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Biomedical subjects

K Maxwell

Publications and source records attributed to K Maxwell.

At least 37 records · Page 2Linked to original sources
PubMed1997

The effect of changing the total parenteral nutrition order form on resident physician ordering behavior.

The quality assurance process at Scott and White Hospital, Temple, Texas, identified a marked variation in total parenteral nutrition (TPN) prescriptions compared with recommendations by the Nutrition Support Service (NSS). A TPN order form with additive guidelines was designed to assist physicians in ordering TPN specific to patient needs. The effect of the change was assessed by comparing 50 TPN patients using the old form (1990) with 50 patients for whom the new form (1992) was used. The groups demonstrated no difference in demographics, mortality, length of stay, or biochemical parameters and were reflective of all TPN patients treated (1990, n = 280; 1992, n = 392). A significant decrease was noted in overfeeding of kilocalories when resident orders were compared with NSS recommendations (125% +/- 24% versus 110% +/- 29%, p = .017; and amino acids (120% +/- 32% versus 105% +/- 29%, p = .071, mean +/- SD). This resulted in a decrease of 8% in the cost of delivering a patient-day of TPN. We conclude that changing the TPN order form to a teaching vehicle results in decreased overfeeding and costs.

Forms and Records Control↗
PubMed1997

An open clinical trial of risperidone monotherapy in young children with autistic disorder.

Autistic disorder (AD) may be associated with dysfunctional behaviors which significantly interfere with a child's functioning. Risperidone has been described as having salutary effects as an adjunctive pharmacotherapy in adult and pediatric patients with AD. The purpose of this 8-week, open-label study was to examine the effectiveness and tolerability of risperidone monotherapy in young patients with AD. Doses of risperidone were to be started at 0.25 mg qhs and were titrated to maximize clinical efficacy. Six patients (ages 5 to 9 years) were enrolled in this protocol, and all completed it. After 8 weeks of treatment, with a mean risperidone dose of 1.1 mg, improvement in symptomatology was demonstrated by reduced scores on both the Children's Psychiatric Rating Scale (p < .005) and the Clinical Global Impressions Scale (p < .001). The most common side effect were weight gain and sedation. This study provides preliminary evidence that risperidone monotherapy may be safe and effective in ameliorating dysfunctional behaviors in children with AD.

Antipsychotic Agents↗
PubMed1994

Murine model of otitis media with effusion: immunohistochemical demonstration of IL-1 alpha antigen expression.

Recent studies have suggested that cytokines likely play a central role in the formation and maintenance of otitis media with effusion (OME). Currently, there is no immunologically defined animal model for the study of cytokines as they contribute to the formation of OME. In the present study, a murine model of OME, using eustachian tube blockage via an external surgical approach, was developed. The murine model temporal bone histology appears to mimic the histology found in chronic otitis media with effusion in humans. Additionally, using this murine model, interleukin-1 alpha (IL-1 alpha) expression was detected in the middle ear using standard immunohistochemical techniques. IL-1 alpha seemed localized to the epithelial lining of the middle ear as well as 5% to 10% of inflammatory cells. This model should provide the necessary tool to further study the immunologic aspects of OME.

Animals↗
PubMed1991

Beta-VLDL increases endothelial cell plasma membrane cholesterol.

