Psychiatric nursing--current practice.
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Humans↗
Biomedical subjects
M Ward
Publications and source records attributed to M Ward.
Role of glycosylation for beta 2-adrenoceptor function in A431 cells.
A431 cells incubated with tunicamycin (0.15 micrograms/ml) for 40 h under conditions where incorporation of [3H] leucine into protein was inhibited less than 10% expressed mainly a beta-receptor species of about Mr 40,000 which was ascribed to the nonglycosylated form of the beta-receptor of about Mr 75,000 found in normal A431 cells by photoaffinity labeling. However, the tunicamycin-treated cells expressed the same number of specific beta 2-receptor-binding sites as untreated cells. Moreover, the aglycoreceptors had the same ligand binding properties as beta-adrenoceptors from control cells; but, functional tests of the receptor from tunicamycin-treated cells in reconstituted lipid vesicles showed that receptors from tunicamycin-treated cells had lost coupling efficiency. The coupling defect was at the receptor level since control experiments indicated that the other components of the signal transmission chain from beta-adrenoceptor to adenylate cyclase, the stimulatory regulatory GTP-binding protein of adenylate cyclase and adenylate cyclase, were fully functional. Homologous desensitization in tunicamycin-treated cells was characterized by export from the cell surface and sequestration of about the same number of beta-adrenoceptors as in normal desensitized cells but without further reduction of hormonally stimulated adenylate cyclase below the low level already attained in nondesensitized tunicamycin-treated cells. This was explained by assuming that the receptors removed in the course of homologous desensitization from the surface of tunicamycin-treated cells were already nonfunctional. Thus, beta-adrenergic desensitization in tunicamycin-treated cells is characterized by the functional disengagement of receptor removal and loss of adenylate cyclase activity.
Adenylyl Cyclases↗
Sequence of the Aspergillus niger pyrG gene.
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Amino Acid Sequence↗
The oliC3 gene of Aspergillus niger: isolation, sequence and use as a selectable marker for transformation.
The oliC3 gene of Aspergillus niger has been isolated and sequenced. This gene encodes an oligomycin-resistant variant of the mitochondrial ATP synthase subunit 9. In transformation experiments the gene can serve as a semi-dominant selectable marker for A. niger. It was possible to recognize transformants in which oliC3 had integrated at the homologous oliC locus, as opposed to elsewhere in the genome, by observation of phenotypes on medium containing oligomycin. DNA sequencing has allowed comparison of the deduced amino acid sequence with subunit 9 proteins from other species and comparison of 5' untranslated sequences with those from other fungi.
Amino Acid Sequence↗
Cigarette smoking and other correlates of cytologic estrogen effect in postmenopausal women.
Cigarette smoking and other factors associated with estrogen-related diseases may influence risk through hormonal mechanisms. To investigate the sex hormone associations of these risk factors, vaginal scrape cytology specimens and questionnaire data were obtained on 215 postmenopausal women at the time of routine pelvic examination. All specimens were read blindly by one cytologist, and the relationships between the indices of maturation and risk factors were assessed with regression techniques. Current cigarette smoking and obesity were associated with increased maturation. In contrast, years past menopause, parity, and coffee and tea consumption were all unrelated to vaginal epithelial maturation. These results elucidate the mechanisms underlying the antiestrogenic effect of cigarette smoking and support the concept that obesity is associated with an estrogenic effect.
Aged↗
Complications of endotracheal intubation.
Tracheal intubation for airway control, once done only by anesthesiologists during surgical procedures, is now being done by physicians in other specialties and by nurses, technicians, and paramedics in areas other than the operating room. Intubation, however, does not always assure a patent airway. Unrecognized esophageal placement of endotracheal tubes is the major cause of cardiac arrest and brain damage associated with intubation. Though auscultation for breath sounds is the universally accepted method of verifying proper tube placement, recent studies indicate that it is reliable only approximately two thirds of the time in situations in which verification of proper placement is needed most and is least obvious. The usefulness of this technique merits reassessment. Identification of carbon dioxide in end-expired air is the most reliable method for verification, but instruments to detect carbon dioxide are usually immediately available only in special care and surgical suites. Mouth-to-tube insufflation with a two-way disposable microbial filter differentiates immediately between esophageal and tracheal placement and can be used in any area. Malpositioned and malfunctioning tubes cause partial or complete obstruction accompanied by varying degrees of hypoxemia and hypercapnia. Respiratory and circulatory derangements and brain damage ensue if the problem is not promptly recognized and corrected. We discuss the most common causes of tube malfunction.
