Maternity Information Act passes in New York.
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Cesarean Section↗
Biomedical subjects
D Young
Publications and source records attributed to D Young.
Clonal analysis of the cellular immune response to the house dust mite Dermatophagoides farinae.
A panel of human CD4+ T cell clones specific for the house dust mite was isolated from an atopic individual with perennial rhinitis. Soluble antigen specificity was defined using proliferation assays and subsequently the antigenic determinants recognized by some of these clones were mapped using nitrocellulose immunoblots of fractionated Dermatophagoides spp. Both cross-reactive and species-specific T cell clones were identified and in some instances their specificity could be mapped to the serologically defined Der f I, Der p I and Der f II allergens. In comparison, the serum antibody response showed additional specificity for Der f III. The antigen recognition by six of these clones was found to be restricted by HLA-DR gene products.
Allergens↗
Fragmented sleep, daytime somnolence and age in narcolepsy.
This study examined whether narcoleptics experience an age-related increase in nocturnal sleep disturbance and, if so, what impact that disturbance has on daytime sleepiness. To evaluate these questions, the records of 228 patients diagnosed as narcoleptic were assessed. Total sleep time (TST) and sleep efficiency (SE) significantly decreased, and wake during sleep (WDS), number of awakenings, and percentage of stage one significantly increased across the decades. This indicates an age-related elevation in sleep fragmentation. Daytime sleepiness, however, did not exhibit age effects. These data further support the theory that narcolepsy is a basic neural defect not confounded by excessive daytime sleepiness secondary to sleep fragmentation.
Adult↗
A study of emergency ambulance utilisation.
An analysis of 373 emergency ambulance calls within the Broadmeadows municipality of Melbourne showed that eighty-seven per cent were handled by standard road car (RC) ambulance, and 13 per cent by mobile intensive care ambulance (MICA). Calls most commonly were associated with cardiorespiratory episodes, loss of consciousness and trauma. Twenty-three per cent of calls did not result in a patient being transferred to hospital mainly because of patient refusal or the absence of a medical need. Forty-two per cent of calls were categorised "not urgent" or eventually the ambulance was not required. This review highlights important topics for further study of ambulance services.
Age Factors↗
Pitfalls in orthopaedics.
Many pitfalls await the general practitioner in managing the orthopaedic problems that arise in everyday practice, mostly as the result of trauma. Many injuries, such as fractures of the arm and hand, seem trivial but they can lead to long term disability. The authors present guidelines to help avoid these pitfalls.
Bone Diseases↗
Patellar tendinitis ('jumper's knee').
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Humans↗
In vivo treatment with IL-1 reduces the severity and duration of antigen-induced arthritis in rats.
IL-1 has been implicated in the pathogenesis of arthritis. Although IL-1 injected in vivo into normal joints results in a transient inflammatory reaction, we have shown that three weekly repetitive injections of IL-1 do not produce a progressive inflammatory condition suggestive of chronic arthritis. In fact, priming normal joints with three weekly IL-1 intraarticular injections results in a significant reduction in joint swelling and diminished histopathologic alterations/lesions caused by subsequent methylated BSA-induced arthritis. Similarly, post treatment with IL-1 intraarticular injection after arthritis induction reduced arthritic swelling and joint injury if IL-1 was given during the developing stage of arthritis. Our results suggest that IL-1 might limit arthritic inflammation and progressive cartilage destruction through an, as yet, undetermined mechanism(s). Further in vivo investigations are required to determine the therapeutic utility of IL-1 in reducing early arthritic inflammation.
Animals↗
Insulin-induced decrease in 5'-nucleotidase activity in skeletal muscle membranes.
Insulin releases inositol phosphoglycans from myocytes in culture [(1986) Science 233, 967-972], which display insulinomimetic activity. Because 5'-nucleotidase is anchored to the membrane through inositol-containing phospholipid glycans, we investigated whether insulin could release the enzyme from the membrane. Membranes prepared from hindquarter muscles of rats perfused with insulin showed a 23% decrease in 5'-nucleotidase activity. Isolated membranes from muscle exposed to insulin in vitro also showed a small but reproducible decrease (9%) in 5'-nucleotidase activity relative to unexposed controls. Phospholipase C from Staphylococcus aureus released 60% of the membrane-bound 5'-nucleotidase. We propose that insulin may activate an endogenous phospholipase C that cleaves phospholipid-glycan-anchored proteins.
5'-Nucleotidase↗
The cDNA and derived amino acid sequences for human and bovine matrix Gla protein.
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Amino Acid Sequence↗
Multiple reoperations in recurrent colorectal carcinoma. An analysis of morbidity, mortality, and survival.
Fifty-eight patients in an existing prospective study were evaluated to determine if multiple reoperations for recurrent colorectal carcinoma extended survival. All patients had at least three major operative procedures. The median survival from first, second, third, fourth, and fifth recurrence was 29.9, 17.3, 16, 12.3, and 7.2 months, respectively. The median postoperative hospital stay was 11 days, with a range of 1 to 96 days. The major complication rate was 17%. Twenty-one patients are still alive 19 to 140 months from diagnosis (mean, 50.3 months), 9 to 125 months from the first recurrence (mean, 31.1 months), and 5 to 109 months (mean, 22 months) from the second recurrence. Eleven patients have no evidence of disease. Reoperation for recurrent colorectal carcinoma can be done with acceptable morbidity and mortality and an increase in survival.