In this study, the distribution of free cholesterol in cholesterol-loaded endothelial cells was examined. For these studies, cell fractionation methods were used to assess marker enzyme activity and cholesterol distribution. Treatment of rabbit aortic endothelial cells for 3 days with 50 micrograms/ml of beta-very low density lipoprotein (beta-VLDL) or malondialdehyde-low density lipoprotein (MDA-LDL) but not LDL caused a 50-100% increase in total cell unesterified cholesterol. The accumulation of free rather than esterified cholesterol in endothelial cells may be due to the ratio of hydrolysis to esterification, which we have shown in this study to be 10-fold higher in endothelial cells than in smooth muscle cells. This free cholesterol is found in the fractions enriched in plasma membrane markers and, to a lesser extent, in the Golgi-enriched fractions. The amount of cholesterol per mg of protein was increased approximately 50% in these fractions from cells treated for 3 days with 50 micrograms/ml of beta-VLDL. These increases in cholesterol content were reversible upon incubation of cells for 3 days in medium containing 15% fetal bovine serum. Alterations in several membrane functions were also observed in cholesterol-loaded cells. The activity of alkaline phosphatase, an enzyme marker for plasma membranes, was decreased by 25% and an alteration in membrane-associated microfilaments was seen with phalloidin staining. This morphological change in microfilaments was reflected in a decrease in filament ends as shown by cytochalasin binding and occurred without a change in total actin or vinculin. These microfilament changes were reversible.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗
PubMed1989

Stimulation of glucose analogue uptake by cerebral microvessel endothelial cells by a product released by astrocytes.

Astroglial cells, both normal and neoplastic, secreted a product that stimulated glucose uptake by cerebral microvessel endothelial cells by 23% and 50%, respectively. Neither cerebral microvessel smooth muscle cells nor oligodendrocytes affected endothelial cell glucose uptake. The astrocytic product(s) did not affect glucose uptake by aortic endothelial cells. The effect on the cerebral microvessel endothelial cells increased with increasing time of exposure of the cells to the astroglial product(s), and required the constant presence of the astrocytic product to be maintained. The presence of a protein synthesis inhibitor during endothelial cell exposure to the astroglial conditioned medium blocked the stimulation of glucose uptake. Treatment of the astrocytic product with a protease destroyed its effectiveness. These results support the hypothesis that astrocytes induce the expression of at least one blood-brain barrier property by the cerebral microvasculature, and suggest that this induction may be produced by a protein released by the astrocytes.

3-O-Methylglucose↗
PubMed1987

Induction of gamma-glutamyl transpeptidase in cultured cerebral endothelial cells by a product released by astrocytes.

gamma-Glutamyl transpeptidase (gamma GTP) is an enzyme found in cerebral capillary endothelial cells, the presumed site of the blood-brain barrier, but not in endothelial cells lining blood vessels in other parts of the body. Using a line of mouse cerebral microvessel endothelial cells (ME-ly cells) and a sensitive colorimetric assay to measure gamma GTP levels we demonstrated that primary cultures of mouse astrocytes and a line of rat C6 glioma cells released a soluble product(s) that induced the production of gamma GTP in cultured endothelial cells by 34% and 39%, respectively, over control levels. Cerebrovascular smooth muscle cells had no significant effect on gamma GTP levels in ME-ly cells, and the astrocyte product(s) had no effect on rabbit aortic endothelial cells. The induction of gamma GTP levels in ME-ly cells was apparent after one day of exposure to the astrocyte product(s) and increased in magnitude with increasing time of exposure of the ME-ly cells to the product(s). Removal of the product(s) from the ME-ly cells resulted in a return to control levels of gamma GTP in the ME-ly cells within 2 days. The presence of a protein synthesis inhibitor during incubation with the product(s) blocked the induction of gamma GTP in ME-ly cells, and treatment of the product(s) with 200 U/ml TPCK-trypsin destroyed its inductive properties.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Treatment of hypertension in pregnancy with methyldopa: a randomized double blind study.

Twenty-five patients whose pregnancies were complicated by chronic hypertension were entered in a double-blind study and randomly allocated to treatment with methyldopa (Aldomet) or placebo. Thirteen patients were in the treatment group and 12 in the placebo group. The two groups showed no significant difference in demographic and pretreatment laboratory profiles. Methyldopa-treated patients registering in the first trimester had a significant reduction in the mean arterial pressure (MAP) during the second and third trimesters (P less than 0.025). No significant differences in birth weight (BW), ponderal index (PI) were found when results were corrected for gestational age (GA), race, and sex. The mean GA was significantly prolonged in the methyldopa-treated group by 10.3 days (P less than 0.05). The frequency of superimposed pre-eclampsia was similar in both groups (33.3% vs. 38.4%). However, 75% of the superimposed pre-eclampsia occurred antepartum in the placebo group, while 80% of the methyldopa-treated group developed superimposed pre-eclampsia intrapartum. The results of this small study suggest that the treatment of hypertension in pregnancy may reduce MAP and possibly delay the occurrence of superimposed pre-eclampsia and thus afford a prolongation of the pregnancy.

