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PubMed1980

Second and third degree atrioventricular block with Graves' disease: a case report and review of the literature.

A previously healthy woman experienced Adams-Stokes attacks ten weeks after the initiation of antithyroid medication for Graves' disease. The patient manifested advanced atrioventricular (A-V) block requiring a temporary transvenous pacemaker. The site of heart block was localized to the A-V node by utilizing a His bundle electrogram. With control of the hyperthyroid state, normal A-V conduction was restored. Review of the literature identified twenty-five additional cases of second or third degree A-V block associated with Graves' disease, ten of whom had Adams-Stokes syncope or convulsive seizures. The A-V nodal block was reversible with cure of the primary endocrine disease. It is postulated that excessive thyroid hormone has a direct effect on the cardiac conduction system, specifically, the region of the A-V node and bundle of His. Recommendations are made regarding the recognition and management of patients at risk for developing heart block associated with Graves' disease.

Adams-Stokes Syndrome↗
PubMed1988

Adam Smith?

Explore the source record for details and available documents.

Fee Schedules↗
PubMed2000

The effect of meta versus para substitution on the efficiency of chemiexcitation in the chemically triggered electron-transfer-initiated decomposition of spiroadamantyl dioxetanes.

A similar viscosity dependence of the CIEEL efficiencies for the para- and meta-substituted spiroadamantyl dioxetanes 1 has been observed, which implies that an electron-transfer mechanism operates through solvent-caged species for both regioisomers. The pronounced difference in the chemiexcitation yields for the meta- and para-substituted dioxetanes is rationalized in terms of the much larger (ca. 200-fold) rate constant for the electron back-transfer (BET) step to afford the excited meta CIEEL emitter. An in-depth kinetic analysis of the viscosity effect on the excited-state generation for the para versus meta regioisomers supports this conclusion.

Adamantane↗
PubMed2003

Bloch-like oscillations in a one-dimensional lattice with long-range correlated disorder.

We study the dynamics of an electron subjected to a uniform electric field within a tight-binding model with long-range-correlated diagonal disorder. The random distribution of site energies is assumed to have a power spectrum S(k) approximately 1/k(alpha) with alpha>0. de Moura and Lyra [Phys. Rev. Lett. 81, 3735 (1998)]] predicted that this model supports a phase of delocalized states at the band center, separated from localized states by two mobility edges, provided alpha>2. We find clear signatures of Bloch-like oscillations of an initial Gaussian wave packet between the two mobility edges and determine the bandwidth of extended states, in perfect agreement with the zero-field prediction.

Journal Article↗
PubMedDate not supplied

Cancer vaccines. Part 2.

Cancer vaccines are being widely studied for the purpose of immune modulation and subsequent antitumor effects. This article cites only a few examples of the many studies underway. Many vaccines have shown efficacy in eliciting systemic responses with minimal toxicities. The use of vaccines as a modality of cancer therapy in combination with chemotherapy, surgery, and radiation therapy is also being investigated. Although the routine use of approved vaccines is still a goal for the future, instituting this fourth modality of cancer therapy is not too distant. Phase III trials with both melanoma and colon cancer vaccines have been completed. Synthetic carbohydrate antigen vaccines have shown efficacy in several tumor types during Phase II trials and are also generating enthusiasm. The potential impact of vaccine therapy on the profession of pharmacy may involve patient counseling regarding management of side effects and possibly also dispensing of vaccine therapy products to patients directly for home administration. As ambulatory sites open in conjunction with pharmacy services and pharmacists obtain prescribing authority, pharmacists' active involvement in vaccine counseling and administration seems likely.

Cancer Vaccines↗
PubMed2005

Measurement of semileptonic branching fractions of B mesons to narrow D** states.

Using the data accumulated in 2002-2004 with the D0 detector in proton-antiproton collisions at the Fermilab Tevatron collider with a center-of-mass energy of 1.96 TeV, the branching fractions of the decays B --> D0(1)(2420)mu+ vmuX and B --> D2(*0)(2460)mu+ vmuX and their ratio have been measured: B(b --> B) x B(B --> D0(1)mu+ vmuX) x B(D0(*0) --> D*- pi+) = [0.087 +/- 0.007(stat) +/- 0.014(syst)]%; B(b --> B) x B(B --> D2(*0) mu+ vmuX) x B(D2(*0) --> D*- pi+) = [0.035 +/- 0.007(stat) +/- 0.008(syst)]% and [B(B --> D2(*0)mu+ vmuX) x B(D2(*0) --> D*- pi+)]/[B(B --> D0(1)mu+ vmuX) x B(D0(1) --> D*- pi+)] = 0.39 +/- 0.09(stat) +/- 0.12 (syst), where the charge conjugated states are always implied.

