Search PubMed⌕ Search

Biomedical subjects

T Johnson

Publications and source records attributed to T Johnson.

At least 181 records · Page 10Linked to original sources
PubMed1994

Transition to quality improvement: adapting the quality management plan.

Health care organizations across the country are in different phases of transition from quality assurance to quality improvement. A plan is essential to ensure quality assessment and improvement requirements are met while the organization is in transition. Based on the hospital's commitment to quality improvement, the Division of Nursing at The New York Hospital has built on the strengths of the QA program and begun transition to QI by incorporating the principles of QI and developing quality improvement teams with other disciplines and within nursing.

Joint Commission on Accreditation of Healthcare Or↗
PubMed1994

Optimizing performance through process improvement.

Health care professionals have found traditional problem solving and traditional management have not succeeded in "assuring quality." Organizations are changing the way they do business and are utilizing process improvement methodology to improve performance. Based on important functions, select dimensions of performance for processes are measured, evaluated, redesigned, and improved. Once priorities for improvement activities are determined, improvement projects can be implemented utilizing various process improvement models. The PRIDE (process, relevant, interpret, design, execute) model, designed by the authors, is one approach that can be applied in any setting.

Efficiency, Organizational↗
PubMed1994

Immediate X-ray-inducible responses from mammalian cells.

It has been nearly 6 years since we reported the induction of new proteins in human normal and tumor cells after ionizing radiation. Since that time there has been an explosion of new data and ideas from a number of laboratories regarding the immediate responses of human cells to ionizing radiation. The data are, however, extremely difficult to interpret since researchers are using confluence-arrested, log-phase, normal or tumor cells, and are exposing these to a variety of doses of ionizing radiation. It is especially difficult to interpret data from cells that are exposed to supralethal doses of ionizing radiation. Thus this session of the workshop entitled "Molecular, Genetic, and Cellular Basis of Radioresistance at Low Doses: A Case Of Inducible Repair?" concentrated on inducible responses (both late and immediate) of human cells exposed to physiological doses of ionizing radiation. A major focus of future research in this field must be directed toward the function(s) of these inducible proteins and the expression of genes in DNA repair, cell cycle progression (especially radiation-induced cell progression delays) and/or cell death, including apoptosis.

Cells, Cultured↗
PubMed1993

An NMR study on the DNA-binding SPKK motif and a model for its interaction with DNA.

The solution structure of one and two repeats of the 'SPKK' DNA-binding motif is reported on the basis of NMR measurements. In dimethylsulphoxide (DMSO) the major population (approximately 90%) of peptides, SPRKSPRK(S2) and GSPKKSPRK(S2b), adopts a conformation, which has two trans prolines. The two 'SP(R/K)K' units in these peptides are equivalent and each adopts a turn structure exchanging with an extended structure. This is suggested by an NOE connectivity of the beta-turn type, between the backbone amide protons of residues (i+2) and (i+3) and NOE connectivities of the Asx(sigma)-turn type, between protons of the ith Ser and the backbone amide proton on residue (i+2). This suggests that each SP(R/K)K unit has a structural intermediate between (or a combination of) a beta-turn and an Asx(sigma)-turn. In 90-10% DMSO/H2O at 4 degrees C the two units of S2 are connected more tightly by folding into a short 3(10) helix, broken at the second proline. For another peptide, Thr-Pro-Arg-Lys(T1), the major population (75%) in 100% DMSO comprises a beta-turn in rapid exchange with an extended structure. We did not observe an NOE connectivity of the Asx(sigma) type with the T1 peptide. A possible structure of the SPKK motif in the complex with DNA is discussed.

Amino Acid Sequence↗
PubMed1993

A sticking valve.

Explore the source record for details and available documents.

Anesthesia, Inhalation↗
PubMed1993

Characterization of somatostatin transactivating factor-1, a novel homeobox factor that stimulates somatostatin expression in pancreatic islet cells.

