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Biomedical subjects

K Warren

Publications and source records attributed to K Warren.

At least 55 records · Page 3Linked to original sources

An assessment of the level of dental and mouthcare knowledge amongst nurses working with elderly patients.

A 60 item questionnaire was completed by a self-selected sample of nurses working with elderly patients. The questionnaire was divided into three sections; to collect personal data, to assess the nurses' attitude to mouthcare and their level of training in this subject, and to assess the level of dental knowledge. This paper identifies the disadvantages of using a self selected as opposed to a random sample. Analysis of the completed questionnaires revealed a fairly high level of basic training in dental and mouthcare matters. There was however, a paucity of specific dental knowledge e.g. there was some confusion over the aetiology and prevention of dental caries and also as to the difference between gingivitis and periodontitis. In addition, few nurses seemed to be aware of the effects systemic disease and drugs may have on the oral tissues. In spite of this most respondents achieved more than 50 per cent correct answers. A number of recommendations to improve nurses' dental knowledge is given at the end of the article.

Aged↗

Multi-disciplinary treatment planning for the restorative patient.

Many older patients present requiring a multi-disciplinary approach to treatment aimed at restoring their dentition to health, satisfactory function, and appearance. The restorative dentist with specialist knowledge of periodontics, and fixed and removable prosthodontics is well qualified to provide a treatment plan to achieve these goals. The basic principles of formulating a treatment plan are discussed and a case presented which required a combination of occlusal therapy, periodontics, orthodontics and fixed and removable prosthodontics.

Female↗

Mouthstick prostheses and other gadgets.

Patients who are physically disabled often face immense problems coping with the simple tasks of everyday life. These problems are particularly acute in those patients who have lost the use of their hands or have only restricted hand use. Their ability to work, study or to participate in leisure activities may be severely impaired. This article describes how the dentist may be able to mitigate the effects of restricted hand use by constructing a variety of tools and gadgets designed to help some of these patients lead a more normal life and reduce their reliance on others.

Adult↗

Adherence induces selective mRNA expression of monocyte mediators and proto-oncogenes.

Adherence is an important regulatory signal for several monokines and the proto-oncogenes c-fms and c-fos in human peripheral blood monocytes. Although there is little if any constitutive expression of the IL-1 beta, TNF-alpha and CSF-1 genes in freshly isolated monocytes, adherence is sufficient to induce high steady-state levels of mRNA for TNF and c-fos and more slowly that of CSF-1. Expression of mRNA for the CSF-1R gene, c-fms, was transiently down-regulated by 4 h. In contrast, the induction of high levels of IL-1 beta mRNA were achieved independent of culture conditions. Although all of these genes could be induced by adherence, actual secretion of the mediators required the exposure to a second signal derived from LPS. Thus adherence rapidly primes monocytes for a variety of inflammatory responses, the magnitude of which depends on the nature of a second "activating" signal. It is likely that some of these products act locally as paracrine or autocrine factors to further regulate the phenotype of the differentiating macrophage.

Cell Adhesion↗

Measurement of urinary histamine: comparison of fluorometric and radioisotopic-enzymatic assay procedures.

Assessment of urinary histamine may prove useful in determining the role of histamine in human health and disease. Urinary histamine may be accurately estimated by a modified fluorometric assay employing diamine oxidase (DAO) digestion and cation-exchange chromatography. Normal urine histamine values obtained by this assay are: arithmetic means (+/- SEM), 8.6 +/- 0.6 ng/ml and 10.5 +/- 0.7 micrograms/24 hr; geometric means (+/- SEM), 6.2 +/- 1.1 ng/ml and 10.0 +/- 1.3 micrograms/24 hr. However, the radioisotopic-enzymatic assay is less expensive, easier to perform, and possibly more sensitive. Therefore the two procedures were compared. The radioenzyme assay was found to be affected by factors in urine (possibly salt concentrations) requiring extraction of histamine from urine by butanol-heptane. Moreover, it was found to be necessary to compare DAO-digested samples with undigested samples to accurately estimate histamine levels and to run the standard curve of histamine in DAO-digested urine. Even with these modifications, the radioenzyme assay was not as accurate as the fluorometric assay for urine samples having histamine values about 60 ng/ml. Therefore we recommend utilization of the modified fluorometric assay for the measurement of urinary histamine levels.

