Transtracheal placement and imaging with a transesophageal echocardiographic probe.
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Biomedical subjects
Publications and source records attributed to R Weiss.
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Ten DNA fragments containing self-complementary alternating sequences of adenine and thymine differing in length and the starting nucleotide were studied by c.d. spectroscopy. It was found that d(TATATATA) but not d(ATATATAT), d(TATATA), d(CTATATAG) or (dT-dA)20 isomerized into the unusual X-DNA double helix at molar concentrations of CsF in solution. But in contrast to poly(dA-dT), the octamer (dT-dA)4, isomerized very slowly, at relatively low CsF concentrations and the isomerization was strongly dependent on the octamer concentration. A model is proposed to account for the observed properties of the B-to-X isomerization on the oligomer level.
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Although vaccination is widely practiced against infection by Erysipelothrix rhusiopathiae in pigs and turkeys, the protective antigen(s) involved have not been fully characterized or purified to homogeneity. Antigens of E. rhusiopathiae strain T28, serotype 2b, and of FRANKFURT XI, serotype N, in culture supernatant and in extracts made with hot acid, 10 mM NaOH, ultrasound or EDTA were compared by SDS-PAGE and immunoblotting and in a mouse protection test. EDTA and 10 mM NaOH yielded highly protective extracts; culture supernatant was less protective and ultrasonic or hot acid extracts stimulated little or no protection in mice. Protective antisera from swine, horses and mice recognized prominent bands of molecular mass (m.m.) of 66-64 and 40-39 kDa in EDTA and 10 mM NaOH extracts. Mice immunized with preparations of the 66-64 kDa band purified by preparative electrophoresis were protected. Both antigens were trypsin sensitive, contained no detectable polysaccharide, and showed a marked tendency to aggregate in the absence of SDS.
Foscarnet is an investigational antiviral agent that has been used effectively in the treatment of cytomegalovirus (CMV) retinitis in AIDS patients. However, it has not been readily available to AIDS patients with renal insufficiency because its major side effect is nephrotoxicity. In this report, the efficacy, safety, and dosing requirements of foscarnet in a hemodialysis-dependent patient with CMV retinitis are presented. Foscarnet was administered for 14 weeks, at an initial dosage of 60 mg/kg after each dialysis session. Plasma concentrations were monitored weekly, and the dosage was adjusted to maintain peak plasma levels in the range of 500-800 microM. Although some laboratory abnormalities occurred (a preexisting anemia continued, serum calcium and phosphorus decreased, and ionized calcium increased), they did not limit therapy. Foscarnet is a potentially useful alternative treatment for CMV retinitis in hemodialysis-dependent AIDS patients.
A pilot study was undertaken to assess the feasibility, toxicity, and efficacy of combined radiation therapy and chemotherapy in the adjuvant treatment of node-positive. Stage II patients with breast carcinoma who had undergone lumpectomy. Therapy consisted of three phases, starting with a six-week CMFVP (cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, prednisone) induction, followed by radiation therapy to the breast, and concluding with four cycles of VATH (vinblastine, Adriamycin, thiotepa, Halotesin). Twenty-seven patients were entered with an average age of 51.5 years (median 50 yrs) and a mean follow-up of 46.2 months. Twenty-three patients (85.2%) are alive and 19 (70.3%) disease free. There were no ipsilateral local recurrences. Cosmetic results were good to excellent in 26/27 patients. The doses of VATH were not compromised by the prior therapy. The regimen was found to be tolerable and is a reasonable approach in the adjuvant treatment of this particular patient population.
Transesophageal echocardiography permits measurement of the pulmonary artery diameter (two-dimensional echocardiography) and pulmonary artery blood flow velocity (pulsed-wave Doppler). These measurements considered with the heart rate allow for the determination of pulmonary artery blood flow, which is equivalent to cardiac output. This study compared the precision of transesophageal Doppler-derived cardiac output (DdCO) with the precision of thermodilution cardiac output (TdCO) and examined the agreement between DdCO and TdCO in 33 cardiac surgical patients. The proximal pulmonary artery diameter was measured in triplicate during systole and end expiration, and the local blood flow velocity was recorded on video tape. The instantaneous pulmonary artery blood flow velocity (centimeters per second) for three random cardiac beats was integrated with respect to time. DdCO was calculated as the product of the flow velocity integral (centimeters per beat), heart rate (beats per min), and the mean cross-sectional area (centimeters squared) of the main pulmonary artery. At the same time that the velocity recordings were made, three serial determinations of TdCO were made by an independent observer. Pulmonary blood flow could be measured in 25 of the 33 patients. The anatomical relationship among the esophagus, the left main stem bronchus, and the pulmonary artery did not allow adequate imaging of the pulmonary artery in 8 (24%) of the patients. A total of 45 sets of triplicate measurements were made. The range of cardiac outputs encountered was 1.7-6.6 l.min-1 by TdCO and 1.5-6.9 l.min-1 by DdCO. The 95% confidence limits for the difference between the two methods (agreement) was 0.030 +/- 0.987 l.min-1.(ABSTRACT TRUNCATED AT 250 WORDS)
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A study of customer satisfaction with clinical laboratory service is used as the basis for identifying potential improvements in service and more effectively targeting marketing activities to enhance customer satisfaction. Data on customer satisfaction are used to determine the aspects of service most critical to customers, how well the organization is doing in delivery of service, and how consistent service delivery is. Importance-performance analysis is used to highlight areas for future resource reallocation and strategic emphasis. Suggestions include the establishment of performance guidelines for customer contact personnel, the enhancement of timely delivery of reports via electronic transmission (computer and fax), and the development of standardized graphics for request and report forms to facilitate identification of appropriate request forms and guide clients to key items of information on reports.
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