Four nitrous oxide scavenging systems were tested for their efficiency under ideal standardized conditions. The volunteers received 35% nitrous oxide for 20 minutes and the levels of nitrous oxide recorded and averaged every five minutes. No density was carried out. All four systems achieved levels below 30 parts per million. With the recommended limit for nitrous oxide levels in dental operatory being 50 parts per million (ppm) rather than the several thousand ppm reached without scavenging, it is necessary to ensure that the scavenging devices available are capable of achieving this level. To do so under normal dental operating conditions provides many variables, such as the type of procedure carried out, movement by the patient, ventilation efficiency of the operatory, type of mouth pack utilized etc. This investigation was therefore designed to eliminate all operator and procedure variabilities. Each system was evaluated under ideal identical conditions and with no actual treatment being carried out.

Air Pollutants, Occupational↗

PubMed1989

Whither health visiting? The blueprint already exists.

Explore the source record for details and available documents.

Attitude of Health Personnel↗

PubMed1989

Women's health--the feminist contribution.

Health visitor education and practice is seen within a feminist context with reference to the patriarchy of language, literature and academic studies.

Community Health Nursing↗

PubMed1988

Separation of neutral reducing oligosaccharides derived from glycoproteins by HPLC on a hydroxylated polymeric support.

A prototype hydroxylated polymeric support, Glyco-PAK N, was employed to separate a number of neutral reducing oligosaccharides derived from various glycoproteins by the hydrazinolysis/re-N-acetylation/mild acid hydrolysis procedure. General features of the separation properties of the matrix are described. A major advantage of the packing over silica-based supports is its stability, a property which is advantageous both in repetitive analytical chromatography and in the preparative isolation and spectroscopic identification of pure compounds, free of column breakdown products.

Acetonitriles↗

PubMed1988

Evaluation of serum phenytoin monitoring in an acute care setting.

Serum phenytoin monitoring is frequently used in the management of epileptic patients because phenytoin has a narrow therapeutic index and exhibits nonlinear pharmacokinetics. This study prospectively evaluated serum phenytoin monitoring in an acute care teaching hospital. Two sets of criteria were established a priori to define (a) appropriate selection of patients with regard to serum phenytoin monitoring, and (b) inappropriate serum phenytoin determinations (SPDs). Eighty patients receiving phenytoin were studied, of whom 58 (72.5%) were appropriately selected. These included 35 patients (43.8%) for whom monitoring was indicated and was performed, and 23 patients (28.7%) for whom monitoring was not indicated and was not performed. There were 39 patients with no indications for serum phenytoin monitoring; however, 16 (41%) of them were monitored. A total of 113 SPDs were performed, of which 83 (73.5%) were deemed to be inappropriate. Seventy percent of SPDs resulted in phenytoin concentrations outside the usual therapeutic range (10-20 micrograms/ml). Overall, physicians appropriately selected patients with regard to serum phenytoin monitoring; however, when inappropriate selection did occur, it tended to involve monitoring of patients who did not require it. The majority of SPDs performed were deemed to be inappropriate, since they were done too soon after admission or a change in therapy to reliably indicate steady-state serum concentrations.

Acute Disease↗

PubMed1987

Evaluation of a nomogram for estimating the rate of phenytoin accumulation.

This study evaluated a nomogram designed to identify a subgroup of the patients whose serum phenytoin concentrations are near steady state at a given time after initiation of therapy. A sample of 95 adult subjects with reported values of Vmax and Km was pooled from the literature, and computer simulations of phenytoin accumulation for 15 days after initiation of phenytoin acid at 300 mg/day were performed. Simulated serum concentrations on days 5, 10, and 15 were used to identify subjects who were predicted by the nomogram to be at greater than or equal to 83% of steady state, and these results were compared with those expected from the Michaelis-Menten model. In the simulations, 42, 62, and 66 subjects reached greater than or equal to 83% of steady state by days 5, 10, and 15, respectively. The nomogram correctly identified 13 (31.0%), 33 (53.2%), and 43 (65.2%) of these individuals, respectively. The frequency of erroneous predictions was low, even in subjects whose Km and volume of distribution were outside the limits set in the development of the nomogram. Use of a nomogram such as this would help a subgroup of patients to attain a desired serum phenytoin concentration earlier in therapy and with fewer serum phenytoin determinations than would otherwise be required. It would also prevent premature increases in phenytoin dose in patients whose serum concentration is still rising.

Adult↗

PubMed1987

Interindividual variation in the extent and rate of phenytoin accumulation.

