[Direct intraureteral dosimetry in gynecologic irradiation].
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Carcinoma↗
Biomedical subjects
K Martin
Publications and source records attributed to K Martin.
Concentrative accumulation of choline by human erythrocytes.
Influx and efflux of choline in human erythrocytes were studied using (14)C-choline. When incubated at 37 degrees C with physiological concentrations of choline erythrocytes concentrate choline; the steady-state ratio is 2.08 +/- 0.23 when the external choline is 2.5 microM and falls to 0.94 +/- 0.13 as the external concentration is raised to 50 microM. During the steady state the influx of choline is consistent with a carrier system with an apparent Michaelis constant of 30 x 10(-6) and a maximum flux of 1.1 micromoles per liter cells per min. For the influx into cells preequilibrated with a choline-free buffer the apparent Michaelis constant is about 6.5 x 10(-6)M and the maximum flux is 0.22 micromole per liter cells per min. At intracellular concentrations below 50 micromole per liter cells the efflux in the steady state approximates first order kinetics; however, it is not flux through a leak because it is inhibited by hemicholinium. Influx and efflux show a pronounced exchange flux phenomenon. The ability to concentrate choline is lost when external sodium is replaced by lithium or potassium. However, the uphill movement of choline is probably not coupled directly to the Na(+) electrochemical gradient.
Biological Transport, Active↗
Membrane transport of drugs.
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Biological Transport↗
Active transport of choline into human erythrocytes.
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Biological Transport, Active↗
[Hyperglycinemia (glycinosis) with familial idiopathic hyperglycinuria. 1st observation in Germany].
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Amino Acid Metabolism, Inborn Errors↗
Antibodies to polymerized human serum albumin in acute and chronic liver disease.
Since antibodies to polyalbumin have been noted to occur in patients with hepatitis or cirrhosis, we investigated sera from 219 patients with a variety of acute and chronic liver diseases with and without HBsAg using an ELISA. The prevalence of circulating polyalbumin antibodies was shown to be significantly increased over that of healthy controls (6.7%) in patients with autoimmune chronic active hepatitis (67%), acute viral hepatitis (41%) and fulminant hepatic necrosis (38%), but such antibodies were absent in chronic hepatitis B patients and other liver diseases. Serial studies in acute hepatitis showed evidence of antibodies early in the course of illness with disappearance prior to full recovery. In acute hepatitis B, the presence of polyalbumin antibodies was significantly associated with female sex (p less than 0.01), 3-fold higher transaminase levels and shorter duration of clinical illness (less than 4 weeks in all cases). Polyalbumin antibodies appear to be associated with diseases characterized by active hepatocyte necrosis. Since they are evident early in acute hepatitis B when complexes of polyalbumin and virus are likely, these antibodies may play an adjunctive role to other hepatitis B-related antibodies in the clearance of hepatitis B virus infection.
Antibodies↗
An isolated left common carotid artery from the main pulmonary artery: possible malseptation of the truncoaortic sac.
An isolated left common carotid artery (LCA) is an extremely rare condition with only four reported cases. In each case, the isolated carotid artery connects to the right or left pulmonary artery via the ductus arteriosus and the embryologic basis for the abnormalities is believed to reflect an error in the development of the branchial arches. We present a case of an isolated LCA connecting to the main pulmonary artery in association with a right aortic arch and an anomalous origin of the left subclavian artery from the descending aorta. The left ligamentus arteriosus was identified separately. This may represent a disturbance in the septation of the truncoaortic sac secondary to abnormal migration of neural crest cells rather than a pure developmental anomaly of the branchial arches.
Aorta, Thoracic↗
A simple acoustically coupled calibrator.
