Radiologic placement of gastrostomy tubes.
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Fluoroscopy↗
Biomedical subjects
M S Johnson
Publications and source records attributed to M S Johnson.
Group IV: enteral feeding tubes: what is available and what is needed?
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Catheters, Indwelling↗
Rehabilitation needs and experiential learning.
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Curriculum↗
Caregiver issues and AIDS orphans: perspectives from a social worker focus group.
This study examines social workers' perceptions of the needs of families coping with acquired immunodeficiency syndrome (AIDS). This research investigates the problems of family caregivers of children orphaned by human immunodeficiency virus (HIV)-related death of their parents. A qualitative semistructured interview format was used in a focus group of 18 social workers. Four questions were designed to assess family needs and resources, as well as to evaluate the social workers' perspectives of governmental policies affecting these families. A list of four problems and two recommendations for change evolved from the focus group. Inadequate finances to house and care for the children was the primary cause for distress in these families. The major governmental policy that hindered the social workers' ability to assist families pertained to the low financial entitlement for caregivers who are related to the orphaned child. It was noted that unrelated caregivers receive substantially more money for the care of these children than family caregivers receive. Recommendations were made to change this policy and to develop guardianship laws that facilitate families' abilities to provide care to AIDS orphans. Family caregivers of AIDS orphans are bombarded with great demands and limited resources. This analysis of their situation from the social workers' perspective is a positive step toward the improvement of support services for these families. Further research should include individual qualitative interviews assessing the needs of the caregivers and AIDS orphans.
Acquired Immunodeficiency Syndrome↗
Barriers to black women's participation in cancer clinical trials.
This study examines attitudes that may deter black women from participating in cancer research. Subjects were recruited from women who did not respond to the initial recruitment mailing for the Women's Health Initiative. Each subject was administered a 7- to 10-minute telephone survey. One third (29) of the 80 subjects were black. Fifty-six percent of black women and 71% of white women had positive attitudes toward cancer clinical trials. More than 80% of the women surveyed agreed that clinical research benefits society and increases medical knowledge. However, almost one third of the black women agreed that scientists cannot be trusted while only 4% of whites responded similarly. Additionally, 29% of black women agreed that researchers did not care about them compared with 14% of white women. Only 28% of black women felt that clinical research in the United States was ethical, and 37% had a preference to be treated by a black scientist compared with 2% of whites. Controlling for other covariates, black women had more negative altitudes overall to clinical trials than white women. These findings support the likelihood that barriers exist for the participation of blacks and other minorities in clinical research. These barriers may impact the involvement of black women in cancer clinical trials. Improving trust and creating a perception of a caring attitude from investigators are important to overcoming these barriers. The inclusion of more black scientists as leaders of cancer clinical trials also may help improve these participation rates.
Adult↗
Psychometric evaluation of the Organizational Job Satisfaction Scale.
Findings are reported from a replicated evaluation of the psychometric properties of the Organizational Job Satisfaction Scale. Data lend strong support for the scale which assesses four dimensions of organizational job satisfaction. Principal component factor analysis of data from two independent samples of urban staff registered nurses (RNs) (n = 496; n = 532) confirmed four dimensions of pay, interaction, administration, and status. Cronbach's alpha for subscales ranged from .76 to .88. Pearson correlation coefficients for the interrelationships among subscales and an estimate of theta verified internal consistency. The Organizational Job Satisfaction Scale scores correlated significantly with a criterion measure of job enjoyment. Hypothesis testing of theoretically predictable relationships supported construct validity. Scores on the organizational job satisfaction subscales correlated significantly with automony, stress, and commitment. Item revisions and recommendations for future use of the instrument are discussed.
Adult↗
Effect of phorbol 12, 13-dibutyrate on ligand binding, enzyme activity and translocation of protein kinase C isoforms in the alpha T3-1 gonadotrope-derived cell line.
