Amino acid activation in crystalline tyrosyl-tRNA synthetase from Bacillus stearothermophilus.
Explore the source record for details and available documents.
Adenosine Monophosphate↗
Biomedical subjects
J Rubin
Publications and source records attributed to J Rubin.
Randomized clinical trial of diethylstilbestrol versus tamoxifen in postmenopausal women with advanced breast cancer.
Before the introduction of tamoxifen, diethylstilbestrol (DES) was widely considered to be the hormonal treatment of choice in postmenopausal women with advanced breast cancer. We performed a randomized clinical trial of these two agents to determine their relative efficacy and toxicity. The trial involved 143 evaluable patients, of whom 99 had received no prior systemic therapy and 44 had received previous chemotherapy. The regression rates (complete plus partial) were higher in patients receiving DES (41 per cent) than in those receiving tamoxifen (33 per cent), but not significantly so (P = 0.37). In patients who had had no prior systemic therapy, the rates were 44 per cent and 38 per cent, respectively (P = 0.55), and in those who had had previous chemotherapy, 32 per cent vs. 23 per cent (P = 0.50). Analysis of the time until treatment failure for the two treatment groups showed no significant difference (medians: DES, 142 days; tamoxifen, 171 days). Toxicity was greater in patients receiving DES; nine of 74 patients (12 per cent) discontinued therapy solely because of adverse reactions. Since there was no statistically significant difference in efficacy and since tamoxifen was less toxic, tamoxifen appears to be the preferred agent.
Aged↗
Uncommon causes of peritonitis in patients undergoing peritoneal dialysis.
In five patients, peritonitis caused by uncommon agents was acquired during continuous ambulatory peritoneal dialysis. Three patients had yeast (two Candida albicans, one C parapsilosis), one Aspergillus fumigatus, and one Nocardia asteroides infections. A review of the literature indicates that yeasts are the most common cause of peritoneal dialysis-associated fungal peritonitis; only one other possible case of Aspergillus sp and no Nocardia infections have been proved, to our knowledge. Observations are recorded in reference to diagnosis and suggested methods of treatment.
Adult↗
Pharmacology of amygdalin (laetrile) in cancer patients.
Plasma and urine concentrations of amygdalin, whole-blood concentrations of cyanide, and thiocyanate concentrations in serum and urine were determined in cancer patients following intravenous (4.5 g/m2) and oral (500-mg tablet) administration of amygdalin. To measure low plasma concentrations of amygdalin following oral administration a GC/MS assay was developed. Following intravenous administration, concentrations of parent drug as high as 1,401 microgram/ml were observed, with no increase in plasma concentrations of cyanide or serum concentrations of thiocyanate. Plasma elimination of amygdalin was best described by a two-compartment open model with a mean distributive phase half-life of 6.2 min, mean elimination phase half-life of 120.3 min, and mean clearance of 99.3 ml/min. Following oral administration of amygdalin, plasma concentrations were much lower, with peak values of less than 525 ng/ml. Cyanide concentrations increased to values as high as 2.1 microgram/ml whole blood. Thiocyanate concentrations did not increase for several days, plateauing at values as high as 38 microgram/ml serum. Ingestion of almonds by two patients taking oral amygdalin increased cyanide concentrations compared with values obtained after oral amygdalin alone.
Administration, Oral↗
Adenomatous polyp of the bladder: a rare cause of hematuria in young men.
A 26-year-old black man presented with gross hematuria and was found to have a papillary lesion of the trigone of the bladder. The lesion proved to be an adenomatous polyp with prostatic-type epithelium. This type of neoplasia ordinarily is found in the prostatic urethra and has not been reported previously in the bladder. Adenomatous polyps are benign tumors and should be considered in the differential diagnosis of hematuria in young men.
Adult↗
Peritoneal dialysis during peritonitis.
Peritonitis during peritoneal dialysis is the most frequent complication associated with this dialysis technique. We studied patients undergoing peritoneal dialysis when they were without peritonitis and during episodes of clinical infection. Peritonitis was associated with a significantly decreased dialysate effluent volume, increased absorption of glucose, clearance of urea and creatinine, and protein loss in the dialysate effluent. We suggest that the changes occurring to the peritoneal dialyzing surface with peritonitis might be explained by alterations in peritoneal blood flow, effective membrane surface area, or permeability.
