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Biomedical subjects

J Carlson

Publications and source records attributed to J Carlson.

At least 163 records · Page 9Linked to original sources
PubMed1994

Respiratory care practitioners as secondary providers of endotracheal intubation: one hospital's experience.

UNLABELLED: The management staff of the Respiratory Care Department at the suggestion of the Department of Anesthesiology determined that there was a need for respiratory care practitioners (RCPs) to be trained to perform endotracheal intubation. This need was demonstrated by the frequency with which anesthesia personnel were called away from the operating room (OR) to perform endotracheal intubations in other hospital areas. METHODS: The training program included didactic instruction followed by written examination, simulations, and intubation experience in the OR under the direct supervision of a staff anesthesiologist. RESULTS: Initially 15 therapists, from all shifts were trained. Currently, there are 20 fully-trained RCPs on staff. These therapists have successfully intubated 160 patients in 178 attempts over a 49 month period. All attempts followed failed attempts by other professionals. No major complications were observed in the patients intubated by RCPs. DISCUSSION: This training program has successfully provided support for endotracheal intubation procedures, sparing the anesthesiology staff and expanding the role of RCPs in our hospital.

Allied Health Personnel↗
PubMed1994

Performance characteristics of children using various braking resistances on the wingate anaerobic test.

This study examined the performances of children exercising against varying braking forces in short-term, all-out cycling tests. The braking force resistances were 0.04, 0.065, 0.075, and 0.08 kiloponds for every kilogram of body mass (kp.kgBM-1). Results for the peak and mean power performances in 30 s Wingate Anaerobic Tests (WAnT) were recorded for a wide age range of male and female children [6 (n = 23), 8 (n = 19), 10 (n = 19), and 12 (n = 14) years of age]. Univariate ANOVAs with repeated measures on resistance, and Newman Keuls post hoc analysis tests revealed that the absolute peak and mean power responses of the children increased incrementally with age and demonstrated very few sex differences. The overall meaned peak and mean power values of the four resistances and age groups were 161, 231, 242 and 248 Watts and 130, 183, 189, and 196 Watts, respectively. In all of the age groups the three higher resistances (0.065, 0.075, and 0.08 kp.kgBM-1) produced significantly higher peak and mean power performances than did the 0.04 kp.kgBM-1 resistance. The overall meaned relative peak and mean power values of the four resistances and age groups were 4.9, 6.9, 7.4 and 7.4 W.kg-1 and 4.2, 5.2, 5.7 and 6.2 W.kg-1, respectively. Among the three higher resistances there was no one resistance which elicited a significantly more powerful performance.

Age Factors↗
PubMed1994

Analysis of lentiviral genomic variation by denaturing gradient gel electrophoresis.

Retroviruses are known for their genetic variability. In any infection, several genotypes usually exist within the host. We have used denaturing gradient gel electrophoresis to study genetic variation of ovine lentiviruses. Starting with viral DNA from cells infected in vitro, a portion of the envelope gene was amplified by PCR, and the products were analyzed by DGGE. With this technique we have been able to detect sequence variations between and within virus isolates and to show evolution of the predominant viral species upon in vivo passage.

Base Sequence↗
PubMed1994

How accurate is the pelvic examination as compared to transvaginal sonography? A prospective, comparative study.

Findings at pelvic examination in 120 patients were compared to those obtained by transvaginal sonography (TVS). Overall, 102 of 472 (22%) pelvic examination assessments did not agree with the TVS findings. Twenty-nine (36%) uterine assessments differed, while 46 (32%) ovarian assessments differed. Among 37 pelvic masses assessed in 20 cases (54%) the pelvic examination differed from the findings obtained by TVS. Only 4 (29%) cases assessed by pelvic examination were in agreement with the laparotomy findings as compared with 10 (71%) cases assessed by TVS.

Adolescent↗
PubMed1993

Invasive vulvar tumors in young women--a disease of the immunosuppressed?

