IMS updates HMM's med-surg indexes.
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Biomedical subjects
Publications and source records attributed to J J Doyle.
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The Glycine tabacina polyploid complex has been shown to include a minimum of two morphological and crossing groups, which also differ in chloroplast DNA (cpDNA) restriction map and nuclear ribosomal gene repeat phenotype. These AAB2B2 and BBB2B2 G. tabacina polyploids contain plastomes referable to the A and B diploid plastome groups of subgenus Glycine, respectively. Eight different cpDNA variants were observed among the 65 B-type polyploids studied, six of which were identical for numerous restriction site characters to plastome types found among the highly polymorphic B genome diploid species. It is hypothesized that there have been numerous independent origins of polyploid G. tabacina: at least one AA x B2B2 event and a minimum of five BB x B2B2 events involving different BB types as female progenitor. Low amounts of cpDNA divergence between diploid and polyploid plastomes and among the plastomes of geographically disjunct polyploids suggest that the origin and dispersal of polyploids are relatively recent events. All hypothesized diploid progenitors are native to Australia, while both A- and B-type G. tabacina polyploids occur on islands of the Pacific outside the range of diploids. The presence of several different plastome types of polyploid G. tabacina in the Pacific islands suggests that several colonization events have occurred.
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Three cases of vitamin B12 deficiency that occurred during infancy are presented. These cases appeared to be the result of pre-existing maternal deficiency. All three infants demonstrated evidence of neurodevelopmental delay at presentation, and one had sustained loss of milestones and developed involuntary motor movements. Prior to the initiation of therapy, all three infants were anemic: one was thrombocytopenic and one pancytopenic. In all three cases the hematologic and neurologic abnormalities were corrected with vitamin B12 therapy. The literature is reviewed and discussed with respect to the mechanism of the infants' vitamin B12 deficiency and neurodevelopmental manifestations.
A healthcare institution must carefully examine its internal needs and external requirements before selecting an information system. The system's costs must be carefully weighed because significant computer cost overruns can cripple overall hospital finances. A New Jersey hospital carefully studied these issues and determined that a contract with a regional data center was its best option.
Bone marrow examination is widely accepted among pediatric hematologists as a mandatory investigation in childhood idiopathic thrombocytopenic purpura (ITP). The aim of this procedure is to confirm the presence of megakaryocytes and to exclude other conditions, such as leukemia and aplastic anemia. To assess the need for bone marrow examination, we reviewed the charts of 127 children with presumed ITP and found that bone marrow examination led to a different diagnosis in five (3.9%) of them. All five patients had presented with clinical and/or laboratory features atypical of acute ITP; none had leukemia. The initial clinical and laboratory findings of 50 patients with aplastic anemia also were reviewed; all had features atypical of acute ITP. Proper history and physical examination as well as a complete blood cell count are reliable means of recognizing patients with typical vs atypical features of ITP. Bone marrow aspiration could be limited safely to those patients with atypical features of ITP or to patients being treated with corticosteroids.
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To assess dose requirements of warfarin in children, we analyzed retrospectively the treatment of 26 patients with the drug. Subsequently we treated 15 children, prospectively, with a regimen derived from our retrospective analysis (0.2 mg/kg/day for 2 days). In the retrospective analysis we found the prothrombin time (PT) at day 2 to correlate significantly with the dose given on day 0 (p less than 0.001) and with the cumulative dose on days 0 and 1 (p less than 0.001), but the standardized loading regimen resulted in a wide range of PTs independent of age, weight, or body surface area. The warfarin dose contributes only 40% of the variability in PT; an individual child's response to warfarin cannot be predicted accurately on the basis of the usual morphometric measurements.
