cell cycle-regulated proteins, proteins sensitive to interferons alpha, beta, and gamma, heat shock proteins, annexins and phosphorylated proteins. The results presented should be considered as the initial phase of a joint effort between our laboratories to undertake a general and systematic analysis of human proteins. Using this integrated approach it will be possible to identify phenotype-specific proteins, to microsequence them and store the information in the database, to identify the corresponding genes, to search for homology with previously characterized proteins and to study the function of groups of proteins (pathways, organelles, etc.) that exhibit interesting regulatory properties. In particular, the 2-D gel protein database may become increasingly important in view of the concerted effort to map and sequence the entire human genome.

Amnion↗

PubMed1991

The master two-dimensional gel database of human AMA cell proteins: towards linking protein and genome sequence and mapping information (update 1991).

The master two-dimensional gel database of human AMA cells currently lists 3801 cellular and secreted proteins, of which 371 cellular polypeptides (306 IEF; 65 NEPHGE) were added to the master images during the last 10 months. These include: (i) very basic and acidic proteins that do not focus under normal running conditions and (ii) low-abundant proteins that can only be detected after prolonged gel exposure. Annotation categories updated in this version include "protein name", "antibody against protein", "cellular localization", and "microsequenced proteins". New entries include "human autoantigens" and "cDNAs". For convenience we have included an alphabetical list of all known proteins recorded in this database. In the long run, the main goal of this database is to link protein and DNA sequencing and mapping information (Human Genome Program) and to provide an integrated picture of the expression levels and properties of the thousands of proteins that orchestrate various cellular functions both under physiological and abnormal conditions.

Cell Line, Transformed↗

PubMed2000

Nucleotide variations amongst V(H)Genes of AMA-producing B cell clones in primary biliary cirrhosis.

Primary biliary cirrhosis, a chronic liver disease characterized by progressive inflammatory destruction of intrahepatic bile ducts, is also characterized by the presence of antimitochondrial antibodies (AMA). The predominant autoantibody is directed at the E2 component of pyruvate dehydrogenase (PDC-E2). Recent studies of this autoantibody response have analysed immunoglobulin-variable regions of human monoclonal antibodies and provided evidence for antigen-driven clonal selection. However, the number of clones analysed has been very limited and the presence of somatic mutations not formally proven. In this study, we took advantage of three stable B cell lines producing human IgG anti-PDC-E2 mAbs from a patient with PBC. We analysed the V(H)and V(L)gene structure of these reagents and, in addition, analysed 10 V(H)-D and D-J(H)sequences over a period of nearly 3 years. The expressed Ig V regions of the heavy chain (V(H)) and the light chain (V(L)) genes of mAb18, mAb37, and mAb82 utilized the V(H)III-VlambdaI, V(H)IV-VlambdaIII, and V(H)IV-V(k)IV gene families, respectively. The utilized gene elements were Ig gene elements that were found frequently in other antibodies with different specificity and affinity. Presence of somatic point-mutations was confirmed in mAb82 by comparison of the expressed V(H)gene sequence with that of corresponding germline V(H)gene obtained from the granulocyte genomic DNA of the same patient. Interestingly, clonally related B cells were consistently found throughout the observation period and nucleotide variations among the V(H)genes were very few, ranging from 0.19 to 0.72% per base. These findings suggest that long-lived B cell clones can exist and may contribute, at least in part, to maintenance of autoantibodies in humans.

Amino Acid Sequence↗

PubMed1980

Restriction of herpes simplex virus by Ama 1 cells. An analysis of viral macromolecule synthesis.

Ama 1 cells, and alpha-amanitin-resistant subline of CHO cells, restricted herpes simplex virus-1 and -2 replication. The infection was characterized by i) induction of typical cytopathology; ii) appearance of all the major virus proteins, glycoproteins and DNA earlier than in HEp-2 cells, followed by shut off of virus macromolecule synthesis; iii) defective maturation of viral particles, i.e. scarce assembly and lack of envelopment. The early shut off of viral DNA and protein synthesis, and the altered glycoprotein pattern may account for herpes simplex virus restriction.

Amanitins↗

PubMed2004

Sampling procedure and a radio-indicator study of mercury determination in whole blood by using an AMA 254 atomic absorption spectrometer.

A sampling procedure appropriate for the determination of mercury in whole blood was tested by using both inactive controls and a 197Hg mercury radio-indicator. To exclude the influence of the instrumental device (an AMA 254 single-purpose mercury atomic absorption spectrometer) on the determination of mercury in whole blood, the function of the instrument was checked by using rat blood with metabolised 197Hg. The measurement procedure was found to be free of errors. However, the study showed that the material used for the sampling vessels is a crucial parameter for obtaining accurate analytical results. The stability of solutions and samples was tested towards polyethylene (PE) and polypropylene (PP) vessels. PE displayed a time-dependent increase in the mercury content both in the samples and in the blood control material. The probable cause of this increase was direct contamination from the material of the vessel and/or diffusion of mercury from the environment through the vessel walls related to a strong complexing affinity of the sample matrix. This assumption was confirmed by supplying the vessels with the complexing agent Na2EDTA (0.05 mol L(-1)). Commercial PP vessels for blood sampling (Sarstedt S-Monovette Metall Analytik) did not give rise to statistically significant variations in mercury content in the samples and blood control material over a 30-day period.

