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Biomedical subjects

R Kramer

Publications and source records attributed to R Kramer.

At least 55 records · Page 3Linked to original sources

A Delphi study of pediatric oncology nurses' facilitative behaviors.

Using a classic Delphi methodology, this study identified the nursing behaviors and interventions that oncology nurses rated as most important in facilitating the patient's, parents', and siblings' coping efforts with the effects of disease and treatment. Random selection of 300 pediatric oncology nurses resulted in a final sample of 69 nurses who completed all 3 rounds of the Delphi. The majority of the nurses were younger than 35 years of age, had less than 10 years of experience, were educated with at least a bachelor's degree, and practiced in an all-oncology setting. Twenty-eight facilitative behaviors were identified for the child with cancer, 25 for the parents, and 25 for the siblings. Results of this study support previous research on patient, parent, and sibling coping.

Adaptation, Psychological↗

The effect of pulmonary impairment on all-cause mortality in a national cohort.

The association between pulmonary impairment and all-cause mortality was investigated among white subjects in a follow-up study of a large national cohort. Pulmonary function was measured during the National Health and Nutrition Examination Survey (NHANESI) (1971 to 1975); subsequent mortality information was obtained from the 1987 NHANES I Epidemiologic Follow-up Study (1982 to 1987). Of 4,764 white sample persons, ages 25 to 74 years examined during NHANES I, 658 (13.8 percent) were identified as having pulmonary impairment defined as a FEV1/FVC < or = 69 percent. A total of 743 (15.6 percent) sample persons died during the follow-up period. The association between pulmonary impairment and all-cause mortality was examined for male and female subjects separately using the Cox proportional hazards model controlling for age, smoking, educational level, body mass index, and respiratory diseases. The analysis suggests that reduced FEV1 percent predicted was a significant risk factor for mortality among both sexes, and the FEV1/FVC ratio was significantly associated with all-cause mortality among male subjects only.

Adult↗

Evaluation of the antihypertensive effect of lisinopril compared with nifedipine in patients with mild to severe essential hypertension.

For several reasons, increasing numbers of patients with hypertension are treated with angiotensin-converting enzyme inhibitors and calcium channel blockers. In a twenty-four week, double-blind, randomized, parallel study, the antihypertensive effect of lisinopril (20 to 80 mg qd) and nifedipine (20 to 80 mg bid) were compared in 21 patients. Fourteen patients received lisinopril (mean dose 35 mg), and 7 patients received nifedipine (mean dose 54 mg). By the end of week 12, 8 patients had responded (supine diastolic pressure less than or equal to 90 mg) to lisinopril and 5 to nifedipine. At the end of the study supine systolic/diastolic blood pressure was reduced from 172/104 to 149/92 mmHg with lisinopril and from 171/102 to 158/94 mmHg with nifedipine. No significant difference between the two treatments was detected. Three patients were reported to have at least one clinical adverse experience during the active treatment period, 1 in the lisinopril group and 2 in the nifedipine group. No serious clinical adverse experiences were recorded. In conclusion, lisinopril and nifedipine are both effective in reducing blood pressure in patients with mild to severe hypertension. Lisinopril qd and nifedipine slow release bid produce similar decreases in blood pressure after twelve weeks of therapy and the safety profiles of the two drugs are similar.

Antihypertensive Agents↗

Victimizers and their victims: children's conceptions of the mixed emotional consequences of moral transgressions.

4-8-year-old children's conceptions of the emotional consequences of moral transgressions were assessed in 2 experiments. In Experiment 1, most children expected victimizers to feel positive emotions and victims to feel negative emotions, but 8-year-olds who assessed victims first subsequently attributed less positive emotions to victimizers. Despite efforts to manipulate the salience of victims' losses in Experiment 2, children had similar expectations about the emotional consequences of transgressions. However, a developmental shift emerged: 4-year-olds attributed extremely positive emotions to victimizers due to the material gains produced by victimization, whereas 8-year-olds attributed less positive emotions to victimizers, in part due to the unfairness and harm produced by victimization. Probe questions revealed that older children also attributed additional negative-valence emotions to victimizers, suggesting that victimizers are expected to feel conflicting rather than exclusively positive emotions. Discussion focused on potential cognitive constraints in children's conceptions of moral emotions.

Awareness↗

Metabolic denitrosation of N-nitrosamines: mechanism and biological consequences.

