Medicare in Massachusetts: the impact of the 1997 Balanced Budget agreement.
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Budgets↗
Biomedical subjects
L Long
Publications and source records attributed to L Long.
Enhanced invasion and liver colonization by lung carcinoma cells overexpressing the type 1 insulin-like growth factor receptor.
The receptor for the type 1 insulin-like growth factor (IGF-1R) and its ligands IGF-1 and IGF-2 play important roles in the maintenance of the malignant phenotype. In previous studies with two sublines of the Lewis lung carcinoma (H-59 and M-27, expressing high and low levels of IGF-1R, respectively) we have shown that receptor levels in these tumor cells correlated with metastasis to the liver. In the present study we asked whether the metastatic properties can be modulated by increasing receptor levels. M-27 carcinoma cells were transfected with a plasmid vector expressing a full-length human IGF-1R cDNA. Expression of the human receptor in the stable transfectants was confirmed by RT-PCR and immunoprecipitation analysis. These cells had an enhanced proliferative response to IGF-1 and hepatocyte-conditioned medium and an increased clonogenic potential in semisolid medium. Moreover, they acquired an invasive potential as measured in the reconstituted basement membrane (Matrigel) invasion assay. When inoculated via the splenic/portal route in vivo, these cells but not mock-transfected cells gave rise to multiple tumor nodules. The results suggest that IGF-1R can modulate several cellular functions which impact on the metastatic phenotype including invasion and liver colonization.
Animals↗
Accounting for two population turnarounds in nonmetropolitan America.
"The turnaround [in U.S. rural-to-urban migration] of the 1970s, the metropolitan resurgence of the 1980s, and the rural rebound of the 1990s [have been] described as three unanticipated changes in migration.... [This chapter] compares the magnitude of the three changes in net migration and contrasts the two nonmetropolitan turnarounds.... The results support a view of the 1970s turnaround as the outcome of long-term deconcentrating trends that were interrupted from the late 1970s to the late 1980s by circumstances that favored metropolitan areas. The return of nonmetropolitan territory to net in-migration in the 1990s appears to be due in part to favorable economic conditions that allow more people to act on preferences for smaller places."
Americas↗
Structural determinants in AUF1 required for high affinity binding to A + U-rich elements.
AUF1 is an RNA-binding protein that contains two nonidentical RNA recognition motifs (RRMs). AUF1 binds to A + U-rich elements (AREs) with high affinity. The binding of AUF1 to AREs is believed to serve as a signal to an mRNA-processing pathway that degrades mRNAs encoding many cytokines, oncoproteins, and G protein-coupled receptors. Because the ARE binding activity of AUF1 appears central to the regulation of many important genes, we analyzed the domains of the protein that are important for this activity. Examination of the RNA binding affinity of various AUF1 mutants suggests that both RRMs may be required for binding to the human c-fos ARE. However, the two RRMs together are not sufficient. Highest affinity binding of AUF1 to an ARE requires an alanine-rich region of the N terminus and a short glutamine-rich region in the C terminus. In addition, the N terminus is required for dimerization of AUF1. However, AUF1 binds an ARE as a hexameric protein. Thus, protein-protein interactions are important for high affinity ARE binding activity of AUF1.
Adenine↗
Conservation approach to duplication of the small bowel.
BACKGROUND/PURPOSE: Intestinal duplication and adjacent small bowel share a single mesentery with straight arteries from the arcade supplying the normal bowel or supplying the duplication. The usual surgical management is resection of the duplication and the adjacent bowel with end to end anastomosis of the remaining bowel. The aim of this study was to conduct an experimental study of blood supply to the bowel and consequences of ligation of the straight arteries to one side of the bowel, and attempt preservation of all normal bowel in patients who have duplication. METHODS: The study was carried out on 25 New Zealand white rabbits. The intestinal blood supply of three groups of rabbits (control, acute, and chronic) have been studied by perfusion, microdissection and stereoscopic microscopic examination, and scanning electron microscopy after impregnation with gold, after ligation of the straight arteries to one side of the intestine. From 1992 to 1996, 14 patients who had duplication of the bowel were treated by resection of duplication and conservation of bowel. They have had follow-up for up 4 years. Barium studies have been performed. RESULTS: In the animal studies, the bowel was viable and functioning normally in all animals but numerous adhesions developed. The results presented show no impairment in bowel function in human studies. CONCLUSION: Ligation of the straight arteries to the duplication with resection of only the duplication is a satisfactory approach to conservation of bowel in patients who have duplication.