Adult↗
Total body potassium--a guide to nutritional health in patients undergoing continuous ambulatory peritoneal dialysis.
Nutritional status in patients undergoing continuous ambulatory peritoneal dialysis was estimated by serial simultaneous measurements (3 to 6 months) of total body potassium, weight, serum, albumin, total serum globulins and IgG, IgA, IgM, total iron binding capacity, and hematocrit. Correlations were performed between the changes per month in these measurements and with episodes of peritonitis per month. Changes per month in serum albumin and total iron binding capacity correlated with total body potassium. Serum immunoglobulins fell with time on continuous ambulatory peritoneal dialysis but there was no correlation with the other measurements. Changes in total body potassium per month correlated negatively with episodes of peritonitis per month. Of these measured parameters only the change in total body potassium per month reflected long-term clinical consequences of peritonitis. The studies suggest that lower rates of infection, hopefully now possible with solutions in plastic bags, will prevent catabolism.
Adult↗
The determinants of average daily census in public mental hospitals: a simultaneous model.
Increasing effort and resources are being devoted to reducing the reliance on state institutions for the mentally ill. Little empirical support is available for many of the proposed policies. In this article we construct and estimate a model based on the assertion that rates of institutionalization in public mental hospitals are dependent upon the availability of alternative treatment facilities, the legal environment, the prevalence of mental illness and the cost of care. A two-equation model is estimated using pooled cross-sectional state data for 1974 and 1975. The results show a significant correlation between rates of public mental hospital average daily census and expenditures per patient day, certain aspects of commitment statutes and the presence of Community Mental Health Center and alcoholic halfway-house beds.
Community Mental Health Centers↗
Influence of patient characteristics on peritoneal clearances.
Few studies have explored how patient characteristics may influence clearances. We sought to determine if patient age, sex, size, renal disease, blood pressure, hematocrit, serum total proteins and albumin affected peritoneal clearances, drainage volumes or dialysate protein concentration. We found inulin clearances to be related to surface area and total serum proteins. Creatinine clearance was related to age, serum albumin and hematocrit. Sex, blood pressure or type of renal disease did not influence peritoneal clearances.
Adolescent↗
Peritoneal abnormalities during infectious episodes of continuous ambulatory peritoneal dialysis.
Exchanges were performed in 1-hour and 3- to 5-hour cycles when patients were noninfected and during episodes of peritonitis. The hourly exchange dialysate effluent volume decreased with the occurrence of peritonitis. These exchanges were associated with increased glucose absorption from dialysate, diminished sodium removal and augmented clearances of urea and creatinine. Protein losses were increased in the dialysate effluent of patients during an episode of peritonitis during the hourly exchanges. In the long-dwell exchanges obtained after clinical improvements of peritonitis, only protein losses were increased over control. Clearances, sodium loss in dialysate and glucose absorption were not altered from control.
Adult↗
A comparison of peritoneal transport in patients with psoriasis and uremia.
Peritoneal solute equilibration studies during prolonged intraperitoneal dwell were performed in patients with psoriasis and normal renal function, and compared to patients with renal failure undergoing peritoneal dialysis. Calcium, phosphorous, uric acid and protein equilibration were faster in uremics. No differences were observed for sodium and chloride. Mass transfer area coefficients (a measure of the mass transfer at infinite dialysate flow rates) were calculated for glucose, protein and uric acid and found to be complimentary to the results obtained by studies of solute equilibration. Possible reasons for the differences obtained are discussed.
Adult↗
The National Plan for the Chronically Mentally Ill: a review of financing proposals.
In this, a companion piece to the preceding article, the author summarizes and examines the financing issues and recommendations set forth in the National Plan for the Chronically Mentally Ill. The major federal programs that provide assistance to chronic patients are described briefly. Sixteen proposed incremental reforms designed to fill gaps in the existing service system are listed and discussed; nine involve changes in the Medicaid program. The author also considers the options to go beyond incremental changes toward the establishment of a comprehensive program focused specifically on the needs of the chronically mentally ill. He discusses the advantages and drawbacks of three methods of organizing financing of mental health services that are described in the National Plan--a structured services program, a benefit-voucher program, and a cash transfer program.
Chronic Disease↗
Total intravenous anaesthesia for major gynaecological surgery.