Journal Article↗
PubMed2006

Temporal trends of young-of-year fishes in Lake Erie and comparison of diel sampling periods.

We explored temporal trends of young-of-year (YOY) fishes caught in bottom trawl hauls at an established offshore monitoring site in Lake Erie in fall during 1961-2001. Sampling was conducted during morning, afternoon, and night in each year. Catches per hour (CPH) of alewife (Alosa pseudoharengus) YOY were relatively low and exhibited no temporal trend. This result was consistent with the species' intolerance to Lake Erie's adverse winter water temperatures. Gizzard shad (Dorosoma cepedianum) YOY decreased sharply after 1991, which was consistent with recent oligotrophication of the lake. Following the establishment in 1979 and rapid increase of white perch (Morone americana) YOY, white bass (Morone chrysops) and freshwater drum (Aplodinotus grunniens) YOY decreased. Trout-perch (Percopsis omiscomaycus) YOY decreased during 1986-1991, but recovered to previous levels during 1991-2001. The recovery coincided with the resurgence of mayflies (Ephemoptera) in the lake. CPH of spottail shiner (Notropis hudsonius) and emerald shiner (N. atherinoides) YOY exhibited no temporal trend between 1961 and the late 1970s to early 1980s. CPH of yellow perch (Perca flavescens) YOY decreased during 1961-1988, and walleye (Sander vitreum) YOY increased overall during the time series. These observations were consistent with published studies of adults in the region. CPH of 4 of the 10 species of YOY considered were greatest during night. CPH for walleye YOY was higher in the morning than in the afternoon, but there was no significant difference between night and morning abundances. The results suggest that (1) CPH of YOY fishes may be a useful monitoring tool for Lake Erie, and (2) offshore monitoring programs that do not include night sampling periods may underestimate recruitment for several common species.

Animals↗
PubMed1991

Gastrointestinal carriage of Clostridium difficile in cats and dogs attending veterinary clinics.

Cats and dogs being treated at two veterinary clinics were investigated for gastrointestinal carriage of Clostridium difficile using selective solid and enrichment media. Thirty-two (39.5%) of 81 stool samples yielded C. difficile. There were significant differences in isolation rates between clinics, 61.0% of animals being positive at one clinic compared to 17.5% at the other (Chi-square, P less than 0.005). Of 29 animals receiving antibiotics, 15 (52.0%) harboured C. difficile while 11 (23.9%) of 46 animals not receiving antibiotics were positive (Chi-square, P less than 0.01). There was no difference in carriage rate between cats (38.1%) and dogs (40.0%). The environment at both veterinary clinics was surveyed for the presence of C. difficile. Fifteen of 20 sites at one clinic were positive compared to 6 of 14 sites at the other clinic. Both cytotoxigenic and noncytotoxigenic isolates of C. difficile were recovered from animals and environmental sites. These findings suggest that household pets may be a potentially significant reservoir of infection with C. difficile.

Animals↗
PubMed2003

Ionic currents in the human serotonin transporter reveal inconsistencies in the alternating access hypothesis.

We have investigated the conduction states of human serotonin transporter (hSERT) using the voltage clamp, cut-open frog oocyte method under different internal and external ionic conditions. Our data indicate discrepancies in the alternating access model of cotransport, which cannot consistently explain substrate transport and electrophysiological data. We are able simultaneously to isolate distinct external and internal binding sites for substrate, which exert different effects upon currents conducted by hSERT, in contradiction to the alternating access model. External binding sites of coupled Na ions are likewise simultaneously accessible from the internal and external face. Although Na and Cl are putatively cotransported, they have opposite effects on the internal face of the transporter. Finally, the internal K ion does not compete with internal 5-hydroxytryptamine for empty transporters. These data can be explained more readily in the language of ion channels, rather than carrier models distinguished by alternating access mechanisms: in a channel model of coupled transport, the currents represent different states of the same permeation path through hSERT and coupling occurs in a common pore.

Animals↗
PubMed2000

Delineation of the roles of amino acids involved in the catalytic functions of Leuconostoc mesenteroides glucose 6-phosphate dehydrogenase.

