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At least 343 records · Page 19Linked to original sources
PubMed2000

Novacor left ventricular assist system versus Heartmate vented electric left ventricular assist system as a long-term mechanical circulatory support device in bridging patients: a prospective study.

OBJECTIVE: Long-term mechanical circulatory support as a bridge-to-transplantation procedure and bridge to recovery is of increasing importance. The implantable left ventricular assist devices, Novacor N100 left ventricular assist system (Baxter Healthcare Corporation, Berkeley, Calif) and TCI HeartMate vented electric left ventricular assist system (Thermo Cardiosystems Inc, Woburn, Mass), have proved to be efficient devices in bridge-to-transplantation settings and for prolonged support. The two systems were compared with regard to reliability and morbidity. METHODS: Between October 1996 and March 1998, a prospective, single-center study was done that included 40 patients, 20 of whom were treated with the Novacor system and 20 of whom were treated with the HeartMate device. The diseases were mainly dilated cardiomyopathy (13/9) and ischemic cardiomyopathy (6/10). There were no statistically significant differences between the two groups regarding age, sex, preoperative clinical blood chemistry values, hemodynamic data, or risk factors. RESULTS: There were no statistically significant differences between the two groups with regard to postoperative hemodynamics, organ recovery, out-of-hospital support, and survival to heart transplantation. Mean duration of support was 235.3 +/- 210 days for the Novacor group and 174.6 +/- 175 days for the HeartMate group and mean out-of-hospital support was 241 +/- 179 days and 166 +/- 152 days for the two groups, respectively. Neurologic complications occurred significantly more often among the Novacor group, whereas the HeartMate group had a higher prevalence of infections and technical problems, which was statistically significant. Survival to transplantation was 65% for the Novacor group and 60% for the HeartMate group. CONCLUSIONS: Most patients had organ recovery with left ventricular assist system support, and a considerable number of patients in both groups underwent transplantation. However, both devices need revision to address the current problems, that is, thromboembolism for the Novacor device and infection and reliability for the HeartMate device.

Female↗
PubMed2000

Cloning and heterologous expression of Dalpha4, a Drosophila neuronal nicotinic acetylcholine receptor subunit: identification of an alternative exon influencing the efficiency of subunit assembly.

A neuronal nicotinic acetylcholine receptor (nAChR) subunit, Dalpha4, has been identified and cloned from the fruit fly Drosophila melanogaster, together with several alternatively spliced transcripts. Intron-exon boundaries within the gene encoding Dalpha4 (nAcRalpha-80B) have been identified by comparison of cDNA and genomic sequence data. The influence of amino acids encoded by alternatively spliced exons upon nicotinic radioligand binding and subunit-subunit co-assembly has been examined by heterologous expression in Drosophila S2 cells. The efficiency of subunit assembly has been shown to be influenced by amino acids surrounding the highly conserved 15 amino acid cysteine-loop motif within the N-terminal extracellular domain of the nAChR Dalpha4 subunit. Extensive use has been made of publicly available data determined by the Berkeley Drosophila Genome Project (BDGP). This includes expressed sequence tag (EST) data as well as whole-embryo in situ hybridisation and polytene chromosome in situ hybridisation data. BDGP in situ hybridisation data suggests that the Dalpha4 mRNA is expressed within Drosophila brain and ventral nerve cord and demonstrates that the gene encoding this nAChR subunit is located at position 80B on chromosome 3. The relationship between Dalpha4 and other previously cloned nAChR subunits has been examined and the implications for the nomenclature of insect nAChRs is discussed.

Alternative Splicing↗
PubMed1997

Salient features of Munsell colour space as a function of monolexemic naming and response latencies.

This study provides a replication of Boynton and Olson's (1990) work (Vision Research, 30, pp. 1311-1317), but using a more extensive model of colour space--Munsell as distinct from OSA-UCS. It involved 20 subjects in a total of 17,840 observations of 446 colours, in which monolexemic naming and response times were recorded. The results clearly differentiate between basic and non,basic colour categories using measures of consistency, consensus and response time. While the results are equivocal in distinguishing between the so-called "landmark" and "other basic colours", they are unequivocal in confirming the salience of the eleven basic colour categories initially proposed by Berlin and Kay [(1969) Basic colour terms: their universality and evolution, Berkeley, CA: University of California Press], and, in so doing, reinforce their perceptual significance and probable physiological basis. The results also reveal differences in non-basic colour naming that further confirm the special status of the basic colour categories and their role in categorical colour perception.

