Networks of tumor suppressors. Workshop: tumor suppressor networks.
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In May 2004, over 100 bacteriologists from 19 different countries discussed recent progress in identification and understanding of individual signal transfer mechanisms in bacteria and in the mutual interactions between these systems to form a functional living cell. The meeting was held in San Feliu and supported by ESF and EMBO. In part through the extensive sequencing efforts of the past few years, the bulk of the bacterial signal transfer systems have been resolved and their detailed characterization is revealing such characteristics as signal specificity, signalling rate constants, molecular interaction affinities, subcellular localization, etc., which should provide a solid basis to a computational extension of this field of studies. In parallel, the new genomics techniques are providing tools to characterize the way a collection of such systems interact in an individual cell, to give rise to 'life'. Systems theory provides rational and convenient ways to bring order to the wide range of observables thus obtained. Ultimately, the performance of engineered design will have to prove whether or not we know enough about the processes involved.
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The neuropeptide red pigment concentrating hormone (RPCH), which we have previously shown to activate the cardiac sac motor pattern and lead to a conjoint gastric mill-cardiac sac pattern in the spiny lobster Panulirus, also activates and modulates the pyloric pattern. Like the activity of gastric mill neurons in RPCH, the pattern of activity in the pyloric neurons is considerably more complex than that seen in control saline. This reflects the influence of the cardiac sac motor pattern, and particularly the upstream inferior ventricular (IV) neurons, on many of the pyloric neurons. RPCH intensifies this interaction by increasing the strength of the synaptic connections between the IV neurons and their targets in the stomatogastric ganglion. At the same time, RPCH enhances postinhibitory rebound in the lateral pyloric (LP) neuron. Taken together, these factors largely explain the complex pyloric pattern recorded in RPCH in Panulirus.
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Lung development depends on endodermal Sonic Hedgehog (Shh) signaling to mesodermal Wingless/int/beta catenin (Wnt/betacatenin), followed by parathyroid hormone-related protein (PTHrP) signaling from endoderm to mesoderm. Fluid distension of fetal rat lung explants up-regulates PTHrP signaling and down-regulates Shh/Wnt/betacatenin signaling, marked by decreases in Patched, Gli, Frizzled, and Dishevelled, inducing fibroblast triglyceride uptake, type II cell saturated phosphatidylcholine, and surfactant protein-B expression. Bumetanide, which inhibits fluid distension, blocked down-regulation of the Shh/Wnt/betacatenin pathway and up-regulation of the PTHrP pathway, whereas PTHrP (1-34, 5 x 10(-7) M) treatment overcame bumetanide inhibition, and the PTHrP receptor antagonist PTHrP (7-34) amide (5 x 10(-6) M) mimicked bumetanide, indicating that PTHrP signaling mediates fluid distension-induced alveolar differentiation. Fetal rat lung explant automaturation was characterized by decreased Wnt/betacatenin signaling and increased PTHrP/PTHrP receptor signaling, up-regulating fibroblast-specific adipocyte differentiation related protein (ADRP) and peroxisome proliferator-activated receptor gamma. Wnt/betacatenin agonists (LiCl or SB415268) maintained Shh/Wnt/betacatenin signaling, blocking spontaneous up-regulation of the PTHrP pathway, whereas PTHrP or cAMP down-regulated Shh/Wnt/betacatenin signaling and stimulated PTHrP signaling for fibroblast and type II cell differentiation. This is the first evidence that alveolar fluid distension is an organizing principle for PTHrP signaling down-regulation of the Shh/Wnt/betacatenin pathway.
BACKGROUND: Hemoglobin A1c (HbA1c) results are generally reviewed several days after office visits. The clinical decisions on elevated HbA1cs may be complex and are rarely urgent. Providers may elect to defer the decision or its implementation to a future clinical encounter. OBJECTIVE: To determine the occurrence rate, predictors, and eventual decision outcomes for HbA1c deferred decisions. DESIGN: Provider questionnaire completed when HbA1c results from type 2 diabetes patients were reviewed, followed by a chart review on deferred cases 6 months later. PARTICIPANTS: Providers at 19 Colorado primary care clinics. MEASUREMENTS: For HbA1c > or =7%, whether the decision or its implementation was deferred. In deferred cases, whether a clinical decision was eventually made. RESULTS: Of the 311 HbA1cs > or =7%, 31 (10.0%) had deferred decisions. In multivariate analysis, deferred decisions were more likely in African Americans (odds ratio [OR] 4.91, 95% CI 1.81, 13.3) and less likely when the patient's usual provider reviewed the HbA1c (OR 0.40, 95% CI 0.18, 0.90). In the chart review, for deferred cases (n = 18), a clinical decision was made in 14 cases, usually at the next clinical encounter. In 4 cases, the HbA1c was never addressed. CONCLUSION: Deferred decisions on HbA1c results are infrequent, and usually the HbA1c is eventually addressed.
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