Animals↗
The practical aspects of epilepsy: critical components of comprehensive patient care.
Patients with epilepsy are often exposed to difficult social dilemmas, some of which may be more challenging than the actual seizure. Although all patients with chronic conditions experience social hardships, the epileptic patient may be at greater risk for social difficulties. Due to unjust restrictions and an overall lack of emphasis on psychosocial matters, patients with epilepsy may be wrongfully denied participation in routine activities. These patients may also lack an understanding of appropriate prevention measures related to self injury. Appropriate restrictions for patients with epilepsy include driving and selected extra-curricular activities. The home environment is particularly dangerous for epilepsy patients. Other social issues for epilepsy patients include suicide attempts, employment and alcohol consumption.
Activities of Daily Living↗
A novel cyclic adenosine monophosphate analog induces hypercalcemia via production of 1,25-dihydroxyvitamin D in patients with solid tumors.
The treatment of cancer patients with conventional chemotherapy is sometimes associated with severe systemic toxicity and only a minimal survival benefit. Because of this, new less toxic and more efficacious treatments have been sought. 8-Chloro-cAMP (8-Cl-cAMP) is one of a new generation of anticancer drugs that act at the level of signal transduction. In preclinical models, 8-Cl-cAMP modulates protein kinase A (PKA) leading to growth inhibition and increased differentiation of cancer cells. 8-Cl-cAMP was given to 16 patients with advanced cancer as an infusion via an indwelling subclavian venous catheter. We showed that 8-Cl-cAMP had a parathyroid hormone-like effect leading to increased synthesis of renal 1,25-dihydroxyvitamin D [up to 14 times the baseline value, median 3.6 times; P = 0.00001 (Student's paired t test)]. This produced the dose-limiting toxicity of reversible hypercalcemia that could not be controlled by the administration of either pamidronate or dexamethasone. The treatment was otherwise well tolerated, and other cAMP-dependent pathways (cortisol and TSH) were not affected, emphasizing the marked differences between organs in their sensitivity to this cAMP analog. Our results have shown that 8-Cl-cAMP is biologically active, and it is feasible that if the hypercalcemia can be controlled, then this drug may have a role as a single agent, or as a short infusion between cycles of chemotherapy.
8-Bromo Cyclic Adenosine Monophosphate↗
The "clean break" revisited: is U.S. population again deconcentrating?
"The Hoover index, calculated across counties and larger spatial units, is again declining--signalling a renewal of population deconcentration in the United States. After increasing for several decades, the index declined in the 1970s when nonmetropolitan population growth surged past metropolitan-area growth, but the index rose in the 1980s as metropolitan population growth recovered and surpassed nonmetropolitan growth. We update these trends, introducing careful controls for changes in metropolitan-area boundaries, and we incorporate a ¿functional urban region' approach. Although the nonmetropolitan population growth rate is still below the metropolitan rate, we conclude that in the 1990s some features of the ¿turnaround' of the 1970s have returned."
Americas↗
Structural determination in AUF1 required for high affinity binding to A + U-rich elements.