Twenty-seven patients under the age of 40 years were treated for invasive vulvar cancer at the Women's Cancer Center, University of Minnesota. Seventeen patients had Stage I, five patients had Stage II, two patients had Stage III, and two patients had Stage IV disease. Twenty patients (80%) gave a history of smoking. Associated medical and immunosuppressive conditions present in these patients included vulval HPV (N = 3), diabetes mellitus (N = 3), pregnancy (N = 2), autoimmune connective tissue disease (N = 2), renal transplant (N = 2), previous chemotherapy for invasive malignancies at other sites (N = 1), chronic hepatitis (N = 1), schizophrenia (N = 1), and one patient on Imuran for herpes zoster and multiple sclerosis. Two of the nonsmokers were in this group of immunosuppressed patients. Three patients have died of intercurrent disease while another is currently alive with invasive disease. All others are alive without evidence of disease. The mean duration of follow-up is 45.2 months (range, 1-158 months). Invasive vulvar tumors are uncommon in young women. Smoking and a history of an immunosuppressive medical illness is common in this patient population.

Adult↗
PubMed1993

The molecular basis of alpha 1-antichymotrypsin deficiency in a heterozygote with liver and lung disease.

Alpha 1-antichymotrypsin (alpha 1-ACT) is a serine proteinase inhibitor (serpin) with cathepsin G, mast cell chymase and chymotrypsin as target enzymes. We present the case of a middle-aged man with low plasma levels of alpha 1-ACT, asthma with progression to emphysema, and chronic HCV positive liver disease with selective accumulation of alpha 1-ACT in hepatocytes. This secretory defect is analogous to that seen in Pi Z alpha 1-antitrypsin deficiency. The molecular basis of alpha 1-ACT deficiency in this patient has been characterized by direct sequencing of the alpha 1-ACT genes from the patient and his father. A C-->G transversion in exon III causing a 229Pro-->Ala substitution is proposed to cause a conformational change resulting in abnormal transport through the RER. This mutation was found in one of 20 additional tested patients with chronic obstructive lung disease, but in no control. Two additional polymorphisms of the gene have been identified in unrelated healthy individuals with normal plasma alpha 1-ACT levels. The alpha 1-ACT deficiency state may predispose to obstructive lung disease and influence the course of liver disease. Identification of a specific mutation allows identification of heterozygotes for this deficiency allowing future evaluation of its clinical significance.

Amino Acid Sequence↗
PubMed1993

Cytogenetic analysis of an immature teratoma of the ovary and its metastasis after chemotherapy-induced maturation.

We report a case of an immature teratoma of the ovary, grade 3, in which cytogenetic studies were performed on the primary tumor at diagnosis and on a metastasis resected 1 year after removal of the primary tumor. The patient was treated with cisplatin, bleomycin, and etoposide (VP-16) combination chemotherapy. The metastatic tumor was composed of mature teratoma with only small foci of immature tissue. Despite the different histologic appearance of the primary tumor and the metastasis, there was no detectable difference in karyotype between the primary and metastatic tumors. Both showed a pseudodicentric chromosome derived from chromosome 1 and monosomy for chromosome 4. Flow cytometry analysis of the metastatic tumor showed a diploid DNA content, in agreement with the cytogenetic findings. From this case it would appear that chemotherapy-induced maturation of metastatic immature ovarian teratoma is not associated with regression of the malignant karyotype or selection of a karyotypically distinct population of tumor cells.

Adolescent↗
PubMed1993

Persistent postmolar gestational trophoblastic disease: use of transvaginal sonography and colour flow Doppler.

Invasive moles have been difficult to diagnose except at hysterectomy. Many patients with persistent gestational trophoblastic disease (GTD) have been treated without ever demonstrating the site of the persistent trophoblastic focus. High resolution transvaginal sonography (TVS) has provided a technique of demonstrating very small uterine lesions, previously unsuspected by transabdominal sonography. The addition of colour flow Doppler further increased diagnostic sensitivity and provides another means of monitoring response to therapy. Three patients with persistent GTD, scanned by TVS and CFD (colour flow Doppler) performed as part of their metastatic work-up are presented. The only abnormalities detected were foci demonstrated within the myometrium that demonstrated increased flow on CFD. Single agent chemotherapy was commenced and the patients were monitored periodically through their course with repeat ultrasonography. After an initial lag period, the lesions decreased in size as the beta-HCG titres fell. An unsuspected adnexal mass was diagnosed on 1 patient, later proving to be a mature ovarian teratoma.

Adult↗
PubMed1993

Effect of estradiol on the temporal pattern of exercise-induced tissue glycogen depletion in male rats.

