Chondrosarcoma of the scapula in an adolescent girl.
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Adolescent↗
Biomedical subjects
K Anderson
Publications and source records attributed to K Anderson.
Voltage-gated Na+ channel EOIII-segment-like immunoreactivity in fish retinal ganglion cells.
Although single-channel and whole-cell patch-clamp recordings have demonstrated the presence of Na+ currents in retinal ganglion cell somata, it has not previously been reported that an anti-Na+-channel antiserum stains both retinal ganglion cell somata and proteins with molecular weights corresponding to complexes of alpha and beta subunits. We probed adult goldfish retinas for Na+ channel-like immunoreactivity with a polyclonal antibody directed against the EOIII segment of vertebrate voltage-gated Na+ channels. In vertical sections and whole mounts, this antibody consistently stained the somata, axons, and proximal dendrites of retinal ganglion cells. Some somata in the proximal third of the inner nuclear layer were also stained. In Western blots, this antibody specifically stained multiple protein bands from retina and optic nerve, all with apparent molecular weights between 200 and 315 kDa. The largest of these molecular weights agrees with that reported previously for complexes of alpha and beta subunits in mammalian neurons, including retinal ganglion cells. The intermediate and lowest molecular weights are consistent with the presence of multiple Na+ channel alpha subunits, either in individual proximal retinal neurons or in different morphological subtypes.
Animals↗
Developmental differences in the expression and modulation of extracellular matrix proteases and inhibitors in mouse skin fibroblasts.
To investigate developmental differences in the wound repair process between fetal and adult skin fibroblasts, we studied the expression of plasminogen activator, plasminogen activator inhibitor, matrix metalloproteinase, and tissue inhibitor of metalloproteinase in E-15, E-17, newborn and adult mouse skin fibroblasts cultured within three dimensional matrices of either collagen or fibrin. Fibrin overlay and reverse overlay analyses revealed that mouse skin fibroblasts secreted tissue plasminogen activator and type1 plasminogen activator inhibitor. However, only E-15 and E-17 fibroblasts secreted the active form of tissue plasminogen activator, while in newborn and adult fibroblasts tissue plasminogen activator was conjugated to type1 plasminogen activator inhibitor. Only adult fibroblasts expressed a high level of active type1 plasminogen activator inhibitor. Gelatin zymography revealed that the predominant matrix metalloproteinase secreted by all the mouse fibroblasts was gelatinase A (matrix metalloproteinase -2). Matrix metalloproteinase -2 was partially activated in the adult fibroblasts cultured within a collagen matrix. The tissue inhibitor of metalloproteinase-2 was expressed by all fibroblasts, but levels were highest in the newborn and adult fibroblasts. When E-15 fibroblasts were cultured within a fibrin matrix, tissue plasminogen activator was downregulated. Transforming growth factor-betadownregulated tissue plasminogen activator while upregulating type1 plasminogen activator inhibitor, and platelet-derived growth factor enhanced tissue plasminogen activator expression in E-15 fibroblasts. Therefore, plasminogen activator and its inhibitor, and matrix metalloproteinase and its associated tissue inhibitor are differentially expressed in fetal and adult fibroblasts, and their expression is controlled by extracellular matrix components and growth factors present in wounds.
Animals↗
Developing seamless shaped woven medical products.
Currently, the cutting and sewing process is utilized to produce medical products with tailored shape, which leads to a number of adverse consequences due to seams. These drawbacks have prompted us to undertake research to develop new methods by which seamless tubular woven products with inherent shape could be produced. The methods could potentially lead to the design and production of seamless shaped textiles that might be used in a wide variety of medical applications. Three variables were tested, specifically yarn shrinkage, weave designs, and thread density. A variety of samples were woven using different combinations of these variables to create structures with different shrinkage properties. Upon finishing in a solution containing a surfactant and soda ash, the structures experience different degrees of shrinkage resulting in desired shapes. Length and width dimensions of each sample were taken before and after finishing. The change in sample shape due to differential shrinkage in terms of yarn shrinkage, weave, and thread density is reported.
Equipment Design↗
A comparison of autoanalyzer and manual methods for red cell antibody screening.
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Antibody Specificity↗
Correlates of informant-rated cognitive decline after stroke.
Cognitive impairment is common after stroke, but measurement is problematic. Six tests of mental ability, unaffected by loss of limb function, were administered to 49 subjects of mean age 74.2 years at a median of 4.3 years (range 0.1-16.8) after stroke together with a depression score and the IQCODE, an informant-rated scale of estimated cognitive decline. Over 90% of stroke patients were able to complete most tests. IQCODE correlated significantly with the HADS depression score (r = 0.35, p = 0.040), the 2-year Barthel score (r = -0.60, p = 0.001) and with a general cognitive factor extracted from the mental ability test scores (r = -0.42, p = 0.016). We conclude that informant-rated methods offer a promising approach to measuring cognitive decline after stroke.
