New ways with old style.
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Education, Nursing, Continuing↗
Biomedical subjects
R Nelson
Publications and source records attributed to R Nelson.
Psoriatic arthritis and acquired immunodeficiency syndrome.
We describe 2 patients who developed psoriatic arthritis during the course of acquired immunodeficiency syndrome. Both patients developed skin and articular involvement characteristic of psoriatic arthritis; these manifestations were refractory to conventional therapy. Our findings suggest that psoriatic arthritis should be added to the expanding spectrum of musculoskeletal manifestations of the acquired immunodeficiency syndrome.
Acquired Immunodeficiency Syndrome↗
Sequence of a bovine herpesvirus type-1 glycoprotein gene that is homologous to the herpes simplex gene for the glycoprotein gB.
The 130-kDa bovine herpesvirus-1 (BHV-1) glycoprotein GVP 6 was found to cross-react immunologically with the herpes simplex glycoprotein gB. Antibodies in polyclonal serum against gB immunoprecipitated GVP 6 and its cleavage products from a lysate of BHV-1-infected cells. Conversely, polyclonal serum against GVP 6 precipitated gB from HSV-1-infected cell lysates. Sera against the other glycoproteins did not demonstrate cross-reactivity. A 3.6-kb Kpnl-Hpal fragment of BHV-1 DNA that hybridized to the gene for gB was cloned and the nucleotide sequence of both strands was determined. The longest codon reading frame in the fragment coded for a protein that showed extensive homology with gB1 and related sequences from pseudorabies virus, varicella-zoster virus, cytomegalovirus, and Epstein-Barr virus. The strongest homologies were observed in two segments of the ectodomain, the transmembrane domain, and sequences adjacent to the transmembrane domain.
Amino Acid Sequence↗
In vitro red tide toxin effects on human bronchial smooth muscle.
Airborne Ptychodiscus brevis toxin (PBTX), produced by Ptychodiscus brevis (Florida red tide), induces cough, rhinorrhea, watery eyes, and sneezing in normal individuals and wheezing in subjects with asthma. The mechanism of PBTX-induced contractile response has been investigated by the authors in vitro in dog and rat tissue. PBTX stimulates neuronal sodium channels, resulting in activation of autonomic cholinergic and adrenergic nerve endings in canine upper and lower airway smooth muscle and in rat vas deferens, respectively. This article concerns the investigation of the effect and mechanism of action of PBTX on human airways in order to determine the unique role of the toxin in the pathogenesis of asthma. PBTX elicited contractions of isolated human airway smooth muscle with a threshold concentration of 0.1 micrograms/ml, very similar to values obtained in canine lower airways. Pharmacologic analysis demonstrated that atropine (10(-6) mol/L) blocked the response to both PBTX and acetylcholine; tetrodotoxin (10(-7) mol/L) blocked PBTX but not acetylcholine; and verapamil (10(-5) mol/L) attenuated but neostigmine (10(-8) mol/L) potentiated the response to PBTX. Other selected blockers did not affect the PBTX response. These data indicate that PBTX produces contraction of human lower airway smooth muscle via stimulation of cholinergic nerve fiber sodium channels. The concept that PBTX triggers asthma through this mechanism is strengthened by these results.
Acetylcholine↗
The neuropsychology of paramedian thalamic infarction.
A longitudinal study of three patients with CT-scan documented paramedian thalamic infarctions (bilateral, primarily right, unilateral left) is reported and the neuropsychology of human paramedian thalamic infarction is reviewed. The neuropsychological deficits following these selected lesions, the nature of the clinical memory disorder, and the neuroanatomy of memory are discussed. The significance of cortical/subcortical relationship in explaining observed behavioral changes is emphasized. Brain damage with maximum involvement in the dorsomedial nuclei and mamillothalamic tracts appears to cause primarily a memory disorder and frontal-limbic behavioral changes, the severity and profile of deficits depending on lesion extent and location. Both anterograde and remote memory loss may be present. Asymmetry in memory at the level of the thalamus was observed, following the left-verbal, right-nonverbal dichotomy.
Aged↗
Branhamella catarrhalis sepsis: a case report and review of the literature.
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Adult↗
Measurement of small intestinal transit time in children.
The lactulose hydrogen breath-test provides a non-invasive measure of mouth to caecum transit-time. Its use, particularly in children has not been thoroughly investigated. We have studied the effects on transit time of altering the lactulose concentration of the test solution, and of administering it in a liquid nutrient preparation. Concentration markedly affected transit-time; studies with an isotonic solution may be least affected by delayed gastric emptying, and so may reflect small bowel transit-time. Day-to-day variation was large, and was not reduced by altering lactulose concentration, or by using the liquid nutrient based test solution. There was no correlation between age and transit-time.
Adolescent↗
Hosp gift shops: the boom is on.
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Budgets↗
The Abbott IMx automated benchtop immunochemistry analyzer system.
We describe a new clinical laboratory instrument, the IMx, used to automate immunoassay testing in the clinical laboratory. The IMx incorporates a novel technology called Microparticle capture Enzyme ImmunoAssay (MEIA) for assays of high-molecular-mass analytes, and fluorescence polarization immunoassay (FPIA) for hapten assays. A front-surface fluorometer is used to quantify the enzymatic generation of fluorescent product at a rate proportional to the concentration of the analyte in an MEIA, and a fluorescence polarization optical system is used to quantify results in an FPIA. The microprocessor-based instrument uses a robotic arm with two degrees of freedom and a rotating carousel to process the samples for assay. One assay can be done on each of 24 patients' specimens in 30 to 40 min with "walk-away" automation. Calibration curves are stable for at least two weeks. Instrument control involves software-labeled "command keys," a numeric keypad, and an interactive display. Results are output to a thermal printer or computer interface.
