Recombinant factor VIII concentrate. The MSAC, Canadian Hemophilia Society. Canadian Hemophilia Clinic Directors Group.
Explore the source record for details and available documents.
Canada↗
Biomedical subjects
I Walker
Publications and source records attributed to I Walker.
Warfarin-induced skin necrosis in 2 patients with protein S deficiency: successful reinstatement of warfarin therapy.
Warfarin-induced skin necrosis is a rare but serious complication of oral anticoagulant therapy. This condition has been associated with protein C deficiency but only rarely reported in patients with a deficiency of protein S. We have managed 2 patients with a history of warfarin-induced skin necrosis who were diagnosed as being protein-S-deficient. Since both patients were candidates for long-term anticoagulant therapy we elected to reintroduce warfarin using a regimen designed to minimize the risk of recurrent skin necrosis. While they were therapeutically anticoagulated with heparin, warfarin was started at 1 mg/day and the dose was increased gradually. Heparin was not discontinued until the prothrombin times were in the therapeutic range for at least 72 h. Both patients tolerated the reinstitution of warfarin without difficulty and they have now been followed for over 2 years on oral anticoagulants without complication.
Adult↗
Empathy, effectiveness and donations to charity: social psychology's contribution.
Charity organizations often use mailed requests to solicit donations from the public. This is not an efficient way to raise large amounts of money. The challenge addressed in this study was to use social psychology's knowledge of helping processes to make mailed requests more effective. Two constructs were identified as possibly useful: empathy and perceived effectiveness of helping. These were manipulated in a field experiment in a 2 x 2 x 2 factorial design (two levels of empathy, two of need extent, and two of need persistence--the last two factors operationalized perceived effectiveness). Letter soliciting donations to a well-known charity were mailed to a random sample of 2648 people in Perth, Western Australia. Manipulations of the three variables were embedded in the letters. The two effectiveness manipulations produced significant main effects, whereas the empathy manipulation was ineffective. We argue that social psychology's knowledge of helping processes is too confined to narrow, theoretical, laboratory-based phenomena to be directly and immediately applicable to the practices of charities.
Charities↗
The pattern of population growth as a function of redundancy and repair.
A basic model of hierarchical structure, expressed by simple, linear differential equations, shows that the pattern of population growth is essentially determined by conditions of redundancy in the sub-structure of individuals. There does not exist any possible combination between growth rate and accident rate that could balance population numbers and/or the level of redundancy within the population; all possible combinations either lead to extinction or to positive population growth with a decline of the fraction of individuals with redundant substructure. Declining populations, however, can be held fluctuating between certain limits by periodic phases of sub-unit repair. These results are particularly pertinent to the population dynamics of diploid (polyploid) organisms.
DNA Repair↗
Measurement of the transfer of the nitrogen moiety of intestinal lumen glutamic acid in man after oral ingestion of l-[15N]glutamic acid.
1. The measurement of the intestinal metabolism of the nitrogen moiety of glutamic acid has been investigated by oral ingestion of l-[15N]glutamic acid and sampling of arterialized blood. 2. Measurements have been made in six normal adults weighing an average of 72.8 kg ingesting 100 mg of l-[15N]glutamic acid after an overnight fast. 3. Measurement of the enrichment of arterial glutamic acid, glutamine and alanine was by gas chromatography-mass spectrometry. Isotopic enrichment of the amino acids was followed for 150 min after the ingestion of the amino acid. 4. Arterialized venous blood amino acid concentrations, measured by h.p.l.c., demonstrated no significant changes during the course of the experiment. 5. From the observed appearance of label in arterialized glutamic acid, alanine and glutamine, little luminal glutamic acid reaches the extracellular pool. The majority of the administered nitrogen label appears in the arterial alanine and glutamine components.
Administration, Oral↗
High-dose cytosine arabinoside as the initial treatment of poor-risk patients with acute nonlymphocytic leukemia: a Leukemia Intergroup Study.