The effect of incubating alpha T3-1 cells with phorbol 12,13-dibutyrate (PDBu) on the protein kinase C (PKC) isoform content (predominantly alpha, epsilon and zeta isoforms) was assessed by immunoblotting, enzyme activity assay and [3H]PDBu binding. After exposure to PDBu for 17 h the immunoreactivity detected for both PKC alpha and PKC epsilon had disappeared from cytosol and had increased slightly in membranes. Immunoreactivity for PKC zeta was present as two bands in cytosol; after PDBu treatment both bands decreased in intensity, the higher molecular weight band more than the lower. The lower molecular weight band corresponded with a component of constitutive PKC activity eluting from DEAE cellulose that was defined by inhibition of basal activity with GF 109203X or H7. Investigation of very short treatment times with PDBu using binding, immunoblot and activity measurements (in the presence/absence of Ca2+) indicated that translocation of PKC alpha and epsilon was very rapid-detectable by 10 sec, maximal within minutes. Reduction of these isoforms in membranes took much longer, and was not apparent up to 150 min. The immunoblot data for PKC zeta in cytosol showed no detectable effect of PDBu treatment on the low molecular weight band up to 150 min although it was reduced at 17 h. Translocation of the upper band was detectable at 10 sec but this band may have resulted from cross-reaction with other PKC isoforms. The constitutive activity and low molecular weight ("authentic') PKC zeta immunoreactivity were partially affected after long exposure only, suggesting an action of PDBu on PKC zeta secondary to activation of the other PKC isoforms. An endogenous receptor agonist, luteinising hormone-releasing hormone (LHRH), was also used to assess by immunoblotting, translocation of the PKC isoforms. Although all the isoforms did translocate from cytosol to membrane fractions, they did so with distinctly different time courses: PKC epsilon moved more rapidly than PKC zeta which appeared to translocate more quickly than PKC alpha. After downregulation of the responsive PKC isoforms with PDBu, the remaining PKC zeta was not translocated by LHRH.
Animals↗
Structure of cytokine hydrophobic cores.
Diagrams were constructed that describe, using a common frame of reference, the interactions that occur within the hydrophobic cores of the left-handed four-helix bundles of interleukin-2, -4, -5, granulocyte/macrophage-, granulocyte-, macrophage-colony-stimulating factor, beta- and gamma-interferon, growth hormone, and leukemia inhibitory factor. Based on the assumption that the topologies of the ligand-receptor complexes are similar, analogous patterns were obtained from these diagrams and lead to the detailed comparison of the hydrophobic cores. These patterns were then used to obtain pairwise rigid-body superpositions among all of the four-helix bundles; values of the root-mean-square deviations (C alpha-atoms) over the four alpha-helices of the bundles range from 1.14 A to 3.22 A. Two distinct groups are formed after clustering based on structural superposition of the ten cytokines.
Cytokines↗
Separation of H7-resistant protein kinase C isoforms from gonadotroph-derived alpha T3-1 cells.
Certain physiological events in anterior pituitary tissue are regulated by protein kinase C that is relatively resistant to the inhibitor, H7. In the present studies we have shown that two H7-resistant protein kinase C activities may be isolated from (pituitary) gonadotroph-derived alpha T3-1 cells using hydroxyapatite chromatography. These activities have the characteristics of PKC zeta and an apparently novel PKC isoform. The availability of clonal alpha T3-1 cells will facilitate investigations of the pituitary events.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
Physicians, pharmaceutical sales representatives, and the cost of prescribing.
OBJECTIVE: To evaluate the influence of primary care physicians' attitudes toward and use of information provided by pharmaceutical representatives on prescribing costs in ambulatory practice. DESIGN: A mailed questionnaire collected information about physician demographic and practice characteristics and attitudes toward and use of information provided by pharmaceutical representatives. PARTICIPANTS: Kentucky physicians practicing primary care adult medicine (family medicine, general practice, general medicine; n = 1603). MAIN OUTCOME MEASURE: Relative cost of prescribing, based on physician responses to treatment choices for ambulatory clinical scenarios in primary care. A multivariable regression model assessed predictive relationships between independent variables and prescription costs. RESULTS: Four hundred forty-six returned questionnaires were suitable for analysis. No significant differences were noted in age, gender, days worked per week, or years since graduation between responders and a sample of nonresponders. A significant positive correlation was found between physician cost of prescribing and perceived credibility, availability, applicability, and use of information provided by pharmaceutical representatives (P < .01, Pearson's Product-Moment Correlation Coefficient). Physicians in academic or hospital-based practice settings had significantly lower prescribing costs than physicians in nonacademic and nonhospital practices (P = .001, analysis of variance). Frequency of use of information provided by pharmaceutical representatives (P = .01, multiple linear regression) and the group practice setting (P = .02, multiple linear regression) remained significant, independent positive predictors of cost in the multivariable regression model. CONCLUSIONS: Frequency of use of information provided by pharmaceutical representatives and the group practice, nonacademic and nonhospital setting may be associated with increased primary care physician prescribing costs.
