Since the isolation of a recombinant containing a cDNA sequence for human phenylalanine hydroxylase (hPH) (Woo et al., 1983; Speer et al., 1986) prenatal diagnosis by linked restriction fragment length polymorphism (RFLPs) has become possible for families in which phenylketonuria (PKU) occurs (Lidsky et al., 1985a). We describe here the application of a Hind III three-allele RFLP in a single family, which allowed the prenatal diagnosis of an affected fetus.

Autoradiography↗

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In vitro degradation of endothelin-1 by endopeptidase 24.11 (enkephalinase).

The breakdown of endothelin-1 by crude membrane preparations of human kidney and choroid plexus was investigated. 125I-labeled endothelin-1 was degraded by both tissues in a phosphoramidon-sensitive way, suggesting a role of endopeptidase 24.11 in the in vitro metabolism of this peptide. Identification of the cleavage sites of purified human renal endopeptidase 24.11 in the sequence of endothelin-1 revealed that bonds involving the amino side of the hydrophobic amino acids (Ser4, Leu6, Val12, Phe14, His16, Leu17, Ile19) were susceptible to cleavage. Endothelin-1 appears thus to be degraded at multiple sites by endopeptidase 24.11 in vitro, producing inactive fragments.

Amino Acid Sequence↗

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[Flight into the imaginary world and dependence: personality trait or opportunist defence mechanism in the transsexual].

While analysing the psychological functioning of sex reassignment candidates, it appeared that they frequently use the mechanism which consist in taking refuge in passivity and fantasies so that they can avoid displeasing situations, responsibilities and decisions making. This unconscious process, identified by Exner in the Rorschach as the Snow-White Syndrome seems to take place in a specific way regarding the real situation faced by the sex reassignment candidates: the achievement of their aim (the sex reassignment) actually depends on the medical crew (doctors, psychologists, surgeons). We wondered if this fact consisted in a stylistic component, that is to say a stable feature of transsexuals' personality or in an opportunist defence. The dependence on the third, executor and decision-maker could be seen either as the indication of this feature being a favourable condition to the construction of the transsexual Issue or a consequence the transsexual's real situation. The hypothesis of the situational use of this process is studied by comparing the frequency of the Snow-White Syndrome during the moment before giving the surgical response with its appearance frequency after the sex reassignment. The individuals' retest (7MF/7FM) after the operation brings favourable arguments to the second interpretation since the process stops being used as soon as the passive dependence position doesn't exist anymore (the Snow-White Syndrome disappears in 70% of cases). So, as the goals are reached (the medico-surgical transformation materialising the desire), the flight in fantasies and passivity is not necessary anymore and the dependence on contributors disappears. During the psychological follow-up, attention should be paid to this psychic impact of anatomical reality so that it favours an earliest access to autonomy the transsexual is able to prove. In regard of a psychological view (in opposition with a surgical view), this autonomy could be researched before the body transformation, validating the "Real Life Test" experience.

Adult↗

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Computer based nursing documentation means to achieve the goal.

New functions have been integrated in the Giessen Hospital Information System WING to support the classification of all intensive care patients into the Therapeutic Intervention Scoring System (TISS). The use of those functions has been pushed when health insurance bodies demanded evidence for the correct classification of ICU beds. This article presents an overview on this development from the start in just one intensive care unit to the complete coverage of six intensive care units and three intensive monitoring units with a total of 109 beds. For those units complete TISS data has been documented for more than a year now at a detailed level. On average 14 interventions have been recorded per patient and day, accumulating to a database with more than a million entries. We describe the experiences made during introduction and the different front-end applications we used to achieve the goal. Results gained from the huge database and their implications for our future work are discussed. TISS documentation is now an established routine on every intensive care unit of our University hospital. It has been implemented without major financial or manpower investments and no specific intensive care information system has been needed. Establishing this type of basic care documentation made nurses aware of their activities, so that now they consider electronic care documentation to be in their very own interest. The next goal has been set by nurses themselves, they want to establish intervention based care documentation on normal wards as well. We think that step by step we will thus be able to achieve a more complete electronic patient record.

Attitude of Health Personnel↗

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[The informational value of L1 statistics required as of 1988 (Federal Law IV) exemplified by an orthopedic university clinic].

1986's data of 2,428 hospitalised cases resp. 1762 patients were evaluated. The three codes most frequently used based on ICD-9 (715, 717 and 722) were separately considered. Repeated admissions to the hospital, patient age and duration of hospitalisation were analysed with reference to diagnoses. Analysis of covariance presented a weak correlation between age and length of stay for the ICD-9-codes 715 and 722. The encoding of diagnoses by different physicians proved to be unreliable and non-uniform. Therefore the encoding process should be centralized. Interpretation has to be made after careful examination of data. The results of more comprehensive statistics may be useful for negotiations concerning hospital allowance.

Adolescent↗

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Schistosoma mansoni: control of female fertility by the male.