An acoustically coupled device is described which is designed to calibrate the electronic caliper systems of diagnostic ultrasound machines. The device is intended primarily for use with linear array machines where electrical interconnection of test equipment is not possible. The transmitter pulse from the linear array machine is detected by a single element transducer held in contact with its probe and used by the calibrator to initiate the injection of accurately timed markers back into the real time probe via the same transducer. The real time caliper system may be calibrated to 1540 or 1600 ms-1 using markers thus displayed on the real time machine. The device is compact and convenient to use.
Calibration↗
Group intervention with pre-recovery patients.
This article examines treatment outcomes of alcohol and drug abusing patients admitted to a university-based alcohol and drug outpatient clinic. Treatment effectiveness of two treatment models were evaluated. The psycho-educational approach utilized a teacher-student model with the goal of imparting information about drugs and consequences of use. The recovery-oriented approach utilized a patient-counselor collaborative model where patients were encouraged to be active in progressing through sequential stages of pre-recovery tasks. Patients in the psycho-education group stayed in treatment longer and were more likely to rate treatment as useful. Results showed minimal differences between the two groups in terms of Addiction Severity Index scores, Drug Attitude, and urine drug screen results.
Adult↗
[A case of Parkinsonian syndrome, cognitive impairment and hyperammonemia induced by divalproate sodium prescribed for bipolar disorder].
Several cases of Parkinsonian syndrome, cognitive impairment or hyperammonemia induced by sodium valproate have been described in the literature. We report the first case presenting an association of the three adverse effects occurring with divalproate sodium prescribed for bipolar disorder: a 58-year-old man with a history of bipolar type I disorder presented with Parkinsonian syndrome and cognitive impairment of insidious onset. This patient had been treated for several years with lithium carbonate, with a successful effect on mood swings, but with distressing adverse effects such as hand tremor and diarrhoea. Lithium therapy was progressively withdrawn while sodium divalproate was initiated. Associated medications, unchanged for several years, were amisulpride (daily dose: 100 mg), liothyronine, ciprofibrate and benfluorex. The patient was treated with sodium divalproate for seven months (daily dose: 1,000 mg), and with trihexyphenidyle for one month for extrapyramidal symptoms. At hospital admission, he presented with temporal disorientation, slowed thinking, severe anterograde memory deficits, and Parkinsonian syndrome. The minimal mental state (MMS) score was 16 (maximum: 30). The patient was anxious but did no present with mood symptoms. He also developed hyperammonemia (124 micromol/liter, normal range: 15 to 60 micromol/liter) without signs or biochemical evidence of hepatic failure. Valproate concentrations were within the therapeutic ranges (79 mg/l, normal range: 50 to 100 mg/l). The CT-scan showed cerebral and cerebellar atrophy with enlarged ventricles. The electroencephalogram showed generalized slowing waves. All the symptoms resolved within one month after the withdrawal of divalproate: the extrapyramidal hypertonia resolved, the MMS score was 29. The CT-scan and the electroencephalogram returned to normal. The divalproate was replaced by lithium. After a one-year follow-up, the cognitive and neurological symptomatology did not reappear at the exception of the pre-existing hand tremor. The pathophysiology of valproate induced hyperammonemic encephalopathy remains unclear. A possible mechanism is neuronal toxicity induced by increased intracellular concentrations of glutamate and ammonium in astrocytes. Indeed, these abnormal intracellular concentrations increase the intracellular osmolarity and thus induce rise in intracranial pressure and cerebral oedema. Reversible dementia could be due to a direct toxic effect of valproate on the central nervous system or to an indirect effect mediated through valproate-induced hyperammonemia. It has been suggested that the occurrence of extrapyramidal syndrome could be explained by a disturbance in the GABAergic pathways inducing reversible dopamine inhibition. A drug adverse reaction should always be considered when a patient treated with valproate presents with extrapyramidal symptoms and cognitive disorders even when valproate concentrations are within standard therapeutic ranges.
Antipsychotic Agents↗
Opportunistic lymphoproliferations associated with Epstein-Barr viral DNA in infants and children with AIDS.