Adolescent↗
PubMed1984

Delayed sequelae of pituitary irradiation.

Since 1958, 781 patients at Lawrence Berkeley Laboratory have received helium-particle stereotactic radiosurgery to the adenohypophysis. Autopsy findings in 15 of these patients are reported. Ten patients received pituitary radiation (average dose, 116 Gy in six fractions) for progressive neovascularization retinopathy due to diabetes mellitus. Evidence of a time-dependent course of progressive fibrosis in their pituitary glands was found. Five patients were treated for eosinophilic adenomas. Although they had lower average doses of radiation (56 Gy in six fractions), their pituitary glands showed cystic cavitation of the adenomas. The adenomas thus appeared more radiosensitive than the normal pars anterior, which, in turn, was more radiosensitive than the adjacent neurohypophysis. No significant radiation changes were found in the surrounding brain or cranial nerves. The endocrine organs under pituitary control showed varying degrees of atrophy, and clinical tests revealed progressive hypofunction. It was concluded that charged-particle therapy produced a sharply delineated focal radiation lesion confined to the pituitary gland but did not cause injury to the critical structures of the surrounding central nervous system.

Acromegaly↗
PubMed1997

Bactericidal/permeability-increasing protein ameliorates hypercoagulability after hemorrhagic shock.

We recently showed that both plasminogen activator inhibitor-1 (PAI-1) and tissue factor (TF) are induced after a massive hemorrhage. In this study, we determined if bactericidal/permeability-increasing protein (BPI) has any effects on the induction of these factors after hemorrhagic shock. Three days after cannulation, rats were bled and maintained at a mean blood pressure of 40 mmHg for 60 min, and then were resuscitated with the shed blood and an equal volume of saline over 60 min. Rats in the BPI group were given at 6 mg/kg of rBPI21 (XOMA, Berkeley, CA; a 3-mg/kg dose at the beginning of hemorrhage followed by two doses of 1.5 mg/kg at the end of shock and at the end of resuscitation). The control group was treated similarly to the BPI group, but received control protein in the same dose as rBPI21. Plasma endotoxin concentration, whole blood clotting time (WBCT) and plasma PAI activity were measured at times 0, 2, 4, 6, and 8 h. The time-course changes in mRNA of TF, PAI-1, tumor necrosis factor alpha (TNF alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) were also detected in the liver by reverse transcription and polymerase chain reaction. The plasma endotoxin levels increased after hemorrhagic shock and showed a peak at 2 h in the control group. These increases were significantly neutralized by rBPI21 treatment at 2 h in the BPI group. WBCT decreased and PAI activity increased rapidly after hemorrhagic shock in the control group. These changes were significantly smaller in the BPI group at 6 and 8 h. The increases in mRNA of TF, PAI-1, TNF alpha, and IL-6 were also attenuated by rBPI21 treatment. These results show that BPI ameliorates hypercoagulability after hemorrhagic shock and suggest that endotoxin plays a role in the pathogenesis of thrombogenic responses after hemorrhagic shock.

Animals↗
PubMed1979

Cranial nerve damage in patients after alpha (heavy)-particle radiation to the pituitary.

The records of 161 patients were reviewed to determine if radiation damage had occurred following cranial irradiation. All of these patients had received alpha-particle radiation to their pituitary glands during the period when this form of therapy was given for diabetic retinopathy. Extraocular muscle palsy developed in 11 of these patients, iridoplegia in six, and fifth nerve damage in six. All of the palsies developed within a short period following their irradiation, and a definite dose relationship was present. The dose rate was approximately 100 rads/min for all cases. Fractionation varied but it is known for all cases. The estimated doses to the third, fourth, fifth, and sixth cranial nerves was calculated at a saggital plane 13 to 15 mm from the pituitary by using computer-drawn dosimetry charts for the respective aperture size. The energetic alpha particles were produced by the 184-in synchrocyclotron at Berkeley, Calif. A dose relationship for radiation palsies was apparent.