The endocrine pancreas consists of several differentiated cell types that are distinguished by their selective expression of peptide hormones such as insulin, glucagon, and somatostatin. Although a number of homeobox-type factors have been proposed as key regulators of individual peptide genes in the pancreas, their cellular distribution and relative abundance remain uncharacterized. Also, their overlapping DNA binding specificities have further obscured the regulatory functions these factors perform during development. In this report we characterize a novel homeobox-type somatostatin transactivating factor termed STF-1, which is uniformly expressed in cells of the endocrine pancreas and small intestine. The 283-amino acid STF-1 protein binds to tissue-specific elements within the somatostatin promoter and stimulates somatostatin gene expression both in vivo and in vitro. Remarkably, STF-1 comprises the predominant tissue-specific element-binding activity in nuclear extracts from somatostatin-producing pancreatic islet cells, suggesting that this protein may have a primary role in regulating peptide hormone expression and specifying endocrine cell lineage in the developing gut.

Amino Acid Sequence↗
PubMed1993

Hematological assessment of patients undergoing plasmapheresis during cardiac surgery.

Methods of reducing patient exposure to homologous blood transfusions include the technique of intraoperative plasmapheresis for the production of platelet rich plasma (PRP). The present study was designed to determine the patient benefits of PRP by examining hemostatic changes in coagulation screens and viscoelastic whole blood monitoring (Thrombelastography, [TEG]). One hundred fifteen patients undergoing elective cardiac surgery were prospectively randomized into a blinded study. Sixty-three patients had 20 percent of the circulating plasma volume sequestered prior to heparinization and pheresed into PRP, which was reinfused 10 minutes following heparin reversal with protamine. The control (CTR) group of 52 patients were exposed to no sequestration procedure. Patients were followed to discharge and 112 parameters, including anthropometric, operative, and postoperative factors, were measured. There were no significant differences between patient groups in preoperative, cardiopulmonary bypass (CPB), or surgical parameters. Average PRP volume was 600+/-100 ml with a total platelet yield of 1.1 billion platelets per patient. TEG indices were determined at four distinct times during the surgical procedure. The CTR group had significantly higher pre-CPB TEG indices of 2.3+/-1.2 and 2.1+/-1.2 (mean+/-SD), vs. 1.8+/-1.5 and 1.4+/-1.7 in the PRP group (p less than .04). Following heparin reversal, pre-PRP reinfusion TEG values were similar between groups, although both groups had significantly decreased indices when compared to pre-CPB values. Thirty minutes post-PRP infusion the treatment group had significantly improved TEG recovery when compared to the CTR group, 1.0+/-1.2 vs. 0.3+/-1.7 (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Interleukin-2-activated human effector lymphocytes mediate cytotoxicity by inducing apoptosis in human leukaemia and solid tumour target cells.

The mode of cytotoxic action employed by cytolytic lymphocytes remains unclear, with the possibility of several mechanisms being utilized dependent upon the activation state of the effector cell. In this work, the induction of apoptosis in target cells by 'killer' lymphocytes at differing states of activation has been studied. Although the cytotoxicity of natural killer (NK) cells and recombinant human interleukin-2 (rhIL-2) or interferon-alpha (IFN-alpha)-activated effector cells, against NK-sensitive target cells, was high, their cytotoxic action appeared to be mediated via differing pathways. Effector cells activated short term (4 hr) with rhIL-2 and those mediating rhIL-2 lymphokine-activated killer (LAK) activity after long-term (4 day) activation were found to induce the formation of sodium dodecyl sulphate (SDS)-insoluble apoptotic bodies in NK-sensitive target cells, as well as increasing the level of activity of the apoptosis related enzyme tissue transglutaminase, thus suggesting the induction of the apoptotic pathway as a means of effecting target cell death. Non-activated and short-term (4 hr) IFN-alpha-activated effector cells did not appear to utilize this pathway in the target cell as their means of cytotoxicity. Effector cells showing LAK activity were also cytotoxic towards NK-insensitive cells, and this cytotoxicity again appeared to be mediated via the apoptotic pathway.

Apoptosis↗
PubMed1992

Early intervention in psychiatric emergencies: a controlled clinical trial.

