Cyclosporine therapy and other adjuncts in the perioperative period with cadaveric and living related donor kidney transplantation.
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Cadaver↗
Biomedical subjects
J Miller
Publications and source records attributed to J Miller.
Flurbiprofen in the treatment of juvenile rheumatoid arthritis.
Thirty-four patients with juvenile rheumatoid arthritis, who were treated with flurbiprofen at a maximum dose of 4 mg/kg/day, had statistically significant decreases from baseline in 6 arthritis indices after 12 weeks of treatment. Improvements were seen in the number of tender joints, the severity of swelling and tenderness, the time of walk 50 feet, the duration of morning stiffness and the circumference of the left knee. The most frequently observed side effect was fecal occult blood (25% of patients); however, there was no other evidence of gastrointestinal (GI) bleeding in these patients. One patient was prematurely discontinued from the study for severe headache and abdominal pain. Most side effects were mild and related to the GI tract.
Abdomen↗
RNA to registered nurse? A study to consider the possibility of granting credit options to registered nursing assistants in a two year program.
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Alberta↗
Socialization and situational influences on sustained altruism.
In this conceptual replication and extension of Rosenhan's study of civil rights activists, the sustained altruism (i.e., help that extends over time) of volunteers at a telephone crisis-counseling agency was examined. Using a prospective format, it was predicted that volunteers with a socialization history of exposure to nurturant parents who modeled altruism (autonomous altruists) would exhibit a greater degree of sustained altruism than those with a history of less nurturant parents who modeled altruism to a lesser degree (normative altruists). The altruism of the normative volunteers, however, was expected to increase given certain situational conditions (here, participation in a highly cohesive training group prior to the actual volunteer activity). As predicted, the rate of sustained altruism of normative volunteers in highly cohesive groups was increased to a level comparable to that of autonomous volunteers, while the altruism of autonomous volunteers was not affected by the training group experience. The implications of these findings for research on altruism and its development, as well as some applications to volunteerism, are discussed.
Adolescent↗
Tests for AIDS and counselling.
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Acquired Immunodeficiency Syndrome↗
Prolonged expiratory apnoea: a disorder resulting in episodes of severe arterial hypoxaemia in infants and young children.
Ten infants with rapidly developing and severe episodes of hypoxaemia (15-120 s duration) were studied. In infants over 2 months old most episodes occurred when awake, after a sudden noxious stimulus. In younger infants frequent yet undetected episodes occurred during sleep and feeding. Arterial PO2 fell below 20 mm Hg within 20 s, and loss of consciousness, sometimes with convulsions, occurred after 30 s. Clinical observations, measurements of respiratory movements, air flow, oesophageal pressure, external oblique surface electromyogram, and, in two cases, chest fluoroscopy and microlaryngoscopy documented episodes of no inspiratory flow but continued expiratory activity at low lung volume with partial or complete glottic closure. In five infants, episodes continued despite tracheostomy or an indwelling nasotracheal tube. No intracardiac shunt could be demonstrated and the rapid fall in arterial PO2 was attributed to lack of ventilation at a maximum expiratory position in the presence of a rapid recirculation time. In five infants tested there was a low proportion of phosphatidylcholine in the tracheal aspirate. In one infant audible expiratory braking (grunting) was present for most of the awake time. This previously unrecognised mechanism for severe hypoxaemia may be one cause of neurodevelopmental damage and sudden death in infants and young children.
Abdominal Muscles↗
Cholecystokinin antagonists selectively potentiate analgesia induced by endogenous opiates.
We have recently observed that exogenous sulfated cholecystokinin octapeptide (CCK) can antagonize various forms of opiate analgesia and that the CCK receptor blocker proglumide potentiates morphine analgesia. These observations, plus the similarity in the distribution of CCK and opiate systems, suggest that endogenous CCK may act as a physiological opiate antagonist. We have extended these initial studies by examining the effect of CCK antagonists on opiate analgesia produced by release of endogenous opiates (front paw footshock induced analgesia) and by intrathecal administration of D-Ala-methionine enkephalinamide, a stable analogue of an endogenous opiate. Additionally, the specificity of proglumide's effect was examined by testing the effect of this drug on various forms of non-opiate analgesia. This series of experiments demonstrate that CCK antagonists can markedly potentiate analgesia induced by endogenous opiates and provide strong support for the hypothesis that endogenous CCK systems can oppose the analgesic effects of opiates. Potentiation of analgesia by CCK receptor blockers appears to be selective for opiate systems since proglumide typically attenuated or had no effect on various forms of non-opiate analgesia. These data suggest that CCK blockers may be clinically useful for enhancing the analgesic effects of procedures such as acupuncture, which may be mediated by release of endogenous opiates.
