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Biomedical subjects

R S Kane

Publications and source records attributed to R S Kane.

18 recordsLinked to original sources
PubMed2001

Basicity of the amino groups of the aminoglycoside amikacin using capillary electrophoresis and coupled CE-MS-MS techniques.

This paper describes the use of capillary electrophoresis (CE), and coupled CE and mass spectrometric techniques, to measure the values of the pKa of the amino groups of the aminoglycoside antibiotic amikacin and of its acetylated derivatives. These values of pKa (8.4, 6.7, 9.7, 8.4) were determined by measuring the electrophoretic mobilities of the molecules as a function of pH; they are within 0.7 unit of certain values reported in the literature (by 13C and 15N NMR spectroscopies) but resolved ambiguities left by these earlier studies. The range of values of pKa of amino groups also indicates the complex dependence of the acidity of a functional group (and thus the extent of ionization at a specified value of pH) on the molecular environment of that group.

Acetylation↗
PubMed2001

Designing a polyvalent inhibitor of anthrax toxin.

Screening peptide libraries is a proven strategy for identifying inhibitors of protein-ligand interactions. Compounds identified in these screens often bind to their targets with low affinities. When the target protein is present at a high density on the surface of cells or other biological surfaces, it is sometimes possible to increase the biological activity of a weakly binding ligand by presenting multiple copies of it on the same molecule. We isolated a peptide from a phage display library that binds weakly to the heptameric cell-binding subunit of anthrax toxin and prevents the interaction between cell-binding and enzymatic moieties. A molecule consisting of multiple copies of this nonnatural peptide, covalently linked to a flexible backbone, prevented assembly of the toxin complex in vitro and blocked toxin action in an animal model. This result demonstrates that protein-protein interactions can be inhibited by a synthetic, polymeric, polyvalent inhibitor in vivo.

Acrylic Resins↗
PubMed2000

Patterned deposition of cells and proteins onto surfaces by using three-dimensional microfluidic systems.

Three-dimensional microfluidic systems were fabricated and used to pattern proteins and mammalian cells on a planar substrate. The three-dimensional topology of the microfluidic network in the stamp makes this technique a versatile one with which to pattern multiple types of proteins and cells in complex, discontinuous structures on a surface. The channel structure, formed by the stamp when it is in contact with the surface of the substrate, limits migration and growth of cells in the channels. With the channel structure in contact with the surface, the cells stop dividing once they form a confluent layer. Removal of the stamp permits the cells to spread and divide.

Animals↗
PubMed1999

Patterning proteins and cells using soft lithography.

This review describes the pattering of proteins and cells using a non-photolithographic microfabrication technology, which we call 'soft lithography' because it consists of a set of related techniques, each of which uses stamps or channels fabricated in an elastomeric ('soft') material for pattern transfer. The review covers three soft lithographic techniques: microcontact printing, patterning using microfluidic channels, and laminar flow patterning. These soft lithographic techniques are inexpensive, are procedurally simple, and can be used to pattern a variety of planar and non-planar substrates. Their successful application does not require stringent regulation of the laboratory environment, and they can be used to pattern surfaces with delicate ligands. They provide control over both the surface chemistry and the cellular environment. We discuss both the procedures for patterning based on these soft lithographic techniques, and their applications in biosensor technology, in tissue engineering, and for fundamental studies in cell biology.

Animals↗
PubMed1997

Cardiopulmonary resuscitation policies in long-term care facilities.

