Preparation and properties of trimethylsulfonium-tetrahydrofolate methyltransferase.
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Adenine Nucleotides↗
Biomedical subjects
C Wagner
Publications and source records attributed to C Wagner.
Spectral absorption characteristics of human methemalbumin.
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Chemistry, Organic↗
Trimethylsulfonium-tetrahydrofolate methyltransferase, a novel enzyme in the utilization of 1 carbon units.
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Alcaligenes↗
Biomechanical abnormalities in musicians with occupational cramp/focal dystonia.
Occupational factors and peripheral injuries are frequently implicated in the development of hand cramps and the syndrome of persistent manual incoordination among musicians and others most commonly given a diagnosis of focal limb dystonia. In an attempt to gain insight into the character and influence of risk factors in the evolution of this disorder, the authors conducted detailed evaluations of 33 individuals who responded to a questionnaire sent to university- and conservatory-level music schools in Germany in September 1989. Response was invited from any musician with complaints of impaired hand control. Of the 33 individuals accepted for evaluation, 18 were musicians who met clinical criteria for the diagnosis of occupational cramp/focal dystonia (OC/FD). Nineteen of the original 33 subjects underwent a quantitative biochemical assessment, comparing active and passive ranges of motion at all joints below the shoulder with those for cohorts of unimpaired musicians, matched for gender and musical instrument. Of the 19 tested biomechanically, 14 had OC/FD and the remaining five had either persistent pain or nonspecific movement idiosyncracies interfering with playing. Compared with the matched groups of normals, no consistent biomechanical abnormality was found in the non-OC/FD group; in the OC/FD group two thirds had marked limitation of passive and/or active abduction range between the central digits of both hands. Based on detailed training and performance histories in these subjects, the authors conclude that a specific biomechanical condition in the hand can interfere with certain high-speed digital movements required in musical instrument performance. Unintended muscle synergies, postures, and movement patterns can develop as attempts are made to increase the speed and fluency of such movements. As rehearsal is intensified, degraded movements are stabilized ("programmed"). In this situation, OC/FD appears to represent an aberrant outcome of normal motor learning whose physiologic correlates mimic neuropathologically based dystonia. The implications for prevention are discussed.
Adult↗
Impact of dialysis modality and acidosis on nutritional status.
Experimental evidence suggests that acidosis may have a deleterious effect on protein metabolism. We evaluated 124 chronic dialysis patients (59 +/- 17 years) and defined acidosis as an anion gap >18 meq/L. A direct correlation (p < 0.0001 was found between anion gap and serum albumin (R = 0.402), BUN (R = 0.488), and serum creatinine (R = 0.473) concentrations. Acidotic patients (43%), when compared with nonacidotic patients, had greater serum albumin concentrations (3.95 +/- 0.50 vs. 3.60 +/- 0.48 g/dl, p = 0.0001, respectively), higher normalized protein catabolic rates (1.12 +/- 0.27 vs. 0.96 +/- 0.26 g/kg/d, respectively; p = 0.0004), and higher BUN (70 +/- 19 vs. 55 +/- 17 mg/dl, p = 0.0001) and serum creatinine (11.1 +/- 3.4 vs. 8.3 +/- 3.2, p = 0.0001 mg/dl) concentrations. However, no differences in midarm muscle circumference, fat free mass, or body cell mass were noted between groups when assessed by dialysis modality or acidosis status. In conclusion, mild chronic metabolic acidosis, likely caused by increased dietary protein intake, does not independently and adversely impact nutritional status in chronic dialysis patients.
Acid-Base Equilibrium↗
Surgical management of Achilles tendon overuse injuries. A long-term follow-up study.
We studied 79 cases of surgically treated Achilles tendon overuse injuries in 66 patients. Fifty-three (80%) of these patients were competitive or serious recreational runners operated on between 1978 and 1991. There were 49 men and 17 women with a mean age of 33 years (range, 17 to 59). The cases were divided into surgical subgroups based on their site of primary symptoms and abnormalities: paratenonitis (23), tendinosis (partial rupture or degeneration) (15), retrocalcaneal bursitis (24), insertional tendinitis (7), and combined abnormalities (10). Followup included a comprehensive patient questionnaire and office examination. There were 79% satisfactory (51% excellent, 28% good) and 21% unsatisfactory (17% fair, 4% poor) results. The percentages of satisfactory results in the paratenonitis group (87%) were best and those in the tendinosis group were the worst (67%). Satisfactory results were obtained in 75% of the patients with retrocalcaneal bursitis and 86% with insertional tendinitis. Seven of the 45 cases with longer than 5-year followup with initially satisfactory results deteriorated with time and required reoperation (16%). Of these, 4 were in the tendinosis group, 2 had retrocalcaneal bursitis, and 1 had paratenonitis. One of the 34 patients followed less than 5 years required reoperation.
Achilles Tendon↗
A retrospective study of laser in situ keratomileusis after radial keratotomy.