Adsorption↗

PubMed2002

Protection against experimental P falciparum malaria is associated with short AMA-1 peptide analogue alpha-helical structures.

Apical membrane antigen-1 (AMA-1) is an integral Plasmodium falciparum malaria parasite membrane protein. Peptides having high activity binding to human red blood cells have been identified in this protein. One of them, peptide 4325, with the amino acid sequence MIKSAFLPTGAFKADRYKSH, for which critical binding residues have already been defined (underlined), is conserved and non-immunogenic. Its critical binding residues were changed for amino acids having similar mass but different charge to change such immunological properties. These changes rendered some peptides immunogenic and protective against experimental challenge in Aotus monkeys. Three-dimensional models of peptide 4325 and its analogues, 20032 and 20034, were calculated from NMR experiments with distance geometry and restrained molecular dynamic methods. Non-immunogenic, non-protective peptide 4325 showed differences in its secondary structure with respect to protective, immunogenic peptides 20032 and 20034. Such data suggest that these modifications could have converted non-immunogenic peptides into immunogenic, protective ones, making them excellent candidates for a multi-component subunit synthetic malaria vaccine.

Amino Acid Sequence↗

PubMed1986

Proliferation-sensitive nuclear phosphoprotein "dividin" is synthesized almost exclusively during S phase of the cell cycle in human AMA cells.

Studies of the polypeptides synthesized by normal and transformed human cultured cells under a variety of physiological conditions have revealed a basic 54-kDa protein NEPHGE 10a, whose rate of synthesis is sensitive to changes in the rate of cell proliferation. This nuclear phosphoprotein, which we have termed "dividin" (present only in populations of cells committed to divide), is synthesized almost exclusively during the S phase of the cell cycle of transformed human amnion cells (AMA). Dividin synthesis is first detected late in G1 near the G1/S transition border, reaches a maximum late in S phase, and declines thereafter. As expected for an S phase-specific protein, no detectable synthesis of dividin was observed in growth-arrested normal human cultured cells of epithelial and fibroblast origin. These findings suggest a role for this protein in events leading to DNA replication and cell division.

Amnion↗

PubMed1984

Single-dose pharmacokinetics of Ro 17-2301 (AMA-1080), a monocyclic beta-lactam, in humans.

Ro 17-2301 (AMA-1080) is a new N-sulfonated monocyclic beta-lactam that is highly active against gram-negative bacteria, especially against Enterobacteriaceae and Haemophilus, Neisseria, and Pseudomonas spp. (Kondo et al., Proc. Int. Congr. Chemother. 13th, Vienna, Austria, p. 56/1-56/5, 1983). The single-dose pharmacokinetics of this compound were studied in six healthy male volunteers who received intravenous infusions of 500, 1,000, and 2,000 mg. A good linear correlation (r2 = 0.99) was found between the dose infused and the resulting area under the plasma concentration-time curve. Maximal plasma concentrations of 36, 78, and 150 micrograms/ml appeared after doses of 500, 1,000, and 2,000 mg, respectively. The mean terminal elimination half-life was 1.8 h (range, 1.4 to 2.3 h), the apparent volume of distribution at steady state was 17 liters, and the total systemic clearance was 150 ml/min. Within 72 h 78 to 89% of the dose was recovered intact from urine. After administration of 14C-labeled Ro 17-2301, 96% of the radioactivity was found in the urine and 3% was found in the feces. The concomitant administration of probenecid did not affect the renal clearance or urinary excretion of this beta-lactam, an indication that the renal elimination of this substance is only by glomerular filtration. Ro 17-2301 was 18% bound to human plasma protein, and this binding was independent of concentration between 25 and 400 micrograms/ml. Based on these data, the pharmacokinetics of this monocyclic beta-lactam should be predictable in the foreseen dose ranges.

Adult↗

PubMed1985

In vitro and in vivo antibacterial activities of carumonam (AMA-1080), a new N-sulfonated monocyclic beta-lactam antibiotic.

The in vitro and in vivo antibacterial activities of carumonam (AMA-1080), a synthetic sulfazecin derivative, were compared with those of aztreonam, cefoperazone, ceftazidime, and cefsulodin. Carumonam was highly active in vitro against members of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus influenzae and weakly active against Streptococcus pneumoniae, but it was not active against Staphylococcus aureus. The MICs of carumonam for 90% of 1,156 clinical Enterobacteriaceae isolates were between 0.013 and 25 micrograms/ml, which were the lowest MICs of the antibiotics tested. The MIC of carumonam for 90% of Klebsiella oxytoca was 0.2 micrograms/ml, whereas that of aztreonam was 50 micrograms/ml. The superiority of carumonam to aztreonam and the reference cephalosporins was also demonstrated by their activities against Klebsiella pneumoniae and Enterobacter cloacae. The MIC of carumonam for 90% of P. aeruginosa was 12.5 micrograms/ml, which was comparable to the MICs of aztreonam and ceftazidime. Carumonam showed a high affinity for the penicillin-binding protein 3 of gram-negative bacteria, but not for the penicillin-binding proteins of S. aureus and Bacteroides fragilis. Carumonam was resistant to hydrolysis by 12 plasmid-mediated beta-lactamases and 7 chromosomal beta-lactamases. It was more stable than aztreonam to hydrolysis by the beta-lactamase of K. oxytoca; this stability is related to the superiority of the in vitro and in vivo activities of carumonam to those of aztreonam against this species. In general, the protective activities (50% effective dose) of carumonam and reference antibiotics in mice with experimental intraperitoneal infections correlated with the in vitro activities (MIC); carumonam showed excellent protective activity against most aerobic gram-negative bacteria.