Attitude of Health Personnel↗
Polychlorinated biphenyls in small mammals from contaminated landfill sites.
PCBs in small mammals living in a contaminated landfill site varied in both concentration and congener composition, reflecting both the feeding strategy of each species and the chlorination of the congeners. Body concentrations of SigmaPCB on a 1:1:1 Arochlor (1242:1254:1260) basis gave a rank order of Sorex araneus >> Apodemus sylvaticus > Microtus agrestis. Comparisons with data for other PCB-contaminated sites suggest that the SigmaPCB values in S. araneus from the landfill site may be of sufficient magnitude to inhibit reproductive capability and to cause other major organ dysfunction. There were also inter-specific differences in the whole body concentrations of the individually quantified congeners. For S. araneus, the rank order of concentrations of the selected ICES 7 marker PCB congeners was: No. 153>138>>180>118>>28>101>52. In M. agrestis the rank order was: No. 28>118>153>138>180, 52>101. The congener order for A. sylvaticus differed from both S. araneus and M. agrestis, but was more similar to the latter, being: No. 153>138>118>180>28>52, 101. The contribution of the different congeners to SigmaPCB in the mammals reflects the degree of chlorination of different congeners but varies with feeding strategy of the species. In the insectivorous S. araneus, heavily chlorinated congeners (Nos 153, 138 and 180) are most abundant, whereas the herbivore, M. agrestis showed congeners Nos 28 and 118 to be present in the highest amounts, whilst the equivalent pattern for the more omnivorous A. sylvaticus was intermediate between S. araneus and M. agrestis. The high concentrations of PCBs in S. araneus relative to the other species, suggests that it may serve as a useful biomarker of terrestrial environmental pollution by organochlorines.
Journal Article↗
Discrimination of common protein folds: application of protein structure to sequence/structure comparisons.
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Amino Acid Sequence↗
Utilizing all opportunities in clinical practice.
Clinical practice provides an abundance of avenues through which nurses may enhance both clinical judgment and scholarly activities. Creative ways to stimulate opportunities for this knowledge exist. The article describes the approaches utilized by clinical nurse specialists in two teaching hospitals. A cardiovascular nursing unit and a neurologic nursing unit served as settings for description. Advanced practice nurses provided motivation.
Cardiovascular Diseases↗
Oxygen taxis and proton motive force in Azospirillum brasilense.
The microaerophilic nitrogen-fixing bacterium Azospirillum brasilense formed a sharply defined band in a spatial gradient of oxygen. As a result of aerotaxis, the bacteria were attracted to a specific low concentration of oxygen (3 to 5 microM). Bacteria swimming away from the aerotactic band were repelled by the higher or lower concentration of oxygen that they encountered and returned to the band. This behavior was confirmed by using temporal gradients of oxygen. The cellular energy level in A. brasilense, monitored by measuring the proton motive force, was maximal at 3 to 5 microM oxygen. The proton motive force was lower at oxygen concentrations that were higher or lower than the preferred oxygen concentration. Bacteria swimming toward the aerotactic band would experience an increase in the proton motive force, and bacteria swimming away from the band would experience a decrease in the proton motive force. It is proposed that the change in the proton motive force is the signal that regulates positive and negative aerotaxis. The preferred oxygen concentration for aerotaxis was similar to the preferred oxygen concentration for nitrogen fixation. Aerotaxis is an important adaptive behavioral response that can guide these free-living diazotrophs to the optimal niche for nitrogen fixation in the rhizosphere.
Azospirillum brasilense↗
Three-dimensional gadolinium-enhanced MR angiography for aortoiliac inflow assessment plus renal artery screening in a single breath hold.
PURPOSE: To develop a magnetic resonance (MR) angiography protocol, with use of breath-hold techniques, for simultaneous aortoiliac inflow assessment and renal artery screening in patients with lower extremity ischemia or aortic aneurysm. MATERIALS AND METHODS: Breath-hold three dimensional gadolinium-enhanced MR angiography was performed in 50 patients (conventional arteriography in 47 was the standard of reference). After multiple strategies were tested in the first 18 patients, a final protocol was formulated and tested in the subsequent 32 patients. RESULTS: The final protocol comprised a single-slab (28 3-mm-thick partitions) coronal acquisition (repetition time, 7 msec; echo time, 2.8 msec; flip angle, 60 degrees) during a single breath hold, enhanced with 30 mL gadoteridol. In the final 32 patients, sensitivity and specificity, respectively, for obstructive lesions were 100% and 100% for the aorta, 100% and 98% for common iliac arteries, 100% and 89% for external iliac arteries, 100% and 89% for main renal arteries, and 100% and 62% for accessory renal arteries. CONCLUSION: This breath-hold protocol improves the accuracy of aortoiliac inflow assessment, but low resolution limits evaluation of small renal arteries.