Adult↗
PubMed1980

Adolescent health and personality: significance for adult health.

Prediction of health at middle age was studied in two longitudinal investigations of urban children: the Berkeley Guidance Study from birth to 42 years of age and the Oakland Growth Study from 11 through 50 years of age. Overall health ratings, weight status, blood pressure, and personality measures were analyzed. Weight/height ratios were highly stable from childhood to adolescence and moderately stable from adolescence to middle age. Systolic and diastolic blood pressures in adolescence were moderately predictive of adult status. Health ratings in adolescence were predictive of health ratings in middle age for female only. Teenage personality traits appear to have significance for adult health in that a calm, controlled personality in adolescence tends to be a significant forecaster of health in midlife. Male and female patterns differ in that female health appears to be influenced more by personality and experiential factors.

Adolescent↗
PubMed2003

Locating gene-environment interaction: at the intersections of genetics and public health.

Over the past two decades, the applications of genetic and genomic technologies have begun to transform research questions and practices within epidemiology and toxicology, the "core sciences" of public health (Annu. Rev. Public Health 21 (2000) 1). These technologies provide new models and techniques for studying genetic traits, environmental exposures, and gene-environment interaction in the production of human health and illness. This paper explores the consequences of emergent genetic and genomic approaches, their ongoing redefinitions of both genetic and environmental "risks", and their potential implications for public health practice. The central argument of the paper is that the increasing focus on gene-environment interaction directs scientific, biomedical, and public health attention both inward, to the gene/genome, and outward, to particular places. In so doing, studies of gene-environment interaction create a challenging and productive tension-at the same time that bodies are being geneticized (Am. J. Law Med. 17 (1992) 15), they also are emphatically emplaced, located where social and cultural practices come to matter. This tension, this simultaneous movement outward and inward, towards the gene and towards the environment, into the body and into place, opens up a vista into the processes through which culture and biology form a locally and historically situated dialectic (Encounters With Aging: Mythologies of Menopause in Japan and North America, University of California Press, Berkeley, CA, 1993) and raises important questions about the production of health and illness.

Disease Progression↗
PubMed2003

'Taking public health out of the ghetto': the policy and practice of multi-disciplinary public health in the United Kingdom.

Until recently, a medical qualification was required for senior public health posts in the UK National Health Service. Since 1997, the new Labour government has expressed its intention to take public health 'out of the ghetto' and to develop multi-disciplinary public health. In particular, it has announced the creation of a new senior professional role of specialist in public health equivalent to the consultant in public health medicine, and open to a range of disciplines. This paper asks 'what is really going on with the policy and practice of multi-disciplinary public health in the UK?' The answer draws on recent debates in the sociology of the professions, in particular the theoretical perspectives of Freidson (Profession of Medicine: a Study of the Sociology of Applied Knowledge, Dodd, Mead & Co, New York, 1970; Professional Powers: a Study of the Institutionalization of Formal Knowledge, University of Chicago Press, Chicago, 1986) and Larson (The Rise of Professionalism: a Sociological Analysis, University of California Press, Berkeley, 1977) concerning the 'professional project', Foucault's (Ideol. Consciousness 6 (1979) 5) notion of 'governmentality' and Harrison and Wood's (Public Admin. 77 (1999) 751) concept of 'manipulated emergence'. Key characteristics of the professional project are 'autonomy', the profession's ability to control its technical knowledge and application, and 'dominance', control over the work of others in the health care division of labour. Although useful as an explanatory framework for the period 1972-1997, the concept of the professional project does not easily explain the process of change since 1997. Here Foucault's concept of governmentality is helpful. Governmentality entails all those procedures, techniques, mechanisms, institutions and knowledges that empower political programmes. Professions are part of the process of governmentality, and their autonomy is always contingent upon the wider political context. Thus public health doctors have not abandoned the professional project; they have simply accepted the political reality that the boundaries need to shift rapidly from a politically unsustainable medical/non-medical distinction to one between those with and without expert knowledge. The concept of manipulated emergence helps explain why, having expressed a commitment towards multi-disciplinary public health, the government has not supported its policy more fully.

