Breast self-examination. A teaching role for nurses.
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Biomedical subjects
Publications and source records attributed to A Ellis.
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Treatment of a patient with a severe thermal injury differs greatly from that of a victim of multiple trauma: if there have been no other injuries, the burned patient will be transferred as soon as possible to a regional burns unit. Our suggested protocol highlights the differences and their management.
The H-35 rat hepatoma is relatively insensitive to the anthracycline antibiotic, daunorubicin (DNR), requiring 0.25 microM daunorubicin for inhibition of cell proliferation by 50%. Studies were undertaken to investigate the basis for the apparent intrinsic resistance in this cell line. The relative insensitivity of the H-35 cells to DNR is not a function of metabolic inactivation of DNR to deoxyaglycone derivatives; after a 2-h incubation, less than 10% of drug is metabolized, exclusively by conversion to daunorubicinol. The limited toxicity of DNR to the rat hepatoma may be explained, in part, by the absence of DNA strand breaks at daunorubicin concentrations up to 1 microM while higher (supraclinical) DNR concentrations (5 and 10 microM) produce direct, "non-protein-associated" DNA strand breaks. Limited daunorubicin toxicity in this tumor cell line may also be related to the apparent absence of free radical-mediated cellular damage as the free radical scavengers dimethyl sulfoxide, catalase, methanol, and mannitol fail to reverse the inhibitory effect of 1 microM DNR on cell proliferation. Daunorubicin does not induce leakage of the cytoplasmic enzyme, glutamic oxaloacetate transaminase, or diminish mitochondrial enzyme function. Conversely, while drug effects on RNA synthesis are small, and protein synthesis is minimally diminished, inhibition of cell proliferation corresponds closely with inhibition of DNA synthesis.
Xenopus laevis (the South African clawed toad) can respond to thymus dependent (TD) and thymus independent (TI) antigens. However, the response to trinitrophenylated Ficoll (TNP-Ficoll), a TI-2 antigen in mammals, is thymus dependent in Xenopus. Polyvinylpyrrolidone (PVP), classed as a TI antigen in mammals, is also a TI antigen in Xenopus, but responses to PVP and TNP-PVP are thymus regulated. As with TNP-Ficoll, capacity to respond to TNP-PVP diminishes during metamorphosis, and tolerance can be induced via the stimulation of TD suppression with trinitrobenzene sulphonic acid. Animals treated with N-methyl-N-nitrosourea and adult-thymectomised Xenopus, which lack certain TD responses, can nevertheless respond to TNP-PVP. Based on this and other information, it is concluded that TNP-PVP should be classed as a TI-2 antigen in Xenopus.
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The case of a neurological patient with severe anomic word-finding difficulties is reported. A detailed cognitive neuropsychological investigation of the patient's ability to name objects to confrontation was carried out in an attempt to determine where his cognitive deficits might lie. In contrast to the findings of recent case studies of word-finding difficulty (e.g., Howard and Orchard-Lisle, 1984), it was observed that the patient seemed to have a clear understanding of the items that he was trying to name, suggesting that his problems in word-finding were not semantically based. Indeed, the patient would often generate partial phonological information about the sought-after word, indicating that he had a specific target in mind, and this was reminiscent of 'tip-of-the-tongue' states in normal word-finding. A difficulty in retrieving complete phonological forms of words is considered as the probable locus of his anomia. A distinction is made between semantically-based and phonologically-based anomias.
Rational-emotive therapy (RET) is a comprehensive, multimodal, active-directive and relatively brief form of psychotherapy that is particularly suited for use by nurse practitioners. RET theory assumes that people have innate tendencies to think rationally and irrationally; therefore, people have the ability to fulfill and actualize themselves and to easily upset and defeat themselves. The basic tenets of RET help people distinguish between their own rational and irrational beliefs, and their consequent appropriate and inappropriate emotions and behaviors. Many cognitive, emotive and behavioral methods are used to help clients minimize their symptoms of anxiety, depression, self-hatred and rage. Nurse practitioners using RET can help their clients make profound philosophic changes that prevent future emotional problems and encourage maximum health and self-actualization.