Chronic Disease↗
PubMed1986

Effect of inorganic lead on some functions of the cerebral microvessel endothelium.

The effect of inorganic lead on two functions of cerebral microvessel endothelium, cell division and glucose analog uptake, was investigated. Lead concentrations considered to be toxic in humans inhibited both functions in cultured endothelial cells. Both effects were dependent on the length of lead exposure and dose over the range of 10(-4) to 10(-6) M lead acetate. After 4 days of exposure there were 76% fewer cells in 10(-4) M lead-exposed cultures relative to control cultures. After 4 days of exposure to 10(-5) M lead there were 55% fewer cells, and after 10(-6) M lead exposure there were 15% fewer cells. Two days after 10(-4) M lead exposure [methyl-3H]thymidine incorporation into endothelial cells was inhibited by 71%. Incorporation was inhibited 47% by 10(-5) M lead but 10(-6) M lead did not inhibit incorporation after 2 days of exposure. Glucose analog uptake was inhibited in both contact-inhibited and log-phase cells; however, the latter were more sensitive to lead and this increased sensitivity correlated with a higher lead content in this cell population. Both the specific carrier-mediated and the nonspecific components of glucose analog uptake were inhibited by exposure of the endothelial cells to lead. A lead exposure of 40 min produced a significant effect on the uptake mechanism. In order to manifest its effects the lead had to be present in serum-containing medium, suggesting that some serum component was necessary to present the lead to the endothelial cells. These findings imply that the initial target of inorganic lead in the CNS may be the plasma membrane of the capillary endothelial cells, and that lead may act by altering the physiological function of these membranes.

3-O-Methylglucose↗
PubMed1985

Uptake of glucose analogues into cultured cerebral microvessel endothelium.

Tritiated glucose analogues 3-O-methylglucose (3-OMG) and 2-deoxyglucose (2-DG) were used to study glucose uptake properties in established lines of cultured mouse cerebral microvessel endothelium. Uptake of both analogues was similar in terms of rate and absolute amount for the first two minutes. Thereafter, intracellular accumulation of 2-DG continued at a more rapid rate because of intracellular phosphorylation of this substrate. The uptake of 3-OMG uptake was temperature-dependent, independent of Na+, and not inhibited by ouabain or 2,4-dinitrophenol. Phloretin and cytochalasin B both significantly inhibited 3-OMG uptake. Other hexoses in high concentration acted as competitive inhibitors at the endothelial cell membrane. Pre-incubation of cells with 50 mM D-glucose resulted in higher levels of 3-OMG accumulation than in control cells (counter-transport phenomenon). In contrast to findings at the blood-brain barrier in vivo, insulin was found to stimulate 3-OMG uptake. Maximal stimulation of approximately 3-fold was found at ambient insulin concentrations of 1,000 ng/ml or higher. The findings provide support at the cellular level for some components of the model of carrier-mediated glucose transport across the blood-brain barrier which has been postulated to exist in vivo. The effect of insulin is discussed in the light of new data that show stimulation of glucose analogue transport into isolated cerebral capillaries.

3-O-Methylglucose↗
PubMed1985

Insulin stimulates DNA synthesis in cerebral microvessel endothelium and smooth muscle.

