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L Shaw

Publications and source records attributed to L Shaw.

At least 181 records · Page 10Linked to original sources
PubMed1986

Periodontal destruction in Down's syndrome and in juvenile periodontitis. How close a similarity?

Advanced destruction of the periodontium, with similarities in alveolar distribution, age range, and diminished host responses of varying severity, may be seen in Down's syndrome and in juvenile periodontitis. This review compares and contrasts periodontal destruction and immunologic mechanisms in the two conditions. Both are characterized by raised serum immunoglobulins, selective cell-mediated immunodeficiencies, and defective neutrophil polymorphonuclear leukocyte chemotaxis. There is a possibility of defective monocyte chemotaxis in both conditions, although this is less clear in juvenile periodontitis. By contrast, antigen-induced DNA synthesis is enhanced in Down's syndrome, but reduced in juvenile periodontitis.

Aggressive Periodontitis↗
PubMed1986

[The self-training of a therapist : a demystification process.].

The authors try in this article to analyse the demands encountered by a therapist in regard to his own growth. Beyond the traditional training, the authors underline the importance of self-training inscribed in the daily life of every health worker with a genuine help-relationship.

English Abstract↗
PubMed1986

Sonographic evaluation of the adnexa during early pregnancy.

Of 3,918 obstetric patients who underwent scanning during the first 20 weeks of gestation, 94 had sonolucent adnexal masses identified. These represented predominantly the corpus luteum of pregnancy. The incidence of such a mass significantly declined after the tenth gestational week. This pattern of degeneration is physiologic and represents the normal course of events for the ovary in the first half of pregnancy. Characteristics of these masses and indications for operative intervention are discussed. The obstetric outcome for eight patients who underwent surgical treatment was uncomplicated. Guidelines for management of significant adnexal masses in pregnancy is similar to that of the nonpregnant state.

Dermoid Cyst↗
PubMed1985

The suicide inactivation of ox liver short-chain acyl-CoA dehydrogenase by propionyl-CoA. Formation of an FAD adduct.

Propionyl-CoA gave an unexpectedly low turnover (0.03 s-1) and high Km (153 microM) as a substrate for ox liver short-chain acyl-CoA dehydrogenase (SCAD). On addition of an excess of propionyl-CoA to SCAD the flavin A448 decreased to about 30% of its original value and the peak at 368 nm was replaced by one at 335 nm. The decrease in A448 exhibited first-order kinetics and correlated with a first-order decrease in the enzyme's catalytic activity to 22% of the initial value. The flavin, released from propionyl-CoA-treated enzyme with trichloroacetic acid, reacted with O2 to form a stable free radical. This suggests that a reduced N-5 flavin adduct is formed on the enzyme and protected from O2. The released adduct was separated from unmodified flavin and excess propionyl-CoA by h.p.l.c., and was shown by 3H-labelling to contain CoA. The incompleteness of the decrease in the enzyme's A448 and specific activity on incubation with propionyl-CoA probably reflects an equilibrium between covalently and non-covalently bound acyl-CoA, since the spectral changes could be reversed. The enzyme was also re-activated by dilution and incubation with a large molar excess of butyryl-CoA. The rate constant, approx. 2 X 10(-3) s-1, for re-activation, taken with the extrapolated rate constant for the opposing inactivation reaction, 8.9 X 10(-3) s-1, explains the 22% residual activity at equilibrium. The results suggest that propionyl-CoA is a suicide inhibitor for SCAD.

Acyl Coenzyme A↗
PubMed1985

Defects of metabolism of fatty acids in the sudden infant death syndrome.

Two hundred consecutive cases of the sudden infant death syndrome were reviewed for the presence of fat in the liver; 14 showed diffuse panlobular microvesicular fatty change indistinguishable from that found in Reye's syndrome. Samples of frozen liver were available in five of the 14 cases; histochemical analysis showed well preserved cytochrome oxidase and succinate dehydrogenase activity in all five, uncharacteristic of Reye's syndrome. Fatty acyl-coenzyme A dehydrogenase activity in the liver was assayed biochemically in two of the same five cases with severe hepatic fatty infiltration; both showed a defect in medium chain acyl-coenzyme A dehydrogenase activity using the substrate octanoyl-coenzyme A. Both cases also showed cerebral oedema in association with fatty infiltration of renal tubules, myocardium, and skeletal muscle, characteristic of Reye's syndrome. It is concluded that diffuse panlobular microvesicular fatty change of the liver in victims of the sudden infant death syndrome, although essentially non-specific, indicates that the state of mitochondrial enzymes should be investigated.

