The response to warfarin is highly variable among individuals and such variability is likely to have some genetic basis. We evaluted the effect of VKORC1 polymorphisms on warfarin response among Japanese, taking advantage of its unique population structure in which CYP2C9 *2 and *3 alleles are relatively rare. Thirty-one patients (12-34 years old; median, 22) on warfarin were recruited from a pediatric cardiology clinic. Genotyping of the C>T polymorphism at position 1173 in intron 1 of VKORC1 revealed that 26 patients (84%) were T/T homozygotes at nucleotide 1173, whereas 5 (16%) were C/T heterozygotes. Complete linkage disequilibrium was observed between the 1173C > T polymorphism and another polymorphism, the 3730G > A, in the 3' untranslated region. The C/T heterozyogtes at the 1173C > T polymorphism tended to require more warfarin than the T/T homozygotes, when adjusted for international normalized ratio (p = 0.003). Both the 1173C > T polymorphism and the 3730G > A polymorphism are likely to be inert from a functional standpoint. Rather, based on the complete linkage disequilibrium between 1173C > T and 3730G > A polymorphisms, we suspect that the actual change that defines the relative resistance to warfarin may be present in the proximity of these two polymorphisms.

Adolescent↗

PubMedDate not supplied

Iron poisoning: report of three cases and a review of therapeutic intervention.

Although the acute ingestion of iron-containing preparations can produce very serious consequences, the majority of reported exposures are not associated with significant morbidity or mortality. We present 3 cases of acute iron ingestion and review the aspects of general management, with an emphasis on the appropriate choice of a gastrointestinal decontamination procedure.

Adolescent↗

PubMedDate not supplied

Radiological findings of retroperitoneal leiomyoma and leiomyosarcoma: report of two cases.

Radiologic findings in cases of retroperitoneal leiomyosarcoma and leiomyoma were reported. These cases showed very similar findings: irregularly marginated large masses with central cyst formation and no calcification on CT and ultrasonography. Angiography showed tumor vessels and tumor stains. Cystic region due to central necrosis or hemorrhage was the most prominent radiologic finding in these cases. However, it was difficult to distinguish leiomyosarcoma from leiomyoma on the basis of the radiologic findings alone.

Angiography↗

PubMedDate not supplied

Intracellular Na+ activates a K+ channel in mammalian cardiac cells.

In a wide variety of cells, various intracellular agents, such as Ca2+, ATP and cyclic nucleotides, regulate ionic conductances of the membrane. In cardiac cells, the intracellular Na+ concentration [( Na+]i) frequently increases when a disturbance occurs in the electrogenic Na-K pump activity or the Na-Ca exchange mechanism. We have investigated a possible role of [Na+]i in controlling ion channels by using a patch-clamp method, and have found a K+ channel that is gated by [Na+]i greater than 20 mM, but not by the intracellular Ca2+ concentration (approximately 10(-4) M). We report here that the channel has a unitary conductance of 207 +/- 19 pS (n = 16) with K+ concentrations of 150 mM outside and 49 mM inside, and shows no detectable voltage-dependent kinetics. The Na+-activated K+ channel represents a novel class of ionic channel.

Adenosine Triphosphate↗

PubMedDate not supplied

Adjunctive hyperbaric oxygen therapy reduces length of hospitalization in thermal burns.

The use of adjunctive hyperbaric oxygen therapy as part of a comprehensive program of burn care at our institution has resulted in a statistically significant reduction in length of hospital stay (p = less than 0.012) with no increase in cost of hospital care in patients suffering burns over 18% to 39% of total body surface area.

Adolescent↗

PubMedDate not supplied

Adjunctive hyperbaric oxygen in the treatment of thermal burns. An economic analysis.

Current reimbursement for burn care underscores the importance of cost containment in the treatment of burn injuries. We evaluate the economic impact of adjunctive hyperbaric oxygen in burns of 19% to 50% total body surface area in patients admitted to our burn center from January 1982 to July 1987. Length of hospitalization, number of surgical procedures, and total cost of care, exclusive of surgical fees, were examined. Eleven patients did not receive adjunctive hyperbaric oxygen therapy, whereas 10 did. The hyperbaric oxygen-treated group had an average decrease in length of stay of 14.8 days, a reduction of surgical procedures of 39%, and an average saving per case of $31,600.

Adolescent↗

PubMedDate not supplied

Calcium crystal deposition in cervical ligamentum flavum: CT and MR findings.