Amine Oxidase (Copper-Containing)↗

Studies on the mechanism of bacterial resistance to complement-mediated killing. III. C5b-9 deposits stably on rough and type 7 S. pneumoniae without causing bacterial killing.

Gram-positive cocci resist direct killing by serum. The mechanism of resistance was studied by measuring consumption of terminal complement components from serum and uptake of purified, radiolabeled C7 and C9 on rough and encapsulated type 7 Streptococcus pneumoniae. Extensive consumption of C5, C7, and C9 occurred when 5 X 10(8) rough or type 7 pneumococci were incubated for 1 hr in 10% pooled normal human serum (PNHS). Approximately 10,000 molecules of C7 and C9 bound per organism during the same period of incubation. Twenty to 30% of C7 and C9 was released from rough organisms. Release was not due to autolysis since it occurred with glutaraldehyde-fixed organisms as well as in S. pneumoniae that were rendered resistant to autolysis by growth in ethanolamine. Between 10 and 30% of bound 125IC9 counts were eluted from the rough and type 7 organisms by incubation in 1 M NaCl or 0.01 M EDTA, which suggests that bound C5b-9 was not attached by predominantly ionic interactions. Elution of 44 to 74% of 125IC9 from live and glutaraldehyde-fixed organisms by 1% sodium deoxycholate suggests that hydrophobic bonds are involved in C5b-9 attachment. Trypsin cleaved 67 and 55% of 125IC9 counts from live rough and type 7 S. pneumoniae, respectively which indicates that the bound complex is not protected by the cell wall from proteolytic attack. Serum resistance in S. pneumoniae does not represent a failure to form C5b-9 on the bacterial cell wall but apparently reflects a failure of the bound complex to penetrate the thick peptidoglycan layer.

Blood Bactericidal Activity↗

Measurement of plasma histamine: description of an improved method and normal values.

The single isotopic-enzymatic assay of histamine was modified to increase its sensitivity and to facilitate measurement of plasma histamine levels. The modification involved extracting 3H-1-methylhistamine (generated by the enzyme N-methyltransferase acting on histamine in the presence of S-[methyl-3H]-adenosyl-L-methionine) into chloroform and isolating the 3H-1-methylhistamine by thin-layer chromatography (TLC). The TLC was developed in acetone:ammonium hydroxide (95:10), and the methylhistamine spot (Rf = 0.50) was identified with an o-phthalaldehyde spray, scraped from the plate, and assayed in a scintillation counter. The assay in plasma demonstrated a linear relationship from 200 to 5000 pg histamine/ml. Plasma always had higher readings than buffer, and dialysis of plasma returned these values to the same level as buffer, suggesting that the baseline elevations might be attributable to histamine. However, all histamine standard curves were run in dialyzed plasma to negate any additional influences plasma might exert on the assay. The arithmetic mean (+/- SEM) in normal plasma histamine was 318.4 +/- 25 pg/ml (n = 51), and the geometric mean was 280 +/- 35 pg/ml. Plasma histamine was significantly elevated by infusion of histamine at 0.05 to 1.0 micrograms/kg/min or by cold immersion of the hand of a cold-urticaria patient. Therefore this modified isotopic-enzymatic assay of histamine is extremely sensitive, capable of measuring fluctuations in plasma histamine levels within the normal range, and potentially useful in analysis of the role histamine plays in human physiology.

Chromatography, Thin Layer↗

Coffee and cancer of the pancreas.

