Biomedical subjects
M Brown
Publications and source records attributed to M Brown.
The greatest guy in the world.
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Benefits for the whole office. Staffing practices go upscale.
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The effect of underlying philosophy upon utilization of a program for impaired medical students.
In recent years, an increasing number of medical schools have implemented educational programs for their impaired, or potentially impaired, students. The present research analyzed one such program viewing it as an organizational innovation and employing a theoretical model from the organizational literature. A survey sample of 170 medical students representing all four classes and recently graduated interns was utilized. Subjects were queried as to anticipated program use, degree of exposure to the program, accuracy of knowledge of the program, and perceived program advocacy. Via ANOVA analysis (regression approach) it was found that the general advocacy stance of the medical school toward the innovation (general diffusion emphasis) was not an influential factor upon potential use of the program by medical students. However, its concentration upon the actual procedures to be employed (specific diffusion emphasis) was a much better predictor. The implications for such a finding on the structure of future kindred educational programs was discussed.
Health care delivery problems.
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Biochemical markers of renal perfusion are preserved during liver transplantation with venovenous bypass.
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Effect of preservation solution on serum glucose levels during liver transplantation.
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Human estrogen receptor forms multiple protein-DNA complexes.
A baculovirus expression system was used to overproduce the human estrogen receptor in insect cells. The estrogen receptor made in this system is full-length, binds estrogen specifically, and is recognized by a monoclonal antibody to the human estrogen receptor. The recombinant estrogen receptor binds the estrogen response element (ERE) in both the absence and presence of estrogen if the binding is carried out in the absence of Mg2+. In the presence of Mg2+, the estrogen receptor binds the ERE in a hormone-dependent fashion. This effect is more pronounced at higher temperatures. Tamoxifen, a nonsteroidal anti-estrogen, is able to stimulate ERE binding to the same extent and under the same conditions as estradiol. Estradiol stimulates formation of an estrogen receptor-ERE complex with an increased mobility in native gels as compared with the complex formed without hormone or with tamoxifen. These results demonstrate that specific DNA binding of the estrogen receptor is not absolutely dependent on the presence of hormone and that estradiol but not tamoxifen is able to induce a change in the estrogen receptor. This differential effect of estradiol and tamoxifen may be important in understanding the role of the receptor to activate target genes differentially.
Cisplatin-based combination chemotherapy in the treatment of advanced-stage testicular cancer: cost-benefit analysis.
A cost-benefit analysis of the impact of cisplatin-based combination chemotherapy for treatment of disseminated testicular cancer showed that the annual estimated economic value of this treatment innovation in the United States is approximately $150 million. The estimate was based on the human capital approach, which conservatively values a human life in terms of economic productivity. Because testicular cancer predominantly strikes young adult males, the savings reported were due to the future earning potential of the survivors. A comparison of relevant National Cancer Institute (NCI) costs for drug development and clinical trials versus annual savings realized indicated that the total costs over a 17-year period are recovered in less than 1 year. This report is an example of health care cost savings resulting from NCI support of biomedical research.
Sympathetic skin responses are decreased and lymphocyte beta-adrenergic receptors are increased in progressive multiple sclerosis.
Immune abnormalities, including deficient CD8 lymphocyte-mediated suppression, have been implicated in the progression of multiple sclerosis (MS). The peripheral sympathetic branch of the autonomic nervous system innervates the lymphoid organs and affects immune function. Animals with an ablated sympathetic nervous system develop more severe experimental allergic encephalomyelitis than control animals and exhibit an increased density of beta-adrenergic receptors on their lymphocytes. Experimental allergic encephalomyelitis shares many features with MS. Accordingly, we investigated the psychogalvanic skin reflex in patients with rapidly progressive MS and found that 13 patients (57%) lacked this sympathetic-mediated response. The density of beta-adrenergic receptors on lymphocyte subsets was increased in progressive MS, most notably on the CD8 suppressor/cytotoxic subset. B lymphocytes had the greatest number of receptors with 12.1 +/- 1.8 fmol/10(6) cells in control subjects and 18.7 +/- 2.6 fmol/10(6) cells in patients with MS. CD8 lymphocytes possessed an intermediate number of receptors with 3.4 +/- 0.4 fmol/10(6) cells in control subjects and 9.1 +/- 1.6 fmol/10(6) cells in patients with MS. CD4 lymphocytes demonstrated the fewest receptors with 1.2 +/- 0.1 fmol/10(6) cells in control subjects and 1.8 +/- 0.4 fmol/10(6) cells in patients with MS. No differences in the affinity or function (cyclic adenosine monophosphate levels in response to 10(-5) M (-)isoproterenol) of the adrenergic receptor were found when patients with progressive MS and control subjects were compared. Autonomic abnormalities in progressive MS and the increased beta-adrenergic receptor density found on CD8 lymphocytes may be related.
