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At least 379 records · Page 21Linked to original sources
PubMed1993

Exit-site care--is it time for a change?

Peritoneal catheter exit-site infections (ESI's) continue to impact significantly on morbidity and catheter longevity. The controversy concerning protocols for daily exit-site care continues for frequency, methodology, cleansing agent, and dressing. Routine daily exit-site care prior to January 1991 consisted of daily showers using liquid soap, povidone scrub, rinsing the shower, and drying with a 4 x 4-in. gauze pad. Catheters have always been immobilized, either with tape or an immobilizing device. Hydrogen peroxide was used only when needed to soften crust formation prior to showering. A light dressing, usually 2 x 2 in., was optional. A recent survey revealed that povidone iodine was the antiseptic of choice for catheter care in 75% of the respondents. However, povidone iodine irritates and dries the skin predisposing it to infection. ESI's are prospectively monitored as part of our quality improvement (QI) program. An incidence of 0.76 episodes/patient-year was noted between January 1989 and May 1991. Given the relative high frequency of ESI's, the protocol was modified and introduced during the January-May 1991 time frame. Routine care now consists of daily showers using only CC-500, a gentle antibacterial cleaner (Care-Tech Laboratories, Inc.), rinsing in the shower, and drying with a 4 x 4-in. gauze. Use of hydrogen peroxide and dressings has remained the same. Additionally, a protocol addressing the prophylaxis for traumatized exist sites was initiated. The incidence of ESI's has dropped significantly to 0.12 episodes/patient-year. Although our population size is small (n = 18), this study does point out the utility of prospectively monitoring trends for appropriate indicators within a QI program.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheters, Indwelling↗
PubMed1996

Recommendations for treatment of exit-site pathology.

Good local care including measures to prevent trauma keeps healthy exit sites free of infection. Acute infection can be cured with aggressive therapy. Chronic infection may progress to cuff infection, which even when treated, may progress to peritonitis. Cuff and tunnel infections require deroofing, cuff shaving, and/or catheter removal. Therapy may prolong the life of a catheter. An equivocal exit site requires aggressive therapy in order to achieve cure. Local care of the exit should include measures to prevent trauma. Should trauma occur, aggressive therapy that includes a systemic antibiotic should be instituted immediately. Aggressive therapy is particularly indicated during the healing period. Prophylactic antibiotics, systemic or topical, are indicated in trauma, recurrent infection, and may be beneficial during the healing period.

Bacterial Infections↗
PubMed1994

Increase in fatal suicidal poisonings and suffocations in the year Final Exit was published: a national study.

Final Exit was a best-selling book that recommended poisoning and suffocation by plastic bag as lethal means of suicide for those with terminal medical illnesses. The authors sought to determine whether the number of suicides involving these methods increased in the United States in 1991, the year the book was published, compared with 1990. Suicidal asphyxiations involving a plastic bag increased 30.8%, from 334 to 437, and poisonings increased 5.4%, from 3,143 to 3,314. There was no change in the number of suicides involving each of the other methods or in the total number of suicides between 1990 and 1991. These ecological data support, but cannot conclusively prove, the hypothesis that Final Exit influenced the choice of lethal means of suicidal individuals.

Asphyxia↗
PubMed1999

On the phase problem in electron microscopy: the relationship between structure factors, exit waves, and HREM images.

In electron microscopy, the word phase is used for different physical phenomena, including crystallographic structure-factor phases and the electron wave phases. This has resulted in great confusion, as to whether the phase information is present or lost when an image is recorded. The aim of this paper is to solve this phase confusion problem by studying the relationships between structure factors, exit waves, and high-resolution electron microscopy (HREM) images. Three approaches are taken. First phases at different stages of the imaging processes are compared analytically for a crystal that can be considered a weak phase object (WPO). Then these different phases are calculated by the multi-slice method based on dynamical diffraction theory, and their numerical values are compared. Finally, the validity of the theoretical description is checked by comparison with experimental data on a real crystal, Ti(2)S. It is demonstrated that it is possible to obtain accurate structure factor-phases directly from HREM images by crystallographic image processing. The two major methods for structure determination from HREM images-exit wave reconstruction and crystallographic image processing-are compared. It is shown that the information utilised by the two methods as well as the results are essentially the same.

Crystallography↗
PubMed1978

Requirements of BHK cells for the exit from different quiescent states.