In the UK, psychiatric care of patients with acute and chronic disorders has increasingly moved from hospital to the community. We have evaluated in a controlled trial patients with severe mental illness, who were assigned to early intervention by community services or to standard hospital treatment. 100 patients aged 16 to 65 years presenting as psychiatric emergencies to an inner London teaching hospital were randomly allocated to a multidisciplinary community-based team (n = 48) or conventional hospital-based psychiatric services (n = 52) and assessed over a 3-month period. Ratings of psychopathology and social functioning were made before treatment and after 2, 4, and 12 weeks by independent assessors. 85 patients completed all assessments, and all patients had evaluable data beyond 2 weeks. 3 patients died during the study, 2 from natural causes and 1 from an accident. Patients referred to the community service showed greater improvement in symptoms and were more satisfied with services than those in the hospital-based service. Patients treated in the hospital-based service spent eight times as many days as psychiatric inpatients as those treated in the community-based service. Patients both prefer and seem to benefit from community-based psychiatric care, and our early-intervention community service might be a good model for such care.

Adolescent↗
PubMed1992

Immunoglobulin V gene expression in CD5 B-cell malignancies.

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphomas (SLL) generally are malignancies of CD5 B cells. Immunophenotypic and clinicopathologic data, however, are required to distinguish subtypes that apparently have a different cytogenesis than that of conventional CLL or SLL. In addition to expressing CD5, neoplastic cells of the latter are also distinctive in that they frequently coexpress surface immunoglobulin (Ig), bearing one or more cross-reactive idiotypes (CRIs) (e.g. 17.109, G6,) that commonly are found on monoclonal IgM autoantibodies. The frequent occurrence of such CRIs reflects both the biased rearrangement and subsequent selected expression of Ig V genes with little or no somatic mutation. IgM/L CLL, for example, frequently (8/33) harbor abortive Ig rearrangements involving Humkv325, the VK gene encoding the 17.109-CRI. Also, the VH1 gene(s) encoding the G6 CRI accounts for over 10% of all VH genes and over 60% of all the VH1 genes used in randomly selected common CLL/SLL. Furthermore, comparison with the Ig expressed by nonmalignant G6 CRI+ B cells reveals an apparent restriction in the CDR3 of IgH expressed by G6 CRI+ CLL. Coupled with the observed potential bias in antibody light chain and heavy chain pairing in B-CLL, these data suggest that the autoantibodies expressed in this disease are selected based on antigen-binding activity. Collectively, our studies indicate that nonstochastic Ig V gene rearrangement and subsequent selection may influence the Ig repertoire expressed in this common B-cell malignancy.

Animals↗
PubMed1992

Bringing parents into school clinics: parent attitudes toward school clinics and contraception.

Prior to implementing a change in school clinic policy to allow dispensing of contraceptives, parents of school-based clinic (SBC) enrollees were surveyed regarding attitudes toward clinic quality of care, desired services, and contraceptive distribution. Telephone interviews were conducted with a systematic sample of 262 parents who normally are in charge of the adolescent's health care. Parental opinion was felt to be crucial in shaping Baltimore SBC contraception policy. Parents overwhelmingly endorsed current clinic services including family planning for sexually active teens, annual physicals, and drug and alcohol counseling. Most parents rated the SBC as excellent (25%) or very good (36%), although a substantial minority found it difficult to rate the clinics (27%, "don't know"). Parents with prior verbal contact (45%) were more likely to rate the clinic as excellent (35% versus 16%) and less likely to respond "don't know" (13% versus 38%, p less than 0.001). Parent attitudes toward contraception was context specific: 63% endorsed and 27-30% opposed prescribing and dispensing. If a boy (or girl) was already having sex, 76% (or 75%) of parents supported and 14% (or 17%) opposed providing birth control pills or condoms. With parental permission, 93% supported contraception and only 3% were opposed. No differences were found by age, race, gender, or grade of student. Prior verbal communication with the clinic did not affect parent attitudes toward contraception. Consideration of parent attitudes was critical to changing SBC contraceptive dispensing policy in Baltimore. Contraceptive distribution, after counseling and necessary medical care, was initiated in September 1990. The parent and community response has been very supportive.

Adolescent↗