Partial gastrectomy for peptic ulcer: a review of 181 cases among British military personnel. 1957.
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Biomedical subjects
Publications and source records attributed to R S Hunt.
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OBJECTIVE: Our purpose was to measure and compare plasma, urinary, and salivary concentrations of 8-epi-prostaglandin F(2alpha) (8-isoprostane) in women with normotensive pregnancies and the respective concentrations in pregnancies complicated by preeclampsia. STUDY DESIGN: Plasma, urinary, and salivary 8-isoprostane levels were measured in pregnant women with preeclampsia (n = 40), normotensive pregnant women (n = 20), and nonpregnant women (n = 10). One-way analysis of variance was used to determine significant differences. RESULTS: Plasma free 8-isoprostane concentrations were increased in women with severe preeclampsia (342 +/- 50 pg/mL), in comparison with nonpregnant women (129 +/- 17 pg/mL) and normotensive pregnant women (150 +/- 11 pg/mL; P =.003, and.0001, respectively). Urinary excretion of 8-isoprostane was slightly but not significantly decreased in preeclampsia (1200 +/- 227 pg/mL), in comparison with urinary excretion in nonpregnant women (1625 +/- 364 pg/mL) and normotensive pregnant women (2149 +/- 432 pg/mL). Salivary concentrations of 8-isoprostane were increased in normotensive women (496 +/- 113 pg/mL), in comparison with nonpregnant women (150 +/- 27 pg/mL) but were not related to preeclampsia (419 +/- 96 pg/mL; P </=.003). CONCLUSION: Free 8-isoprostane concentrations are increased in the plasma of women with severe preeclampsia. Further studies are warranted to determine whether such increases are caused by an increase in phospholipase A(2) activity, or by lipid peroxidation, or by a decrease in renal excretion.
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Many previous studies have shown that a proportion of patients with carcinoma of the prostate have increased activity of the creatine kinase (E.C. 2.7.3.2) isoenzyme designated BB in sera from their peripheral blood. We have analyzed tissues from prostatic hyperplasia of 22 patients and from prostatic carcinoma of 23 additional patients. Prostatic carcinomas contain less (p less than 0.001) creatine kinase activity (units/g) than do prostates with benign prostatic hyperplasia. The facts that (a) histochemical studies that we performed confirmed the observation reported previously by others that creatine kinase activity is found primarily in the epithelial elements of hyperplastic prostates and prostatic carcinomas, (b) the carcinomas that we examined had, on the average, a somewhat larger epithelial component than the hyperplastic prostates that we examined, and (c) prostate cancer was found to contain less creatine kinase activity than hyperplastic prostates suggest that the epithelial cells in prostate cancers contain less creatine kinase activity per cell than do those from hyperplastic prostates. The BB form of creatine kinase accounts for 98% of the activity in prostatic carcinoma and in prostates without cancer. Creatine kinase has been discussed as a possible marker for prostatic carcinoma, and we had hoped that it might be useful for the assay of tumor burden. Our data suggest that, if creatine kinase is to be useful in the monitoring of tumor burden, it will be useful only in the contexts of particular patients studied longitudinally since the creatine kinase activity varies enormously among different prostatic carcinomas.
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A simple five-step quality assessment model has been easily and economically implemented in emergency departments of varying size and activity. The model has encouraged quick action in correcting deficiencies, systematic problem solving, and the development of ED standards and criteria.
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The Canadians have been impressive in delivering universal healthcare access and high-quality care. Operating under global budgets set by provincial governments, Canadian hospitals have prudently managed available resources to meet community needs. A weakness of this single-payer system, however, is its inability to effectively coordinate and integrate services delivered by hospitals, physicians, and other providers. As the U.S. health system faces stringent cost containment with President Bill Clinton's proposal, significant savings are expected of U.S. hospitals. New alliances constrained by global budgets might require healthcare services managers to operate under a disparate set of assumptions and incentives. Before making such a transition, we can learn from the experiences of our Canadian colleagues. The challenges for both nations in the remaining years of this century will be drawn primarily from the effective macromanagement controls of the Canadian system and the lessons being learned from the U.S. managed care networks. This will occur as each nation strives to provide a more effective, less costly, integrated delivery of healthcare services.