A technique of total intravenous anaesthesia using etomidate by bolus intravenous (IV) injection for induction and by continuous intravenous infusion for maintenance of anaesthesia, with supplementary intravenous fentanyl analgesia, is described. Muscle relaxation was provided by competitive neuromuscular blockade, allowing controlled ventilation of the lungs with oxygen-enriched air. Arterial blood pressure, heart rate and rhythm remained stable throughout the procedure. Few complications were encountered of which the most significant was a 13% incidence of nausea and/or vomiting. Pain on injection, abnormal muscular movements on induction, and post operative venous sequelae were uncommon. Patients were easily rousable shortly after termination of drug infusion. The technique proved acceptable to the patient, surgeon and experienced anaesthetist and, thereby, would appear to offer a reasonable alternative to the more conventional inhalational anaesthetic technique.
Adult↗
Evaluation of stagnant fluid films during simulated peritoneal dialysis: in-vitro and in-vivo studies.
Peritoneal dialysis as conventionally performed is an intermittent low dialysate flow system. Few studies have explored the effects of the intermittent nature of dialysate flow. Using an in-vitro model, we demonstrated that conventional peritoneal dialysis permits the development of stagnant fluid films and that by disruption of these films, dialysance could be augmented. We tested and confirmed these observations by carrying out peritoneal dialysis in rats. Stagnant fluid films may be an important contributor to overall membrane resistance in the peritoneal dialysis system
Animals↗
A controlled clinical and immunological evaluation of immunotherapy with Bacillus Calmette--Guerin in patients with metastatic cancer.
One hundred thirty adult patients with metastatic solid tumors were studied to evaluate the therapeutic results, toxicity, and immunological effects of three BCG preparations given intradermally by the multiple puncture time technique on either a monthly or weekly schedule: Tice lyophilized BCG, Pasteur lyophilized BCG, and Pasteur fresh-frozen BCG. Patients were randomly assigned in a double-blind manner to receive one of the BCG preparations or saline placebo administered in an identical manner. A battery of immunological tests were performed pretreatment and serially during the investigation. None of the 82 patients with measurable indicator lesions experienced an objective tumor response, nor were there any differences in survival among patients receiving any of the BCG preparations compared to placebo. Toxicity consisted of mild to moderate local cutaneous reactions and liver function abnormalities in BCG-treated patients with no significant differences between BCG preparations. Improvements in each of the assays of immune function performed occurred with roughly equal frequency among patients receiving BCG or placebo. It was not possible to demonstrate any significant clinical or immunological benefit from BCG administration in this patient population with the methodology employed.
Adult↗
Continuous ambulatory peritoneal dialysis. Treatment of dialysis-related ascites.
Continuous ambulatory peritoneal dialysis is a new dialysis technique. It is unknown at this time which patient would be served best by this therapy. Two cases of dialysis-related ascites were successfully treated by this technique. We suggest that the continuous control of salt and water balance possible with this technique, as well as frequent drainage of the peritoneal cavity to prevent fluid reaccumulations, contributed to successful treatment. Continuous ambulatory peritoneal dialysis may be used to treat dialysis-related ascites.
Adult↗
Lorazepam as a premedicant in dental surgery.
In a double-blind study, 100 young, healthy (American Society of Anesthesiologists physical status 1) patients received lorazepam (Ativan; Wyeth) 2,5 mg or placebo orally as premedication before general anaesthesia for extraction of wisdom teeth. Lorazepam produced a significant reduction in the incidence of pre-operative anxiety and post-anaesthetic headache compared with placebo (P less than 0,01). Anterograde amnesia was also more frequent in the patients who had received lorazepam (P less than 0.001). The medicolegal implications of using lorazepam as a premedicant in dental surgery at a day clinic are discussed.
Adolescent↗
Effect of domperidone on lower esophageal sphincter tone in late pregnancy.
Increasing the resting lower esophageal sphincter (LES) tone is a useful method of preventing gastroesophageal reflux. The effects of a new antiemetic, domperidone, on LES were studied in 28 subjects. Group I included eight normal nonpregnant control subjects. The remaining 20 pregnant women were divided into two groups, Group II and III--ten parturients without and ten with symptoms of heartburn. Domperidone increased LES pressure by 19, 11 and 10 cm H2O in Groups I, II and III, respectively (P less than 0.05). Domperidone may be a valuable premedicant in some patients to decrease the chance of gastro-esophageal reflux.
Adolescent↗