Considerable information is now available concerning the 7 S seed storage proteins of legumes and the genes that encode them. Our study compares the gene encoding a beta-type subunit of phaseolin (Pvu beta), the 7 S protein of common bean (Phaseolus vulgaris), with the gene encoding an alpha'-subunit of beta-conglycinin (Gma alpha'), the 7 S protein of soybean (Glycine max). The comparison involves 2880 base pairs of Pvu beta and 3636 base pairs of Gma alpha' and includes approximately 1 kilobase pair of 5'-flanking sequences, and 5' and 3' untranslated sequences, as well as the six exons and five introns that are found to occur in similar positions in both genes. Conserved sequences in the 5'-flanking regions of these genes are discussed in light of their potential regulatory role. Published sequences for 7 S genes of pea (Pisum sativum) permit the inference of the nature and direction of evolutionary change and, in particular, show that the major size difference between the large Gma alpha' polypeptide and the smaller polypeptides of pea and common bean is due to a large insertion in the first exon of Gma alpha'. Comparisons of protein primary structure, potential glycosylation sites, and predicted protein hydropathy show that strongly conserved features of 7 S proteins cut across exon boundaries and that nonconserved regions exist that may have potential for protein modification.
To study the effect of 1-deamino-8D-arginine vasopressin (DDAVP) on the factor VIII response in nephrogenic diabetes insipidus (NDI), 0.30 microgram/kg DDAVP was given to 2 unrelated NDI patients, 3 obligate carriers, and 20 controls. Factor VIII coagulant activity (FVIIIC) and factor VIII related antigen (FVIIIR:Ag) responses were absent in both NDI patients and were decreased by approximately 50% in the carriers by comparison with controls. These results show that the vasopressin receptor defect in NDI is not confined to the kidney but is equally expressed in other tissues including the vascular endothelium and hepatic sinusoids, the respective sites of FVIIIR:Ag and FVIIIC production. A decreased factor VIII response may help in identifying carriers in families at risk.
A naturally occurring variety of soybean Glycine max cv. Keburi, which lacks the alpha'-subunits of the 7S seed storage protein (beta-conglycinin), was recently described by Kitamura and Kaizuma. Keburi beta-conglycinins contain a normal complement of alpha-, beta-, and gamma-subunits that accumulate in a temporally and spatially regulated manner comparable to that of the standard cultivar Provar. Poly(A)+ RNA isolated from mid-to-late maturation stage Keburi seeds was translated in vitro, yielding products equivalent to those of Provar poly(A)+ RNA except that Keburi mRNA did not produce the pre-alpha'-subunit polypeptide. The basis of the Keburi phenotype was determined by examining genomic DNA using Southern blot hybridization. Restriction fragments isolated from a cloned 11.5 kb EcoRI fragment of genomic DNA containing a normal alpha'-subunit gene (Gmg 17.1) were used as hybridization probes. Sequences far upstream of the alpha'-subunit gene were present in both Provar and Keburi cultivars. However, hybridization reactions with probes from within the gene demonstrated that a deletion had occurred in Keburi DNA beginning immediately 5' to the alpha'-subunit gene represented on this 11.5 kb fragment. The deletion extends through most of the coding sequences, producing the Keburi phenotype.
Five groups of cattle were dosed daily with either 0, 6.3, 7.8, 9.8 and 12.2 mg of lead/kg of body weight for 118 days or for as long as they lived, and tissue concentrations of lead, iron, zinc, copper and manganese were determined post-mortem. Mean intakes of lead for the five groups were 0, 34, 165, 55 and 57 g respectively. Lead accumulated in all tissues of treated animals and was greatest in kidneys and liver. The accumulation of lead and iron in livers of the treated animals appeared to be related to lead intake. The zinc and iron concentrations in liver were significantly increased by the ingestion of lead whereas the copper concentrations in liver and heart and the manganese concentration in kidney were significantly decreased by the ingestion of the lead.
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We have described some rearrangements of a variable-antigen gene in T. brucei. We suggest that there are two copies of the ILTat 1.2 variable-antigen gene in each of a number of trypanosome clones closely related by sequential relapses. Both copies of the gene undergo rearrangements, apparently the result of insertion and deletion of lengths of DNA in a region at or beyond the 3' end of the coding sequence, giving rise to different-size restriction enzyme fragments in different clones of trypanosomes. No feature of these rearrangements can be correlated with expression of the gene. Our data differ from those of Hoeijmakers et al. (1980) in two important respects: (1) Neither copy of the gene remains in a constant genomic context in all trypanosome clones. (2) We do not see an extra copy associated with the expression of the gene. These observations do not suggest any obvious mechanism for the phenomenon of antigenic variation.
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