The roles of particular amino acids in substrate and coenzyme binding and catalysis of glucose-6-phosphate dehydrogenase of Leuconostoc mesenteroides have been investigated by site-directed mutagenesis, kinetic analysis, and determination of binding constants. The enzyme from this species has functional dual NADP(+)/NAD(+) specificity. Previous investigations in our laboratories determined the three-dimensional structure. Kinetic studies showed an ordered mechanism for the NADP-linked reaction while the NAD-linked reaction is random. His-240 was identified as the catalytic base, and Arg-46 was identified as important for NADP(+) but not NAD(+) binding. Mutations have been selected on the basis of the three-dimensional structure. Kinetic studies of 14 mutant enzymes are reported and kinetic mechanisms are reported for 5 mutant enzymes. Fourteen substrate or coenzyme dissociation constants have been measured for 11 mutant enzymes. Roles of particular residues are inferred from k(cat), K(m), k(cat)/K(m), K(d), and changes in kinetic mechanism. Results for enzymes K182R, K182Q, K343R, and K343Q establish Lys-182 and Lys-343 as important in binding substrate both to free enzyme and during catalysis. Studies of mutant enzymes Y415F and Y179F showed no significant contribution for Tyr-415 to substrate binding and only a small contribution for Tyr-179. Changes in kinetics for T14A, Q47E, and R46A enzymes implicate these residues, to differing extents, in coenzyme binding and discrimination between NADP(+) and NAD(+). By the same measure, Lys-343 is also involved in defining coenzyme specificity. Decrease in k(cat) and k(cat)/K(m) for the D374Q mutant enzyme defines the way Asp-374, unique to L. mesenteroides G6PD, modulates stabilization of the enzyme during catalysis by its interaction with Lys-182. The greatly reduced k(cat) values of enzymes P149V and P149G indicate the importance of the cis conformation of Pro-149 in accessing the correct transition state.

Arginine↗
PubMed2000

An elementary school-based health clinic: can it reduce medicaid costs?

OBJECTIVE: School-based health services have evolved from primarily controlling communicable disease to comprehensive programs with direct services, education, and improvement of the school environment. School-based health clinics (SBHCs), currently 1157 in number, are used to reach children for preventive and other routine care. Although several studies have examined the costs and effects of such programs, few, if any, have examined their potential to save Medicaid program outlays. The objective of this study was to assess the effect of the Whitefoord Elementary School-Based Health Clinic (WESBHC), located in Atlanta, Georgia, on health care costs paid by Georgia Medicaid over the 1994-1996 period. This clinic has been in operation since late 1994. DESIGN: The analysis uses 1994-1996 claims data for Medicaid-enrolled children 4 through 12 years old served by the WESBHC and similar children in a comparison school district without such a clinic. Descriptive and multivariate analyses are used to discern the differences in the changes in Medicaid expenses per child-year enrolled for these 2 groups of children. Both those who only used the WESBHC sporadically and those for whom it was their medical home were identified for analysis. RESULTS: The descriptive analysis shows that although there were no significant differences in the Medicaid expenses for the WESBHC and comparison children in 1994, before the operation of the WESBHC, by 1995, the WESBHC children had significantly lower emergency department expenses. In addition, they had higher Early Periodic Screening Diagnosis and Treatment preventive care expenses. By 1996, the WESBHC children had significantly lower inpatient, nonemergency department transportation, drug, and emergency department Medi- caid expenses. Multivariate analysis confirmed the effect of the WESBHC on lowering emergency department expenses. CONCLUSIONS: The results strongly suggest that the operation of a SBHC can have effects on the child's use of services and health care expenses. Given that these clinics serve all those who come for care and many of these are low-income children, these savings are likely to accrue to the Medicaid program of the state. As states continue to implement Medicaid-managed care for their child populations, they will need to consider the ability of SBHCs to participate in and receive Medicaid revenues through health maintenance organization networks.

Child↗
PubMed1994

Hexokinase autophosphorylation: identification of a new dual specificity protein kinase.

Hexokinase 1 (HK1) purified from rat brain exhibits protein kinase activity, including autophosphorylation and phosphorylation of other protein substrates. The amino acid specificity of rat brain autophosphorylation was analyzed with monoclonal antibodies directed against phosphotyrosine and by acid hydrolysis of the phosphorylated enzyme. The results show that serine, threonine, and tyrosine residues are phosphorylated after incubation with ATP. The stoichiometry of this phosphorylation was 0.2 mole phosphate per mole hexokinase after 30 min of incubation. Evaluation of freshly isolated HK1 with monoclonal anti-phosphotyrosine antibody indicates that the enzyme is phosphorylated at a basal level in its native state. We concluded that rat brain HK1 is a dual specificity protein kinase that is phosphorylated physiologically.