We have established an in vitro culture system for adult schistosomes that allows monitoring gene expression for up to more than ten days. Comparing female worms that are paired with those that have been separated, we find distinct differences, clearly documenting an influence of the male in female gene expression. In perfect coincidence with classical observations that were based on histological techniques, we find that the male particularly regulates gene expression in those tissues that are characterized by cell proliferation, e.g. the vitellaria. From these results, we hypothesize that the key target for the inductive signal that is transferred from the male to the female during pairing is the activation of a growth factor that stimulates mitotic proliferation.

Animals↗

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Expression of ligand-gated ion channels with the Semliki Forest virus expression system.

Two types of ligand-gated ion channels were expressed with the Semliki Forest virus (SFV) expression system. The cDNAs for mouse serotonin 5-HT3 receptor and rat and human purinoreceptor P2x subtypes were introduced into the pSFV1 vector. In vitro transcribed RNAs were coelectroporated with pSFV-Helper2 RNA into BHK cells, where in vivo packaging resulted in high titer SFV-5-HT3 and SFV-P2x virus stocks. Infection of BHK, CHO and RIN cells resulted in high-level expression of recombinant receptors. Saturation binding analysis indicated the presence of more than 3 x 10(6) 5-HT3 receptors per cell. Binding studies on isolated membranes yielded from 10 to 60 pmol of either 5-HT3 or P2x receptor per mg protein. Functional responses to the P2x receptors were demonstrated in SFV-infected CHO cells by Ca2+ mobilization or by 45Ca2+ influx. High amplitude electrophysiological responses were also detected for both SFV-5-HT3 and SFV-P2x infected CHO cells in whole-cell patch clamp recordings. To facilitate the purification procedure of SFV-expressed recombinant receptors a histidine tag was introduced at the C-terminus of the 5-HT3 receptor. This 5-HT3His receptor showed high levels of expression, specific binding and high amplitude electrophysiological responses. For large scale expression the BHK cells were adapted to suspension culture and were efficiently infected in a 11.5 liter fermentor culture with SFV-5-HT3His resulting in high-level expression, 52 pmol receptor per mg protein corresponding to 3.2 x 10(6) receptors per cell.

Adenosine Triphosphate↗

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[Was Snow White a transsexual?].

The Rorschach Ink Blot test is considered to be an essential analytical instrument when studying the personalities of individuals presenting identity disorders, in particular, in the context of a sex change request. Nevertheless, there exist less than 20 studies of transsexualism utilising the Rorschach since the creation of this diagnostic category in 1953. This research has mostly concerned itself with relations between psychopathology and transsexualism. Practically non-existent are studies investigating the psychological conditions that permit, shape or induce sex change requests in individuals. Transsexuals request the removal of their genitals through mutilation surgery, which can be seen as subjects literally crying out to be castrated. This request is all the more surprising given that castration, in psychoanalytic terms, is considered to be the most severe punishment that an individual (woman or man) can be threatened with. Therefore, we asked ourselves which psychic conditions could motivate such as request. Based on any earlier study where answers (some explicit, others symbolic) given by sex-change applicants tested on the Rorschach were analysed, results seemed to suggest a counter-phobic attitude underlying sex-reassignment requests (28). According to these hypotheses, the fear of castration (banal as such) can only be overcome through the active search for castration itself. In opting for castration, the transsexual puts an end to the states of anxious waiting that are dominated by feelings of the incertitude and unpredictability of an eventual castration. Once obtained, the threat it constituted disappears, and with it so does the fear. Thus, by taking this active and voluntary step, the subject is no longer exposed to an imminent danger in a passive manner. This in itself creates a great feeling of relief, if not of actual pleasure in the subject (28). In this article, we postulated in a purely speculative manner, the existence of one or several modalities in the transsexual dynamics. Nevertheless, one can ask oneself about the possibility of a request based on a desire rather than on a defense, or even on the existence of a defensive process diametrically opposed to the counter-phobic attitude and which, instead of actively provoking the dreaded reality, would privilege its avoidance and the search of passivity. This latter hypothesis has the advantage of being rather easy to explore with the Rorschach because, according to Exner, the predominance of passive compared to active human movement responses (which he terms the Snow White Syndrome) indicates the propensity to escape into passive fantasies and the tendency to avoid the initiative for behaviour or decision-making, if other people can do it in the subject's place (12). Our results largely confirmed the hypothesis of the existence of an opposite mechanism, as a third of subjects (n = 26) presented Snow White Syndrome. According to Exner, these transsexuals are typically characterized by hiding into a world of make believe, avoiding all responsibility, as well as any decision-making. This passivity in our Snow White Syndrome group was all the more remarkable in that, on the whole, it infiltrated into all the movement responses and seemed to define a rigid style of thinking and mental elaboration, in addition to a suggestive content of passivity. However, this condition cannot be associated with a general lack of dynamism or energy. In fact, the treatment of information, which provides data concerning the motivation to treat a stimulus field of the stimulus--whether this concerns the capture (L) of the stimulus or the elaboration (DQ+) of the response--displayed a sufficient amount of motivation. Furthermore, internal resources (EA) were considerable and were brought into play whenever it was necessary to adopt a behaviour or make a decision. Furthermore, based on these Rorschach findings, we note that in transsexuals with Snow White Syndrome, there is a stereotyped tendency to shy away from difficulties by seeking refuge in realistic representations (but that lack in variety), which could be materialized by actions, but where the initiative is delegated to others. These transsexuals appear to shy away from the difficulties of life by seeking refuge into a world of fantasy, which they fill with the representations borrowed from reality (rather than fantasy) and consequently that are liable to be transposed, if necessary, back into reality. Therefore, one can better understand why they shun away from the deceiving reality that their physical sex represents, into the satisfying dream where they possess the genitals of the opposite sex, that is, a perfectly real organ, no longer the result of the subject's fantasy world.

