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Biomedical subjects

J R Webster

Publications and source records attributed to J R Webster.

At least 55 records · Page 3Linked to original sources
PubMed1987

Faculty on call.

Explore the source record for details and available documents.

Faculty, Medical↗
PubMed1985

Prepaid entitlements. A new challenge for physician-patient relationships.

The transition from a fee-for-service model to a prepaid health care system creates new challenges for both physicians and patients. Occasionally both can feel trapped in the new setting and must rely on new or different strategies to reach sometimes divergent objectives. This may alter the physician-patient relationship in ways that neither likes. Based on our experience in a large multispecialty academic group practice, we have developed management strategies to mitigate such stresses on both parties. These include review of marketing efforts; education of new patients to foster realistic expectations; a physician-generated, prospective internal policy for dealing with dissatisfied patients and physicians; a strong central administrative physician to serve as a "lightning rod" and counselor; and continuing physician orientation and education to improve judgment and attitudes. These strategies promote the physician's role as expert consultant-educator with the best interests of the patient as the first priority.

Chicago↗
PubMed1985

Advancement of reproductive activity, seasonal reduction in prolactin secretion and seasonal pelage changes in pubertal red deer hinds (Cervus elaphus) subjected to artificially shortened daily photoperiod or daily melatonin treatments.

Prepubertal red deer hinds were subjected to shortened daily photoperiod (8 h light per day, N = 3) or a daily (afternoon) melatonin injection (N = 4) for 83 days starting on 8 January, 2 weeks after the summer solstice. Compared with control hinds (N = 3) these treatments caused premature moulting of summer pelage, reduced serum prolactin concentrations to barely detectable levels about 34 days earlier than usual and advanced the date of mating. Calves were born earlier (P less than 0.005) in the hinds exposed to a shortened photoperiod (12 November +/- 1.7 days) and melatonin treatment (11 November +/- 3.2 days) than in control hinds (13 December +/- 7.9 days). Serum progesterone levels recorded before the first detected oestrus indicated that silent ovulations had occurred in many of the hinds (6 of 10) in this experiment. This study demonstrated the role of shortened daily photoperiod in red deer and indicated that the effects of reduced photoperiod observed were mediated by melatonin.

Animals↗
PubMed1981

Purification and Characterization of an Autolysin from Clostridium acetobutylicum.

A proteinaceous substance with antibiotic-like activity, resembling that of a bacteriocin, was isolated from an industrial-scale acetone-butanol fermentation of Clostridium acetobutylicum. The substance, purified by acetone precipitation, diethylaminoethyl cellulose chromatography, and polyacrylamide gel electrophoresis, was characterized as a glycoprotein with a molecular weight of 28,000. The glycoprotein was partially inactivated by certain protease enzymes. It had no effect on deoxyribonucleic acid, ribonucleic acid, or protein synthesis, and it did not result in the loss of intracellular adenosine triphosphate. The glycoprotein lysed sodium dodecyl sulfate-treated cells and cell wall preparations, and therefore it is referred to as an autolysin. The autolysin gene appeared to be chromosomal since plasmid deoxyribonucleic acid was not detected in the C. acetobutylicum strain.

Journal Article↗
PubMed1980

Pulmonary alveolar proteinosis in two siblings with decreased immunoglobulin A.

A brother and sister with classic, biopsy proved pulmonary alveolar proteinosis are described. Both had low serum and low normal secretory immunoglobulin A (IgA) levels. A tendency for familial occurrence is possible and it is recommended that patients with pulmonary alveolar proteinosis, and their families, be evaluated for immunologic deficiencies.

Adolescent↗
PubMed1979

Bacteriocin production by Clostridium acetobutylicum in an industrial fermentation process.

High titers of a noninducible bacteriocin were produced by Clostridium acetobutylicum in a molasses fermentation medium used for the industrial production of solvents. Release of the bacteriocin towards the end of the exponential growth phase was accompanied by lysis of the culture and inhibition of the production of solvents. The producer cells were sensitive to the bacteriocin, which only affected other C. acetobutylicum strains and a Clostridium felsineum strain. The thermolabile bacteriocin was not inactivated by protease enzymes and had no optimum stability between pH 4 and 5. The sedimentation coefficient of the bacteriocin was 6S.

Bacteriocins↗
PubMed1975

Combined video/pressure/flow cystourethrography in female patients with voiding disturbances.

The urodynamic investigation of 152 female patients with symptoms of recurrent cystitis by synchronous video/pressure/flow cystourethrography is presented. The results fall into the following groups: (1) Normal: In 77 patients, no abnormality was found. (2) Bladder outflow obstruction: In 52 patients increased resistance to micturition was demonstrated at the level of the external sphincter. Levels of bladder pressure, flow rate, calculated urethral resistance, and cystographic appearance allow the degree of obstruction to be assessed and the urodynamic effect of treatment by dilation or urethrotomy to be appreciated. (3) Reflux: In 17 patients, reflux was demonstrated, 14 of whom showed no evidence of outflow obstruction. Postoperative assessment of reimplantation procedures are briefly discussed. (4) Systolic and unstable bladders: Six patients were in this group; the manifestations of instability are discussed together with the concept of sensory and motor urgency.

Adolescent↗
PubMed1975

Lactic acidosis from carboxyhemoglobinemia after smoke inhalation.

Tissue hypoxia as a result of a wide variety of clinical situations had frequently been implicated as a cause of systemic acidosis due to the accumulation of lactic acid. Four patients suffering from smoke inhalation had lactic acidosis in association with carboxyhemoglobinemia. There was no evidence of decreased tissue perfusion, hypotension, arterial hypoxemia, or anemia. The following were tested in all patients: arterial pH (7.25 to 7.40), Pco-2 (19 to 27 mm Hg), Po (63 to 116 mm Hg), HCO-2- (11 to 19 meq/litre), carboxyhemoglobin (13% to 37%), and lactic acid (5.1 to 9.3 meq/litre). After therapy with oxygen and intravenous corticosteroids, there was prompt return of lactic acid levels, carboxyhemoglobin values, and arterial pH to normal. It is concluded that the cause of lactic acidosis in the presence of carboxyhemoglobinemia during smoke inhalation is tissue hypoxia. This tissue hypoxia is due to the reduction of the oxygen-carrying capacity of the blood and the concomitant shift of the oxyhemoglobin dissociation curve to the left, both known to result from carboxyhemoglobinemia.

Acidosis↗
PubMed1974

Videocystography with synchronous detrusor pressure and flow rate recordings.

The addition of pressure and flow rate recordings to conventional cystourethrography is relatively inexpensive in terms of cost and of radiologist's time, each investigation requiring approximately half an hour.The value of this investigation in males lies in assessing the severity and site of outlet obstruction, particularly when the prostate is not clinically enlarged. Its value in demonstrating detrusor instability in cases of obstruction and in patients with post-prostatectomy problems is discussed. It is essential to the adequate assessment of sphincter mechanisms in both males and females. The particular importance of this in the female lies in the poor results of routine surgery for incontinence where this is due to detrusor instability.Finally the importance in neurological patients of a urodynamic evaluation of continence mechanisms and voiding dysfunction, both as a preliminary assessment and as a guide to the efficacy of treatment, is outlined.Various criticisms of the technique are reviewed and appropriate rebuttals provided.

Endoscopy↗