Credentialing↗
PubMedDate not supplied

The drive for professionalization in acupuncture: a preliminary view from the San Francisco Bay area.

Although various biomedical physicians and chiropractors now employ acupuncture, generally as an adjunct therapy to their practices, acupuncture is quickly evolving into a professionalized heterodox medical system in various areas of the United States. This process has overlapped considerably with the rise of the holistic health movement. Acupuncture particularly obtained public recognition and political legitimation in California, where about one half of all the licensed acupuncturists in the U.S. presently practice. In part drawing upon case studies that various students conducted in a course titled "Medical Pluralism in North America and Europe" that one of the authors taught at Berkeley in the spring of 1994, this paper examines several aspects of the drive for professionalization within acupuncture in the San Francisco Bay area, one of the major centers of acupuncture in the U.S. Other major centers of the holistic health movement include New York, Boston, Washington, DC, Houston, Seattle, and Santa Fe. It considers two dimensions involved in the professionalization of acupuncture: (1) the creation of schools of traditional Chinese medicine and acupressure and (2) accommodation to the biomedical model. The essay also explores the health policy implications of the emergence of acupuncture as a professionalized heterodox medical system that views itself as an alternative or complementary form of primary health care.

Acupuncture Therapy↗
PubMed2002

Synchrotron soft X-ray and field-emission electron sources: a comparison.

The soft X-ray spectral region and the useful range of electron energy-loss spectroscopy are very similar, both including the energy range 100-1000 eV. Moreover, well-developed monochromators and parallel detection devices with comparable resolution exist for both. Despite the differing interactions of electrons and photons, many complementary experiments in imaging, spectroscopy and diffraction have been performed using both techniques. We therefore compare the brightness, degeneracy, monochromaticity, beam size, source size, spatial and temporal coherence of field-emission electron beams and soft X-ray synchrotron radiation from typical undulators. Recent brightness values for nanotip field emitters and undulators, both measured and calculated, are provided with examples from the Advanced Light Source synchrotron-radiation facility at Berkeley USA. The quantum mechanical upper limit on source brightness, as well as relationships among beam brightness, coherence parameters, and degeneracy, are discussed. Factors which limit these parameters and methods of measurement are reviewed, and the implications for diffraction, imaging and spectroscopic experiments as well as radiation damage are briefly commented on.

Journal Article↗
PubMed1997

Anterior segment sparing to reduce charged particle radiotherapy complications in uveal melanoma.

PURPOSE: The purpose of this investigation is to delineate the risk factors in the development of neovascular glaucoma (NVG) after helium-ion irradiation of uveal melanoma patients and to propose treatment technique that may reduce this risk. METHODS AND MATERIALS: 347 uveal melanoma patients were treated with helium-ions using a single-port treatment technique. Using univariate and multivariate statistics, the NVG complication rate was analyzed according to the percent of anterior chamber in the radiation field, tumor size, tumor location, sex, age, dose, and other risk factors. Several University of California San Francisco-Lawrence Berkeley National Laboratory (LBNL) patients in each size category (medium, large, and extralarge) were retrospectively replanned using two ports instead of a single port. By using appropriate polar and azimuthal gaze angles or by treating patients with two ports, the maximum dose to the anterior segment of the eye can often be reduced. Although a larger volume of anterior chamber may receive a lower dose by using two ports than a single port treatment. We hypothesize that this could reduce the level of complications that result from the irradiation of the anterior chamber of the eye. Dose-volume histograms were calculated for the lens, and compared for the single and two-port techniques. RESULTS: NVG developed in 121 (35%) patients. The risk of NVG peaked between 1 and 2.5 years posttreatment. By univariate and multivariate analysis, the percent of lens in the field was strongly correlated with the development of NVG. Other contributing factors were tumor height, history of diabetes, and vitreous hemorrhage. Dose-volume histogram analysis of single-port vs. two-port techniques demonstrate that for some patients in the medium and large category tumor groups, a significant decrease in dose to the structures in the anterior segment of the eye could have been achieved with the use of two ports. CONCLUSION: The development of NVG after helium-ion irradiation is correlated to the amount of lens, anterior chamber in the treatment field, tumor height, proximity to the fovea, history of diabetes, and the development of vitreous hemorrhage. Although the influence of the higher LET deposition of helium-ions is unclear, this study suggests that by reducing the dose to the anterior segment of the eye may reduce the NVG complications. Based on this retrospective analysis of LBNL patients, we have implemented techniques to reduce the amount of the anterior segment receiving a high dose in our new series of patients treated with protons using the cyclotron at the UC Davis Crocker Nuclear Laboratory (CNL).