Airway Obstruction↗
Problems experienced by adolescents already in families that adopt older children.
Many families adopt school-aged children, yet the impact of such adoptions on children already in the family is virtually unknown. This paper reports results from a questionnaire administered to a small sample of adolescents concerning difficulties experienced with both newly adopted school-aged siblings and, for comparison, other children already in the family. Difficulties with all siblings were seen primarily as hassles. The adoptee was, however, reported as creating more problems than "old" siblings. The problems with the adoptee, but not with other siblings, suggested invasion of "turf" and, more particularly, interference with parent-child relationships. Difficulties are discussed in relation to their impact on the family system.
Adolescent↗
Outcome in patients on continuous ambulatory peritoneal dialysis and haemodialysis: 4-year analysis of a prospective multicentre study.
In a study in seven large renal units in England, the morbidity and mortality of all patients starting continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis during 1983-85 were monitored prospectively over a 4-year period and related to reasons for choice of therapy and potential risk factors. 610 new patients (median age 52 years, range 3-80 years) started CAPD; 16% had diabetes mellitus and 21% cerebrovascular or cardiovascular disease. 329 patients (median age 48 years, range 5-77 years) started haemodialysis; 7% had diabetes mellitus and 17% cerebrovascular or cardiovascular disease. The Kaplan-Meier patient survival estimates at 4 years were 74% for haemodialysis and 62% for CAPD; technique survival figures for the same period were 91% for haemodialysis and 61% for CAPD. Cox's proportional hazards regression analysis showed that cerebrovascular/cardiovascular disease, age over 60 years, and diabetes mellitus were important predictors for survival in CAPD patients; there were no risk factors associated with permanent change to haemodialysis. In the haemodialysis group early change to CAPD was associated with presence of cerebrovascular or cardiovascular disease. The major cause of drop-out in both groups was transplantation. The mean length of hospital admission was 14.8 days per patient-year for CAPD and 12.4 days per patient-year for haemodialysis.
Adolescent↗
Untrapping the metaphor of AIDS.
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Acquired Immunodeficiency Syndrome↗
Comparison of computed tomography and conventional radiology in the assessment of treatment response of lytic bony metastases in patients with carcinoma of the breast.
Full skeletal survey, localised radiographs and computed tomography (CT) examinations were compared with clinical assessment in the evaluation of treatment response of bony metastases in 20 patients with carcinoma of the breast. Conventional radiology, skeletal survey and localised views compared poorly with clinical assessment agreeing in only 35% and 50% respectively. CT concurred with the clinical assessment in 65% of patients, particularly with respect to healing (86%). CT predicted the effect of treatment in six additional patients and this was confirmed on follow-up assessment. It is suggested that the use of skeletal surveys in monitoring treatment response is limited and that for critical evaluation of treatment CT should be the method of choice.
Adult↗
Enprostil and ranitidine: comparative efficacy and safety in patients with duodenal ulcer.
This randomised, double-blind, double-dummy, multiclinic study of duodenal ulcer healing compared the efficacy and safety of enprostil with ranitidine. The six week trial admitted 164 patients with endoscopically demonstrated duodenal ulcer. Ratings of symptoms and adverse events were collated from patients' daily diaries, and endoscopy was repeated to verify healing after four weeks and, if appropriate, after six weeks. Medication used was enprostil (35 micrograms capsule) or ranitidine hydrochloride (150 mg tablet) with matching placebos twice daily. After six weeks, 81% of patients treated with enprostil and 95% of those treated with ranitidine had healed ulcers, a statistically significant difference (p = 0.007). There were no differences between treatment groups for the number of days until the daytime ulcer pain completely ceased. Night-time ulcer pain ceased significantly earlier in the group receiving ranitidine (p = 0.019) and was less severe during the week before the last visit (p = 0.001); daytime pain for ranitidine users was also less severe (p = 0.020) during this week. Mild to moderate adverse experiences were reported by 44% of enprostil and 35% of ranitidine patients. There were no severe adverse events. In conclusion, both enprostil and ranitidine were found to be safe and effective in the treatment of duodenal ulcer. However, the ranitidine regimen used in this trial produced better results than the enprostil regimen.
Clinical Trials as Topic↗
An open trial of L-tyrosine in the treatment of attention deficit disorder, residual type.