We questioned 369 patients with histologically proved cancer of the pancreas and 644 control patients about their use of tobacco, alcohol, tea, and coffee. There was a weak positive association between pancreatic cancer and cigarette smoking, but we found no association with use of cigars, pipe tobacco, alcoholic beverages, or tea. A strong association between coffee consumption and pancreatic cancer was evident in both sexes. The association was not affected by controlling for cigarette use. For the sexes combined, there was a significant dose-response relation (P approximately 0.001); after adjustment for cigarette smoking, the relative risk associated with drinking up to two cups of coffee per day was 1.8 (95% confidence limits, 1.0 to 3.0), and that with three or more cups per day was 2.7 (1.6 to 4.7). This association should be evaluated with other data; if it reflects a causal relation between coffee drinking and pancreatic cancer, coffee use might account for a substantial proportion of the cases of this disease in the United States.

Aged↗

The multilayered film analyzer: glucose in serum, plasma, cerebrospinal fluid, and urine; and urea nitrogen in serum and plasma.

Some basic laboratory performance criteria were studied for the Eastman Kodak glucose and urea nitrogen analyzer. Serum, plasma, urine, and cerebrospinal fluid were tested. Precision, both "within-day" and "between-day," for both analytes was less than 2.2% (CV). Both analytes demonstrated linearity, with about 100% recovery of added substrates. Comparisons with continuous-flow procedures demonstrated good correlation. A variety of sera and plasmas can be used for glucose analysis; oxalate--fluoride-treated plasma is unacceptable for use in analysis for urea nitrogen. We saw no effects on glucose or urea nitrogen analysis from hemolysis, lipemia, icterus, some common drugs, ammonia, or abnormally high protein concentrations. Minimum amounts detectable were: glucose (serum) 104 mg/L; glucose (cerebrospinal fluid) 100 mg/L; and urea nitrogen (serum) 21 mg/L. Calibration procedures are discussed for protein-based and aqueous samples.

Autoanalysis↗

Evaluation of a new commercial radioassay kit for aldosterone using an iodinated tracer.

We have evaluated a new non-chromatographic commercial radioimmunoassay kit for serum, plasma, and urine aldosterone levels which employs 125 iodine as the tracer. Within-run and run-to-run precision data show coefficients of variation of 3 to 6% and 8 to 16%, respectively. Recovery of aldosterone added to serum and urine at several levels range from 92 to 109%. Antibody specificity was tested with six structurally related steroids at grossly elevated concentrations and no crossreactivity was observed. Serum or plasma can be used interchangeably in the assay, and normal levels correspond to generally accepted values.

Aldosterone↗

Introducing students to the medical literature.

It is extremely difficut to determine if it really makes a difference to provide a medical journal to medical students. Does it alter their reading habits? Does it indeed form the basis for learning? In 1976 84% of the third year class and in 1972 69% (n=97), personally subscribed to a Journal designated. In the fourth year class, 75% (n=149) subscribed in 1976 and 58% (n=82) in 1972. The conclusion is that the New England Journal of Medicine Project can be viewed as an endeavour which meets the need of students.

Education, Medical, Undergraduate↗

Radioimmunoassay of serum myoglobin: evaluation and modification of a commercial kit and assessment of its usefulness for detecting acute myocardial infarction.

We evaluated a modified procedure for a commercially available myoglobin radioimmunoassay kit (Nuclear Medical Systems). Within-run and run-to-run precision was acceptable. Normal ranges were established and paralelism studies performed. Clinical usefulness was assessed in 100 consecutive patients admitted to our coronary-care facility. The determinations were done daily, along with creatine kinase and its isoenzymes, and lactate dehydrogenase and its isoenzymes. Fifty of the 100 patients ultimately were shown to have had acute myocardial infarction. Myoglobinemia was present in most of the patients with acute myocardial infarction, but information on its presence was less usefull clinically than was detection of creatine kinase isoenzyme MB.

Creatine Kinase↗