The effect of 17 beta-estradiol 3-benzoate (10 micrograms.01 ml of sunflower oil-1 x 100 g body wt-1) on the temporal pattern of exercise-induced tissue glycogen depletion and tissue lipid availability during submaximal treadmill running was determined in male rats. Animal were administered estradiol or oil for 5 days and were then time matched for motorized treadmill running for 30, 60, 90, or 120 min. Significant depletion of liver, soleus muscle, and red and white vastus lateralis muscle tissue glycogen occurred in oil-administered animals run between 30 and 120 min. The greatest extent of tissue glycogen depletion occurred during the first 30 min of exercise with the rate of glycogen depletion slowing between 30 and 120 min of exercise. Administration of estradiol attenuated the temporal pattern of glycogen depletion in both liver and muscle tissues. Significant depletion of red and white vastus glycogen of estradiol-administered animals did not occur until 90 and 120 min of exercise, respectively. Administration of estradiol significantly increased resting plasma free fatty acids and red and white vastus triacylglycerol content. These data indicate that estradiol administration for 5 days resulted in significant glycogen sparing of liver and muscle tissues during submaximal treadmill running for up to 120 min by altering the temporal pattern of glycogen depletion of male rats secondary to an estradiol-mediated increase in availability of lipid substrate during exercise.

Animals↗
PubMed1993

An international comparison of case definition of severe adverse cutaneous reactions to medicines.

There is substantial intercountry variation in the proportion of cases of toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) which are attributed to specific drugs. This study was undertaken to determine whether these differences might reflect biases in diagnosis of these conditions. A total of 138 reactions in 5 countries originally diagnosed as TEN or SJS were coded on to standardised forms. A single observer blind to the original diagnosis assessed each case according to specified criteria. This observer's diagnoses were compared with the original diagnoses. Overall, 111 of the 138 cases had information adequate for assessment. The blinded observer agreed with the diagnosis for 61% of cases where the original diagnosis was TEN and 58% of cases where the original diagnosis was SJS. There was no significant difference in rates of agreement when reactions attributed to sulphonamide antibiotics were compared with reactions attributed to other drugs. There were substantial and significant differences in percentage agreement between the blinded observer's diagnosis and the original diagnoses between countries. The lowest rates of agreement between the blinded observer and the original reports occurred in the US. Our results illustrate the difficulty in comparing reaction rates based on spontaneous reports between countries where the systems for gathering such reports vary. This illustrates the need for a minimum quantity of standard data and precise definitions of reactions if spontaneous reports of adverse reactions are to provide useful information about severe adverse skin reactions associated with drugs.

Adolescent↗
PubMed1993

The effects of hemoglobin genotype and ABO blood group on the formation of rosettes by Plasmodium falciparum-infected red blood cells.

The mechanisms by which the hemoglobin genotype AS protect against severe malaria are not fully understood. We have investigated the possibility that protection might be achieved through an inability of red blood cells (RBC) with the AS genotype to form rosettes with RBC infected by Plasmodium falciparum. No evidence was obtained to support this hypothesis because RBC with the AS genotype formed rosettes with wild isolates of P. falciparum as readily as RBC with the AA genotype. However, the previous finding that parasitized RBC form rosettes more readily with RBC belonging to group A or B than with RBC belonging to group O was confirmed even in fresh clinical isolates.

ABO Blood-Group System↗
PubMed1993

Transvaginal color flow Doppler sonography in the assessment of gestational trophoblastic disease.

The aim of this study was to evaluate the blood flow characteristics of the uterine artery and intratumoral vessels in patients with GTD. Twelve patients with GTD were evaluated with TVS, and 11 also had CFD sonography performed. Spectral analysis of both uterine artery and samples intratumoral and intramyometrial vessels revealed systolic frequencies and PI that were significantly higher in the uterine artery than in sampled intratumoral vessels (P < 0.05). Uterine artery PI correlated significantly with age (P = 0.043), uterine size (P = 0.003), and beta-HCG titer (P = 0.03). Intratumoral PI correlated significantly with uterine size (P = 0.05). Intratumoral PI did not correlate with patient age, the shape or orientation of the uterus, presence or absence of subendometrial halo, endometrial thickness or echogenicity, or impression of myometrial invasion. Regression analysis of beta-HCG titers on uterine artery and intratumoral PI revealed a linear association. TVS and color flow Doppler sonography are useful in the assessment of patients with GTD. The PI is strongly associated with prognosis and correlates with beta-HCG titers.