The prevalence of Lyme disease in an endemic region.
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Criteria for assessing recovery of function after spinal cord injury: behavioral methods.
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Strongyloides stercoralis: identification of a protease that facilitates penetration of skin by the infective larvae.
Host invasion and tissue migration of several helminths have been linked to the expression and release of parasite-derived proteases. One of the most remarkable examples of tissue migration is that of larvae of the nematode parasite Strongyloides stercoralis, which can move through tissue at speeds of up to 10 cm per hour. We have shown the Strongyloides L3 larvae secrete a potent histolytic metalloprotease to facilitate their rapid migration. This protease has elastase activity and catalyzes the degradation of a model of dermal extracellular matrix. The importance of this enzyme in the pathogenesis of strongyloidiasis is underscored by the observation that invasion by larvae of skin in vitro is prevented by metalloprotease inhibitors. These results substantiate the role of proteases as virulence factors in strongyloidiasis, as well as other related parasitic infections, and suggest new approaches to therapy.
Elastic band mobilisation after flexor tendon repair; splint design and risk of flexion contracture.
Elastic band mobilisation of repaired flexor tendons in zone 2 may be complicated by flexion contracture of the P.I.P. joint. The mechanics of three types of elastic band mobilisation were analysed from lateral video-recordings of finger movement and the flexion moment at the P.I.P. joint was derived at every 10 degrees of flexion. The conventional forearm attachment of the elastic band produced a steep rise in P.I.P. joint flexion moment during extension; this effect was greatest when the M.P. joint was at 70 degrees and least at 20 degrees. Flexion moments for attachments around the dorsum of the hand or under a palmar pulley were lower, uniform throughout the range of P.I.P. joint motion and independent of the position of the M.P. joint. The effort needed to extend the P.I.P. joint is strongly influenced by the method of elastic band attachment; consideration should be given to both tension and moment arm in application of elastic band mobilisation.
Exercise as a treatment for hypertension in low-socioeconomic-status black children.
Low-socioeconomic-status (SES) Black children have a higher mean blood pressure than most other groups. The antihypertensive effects of a 12-week aerobic exercise program were examined on 11 low-SES Black children, ages 8-12, who had blood pressure above the 95th percentile. A multiple baseline across three groups of children with baseline and exercise conditions was conducted. After the introduction of the exercise program, there were significant decreases in diastolic and systolic blood pressure. Cardiovascular fitness improved concurrently. The results suggest that vigorous exercise can decrease the blood pressure of low-SES hypertensive Black children.
Design and synthesis of putative inhibitors of glucosamine synthetase.
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The effect of a national campaign on attitudes toward AIDS.
Following a national campaign in Australia which had shown no change in level of knowledge about AIDS (using random samples of the population over 16 years, before and 5 months after the campaign), we assessed the change of attitudes towards, and beliefs about AIDS in the same samples. Results indicated that there were changes in beliefs about how much is known about the transmission of HIV, and that people were less concerned about casual transmission. Those respondents reportedly influenced most by the campaign were those with greater fear of diseases and death. We conclude that media campaigns may have a significant effect on attitudes and beliefs toward AIDS even where there is no effect on level of knowledge, and that the attitudinal changes which may be promoted by such campaigns should also be considered as objectives in campaign design.
Health care systems: predictions for the future.
What current forms of systems will ultimately lead health care in the direction of a high-quality, comprehensive, efficient, and more caring system of services for the future?