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Biomedical subjects

J Bowie

Publications and source records attributed to J Bowie.

At least 19 recordsLinked to original sources
PubMed1995

Postoperative pain control with a new transdermal fentanyl delivery system. A multicenter trial.

BACKGROUND: A new transdermal delivery system for fentanyl is available in two strengths: 70-80 and 90-100 micrograms.kg-1.h-1 (40- and 60-cm2 patches, respectively). Their short onset and 24-h drug delivery make them attractive for postoperative pain control. METHODS: Both doses of the new transdermal fentanyl patches were evaluated for the relief of postoperative pain in 143 patients after gynecologic exploratory laparotomy. The study was conducted at four centers using a prospective, randomized, placebo-controlled, double-blind format. Patients were randomly assigned to one of three study groups: group 1 patients received two placebo patches: group 2 patients received a 40-cm2 fentanyl patch and a 60-cm2 placebo patch; and group 3 patients received a 60-cm2 fentanyl patch and a 40-cm2 placebo patch. Patient-controlled morphine use and pain, sedation, and comfort scores were assessed postoperatively every 4 h for 36 h after patch placement. RESULTS: Patients' assessment of their analgesia was significantly (P < or = 0.05) better in group 2 at 16 and 24 h and in group 3 at 8, 12, 16, 20, and 24 h postoperatively, compared with the patients in group 1. Patients in groups 2 and 3 required less supplemental morphine to maintain satisfactory analgesia than did the patients in group 1. Patients in groups 2 and 3 had greater incidences of pruritus, erythema, and respiratory depression than did those receiving placebo. CONCLUSIONS: Concern exists regarding the side effects of this this new transdermal fentanyl patch. Therefore, this new patch will need further research before it can be recommended as an adjunct in controlling postoperative pain.

Administration, Cutaneous↗
PubMed1990

Clinical significance of ultrasonographically detected coincidental gallstones.

The clinical profiles of 139 patients with gallstones found coincidentally during ultrasonography were reviewed and the patients followed prospectively for five years. Indications for ultrasonography included follow-up of abdominal malignancy (33%), evaluation of abdominal aortic aneurysm or other arteriosclerotic vascular disease (22%), renal insufficiency (12%), and lower abdominal pain (7%). At the time of gallstone detection, 14 patients (10%) had symptoms attributable to cholelithiasis. Over the next five years, only 15 patients (11%) developed episodes resembling biliary pain. Nine patients underwent cholecystectomy during this period. Three of the cholecystectomies were incidental to other abdominal procedures. Two cholecystectomies were performed as emergencies for gallstone complications with no perioperative mortality. Interestingly, 54 patients (40%) with coincidental gallstones died during the follow-up period. All the deaths were unrelated to gallstones. These data indicate that ultrasonographically detected coincidental gallstones rarely have clinical significance, leading strong support to the expectant management of most patients with purely coincidental gallstones.

Age Factors↗
PubMed1990

Low plasma iron status and akathisia.

Thirty patients were examined to test the hypothesis that a depletion of iron levels is associated with symptoms of akathisia. Fifteen akathisic patients were pair-matched with 15 non-akathisic patients. Plasma ferritin levels were significantly decreased in the akathisic patients, and there was a significant inverse correlation between plasma iron levels and akathisia rating. In addition, akathisia ratings were found to be correlated with a scale measuring symptoms of tardive dyskinesia.

Adult↗
PubMed1987

Polypeptide sequences essential for RNA recognition by an enzyme.

Many RNAs are complex, globular molecules formed from elements of secondary and tertiary structure analogous to those found in proteins. Little is known about recognition of RNAs by proteins. In the case of transfer RNAs (tRNAs), considerable evidence suggests that elements dispersed in both the one- and three-dimensional structure are important for recognition by aminoacyl tRNA synthetases. Fragments of alanine tRNA synthetase were created by in vitro manipulations of the cloned alaS gene and examined for their interaction with alanine-specific tRNA. Sequences essential for recognition were located near the middle of the polypeptide, juxtaposed to the carboxyl-terminal side of the domain for aminoacyl adenylate synthesis. The most essential part of the tRNA interaction strength and specificity was dependent on a sequence of fewer than 100 amino acids. Within this sequence, and in the context of the proper conformation, a segment of no more than 17 amino acids was responsible for 25% or more of the total synthetase-tRNA free energy of association. The results raise the possibility that an important part of specific RNA recognition by an aminoacyl tRNA synthetase involves a polypeptide segment that is short relative to the total size of the protein.

