We investigated the diagnostic value of electromyographic (EMG) examination of the anterior abdominal wall muscles (AWMS) in thoracic radiculopathy and compared it with examination of thoracic paraspinal muscles (TPSM). Technically, examination of AWMS was much easier compared to TPSM. In eight patients with thoracic diabetic radiculopathy at the level of T7-T12, AWMS was abnormal in all and was considered to be diagnostic, whereas AWMS was normal in diabetic lumbar radiculopathy, patients with diabetes mellitus without radiculopathy, patients with unspecified gastrointestinal pain, and patients with musculoskeletal-type back pain. We conclude that EMG evaluation for possible thoracic radiculopathy should include examination of AWMS, and if abnormal, would be of great diagnostic help in patients with unspecified gastrointestinal symptoms.

Abdominal Muscles↗

PubMedDate not supplied

A protein kinase involved in the regulation of inflammatory cytokine biosynthesis.

Production of interleukin-1 and tumour necrosis factor from stimulated human monocytes is inhibited by a new series of pyridinyl-imidazole compounds. Using radiolabelled and radio-photoaffinity-labelled chemical probes, the target of these compounds was identified as a pair of closely related mitogen-activated protein kinase homologues, termed CSBPs. Binding of the pyridinyl-imidazole compounds inhibited CSBP kinase activity and could be directly correlated with their ability to inhibit cytokine production, suggesting that the CSBPs are critical for cytokine production.

Amino Acid Sequence↗

PubMedDate not supplied

Psychoendocrine aspects of cancer of the breast.

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Adult↗

PubMedDate not supplied

A randomized study of the effects of a home diabetes education program.

Home health nurses provided individualized instruction in diabetes self-care within the home environment of 393 diabetic individuals. Each subject was randomly assigned to either the intervention (those receiving home teaching) or control (those not receiving home teaching) group. At 6 mo postenrollment, intervention subjects showed significantly greater self-care knowledge and skills than control subjects, although the actual differences between the two groups in terms of self-care skills were probably too small to have any practical meaning. The primary objective of the study, which was the reduction of the number of preventable diabetes-related hospitalizations (ketoacidosis, ketotic coma, nonketotic coma, insulin reaction, and diabetes out of control), was not achieved; no differences between the groups were noted after 12 mo of follow-up. Similarly, length of hospital stay, foot problems, emergency room and physician visits, and sick days were roughly equivalent in both groups during the follow-up year. These results suggest that, in the absence of concurrent changes in the health-care delivery system and strategies for influencing attitudes toward self-care, education alone is ineffective.

Diabetes Complications↗

PubMedDate not supplied

Determination of insulin requirements: excessive insulin dosages common in type 1 diabetes mellitus.

OBJECTIVE: To report our experience of determining insulin requirements for initiating continuous subcutaneous insulin infusion (CSII) pump therapy, using an algorithm for intravenous administration of insulin, in patients with poorly controlled diabetes. METHODS: We describe assessment of insulin requirements and analyze data from 27 consecutive admissions. All patients had type 1 diabetes mellitus and were being converted to CSII pump therapy. Twenty-four-hour intravenous insulin requirements were used to initiate CSII pump therapy, and further dose adjustments were undertaken, to optimize glycemic control. Basal, bolus, and total daily insulin requirements were calculated before, during, and 3 months after conversion to CSII therapy. RESULTS: At entry, the mean glycohemoglobin was 11.2% (normal, 5.0 to 8.0%), and the mean daily insulin dose were 45.8 U (0.59 U/kg). Calculated daily insulin requirements using an algorithm for intravenously administered insulin were 37.3 U (0.50 U/kg). At 3 months, mean daily insulin requirements had increased to 39.2 U (0.52 U/kg), and glycohemoglobin improved to 9.4%. Most patients (78%) remained on insulin doses within 10% of the calculated requirements. All patients who were receiving more than 0.6 U/kg daily before assessment required a reduction in insulin dosage to improve glycemic control. CONCLUSION: Many patients with type 1 diabetes are receiving excessive insulin doses. An algorithm for intravenous administration of insulin may be useful for determining requirements and appropriate insulin doses for CSII pump therapy, especially in patients with poor glycemic control.

Journal Article↗

PubMedDate not supplied

A new method for treatment of unresectable, recurrent brain tumors with single permanent high-activity 125iodine brachytherapy.

We describe a new method for treating unresectable recurrent brain tumors in previously-irradiated patients with localized high-dose intracranial brachytherapy of 10,000-30,000 rads using permanent implantation of a single high-activity 125Iodine seed. For unresectable recurrent previously-irradiated pituitary tumors, a single high-activity 125Iodine seed is permanently implanted into the center of the tumor with an interstitial needle inserted under fluoroscopic guidance via a transsphenoidal approach. For unresectable recurrent meningiomas, a single high-activity seed is permanently implanted into the tumor at craniotomy. The clinical course of five patients treated by this method is described. Excellent long-term local control was obtained in all implanted cases. There were no intraoperative, postoperative, or chronic complications.

Adenoma↗

PubMedDate not supplied

A defect of steroid hormone metabolism in acute intermittent porphyria.

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5-Aminolevulinate Synthetase↗