Adolescent↗
PubMed1988

Vision following helium ion radiotherapy of uveal melanoma: a Northern California Oncology Group study.

One hundred eighty-six uveal melanoma patients were treated with helium ion radiotherapy at Lawrence Berkeley Laboratory and followed for at least 6 months. (Follow-up times ranged from 6 to 90 months; median 26.4 months.) At last examination, 92 of 186 patients (49%) had visual acuity of 20/200 or better in the treated eye. Univariate statistical analysis revealed that post-treatment vision correlated with tumor size, distance between tumor and optic disc, distance between tumor and fovea, pretreatment visual acuity, dose delivered to the optic disc, and dose delivered to the fovea (p less than .05). Neither the maximum tumor dose nor site of tumor origin (ciliary body vs. choroid) correlated with post-treatment vision on a univariate basis. However, multivariate statistical analysis revealed that the strongest independent risk factors influencing vision outcome (p less than .05) were tumor size, pretreatment visual acuity, tumor-fovea distance, and maximum tumor dose. Neither the fovea dose nor the dose to optic disc appeared to significantly affect vision outcome when other variables were taken into account. These results suggest that post-treatment visual acuity of 20/200 or better can be achieved in one-half of uveal melanoma patients treated using helium ion irradiation. Several independent risk factors affecting vision outcome have been identified.

Helium↗
PubMed2002

A P-insertion screen identifying novel X-linked essential genes in Drosophila.

The recent determination and annotation of the entire euchromatic sequence of the Drosophila melanogaster genome predicted the existence of about 13600 different genes (Science 287 (2000) 2185; http://www.fruitfly.org/annot/index.html). In parallel, the Berkeley Drosophila Genome Project (BDGP) has undertaken systematic P-insertion screens, to isolate new lethals and misexpressing lines. To date, however, the genes of the X chromosome have been under-represented in the screens performed. In order both to characterize several X-linked genes of prime interest to our laboratories and contribute to the collection of lethal P-insertions available to the community, we performed a P-insertion mutagenesis of the X chromosome. Using the PlacW and PGawB P-elements as mutagens, we generated two complementary sets of enhancer-trap lines, l(1)(T)PL and l(1)(T)PG, respectively, which both contain a reporter gene whose developmental expression can be monitored when driven by nearby enhancer sequences. We report here the characterization of 260 new insertions, mapping to 133 different genes or predicted CGs. Of these, 83 correspond to genes for which no lethal mutation had yet been reported. For 64 of those, we could confirm that lethality was solely due to the P-element insertion. The primary molecular data, reporter gene expression patterns (observed in embryos, third instar larvae and adult ovaries) and proposed CG assignment for each strain can be accessed and updated on our website at the following address: http://www-cbd.ups-tlse.fr:8080/screen.

Animals↗
PubMed1999

A peritrophin-like protein expressed in the embryonic tracheae of Drosophila melanogaster.

We have cloned and sequenced a cDNA from Drosophila melanogaster that encodes a protein homologous to the peritrophins, a family of chitin-binding proteins from the peritrophic matrix of insects. Unexpectedly, the gene, Gasp, is expressed in the embryonic tracheae. We suggest that this family of proteins may be present in other tissues than the peritrophic matrix, particularly where nutrient or gas exchange are important, and/or where invasion by parasites or viruses is possible. We have also mapped two similar genes that had been sequenced by the Berkeley Drosophila Genome Project, and find that these three very similar genes are not clustered, but are located on three different chromosomes.