Acyl-CoA Dehydrogenase↗
PubMed1985

Inappropriate admissions to psychiatric wards.

Our seven clinical vignettes illustrate different mechanisms of inappropriate admissions to psychiatric wards and the circumstances and outcome of such admissions, with emphasis on the shared responsibility of psychiatric and nonpsychiatric physicians, the financial consequences, and the implications of such admissions on the profession's public image. Inappropriate admissions create undue tensions and demands on an already overworked psychiatric staff, and raise legitimate issues of quality of care, the need for clinical and administrative guidelines for consultation and transfer, the degree of communication between psychiatry and other specialties, and a host of psychodynamic considerations, somehow overlooked in recent years. The main issue in most cases is the level of communication between the psychiatric and nonpsychiatric camps. Clinical, epidemiologic, and actuarial studies are needed in this area.

Adult↗
PubMed1985

Treatment of hypercalcemia in parathyroid cancer with WR-2721, S-2-(3-aminopropylamino)ethyl-phosphorothioic acid.

The chemoprotective and hypocalcemic agent WR-2721, S-2-(3-aminopropylamino) ethyl-phosphorothioic acid, inhibits parathyroid hormone secretion in vivo and in vitro. We report the first clinical use of WR-2721 in refractory hypercalcemia secondary to parathyroid cancer. After several days of saline diuresis the patient received WR-2721, 740 mg/m2 over 15 minutes, resulting in a fall in serum calcium from 11.76 to 9.06 mg/dL within 24 hours. Serum parathyroid hormone levels decreased from 675 to 140 microLeq/mL 2 hours after the infusion was complete. When hypercalcemia recurred the patient was retreated with differing doses and infusion rates to determine the optimal method of drug administration to provide a satisfactory hypocalcemic response without adverse effects. In this patient, WR-2721 in intravenous boluses of 150 mg/m2 was effective without adverse effects. Using high-pressure liquid chromatography with electrochemical detection, plasma pharmacokinetic studies showed that WR-2721's distribution half-life is 0.55 minutes.

Adenoma↗
PubMed1985

Pharmacokinetic analysis of a case of isopropanol intoxication.

A comatose 46-year-old woman, admitted to the emergency room, had isopropanol and acetone concentrations of 2000 and 120 mg/L, respectively, in her serum. She had no known history of acute isopropanol intoxication and was otherwise physically healthy. Pharmacokinetic analysis showed that the elimination of both isopropanol and its major metabolite acetone obeyed apparent first-order kinetics with half-lives of 6.4 and 22.4 h, respectively. These data contrast with the commonly held view that isopropanol is slowly metabolized. Concentrations of these analytes in cerebrospinal fluid 6 h after admission were similar to those in serum. This is the first report of the pharmacokinetics of both agents in a nonalcoholic person, and it gives the first data on concentrations of these substances in cerebrospinal fluid.

1-Propanol↗
PubMed1984

On-site physician staffing in a community hospital intensive care unit. Impact on test and procedure use and on patient outcome.

To determine whether on-site physician staffing changed test and procedure use and improved patient outcome in a community hospital intensive care unit (ICU), we studied all ICU admissions for matched periods before and after the staffing change. Compared with the 463 year-1 patients, the 491 year-2 patients were no more likely to receive life-support interventions (respirators, dialysis, or pacemakers), but had substantially more monitoring interventions, such as pulmonary artery catheters (22% v 2%, P less than .0001) and arterial catheters (9% v 0%, P less than .0001). After controlling for factors that predicted death (age, mental status at time of admission, reason for ICU admission), year-2 patients were significantly more likely to survive the ICU and subsequent hospital stay (P = .01). Nearly all of the improvement of survival rate took place among patients with intermediate likelihoods of death; this improved survival rate persisted at the 12-month follow-up (P = .01).

Female↗