Activities of Daily Living↗
A model for the prediction of osmolalities of modular formulas.
A model is proposed for evaluation of osmolality of multicomponent formulas composed of modular ingredients. Nonlinear curve-fitting techniques applied to empirical data result in prediction of the osmolality of ingredients for any concentration desired. Osmolality of a multicomponent formula can be obtained by adding osmolalities of ingredients. Data handling is made possible by the use of simple microcomputer programs. The model is tested with products available for construction of amino acid-restricted diets.
Amino Acids↗
Trace element status of PKU children ingesting an elemental diet.
We assessed the trace metal status of 10 children (3.5 to 13.3 yr) with phenylketonuria (PKU) who were successively treated for at least 6 months with a semi-synthetic formula restricted in phenylalanine, then for 6 months with a reformulated formula. The reformulated product contained higher concentrations of magnesium (Mg), potassium (K), phosphorus (P), selenium (Se), and zinc (Zn) and lower concentrations of calcium (Ca), sodium (Na), and unsaturated fats. Diet records, blood samples, and urine specimens were collected from each subject. Mean intakes of Mg, K, and Zn increased significantly when subjects were switched to the reformulated product. The subject's mean intakes of Se (for all age groups) and Zn (children 11 to 14 yr old) were below 67% of recommended intakes while they were ingesting the original formula. The mean trace metal concentrations of urine, blood, and serum did not differ significantly during the two periods. Mean serum Zn, Se, and Cu concentrations of the subjects were less than those reported for normal children. Significant negative correlations were obtained between serum Zn concentrations and the molar ratio of dietary (Ca + P):Zn, and the molar ratio of dietary Fe:Zn. No significant differences in mean urinary Cu and Zn excretion (mg/g creatinine) were observed in subjects after they were changed to the reformulated product. Individuals whose primary source of energy and protein is derived from semi-synthetic elemental diets are especially at risk for multiple trace element deficiencies.
Adolescent↗
Hip and groin injuries in athletes.
Although athletic injuries about the hip and groin occur less commonly than injuries in the extremities, they can result in extensive rehabilitation time. Thus, an accurate diagnosis and well-organized treatment plan are critical. Because loads of up to eight times body weight have been demonstrated in the hip joint during jogging, presumably even greater loads can occur during vigorous athletic competition. The available imaging modalities are effective diagnostic tools when selected on the basis of a thorough history and physical examination. Considerable controversy exists as to the cause and optimal treatment of groin pain in athletes, or the so-called "sports hernia." There has also been significant recent attention focused on intraarticular lesions that may be amenable to hip arthroscopy. This article briefly reviews several common hip and groin conditions affecting athletic patients and highlights some newer topics.
Acetabulum↗
Augmentation of tendon healing in an intraarticular bone tunnel with use of a bone growth factor.
We hypothesized that an exogenous bone growth factor could augment healing of a tendon graft in a bone tunnel in a rabbit anterior cruciate ligament-reconstruction model. Seventy rabbits underwent bilateral anterior cruciate ligament reconstructions with a semitendinosus tendon graft. One limb received a collagen sponge carrier vehicle containing a mixture of bone-derived proteins while the contralateral limb was treated with either no sponge or a sponge without bone-derived proteins. The reconstruction was evaluated at 2, 4, or 8 weeks with histologic, biomechanical, and magnetic resonance imaging analysis. Histologic analysis demonstrated that specimens treated with bone-derived proteins had a more consistent, dense interface tissue and closer apposition of new bone to the graft, with occasional formation of a fibrocartilaginous interface, when compared with control specimens. The treated specimens had significantly higher load-to-failure rates than did control specimens. Treatment with bone-derived proteins resulted in an average increase in tensile strength of 65%. The treated specimens were stronger than control specimens at each time point, but the difference was greatest at 8 weeks. On the basis of signal characteristics and new bone formation, magnetic resonance imaging was useful for predicting which limb was treated, the site of failure, and the limbs with higher load-to-failure values. This study demonstrates the potential for augmenting tendon healing in an intraarticular bone tunnel using an osteoinductive growth factor.
Animals↗
A biomechanical evaluation of taping and bracing in reducing knee joint translation and rotation.
We used five randomly selected cadaver specimens to evaluate the Anderson Knee Stabler and the Lenox Hill Knee Brace, individually and in combination with an anterior cruciate ligament protective tape method. Reduction of total laxity, as well as a defined pathologic anterior-posterior translation and internal-external rotation, was tested after the anterior cruciate and medial collateral ligaments of the specimens had been sectioned. Displacements were produced pneumatically; loads were applied to the tibia with the knee in 50 degrees of flexion. The tape and Lenox Hill Brace combination showed the greatest reduction in both anterior-posterior translation and internal-external rotation. The Lenox Hill Brace and the tape method used individually both restricted anterior-posterior translation and internal-external rotation better than the Stabler Brace alone. This study provides objective evidence of the restraining capabilities of these protective systems that may prove to be beneficial in the clinical setting.
