Biomedical subjects
Publications and source records attributed to P Roux.
Propofol has been used in anesthesia for trigeminal nerve thermocoagulation. 9 patients were studied. This anesthetic agent allows speedy arousal of good enough quality for patient questioning. No cardiovascular or respiratory complications were noted.
OBJECTIVE: To determine extent of appropriate (medically necessary) and inappropriate bed use and level of care (LOC) needed by patients admitted to hospital. DESIGN: A cross-sectional, descriptive survey. SETTING: Medical wards of Red Cross War Memorial Children's Hospital (RCCH), a teaching hospital of the University of Cape Town. MEASUREMENT AND RESULTS: A 25% sample of beds was selected randomly each day for 12 consecutive days during September-October 1990. Data were collected using a questionnaire based on the Pediatric Appropriateness Evaluation Protocol and the Delay Tool. A subjective measure of LOC was developed. Questionnaires were completed for 171 admissions and 365 patient days; 98% of admissions and 79.5% of patient days were medically justified, and 49% of admissions needed tertiary care. The remaining 51% could have been treated by general paediatricians (17%) or medical officers (32%) in community hospitals. Of delays (unnecessary patient days) 62% were hospital-related, 20% were family-related and 18% were related to inadequate lower level institutional care and outpatient services. CONCLUSION: RCCH is functioning as a general, specialist and super-specialist hospital. Its future role as a tertiary referral centre will depend on adequate provision of community-based care. Further cost-benefit research is needed to address areas of inappropriate bed use identified in this study.
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A cDNA encoding a complete human c-fos protein was isolated and inserted into two different murine MoMuLV-derived recombinant retroviruses allowing expression of c-fos protein in different cell types. One c-fos-expressing retrovirus, chosen for its ability to express high levels of proteins in fibroblast-like cells, was shown to potentiate long-term cultures of mouse bone marrow stromal cells in vitro and therefore constitutes a potential tool for immortalizing such cells. Moreover, when tested in an in vitro differentiation assay, stromal cells constitutively expressing c-fos favor the granulocyte differentiation of hematopoietic precursors. Interestingly, retroviruses expressing v-src and v-abl oncogenes, included as controls in our experiments, do not produce any detectable effects, whereas those expressing polyoma virus middle T antigen facilitate long-term growth in vitro of stromal cells that favor the macrophage differentiation pathway of bone marrow stem cells. Our observation supports the idea that constitutive expression of some oncogenes, including c-fos and polyoma virus middle T antigen, may influence cytokine production by bone marrow stromal cells.
Narcotics are used in neuro-anesthesiology according to their pharmacology and their effects on cerebral physiology. New narcotics (fentanyl, sufentanil, alfentanil) fulfill the requirements of modern neurosurgical anesthesiology looking for quick awakening.
Propofol combined with Alfentanil was used for intracranial aneurysm surgery in 145 patients. These anaesthetic agents prevent blood pressure increase. They facilitate induced hypotension. The effect upon intracranial pressure is moderate. This technique is versatile. The speedy awakening make the postoperative neurological supervision easier.
There are now three methods to evaluate treatments of pneumocystosis: (1) the animal model, using adult rats under corticosteroids; the intensity of infection is assessed on pulmonary appositions and can then be evaluated after administration of a potential treatment compared with a reference; (2) the in vitro propagation of P. carinii observed from rat lung extracts cultured on cell lines; this method, however, is limited by the difficulties encountered in quantifying the parasitic types; (3) the inhibition by the drugs tested of enzymes involved in folate synthesis is a method that is still under evaluation. The animal model remains the reference method.
We report here that transport of the protein product of the c-fos proto-oncogene from the cytoplasm, where it is synthesized, into the nucleus, where it operates as part of the AP-1 transcription complex, is not spontaneous but depends on the continuous stimulation of cells by serum factors. A labile protein inhibitor of transport, the effect of which is reversed by cAMP, is responsible for retention of c-Fos protein within the cytoplasm of serum-starved fibroblasts. In contrast, v-Fos proteins transduced by the murine retroviruses FBJ and FBR, which remain nuclear in the absence of serum, evade the translocation control, which therefore appears to contribute to their tumorigenic potential.