We report three patients with calcium pyrophosphate dihydrate crystal deposition disease within the ligamenta flava of the cervical spine who presented with progressive myelopathy. Plain radiography showed oval calcified nodules at the level of C4-C5 and C5-C6. On computed myelography, oval calcified nodules were seen in the ligamenta flava of the posterior cervical spinal canal compressing the dural sac. Magnetic resonance revealed oval corresponding hypointense foci both on T1-and T2-weighted images. In two cases, the cervical cord showed hyperintensity at the compression site on T2-weighted images.

Aged↗

PubMedDate not supplied

A new anti-B lectin.

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ABO Blood-Group System↗

PubMedDate not supplied

Using a computer color-matching system in color reproduction of porcelain restorations. Part 1: Application of CCM to the opaque layer.

The reproduction of natural tooth color using porcelain restorations is quite cumbersome, for it is difficult to select, communicate, reproduce, and evaluate color objectively. The present process of color reproduction lacks precision and is primarily dependent on the individual efforts and abilities of the dentist and ceramist. The computer color-matching system, aided by a spectrophotometer and computer, can be an excellent method for reproducing specific colors of various objects. This paper reports application of the system to reproduce various opaque colors used for metal ceramic restorations.

Color↗

PubMedDate not supplied

A cross-sectional study of vitamin C and cognitive function in older adults: the differential effects of gender.

Previous studies have suggested that vitamin C status may be associated with cognitive function in community-dwelling populations. However, this has not been consistent across all studies due to methodological differences. This cross-sectional study assessed the association between vitamin C and cognitive function in 544 community-dwelling older adults aged 65 or older who participated in both the Cardiovascular Health Study (CHS) and the CLUE II study in 1989. Three percent of the subjects had low plasma vitamin C concentrations (< 40 mg/dL) and 15% had low total vitamin C intake (< 60 mg/day). Most participants (96.7 percent) had normal cognitive function. In the unadjusted analyses, the highest fifth of plasma vitamin C concentration was associated with better Digit Symbol Substitution Test (DSST) scores and marginally associated with Mini-Mental State Examination (MMSE) compared to the lowest fifth. Total vitamin C intake, measured by Block's food frequency questionnaire, was generally associated with higher MMSE scores, though it was not significant. Adjusting for numerous factors did not substantially change results. In a stratified analysis by gender, higher plasma concentrations or intake were associated with higher MMSE scores for men but not for women. These mixed results do not provide strong evidence of an association between vitamin C concentrations or intake and cognitive function.

Aged↗

PubMedDate not supplied

Relative electrophysiological potencies of quinidine, 3-OH quinidine and quinidine-N-oxide in guinea-pig heart.

The relative potencies of the quinidine metabolites, 3-OH quinidine (3OHQ) and quinidine-N-oxide (QNO), to their parent drug, quinidine, were obtained electrophysiologically using guinea-pig hearts. The items examined were QT interval of local extracellular electrogram in a Langendorff's perfused heart, effective refractory period (ERP) and action potential duration at 90% repolarization (APD90) in the right papillary muscle. Quinidine (0.125-1 mg/l) and 3OHQ (0.5-4 mg/l) prolonged QT interval in a concentration-dependent manner and the relative potency of 3OHQ to quinidine was 0.25. The effect of QNO on QT interval within the range of concentration used (up to 8 mg/l) was small and the relative potency was 0.04 at the most. An apparent additive effect of 3OHQ to that of quinidine was revealed, but QNO of 4 mg/l has no effect on the concentration-effect relationship of quinidine for prolonging QT interval. These results were quite similar to those in humans reported previously. Quinidine (0.5-4 mg/l), 3OHQ (1-8 mg/l) and QNO (2-8 mg/l) prolonged APD90 in a concentration-dependent manner. These effects were accompanied by the prolongation of ERP in similar degrees. The relative potencies of 3OHQ to Q were 0.22 for APD90 and 0.27 for ERP and those of QNO were 0.087 for APD90 and 0.084 for ERP. Quinidine (10(-5) M) depressed the maximum upstroke of action potential (Vmax) in a frequency-dependent manner. 3OHQ of the same concentration also depressed it in the same manner to a much lesser extent and QNO had no effect. In conclusion, relative potencies of quinidine metabolites to quinidine for prolonging QT interval of local extracellular electrogram represent those to prolong APD90 and ERP, suggesting the relative potencies for antiarrhythmic activity in the same order. In the physiological range of concentrations of metabolites, 3OHQ may contribute to the antiarrhythmic effect of quinidine in an additive way, but QNO may have little effect when we take into account the fact that the free fraction of 3OHQ is 2.5 times that of quinidine.

Action Potentials↗

PubMedDate not supplied

Partial purification and some spectral properties of hepatic microsomal cytochrome P-450.

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Animals↗