Amino Acid Sequence↗
PubMed2000

Development of a sealed-accelerator-tube neutron generator

Sealed-accelerator-tube neutron generators are being developed in Lawrence Berkeley National Laboratory (LBNL) for applications ranging from neutron radiography to boron neutron capture therapy and neutron activation analysis. The new generation of high-output neutron generators is based on the D-T fusion reaction, producing 14.1-MeV neutrons. The main components of the neutron tube--the ion source, the accelerator and the target--are all housed in a sealed metal container without external pumping. Thick-target neutron yield computations are performed in this paper to estimate the neutron yield of titanium and scandium targets. With an average deuteron beam current of 1 A and an energy of 120 keV, a time-averaged neutron production of approximately 10(14) n/s can be estimated for a tritiated target, for both pulsed and cw operations. In mixed deuteron/triton beam operation, a beam current of 2 A at 150 keV is required for the same neutron output. Recent experimental results on ion sources and accelerator columns are presented and discussed.

Journal Article↗
PubMed2000

Mean arterial pressure, pregnancy induced hypertension, and preeclampsia. Evaluation as independent risk factors and as surrogates for high maternal serum alpha-protein in estimating breast cancer risk.

PURPOSE: Data from a nested case-control study were analyzed to examine high mean arterial pressure (MAP), hypertension of pregnancy and preeclampsia as independent predictors, and as surrogate markers for elevated Alpha-fetoprotein (AFP) levels in evaluating breast cancer risk.METHODS: Cases (n = 205) were identified by the California Cancer Registry from a cohort of pregnant women who were part of the Kaiser Health Plan and took part in the Child Health and Development Studies initiated by the University of California, Berkeley, from June 1959 to September 1966. Controls (n = 337) were selected by randomized recruitment from the same cohort probability matched to cases by distribution of birth dates of cases.RESULTS: High MAP was associated with breast cancer risk, and was different across quartiles of age at first full term pregnancy. Odds Ratios across quartiles were 0.24 (95% CI = 0.08-0.71), 0.84 (95% CI = 0.39-1.66), 1.00 (referent), and 2.50 (95% CI = 1.21-5.13). Neither diagnosed preeclampsia nor hypertension of pregnancy showed any association with breast cancer risk. When both high Alpha-fetoprotein and high mean arterial pressure were entered into the same analysis neither changed the odds ratio for the other more than eight percent. Additionally, AFP level was not a linear function of MAP.CONCLUSIONS: Although the pattern of odds ratios across quartiles of age at first full term pregnancy were similar for the two variables it can not be concluded that high MAP is an adequate surrogate for high levels of maternal serum AFP, but rather represents some related process which is in and of itself a risk factor for breast cancer.

Journal Article↗
PubMed1995

Lessons in cooperation: four hospital consortia relate their quality improvement experiences.

BACKGROUND: In 1989, The Robert Wood Johnson Foundation launched a demonstration project to test a consortium approach to quality improvement. As part of this project, four hospital consortia in various parts of the United States are currently sharing quality resources (for example, training) and collaborating on various improvement efforts. The purpose of the project is to demonstrate that hospitals can take on more difficult problems and accomplish more in cooperation with each other than on their own. CASE STUDIES: The Institute for Quality Healthcare (Iowa City, Iowa) has built a comparative database so that 40 member hospitals can make meaningful comparisons on various aspects of performance; The Vermont Program for Quality in Health Care has lowered the postoperative infection rate in Vermont by monitoring compliance with consensus guidelines; Interwest Quality of Care, Inc, which has member organizations in Utah, Wyoming, and Idaho, has adapted and disseminated guidelines for diabetic care; and The Public Hospital Institute, in Berkeley, California, has worked with the Joint Commission on Accreditation of Healthcare Organizations to develop a written guide to help surveyors understand the unique operational traits of public hospitals. LESSONS LEARNED: Projects such as those with champions in several member organizations and comparative data analysis lend themselves more easily to cooperative work than others. They also provide some strategies for collaboration, such as continually reinforcing the principles of collaboration, obtaining a fully informed commitment, beginning with initiatives that are likely successes, and being serious and vocal about the commitment to confidentiality. CONCLUSIONS: Collaborators in quality improvement gain important resources, such as better information, more relevant reference databases, colleagues and support for quality improvement specialists, and economies of scale in education programs, training materials, and interaction with vendors. However, the difficulties in collaboration are great. Hospitals must continually consider not only "What's in this for me," but also "What can we accomplish as a group that is greater than what each of us can do alone?"

California↗