Adult↗
PubMed1993

Molecular genetics of Drosophila olfaction.

The functional organization of the Drosophila olfactory system has been studied using two complementary approaches. (1) A genetic screen has yielded olfactory mutants, of which one, acj6, shows greatly reduced electrical responses of its olfactory organs to all odorants tested except benzaldehyde (odour of almond). This mutant is also defective in olfactory behaviour at the larval stage. It is normal in tests of visual system physiology and behaviour. We aim to determine whether the acj6 gene is expressed on a fraction of the antennal surface. (2) We have carried out an enhancer trap screen for olfactory genes which are expressed on regions of the antennal surface. From a screen of 6400 enhancer trap lines, 12 show expression of a lacZ reporter gene in both larval and adult olfactory organs, but relatively little expression elsewhere. Most lines identify regions of the adult antenna and some show labelling of very small numbers of cells. One line shows sexual dimorphism in its expression pattern and another pattern becomes increasingly restricted with adult age. Several lines also show staining of other chemosensory organs and one also shows staining in the male reproductive tract. We have generated deletions of DNA flanking these enhancer trap insertions to determine whether any of the lines define genes associated with responses to specific sets of odorants.

Animals↗
PubMed1993

Europium-labeled oligonucleotides to detect point mutations: application to PIZ alpha 1-antitrypsin deficiency.

We describe a novel assay for detection of point mutations. The method combines the specificity and sensitivity of the polymerase chain reaction (PCR) and allele-specific oligonucleotides (ASO) with highly sensitive time-resolved fluorometry. ASO probes differing by a single base substitution and labeled with europium (Eu) chelates were hybridized in solution simultaneously with a biotinylated oligomer to a PCR-amplified nucleic acid fragment. The hybrids formed were then collected onto streptavidin-coated microtitration wells. Subsequently, the hybrids were washed under stringent conditions and the remaining ASO probe was measured in a time-resolved fluorometer. We discuss the strategy underlying the design of the Eu-labeled ASO probes for the solution hybridization assay. The method was applied to the detection of the Z-mutation in the alpha 1-antitrypsin gene. Evaluation of whole-blood samples spotted on Guthrie cards demonstrated successful accuracy of the method.

Base Sequence↗
PubMed1993

Borderline and invasive epithelial ovarian tumors in young women.

OBJECTIVE: To review the occurrence, morbidity, and mortality of borderline and invasive epithelial ovarian tumors in young women. METHODS: We conducted a 15-year retrospective review of the case records of the Women's Cancer Center, University of Minnesota, and the JL McKelvey Tumor Registry. RESULTS: We identified 67 patients under age 40 with borderline or invasive epithelial ovarian tumors. Fifty patients (75%) had borderline tumors and 17 (25%) had invasive tumors. The mean age at presentation was 31 years (range 14-39) for the borderline group and 34 years (range 23-39) for the invasive group. Pelvic pain and a palpable mass, present for less than 6 months, were the predominant presenting symptom and sign. There was no difference in the age at menarche between the patients with borderline (mean 12 years) and invasive tumors (mean 13 years). Fifty-seven patients were optimally cytoreduced to less than 2.0 cm after primary surgery. Thirty-five patients underwent second-look laparotomy, 15 of which were positive for tumor. A minority of patients in both groups had stage I tumors (17 in the borderline and one in the invasive group). Among patients with borderline tumors, there was no difference between "very young" and "young" patients in the stage at presentation or outcome. Similar proportions of patients presented with early- and late-stage disease. Three very young women (14%) and five young women (17%) have died. Among patients with invasive tumors, no difference existed between young and very young patients for stage at presentation, whereas grade and outcome differed significantly between the age groups (P < .05). Very young patients were more likely to present with grade 1 lesions, whereas patients aged 30-40 years were more likely to have grade 2 or 3 tumors (P < .05). Three (100%) of the very young patients have died, whereas seven (50%) of the young patients aged 30-40 years have died. The median survival of patients with borderline tumors was 36 months (range 2.0-150.5), significantly different from those with invasive tumors, whose median survival was 21 months (range 2.9-89.7) (P < .001). CONCLUSION: Borderline and invasive epithelial ovarian tumors are encountered in young women. Despite the implication of the term "borderline," such tumors are associated with considerable morbidity and mortality.

Adolescent↗