AUF1 is a RNA-binding protein that contains two non-identical RNA recognition motifs (RRMs). AUF1 binds to A + U-rich elements (AREs) with high affinity. The binding of AUF1 to AREs is believed to serve as a signal to a mRNA processing pathway which degrades mRNAs encoding many cytokines, oncoproteins and G protein-coupled receptors. Because the ARE-binding activity of AUF1 appears central to the regulation of many important genes, we analyzed the domains of the protein that are important for this activity. Examination of the binding affinity of various mutants indicates that both RRMs may be required for binding. However, they are not sufficient. Highest affinity binding requires an alanine/glycine-rich region of the N-terminus and a short glutamine-rich region in the C-terminus. The N-terminus is required for dimerization of AUF1. However, AUF1 binds an ARE as a hexameric protein. Thus protein-protein interactions are important for high affinity ARE-binding activity of AUF1.
Binding Sites↗
Localization and physical mapping of genes encoding the A+U-rich element RNA-binding protein AUF1 to human chromosomes 4 and X.
Messenger RNAs encoding many oncoproteins and cytokines are relatively unstable. Their instability, which ensures appropriate levels and timing of expression, is controlled in part by proteins that bind to A+U-rich instability elements (AREs) present in the 3'-untranslated regions of the mRNAs. cDNAs encoding the AUF1 family of ARE-binding proteins were cloned from human and murine cDNA libraries. In the present study monochromosomal somatic cell hybrids were used to localize two AUF1 loci to human chromosomes 4 and X. In situ hybridization analyses using P1 clones as probes identified the 4q21.1-q21.2 and Xq12 regions as the locations of the AUF1 genes.
Animals↗
Self-concept and behavior in adolescent girls with Turner syndrome: potential estrogen effects.
Data on self-concept and behavior were gathered from 31 girls with Turner syndrome (TS) followed longitudinally between the ages of 12 and 16 and from 89 normal control girls recruited from public schools and assessed cross-sectionally. The two groups of girls were similar in age and racial composition. The girls with TS were treated with estrogen replacement therapy in increasing doses between the ages of 12 and 16 (100-400 ng/kg-day ethinyl estradiol). Their self-reported self-esteem and psychological well-being (Piers-Harris Self-Concept Scale) revealed significant improvement over time for most scales as well as the total score (P < 0.001). Parents reported improvement in problem behaviors, as reflected in the Child Behavior Checklist (CBCL) scales: Behavior Total, Externalizing Behavior, Aggressive Behavior, and Social Problems Behavior scales (all P < 0.001). Analysis of covariance comparing normal controls to the TS subjects revealed that at age 12 yr, TS and normal subjects differed significantly for the School Social Competency sub-scale and the Social Problems Behavior subscale (all P < 0.001). Girls with TS resembled the normal controls on all CBCL scales by ages 14-15 yr. Thus, we found improved self-concept both by self- and parental report in estrogen-treated girls with TS followed longitudinally through adolescence. An analogous correlation with age was not seen in the cross-sectional normal control sample. These findings support positive effects of estrogen on psychological well-being in girls with TS and underscores the need to initiate estrogen replacement therapy by ages 12-14 yr in this population.
Adolescent↗
Pesticide appliers with mixed pesticide exposure: G-banded analysis and possible relationship to non-Hodgkin's lymphoma.
To further investigate the possible relationships between agricultural pesticide exposure and the increased risk of non-Hodgkin's Lymphoma among farm workers in the north central United States, we performed G-banded chromosome analyses of peripheral blood from workers classified according to primary types of pesticide exposure: herbicides (n = 20), insecticides (n = 18), fumigants (n = 23), and occupationally unexposed controls (n = 33). Significantly increased rearrangement frequencies were demonstrated in fumigant and insecticide appliers compared to control subjects. At certain chromosome bands there were significant excesses of breaks observed in pesticide appliers, but no breaks were observed in controls. Some of these bands contained genes with potential implications for cancer risk, including oncogenes and genes involved in tumor suppression and apoptosis. Of particular interest with regard to lymphoma risk were the excess rearrangement and breaks involving band 14q32 in fumigant appliers and the excess breaks involving band 18q21 in herbicide appliers; translocations linking 14q32 and 18q21 are the most common rearrangements observed in non-Hodgkin's lymphoma patients. The potential pathobiological relevance of these cytogenetic events warrants additional investigation at the molecular level.