We have investigated the kinetics of exit from the resting state of BHK cells which had been arrested by isoleucine deprivation, serum starvation, or high temperature in the case of three ts G1 mutants. In addition, we have studied the effect of imposing a secondary deprivation on cells which had been released from one of the above mentioned blocks. The results obtained show that the quiescent states reached by BHK cells following serum or isoleucine deprivation cannot be differentiated on the basis of the exit kinetics from Smith and Martin's probabilistic A-state. Nevertheless, the response of cells to secondary deprivation is different, depending on the nature of the primary arresting condition used, reflecting physiological differences between the different resting states. A model is presented which postulates that cycle transition specific genes require the presence of different proliferative agents for their expression.

Cell Cycle↗
PubMed1990

Low temperature blocks exit of pro-opiomelanocortin from the endoplasmic reticulum but not subsequent delivery to the site of prohormone processing.

The effect of reduced temperature on the delivery of the prohormone pro-opiomelanocortin (POMC) to the site of prohormone processing was investigated in the mouse anterior pituitary cell line AtT20. At 20 degrees C processing was substantially inhibited and was almost completely arrested at 18 degrees C. Earlier studies with membrane glycoproteins indicated that at these temperatures protein movement was blocked at the level of exit from the Golgi apparatus. In contrast it was found here that the inhibition of processing at reduced temperature was due to the retention of POMC in the endoplasmic reticulum. When POMC was allowed to progress to the Golgi before temperature was reduced, subsequent processing was only slightly retarded by incubation at 18 degrees C. This indicates either that Golgi exit is not inhibited at this temperature, or that the processing apparatus exists in the Golgi. A surprising incidental result was that when held in the endoplasmic reticulum at low temperature POMC is apparently subject to post-translational N-linked glycosylation.

Animals↗
PubMed2005

Potocytosis and cellular exit of complexes as cellular pathways for gene delivery by polycations.

BACKGROUND: Although polycations are among the most efficient nonviral vectors for gene transfer, the gene expression they allow is still too low for in vivo applications. To engineer more potent polycationic vectors, the factors governing the intracellular trafficking of a plasmid complexed with current polycations need to be identified. METHODS AND RESULTS: The trafficking of plasmid DNA complexed to glycosylated polylysines or polyethylenimine (PEI) derivatives was studied by electron microscopy of human airway epithelial cells. The cellular processing of complexes varied with their size and the polycation derivative used: large complexes (> 200 nm) made with all polycationic vectors studied were internalized by macropinocytosis. In contrast, intermediate (100-200 nm) ligand-coupled polylysine and PEI complexes primarily entered through clathrin-coated pits. Complexes were then found in endosomal vesicles, accumulated in lysosomes or vesicles near the nucleus and their nuclear entry was limited. For the population of small complexes (< or = 100 nm) obtained with PEI derivatives, they were internalized through caveolae and pursued a traffic pattern of potocytosis to the endoplasmic reticulum where their fate remains unclear. Finally, some complexes exited the cells either by regurgitation when PEI derivatives were used or through an exosome-like pathway for glycosylated-polylysine complexes. CONCLUSIONS: The different pathways of complex trafficking observed in relation with complex size imply the development and study of vectors forming complexes with definite size. Moreover, the complex exit we describe may contribute to the well-established short-term efficiency of gene transfer based on synthetic vectors. It favors the engineering of vectors allowing repeated treatment.

Bronchi↗
PubMed1999

Chromosome separation and exit from mitosis in budding yeast: dependence on growth revealed by cAMP-mediated inhibition.

Cell cycle progression of somatic cells depends on net mass accumulation. In Saccharomyces cerevisiae the cAMP-dependent kinases (PKAs) promote cytoplasmic growth and modulate the growth-regulated mechanism triggering the begin of DNA synthesis. By altering the cAMP signal in budding yeast cells we show here that mitotic events can also depend on growth. In fact, the hyperactivation of PKAs permanently inhibited both anaphase and exit from mitosis when cell growth was repressed. In S. cerevisiae the anaphase promoting complex (APC) triggers entry into anaphase by mediating the degradation of Pds1p. The cAMP pathway activation was lethal together with a partial impairment of the Cdc16p APC subunit, causing a preanaphase arrest, and conversely low PKA activity suppressed the lethality of cdc16-1 cells. Deregulated PKAs partially prevented the decrease of Pds1p intracellular levels concomitantly with the anaphase inhibition, and the PKA-dependent preanaphase arrest could be suppressed in pds1(-) cells. Thus, the cAMP pathway and APC functionally interact in S. cerevisiae and Pds1p is required for the cAMP-mediated inhibition of chromosome separation. Exit from mitosis requires APC, Cdc15p, and the polo-like Cdc5p kinase. PKA hyperactivation and a cdc15 mutation were synthetically lethal and brought to a telophase arrest. Finally, a low cAMP signal allowed cell division at a small cell size and suppressed the lethality of cdc15-2 or cdc5-1 cells. We propose that mitosis progression and the M/G1 phase transition specifically depend on cell growth through a mechanism modulated by PKAs and interacting with the APC/CDC15/CDC5 mitotic system. A possible functional antagonism between PKAs and the mitosis promoting factor is also discussed.