Sixty-seven patients with newly diagnosed acute nonlymphocytic leukemia (ANLL) who were considered to be poor candidates for treatment with cytosine arabinoside (ara-C)/anthracycline antibiotic therapy were treated with high-dose ara-C (HDara-C) remission induction therapy. Thirty-four of the 67 patients had a hematologic disorder before developing acute leukemia or had a history of exposure to marrow toxins, 23 patients were greater than 70 years old, and 10 patients had medical problems that were felt to be a contraindication to therapy with an anthracycline antibiotic. Forty-two percent of patients entered complete remission (CR), whereas 22% failed to enter remission because of persistent leukemia. Treatment was associated with substantial toxicity varying from nausea and vomiting to irreversible cerebellar toxicity. Thirty-four percent of patients died during therapy. Poor performance status, a low serum albumin, and a low platelet count were associated with death during remission induction therapy, whereas a high pretherapy leukemic cell mass and a large number of residual leukemic cells in the marrow after six days of therapy were associated with treatment failure due to persistent leukemia.
Acute Disease↗
High-dose cytosine arabinoside in the treatment of preleukemic disorders: a leukemia intergroup study.
Fifteen patients with myelodysplastic/myeloproliferative disorders were treated with high-dose cytosine arabinoside therapy. While severe toxicity was produced in every patient, only two of the 15 patients entered complete remission and two achieved partial remission status. The therapeutic responses were confined to patients who had severe myelofibrosis of apparently recent onset.
Adult↗
Treatment of patients with acute nonlymphocytic leukemia in relapse: a Leukemia Intergroup study.
Forty patients with acute nonlymphocytic leukemia (ANLL) in first relapse were treated at eight member institutions of the Leukemia Intergroup with a 10-day continuous intravenous infusion of cytosine arabinoside and an anthracycline antibiotic administered on days 1, 2, and 3. Twenty of the 40 patients achieved a complete response. Seven of the patients who did not enter remission were drug-resistant failures, while 13 patients failed to enter remission for reasons other than persistent leukemia. Pretreatment parameters such as age, presence of infection, platelet count, and liver function tests were important predictors of survival. The percent bone marrow cellularity, the percent circulating abnormal (leukemic) cells, and the height of the white blood cell count prior to treatment were helpful in distinguishing patients who would enter remission from those who would not enter remission because of persistent leukemia.
Adolescent↗
The mechanical properties of proteins determine the laws of evolutionary change.
The general inorganic nature of traditional selection theory (based on differential growth between any two systems) is pointed out, wherefrom it follows that this theory cannot provide explanations for the characteristics of organic evolution. Specific biophysical aspects enter with the complexity of macro-molecules: vital physical conditions for the perpetuation of the system, irrevocable extinction (= death) and random change leading to novelty, are the result of 'complexity per se'. Further biophysical properties are a direct function of the pathway along which random mutation in nucleic acids is converted into continuous protein - (specifically enzyme) - function, from there into organismic phenotype with fitness components which may, or may not, correspond to identifiable structural units in DNA. The general machine-like properties of enzymes, in that there is no additive relationship between structural (amino acid) composition and functional output, is discussed in more detail. The continuous growth functions of molecular concentrations, directed by enzyme turnover, determine simple laws of growth and morphogenesis in the organic hierarchy and thus of phenotype. Thus, the combined effect of DNA-structure and of environmental parameters (temperature, pressure, pH, etc.) on protein function determines ultimately the actual phenotype and hence, quality and intensity of genotypic selection.
Amino Acids↗
The value of adding impedance plethysmography to 125I-fibrinogen leg scanning for the detection of deep vein thrombosis in high risk surgical patients: a comparative study between patients undergoing general surgery and hip surgery.
Explore the source record for details and available documents.
Adult↗
The "triple jump" exercise--a structured measure of problem solving and self directed learning.
Explore the source record for details and available documents.
Diagnosis↗
The evolution of sexual reproduction as a repair mechanism. Part I. A model for self-repair and its biological implications.