Steady-state serum phenytoin concentration (Css) is known to increase nonlinearly with dose, but it is less well recognized that the rate of phenytoin accumulation is also dose dependent. This stimulation study estimated the extent and rate of phenytoin accumulation in a sample of 95 adult subjects, with known values of Vmax and Km, pooled from the literature. Simulations were done using a Michaelis-Menten model and phenytoin sodium doses of 200, 300, and 400 mg/day. The distributions of Css and the time required to reach 90% of steady state (T90) became increasingly positively skewed as dose was increased. The T90 and Css were positively correlated (r greater than or equal to 0.8880, p less than 0.00001) and subjects reached 90% or more of Css more slowly as the initial phenytoin dose was increased. At an initial dose of 300 mg/day of phenytoin sodium, mean Css was 11.0 +/- 9.10 micrograms/ml (median, 7.62 micrograms/ml), and mean T90 was 12.2 +/- 15.4 days (median, 5.98 days). Only 25.3% of the subjects would be expected to achieve therapeutic serum concentrations (10-20 micrograms/ml) on this dose, and 88.4% would reach 0.9 Css within 30 days. Phenytoin dosage must be individualized to achieve concentrations of 10-20 micrograms/ml. Multiple serum phenytoin determinations during the first 30 days or more are required to determine that steady state has been reached, but these need not be done more often than once a week.

Adolescent↗

PubMed1987

Mammographic dual-screen-dual-emulsion-film combination: visibility of simulated microcalcifications and effect on image contrast.

Three test objects simulating different mammographic problems were imaged with a new low-dose dual-screen-dual-emulsion-film combination and a standard screen film combination, with and without a moving grid, at 28 and 32 kVp, and with 0.3- and 0.5-mm focal spots. The new combination reduced exposure by 50%, but it failed to equal the other combination in the depiction of simulated microcalcifications, even when a different brand of film-processing chemicals was used. Compared with the standard screen-film combination exposed without a grid, the new combination exposed with a grid resulted in a superior image of dense parenchyma without an increase in dose. Furthermore, when the exposure time was decreased by 25% (rather than 50%), dense breasts were imaged with greater penetration by the new combination. A clinical trial of the new combination in 200 patients showed prominent quantum mottle and reduced contrast in regions of dense parenchyma. In addition, the skin and subcutaneous tissue were often poorly depicted with both standard and high-intensity illumination.

Breast Neoplasms↗

PubMed1987

A 68-year-old black woman with weight loss, increased abdominal girth, and hirsutism.

Explore the source record for details and available documents.

Aged↗

PubMed1986

Mucin synthesis. Conversion of R1-beta 1-3Gal-R2 to R1-beta 1-3(GlcNAc beta 1-6)Gal-R2 and of R1-beta 1-3GalNAc-R2 to R1-beta 1-3(GlcNAc beta 1-6)GalNAc-R2 by a beta 6-N-acetylglucosaminyltransferase in pig gastric mucosa.

A UDP-GlcNAc:R1-beta 1-3Gal(NAc)-R2 [GlcNAc to Gal(NAc)] beta 6-N-acetylglucosaminyltransferase activity from pig gastric mucosa microsomes catalyzes the formation of GlcNAc beta 1-3(GlcNAc beta 1-6)Gal-R from GlcNAc beta 1-3Gal-R where -R is -beta 1-3GalNAc-alpha-benzyl or -beta 1-3(GlcNAc beta 1-6)GalNAc-alpha-benzyl. This enzyme is therefore involved in the synthesis of the I antigenic determinant in mucin-type oligosaccharides. The enzyme also converts Gal beta 1-3Gal beta 1-4Glc to Gal beta 1-3(GlcNAc beta 1-6)Gal beta 1-4Glc. The enzyme was stimulated by Triton X-100 at concentrations between 0 and 0.2% and was inhibited by Triton X-100 at 0.5%. There is no requirement for Mn2+ and the enzyme activity is reduced to 65% in the presence of 10 mM EDTA. Enzyme products were purified and identified by proton NMR, methylation analysis and beta-galactosidase digestion. Competition studies suggest that this pig gastric mucosal beta 6-GlcNAc-transferase activity is due to the same enzyme that converts Gal beta 1-3GalNAc-R to mucin core 2, Gal beta 1-3(GlcNAc beta 1-6)GalNAc-R, and GlcNAc beta 1-3GalNAc-R to mucin core 4, GlcNAc beta 1-3(GlcNAc beta 1-6)GalNAc-R. Substrate specificity studies indicate that the enzyme attaches GlcNAc to either Gal or GalNAc in beta (1-6) linkage, provided these residues are substituted in beta (1-3) linkage by either GlcNAc or Gal. The insertion of a GlcNAc beta 1-3 residue into Gal beta 1-3GalNAc-R to form GlcNAc beta 1-3Gal beta 1-3GalNAc-R prevents insertion of GlcNAc into GalNAc. These studies establish several novel pathways in mucin-type oligosaccharide biosynthesis.