Experiments were performed to test the hypothesis that insulin stimulates DNA synthesis in cerebral microvessel endothelium and smooth muscle. Cultured endothelium and smooth muscle derived from isolated mouse cerebral microvessels were exposed to insulin in serum-free medium, and [3H]-thymidine incorporation in the cells was measured. Up to 40-fold stimulation of DNA synthesis in endothelium and fourfold stimulation in smooth muscle were observed. Stimulation became maximal in both cell types at an insulin concentration of approximately 10(4) ng/ml, although an effect was observed at much lower concentrations. Similar concentrations of insulin produced a less-dramatic (approximately twofold) increase in both endothelial and smooth muscle cell numbers. This effect of insulin, observed in microvessel endothelium and smooth muscle, but not in bovine aortic endothelium, emphasizes another way in which large- and small-vessel endothelia appear to differ.

Animals↗
PubMed1977

Effects of prazosin on forearm resistance and capacitance vessels.

The effects of oral prazosin on the peripheral circulation were evaluated in 10 subjects, including 7 patients with chronic congestive failure due to coronary heart disease. To achieve this purpose the actions of 30 to 50 micrograms/kg body weight prazosin were assessed on both the forearm arteriolar and venous beds simultaneously with the use of the limb plethysmographic technique. Prazosin produced marked decline of forearm venous tone (FVT) from 44.5 +/- 12.3 to 14.3 +/- 3.1 mm Hg/ml (p less than 0.01) concomitant with marked decrease in forearm vascular resistance (FVR) from 70.2 +/- 11.4 to 48.4 +/- 4.9 mm Hg/ml/100 gm/min (p less than 0.05) which persisted for at least 60 mins without change in heart rate. These findings, demonstrating that prazosin induces systemic venodilation and peripheral arteriolodilation, indicate potential benefits of the oral drug for relief of pulmonary congestion and elevations of cardiac output in patients with chronic congestive heart failure.

Adult↗
PubMedDate not supplied

Effects of weight training on the emotional well-being and body image of females: predictors of greatest benefit.

BACKGROUND: This study was conducted to determine the extent to which participation in a weight training intervention was associated with changes in the emotional well-being and body image of females compared to non-weight trainers. An ancillary objective was to study the extent to which psychological, physical, and demographic factors accounted for changes in emotional well-being and body image. METHODS: The experimental group consisted of 60 females, and a comparison group was comprised of 92 females. Experimental subjects participated in a 15-week, two-day-per-week weight training intervention, while subjects in the comparison group did not participate in any weight training activities. Subjects were pre- and posttested on the General Well-Being Schedule and the Body Cathexis Scale. Experimental subjects were also tested in muscular strength and three skinfold measurements. RESULTS: With pretest scores controlled, the weight trainers had significantly higher General Well-Being and Body Cathexis posttest scores than the comparison group. Weight trainers also showed significant increases in muscular strength, and significant decreases in skinfold thickness. Four variables predicted 38.8% of the variance of those who improved most in General Well-Being: lower pretest General Well-Being, lower parental income, greater loss of body weight, and lower posttest skinfold. Five variables predicted 61.5% of the variance of those women who improved most in Body Cathexis: lower pretest Body Cathexis, greater body weight at the outset, shorter in height, less involvement in non-weight training exercise, and lower posttest skinfold. DISCUSSION: (ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Medical students' knowledge, attitudes, and behavior concerning diet and heart disease.

Demand for physician-based dietary treatment of hypercholesterolemia is increasing, but medical care providers feel that they lack the skills and confidence necessary to provide these services. Using a self-administered questionnaire, we studied the relationships among dietary knowledge, attitudes, and behaviors to identify the educational needs of entering medical students. On average, dietary behavior and background knowledge of the diet-coronary heart disease association compared favorably to national dietary recommendations and knowledge of the U.S. public. However, practical knowledge necessary for diet counseling was weak, and attitudes about the "prudent" diet were poor. More favorable attitude scores were associated with healthier eating habits, while greater knowledge was not. Our results suggest that entering medical students already have a basic understanding of the diet-heart disease link, which is covered in the curricula of most medical schools. Medical education should include more emphasis on practical dietary knowledge and improving attitudes about the prudent diet.

Adult↗