Biomedical subjects
L Walker
Publications and source records attributed to L Walker.
Treatment of mandibular angle fractures using two noncompression miniplates.
PURPOSE: To evaluate treatment with two 2.0-mm noncompression miniplates for patients with angle fractures. PATIENTS AND METHODS: Sixty-seven consecutive patients with 69 fractures of the mandibular angle were treated by open reduction and internal fixation using two noncompression miniplates and 2.0-mm self-threading screws placed through a transoral incision with transbuccal trochar instrumentation. No patient was placed into postsurgical maxillomandibular fixation or elastics. RESULTS: Overall, 19 fractures (28%) experienced complications requiring secondary surgical intervention. Most of the complications were postoperative infections requiring surgical drainage (n = 17) and subsequent hardware removal (n = 16). Of the 17 infected fractures, 11 were healed at the time of hardware removal and required no further treatment. Five were still mobile and required a period of maxillomandibular fixation for healing. One of the fractures did not heal and required bone grafting. CONCLUSION: The use of two noncompression miniplates was found to be relatively easy, but resulted in an unacceptable rate of infection in our patient population when used for treatment of fractures of the mandibular angle.
The contributions of renin and vasopressin to the adaptation of the Australian spinifex hopping mouse (Notomys alexis) to free water deprivation.
Xeric-adaptation was studied during 28 days of total water deprivation (TWD) in Notomys alexis. Beyond 7 days, the initial reductions in body weight and increases in haematocrit, plasma renin and juxtaglomerular (JG) cell morphological activity returned to normal. Mus musculus showed similar changes at 7 days but could not be maintained thereafter. TWD decreased the blood pressure of Notomys but endogenous angiotensin and vasopressin did not support pressure to a greater extent than controls, as revealed by selective antagonists. The normal morphology of the JG apparatus in Notomys was similar to other rodents. Fluid volume and blood pressure maintenance during TWD in Notomys do not depend upon enhanced activities of the renin-angiotensin and antidiuretic hormonal systems.
Gene therapy for cystic fibrosis using cationic liposome mediated gene transfer: a phase I trial of safety and efficacy in the nasal airway.
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Unlocking the information vault.
With a multitude of departmental information systems, executives find it difficult to make well-informed decisions affecting cost or to change physician behavior. A well-conceived EIS is alleviating such difficulties at many organizations.
Unlocking the information vault.
With a multitude of departmental information systems, executives find it difficult to make well-informed decisions affecting cost or to change physician behavior. A well-conceived EIS is alleviating such difficulties at many organizations.
Lorri Walker, RNP. Interview by Ina May Gaskin.
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Setting up a foolproof follow-up system.
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Cell cycle activity and expression of prohibitin mRNA.
Prohibitin, a novel intracellular antiproliferative protein, blocks entry into the S phase of the cell division cycle when its mRNA is microinjected into normal fibroblasts or HeLa cells. To learn more about the interaction between prohibitin and the cell cycle, we studied the effect of microinjecting prohibitin mRNA at different points during the transition from G0 to S phase and analyzed prohibitin mRNA and protein levels in different parts of the cell cycle. The antiproliferative activity of microinjected prohibitin mRNA is high in G0/G1 and falls as cells approach S phase. Prohibitin mRNA and protein levels are high in G1, fall with S phase, rise again in G2, and fall in M. Together, these findings suggest that endogenous prohibitin contributes to the control of the G1 to S transition in cycling cells in a complex manner, which involves both a transcriptional and posttranslational mechanism.
Does flexible cystoscopy miss more tumours than rod-lens examination?
The first blind, prospective, randomised comparison of flexible cystoscopy with rod-lens cystoscopy was carried out on 53 consecutive volunteers with bladder tumours or haematuria. Three patients' recurrences were missed on flexible cystoscopy and 3 others on rod-lens examination. It was expected that the 9% rate of missed tumours would lessen with increased experience of flexible cystoscopy, as 2 of them occurred in the first 12 examinations and all of the lesions missed were < 5 mm in diameter. Rod-lens cystoscopy, the accuracy of which appears to have been measured for the first time, was no more sensitive.