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To facilitate cloning procedures in recombinant murine leukemia virus-derived retroviruses, we have constructed vectors that both carry a polylinker with multiple restriction sites and express resistance to either G418 or hygromycin B. Our vectors are self-inactivating retroviruses that suppress interferences between LTR enhancers and internal promoters and avoid transcriptional stimulation of host cell genes. They can also be used as expression vectors in direct transfection assays, since no translation initiation codon lies between the 5' LTR and the cloning polylinker.
We reviewed the records of 1,156 patients treated for acute staphylococcal osteitis or septic arthritis over a 12-year period; 38 had been critically ill with evidence of multiple-organ involvement and 30 (79%) had features of the toxic shock syndrome. The mortality rate of these 38 patients was 13% and the long-term orthopaedic complication rate was 39%. The diagnosis and management of patients with osteitis or septic arthritis, disseminated staphylococcal disease, and the toxic shock syndrome is discussed.
Pulmonary aspergillosis invading the thoracic wall is rare and of sombre prognosis. We report the case of a 49-year old man who developed a pulmonary aspergilloma some time after lung resection and radiotherapy for bronchial adenocarcinoma. Surgical excision of the aspergilloma was followed by sternal, then costal aspergillosis. Conventional surgery and antifungal therapy failed, and the lesion stubbornly followed a chronic course until itraconazole therapy was instituted, resulting in a complete cure which still persists nearly 4 years after withdrawal of any chemotherapy.
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Sequence determinants responsible for c-myc RNA rapid turn-over are localized within the 3' non-coding region which is mainly characterized by the presence of two polyadenylation signals and a high content in A and U. Although the AUUUA/UUAUUUA motif is commonly thought to specify a whole class of unstable RNAs coding for various onco-proteins and cytokines, site-directed mutagenesis showed that both of the two such sequences found in the mouse c-myc RNA are dispensable for rapid RNA degradation. Although less efficient than the whole 3' non-coding region, the last 50 nucleotides of c-myc RNA, mainly made up of U and A and devoid of AUUUA/UUAUUUA motif, are sufficient to confer instability to the coding sequence.
PURPOSE: To perform a retrospective and descriptive study of Toxoplasma gondii pneumonia in patients infected with the human immunodeficiency virus (HIV). Clinical presentation, diagnostic procedures, results of therapy, and hypotheses on pathophysiology are discussed. PATIENTS AND METHODS: The study consisted of 13 HIV-infected patients who had developed T. gondii pneumonia. Eight had acquired immunodeficiency syndrome (AIDS) prior to T. gondii pneumonia and three of them had non-Hodgkin's lymphoma. Mean CD4 cell count was 32 x 10(6)/L. Serum anti-toxoplasma antibody titers were measured by an indirect hemagglutination assay and/or by an indirect immunofluorescence assay. RESULTS: All patients had fever and bilateral pulmonary infiltrates; two of them presented with septic shock. Mean arterial oxygen tension was 47 +/- 12 mm Hg. The diagnosis was established by bronchoalveolar lavage in 10 of 11 cases, open lung biopsy in one case, and postmortem biopsy in two cases. Serologic evidence of past infection was observed in 11 of 12 cases, while one patient presented with acute disseminated disease and absence of serum anti-toxoplasma antibody response. Extrapulmonary involvement was present in seven patients: liver (four), brain (three), bone marrow (two), heart (two), stomach (one). Ten patients recovered from T. gondii pneumonia. CONCLUSION: T. gondii pneumonia must be considered in AIDS patients with severe diffuse bilateral pneumonia, especially when associated with a very low CD4 cell count or non-Hodgkin's lymphoma. In most of these cases, disseminated disease was associated with reactivation of prior latent infection.
Persistent depolarization with a high K+ concentration (30 mM) or sustained activation of N-methyl-D-aspartate (NMDA) receptors (12.5 mM K+ plus 100 microM NMDA) enhance both survival and maturation of mouse cerebellar granule neurons in vitro taking as criteria the amount of protein and DNA and the release of endogenous glutamate respectively. K+ and NMDA neurotrophic effects are associated with c-fos protein expression in the nucleus of these cells suggesting that c-fos protein could play a role in the survival and/or maturation of granule neurons.
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