NADPH-dependent microsomal metabolism of N-nitrosamines results in both oxidative dealkylation and denitrosation of the molecule. For denitrosation, two enzymatic mechanisms have been proposed: (i) cytochrome P450 (P450)-dependent one-electron reduction of the nitrosamine molecule, resulting in the formation of nitric oxide (NO) and secondary and primary amine, and (ii) liberation of NO via an oxidative mechanism mediated by a P450-dependent one-electron abstraction. In order to clarify the mechanism of denitrosation, the metabolism and kinetics of N-nitrosodibenzylamine (NDBzA) and its corresponding secondary amine dibenzylamine were studied. The main metabolites of NDBzA are benzaldehyde, the primary amine benzylamine and nitrite. An important finding is that benzaldehyde is generated more rapidly from dibenzylamine than from the parent NDBzA. During reductive denitrosation of NDBzA, the oxygen atom in benzaldehyde is derived from air, while benzaldehyde generated via the oxidative mechanism of denitrosation receives its oxygen atom from water due to hydrolysis of the intermediary benzylidenebenzylamine. Microsomal incubation of NDBzA in buffer containing 18O-H2O resulted in no incorporation of 18O from water into benzaldehyde, which could be related to the formation of the corresponding benzaldehyde, which could be related to the formation of the corresponding benzylidenebenzylamine. It is concluded that NDBzA is denitrosated by the proposed reductive mechanism. Current belief is that denitrosation leads to detoxification of the NA molecule; however, toxic effects cannot be excluded if the conversion of NO into NO2- and NO3- involves intermediary formation of the NO2 radical.(ABSTRACT TRUNCATED AT 250 WORDS)

Biotransformation↗

Activation of epileptic foci by transcranial magnetic stimulation: effects on secretion of prolactin and luteinizing hormone.

Transient elevation of serum levels of prolactin has been observed following several types of epileptic seizures and after electrical stimulation of limbic temporal lobe structures via implanted electrodes. Transcranial magnetic stimulation has been found to selectively induce epileptiform afterdischarges in the epileptic focus of candidates for epilepsy surgery who suffered from temporal lobe epilepsy. Lateralized serial transcranial magnetic stimulation was therefore used and serum levels of prolactin or luteinizing hormone were measured to find if it could be used as a non-invasive diagnostic tool. The investigation was performed on six patients and five healthy volunteers. In the patients the induction of epileptiform potentials was continuously monitored via subdural electrodes. A transient surge of prolactin and luteinizing hormone was found in only one patient, in whom a complex partial seizure was induced. Thus, transcranial magnetic stimulation appeared not to be helpful for the lateralization of the (primary) epileptic focus during presurgical evaluation.

Adult↗

Purification and characterization of recombinant Rev protein of human immunodeficiency virus type 1.

Recombinant Rev protein of human immunodeficiency virus type 1 has been expressed in Escherichia coli and purified by ion-exchange and gel-filtration chromatography. Specific binding of the purified protein to the Rev-responsive element of the viral RNA is demonstrated. Physical characterization of the purified protein by circular dichroism and intrinsic fluorescence spectroscopy indicate that the protein preparation is suitable for structural analysis. Circular dichroism measurements show that the protein is approximately 40-45% alpha-helix. Tryptophan fluorescence measurements suggest that the single tryptophan residue is located near the surface of the protein. Gel-filtration chromatography of the protein indicates that it has an apparent molecular mass of 33,000 daltons. This suggests that the protein in solution forms a stable tetramer consisting of monomers having molecular mass of 13,000 daltons.

Chromatography, Gel↗

Purification of biologically active human immunodeficiency virus rev protein from Escherichia coli.

A genetic approach was used to facilitate purification of human immunodeficiency virus (HIV) rev protein. A recombinant protein containing a stretch of six histidine residues at the amino terminus was engineered and overexpressed in Escherichia coli. Purification of greater than 95% was achieved in a single step using an immobilized metal ion chromatography with a resin that has selectivity for proteins with neighboring histidine residues. We show that the modified protein is both properly modified and biologically active.

Amino Acid Sequence↗

The human immunodeficiency virus rev protein is a nuclear phosphoprotein.

The human Immunodeficiency virus rev protein is one of several key regulatory proteins involved in the control of viral structural protein synthesis and replication. In this report, we identify the 20-kDa rev protein as a nuclear phosphoprotein. Post-translational modification was observed solely on serine residues. In vitro kinase reactions utilizing a derivative of Rev purified from Escherichia coli identified a nuclear kinase capable of phosphorylating exogenously added rev protein. Our results suggest that the nuclear kinase activity observed in vitro is likely to be responsible for the in vivo post-translational modification of Rev.

Animals↗

Who benefits most from respite care?

This study examines the effect of five measures of utilization of respite care services (desire to use respite care services, actual use, accessibility, scheduling and helpfulness) upon mothers' coping resources. Using the analysis of variance between utilization measures and coping resources with the following intervening variables as covariates--mothers' self-esteem, family cohesion and adaptation, and clients' and mothers' characteristics--it was found that respite care acts as a differential service that can enhance coping resources (i.e., stress reduction skills) and is of most benefit to high self-esteem mothers of young developmentally disabled children. A home-based model was found to be the most beneficial to mothers in terms of enhanced coping resources. Findings are interpreted with respect to their implications for research, program model, planning and intervention.

Adaptation, Psychological↗

Supplementary motor seizures: clinical and electroencephalographic findings.

The clinical and EEG features of 11 patients with seizures arising in the supplementary motor area (SMA) were reviewed. All patients underwent prolonged EEG with simultaneous video recording. Three patients had recordings and electrical stimulation of the SMA using subdural electrode arrays. All patients had preservation of consciousness during the seizure unless it became secondarily generalized. Tonic posturing of the extremities was present in all patients, and in seven it was present bilaterally. Adversive movements were not seen unless the seizure became secondarily generalized. Interictal and/or ictal abnormalities were present at or adjacent to the midline in ten patients. Seizures arising from the supplementary motor region are clinically distinct, and the diagnosis can almost always be verified with prolonged EEG/video recording.

