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Biomedical subjects

J Daniel

Publications and source records attributed to J Daniel.

104 records · Page 6Linked to original sources
PubMed1976

Labetalol in resistant hypertension.

1 The efficacy of labetalol in lowering blood pressure has been assessed in a group of 16 patients with severe hypertension whose blood pressure was inadequately controlled (supine diastolic blood pressure greater than 110 mmHg on two consecutive occasions) on existing therapy or in whom severe side-effects necessitated a change in therapy. 2 All patients had an original pretreatment supine diastolic blood pressure of greater than 120 mmHg and most had evidence of target organ damage. Patients were hospitalized for the purposes of changeover of therapy, labetalol being added to the existing regime which was reduced stepwise and eventually withdrawn. 3 Treatment with labetalol resulted in satisfactory blood pressure control in 10 of 16 patients in this study but high doses were required, the mean daily dose being 3,091 mg (range 1,200-8,000). 4 Treatment with discontinued in 6 patients on account of postural hypotension (3), failure to control supine diastolic blood pressure (2) and retention of urine (1). Long-term treatment was relatively free from side-effects. 5 From preliminary studies in animals it is suggested that an action within the central nervous system may contribute to the hypotensive effect of labetalol.

Adult↗
PubMed1975

Mutants of Escherichia coli K12 unable to grow on non-fermentable carbon substrates.

Among a number of mutants unable to utilize non-fermentable carbon substrates, scoring for membrane ATPase and for ATP-driven transhydrogenase activity permitted to distinguish two phenotypes: (A) mutants lacking ATPase and ATP-driven transhydrogenase; (B) one mutant with an ATPase which behaved according to several criteria as released into solution instead of being membrane bound, a.o it exhibited no ATP-driven transhydrogenase activity. All A and B mutants exhibited a common nutritional pattern. The ATPase-deficient group, when scored for ATPase-binding sites on its membrane particles revealed three different subgroups: (1) mutants having free ATPase-binding sites, (2) mutants with ATPase-binding sites made available by the procedure which releases ATPase from wild-type membrane, and (3) mutants with no detectable ATPase-binding sites. Membranes of the mutant B with unbound ATPase also exhibited a deficiency in ATPase-binding sites, but its soluble ATPase was also found unable to bind to ATPase-binding sites of wild type membranes. The double alteration, namely abnormal or inactive ATPase and absence of ATPase-binding sites on the membrane is compatible with a single mutational defect.

Adenosine Triphosphatases↗
PubMedDate not supplied

Synthesis and nca-radioiodination of arylstannyl-cobalamin conjugates. Evaluation of aryliodo-cobalamin conjugate binding to transcobalamin II and biodistribution in mice.

A new method of preparing radiolabeled cobalamin derivatives has been developed. The method involves the use of cobalamin-tri-n-butylstannyl hippurate conjugates as intermediates to obtain radioiodinated cobalamin-iodohippurate conjugates. The arylstannyl functionality was used as an exchangeable group to obtain high specific activity radioiodinations and to circumvent some deleterious side reactions common to cobalamins under electrophilic iodination conditions. The first step in the synthesis of tri-n--butylstannyl hippurate conjugates was to obtain free carboxylate groups on the cobalamin moiety. This was accomplished by mild acid hydrolysis of the b-, d-, or e-propionamide side chains on the corrin ring, followed by careful separation of the isomeric products. The second step was to couple a linking molecule (diaminododecane) to the carboxylate. The final step was to conjugate p-tri-n-butylstannyl hippurate to the cobalamin-diaminododecane adduct. All three isomeric cobalamin-p-tri-n-butylstannyl hippurate conjugates were prepared, as were the corresponding cobalamin-p-iodohippurate conjugates (HPLC standards). Radioiodination reactions were conducted with N-chlorosuccinimide and Na[*I]I in Me OH using conditions previously developed for arylstannylations. However, unlike the previous reactions, a key factor in obtaining the desired radioiodinated cobalamins was that the reaction be conducted under neutral conditions. Isolated yields of 40-65% were obtained for all three cobalamin isomers. Specific activities of 10-33% theoretical were obtained for the radioiodinated cobalamins. Evaluation of competitive binding of (nonradioactive) cobalamin-iodohippurate conjugates with recombinant human transcobalamin II showed that the e-isomer bound nearly as well as [57Co]cyanocobalamin (50%), whereas the b-isomer had decreased binding (6%) and the d-isomer was significantly decreased in its binding (0.7%). Two biodistributions of the radioiodinated e-isomer were conducted in athymic mice. One biodistribution investigated tissue localization in mice bearing a renal cell carcinoma xenograft, and the other biodistribution investigated tissue localization when the radioiodinated cyanocobalamin was mixed with 1% BSA prior to injection. A comparison of the results of the two biodistributions and a discussion of how they relate to previous [57/60Co]cyanocobalamin biodistributions are provided.

