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Biomedical subjects

D L Smith

Publications and source records attributed to D L Smith.

At least 361 records · Page 20Linked to original sources
PubMed1987

Sjögren's syndrome. More than dry eyes and dry mouth.

Sjögren's syndrome is a complex disease state with multisystem manifestations. Two forms of the disease, primary and secondary, are recognized; the secondary form is more easily diagnosed because of its association with an already established rheumatic or autoimmune disease. Treatment consists of measures to prevent damage from ocular and oral dryness (sicca complex) and to minimize systemic manifestations.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1987

Gynecomastia. A worrisome problem for the patient.

Gynecomastia is common in obese or elderly men. Drug-induced breast enlargement is also frequent, whereas other causes of gynecomastia are relatively uncommon. Standardized measurement of breast tissue should be routinely performed in male patients. Diagnostic evaluation should be individualized on the basis of clinical suspicion. Therapy most often involves treating an underlying condition or discontinuing use of an offending drug.

Adult↗
PubMed1987

New method for formulation of amino acid concentrations and ratios in diets of rats.

Parameters derived from the application of the saturation kinetics model (SKM) to rat growth experiments were used to formulate a complete dietary amino acid mix for weanling rats. Dietary ratios and concentrations for indispensable amino acids (IAA) and arginine were calculated using the parameter K0.5. A curve shift technique was used to determine dietary concentrations for conditionally indispensable amino acids (CAA) and dispensable amino acids (DAA). The model was also used to determine a dietary ratio of (IAA + Arg)/(CAA + DAA). Using the dietary amino acid concentrations suggested by the model and an (IAA + Arg)/(CAA + DAA) ratio of 1, a growth response curve was constructed and compared to a similar curve using the amino acid mix of Rogers and Harper. The modeling approach produced a 10-15% improvement in growth over the Rogers and Harper mix. The SKM is discussed in terms of calculating an ideal nutrient ratio and choosing a desired response level. It is demonstrated that the model can rapidly produce accurate estimates for dietary amino acid levels, while minimizing required numbers of laboratory animals.

Amino Acids↗
PubMed1987

Formulating and evaluating hypotheses in psychoanalytic psychotherapy.

Little psychoanalytic literature exists dealing with the formulation and evaluation of hypotheses in the therapeutic situation. This paper is an initial exploration and systematization of criteria presently in use. Hypothesis formation is discussed in terms of the accumulation of data and its recontextualization. Then follows an account of prevalidation, the silent evaluation of an hypothesis. Before an hypothesis can be turned into an intervention considerations of spoken form, order and timing must be taken into account. Finally, after intervening, post-validation can occur: the evaluation of the hypothesis on the basis of the patient's responses.

Freudian Theory↗
PubMed1987

Orally active prostacyclin-mimetic RS-93427: therapeutic potential in vascular occlusive disease associated with atherosclerosis.

RS-93427 is a potent, orally active prostacyclin-mimetic that is very rapidly absorbed but with generally long-lived actions in most species. It has antithrombotic, thrombolytic, and antivasospastic potential. Alone among several tested PGI-mimetics, it inhibits release of platelet mitogens more potently than its ability to inhibit aggregation. It also inhibits mitogen release from macrophages and vascular endothelial cells. RS-93427 is also potent at inhibiting macrophage accumulation of cholesteryl esters. These data suggest a broad spectrum of potential therapeutic utility for RS-93427 via the oral route. It might be useful both in acute manifestations of vascular occlusive disease involving thrombosis and vasospasm, in addition to the more chronic conditions involving intimal hyperplasia (as in arteriovenous grafts) and possibly frank atherosclerosis. Much work remains to be done, including examination of RS-93427 in chronic studies with various dosage forms, particularly in the study of atherosclerosis.

Administration, Oral↗
PubMed1987

Unruptured abdominal aortic aneurysm mimicking hip joint disease.

A 66-year-old man with an 8-month history of progressive left hip pain was found to have a large unruptured infrarenal aortic aneurysm. The hip pain abated after aneurysm repair. His clinical picture suggested that the hip pain was caused by aneurysmal sac encroachment upon a nerve branch of the lumbar plexus. We report this previously unrecognized association to heighten awareness of this atypical but potentially life threatening cause of hip pain.

Aged↗
PubMed1986

Preliminary X-ray data for aspartate aminotransferase from Escherichia coli.

Crystals of the aspartate aminotransferase from Escherichia coli (aspC gene product) have been examined by X-ray analysis. The crystals grow as elongated rectangular prisms, with the symmetry of space group C2221. Unit cell dimensions are a = 156 A, b = 87.6 A, c = 80.6 A and alpha = beta = gamma = 90 degrees. There is one protein subunit of molecular weight 43,600 per asymmetric unit.