Anaphase↗
PubMedDate not supplied

DNA at the entry-exit of the nucleosome observed by cryoelectron microscopy.

Whereas the DNA path inside the nucleosome is well established, it is essentially unknown in the "entry-exit" region, a missing piece in our understanding of the chromatin fiber's folding. The three-dimensional structure of "linker" DNA was investigated here on single nucleosomes reconstituted without H1 on a 256-bp DNA fragment. Cryoelectron microscopy and three-dimensional reconstruction of the DNA axis reveal these nucleosomes as 1.61 +/- 0.15 left-handed superhelical turn particles whose DNA arms bend away from the core particle, thus preventing the occurrence of a crossing in the entry-exit region.

Animals↗
PubMed2002

The cyclin-dependent kinase inhibitors p19(Ink4d) and p27(Kip1) are coexpressed in select retinal cells and act cooperatively to control cell cycle exit.

Cyclin-dependent kinase inhibitors (cdki's), including p19(Ink4d) and p27(Kip1), mediate exit from the cell cycle. To determine the function of these cdki's in regulating neurogenesis, we examined retina from wild-type, Ink4d-null, and Ink4d/Kip1-double null animals. Ink4d was expressed in progenitors and select neurons in the mature retina. Ink4d-null retina showed an extended period of proliferation, followed by apoptosis. Colabeling for p19(Ink4d) and p27(Kip1) revealed that a subpopulation of cells expressed both inhibitors. Deletion of Ink4d and Kip1 resulted in continued proliferation that was synergistic. This hyperproliferation led to an increase in number of horizontal cells and differentiated neurons reentering the cell cycle. Deletion of Ink4d and Kip1 also exacerbated the retinal dysplasia observed in Kip1-null mice, which was shown to be partly dependent on p53. These data indicate that select retinal cells express both p19(Ink4d) and p27(Kip1) and that they act cooperatively to ensure cell cycle exit.

Amacrine Cells↗
PubMed1979

The erythrocytic entry- and exit-mechanism of Aegyptianella pullorum Carpano, 1928.

The erythrocytic entry- and exit-mechanisms of Aegyptianella pullorum were investigated and characterized by scanning (SEM) and transmission electron microscopy (TEM) using for TEM ruthenium red as a marker of the red cell plasmalemma. The scanned Aegyptianella preparations produced static evidence of an endocytosis followed by an erythrocytic vesiculation as the possible mode of entrance of initial bodies into erythrocytes. The presence of ruthenium red only coating the membrane around the parasitophorous vacuole during the whole invasive process and the complete absence of the stain inside the host cell indicate that the entry of aegyptianellas is accomplished by invagination of the host cell plasmalemma and is not preceded nor followed by its breakage, furthermore unequivocally proving the intracellular parasitism of A. pullorum during its reproductive cycle. One possible mode of exit of initial bodies from parasitized erythrocytes appeared to be the invasive mechanism in reverse order, an exocytosis. Generally, however, the affected erythrocytes are parasitogenically injured, resulting in release of the parasites into the plasma and, subsequently, in host cell lysis.

Animals↗
PubMed1984

Volume regulation by Necturus gallbladder: basolateral KCl exit.

Swelling of the epithelial cells of Necturus gallbladder caused by an 18% reduction in the osmolality of the mucosal bath is followed by rapid volume readjustment. This volume regulatory decrease requires Cl and is sensitive to the K and Cl gradients across the basolateral cell membrane. Volume regulatory decrease is not inhibited by amiloride, SITS, ouabain or bicarbonate removal. The process is blocked by bumetanide in the serosal bath. Measurement of the intracellular activities of K and Cl and the rate of volume regulation under five different experimental conditions showed that KCl exited from the cell across the basolateral membrane with a stoichiometry of 3 K to 2 Cl. This KCl exit process appears to be transiently activated following the reduction in osmolality of the mucosal perfusate.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗
PubMed2005

[Anesthesiological management of the EXIT procedure. Case report and literature review].