Animals↗

PubMed1988

In vitro activity of carumonam (Ro 17-2301; AMA-1080) versus enteropathogenic and nonfermentative gram-negative rods and Legionella pneumophila.

The in vitro activity of carumonam (Ro 17-2301; AMA-1080) was tested against 355 single-patient isolates, by and large enteropathogenic or nonfermentative rods. The new monobactam was inhibitory and bactericidal against the majority of diarrhea-causing members of the family Enterobacteriaceae at concentrations of less than and equal to 8 micrograms/ml. Although known to be active against Pseudomonas aeruginosa, it generally did not exhibit clinically useful activity against other nonfermenters or against Legionella pneumophila, thus confirming its narrow spectrum of activity.

Anti-Bacterial Agents↗

PubMed1991

Pharmacokinetics of carumonam (AMA-1080) in patients with impaired renal function and in those undergoing hemodialysis.

The pharmacokinetics of carumonam (AMA-1080) were studied after a single intravenous 1.0-g dose was given to 26 subjects grouped according to their renal functions. Creatinine clearance (CLCR) was above 85, 50 to 84, 10 to 49, and below 10 ml/min/1.73 m2 in groups 1, 2, 3, and 4, respectively. All of the six patients in groups 4 were receiving maintenance hemodialysis, and they were studied both during and between hemodialysis sessions. Carumonam obeyed two-compartment model kinetics in all four group. The volume of distribution based on the area under serum concentration-time curve (Varea) did not differ significantly among the four groups, the mean value being 0.309 +/- 0.084 liter/kg. The elimination-phase (beta) half-lives were 1.53 +/- 0.36, 2.00 +/- 0.64, 5.08 +/- 1.85, and 12.8 +/- 4.1 h in groups 1, 2, 3, and 4, respectively. The 0- to 24-h cumulative urinary recoveries of carumonam were 83 +/- 11, 76 +/- 20, 58 +/- 25, and 12 +/- 9% of the administered dose in groups 1, 2, 3, and 4, respectively. The systemic and the renal clearances of carumonam decreased according to the severity of renal dysfunction, and the nonrenal clearance, which was calculated as the difference between renal and systemic clearances also decreased as CLCR decreased. A significant positive correlation existed between beta and CLCR (r = 0.847, P less than 0.01), and the beta of carumonam could be predicted by the following equation: beta (h-1) = 0.00460 X CLCR (ml/min/1.73 m2) + 0.049. Hemodialysis shortened the elimination-phase half-lives from 12.8 +/- 4.1 to 2.66 +/- 1.49 h in the six subjects in group 4. A 5-h hemodialysis in a hypothetical anephric subject weighing 60 kg was estimated to remove 51.4% of the drug present in the body at the start of hemodialysis.

Adult↗

PubMed1984

Interaction of Ro 17-2301 (AMA-1080) with beta-lactamases.

Against a variety of beta-lactamases tested, mostly of chromosomal origin, Ro 17-2301 (AMA-1080) proved to be more stable than the new cephalosporins and thus resembles aztreonam. Against the beta-lactamases from Klebsiella oxytoca and Pseudomonas vulgaris, however, Ro 17-2301 proved to be much more stable than aztreonam. Enzymatic hydrolysis, performed with the K. oxytoca beta-lactamase, yielded a single compound, viz. the microbiologically inactive, ring-opened structure. Ro 17-2301 is a potent and progressive inhibitor of cephalosporinases found, e.g., in Enterobacter cloacae and other gram-negative organisms. The IC50 and Ki values, however, showed that the affinity for these enzymes is lower than that of aztreonam.

Anti-Bacterial Agents↗

PubMed2003

The Abbreviated Math Anxiety Scale (AMAS): construction, validity, and reliability.

Psychometric properties of mathematics anxiety measures have not adequately been studied. Using a large sample size (N = 1,239), the authors developed an abbreviated math anxiety measure, examined its psychometric properties, and assessed the generalizability of the model across samples. Exploratory factor analysis yielded a nine-item measure and strong internal consistency, test-retest reliability, and good convergent/divergent validity was demonstrated with an independent sample. When administered to a replication sample, indexes suggested an excellent model fit. TheAbbreviated Math Anxiety Scale (AMAS) may represent a more parsimonious and valid approach to assess mathematics anxiety.

Adult↗