Adult↗
Testing time in the lab.
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Clinical Laboratory Techniques↗
Narcolepsy in a pediatric population.
Narcolepsy, a sleep-wake disorder of unknown cause, has been reported as occurring in the pediatric population, but only two reports of cases in the literature have included polysomnographic data on children with narcolepsy. We compared the clinical and polysomnographic data on a series of eight patients 15 years of age or younger and an adult comparison group with narcolepsy. All patients presented with excessive daytime sleepiness, and no significant difference was found between groups for the incidence of cataplexy, hypnagogic hallucinations, and sleep paralysis. On polysomnographic evaluation the pediatric group had increased total sleep time, percent-stage 3/4 sleep, percent rapid eye movement sleep, and decreased stage 1 sleep, which all are expected age-related differences. The pediatric group also showed a greater degree of daytime sleepiness and an increased frequency of sleep-onset rapid eye movement periods. While pediatric patients with narcolepsy resemble adults in their mode of presentation and the incidence of accessory symptoms, the increase in severity of sleepiness highlights the importance of diagnosing narcolepsy in children as early as possible so that treatment can be initiated.
Adult↗
San Diego Suicide Study. III. Relationships between diagnoses and stressors.
Few attempts have been made to look for potential correlations between psychiatric diagnoses and psychosocial stressors in suicides. In this study, we examine relationships between the most common psychiatric illnesses and the most common stressors in 283 suicides from San Diego County. We found that interpersonal loss/conflicts occurred more frequently near the time of death for substance abusers with and without depression than for persons with "pure" affective disorder. These findings are consistent with those of previous reports, suggesting a difference between the way suicidal persons with substance abuse and pure affective disorder respond to certain external stressors.
Adult↗
Estimation of the rate constants in a data-sparse environment: comparison of a mathematical method and least squares analysis.
A new method is presented for estimating the rate constants for the one-compartment open model with first-order absorption in a data-sparse environment. It is based on the principles of matrix algebra and system theory and requires only three to four plasma samples drawn at equal time intervals (a minimum of at least one sample in the absorption phase and one sample in the elimination phase). The utility of the technique is illustrated by comparing the parameter estimates from the matrix method with the estimates from a nonlinear computer parameter estimation program. In the preliminary evaluation of the method with both perfect data and data with randomly distributed error, the parameter estimates from the matrix method proved to be as good as the computer estimation for data-sparse systems. In a more realistic comparison with published patient data, the matrix method resulted in 0 to 456% better estimates of kel and ka than the computer estimation. Since the matrix method is mathematically simple and requires only three to four blood samples, it should prove very useful in data-sparse systems (e.g., clinical or small animal situations) where a minimum amount of blood samples can be drawn.
Absorption↗
Sensitive electrochemical high-performance liquid chromatography assay for the simultaneous determination of haloperidol and reduced haloperidol.
An electrochemical HPLC method for the simultaneous determination of haloperidol and reduced haloperidol in plasma is presented. Chlorohaloperidol serves as the internal standard. A cyanopropyl bond elut column was used for sample preparation. The eluate was evaporated and reconstituted with mobile phase and injected onto a nitrile bonded column. The chromatographic system consisted of an ESA Coulochem detector operated in the screen mode. Intra- and interassay coefficients of variation for both compounds were less than 7%, with a sensitivity limit of 20 pg on the column. A plasma level-time profile is presented to illustrate the sensitivity and applicability of this assay in small animal and human pharmacokinetic studies.
Animals↗
Suicide by psychotics.
The authors studied 31 cases with psychotic diagnoses from a consecutive series of 204 suicides in San Diego. They were compared to 25 similar cases from 134 suicides gathered in the city of St. Louis and St. Louis county 25 years earlier. The proportion of psychotic subjects (less than 20%) in the two samples was similar. The San Diego psychotics were younger on the average than those from St. Louis and had more polysubstance abuse than alcoholism. Only rarely did psychotics in either sample commit suicide by particularly "crazy" methods. In the San Diego suicides, the psychotics without a depressive syndrome had as many depressive symptoms as those with a depressive syndrome. Schizophrenics in the San Diego sample made suicidal communications just as often as the other psychotics and the nonpsychotics. Fewer schizophrenics than other psychotics or nonpsychotics had stressors identified at the time of death, but over half of all the subjects did have them.
Adult↗
Stress proteins are immune targets in leprosy and tuberculosis.
To understand the immune response to infection by tuberculosis and leprosy bacilli and to develop improved vaccines, the nature of antigens that are involved in humoral and cell-mediated immunity was investigated. We have determined that five immunodominant protein antigens under study are homologues of stress proteins. This finding and observations with other pathogens suggest that infectious agents may respond to the host environment by producing stress proteins and that these proteins can be important immune targets. We postulate that abundant and highly conserved stress proteins may have "immunoprophylactic" potential for a broad spectrum of human pathogens.
Amino Acid Sequence↗