To elucidate the role of catecholamines in attention deficit disorder, the authors conducted an open 8-week trial of L-tyrosine in 12 adults with attention deficit disorder, residual type. Eight showed marked to moderate clinical response in 2 weeks; at 6 weeks these eight developed tolerance, suggesting that L-tyrosine is not useful in attention deficit disorder, residual type.
Adult↗
Suprofen-related nephrotoxicity. A distinct clinical syndrome.
We describe a unique clinical syndrome of flank pain and acute renal failure that is associated with suprofen, a nonsteroidal anti-inflammatory drug that has recently been made available in the United States. In the initial 6 months of the drug's distribution in this country, at least 16 patients developed this syndrome. All 16 had acute flank pain and 13 developed mild reversible renal failure within 12 hours of ingestion of one to three suprofen capsules. This syndrome is unlike other nephrotoxic syndromes related to nonsteroidal anti-inflammatory drugs. The mechanism is not known.
Abdomen↗
Multi-centre study on outcome of treatment in patients on continuous ambulatory peritoneal dialysis and haemodialysis.
In a multi-centre study by seven large renal units in the United Kingdom, the morbidity and mortality of all patients starting CAPD and haemodialysis during a 2-year period (1983-1984) has been monitored prospectively and related to reasons for choice of therapy and potential risk factors. Over this period 338 new patients (mean age 48; range 3-77 years) started CAPD; 17% had diabetes mellitus and 25% had cerebro/cardiovascular disease. One hundred and seventy-five patients (mean age 45; range 5-73 years) started haemodialysis; 6% had diabetes mellitus and 14% had cerebro/cardiovascular disease. The Kaplan-Meier actuarial patient survival estimates at 2 years were haemodialysis 84% and CAPD 83%, whilst technique survival figures for the same period were haemodialysis 92% and CAPD 80%. Cox's regression analysis showed that cerebro/cardiovascular disease and age greater than 60 years were most important predictors for survival in CAPD patients, in whom smoking appeared to be a significant risk factor, for permanent change of therapy to haemodialysis. The major cause of 'drop out' in both groups was transplantation, whilst hospitalisation was 14.9 days per patient year for CAPD and 12.8 for haemodialysis patients. Within the CAPD group a temporary change to haemodialysis (less than 2 months) occurred on 106 occasions (each of mean of 19 days duration), amounting to 10 days per patient year of therapy. CAPD was used twice as often as haemodialysis for managing new patients. After 2 years hospitalisation technique and patient survival were comparable in the two groups, with cerebro/cardiovascular disease, age, and smoking being significant predictors of outcome.
Adolescent↗
Prenatal effects of maternal-fetal HLA compatibility.
Both retrospective studies of idiopathic aborters, as well as prospective studies of normal couples, have shown reduced fertility among couples sharing HLA antigens. However, the effects of maternal-fetal histocompatibility on surviving embryos are largely univestigated. We thus prospectively studied 53 healthy, fertile women whose timed pregnancies were verified within 21 days of conception. Maternal-fetal histocompatibility status was determined for HLA-A,-B, and -DR locus antigens. Fetal growth rates were monitored by ultrasound at 8, 12, and 20 weeks gestation. Neonates were weighed, measured (birthlength, chest circumference, head circumference), and examined within 72 h of delivery (116 major and minor anomalies) in standardized fashion by one of two geneticists. Although no significant differences were found between infants compatible and incompatible at the HLA-A or HLA-B locus, significant differences were observed between HLA-DR compatible and incompatible infants for sex ratios (p less than .003) and minor anomaly rates (p less than .05). Although differences in mean birthweights between HLA-DR compatible and incompatible infants were not significant in this sample, HLA-DR compatible infants were on average 200 grams smaller than HLA-DR incompatible infants. We interpret these findings as evidence for selection against histocompatible fetuses throughout gestation, particularly with respect to HLA-DR compatibility. Potential immunologic and genetic mechanisms are discussed.
Adult↗
The management of the patient with peptic ulceration--an update.
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Aged↗
The influence of colonoscopy on the operative management of colorectal cancer.
Total colonoscopy was used in the evaluation of 85 patients with colorectal cancer, either preoperatively or within six months of surgery. Synchronous lesions (six carcinomas, 22 adenomatous polyps, one villous adenoma and nine cases of severe diverticular disease) were detected in 38 (44.7%) patients. The planned surgical procedure was altered in 10 patients (11.8%)--a more extensive resection being performed in each case. In particular, five of the six cases of synchronous cancers were located in different surgical segments. Colonoscopy is a necessary prerequisite in the evaluation of patients with colorectal cancer.
Aged↗