The theory is presented that the sexual process is a repair mechanism which maintains redundancy within the sub-structure of hierarchical, self-reproducing organisms. In order to keep the problems within mathematically tractable limits (see Part II), a simple model is introduced: a wheel with 6 spokes, 3 of them vital and 3 redundant, symbolizes the individual (cell or organism). Random accidents destroy spokes; the wheels replicate at regular cycles and engage periodically in pairing and repair phases during which missing spokes are copy-reproduced along the intact spokes of the partner wheel. The hierarchical structure of such a system is analysed and an 'autonomous unit' is defined: this is the unit of minimal hierarchical complexity which is capable of perpetuating autonomously all higher and all lower levels of the hierarchy; this is the central unit of selection. Four basic, physical parameters are isolated which determine the essential features of any eucaryotic life cycle: 1. The number of levels of the hierarchy (unicellular, multicellular, colonial, etc.); 2. the relation between the phases of replication (asexual generations) and repair (sexual generations); 3. the duration of potential repair (haplo-diplo-phase); 4. the position of the sexual partners within the hierarchy (selfing, monecy, dioecy, reproductive individuals within colonies, etc.). The evaluation of fitness components is considered in relation to trends of reproductive patterns in evolution.
Animals↗
The evolution of sexual reproduction as a repair mechanism. Part II. Mathematical treatment of the wheel model and its significance for real systems.
The dynamics of populations of self-replicating, hierarchically structured individuals, exposed to accidents which destroy their sub-units, is analyzed mathematically, specifically with regard to the roles of redundancy and sexual repair. The following points emerge from this analysis: 1. A population of individuals with redundant sub-structure has no intrinsic steady-state point; it tends to either zero or infinity depending on a critical accident rate alpha c. 2. Increased redundancy renders populations less accident prone initially, but population decline is steeper if alpha is greater than a fixed value alpha d. 3. Periodic, sexual repair at system-specific intervals prevents continuous decline and stabilizes the population insofar as it will now oscillate between two fixed population levels. 4. The stabilizing sexual interval increases with increased complexity provided this is accompanied by appropriate levels of redundancy. 5. The model closely simulates the dynamics of heterosis effects. 6. Repair fitness is a population fitness: the chance of an individual being repaired is a function of the statistical make-up of the population as a whole at the particular period. Populations living at alpha greater than alpha c either engage in sexual repair at the appropriate time or they die out. 7. The mathematical properties of the model illustrate mechanisms which possibly played a role in the evolution of a mortal soma in relation to sexual reproduction.
Animals↗
Impedance plethysmography: the relationship between venous filling and sensitivity and specificity for proximal vein thrombosis.
We investigated the hypothesis that the diagnostic accuracy of impedance plethysmography (IPG) for thrombosis of the popliteal or more proximal veins increases with enhanced venous filling. Venous filling was increased by prolonging cuff occlusion and by sequential testing. IPG and vengography were performed on 169 legs with and 317 legs without proximal vein thrombosis. The sensitivity and specificity of IPG rose significantly with increased venous filling. Changes in venous filling were associated with corresponding changes in emptying in normal legs, but not those with proximal vein thrombosis, so that the regression lines relating venous filling and emptying in normal and abnormal legs diverged significantly (P less than 0.001). If the IPG sequence had been terminated after only a single 45 second occlusion time test, sensitivity would have deteriorated by 10% and specificity by 20%. These observations indicate that the accuracy of IPG can be significantly enhanced if optimal venous filling is obtained.
Evaluation Studies as Topic↗
Combined use of leg scanning and impedance plethysmography in suspected venous thrombosis. An alternative to venography.