Adolescent↗

Regulation of differentiation and polarized secretion in mammary epithelial cells maintained in culture: extracellular matrix and membrane polarity influences.

Several previous studies have demonstrated that mammary epithelial cells from pregnant mice retain their differentiated characteristics and their secretory potential in culture only when maintained on stromal collagen gels floated in the culture medium. The cellular basis for these culture requirements was investigated by the monitoring of milk protein synthesis and polarized secretion from the mouse mammary epithelial cell line, COMMA-1-D. Experiments were directed towards gaining an understanding of the possible roles of cell-extracellular matrix interactions and the requirements for meeting polarity needs of the epithelium. When cells are cultured on floating collagen gels they assemble a basal lamina-like structure composed of laminin, collagen (IV), and heparan sulfate proteoglycan at the interface of the cells with the stromal collagen. To assess the role of these components, an exogenous basement membrane containing these molecules was generated using the mouse endodermal cell line, PFHR-9. This matrix was isolated as a thin sheet attached to the culture dish, and mammary cells were then plated onto it. It was found that cultures on attached PFHR-9 matrices expressed slightly higher levels of beta-casein than did cells on plastic tissue culture dishes, and also accumulated a large number of fat droplets. However, the level of beta-casein was approximately fourfold lower than that in cultures on floating collagen gels. Moreover, the beta-casein made in cells on attached matrices was not secreted but was instead rapidly degraded intracellularly. If, however, the PFHR-9 matrices with attached cells were floated in the culture medium, beta-casein expression became equivalent to that in cells cultured on floating stromal collagen gels, and the casein was also secreted into the medium. The possibility that floatation of the cultures was necessary to allow access to the basolateral surface of cells was tested by culturing cells on nitrocellulose filters in Millicell (Millipore Corp., Bedford, MA) chambers. These chambers permit the monolayers to interact with the medium and its complement of hormones and growth factors through the basal cell surface. Significantly, under these conditions alpha 1-, alpha 2-, and beta-casein synthesis was equivalent to that in cells on floating gels and matrices, and, additionally, the caseins were actively secreted. Similar results were obtained independently of whether or not the filters were coated with matrices.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Comparative trial of lisinopril and nifedipine in mild to severe essential hypertension.

A total of 136 patients with mild to severe uncomplicated essential hypertension were evaluated in a multicenter, randomized, double-blind, double-placebo, parallel study to compare the effect of lisinopril, a new angiotensin-converting enzyme inhibitor, with that of nifedipine. Following a 2-week placebo control period the patients were treated with either 20-80 mg/day of lisinopril (n = 89) or with 40-80 mg/day of nifedipine (n = 47). Blood pressure was significantly reduced in both groups after 4, 8, and 12 weeks of treatment. There was no difference in the effect of lisinopril compared to nifedipine. No serious clinical or laboratory adverse experiences were observed during the study. The incidence of clinical side effects was significantly lower in the lisinopril group than in the nifedipine group (21.3 vs. 48.9%, p less than or equal to 0.01). There were no significant changes in laboratory data in either group. The results indicate that lisinopril is as effective as nifedipine in the treatment of uncomplicated essential hypertension and that lisinopril is well tolerated and has an acceptable safety profile.

Angiotensin-Converting Enzyme Inhibitors↗

Some aspects of cytochrome P450-dependent denitrosation of N-nitrosamines.

The present paper deals with three aspects of cytochrome P450-dependent denitrosation of N-nitrosamines. (1) Nitrate was found in addition to nitrite as a metabolic product of the denitrosation reaction when N-nitrosamines were incubated with a microsomal system. This could also be shown when nitric oxide was added to the microsomes. (2) In order to determine the amount of denitrosation in vivo, the nitroso group of N-nitroso-N-methylaniline was labelled with the 15N isotope and administered to rats; then, the concentrations of 15N-nitrate and 15-N-nitrite in the urine were quantified by measuring the reaction of nitrate and benzene to nitrobenzene. It is estimated from these data that about 33% of the applied dose of 15N-nitroso-N-methylaniline is denitrosated in vivo. (3) Although N-nitrosodiphenylamine (NDPhA) has been classified as a noncarcinogen, recent long-term and short-term studies have cast some doubt. In order to evaluate the mechanism by which NDPhA exerts its possible genetoxic effects, its metabolism was studied in vitro, and NDPhA and its metabolites were tested for induction of DNA single-strand breaks in rat hepatocytes and in Chinese hamster V79 cells. One metabolite was identified as diphenylamine; others were suspected to be the 4-hydroxylated derivative and its corresponding quinoneimine. NDPhA caused DNA damage in rat hepatocytes but not in V79 cells. Diphenylamine also gave negative results in V79 cells, but its putative metabolite, diphenylhydroxylamine, induced a significant increase in DNA single-strand breaks.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