Analgesia↗
Hypodontia, ectodermal dysplasia and sweat pore count.
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Adolescent↗
Repetitive zinc-binding domains in the protein transcription factor IIIA from Xenopus oocytes.
The 7S particle of Xenopus laevis oocytes contains 5S RNA and a 40-K protein which is required for 5S RNA transcription in vitro. Proteolytic digestion of the protein in the particle yields periodic intermediates spaced at 3-K intervals and a limit digest containing 3-K fragments. The native particle is shown to contain 7-11 zinc atoms. These data suggest that the protein contains repetitive zinc-binding domains. Analysis of the amino acid sequence reveals nine tandem similar units, each consisting of approximately 30 residues and containing two invariant pairs of cysteines and histidines, the most common ligands for zinc. The linear arrangement of these repeated, independently folding domains, each centred on a zinc ion, comprises the major part of the protein. Such a structure explains how this small protein can bind to the long internal control region of the 5S RNA gene, and stay bound during the passage of an RNA polymerase molecule.
Amino Acid Sequence↗
Stress analysis of a condylar knee tibial component: influence of metaphyseal shell properties and cement injection depth.
We generated three-dimensional finite element models of the proximal tibia with an implanted tibial component. The component features a cobalt-chromium tray with four short vertical posts and a porous-coated surface for improved fixation to polymethylmethacrylate (PMMA). We examined the stresses after varying: the structural rigidity of the metaphyseal cortical shell; the surface area of the cobalt-chromium tray; and the depth of pressure-injected PMMA bone cement. Our results indicate that previous finite element models of prosthetic tibial components have overestimated the structural contribution of the metaphyseal cortical shell by a factor of approximately 6. A standard size tray, in contrast to a tray that extends to the cortical shell, does not significantly alter the axial load distribution but could result in bone resorption beyond the tray periphery. An important consequence of the component peg locations is that they direct the compressive stresses into dense regions of trabeculae that run from the subchondral articular surface to the metaphyseal-diaphyseal junction. The use of a modified von Mises failure criterion suggests that at excessive load levels the most likely location of material failure is at the bone cement-trabecular bone interface immediately distal to the fixation posts. Due to its added rigidity, injection of cement beyond the fixation posts results in slightly increased stresses in this region, but these stress increases are compensated for by an increased strength of the cement-bone composite.
Bone Cements↗
Rapid recovery from aphasia: a detailed language analysis.
The paper presents a daily analysis of the language recovery of a patient who was globally aphasic at the time of her first observation and who had recovered language, as measured by the Western Aphasia Battery, at the time of her discharge 14 days later. The paper emphasizes the relatively regular growth of normal syntactic, lexical, and pragmatic features coupled with similar regular decreases in aphasic features. Observations of both phenomena are necessary to describe language recovery.
Adult↗
Cyclosporin partitions into phospholipid vesicles and disrupts membrane architecture.
Cyclosporin is a fungal metabolite demonstrating potent immunosuppressive activity both in vitro and in vivo, but the mechanism of action is poorly understood. Using [3H]dihydrocyclosporin C ([3H]CsC) we observed significant binding by mononuclear cells, erythrocytes and phosphatidyl choline (PC) vesicles which was reversible by the addition of excess CsA. Trypsin, pronase or heat treatments demonstrated that B cells and adherent cells express a protease-sensitive membrane binding site not observed on T cells. The nature of the interaction between CsA and the PC vesicles was studied using the membrane surface probe 1-anilino-8-naphthyl sulfonic acid (ANS-). ANS- -induced fluorescence was reduced by 24% in the presence of 4.75 X 10(-7). M CsA indicating that CsA displaces ANS- from the PC vesicles. CsA also effected a shift in the phase transition temperature of PC vesicles from 23 degrees C to 19 degrees C. Finally, the rate of concanavalin A (Con A)-induced cap formation by T lymphocytes was approximately doubled in the presence of 2.6 X 10(-5) M CsA. These data demonstrate that CsA partitions into phospholipid vesicle membranes and the plasmalemma of mononuclear cells resulting in an increased membrane fluidity.
Concanavalin A↗
A longitudinal study of work loss related to dental diseases.