Adenosine Triphosphate↗
PubMed1984

Bovine alpha- and beta-thrombin. Reduced fibrinogen-clotting activity of beta-thrombin is not a consequence of reduced affinity for fibrinogen.

beta-Thrombin, a product of the limited proteolysis of alpha-thrombin, is characterized by greatly reduced fibrinogen-clotting activity as compared to alpha-thrombin but with unchanged activity toward ester substrates. The present study was designed to elucidate the basis for the changes in the catalytic activity resulting from the conversion of bovine alpha-thrombin to bovine beta-thrombin. Fibrinogen was utilized as a competitive inhibitor in the hydrolysis of a peptide nitroanilide substrate by bovine alpha- and beta-thrombin. The Ki values obtained for fibrinogen in these experiments were similar for alpha- and beta-thrombin (about 10 microM). Similar values for Ki were obtained when fibrinogen was used to inhibit the inactivation of bovine alpha- and beta-thrombin by diisopropylphosphorofluoridate. These experiments suggested that the conversion of bovine alpha- to beta-thrombin does not affect the fibrinogen-binding site on thrombin. Differences in the reactivity of functional groups at the active site were then explored. beta-Thrombin was observed to undergo modification at the active site histidine at a slower rate than that of alpha-thrombin when reacted with either tosyllysyl chloromethyl ketone or diethyl pyrocarbonate. It is suggested that the difference in the fibrinogen-clotting activity of these two forms of thrombin can result from changes in the reactivity of the active site histidine residue.

Affinity Labels↗
PubMed1982

Review. In utero sonographic diagnosis of fetal cerebral anomalies.

Obstetric sonography can be used to diagnose anomalies in the fetal brain. Cystic masses in the fetal brain may be due to hydrocephalus, hydranencephaly, holoprosencephaly, or arachnoid cysts. The relations of the falx cerebrum, ventricular system, and cerebral convexities are essential in distinguishing among these anomalies. Anencephaly and encephaloceles can also be detected by sonography. A review of the literature and experience with 10 cases is discussed.

Anencephaly↗
PubMed1981

Sudden death from occlusive disease of the atrioventricular node artery.

Non-atherosclerotic focal occlusive disease of the atrioventricular node artery was the only significant pathological lesion found at autopsy in 2 individuals aged 40 and 17 yr who died suddenly and unexpectedly. The cases were observed amongst 115 autopsies categorized as sudden cardiac death and performed during an 18 mth period. Occlusive disease of the atrioventricular node artery is a poorly documented entity of unknown aetiology and pathogenesis. We believe it is a more frequent pathological finding in sudden cardiac death than has been previously recognized and that it deserves more attention than it currently receives.

Adolescent↗
PubMed1980

Computer software.

While many nurses are aware that the term "software" denotes the programs of instructions by which the computer operates, most of us could probably benefit by knowing more about software basics--what constitutes a program, what constitutes a system, what distinguishes various types of systems, and levels of computer language, and so forth. Few of us are familiar with the types of computer languages in use today. Fewer still realize that the type of language used to program a system has a significant effect on the resources needed to develop and maintain application programs; that specific languages are best used for specific types of applications; or that the amount of flexibility inherent in a specific system depends largely on the language used to program it. This article attempts to inform nurses at the decision-making level about the characteristics of computer software and their implications as criteria for selecting software systems that perform the required functions as efficiently and economically as possible.

Computers↗
PubMed1979

Value of new diagnostic aids in relation to the disease process in pancreatic cancer.