Two types of lymphoproliferative disease associated with Epstein-Barr viral (EBV) DNA--central-nervous-system lymphoma and chronic lymphocytic interstitial pneumonitis (LIP)--were recognised in children with human T-lymphotropic virus type III/lymphadenopathy virus infection and the acquired immunodeficiency syndrome (AIDS). Eight of ten lung biopsy specimens from children with LIP contained EBV DNA. EBV DNA was not identified in lung biopsy specimens with Pneumocystis carinii, cytomegalovirus, or atypical mycobacteria but without LIP, nor was EBV found in lung biopsy specimens from five adults with AIDS. Children with these EBV-associated complications had raised serum antibody titres to the replicative EBV antigens, but most of them lacked antibody to the component of the EB nuclear antigen encoded by the Bam HI K fragment. EBV-associated lymphoproliferative disease is a common and important complication of childhood AIDS.
Acquired Immunodeficiency Syndrome↗
Degenerate perturbations of protein structure as the mechanism of anaesthetic action.
The interaction of the n-alkanols with lipid bilayers and excitable membranes shows that there is no simple correlation between conduction block and any of the perturbations of bilayer structure currently proposed as unitary mechanisms of local anaesthetic action. We propose instead that the n-alkanols act by direct interaction with target proteins to cause perturbations which depend directly on the precise structure of the alcohol.
Alcohols↗
Insulin-like growth factor-1 inscribes a gene expression profile for angiogenic factors and cancer progression in breast epithelial cells.
Activation of the insulin-like growth factor-1 receptor (IGF-1R) by IGF-1 is associated with the risk and progression of many types of cancer, although despite this it remains unclear how activated IGF-1R contributes to cancer progression. In this study, gene expression changes elicited by IGF-1 were profiled in breast epithelial cells. We noted that many genes are functionally linked to cancer progression and angiogenesis. To validate some of the changes observed, the RNA and/or protein was confirmed for c-fos, cytochrome P450 1A1, cytochrome P450 1B1, interleukin-1 beta, fas ligand, vascular endothelial growth factor, and urokinase plasminogen activator. Nuclear proteins were also temporally monitored to address how gene expression changes were regulated. We found that IGF-1 stimulated the nuclear translocation of phosphorylated AKT, hypoxic-inducible factor-1 alpha, and phosphorylated cAMP-responsive element-binding protein, which correlated with temporal changes in gene expression. Next, the promoter regions of IGF-1-regulated genes were searched in silico. The promoters of genes that clustered together had similar regulatory regions. In summary, IGF-1 inscribes a gene expression profile relevant to cancer progression, and this study provides insight into the mechanism(s) whereby some of these changes occur.
Blotting, Western↗
Women's initiative for nonsmoking (WINS) II: the intervention.
Women's Initiative for Nonsmoking (WINS) is a randomized clinical trial designed to test the efficacy of a nurse-managed smoking cessation and relapse prevention intervention designed specifically for women. The WINS intervention is rooted in social learning theory, specifically that of self-efficacy. It is a multimedia approach that provides education, counseling, and telephone follow-up that meet the smoking cessation intervention guidelines established by the Agency for Health Care Policy and Research. The WINS intervention has been successfully implemented in more than 140 women and has proven to be feasible and well accepted by both the women and their health care providers. Although the intervention in the protocol-driven randomized clinical trial was begun in the hospital, it is anticipated that nurses in any setting, inpatient or outpatient, who serve populations at risk for cardiovascular disease, peripheral vascular disease, lung cancer, or pulmonary disease could successfully provide the intervention.
Cardiovascular Diseases↗
Validation of changes in extracellular volume measured during hemodialysis using a segmental bioimpedance technique.