Agricultural Workers' Diseases↗
Epilepsy: a review of seizure types, etiologies, diagnosis, treatment, and nursing implications.
Critical care nurses must be able to adequately identify and document seizure activity, perform appropriate interventions, and recognize signs of AED toxicity. Critical care nurses not only share the responsibility of taking care of epilepsy patients, but also must help in valuable patient and family education as it relates to long-term management. Becoming better informed of the plan of care for epilepsy patients helps optimize expected outcomes and enables patients and families to manage this illness better.
Anticonvulsants↗
[Studies on purification and some properties of nisin from Lactococcus lactis subsp. lactis Al2].
Nisin from Lactococcus lactis subsp. lactis AL2 was extracted with n-propanol from NaCl-saturated culture and purified by ion-exchange chromotography on CM-Sephadex C-25. Nisin was purified 1.63 fold with a yield of 41.7%. The molecular weight of nisin was determined by SDS-PAGE to be about 3500. Nisin activity was stable at low pH and sensitive to digestion by a-chymotrypsin. Nisin is capable of inhibiting a broad range of gram-positive bacteria. In contrast, the gram-negative bacteria, yeasts, molds and Nip+ L. lactis subsp. lactis ATCC11454 were not inhibited.
Anti-Bacterial Agents↗
Loss of the metastatic phenotype in murine carcinoma cells expressing an antisense RNA to the insulin-like growth factor receptor.
The ability of malignant cells to form metastases in secondary sites remains a major obstacle to the curative treatment of cancer. Previously, we identified type 1 insulin-like growth factor (IGF-1) as a paracrine mitogen for highly metastatic murine carcinoma, H-59 cells. Here the role of IGF-1 and its receptor (IGF-1R) in metastasis was further investigated using H-59 cells transfected with a plasmid vector expressing IGF-1R cDNA in the antisense orientation. The transfectants had a markedly reduced expression of IGF-1R and lost the ability to respond to IGF-1 in vitro. When injected in vivo, either directly into the microvasculature of the liver or lung (experimental metastasis) or s.c. to allow the growth of primary local tumors (spontaneous metastasis), these cells did not give rise to any metastases under conditions which allowed wild-type or control transfectants to form multiple hepatic and pulmonary metastases. The results demonstrate that the IGF-1R can play a critical role in the regulation of carcinoma metastasis.
Animals↗
An instrument to assess the oral health status of nursing home residents.
This article presents data from the development and testing of an instrument to evaluate the oral health of nursing home residents by nursing personnel (RNs, LVNs, and CNAs). After the instrument was developed, nursing staff were taught to do a brief oral health status examination (BOHSE). Using the instrument, a dentist examined 100 residents; the examination was repeated on the same residents by each category of nurse examiners. Correlation coefficients indicate that statistically significant interrater reliability between the three categories of nursing personnel and the dentist was established, suggesting that nursing staff can be taught to evaluate the oral health of residents. Replication of the study in multiple sites is recommended.
Aged↗
The differential experience of Mozambican refugee women and men.
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Africa↗
Usher syndrome: increasing awareness in Scotland.
In July 1993, professionals from a number of European countries met at the 7th European Usher Syndrome Study Group. The purpose of the Study Group (which meets on a biannual basis) is to give professionals working in this specialized field the opportunity to share ideas and examples of their work. People attending included medical practitioners, social service workers, representatives from voluntary bodies and individuals with Usher. The following article is an expanded version of a paper presented at the Study Group. It describes the development of a 3 hour workshop for the wide range of practitioners a child or young person with Usher syndrome may meet. Through group work, positive approaches to working through the personal and practical implications of Usher syndrome are explored.
Activities of Daily Living↗