PURPOSE: This is a retrospective study designed to present results of laser in situ keratomileusis (LASIK) after radial keratotomy (RK). METHODS: Eighty eyes of 56 patients underwent LASIK for residual myopia, astigmatism, and hyperopia after RK. Absolute mean preoperative spherical equivalent refraction was 2.36 +/- 1.17 D. Best spectacle-corrected visual acuity (BSCVA) was 20/20 in 56% of eyes, 20/25 in 25%, 20/30 in 13%, 20/40 in 5%, and 20/60 in 1%. Uncorrected visual acuity was better than 20/40 in four eyes. Follow-up ranged from a minimum of 1 day after surgery to a maximum of 2 years, with an average of 6 months. RESULTS: Mean final absolute spherical equivalent refraction was 0.62 +/- 0.611 D. Six eyes experienced a loss of BSCVA of one line, one eye lost two lines, and one lost more than two lines. Three eyes had one line of improvement and one eye had two lines of improvement. Uncorrected visual acuity was 20/20 in 21 eyes, 20/25 in 20 eyes, and 20/30 in 19 eyes. There was stromal opacity in two eyes, epithelial defects in two eyes, and epithelial ingrowth in four eyes. CONCLUSION: LASIK may be an effective treatment for myopia, astigmatism, and hyperopia in patients with residual refractive error after RK. Extreme caution should be exercised due to the complexity of this group of patients.
Astigmatism↗
Interpreting a living will after stroke.
Mr. Duffy is 83 years old and is admitted to rehabilitation 4 weeks after a right thalamic cerebral vascular accident (CVA). He has dysphagia, dysarthria, left hemiplegia, and is moderately-severely confused. He pulls out his nasogastric feeding tube and his physician decides not to reinsert it because of significant nasal tissue necrosis. The team recommends a gastrostomy tube for nutrition because of Mr. Duffy's lack of alertness and high risk for aspiration. Mr. Duffy has a Living Will that states he does not wish to have his life sustained with a feeding tube. He does not have a formal Durable Power of Attorney for Health Care. His wife has dementia and their daughters are making decisions for both parents. They are not sure about his wishes in this particular circumstance, but report that he said of a relative who died of cancer, "things went on too long because of that feeding tube." After 3 days, Mr. Duffy is more alert, and during a discussion about tube feedings he says, "I'll go for the works." His fluctuating alertness level prevents him from responding to this question again. His daughters feel he would not want the tube and suggest waiting to see if his swallowing improves in the next week before making a decision.
Aged↗
Field perimortem cesarean section.
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Accidents, Traffic↗
Abdominal aortic coarctation and pregnancy.
Coarctation of the abdominal aorta was diagnosed in a pregnant hypertensive patient who presented with acute abdominal pain and fever. Extensive workup failed to establish another cause for the acute illness. Successful vascular reconstruction to correct renovascular hypertension and to bypass the coarctation was accomplished. The relationship of prgnancy to the symptomatology is discussed and evidence is presented which suggests that this case represents a variant of Takayasu's arteritis.
Adult↗
Flavipucine and brunnescin, two antibiotics from cultures of the mycophilic fungus Cladobotryum rubrobrunnescens.
Two antimicrobial metabolites were isolated from submerged cultures of Cladobotryum rubrobrunnescens, a mycophilic fungus growing on a Inocybe species. One of the compounds proved to be identical to flavipucine (2), an antibiotic previously isolated from Aspergillus flavipes (Casinovi et al., 1968) and from a Macrophoma species (Sassa T. and Onuma Y. (1983), Agric. Biol. Chem. 47, 1155-1157). The other metabolite, brunnescin (1), is a new tetrasubstituted furan derivative which exhibits antibacterial, antifungal and cytotoxic effects.
Animals↗
Induction of matrix protein synthesis in human glomerular mesangial cells by the terminal complement complex.
Exposure of human glomerular mesangial cells (GMC) in culture to sublytic doses of the terminal complement proteins C5b-8 and C5b-9 caused a transient increase in abundance of mRNA specific for collagen type IV and fibronectin; mRNA of laminin was not affected. Since C5b-9 is found deposited in inflamed or sclerotic areas we propose that stimulation of matrix protein synthesis by C5b-9 might contribute to the development of glomerular sclerosis.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
[Obstetrical management in maternal tuberous sclerosis (Pringle-Bourneville syndrome)--a case report].
The rupture of visceral hamartomas in tuberous sclerosis (Pringle-Bourneville) is more likely in pregnancy because of the increased blood volume and can be followed by lifethreatening retroperitoneal hemorrhage. To avoid complications during delivery the vacuum extraction in epidural anesthesia is recommended. Preconceptional genetic counseling in this autosomal dominant disorder is obligatory.
Adult↗
HIV-positive women living in the metropolitan Toronto area: their experiences and perceptions related to HIV testing. The HIV Women's Study Group.
Forty HIV-positive women from diverse socioeconomic backgrounds were interviewed. Most (90%) did not perceive themselves to be at risk of HIV infection prior to knowing their HIV-positive status. The majority (61%) were tested because they developed symptoms, or because someone with whom they were intimate, or their child, tested positive for HIV or became ill. The majority (93%) of the women interviewed indicated that they did not receive both pre- and post-test counselling. The findings from this study suggest that encouraging individuals to be tested if they have engaged in "at risk" activities will not be appropriate for individuals who have no perception of risk, and other strategies to encourage appropriate testing may be needed. This research also suggests that continued emphasis needs to be placed on the counselling process, and that consideration may need to be given to multiple counselling sessions to ensure individuals clearly understand the information provided.
AIDS Serodiagnosis↗