Sum of segmental bioimpedance analysis (BIAs) has recently been introduced as a more accurate estimation of extracellular volume (ECV). The current study was designed to compare the changes in ECV estimated by whole body bioimpedance (BIA(W)) and BIAs and to determine whether BIAs could be used to accurately estimate changes in ECV compared with the ultrafiltration volume (UFV) as measured by the dialysis machine. Ten men (age, 49 +/- 10 years; dry weight, 78 +/- 13 kg) were studied during hemodialysis (HD). A multifrequency bioimpedance analyzer (BIS4000B; Xitron Technologies, San Diego, CA) and a digital switch developed by the authors were used to automatically collect data from three body segments (arm, trunk, and leg) and the whole body using the stated technique. There was a significant difference in delta ECV(W) and UFV at the end of the treatment (2.75 +/- 0.74 L vs 3.95 +/- 0.73 L, p < 0.05) because fluid removal from the trunk has almost no effect on whole body resistance. However, delta ECVs was not significantly different from UFV (3.76 +/- 0.65 L vs 3.95 +/- 0.73 L, p = NS). BIAs is a more accurate approach to monitor changes in ECV during HD than is BIA(W) because changes in local resistance can be allocated to segments with uniform geometry and resistivity. This is a prerequisite for future studies on dynamics of regional fluid distribution during hemodialysis.
Biophysical Phenomena↗
Predictive value of access blood flow in detecting access thrombosis.
The aim of this study was to evaluate whether repeated measurement of access blood flow (Qac) using the ultrasound dilution technique could predict access failure in patients on hemodialysis. One hundred thirty-one patients were evaluated at intervals of 8 weeks for a period of 6 months. The incidence of thrombosis was determined within each study period. During the 6 month follow-up, 36 thrombotic events occurred in 27 of 68 polytetrafluoroethylene (PTFE) grafts, and only six thrombotic events in 5 of 63 arteriovenous (AV) fistulas. The relative risk for access thrombosis for patients with PTFE grafts was 5.6 times greater than for patients with AV fistulas. Qac was significantly lower in thrombotic compared with patent PTFE grafts (958 +/- 506 ml/min vs 1141 +/- 482 ml/min, p < 0.05). A significant relationship was found between the incidence of subsequent PTFE graft thrombotic events and Qac (p < 0.001). Compared with accesses with high blood flow (1100-1400 ml/min), the risk for subsequent thrombosis tripled in grafts with a Qac of less than 500 ml/min. This relationship was not seen with AV fistulas. In patent PTFE grafts, Qac remained unchanged within each 2 month interval, whereas it decreased in thrombotic PTFE grafts. Thus, repeated measurements of Qac have the potential to predict future access failure in PTFE grafts; however, an increased measuring frequency might improve the predictive value of graft failure with high Qac.
Female↗
Reducing complications of thoracic gunshot wounds.
With the persistent presence of violence in our urban areas and the availability of guns, penetrating injuries as a result of firearm use continue to be a challenge for the emergency, surgery, and operating room nurse. Because gunshot wounds may be rapidly fatal, an understanding of firearms and the injuries they produce, as well as their possible complications, can assist the critical care nurse in caring for patients with gunshot wounds to the chest. Thoracic trauma is present in 50% of all trauma patients and is the cause of death in 25% of these victims. Penetrating trauma from violent episodes accounts for approximately 50% of cases of chest trauma in the urban setting.
Critical Care↗
Computed tomography of portal vein thrombosis: unusual appearances and pitfalls in diagnosis.
In a review of 25 cases examined by CT in whom the diagnosis of visceral vein thrombosis had been made, we encountered four cases in which problematic CT findings led to an error in diagnosis by the prospective interpreter. In one case, gas in collateral periportal veins mimicked an abscess; in one case, segmentally occluded portal veins resembled dilated bile ducts; and in one case, expansion of the inferior mesenteric vein was interpreted as a pancreatic pseudocyst. One additional case of multiple intrahepatic stones mimicked calcified portal vein thrombus. Although most cases are straightforward, there is a spectrum of findings in visceral vein thrombosis that may lead to confusion; alternative imaging techniques may be necessary in these situations.
Adult↗