Animals↗

PubMed1986

Capillary gas chromatography-mass spectrometry of valproic acid metabolites in serum and urine using tert.-butyldimethylsilyl derivatives.

A quantitative method has been developed for valproic acid and twelve of its metabolites using capillary gas chromatography--mass spectrometry with selected-ion monitoring. The method is applicable to serum or urine and all metabolites are measured in a single run. Ions selected for quantitative purposes were the characteristic (M-57)+ ions of the tert.-butyldimethylsilyl (tBDMS) derivatives. The 4-hydroxyvalproic acid was measured as the gamma-lactone. Calibration curves were found to be linear and the sensitivities in the order of 0.1 microgram/ml. Patient data are presented. A comparison of tBDMS and trimethylsilyl (TMS) derivatives showed that tBDMS gave superior sensitivity for the unsaturated metabolites and a shorter analysis time. Mixed tBDMS-TMS derivatives were also investigated.

Gas Chromatography-Mass Spectrometry↗

PubMed1985

Mucin synthesis. UDP-GlcNAc:GalNAc-R beta 3-N-acetylglucosaminyltransferase and UDP-GlcNAc:GlcNAc beta 1-3GalNAc-R (GlcNAc to GalNAc) beta 6-N-acetylglucosaminyltransferase from pig and rat colon mucosa.

Pig and rat colon mucosal membrane preparations catalyze the in vitro transfer of N-acetyl-D-glucosamine (GlcNAc) from UDP-GlcNAc to GalNAc-ovine submaxillary mucin to form GlcNAc beta 1-3GalNAc-mucin. Rat colon also catalyzes the in vitro transfer of GlcNAc from UDP-GlcNAc to GlcNAc beta 1-3GalNAc-mucin to form GlcNAc beta 1-3(GlcNAc beta 1-6) GalNAc-mucin. This is the first demonstration of in vitro synthesis of the GlcNAc beta 1-3GalNAc disaccharide and of the GlcNAc beta 1-3-(GlcNAc beta 1-6)GalNAc trisaccharide, two of the four major core types found in mammalian glycoproteins of the mucin type, i.e., those containing oligosaccharides with GalNAc-alpha-serine (threonine) linkages. The activity catalyzing synthesis of the disaccharide has been named UDP-GlcNAc:GalNAc-R beta 3-N-acetylglucosaminyltransferase (mucin core 3 beta 3-GlcNAc-transferase), while the activity responsible for synthesizing the trisaccharide has been named UDP-GlcNAc:GlcNAc beta 1-3GalNAc-R (GlcNAc to GalNAc) beta 6-N-acetylglucosaminyltransferase (mucin core 4 beta 6-GlcNAc-transferase). The beta 3-GlcNAc-transferase from pig colon is activated by Triton X-100, has an absolute requirement for Mn2+, and transfers GlcNAc to GalNAc-alpha-phenyl, GalNAc-alpha-benzyl, and GalNAc-ovine submaxillary mucin with apparent Km values of 5, 2, and 3 mM and Vmax values of 59, 62, and 37 nmol h-1 (mg of protein)-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1985

Obesity.

While recognizing that many factors may contribute to the causation of ischaemic heart disease, this project attempts an in-depth examination of just one of them--obesity. The author has endeavoured to discover if there are sex differences in the incidence of obesity and whether or not obesity is related to age. Whilst recognizing the limitations of the small sample used in this project some tentative conclusions/speculations will be outlined. Some attempt has been made to discover if the average person is aware of what is meant by the term 'obesity' and if they see themselves as having this problem. Because of an intuition that people may become obese due to bad eating habits and ignorance about the nutritional value of certain foodstuffs, subjects were asked to list the calorific value of certain foods and their responses are discussed. A further attempt was made to ascertain whether the respondents had ever gone on a diet and if so, the type of diet and the success or otherwise of this measure. The subjects were further questioned to discover their level of knowledge regarding the possibility of certain disorders arising as a consequence of obesity and asked to outline what action they would take if they were faced with these consequences. Some conclusions have been drawn regarding the actions which would be taken when faced with crippling consequences. Finally, an attempt has been made to discover if some psychosocial states contributed to the causation of obesity or whether obesity leads to some psychosocial problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