An assessment was made of the diagnostic value of six tests done on 28 patients who proved to have resectable and 45 patients who had non-resectable pancreatic cancer. Ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP) were the most sensitive tests for the diagnosis of resectable tumours. Ultrasonography was slightly, and cytology definitely, better for the diagnosis of resectable tumours than for the diagnosis of non-resectable tumours. Computerised tomography, angiography, and scintigraphy were not effective means of diagnosing resectable tumours. The differences in diagnostic sensitivities of the tests for resectable and non-resectable disease are probably due to variations in pathological features which influence not only the stage of presentation, but also the detectability of the tumour. As long as investigation is limited to patients with symptoms, a large proportion of tumours will not be diagnosed at a resectable stage. However, the results of this study suggest that the resectability rate may be maximised by the early use of ultrasonography in patients with symptoms suggesting cancer in the region of the head of the pancreas, and in patients with vague, non-specific complaints. A combination of ERCP and direct ductal aspiration for cytology is the best means of diagnosing resectable tumours.

Angiography↗
PubMed1979

Ultrasonography and tumor-associated antigens. The concept of combining noninvasive tests in the screening for pancreatic cancer.

A total of 134 patients suspected of having pancreatic cancer were given preoperative ultrasonic examinations. A total of 54 cases had a final diagnosis of pancreatic cancer histologically confirmed. The diagnostic sensitivity and specificity of the ultrasonographies were 76% and 91% or 87% and 74%, depending on whether doubtful results were called abnormal or normal. "Doubtful" results were defined as those that stated that pancreatic cancer was "possible" or "could not be excluded." When these results were divided into abnormal and normal groups on the basis of the patients' preoperative serum carcinoembryonic antigen and pancreatic oncofetal antigen levels, the sensitivity and specificity of the combined tests may prove to be a more accurate means of screening patients for pancreatic cancer than ultrasonography alone.

Adenocarcinoma↗
PubMed1978

Prospective evaluation of gray scale ultrasonography in the diagnosis of pancreas cancer.

One hundred thirty-four patients suspected of having pancreas cancer successfully underwent gray scale ultrasound examination of the pancreas. The prospective ultrasound findings were correlated with the final diagnoses, laparotomy findings, and pathology findings. Fifty-four patients had pancreas cancer, confirmed by resection or biopsy in all cases. On ultrasonography, the pancreas was correctly reported to have abnormalities in sixty-one of seventy-eight patients (78 per cent) and correctly reported to have no abnornalities in thirty-eight of fifty-six patients (68 per cent). A correct ultrasound diagnosis of pancreas cancer was made for forty-four of fifty-six patients (81 per cent), and there were thirteen false-positive reports. Ninety-four percent of cancers confined to the head of the pancreas and 70 per cent of cancers at other locations within the gland were detected by ultrasound examination. The correct ultrasound diagnosis was given for fifteen of seventeen patients with resectable pancreas cancer, the degree of associated pancreatitis ranging from minimal to severe. Analysis of the predictive values of positive and negative ultrasound examinations suggests that this test could be used to screen a population of patients with symptoms mildly suggestive of pancreas cancer. The importance of preselecting the level of confidence of a positive test result, a,ove which further investigation is indicated, is emphasized.

Diagnosis, Differential↗
PubMed1976

MUMPS--an economical and efficient time-sharing system for information management.

MUMPS, the Massachusetts General Hospital Utility MultiProgramming System, is a compact time-sharing system for information management. This paper discusses the historical development of MUMPS and describes the basic modules found in its implementation. Detailed descriptions of the time-sharing executive, MUMPS language interpreter, input/output file system, and global data base are given, emphasizing their integration into an easy-to-use yet powerful system for application program design, development and maintenance.

Computers↗
PubMed1976

Comparative value of four methods of investigating the pancreas.

In a prospective study for the diagnosis of pancreatic cancer, ultrasonography, radionuclide scanning, selective arteriography, and endoscopic retrograde cholangiopancreatography (ERCP) were compared. Eighty-nine consecutive patients were investigated; 58 underwent laparotomy, and 36 were found to have periampullary cancer; seven had other malignant tumors within the abdomen, and nine had pancreatitis on biopsy. Five had other benign disease, and there was one negative laparotomy. Thirty-one patients who did not have laparotomy have shown no evidence of cancer at one year follow-up. Ultrasonography was found to be more reliable than scan or arteriography in the detection and diagnosis of a mass in the pancreas. ERCP achieved the highest rate of correct definitive diagnosis.

Angiography↗