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Biomedical subjects

C Kline

Publications and source records attributed to C Kline.

12 recordsLinked to original sources
PubMed2001

Patient demand matching in total knee arthroplasty: is it necessary?

Patient demand matching has been accepted as an appropriate method of implant management by hospitals for cost reduction. However, there have been no prospective studies to substantiate whether these patients change their demand levels postoperatively. Theoretically, functional activity levels should not increase significantly postoperatively in patients with preoperative low demand levels for patient demand matching to be effective in avoiding premature prosthetic failure. Preoperative and postoperative demand levels were prospectively reviewed in 279 patients undergoing total knee arthroplasty (TKA). Preoperatively, the medium/high-demand patients performed significantly more activities overall than low-demand patients. Postoperatively, both low- and medium/high-demand patients dramatically increased the number of activities performed. The hypothesis that prosthetic choice should be determined by preoperative activity level (demand matching) was not validated by this study because patient activity levels significantly increased in all categories subsequent to TKA.

Activities of Daily Living↗
PubMed2000

Outcome results after total knee arthroplasty: does the patient's physical and mental health improve?

An ongoing prospective study with continuing enrollment and follow-up of 279 patients analyzed the postoperative mental and physical outcomes on an interim basis using the SF-36 Physical and Mental Health Summary Scale, which allows for patient self-assessment of total knee arthroplasty (TKA) outcome. Results of this study support the hypothesis that patients can assess their own physical health after surgery and suggest that while physical health component scores increased dramatically subsequent to TKA, mental health component scores remained essentially unchanged. The lack of significant improvement of the mental health component score can be explained in part by noting that the mean mental health component score for the study patient cohort was already above average preoperatively. Thus, mental health component scores did not correlate with the dramatic improvement of physical health component scores. Physical health component score appears to be a more accurate indicator of the benefits of TKA than mental health component score.

Adult↗
PubMed1999

Sphincteric stent versus external sphincterotomy in spinal cord injured men: prospective randomized multicenter trial.

PURPOSE: In a prospective randomized multicenter trial we compared the treatment results of conventional external sphincterotomy with those of UroLume sphincteric stent prosthesis placement in men with spinal cord injury and external detrusor-sphincter dyssynergia. MATERIALS AND METHODS: We randomized 57 men with spinal cord injury in whom urodynamics verified external detrusor-sphincter dyssynergia into 2 groups to undergo either sphincter defeating procedure. We compared the primary urodynamic parameter of maximum detrusor pressure, and secondary urodynamic parameters of bladder capacity and post-void residual urine volume in men who underwent sphincterotomy or sphincteric stent placement. Parameters were measured preoperatively, and 3, 6, 12 and 24 months postoperatively. Patients completed questionnaires regarding voiding sensation and quality of life issues at each followup visit. RESULTS: Demographic data of the 26 patients treated with sphincterotomy and the 31 treated with sphincteric stent placement were statistically similar. Preoperatively mean maximum detrusor pressure plus or minus standard deviation in sphincterotomy and stent cases was 98.3 +/- 27.6 and 95.7 +/- 27.7 cm. water, respectively (p = 0.73). At 12 months mean maximum detrusor pressure decreased to 48.9 +/- 16.4 and 52.6 +/- 31.6 cm. water in the sphincterotomy and stent groups, respectively (p = 0). Preoperatively mean bladder capacity in sphincterotomy and stent cases was 245 +/- 158 and 251 +/- 145 ml., respectively (p = 0.87). Bladder capacity did not change significantly in either treatment group throughout followup. Preoperatively mean post-void residual urine volume in the sphincterotomy and stent groups was 212 +/- 163 and 168 +/- 114 ml., respectively (p = 0.33). Residual urine volume decreased in each group at some but not all followup evaluations. The duration of hospitalization was greater for sphincterotomy than stenting (p = 0.036). Six stents required explantation. CONCLUSIONS: The UroLume stent is as effective as conventional external sphincterotomy for treating external detrusor-sphincter dyssynergia. However, sphincteric stent placement is advantageous because it involves shorter hospitalization and is potentially reversible.

Adult↗
PubMedDate not supplied

Domain of E. coli DNA polymerase I showing sequence homology to T7 DNA polymerase.

Escherichia coli contains three DNA polymerases that differ in their size, ability to interact with accessory proteins and biological function. Monomeric DNA polymerase I (Pol I) has a relative molecular mass (Mr) of 103,000 (103K) and is involved primarily in the repair of damaged DNA and the processing of Okazaki fragments; polymerase II is of Mr 120K, and polymerase III has a Mr of 140K, is responsible for the replication of the DNA chromosome and is just one of several proteins that are required for replication. DNA polymerases from bacteriophage as well as those of eukaryotic viral and cellular origin also differ with respect to their size and the number of associated proteins that are required for them to function in replication. However, the template-directed copying of DNA is identical in all cases. The crystal structure of the large proteolytic fragment of Pol I shows that it consists of two domains, the larger of which contains a deep crevice whose dimensions are such that it can bind duplex DNA. The T7 polymerase consists of two subunits, the 80K gene 5 protein and the host-encoded 12K thioredoxin of E. coli. We show here that there is an amino acid sequence homology between at least eight polypeptide segments that form the large cleft in the Klenow fragment and polypeptides in T7 DNA polymerase gene 5 protein, suggesting that this domain evolved from a common precursor. The parts of the Pol I and T7 DNA polymerase molecules that bind the DNA substrate appear to share common structural features, and these features may be shared by all of these varied DNA polymerases.

Amino Acid Sequence↗
PubMedDate not supplied

Communicating more effectively.

Communicating is something people take for granted. But some organizations have still not learned that information should not be a closely guarded commodity, but something to be shared freely. To be productive, employees must know the organization's goals and constraints. Managers must develop an early warning system so little problems do not grow into big ones. They must be able to assess their employees' morale and prevent personality problems from getting out of hand. In this issue, we asked some top communicators for their tips on promoting better information exchange.

Arizona↗