Aspartate Aminotransferases↗
PubMed1986

A new approach for detection and assignment of disulfide bonds in peptides.

A new procedure is described for identification of disulfide bonds in peptides by fast atom bombardment mass spectrometry (FABMS). Prolonged bombardment of a disulfide-containing peptide in solution by a high-energy xenon beam results in gradual reduction of the disulfide bond. The reduction is the result of reaction intermediates initially produced by the xenon beam. The method for characterization of interchain disulfide bonds is based on the increase in the relative intensity of the pseudomolecular ions of the reduced peptides with a simultaneous decrease in the relative intensity of the protonated molecular ion of the oxidized peptide. This information allows one to identify peptide fragments covalently linked via intermolecular disulfide bonds. The intrachain disulfide bonds are identified by the increase in the relative intensity of the protonated molecular ion of the reduced peptide, relative to the intensity of the protonated molecular ion of the oxidized peptide. These results indicate that this method can be used to detect disulfide bonds of peptides and provides unambiguous information regarding disulfide bond assignment in peptides. Approximately 1 nmol of sample is required.

Chemical Phenomena↗
PubMed1986

The role of cardiac beta-1 receptors in the hemodynamic response to a beta-2 agonist.

The role of beta 1-receptors in the hemodynamic response to beta 2-stimulation was assessed in seven healthy subjects by infusion of the selective beta 2-agonist terbutaline both with and without selective beta 1-blockade by atenolol (50 mg). Infusion of terbutaline increased heart rate (+28 bpm) and indices of left ventricular (LV) performance associated with a marked decrease in LV end-systolic wall stress. The LV end-diastolic dimension remained unchanged despite the tachycardia, suggesting that venous return had increased. Systolic blood pressure increased, whereas total peripheral resistance and diastolic blood pressure decreased. Atenolol pretreatment caused the hemodynamic changes expected of beta 1-blockade but did not blunt the effects of terbutaline on heart rate, peripheral resistance, or venous return. Increases after terbutaline in LV performance and systolic blood pressure were significantly blunted by atenolol. Stimulation of beta 1-receptors therefore appears to play no role in the chronotropic and only a moderate role in the inotropic response after infusion of a beta 2-agonist. Alternative mechanisms for the cardiac changes with terbutaline include (1) withdrawal of vagal tone, (2) decrease in afterload, and (3) stimulation of cardiac beta 2-receptors.

Adult↗
PubMed1986

Epidemiology of colonization by nontypable Haemophilus influenzae in children: a longitudinal study.

Eighty-six nasopharyngeal isolates of Haemophilus influenzae were prospectively obtained from three children who attended a day care center from infancy until early childhood (five to seven years). A majority of the strains were nontypable. We analyzed strains by comparing their biotypes and by performing electrophoresis of outer membrane proteins on polyacrylamide gels. Profiles of outer membrane proteins were very heterogeneous and could not be used as the basis for the development of a subtyping scheme. The children characteristically carried a nasopharyngeal strain defined by a unique outer membrane pattern for a period of months, lost it, and then acquired a new strain. We probed the outer membrane proteins of a child's strains by the western blot technique with serum obtained serially from the child. Isolates whose outer membrane proteins appeared identical on stained gels generally had similar antigenic bands on western blots but were occasionally immunologically distinct. Serum immunoglobulins of the IgG class that reacted with the outer membrane proteins did not appear to change greatly over time or to play a role in preventing or terminating colonization. We conclude that nasopharyngeal colonization in children by nontypable H. influenzae is a dynamic process and that factors that cause loss and acquisition of strains remain to be determined.

Antigens, Bacterial↗
PubMed1986

A comparison of nursing care requirements of patients in long-term geriatric and acute care nursing units.

It is commonly assumed that elderly patients in long-term care facilities require less total care and less professional care than patients in active 'treatment' settings. However, no objective data have been available to support or refute these assumptions. This study examined patient classification data obtained from eight acute care medical and surgical units and four long-term care geriatric units over a 1-year period. Results indicated that geriatric patients in long-term care units had differing (as opposed to similar) nursing care needs, nursing care requirements of geriatric patients in several long-term care units differed from those of patients in another long-term care unit, geriatric patients in the selected long-term care units required at least as much nursing care as those in the medical surgical units, and the long-term care units had many patients with extensive nursing care requirements but no patients with very complex requirements when compared with the medical/surgical units. The potential impact of these findings on staffing of long-term care units is considerable. Issues relating to reliability, validity and comparability are discussed. There is a great need to utilize standardized, state-of-the-art methods for nursing workload measurement to facilitate comparisons of nursing care requirements of geriatric long-term care patients with those of patients in other areas.

Aged↗