Animals↗
PubMedDate not supplied

Copper in drinking water, Nebraska, 1994.

In 1993, the levels of copper (Cu) in much of Nebraska's drinking water exceeded the U.S. Environmental Protection Agency's (EPA) action level of 1.3 mg/L. To determine the association of copper with gastrointestinal (GI) illness in August 1994 the authors interviewed persons living in households with 1993 Cu levels > 3 mg/L (51 households), 2-3 mg/L (54 households), and < 1.3 mg/L (43 households). Cases were defined as persons who had experienced the rapid onset of vomiting or nausea with abdominal pain during the preceding two weeks. To validate their exposure index, the authors immediately resampled drinking water in the households of 25 cases and 27 controls matched for age. Reassessment in December 1994 of the exposure and case status of the original cohort showed no association between copper in drinking water in 1993 and case status in 1994. The risk of GI illness seemed no greater with Cu > 3 mg/L (RR = 1.03; 95% CI = 0.43, 2.49) or 2-3 mg/L (RR = 0.50; 95% CI = 0.18, 1.41) than with Cu < 1.3 mg/L. The 1993 Cu concentrations could not be reproduced in August 1994; resampling in December 1994 again showed no association between GI illness and Cu exposure (RR > 1.3-2.9 mg/L, < or = 1.3 mg/L = 0.25, 95% CI = 0.10, 0.64, and RR > or = 3.0 mg/L, < or = 1.3 mg/L = 0.36, 95% CI = 0.09, 1.49).

Case-Control Studies↗
PubMedDate not supplied

Closed-system technique for implantation of iris-supported negative-power intraocular lens.

BACKGROUND: The iris-supported claw lens can reversibly correct a wide range of ametropia and aniseikonia with excellent predictability and stability. However, concerns regarding its potential harm to the corneal endothelium have prevented its widespread use. Our experience with the closed-system surgical technique and the spreader device used in 180 cases between 1987 and 1993 has led us to conclude that potential complications are more likely due to the technique of implantation rather than to the properties of the lens itself. METHOD: We conducted a prospective study of 35 eyes of 20 consecutive patients (mean age, 38 years; range, 21 to 55 years) operated on between August 1993 and August 1994. Preoperative spherical equivalent refractions ranged from -6.00 to -21.25 diopters (D) (mean, -12.50 D). Follow up was 6 months (86% of eyes) to 1 year (57% of eyes). Spectacle-corrected visual acuity and endothelial cell density were measured prior to, and 1, 6, and 12 months following lens implantation. All data were analyzed using the paired t-test. RESULTS: Mean endothelial cell density dropped insignificantly (p > .10):by 1.22% at 1 month (n = 34), by 2.25% at 6 months (n = 27), and by 1.21% at 12 months (n = 18). Spectacle-corrected visual acuity increased significantly (p < .001): from a mean of 0.61 preoperatively to 0.77 at 1 month, 0.84 at 6 months, and 0.93 at 12 months postoperatively. At 12 months, 15 eyes (75%) had a refraction within +/-0.50 D, 19 eyes (95%) within +/-1.00 D, and 20 eyes (100%) within +/-2.00 D of emmetropia. CONCLUSIONS: Our results suggest that the closed-system approach using the spreader device allows safe implantation of the Worst iris-supported claw lens.

Adult↗
PubMedDate not supplied

Improved technique of circular keratotomy for the correction of corneal astigmatism.

