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Biomedical subjects

L Smith

Publications and source records attributed to L Smith.

At least 379 records · Page 21Linked to original sources
PubMed1992

Primary colorectal anastomosis with the intracolonic bypass tube.

BACKGROUND: Intracolonic bypass with primary colocolonic or colorectal anastomosis may be an effective option in the operative management of complicated colonic disease when adequate bowel preparation is not possible. A pliable latex tube is anchored to mucosa and submucosa 3 centimeters proximal to a site of colocolonic anastomosis and later spontaneously evacuated by way of the rectum. METHODS: Twenty-nine consecutive patents who required urgent colorectal operations in the presence of unprepared bowel underwent left colon resection with intracolonic bypass and primary anastomosis. These patients would have otherwise undergone multistage procedures for the management of the colorectal disorders. Demographic data, APACHE II scores, and type and frequency of complications were recorded. RESULTS: Between July 1, 1990, and June 30, 1991, 31 patients were eligible for entry in the study. Two patients ultimately had contraindications for the use of intracolonic bypass. The causes encountered included complicated diverticular disease, colonic carcinoma, sigmoid volvulus, and iatrogenic colorectal injury. Complications included wound infection (7), myocardial infarction (2), prolonged ileus (1), deep vein thrombosis (2), and anastomotic leak (2). Postoperative myocardial infarction and subsequent multiorgan system failure were responsible for the only death in this study. CONCLUSIONS: Intracolonic bypass permits a safe primary anastomosis where multistage procedures would otherwise be required. Avoidance of colostomy and the attendant socioeconomic benefits warrants further study of this method.

Aged↗
PubMed1992

Work-related electrocutions involving portable power tools and appliances.

Portable power tools and appliances can be identified as the source of injury in approximately 9% of occupational electrocutions. A search of fatality records for 1984 through 1986 in National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) data bases identified 102 electrocutions involving portable appliances and tools that used 110-volt AC and 33 deaths involving welding equipment, which usually operates on 220-volt AC or higher. Of these 102 deaths, 51 occurred in the construction industry, 13 in services, 13 in manufacturing, and 25 in other industries. Plumbing contractors (Standard Industrial Classification [SIC] 1711) had the largest number of deaths (15) in construction. Powered hand-tools were involved in 58 deaths, with electric drills (23) and saws (13) the two largest classes. Proper provision of ground-fault circuit interrupter protection, particularly at temporary work sites, could have prevented most of the deaths from 110-volt AC. Engineering controls for preventing electrocution from portable arc-welding equipment should be evaluated.

Accidents, Occupational↗
PubMed1992

Vocal cord dysfunction during wartime.

Vocal cord dysfunction (VCD) often masquerades as asthma. The diagnosis is rarely suspected, but should be considered in cases of asthma that present atypically or that fail to respond to standard therapy. The frequency of VCD would be expected to increase during times of stress, including periods of war, since it is thought to be a conversion reaction. A high level of suspicion for VCD is essential to make the diagnosis so as to avoid unnecessary, potentially toxic medications and to direct the patient to prompt psychiatric care, which along with speech therapy, is the cornerstone of care.

Adult↗
PubMed1992

Nursing at the grassroots.

A new model of what constitutes political activity--recognizing grassroots issue involvement as well as partisan politics as legitimate political activism--offers hope for the prospect of the nursing profession becoming a strong political force in the future. Increasing involvement by nurses in health and environmental issues will be the nurses' means to achieve political strength. After all, it is that unique ethic of compassion, common to all nurses, that distinguishes a great political leader.

Health Policy↗
PubMed1992

HIV associated risk factors: a survey of a troubled adolescent population.

The incidence of Acquired Immunodeficiency Syndrome (AIDS) in young adults and the typical incubation period for AIDS suggest that exposure to this disease often occurs in adolescence, a period of life during which risk taking behavior is particularly common. The population of adolescents with mental or behavioral problems and substance abuse problems at the South Dakota Human Services Center were studied by questionnaire and by human immunodeficiency virus (HIV) screening to assess the current prevalence of seropositivity and the potential for HIV transmission in these troubled youths. Sexual behavior, number of partners, prior incarceration, history of sexual abuse, drug and alcohol use, and knowledge about HIV transmission were examined. While no cases of HIV seropositivity were discovered, the authors are disturbed by the prevalence of known and suspected correlate behaviors and historical traits for HIV infection in this population. Implications for intervention and education are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Help seeking in alcohol-dependent females.

This paper reviews the literature on the help-seeking behaviours of alcohol-dependent and problem-drinking women. Triggers to treatment and barriers to treatment are identified and explored within the specific context of female alcohol dependency. The female alcohol literature is used to explore factors which may affect a woman's ability to enter, maintain or sustain alcohol treatment.

Adult↗
PubMed1991

A gene required for class II-restricted antigen presentation maps to the major histocompatibility complex.