Adult↗
Complex biliary stones: treatment with a small choledochoscope and laser lithotripsy.
PURPOSE: To evaluate the use of a small choledochoscope and laser lithotripsy in the treatment of complex biliary stone disease. MATERIALS AND METHODS: Twenty-five consecutive patients with complex biliary stone disease not amenable to surgical therapy, peroral endoscopic removal, or simple percutaneous retrieval techniques underwent 35 stone-removal procedures. A 3.4-mm endoscope and a pulsed dye coumarin green laser were used to pulverize and remove stones through preexisting, mature transhepatic biliary drain tracts (n = 18), t-tube tracts (n = 3), cholecystostomy tube tracts (n = 3), and a hepaticocutaneous enterostomy (n = 1). Procedures in 14 of the 25 patients (56%) were performed on an outpatient basis. RESULTS: Twenty-four of the 25 patients (96%) were cleared of their stone burden and underwent subsequent catheter therapy of strictures or abscesses as necessary. Complications of the stone removal included fever and chills in six patients (24%) and mild bleeding from a bile duct wall during removal of an adherent stone in one patient. CONCLUSION: Use of a small choledochoscope and a coumarin green pulsed dye laser is safe and effective in the management of complex biliary stone disease.
Bile Duct Diseases↗
Transjugular intrahepatic portosystemic shunt procedure: efficacy of 10-mm versus 12-mm Wallstents.
PURPOSE: To compare results of transjugular intrahepatic portosystemic shunt (TIPS) placement with 10- and 12-mm Wallstents. MATERIALS AND METHODS: Forty-six TIPS procedures in 47 patients were retrospectively reviewed. Wallstents that were 10 mm in diameter were used in 23 patients, and those that were 12 mm in diameter were used in 23 patients. Immediate results were compared, which included initial portosystemic gradient and Doppler measurements of blood flow velocity through the shunt at 1 day. Long-term patency and velocities were also assessed. RESULTS: TIPS were successfully created in 46 of 47 patients (98%). In one patient in the 10-mm group, the portal vein could not be accessed. When compared with TIPS in the 10-mm group, TIPS placed in the 12-mm group required dilation to larger diameters (mean, 11.1 vs 9.2 mm; P < .0001) to achieve an identical target gradient of 10 mm Hg and exhibited lower 1-day velocities (mean, 1.3 m/sec vs 1.7 m/sec; P < .03). The 1-day occlusion rate was 17% (four of 23 patients) in the 12-mm group versus 0% in the 10-mm group (P < .02). Patient survival was statistically significantly less in the 12-mm group (P < .03). CONCLUSION: Twelve-millimeter Wallstents yield statistically significantly poorer short- and long-term results in TIPS procedures. This is most likely due to the decreased radial strength of the larger stent, which is 50% less than that of the 10-mm stent.
Adolescent↗
Pulmonary emboli from pulse-spray and mechanical thrombolysis: evaluation with an animal dialysis-graft model.
PURPOSE: To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts. MATERIALS AND METHODS: Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device. Perfusion imaging, pulmonary-artery pressure measurements, and pulmonary arteriography were performed before and after each procedure. RESULTS: A total of 22 procedures were performed (11 PSPMT and 11 mechanical thrombolysis). Declotting was successful in all procedures, with 100% 30-day patency. Segmental defects were seen on perfusion images after 10 (91%) of 11 PSPMT procedures and two (18%) of 11 mechanical thrombolysis procedures (P < .002). Transient increases in pulmonary-artery pressure occurred in the PSPMT group. Complete resolution of emboli and return to baseline pressures were seen in all cases, even after multiple (up to four) procedures in the same animal. There was no histologic evidence of pulmonary infarction in either group. CONCLUSION: The percutaneous thrombolytic device is effective for declotting dialysis grafts in dogs and results in statistically significantly fewer pulmonary emboli compared with PSPMT.
Animals↗