Oncogene activation by fusion of chromosomes in leukaemia.
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Chromosomes, Human, 21-22 and Y↗
Biomedical subjects
J M Adams
Publications and source records attributed to J M Adams.
The c-myc oncogene driven by immunoglobulin enhancers induces lymphoid malignancy in transgenic mice.
Transgenic mice bearing the cellular myc oncogene coupled to the immunoglobulin mu or kappa enhancer frequently develop a fatal lymphoma within a few months of birth. Since the tumours represent represent both immature and mature B lymphocytes, constitutive c-myc expression appears to be highly leukaemogenic at several stages of B-cell maturation. These myc mice should aid study of lymphoma development, B-cell ontogeny and immunoglobulin regulation.
Animals↗
Implications of issues in typographical design for readability and reading satisfaction in an aging population.
The issues in typographical design that influence readability in an aging population are explored. The traditional response to age-related changes in vision has been "bigger is better," but we explore other major variables and vocabulary associated with page layout and design, including type classification and readability, justification, traditional rules of page composition, and issues of word forms versus character strategies. Other research areas that should be explored are also considered.
Aged↗
Applying e-health to case management.
The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.
Case Management↗
Measurement of rCBF by H2 clearance: theoretical analysis of diffusion effects.
Although experimental evidence now indicates that diffusion of hydrogen can influence the measured clearance curves from which local blood flow is inferred, its exact role has not yet been well defined. For this reason we have developed a theoretical treatment of the effects of diffusion near a boundary separating regions of inhomogeneous perfusion (e.g. the gray-matter interface), and reexamined the appropriateness of the currently used bi-exponential model. Using our model, we confirmed empirical estimates of important diffusion effects up to approximately 2 mm from an inhomogeneity, and further refined the concept of spatial resolution. We also showed that fitting data to bi-exponential curves may be incorrect and lead to inaccurate results. We conclude from these studies that diffusion does indeed have an important effect on the clearance curves measured near an inhomogeneity.
Blood Flow Velocity↗
Detection of hyperoxemia in neonates by a new pulse oximeter.
OBJECTIVE: We studied the ability of a new pulse oximeter to detect hyperoxemia in neonates. METHODS: One hundred arterial blood samples were obtained from umbilical artery catheters of 41 acutely ill neonates (birth weight 560-4100 grams) while SpO2 was simultaneously measured at a postductal site. The relationship between PaO2 and SpO2 was examined and expressed on a matrix. Hyperoxemia was defined as PaO2 greater than 90 mm Hg and upper alarm limit for pulse oximetry was set at 95%. The incidence of true hyperoxemia (PaO2 greater than 90 mm Hg, SpO2 greater than 95%) was determined and sensitivity and specificity for detection of hyperoxemia by the SpaceLabs device was calculated. RESULTS: Hyperoxemia was detected in eighteen samples with sixteen having SpO2 greater than 95% (89% sensitivity). In 82 samples having a PaO2 value less than or equal to 90 mm Hg, 53 were associated with SpO2 less than or equal to 95% (65% specificity). Among 55 samples with SpO2 less than or equal to 95% hyperoxemia occurred in only 2 (3.6%). Sensitivity of 95% would have been achieved with upper alarm limit set at 94%. CONCLUSION: The new pulse oximeter evaluated detected 89% of episodes of hyperoxemia with upper alarm limits set at 95% and 95% of episodes if upper limit was set at 94%. As previously reported, both individual device algorithms and upper alarm limits chosen determine ability of pulse oximeters to detect hyperoxemia.
Blood Gas Analysis↗
Pump administration of exogenous surfactant: effects on oxygenation, heart rate, and chest wall movement of premature infants.
Adverse reactions of infants to surfactant administration include loss of chest wall movement and decrease in oxygen saturation and heart rate. We are aware of no previous studies addressing the administration of surfactant. We studied 22 infants with respiratory distress syndrome to determine whether these adverse reactions could be reduced by giving surfactant slowly by microinfusion syringe pump. Loss of chest wall movement was significantly greater in infants receiving surfactant by the hand-dosing method as compared with administration of surfactant by pump. A significant increase in ventilator pressure interventions was observed when surfactant was given by standard hand bolus method compared with pump infusion. Heart rate and oxygen saturation did not differ significantly between the two techniques. These findings suggest that pump administration of surfactant minimized potential airway obstruction; thus it may be an alternative to standard bolus dosing techniques.
Airway Obstruction↗
Effects of spontaneous gastric hypoacidity on the pharmacokinetics of zidovudine and didanosine.
STUDY OBJECTIVE: To determine the effect of spontaneous gastric hypoacidity on the pharmacokinetics of zidovudine and didanosine in subjects infected with the human immunodeficiency virus (HIV). DESIGN: Controlled, open-label, single-dose, pharmacokinetic study. SUBJECTS: Thirty-two asymptomatic HIV-infected subjects. INTERVENTIONS: Gastric pH studies were conducted in all 32 subjects, and 20 of these subjects (8 women, 12 men) were enrolled into the pharmacokinetic study. They were stratified into two groups according to fasting gastric pH: those without and with gastric hypoacidity (minimum gastric pH < 3 and > or = 3, respectively). Gastric pH was measured using the Heidelberg pH monitoring system in all subjects before and during pharmacokinetic analysis of zidovudine 100 mg or didanosine 200 mg (given as two 100-mg tablets dissolved in 6 oz water). Plasma samples were collected over 8 hours after dosing. MEASUREMENTS AND MAIN RESULTS: Six (20%) of 30 subjects had a minimum gastric pH of 3 or above on at least two occasions, and the remaining 2 had variable gastric pH. Although gastric pH was unchanged during the administration of zidovudine, it increased to greater than 9 in 11 of 12 subjects with didanosine, regardless of baseline value. For both drugs, there were no statistically significant differences in peak plasma concentration (Cmax), time to reach peak plasma concentration (Tmax), elimination rate constant (ke), and area under the plasma concentration-time curve from time zero to infinity (AUC0-infinity) between subjects with and without gastric hypoacidity despite sufficient statistical power to detect a 56% difference in clearance for either drug (alpha 0.05, beta 0.1). CONCLUSION: Gastric hypoacidity occurs in approximately 20% of HIV-infected patients and does not appear to influence zidovudine or didanosine pharmacokinetics.
Acquired Immunodeficiency Syndrome↗
Understanding the Y2K problem in health care: party's over, we're out of time.
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Chronology as Topic↗