We have previously described a set of mutants (16.23-selected mutants) of a B lymphoblastoid cell line that are defective in the presentation of intact proteins to class II-restricted T cells, but effectively present immunogenic peptides. The mutations in these mutants are recessive in somatic cell hybrids and are not in Class II structural genes. Here, we report on a unique mutant, 5.2.4, in which a similar defect in class II-restricted antigen presentation has occurred in association with a one-megabase homozygous deletion in the class II region of the major histocompatibility complex (MHC). The defects in class II presentation among three of the 16.23-selected mutants, and between these mutants and 5.2.4, are noncomplementary in somatic cell hybrids. This suggests that the class II presentation-defective phenotype in all four mutants results from lesions in a single MHC-linked gene, a conclusion strengthened by the finding that in a hybrid made with a second, unrelated MHC deletion mutant, T2, the class II presentation defect in a 16.23-selected mutant is also not complemented. Mutant 5.2.4, in addition to its class II presentation defect, is also defective in surface expression of MHC class I molecules, most likely because its deletion encompasses the peptide supply factor 1 gene, whose function is known to be required for normal abundance of cell surface class I molecules. However, the surface abundance of class I molecules is normal in the 16.23-selected mutants, suggesting that the lesions affecting class I surface abundance and class II presentation result from mutations in different genes.

Antigen-Presenting Cells↗
PubMed1991

Stem cells.

Explore the source record for details and available documents.

Animals↗
PubMed1991

A cure for what ails medical care.

Call it the American disease. The symptoms: unchecked health care spending and too many uninsured. The remedy: introducing more marketplace logic into the system.

Community Participation↗
PubMed1991

Inhibition of sodium-calcium and sodium-proton exchangers by amiloride congeners in arterial muscle cells.

The inhibitory potencies of several amiloride congeners towards Na(+)-Ca2+ and Na(+)-H+ exchange were compared in rat aortic myocytes. N-(2,4-Dimethylbenzyl)amiloride (DMB) was 10 times more potent towards Na(+)-Ca2+ than Na(+)-H+ exchange. Amiloride and ethylisopropylamiloride were about 5,000 and 10,000 times more potent toward Na(+)-H+ than Na(+)-Ca2+ exchange respectively. N-(3,4-Dichlorobenzyl)amiloride was almost equipotent towards both exchangers. About 40 nM ethylisopropylamiloride inhibited Na(+)-H+ exchange by 50%. Ethylisopropylamiloride (10 microM) had no effect on basal or angiotensin-evoked 45Ca2+ efflux or net Ca2+ efflux. In contrast to ethylisopropylamiloride, 25-50 microM DMB, which strongly inhibits Na(+)-Ca2+ exchange, markedly decreased both 45Ca2+ efflux and net Ca2+ efflux produced by angiotensin. Replacing extracellular Na+ with N-methyl-D-glucamine inhibited angiotensin-evoked 45Ca2+ efflux similarly to DMB. Neither DMB nor Na+ placement had any effect on basal or angiotensin-evoked production of [3H]inositol phosphates. These findings suggest that Na(+)-H+ exchange has no major influence on short-term Ca2+ regulation and provide evidence that Na(+)-Ca2+ exchange is a major pathway of rapid Ca2+ efflux in stimulated arterial muscle cells.

Amiloride↗
PubMed1991

Synthesis and characterization of the Kunitz protease-inhibitor domain of the beta-amyloid precursor protein.

To understand the pathological process by which amyloid is deposited in Alzheimer's disease, it is important to characterize the proteolytic processing events of the beta-amyloid precursor protein (beta-APP) from which the amyloid-forming fragment is excised. A potentially important component in beta-APP processing is the 57-amino acid (aa) Kunitz serine protease inhibitor (KPI) located within the extracellular domain of both the 751- and 770-aa isoforms of beta-APP. We have synthesized DNA encoding the 57-aa KPI domain as a necessary step in identifying the role of the protease inhibitor in beta-APP processing and amyloid formation. A bacterial secretion system directed by the alkaline phosphatase signal peptide of Escherichia coli linked to a synthetic gene encoding KPI was used to produce soluble, extracellular recombinant KPI (reKPI) protein. The reKPI protein was purified to homogeneity from bacterial supernatants and was biochemically and biologically characterized. Complete aa sequence analysis confirmed the fidelity of the reKPI, and fast-atom bombardment mass-spectral analysis was used to document that reKPI was of the predicted Mr. The reKPI is as active on a molar basis as the inhibitor-containing beta-APP when assayed for inhibition of trypsin activity. Together these data suggest that reKPI protein is properly folded and lacking in modified aa. Hence, this reKPI will be an important reagent in gaining a better understanding of the role of the KPI domain in beta-APP function and metabolism, as well as in the proteolytic events involved in beta-amyloid formation.

Alzheimer Disease↗