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P Frankel

Publications and source records attributed to P Frankel.

27 records · Page 2Linked to original sources
PubMed1995

Selective activation of protein kinase C isoforms by v-Src.

Protein kinase C (PKC) is a gene family consisting of no less than 11 distinct isoforms. In both murine and rat fibroblasts, we detected expression of four PKC isoforms: the conventional PKC alpha, the novel PKCs delta and epsilon, and the atypical PKC zeta. With the conventional and novel PKC isoforms, membrane association has been used to show PKC activation. In cells transformed by v-Src, there was a Ca(2+)-dependent increase in membrane association of the alpha isoform relative to the nontransformed parental cells. The zeta isoform had a slightly increased membrane association in murine fibroblasts transformed by v-Src but not in rat fibroblasts transformed by v-Src. However, since it is not clear whether cellular distribution of zeta isoform correlates with activation, the data are inconclusive with regard to this isoform. Interestingly, of the Ca(2+)-independent PKC isoforms delta and epsilon, only the delta isoform was preferentially associated with membrane fractions in v-Src-transformed cells. The lack of PKC epsilon activation was not due to lack of responsiveness to diacylglycerol (DG), since exogenously supplied DG and phorbol ester were both able to induce membrane association of PKC epsilon. Thus, the differential activation of the delta and epsilon isoforms by v-Src suggests a more complex mechanism for the activation of the novel Ca(2+)-independent PKC isoforms, involving more than simply elevating DG levels. Since PKC has been implicated in the intracellular signals activated by v-Src that lead to transformation, the selective activation of PKC alpha and delta suggests a role in mitogenesis and transformation for these PKC isoforms.

3T3 Cells↗
PubMed1994

Information technology enters the doctor's office: Part II--Six lessons about intended ... and unintended ... results.

Part I of this article ("Six Design and Implementation Lessons," Physician Executive, Sept.-Oct. 1993, pp. 46-50) described an ambulatory utilization review (AUR) program designed and implemented by Metropolitan Life Insurance Company and reviewed some of the lessons learned over the past five years. Those lessons pertained to the tasks of inventing a new information technology to measure and evaluate ambulatory care and some of the practical implementation issues associated with review of 30,000 small dollar value claims per day in 19 claim offices nationwide. This article turns to the basic purpose of AUR--to review the medical necessity and appropriateness of ambulatory utilization. One lesson learned about AUR in this context is that AUR works: savings from the program outweigh costs by almost 5:1. The more important lessons, however, stem from understanding how the savings are achieved, and what some of the other unintended benefits of the program are.

Ambulatory Care↗
PubMed1981

[Anterior strut grafting in kyphosis and kyphoscoliosis (author's transl)].

The authors have reviewed 58 cases submitted to strut grafting in the concavity of the curve. There were 44 kyphoscolioses and 12 kyphoses. The average follow-up was more than two years and the average pre-operative deformity was 127 degrees. The average improvement was 38 degrees and the secondary loss was only 3 degrees. The results are analysed with regard to the surgical technique used. In some cases, posterior fixation was added and the graft was either from the tibia, the fibula or a rib. In 16 cases a secondary fracture of the graft was found. It appeared between the fourth and tenth post-operative months. During this period, reduction of the graft was seen. The graft was found to thicken later at about the eighteenth post-operative month. It is concluded that the technique is worthwhile provided it is associated with posterior internal fixation, and that an external brace is worn for at least eighteen months after operation.

Adolescent↗
PubMedDate not supplied

Information technology enters the doctor's office: Part I--Six design and implementation lessons.

Because of a trend toward increased cost escalation outside of the hospital, in the ambulatory care setting, Metropolitan Life Insurance Company initiated an Ambulatory Utilization Review ("AUR") program in 1986. This is an overview of the lessons learned since that time. Some of what was learned was simply--or not so simply--"how to," the subject of this first article in a two-part series. Once this deceptively difficult technology was understood, there were two additional categories of lessons to learn: the extent of expected program results and some unexpected results. This second set of lessons is reviewed in Part II of the article.

Ambulatory Care↗
PubMedDate not supplied

Trauma care documentation: a comprehensive guide.

The medical record serves numerous functions. It provides chronologic evidence of patient evaluation, treatment, and response to therapy, and a means to review the quality of the care. Communication among members of the health care team regarding the patient's status and plan of care also occurs by means of the medical record. The medical and legal importance of a comprehensive, accurate trauma resuscitation record cannot be overemphasized. The success of this type of documentation will depend on the design of the record and the understanding of the personnel involved. In addition, nursing managers responsible for the fiscal accountability of their departments understand the value of accurate documentation. The trauma resuscitation record can be used to demonstrate to insurance companies the reason for charging trauma patients additional fees. Inadequate documentation can cause charges to be disallowed by the third-party payors. Perhaps one of the most important functions of the medical record is to assist in protecting the legal interest of the patient and the health care provider. Minimum documentation for care provided in the emergency department must include patient identification, how the patient arrived, care that was rendered before arrival, pertinent history, chronologic notation of results of physical examination including vital signs, and the results of diagnostic and therapeutic procedures and tests. The physician's orders and diagnostic impression should be recorded. It is important that the patient's response to the interventions, not just the intervention itself, be described. The patient's disposition and condition on discharge from the emergency department must be documented. For the trauma patient, mechanisms of injury, GCS, trauma score (or essential components), spinal immobilization, and the status of airway, breathing, and circulatory systems also must be recorded. The importance of accurate and comprehensive documentation on every medical record should not be underestimated. (National Standards of Emergency Nursing Practice dictate that nurses are responsible for the accurate documentation of patient care.) The medical record provides both important information about the patient's clinical condition and the corner-stone for lawsuits in alleged medical negligence. It is the legal documentation of ongoing patient care delivery and the chronicle of the patient's responses to therapeutic interventions.

Documentation↗