OBJECTIVES: To describe CPR policies and the procedures for discussing CPR policies of Wisconsin long-term care facilities. DESIGN: Mail survey and telephone interview. MEASUREMENTS: Information about CPR policy, how policy is disclosed to residents and by whom, emergency medical technician team (EMT) response time, and number of CPR attempts during 1993. RESULTS: The 1994 survey response rate was 85% (346/ 404 facilities). Four percent of responding facilities maintain a policy of never initiating CPR. Another 23% never initiate CPR but would call an EMT. Lack of efficacy was the usual basis for policies never initiating CPR. About 15% of facilities would initiate CPR only on residents who had previously indicated a preference. On individuals who had not made an advanced directive decision, 57% of facilities would initiate CPR in the event of an arrest. Almost 30% of facilities offering CPR would initiate CPR on unwitnessed arrests. Approximately 51% of all facilities assigned a social worker alone to discuss CPR policy and preference, whereas 12.5% assigned a physician alone or as part of a team. During 1993, an estimated 118 attempts at CPR were reported for 172 facilities with a total of 19,596 licensed beds, for a frequency of one CPR attempt per 166 beds per year. CONCLUSIONS: Poor efficacy in this population was the main reason given for policies of never initiating CPR. Specific factors relating to CPR efficacy, such as EMT response time and ease of maintaining trained staff, were not major influences. Almost 30% of facilities offering CPR would perform it in unwitnessed situations, despite unlikely success. Many decisions about CPR may not be fully informed as nurses and physicians are not often assigned to discuss advance directives with residents or surrogates. Utilization of CPR in nursing homes offering resuscitation is low.

Aged↗
PubMed1995

Minimal trauma fractures in older nursing home residents: the interaction of functional status, trauma, and site of fracture.

OBJECTIVE: This study was conducted to determine the incidence of long bone fractures in institutionalized older persons and to describe preceding traumatic events and the functional status of individuals sustaining fractures. DESIGN: A 1-year, prospective, cumulative incidence survey. SETTING: Eleven skilled nursing care facilities in the state of Wisconsin. PATIENTS: All residents of the 11 facilities. MEASUREMENTS: All incident reports of long bone fractures, description of events preceding the fractures, and functional status of the fracture cases. In addition, demographic and medical information was collected on fracture cases and the general nursing home population. MAIN RESULTS: Overall long bone fracture incidence was 3.52 per 100 subjects per year. Minimal trauma fracture incidence was 0.84 per 100 subjects per year. Fracture location was significantly related to type of trauma. Functional status was significantly related to fracture location and to the type of trauma preceding the fracture. Minimal trauma fractures occurred in individuals who were less mobile and more likely to be bed-bound, and the location was more likely to be the lower extremity below the hip. CONCLUSION: This is the first prospective survey of long bone and spontaneous fracture incidence rates in multiple nursing home facilities. Minimal trauma fractures are common in the nursing home, and most have no clear precipitating factors other than severely impaired mobility.

Accidental Falls↗
PubMed1993

Factors affecting physician participation in nursing home care.

Physicians generally consider nursing home practice a low priority compared with other aspects of their practices. In order to encourage more enthusiastic physician involvement, negative influences needed to be identified so that corrective ideas can be formulated. Negative factors include low reimbursement, frequent office interruptions, excessive paperwork, and a sense of loss of authority. The problem of quality physician involvement must be viewed from new perspectives. An increase in reimbursement is only part of the solution. Other measures that enhance the professional image and responsibility will increase physician participation more than laws and regulations, which increase physician time commitment without increasing reimbursement. Laws and regulations, through misperception, misinterpretation, and misapplication, can have unintended adverse results. Only creative solutions addressing identified negative factors will cut through the Gordian knot, which prevents enthusiastic and quality medical care for all NH residents.

Attitude of Health Personnel↗
PubMed1991

Spontaneous fractures of the long bones in nursing home patients.

Six long-term nursing home residents who experienced fractures of the long bones in the absence of obvious trauma are described. All patients had been essentially non-weight-bearing for at least 2 years before the episode. Four patients experienced fractures on more than one occasion. There was no evidence of physical abuse in any of these of patients; indeed, evidence against abuse was fairly good. Nonetheless, physical abuse was alleged by the patients' families in four of the cases. Long bone fracture in the absence of trauma in patients after prolonged bed rest has been well described in the radiologic and orthopedic literature, but not previously in geriatrics. It is important that this phenomenon be recognized, lest all unexplained fractures in nursing home patients automatically be taken as evidence of abuse or neglect.

Aged↗
PubMedDate not supplied

Unilateral decisions.

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Beneficence↗