Aged↗
Suprascapular nerve entrapment at the spinoglenoid notch in a professional baseball pitcher.
Suprascapular nerve injuries at the spinoglenoid notch are uncommon. The true incidence of this lesion is unknown; however, it appears to be more common in athletes who participate in sports involving overhead activities. When a patient is being evaluated for posterior shoulder pain and infraspinatus muscle weakness, electrodiagnostic studies are an essential part of the evaluation. Electromyography will identify an injury to the suprascapular nerve as well as assist in localizing the site of injury. In addition, imaging studies are also indicated to help exclude other diagnoses that can mimic a suprascapular nerve injury. The initial management should consist of cessation of the aggravating activity along with an organized shoulder rehabilitation program. If the patient fails to improve with 6 months to 1 year of nonoperative management, surgical exploration of the suprascapular nerve should be considered. Release of the spinoglenoid ligament with resultant suprascapular nerve decompression may result in relief of pain and a return of normal shoulder function.
Adult↗
Discussing cardiopulmonary resuscitation with patients.
The British Medical Association and the Royal College of Nursing acknowledge that patients should be involved in the decision-making process regarding cardiopulmonary resuscitation (CPR) in order to gain compliance with any decision made on their behalf. In the past, it was apparent that decisions concerning the eligibility of patients for CPR were being made arbitrarily and older people were being treated unfairly in respect of their consideration for this intervention. This article reviews literature associated with patient involvement in decision-making regarding CPR and 'do not resuscitate' orders and how an assessment and rehabilitation unit promoted this activity as usual practice. In order to enhance partnership with patients and promote best possible practice in respect of CPR decision making the authors suggest a strategy that includes (1) evaluating documentation (2) development of a patient information leaflet and (3) an education programme for healthcare personnel.
Advance Directives↗
Reviewing and revising P&P manuals.
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British Columbia↗
The purpose at the heart of management.
To succeed, startup enterprises need both passion and good management. But entrepreneurs can be famous for their visionary ardor and still be lousy managers. Traditionally, the key to long-term growth is getting the company founder to step aside so professional management can take over. Sometimes, however, this means abandoning a company's greatest asset in order to improve its procedures. A better solution is for the entrepreneur to learn to manage. Kye Anderson had motivation to spare. When she was 13, her 47-year-old father suffered recurrent shortness of breath followed by a massive heart attack. For her, the result was a single-minded career in medical technology and the development of innovative systems for diagnosing heart-and-lung disease. She had the zeal and determination it took to sell her ideas to investors and doctors, found a company, and grow it. But then, on the grounds that she lacked the financial and managerial expertise to carry her business from exuberant adolescence to profitable maturity, she stepped aside. A year and a half later, Anderson came back. She picked new board members who could act as entrepreneurial mentors. She reasserted certain original core values such as the importance of R&D and the emphasis on the patient as the ultimate customer. She discarded business lines that had strayed too far afield, and she learned how and what to delegate. Most important of all, Anderson realized that a leader's greatest obligation is to preach, and she began to spend much of her time communicating with her own employees about the purpose, mission, values, and strategy that could carry the company into a billion-dollar primary-care market.
Administrative Personnel↗
Quantitative assessment with SPECT imaging of stress injuries of the pars interarticularis and response to bracing.
The evaluation and management of acute spondylolysis remains unclear in part because of outcome data that are primarily subjective. The aim of this study was to evaluate and monitor these patients objectively using quantitative single-photon emission computed tomography (SPECT). Thirty-four patients were so observed clinically between 1987 and 1996 and were studied with an initial and at least one follow-up SPECT scintigram. Initial radiographs and planar bone scans failed to demonstrate the pars lesion in 53 and 19% of the patients, respectively. The average SPECT ratio before brace treatment was 1.45. After treatment, this ratio significantly decreased to 1.27 (p = 0.03). A subset of patients remained symptomatic at follow-up. Their reduction in SPECT ratio averaged only 2.8% as compared with 13% for the remainder of the patients (p = 0.01). Patients diagnosed and braced in the early, more active stage of the condition (with greater intensity on SPECT) had more predictable symptom relief. An initial SPECT ratio of >1.5 was associated with complete symptom resolution after brace treatment. Patients treated with activity restriction only (>3 months) before bracing were more likely to have persistent symptoms and more modest improvement on SPECT (p = 0.01). These data, which use SPECT scintigraphy, support prompt treatment with brace immobilization for acute spondylolysis in children and adolescents.
Adolescent↗
Communication breakdown.
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Communication↗
CDS responds to hygienist shortage.
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Chicago↗