BACKGROUND: Based on Gauss' law governing the comparison of hyperbaric pressure in the eye and atmospheric pressure, the authors present a procedure to correct astigmatism. The present paper describes an improvement of a technique for circular keratotomy that was published previously. METHODS: We present data on a consecutive series of 32 eyes with a mean corneal astigmatism of 4.66 diopters (D) (range -2.25 to -6.00 D) with a variety of clinical diagnoses. The astigmatic cornea was trephined with a diameter of 7 mm and a depth of 300 microns. After deepening of the trephination with a diamond knife to 550 microns over the steeper semimeridians, the intraocular pressure created a rounding of the cornea. The amount of astigmatic correction and extent of deepening were controlled intraoperatively with a keratoscope. No sutures were placed. RESULTS: In 32 consecutive eyes, corrections were between 50 and 90% of the initial cylindrical values after 1 week to 1 month. In 29 eyes (91%), the results obtained remained stable during a 1-year follow-up; in two eyes (6%), the 1-month results worsened by more than 1.00 D and in one eye (3%), results improved by more than 1.00 D. There were no complications during or after surgery. Wound gaping resulting in epithelial plugs did not occur. No patient lost one or more lines of spectacle-corrected visual acuity, but 13 eyes (40%) gained one or more lines. CONCLUSION: The technique of correcting corneal astigmatism by trephining to a depth of 300 microns, with deepening of the wound to 550 microns along the steep meridian and using no sutures can correct up to 10.00 D of astigmatism with reasonable stability.

Astigmatism↗
PubMedDate not supplied

The suction bridge for radial keratotomy may avoid late hyperopic shift.

BACKGROUND: Radial keratotomy may induce late hyperopic shift. We present data on 140 consecutive eyes with a follow-up of up to 3 years that underwent radial keratotomy with the RK suction bridge. METHODS: We conducted a retrospective study of 140 consecutive eyes that had radial keratotomy between 1987 and 1994. Mean preoperative spherical equivalent was -5.21 D (range -2.00 to -9.75 D). All operations were performed by one surgeon (JHK) with the RK suction bridge. A suction ring maintaining physiological intraocular pressure immobilized the eye and left a peripheral rim of uncut cornea. The ring incorporated an eccentric bridge that guided the radial keratotomy knife. The knife setting was 90% of the central corneal thickness, measured by pachymetry. Spherical equivalent refraction and spectacle corrected visual acuity were measured at 1 week, 1, 3, 6 months, 1 year, and 3 years after radial keratotomy. RESULTS: The mean preoperative spherical equivalent refraction of -5.21 D dropped to -0.43 D at 1 week (n = 136), -0.71D at 1 month (n = 120), -0.85 D at 3 months (n = 95), -0.74 D at 6 months (n = 73), -0.77 D at 12 months (n = 79), and -0.85 D at 3 years (n = 67). Compared to 1 month spherical equivalent, at 3 years three eyes (4.4%) had moved > = or 1.00 D toward hyperopia. One eye (1.4%) shifted by 1.25 D. Paired t-tests of mean spherical equivalent refraction did not reveal significant shifts toward hyperopia. Mean preoperative spectacle-corrected visual acuity was slightly diminished at 1 week and was equal or better thereafter. CONCLUSIONS: Our 3-year data suggest that a late hyperopic shift following radial keratotomy may be prevented if an intact peripheral rim is maintained and cutting depth does not exceed 90% of the lowest corneal thickness.

Adolescent↗
PubMedDate not supplied

Brachial plexus block. A comparison of the supraclavicular lateral paravascular and axillary approaches.

BACKGROUND AND OBJECTIVES: Anesthesia of the brachial plexus has been associated with injuries to adjacent structures (e.g., pneumothorax, vascular penetration). It is not uncommon to have only partial block of the upper extremity, hindering completion of the surgical procedure. The supraclavicular lateral paravascular approach to brachial plexus anesthesia has been proposed as an effective, safe alternative to the traditional approaches to brachial plexus anesthesia. METHODS: This prospective, randomized study sought to determine if the supraclavicular lateral paravascular (SCLP) approach is as effective as the transarterial axillary approach, the most common brachial plexus block used at our institution. RESULTS: 16/20 (80%) of SCLP blocks were good. 13/20 axillary blocks were good. The success rate with the SCLP approach was 95%. The success rate with the axillary approach was 90%. CONCLUSIONS: The supraclavicular lateral paravascular approach is as effective as the axillary approach.

Adult↗
PubMedDate not supplied

A model for professional nursing in organizations: the Rainbow.

This paper presents a model of professional nursing in organizations that provides cohesive direction to the development of patterns that shape how nursing is structured in an organization. Such cohesive direction can foster integration between the practice and the discipline components of nursing. The model can influence the structure of nursing on a macro level within the organization and on a micro level by influencing patterns of nursing care delivery. A set of values, assumptions, dimensions, constructs, principles and propositions have been identified and brought together in this model. As a framework, it can be used to shape the structures and processes that contribute to professional nursing excellence in practice settings.

Health Knowledge, Attitudes, Practice↗