Animals↗
PubMed2005

Millimeter-wave-detected, millimeter-wave optical polarization spectroscopy.

We report a new form of microwave optical double-resonance spectroscopy called millimeter-wave-detected, millimeter-wave optical polarization spectroscopy (mmOPS). In contrast to other forms of polarization spectroscopy, in which the polarization rotation of optical beams is detected, the mmOPS technique is based on the polarization rotation of millimeter waves induced by the anisotropy from optical pumping out of the lower or upper levels of the millimeter wave transition. By monitoring ground-state rotational transitions with the millimeter waves, the mmOPS technique is capable of identifying weak or otherwise difficult-to-observe optical transitions in complex chemical environments, where multiple molecular species or vibrational states can lead to spectral congestion. Once a transition is identified, mmOPS can then be used to record pure rotational transitions in vibrationally and electronically excited states, with the resolution limited only by the radiative decay rate. Here, the sensitivity of this nearly-background-free technique is demonstrated by optically pumping the weak, nominally spin-forbidden CS e (3)Sigma(-)-X (1)Sigma(+) (2-0) and d (3)Delta-X (1)Sigma(+) (6-0) electronic transitions while probing the CS X (1)Sigma(+) (v(")=0,J(")=2-1) rotational transition with millimeter waves. The J(')=2,N(')=2<--J(')=1,N(')=1 pure rotational transition of the CS e (3)Sigma(-) (v(')=2) state is then recorded by optically preparing the J(')=1,N(')=1 level of the e (3)Sigma(-) (v(')=2) state via the J(')=1,N(')=1<--J(")=1 transition of the e (3)Sigma(-)-X (1)Sigma(+) (2-0) band.

Journal Article↗
PubMed1995

Effect of intracerebroventricular beta-funaltrexamine on mu opioid receptors in the rat brain: consideration of binding condition.

Effects of 24 h pretreatment with intracerebroventricular (icv) beta-funaltrexamine (beta-FNA) on brain opioid receptor binding in rats were examined under various conditions. Agonist binding to mu and delta opioid receptors (with [3H][[cap]dAla2,MePhe4,Gly-ol5]enkephalin (DAMGO)[3H][D-Pen2, D-Pen5]enkephalin (DPDPE), respectively) was performed under three different conditions: i) pretreatment of membranes with GDP and Na+ and binding in the presence of Mg++ in Tris-HCI buffer containing EGTA and leupeptin for 1.5 to 3 h; ii) binding in Tris-HCI buffer containing bacitracin, leupeptin, chymostatin and bestatin for 3 to 4 h; iii) binding in Tris-HCI buffer containing EGTA and leupeptin for 45 min. Condition i was shown to convert opioid receptors to a high affinity state for agonists. beta-FNA (2, 6 or 20 nmol) significantly reduced 1 nM [3H]DAMGO binding in the whole brain with i but not with ii. With iii, 20 nmol beta-FNA reduced [3H]DAMGO binding, but not 2 or 6 nmol. Saturation experiments with i showed that the reduction in [3H]DAMGO binding after 6 or 20 nmol beta-FNA was due to a decrease in Bmax and an increase in KD. For delta binding, there was no significant change in [3H]DPDPE (2 nM) binding with i after 2, 6 or 20 nmol beta-FNA. Thus, under i, icv beta-FNA reduced [3H]DAMGO binding significantly without affecting [3H]DPDPE binding. In addition, mu binding was also conducted with 1 nM [3H]naloxone under three different conditions: iv) in the presence of Na+ and GDP; v), in the presence of Na+, Gpp(NH)p and Mg++; vi) in the presence of Na+. Both iv and v were shown to shift opioid receptors to a low affinity state for agonists. beta-FNA (20 nmol) significantly decreased 1 nM [3H]naloxone binding under each of the three conditions. Competitive inhibition of 1 nM [3H]naloxone binding by DAMGO in the presence of Na+ and GDP showed that receptors existed in a single low affinity state for DAMGO, and that icv beta-FNA caused a reduction in Bmax without affecting the KD of DAMGO. In summary, when all the receptors were converted to a high agonist affinity state i or a low agonist affinity state iv, the changes in mu binding induced by beta-FNA could be revealed with agonist binding. Additionally, changes in mu binding induced by beta-FNA could be detected with [3H]naloxone, which always displayed high affinity regardless of agonist affinity states, under each of the three conditions (iv, v and vi).