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Electrocardiograms were recorded in a longitudinal study on six adult dogs with canine ceroid-lipofuscinosis (CCL) and compared with those of four unaffected animals. Two dogs exhibited minor conduction abnormalities, QRS-notching and LVH at 12 months of age. By 24 to 25 months of age, the underlying cardiac rhythm was that of a pronounced sinus arrhythmia. Some dogs developed premature atrial beats, A-V dissociation or tachycardia. No gross cardiac abnormalities were noted at necropsy, but histologically, autonomic ganglion cells in the atrium, near the conducting system and in ventricular myocardial cells were filled with autofluorescent lipopigments. Quantification by micro-spectrophotometry showed peak emission at 538 nm. At the ultrastructural level, these fluorescent particles consisted of collections of curvilinear and lamellar profiles, similar to those present in other viscera. Ceroid-lipofuscinosis has been utilized for many years as a model for human ceroid-lipofuscinosis and the results described here are similar to those previously reported in hearts of patients with this disease. Because related lipopigments accumulate in normal aging of the heart and contraction/conduction abnormalities develop with time, the canine model may also be useful in aging studies as well. The studies described here are the first to demonstrate possible structural-functional relationships in the heart of dogs with CCL.
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Average blood flow (q) was determined by trapping of 15 micron radioactive microspheres in the vastus lateralis, the gastrocnemius-flexor digitorum superficialis and the triceps brachii of five 18 kg untrained mongrel dogs at rest and during graded treadmill running. Oxygen uptake (VO2) and cardiac output (Qco) were simultaneously determined. q leveled off in all investigated muscles at 60-100 ml X 100 g-1 X min-1 when VO2 was ca. 70% of peak VO2. Qco increased linearly with VO2 up to peak VO2. The regional blood flow (qR) distribution pattern within the muscle was found to be extremely scattered around q, both at rest and at heavy exercise. qR ranged from approximately 5 to approximately 55 ml X 100 g-1 X min-1 at rest and from approximately 10 to approximately 200 ml X 100 g-1 X min-1 at maximal exercise. No significant topographic pattern was observed in the qR distribution of the gastrocnemius muscle which was essentially similar to that previously found for the isolated-perfused muscle preparation. The results indicate that maximal limb muscle blood flow and/or its uneven distribution may be the primary limiting factor to peak VO2 in untrained running dogs.
The recently devised methods for surgical sampling of chorio-retinal tissue permits morphological evaluation of retina in various diseases. In the present report it is demonstrated, that the retinal pigment epithelium in such samples can be isolated as a viable cell population, and that the cell mass can be increased sufficiently in culture to permit biochemical as well as morphological studies. This procedure thereby expands the diagnostic potential of the sample tissue.
Non-malignant ulceration of the stomach and duodenum was, until relatively recently, considered to be one disease and was known by the all-embracing term peptic ulcer. Evidence from several sources tends to support the idea that even the broad divisions of gastric and duodenal ulcer may themselves be the end results of multiple separate disease processes. Genetic studies have helped considerably in the characterisation of these individual conditions.
Baboons were given intravenous injections of 50-70 microCi of 59Fe citrate to label young and old red cells. Blood subsequently collected from these animals was stored at 4 C in ACD, CPD, or CPDA-1 for up to 36 days. The 59Fe-labelled young and old red cells from the stored blood samples were labelled in vitro with 51Cr and 99mTc and then separated by counterflow centrifugation-elutriation into 7 fractions which differed in red cell volume. 59Fe-labelled young red cells were found in the fractions with the larger red cell volumes; 59Fe-labelled old red cells were found in the fractions with the smaller red cell volumes. 51Cr and 99mTc labelled young and old red cells in the 7 fractions in a similar manner. When salivary antigens were used to identify ABO compatible baboons, rapid removal of the donor red cells from the circulation was seen in 7 of the 15 homologous transfusions. This prompted us to assess compatibility from the survival of 51Cr-labelled donor red cells. In transfusions in which compatibility was identified from 51Cr T50 values of 8 days or greater, 24-hour posttransfusion survival values were similar for the 59Fe young and old red cells. Our data show that in vivo aging of red cells is a different process from that occurring with in vitro deterioration of red cells during liquid storage at 4 C.
Sixty nine propositi from a family study of coeliac disease were typed for HLA-DR antigens. Sixty three (91%) were found to carry the antigen DR3, which was a significantly greater proportion (p = 9.6 X 10(-24] than among the 168 controls (26%). Concurrently 42 children with the disease were DR typed. Not only was the frequency of DR3 significantly increased in these patients (86% versus 26% in controls; p = 3.1 X 10(-12] but so also was the frequency of DR7 (patients 60%, controls 29%; p = 5.8 X 10(-4]. When those propositi whose coeliac disease presented before the age of 20 were combined with the childhood coeliac group and a comparison made between these patients and the remainder of the propositi, all of whom presented when they were older than 20, the childhood onset group had a significant excess of DR7 (p = 2.2 X 10(-3] and a significant deficiency of DR2 (p = 3.5 X 10(-3]. These findings indicate that childhood coeliac disease and adult coeliac disease are genetically heterogeneous.