This paper analyzes the effects of dental conditions on social functioning by measuring the incidence of work loss days associated with dental problems and treatments in 1 year. A longitudinal study of 1992 employed adults in the Hartford, Conn. area was conducted. Participants were interviewed at baseline to collect data on sociodemographic, health care and health status factors and were followed for 1 year to assess the incidence of dental work loss days. The results showed that 26.4% of the sample reported an episode of dentally-related work, with a mean of 1.26 hours per person per year. The most important predictors of having work loss were high number of dental visits, previously having an episode of work loss, being young and being in the higher social classes. The most important variables explaining total hours of work loss were treatment severity, previous work loss, low income and being non-white. While work loss rates varied by some important treatment and sociodemographic factors, more sensitive outcome indicators are needed to detect individual differences in the effects of dental conditions on social functioning. Yet, the results do suggest that work loss days may be a useful population statistic in measuring oral health status because of the high prevalence of dental disease.
Absenteeism↗
A psychophysical analysis of morphine analgesia.
Intravenous administration of 0.04-0.08 mg/kg morphine sulfate reduced both sensory intensity and unpleasantness visual analogue scale (VAS) responses to graded 5 sec nociceptive temperature stimuli (45-51 degrees C) in a dose-dependent manner. The lower doses of morphine (0.04 and 0.06 mg/kg) resulted in statistically reliable reductions in affective but not sensory intensity VAS responses, possibly reflecting supraspinal effects on brain regions involved in affect and motivation. However, the highest dose of morphine tested (0.08 mg/kg) reduced both sensory and affective VAS responses to graded nociceptive stimuli as well as VAS sensory responses to first and second pain evoked by brief heat pulses. Morphine also had an especially potent inhibitory effect on temporal summation of second pain that is known to occur when intense nociceptive stimuli occur at rates greater than 0.3/sec. The results support current hypotheses about neural mechanisms of narcotic analgesia and further clarify the relative effects of morphine on sensory and affective dimensions of experimental pain. The derived morphine dose-analgesic response functions also provide a reference standard for quantitatively comparing magnitudes of different CNS-mediated forms of analgesia.
Adult↗
Biochemical and behavioral changes in rats during and after chronic d-amphetamine exposure.
Two groups of rats were implanted with ALZET minipumps to deliver vehicle or a theoretical amount of 1 mg/kg per h of d-amphetamine (A) for 12 days. After 3 days of A-exposure, motor movements and stereotypic behavior were markedly increased. Subsequent testing during A-exposure showed that motor movements and stereotypic behavior remained significantly increased but declined. After removal of the pumps, these effects disappeared and no differences at rest, during stress or A challenge, were apparent in either group. Animals sacrificed after 3 days of drug exposure, showed a drastic decrease in cardiac, but not adrenal, catecholamine levels. In the brain, norepinephrine (NE) levels were markedly decreased in the frontal cortex, hypothalamus, caudate, pons-medulla and cerebellum. Epinephrine (E) levels were unaffected and dopamine (DA) levels were decreased in most areas without reaching statistical significance. Plasma corticosterone levels were similar in both groups. Animals in both groups sacrificed about 25 days after pump removal were biochemically similar. Under our conditions, A-exposure produced marked behavioral and biochemical changes but there was no evidence of residual abnormalities after cessation of drug treatment.
Animals↗
Electrophysiology studies: precordial thumping patients paced into ventricular tachycardia.
The American Heart Association currently recommends the precordial thump as the initial maneuver in the treatment of ventricular tachycardia and monitored ventricular fibrillation. Advocates of the precordial thump maintain that it affords the advantage of immediate availability and might prove lifesaving in cases of ventricular tachycardia. A canine study and a prehospital study have argued that in the cardiac arrest model, thumping ventricular tachycardia causes ventricular fibrillation as often as reversion to a sinus rhythm. We therefore studied the effects of the precordial thump on patients undergoing electrophysiology studies who had been paced into ventricular tachycardia. A total of nine patients received precordial thumps for 11 separate episodes of electrically induced sustained ventricular tachycardia. Our thumps failed on all 11 attempts to convert any of our patients. All 11 were subsequently successfully restored to a supraventricular rhythm with overdrive pacing or countershock. There was no detrimental effect from thumping ventricular tachycardia as has been previously reported. Our results would indicate that countershock is more effective than precordial thumping for converting ventricular tachycardia to a supraventricular rhythm, but previously reported "detrimental effects" of thumping are not confirmed by this study.
Electric Countershock↗