Beyond benchmarks: assuring hardware performance.
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Instant image: scanning photos into the electronic medical record.
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Medicare claims system knows a character when it sees one.
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Localized conformational changes in the N-terminal domain of CD4 identified in competitive binding assay of monoclonal antibodies and HIV-1 envelope glycoprotein.
The CD4 antigen is established as a major cellular receptor for the human immunodeficiency virus (HIV). Previous studies have suggested that certain anti-CD4 monoclonal antibodies (MAbs) can inhibit or enhance the binding of the viral envelope glycoprotein gp120 to CD4 by allosteric effects. In the study reported here, 17 anti-CD4 MAbs were tested for their ability to influence the binding of each other to recombinant soluble CD4 in a solid-phase radioimmunoassay. Marked enhancement of binding between specific pairs of MAbs was seen, as well as inhibition or lack of interaction. Enhancement was seen less often when CD4+ cells were used as the target antigen. Information on patterns of enhancement and inhibition permitted grouping of MAbs on the basis of epitope specificity, and this grouping was in agreement with published findings based on X-ray crystallographic studies. These results demonstrate connectivity between epitopes in the first domain of recombinant CD4 and suggest a high degree of flexibility of surface structure. These findings may be of physiological significance both in the normal function of CD4 and in the interaction of CD4 with HIV. The data have implications for research or therapeutic strategies based on recombinant CD4 or CD4 mutants and highlight the problems of interpreting experimental findings based on abrogation of MAb binding.
Inhibitory activity of HIV envelope gp120 dominates over its antigenicity for human T cells.
HIV-1 envelope glycoprotein (gp120), as a CD4-binding reactant, has been shown to inhibit in its native form human T cell responses to several antigens. Here we show that gp120 in soluble form also inhibits activation of a specific human T cell line that responds to gp120-pulsed autologous antigen-presenting cells. In addition the inhibitory property of gp120 for antigen-driven T cell proliferation depends upon its ability to bind CD4 and is lost when CD4-binding capacity is abolished by denaturation, or blocked by complexing with soluble CD4 or with polyclonal antibodies. In contrast, antigenicity of denatured or complexed gp120 for specific human T cells is preserved. Similar effects are also observed with another CD4-binding reactant (i.e. anti-Leu 3a MoAb), which stimulates and/or inhibits human T cells specific for mouse immunoglobulins depending on native or denatured conformation.
Integrating medical records systems improves care.
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Panacea or placebo? UNIX in healthcare.
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Power to the portables.
Portable computing devices generally are classified into four categories: laptop, palmtop, notebook, and pen-based computers. If a portable unit weighs over eight pounds, call it a laptop. If a stylus is used to input data, call it pen-based or a pen computer. Palmtops frequently are electronic organizers or resources: Sharp's Wizard line stores appointments and addresses; Franklin's Med-Spell contains Stedman's medical dictionary. Notebooks often incorporate a QWERT keyboard, and sometimes include a pointing device. NEC's notebooks in 1988 were the first sub-laptop computers. According to a 1992 report from Market Intelligence Research Corp., Mountain View, Calif., 4.6 million sub-laptops were sold in 1991 for $2.6 billion. By 1998 the market may reach $25 billion. The report predicts that one sub-category of pen computers, which are designed to be held in one hand while information is input with a pen-like stylus, will prove most useful to the health-care industry. Pen tablets, as opposed to pen clipboards, use faster, more expensive processors, store more data, and "are expected to allow [caregivers] to carry full patient charting with them ... and allow information to be recorded directly to patient files." Sub-laptops are on-line in many healthcare facilities: Greenwich hospital, Stanford University Medical Clinic, Humana Hospital Audubon, Rancho Los Amigos Medical Center, and others.