Analgesics↗
PubMed1997

Changes in platelet count, coagulation and fibrinogen associated with elective repair of asymptomatic abdominal aortic aneurysm and aortic reconstruction for occlusive disease.

BACKGROUND: Mortality and morbidity following aortic surgery, particularly repair of ruptured abdominal aortic aneurysm (AAA), is frequently associated with the development of coagulopathy. OBJECTIVES: To examine changes in platelet count (PC), fibrinogen, and coagulation in patients undergoing elective repair of asymptomatic abdominal aortic aneurysm (AAA) and aortic surgery for occlusive disease. DESIGN: Prospective clinical study in a University Department of Vascular Surgery. PATIENTS: Thirty-three patients undergoing elective repair of asymptomatic AAA and 19 patients undergoing aortic surgery for occlusive disease. METHODS: Full blood count (FBC), clotting screen, and fibrinogen measured pre-operatively; 6, 12, 24, 48 h postoperatively; and thereafter as clinically indicated in 23 consecutive patient's undergoing AAA repair (Group 1). Pre- and postoperative PC measured weekly for 4 weeks following operation in a further 10 consecutive patients undergoing AAA repair (Group 2) and perioperative PC measured in 19 consecutive patients undergoing aortic surgery for occlusive disease (Group 3). RESULTS: Group 1: Preoperative haematological parameters were normal. There was no mortality. Postoperatively, 21 (91%) patients developed thrombocytopenia (PC < 150 x 10(9)/l). The postoperative fall in PC (median 90, range 12-160 x 10(9)/l) was significantly related to the duration of aortic cross-clamp (median 46, range 20-127 min, r2 = 0.33, p < 0.01). At 10 days all patients had developed thrombocytosis (PC > 350 x 10(9)/l) Postoperatively, by 48 h, 17 (74%) patients had developed hyperfibrinogenaemia. One patient suffered a myocardial infarction associated with a PC of 105 x 10(9)/l and a fibrinogen of 7.2 g/l. GROUP 2: In a further 10 patients undergoing AAA repair postoperative thrombocytosis was found to persist for several weeks in five of nine survivors. GROUP 3: Patients undergoing aortic surgery for occlusive disease had significantly higher preoperative PC than AAA patients (median 292, range 179-251 x 10(9)/l vs. median 204, range 140-293 x 10(9)/l, p < 0.01). CONCLUSIONS: Patients undergoing elective repair of AAA demonstrate similar, albeit less dramatic, changes in platelet count to those we have previously reported in patients undergoing repair of ruptured AAA. Aortic clamping leads to platelet sequestration and thrombocytopenia in the early postoperative period. Later, patients develop hyperfibrinogenaemia and thrombocytosis which may persist for several weeks. Similar changes are seen in patients undergoing aortic surgery for occlusive disease. These changes may represent a hypercoagulable state that predisposes these patients to thrombotic complications.

Aged↗
PubMed2001

Anomalous Vibrational Dependence of the Rotational and Hyperfine Parameters in the B(4)Pi-X(4)Sigma(-) Transition of NbO.

The laser excitation spectrum of jet-cooled NbO in the region 16 000-18 000 cm(-1) has been recorded at high resolution, giving rotational and hyperfine constants for the levels v=0-3 of the B(4)Pi state and v=1 of the X(4)Sigma(-) state; zero gaps have also been measured at low resolution for some weaker bands involving higher vibrational levels. Taken together with the laser data for the B-X (0,0) band from Adam et al. (J. Chem. Phys. 94, 6240-6262 (1994)) and the Fourier transform emission data for the doublet manifold from Launila et al. (J. Mol. Spectrosc. 186, 131-143 (1997)), the new data give a very complete picture of the vibrational energy level pattern in this region. Strong irregularities in the vibrational dependences of the B(4)Pi rotational and hyperfine constants can be interpreted in terms of spin-orbit interaction between the B(4)Pi state and the f(2)Pi, e(2)Phi, and d(2)Delta states. The interaction is strong enough that all three doublet states can be seen in absorption from the X(4)Sigma(-) ground state, adding to the complexity of the spectrum. The hitherto unknown sigmadeltasigma* (4)Delta state is estimated to lie near 17 500 cm(-1), from the change of sign in the spin-rotation parameter gamma of the B(4)Pi state between v=2 and 3. Copyright 2001 Academic Press.

Journal Article↗