Adult↗

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[Anaesthesia. Resuscitation problems arising from the surgical treatment of chemodectomas in the carotid fork (author's transl)].

Chemodectomas in the carotid fork are rare and usually benign tumours. Their removal by surgery creates certain problems in terms of operating technique since they are, anatomically, awkwardly situated. An additional problem arises from loss of blood resulting from their removal and possible cardiac disturbance which might affect the functioning of the carotid sinus should the tumours have been situated in this region. Furthermore, the possible eventuality of having to clamp the internal carotid for a short or even long time, should the operation require it, presupposes a perfect knowledge of the patient's cerebral circulation. Hence, therefore, the necessity of a verification of this circulation by centrolateral carotid arteriography to confirm the permeability of the circle of Willis and a potentially good supply of blood when the blood in the region of the tumour is restricted. It is equally necessary to have a complete record of the general state of the patient's cardiovascular, circulatory, respiratory, renal and neurological conditions. These must, within certain limits, be deemed satisfactory before the decision to operate is taken. Indeed, it is these conditions that will determine the per-operative as well as the post-operative condition of the patient.

Adult↗

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Cardiac beta-adrenergic receptors in diabetic rats: alteration of guanyl nucleotide regulation.

Cardiac beta-adrenergic receptors (beta AR) were studied in rats after 4 months of diabetes induced by streptozotocin (50 mg/kg, i.v.). Saturation binding studies performed using [125I]-iodocyanopindolol (ICYP) as an antagonist ligand showed that the number and affinity of beta AR were not significantly altered. Analysis of competition curves of ICYP binding by the agonist (-)-isoproterenol showed that diabetes induces an increase in the (-)-isoproterenol IC50 and a steepening of the curve ("pseudo-Hill" coefficient not significantly different from 1) in the absence of Gpp(NH)p, while these parameters were not significantly modified in the presence of Gpp(NH)p (10(-4) M). These results indicates that beta AR were not significantly reduced in number but altered in their capacity to efficiently couple with the GTP-binding protein of adenylate cyclase (AC). These data can be correlated to the alteration of beta-adrenergic stimulation of cardiac AC previously observed after 4 months of diabetes. The characteristics of beta AR alteration at this stage of the disease are similar to those of a first step of a beta AR desensitization process due to overstimulation.

Animals↗

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[Pseudocystic pancreatic formations: 50 cases].

Explore the source record for details and available documents.

Adolescent↗

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[Indications and results of total gastrectomy in treatment of ulcer disorders (11 cases)].

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

Cardiovascular risk factor status of an Old Order Mennonite community.

BACKGROUND: The Old Order Mennonites are members of rural farming communities whose religious and cultural traditions pervade their dietary and health practices. These cloistered Christian communities often present special challenges to primary care physicians unfamiliar with the Mennonite way of life. Anecdotal descriptions of Mennonite customs suggest heightened risk for cardiovascular disease because of a dairy and meat-based diet and a lack of utilization of the traditional health care system. METHODS: With approval from the church bishop, households from a New York State Mennonite community were interviewed about personal and family history of cardiovascular disease, knowledge of dietary cardiovascular risk factors, and personal awareness of their cardiovascular risk factor status. A standardized Saturated Fat/Cholesterol Avoidance Scale was used to assess qualitatively the community's traditional diet. Blood pressures and total serum cholesterol levels were measured in all willing participants. RESULTS: Two hundred fifty interviews were completed. A significant difference was found between the cholesterol level of the men (181 mg/dL) and the women (192 mg/dL). When compared with the general population, the Mennonite men had significantly lower total serum cholesterol levels and systolic and diastolic blood pressures. Only 8 percent of the study population had been previously screened for serum cholesterol. One-third of the population older than 55 years had a personal history of either myocardial infarction or stroke. The study population's score on the Saturated Fat/Cholesterol Avoidance Scale indicated a diet higher in saturated fat and cholesterol than that of other study populations. CONCLUSIONS: Our findings indicate a significant lack of preventive health care practices, minimal avoidance of dietary cardiovascular risk factors, and a significant difference between men's and women's cardiovascular risk factor status in this Old Order Mennonite population.

Adult↗