Autoanalysis↗
Long distance transport of cardiac patients in extremis: the mobile intensive care (MOBI) concept.
Critically ill cardiac patients may require transport to distant centers. Their clinical demands often exceed the capabilities of land or air ambulance services. To provide this service, a new, safe, and cost-effective concept for transport of the critically ill was developed. A mobile intensive care unit system (MOBI) was developed with support capabilities of an intra-aortic balloon pump, defibrillator, ventilator, pulse oximeter, multiple infusion pumps, and pressure and EKG monitoring. Eleven patients in cardiogenic shock, all with multidrip inotropic therapy, eight requiring intra-aortic balloon pump, three of whom were on the ventilator, were transported. Six patients were transported in aircraft, with the longest transport over 2,000 mi. Five patients were transported by ground ambulance. All patients survived the transport: no complications were attributed to the transport process. The system is cost effective since slight modification is required in regular ambulance or chartered aircraft to provide the highest level of care.
Aircraft↗
Enzymatic activation of Fujinami sarcoma virus gag-fps transforming proteins by autophosphorylation at tyrosine.
Site-directed mutagenesis of the Fujinami sarcoma virus (FSV) genome has suggested that Tyr 1073 of the P130gag--fps protein-tyrosine kinase is a regulatory site. To investigate directly the ability of tyrosine phosphorylation to affect P130gag--fps kinase activity, the phosphotyrosyl phosphatase inhibitor orthovanadate and partially purified phosphotyrosyl phosphatases were used to manipulate the stoichiometry of P130gag--fps phosphorylation. Phosphorylation of P130gag--fps at Tyr 1073 correlated with enhanced kinase activity. The thermolabile phosphorylation, kinase activity and transforming ability of P140gag--fps encoded by a temperature-sensitive (ts)FSV variant were restored at the non-permissive temperature for transformation by incubation of infected cells with orthovanadate. In this case tyrosine phosphorylation can apparently functionally reactivate a conditionally defective v-fps kinase activity. These data suggest that reversible autophosphorylation at a conserved tyrosine within the v-fps kinase domain is a positive regulator of enzymatic activity and biological function. Phenotypic suppression of the tsFSV genetic defect by orthovanadate emphasizes the potential importance of phosphotyrosyl phosphatases in antagonizing tyrosine kinase action. It is suggested that autophosphorylation may constitute a molecular switch by which some protein-tyrosine kinases are activated.
Animals↗
The effects of relaxation training with cognitive or nondirective therapy and the role of relaxation-induced anxiety in the treatment of generalized anxiety.
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Adolescent↗
Posterior cervical fusion with local anesthesia. The awake patient as the ultimate spinal cord monitor.
A technique is described for posterior cervical stabilization with wire and fusion using iliac crest bone graft, performed under local anesthesia. Thirty-four consecutive cases performed at Rancho Los Amigos Medical Center are reviewed. In patients with unstable cervical spines and variable degrees of neurologic injury, posterior stabilization and fusion using local anesthesia allows the patient to interact with the surgeon during crucial moments of spinal manipulation. The technique is well tolerated by patients, and no untoward complications have occurred with use of this technique.
Adolescent↗
Mechanism of attachment of swarm cells of Thiothrix nivea.
Swarm cells of Thiothrix nivea were found to possess a group of fimbriae at one pole. The other pole either was bare or possessed from one to three fimbriae. By using this polarity as a marker, it was found that the initial step in attachment of swarm cells involves the fimbriated pole and that this initial step is followed by the production of holdfast material.
Bacterial Adhesion↗
Duodenal ulceration: review of 110 cases.
This paper describes 110 cases of childhood duodenal ulcer, which were diagnosed over 26 years: 63 were diagnosed by barium meal examination; 47 by upper gastrointestinal endoscopy. The mean age at diagnosis was 11.2 years, with symptoms reported in 46% before 10 years and in 15% before 6 years of age. There was often a considerable delay in diagnosis, particularly in the younger age group. Nocturnal pain (61%) and a close family history of duodenal ulcer disease (62%) were the most valuable pointers to the diagnosis. Fifteen children had required surgery for persistent symptoms. Thirty four had received treatment with an H2 receptor antagonist, and all but four had had a satisfactory initial response. Seventy per cent relapsed within six months of discontinuing treatment, and long term maintenance treatment may therefore be necessary.
Adolescent↗
Resolution in EM autoradiography V: 45Ca (and 33P).
We devised a specimen to test EM autoradiographic resolution for calcium-45 (and phosphorous-33). A dry emulsion film was used for soluble compounds. We obtained a resolution (HD) value of 2300 +/- 500 A. This value is no larger than that previously obtained for Carbon -14, whose emission is about 1.6-fold lower. This result is as expected on theoretical grounds.
Autoradiography↗
Videofluoroscopic and scintigraphic analysis of dysphagia in the head and neck cancer patient.
This paper presents two advances in the evaluation of swallowing function which better define the swallowing processes in the head and neck cancer patient. Videofluoroscopy, improved by computer-assisted image analysis, provides more accurate information regarding oral and pharyngeal movement of structures. Radionuclide scintigraphy, a complementary technique, quantitates bolus flow (transit times) and the degree of aspiration. Several cases demonstrate the advantages of the methods and their usefulness in evaluating the effects of cancer treatment. The improved techniques also provide opportunity for designing new strategies of medical and surgical rehabilitation.
Adult↗