Venography is the standard method for the diagnosis of venous thrombosis but is invasive and may cause discomfort. We evaluated the combination of impedance plethysmography and 125I-fibrinogen leg scanning as an alternative to venography in 200 symptomatic patients. One or both of these less invasive tests was positive in 81 of 86 patients with positive venograms (sensitivity of 94 per cent) and both were negative in 104 of 114 patients with negative venograms (specificity of 91 per cent). These two tests detected all 60 patients with popliteal or more proximal venous thrombosis and 21 of 26 patients with calf-vein thrombosis. In addition, this approach detected 21 of 22 patients with calf-vein thrombosis with symptoms for eight days or less. These results suggest that the combination of these two less invasive tests can be used as an alternative to venography in selected patients with clinically suspected venous thrombosis.
Adolescent↗
Maxwell's demon in biological systems.
Boltzmann's gas model representing the second law of thermodynamics is based on the improbability of certain molecular distributions in space. Maxwell argued that a hypothetical 'being' with the faculty of seeing individual molecules (Maxwell's Demon) could bring about such improbable distributions, thus violating the law of entropy. However, it appears that to render the molecules visible for any observer would increase the entropy more than the demon could decrease it, hence 'Maxwell's Demon cannot operate' (Brillouin, 1951). In the study presented here Maxwell's Demon is interpreted in a general way as a biological observer system within (possibly closed) systems which can upset thermodynamic probabilities provided that the relative magnitudes between observer system and observed system are appropriate. Maxwell's Demon within Boltzmann's Gas Model thus appears only as a special case of inappropriate, relative magnitude between the two systems.
Biophysical Phenomena↗
The evolution of the cooperative group.
A simple model, illustrating the transition from a population of free swimming, solitary cells (Chlamydomonas-type) to one consisting of small colonies (Gonium-type) serves as a basis to discuss the evolution of the cooperative group. The transition is the result of a mutation of the dynamics of cell division, delayed cell separation leads to colonies of four cells. With this mutation cooperative features appear, such as synchronised cell divisions within colonies and coordinated flagellar function which enables the colony to swim in definite directions. The selective advantages under given, environmental conditions are defined and the periods necessary for complete allelic replacement in small populations are calculated for asexual and sexual reproduction. The assumption of a steady-state population during allelic substitution is critically considered, particularly under conditions of competition. It is shown that density-dependent population control must operate in the process of selection, Sexual reproduction slows down the rate of selection even though all cells are haploid. This phenomenon can be explained in general terms of "organizational dominance', where individual units coordinate the function of their neighbours which may be of a different allelotype. Cooperativity is pointed out as an a priori systemic feature which resides in the sub-units of systems, group formation and coordination appears thus as an almost inevitable event. A particular type of system described as 'closed cycle of positive fitness interaction' is discussed in more detail. It has the remarkable feature that its members cannot compete with each other; selection takes place between whole cycles (in analogy to Eigen's 1971 model). Gonium has a wide spectrum of 'somatic plasticity' which enables it to assume various colonial configurations depending on physiological and environmental conditions. This feature can be explained as the result of dynamic flexibilities on the macro-molecular level. The particular relationship between the vast, molecular complexity and the relative simple dynamics of the cell cycle must lead eventually to the genetic fixation of an environmentally induced phenotype.
Animals↗
Impedance plethysmography using the occlusive cuff technique in the diagnosis of venous thrombosis.
Impedance plethysmography using the cuff technique has been compared with venography in 346 consecutive patients with suspected venous thromboembolism. The limbs were classified according to the venographic results as no thrombosis, proximal (popliteal, femoral, or iliac) vein thrombosis, and calf thrombosis. A discriminant analysis was performed. The impedance plethysmographic result was normal in 386 of 397 limbs which were normal on venography, a specificity of 97%, and abnormal in 124 of 133 limbs which showed proximal vein thrombosis, a sensitivity of 93%. Seventy-three of 88 limbs with calf vein thrombi and a normal impedance plethysmographic result. The sensitivity in 29 limbs with asymptomatic proximal vein thrombosis was 83%. Impedance plethysmography is an accurate method for detecting proximal vein thrombosis but has limitations which include the possibility of false positive results due to arterial insufficiency and muscle tension.
Adolescent↗