The ex-utero intra-partum (EXIT) procedure enables the surgeon to perform invasive procedures in an infant during cesarean section before clamping the umbilical cord. Specific anesthesiological concepts are necessary for ensuring sufficient umbilical perfusion. We report the case of a 33-year-old female undergoing cesarean section in the 36th week of pregnancy because of a large fetal cervical tumor. The EXIT procedure was performed in order to secure the infant's airway during delivery. The anesthesiological management and interdisciplinary tasks are discussed in the literature review.

Adult↗
PubMed2005

Predicting re-victimization of battered women 3 years after exiting a shelter program.

This study examined interpersonal and ecological predictors of re-victimization of a sample of women with abusive partners. All women (N = 124) had sought refuge from a battered women's shelter 3 years earlier, and half the sample had been randomly assigned to receive free, short-term advocacy services immediately upon exit from the shelter. Results 2 years post-intervention revealed positive change in the lives of participants (C. M. Sullivan & D. Bybee, 1999), including a decrease in abuse for women who had worked with advocates. The current study examined intervention effects 3 years after the program ended, as well as other predictors of re-abuse. Nineteen percent of the original sample had experienced domestic violence between 2 and 3 years after shelter exit (65% by current partners, 35% by ex-partners). The advocacy program's effect on risk of re-victimization did not continue 3 years post-intervention. However, having worked with an advocate 3 years prior continued to have a positive impact on women's quality of life and level of social support. The risk of being abused 3 years post-shelter stay was exacerbated by a number of factors present 1 year prior, including women's (1) having experienced abuse in the 6 months before that point; (2) having difficulties accessing resources; (3) having problems with the state welfare system; and (4) having people in their social networks who made their lives difficult. Women were at less risk of abuse if, 1 year earlier, they (1) were employed; (2) reported higher quality of life; and (3) had people in their networks who provided practical help and/or were available to talk about personal matters. These findings support the hypothesis that access to resources and social support serve as protective factors against continued abuse.

Adolescent↗
PubMed1983

Design guidelines for operator entry-exit systems on mobile equipment.

The space available on mobile equipment for an operator's workplace is often restricted and can cause design conflicts. Easy entry and exit is important for safety, productivity and comfort. The paper presents guidelines for the design of entry-exit systems. The recommendations are based mainly on the results of an extensive series of laboratory experiments. These were conducted to establish generally acceptable standards rather than the optimum arrangements more frequently presented in the literature. The need to consider the whole access system is emphasised because of the interactions between the size and location of steps, handholds, doors and workplace arrangement. Some experimental assessment of access systems for new designs is recommended.

Journal Article↗
PubMed1994

Efficient product clearance through exit channels in substrate hydrolysis by acetylcholinesterase.

The channels connecting the active site of acetylcholinesterase (AChE) to the protein exterior were mapped by computational techniques in order to find potential exit routes for charged reaction products. 3.9% of the total volume of the AChE monomer is hollow space and over 50% of the void is located in the center; it is partitioned into three chambers, a deep entry channel, below it a wide channel located in a slightly positive region of AChE and ideally suitable for the exit of negatively charged fragments and a small chamber above Trp84 and Met83. The latter serve as gates for the departure of the positively charged choline product of the hydrolysis of acetylcholine into the small cavity. An efficient product clearance is a prerequisite to a very low energy pathway for the irreversible hydrolysis of acetylcholine.

Acetates↗
PubMed1990

Parasystolic ventricular tachycardia with exit block.

A rare case of parasystolic ventricular tachycardia with variable exit block concurring with runs of reentrant ventricular tachycardia is described. The reentrant ventricular tachycardia or isolated ventricular extrabeats modified the exit block patterns of the parasystolic tachycardia.

Adult↗
PubMed1992

Failure of parasystolic impulses to appear on schedule. Exit block due to concealed conduction of sinus impulses.

A 45-year-old patient free of any heart disease was admitted to the hospital with an electrocardiographic pattern of ventricular parasystole. The parasystolic rhythm was relatively fast, such that several consecutive ectopic complexes manifested. A later tracing reflected only isolated parasystolic complexes with long and fixed coupling intervals. The interectopic intervals, however, were once more in multiple of the parasystolic cycle as directly measured during the phases of undisturbed parasystolic rhythm. In the latter tracing, several scheduled parasystolic impulses did not yield a response, despite calculation suggesting that these impulses occurred outside the refractory period. In other words, an exit block was present. Analysis of the tracing suggests that the exit block was caused by concealed penetration of the sinus impulses into the ectopic-ventricular junction. That is, any sinus impulse penetrates into the junction and renders it refractory, in such a way that only parasystolic impulses that are relatively late within the sinus cycle may be conducted to the surrounding myocardium and result in a parasystolic complex.

Cardiac Complexes, Premature↗