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PubMed2005

[Anesthetic management of the ex-utero intrapartum treatment (EXIT) procedure for congenital high airway obstruction syndrome (CHAOS)].

We report an experience of anesthetic management of the ex-utero intrapartum treatment (EXIT) procedure performed in a fetus with congenital high airway obstruction syndrome (CHAOS) due to laryngeal atresia at 30 weeks' gestation. Anesthesia of the mother was induced with rapid sequence, and maintained with 3.5% sevoflurane in 100% oxygen and fentanyl before delivery. Two minimum alveolar concentration (MAC) sevoflurane provided excellent uterine relaxation without maternal hypotension. After hysterotomy, a sterile pulse oxymeter was placed on the fetus hand for monitoring fetal SpO2 and pulse rate, and a Doppler ultrasound transducer was applied to monitor fetal heart rate. Fentanyl (5 microg x dl(-1)) and pancuronium (0.2 mg x dl(-1)) were injected into the fetal upper arm in addition to transplacental anesthetic agents. The fetal heart rate and SpO2 were stable throughout the fetal manipulations, but the rise in SpO2 after initiating ventilation via tracheostomy was very slow. The uterine tone improved soon after discontinuing sevoflurane and oxytocin infusion was started after delivery. Surfactant administration before first ventilation is recommended in preterm babies undergoing EXIT procedure, and capnometer may be useful to confirm the adequate ventilation before cutting the umbilical cord.

Adult↗
PubMed2006

Pig characteristics associated with mortality and light exit weight for the nursery phase.

One thousand and ten weaned pigs that were reared in 1 nursery in Iowa from weaning (17 +/- 2 days ) until 10 weeks of age were evaluated. A weaning weight threshold of 3.6 kg maximized the sensitivity and specificity to correctly predict the likelihood of dying or being light in weight at exit from the nursery (< or = 14.5 kg). Weaning weight < or = 3.6 kg (OR = 2.92), barrow (OR = 1.75), and sow unit (A versus B, OR = 2.14) were significant predictors of mortality in the nursery. Birth weight < or = 1.0 kg (OR = 2.66), weaning weight < or = 3.6 kg (OR = 8.75), gilt (OR = 1.4), sow unit (OR = 2.38), and gilt as nursing sow at weaning (OR = 1.66) were significant predictors of being lightweight at nursery exit. Eighteen per cent of the nursery deaths and almost half of lightweight nursery pigs could be prevented if there were no lightweight pigs at weaning.

Age Factors↗
PubMedDate not supplied

When nurses terminate: the exit interview/questionnaire.

Reliable information on termination issues can enhance retention and recruitment efforts. Blank nursing exit questionnaire/interview forms from 49 hospitals were analyzed. A sample exit questionnaire and recommendations for the collection of data regarding the departing nurse are provided.

Employment↗
PubMed1990

Clinical experience with alumina ceramic transcutaneous connector to prevent skin-exit infection around CAPD catheter.

To prevent skin-exit infection, an important CAPD complication, we developed a transcutaneous connector made of Alumina ceramic. The new connector could be downsized, because an Alumina ceramic is characteristically bio-inert, rigid and non-porous. Our animal experiments with Alumina ceramic in soft tissue demonstrated the outstanding bio-compatibility of this material. The shape of the new transcutaneous connector was of simple cylindrical configuration so as to inhibit macrostress beneath the skin. To make contact with this connector in the body, a silicon tube was made into a Swan-necked catheter with a disk-shaped polyester cuff, which was positioned subcutaneously beneath the transcutaneous connector in order to reinforce adhesion to soft tissue. The silicon tube itself was L-shaped in its outside portion just before reaching the connector. We are now using this new transcutaneous connector made of Alumina ceramic on a CAPD catheter in 8 patients. In the longest case of a patient using it, there has been no skin-exit infection for 12 months. Also, there has been virtually no downgrowth phenomenon in the skin around the connector, and the connector and tissue have remained in very close contact, although fibrous connective tissue has been seen to form in the area.

Aluminum Oxide↗
PubMedDate not supplied

Modes of exit from foster family care and adjustment at time of departure of children with unstable life histories.

In a study of the modes of exit and condition at exit of 585 children who left the care of The Casey Family Program, a program devoted to the care of children who were judged not able to be reunited with their families, the research reveals a number of significant relationships between certain conditions, circumstances, and characteristics of the children previous to admission and their condition upon departure from agency care.

Adolescent↗
PubMed1983

The exit interview: a nursing management tool.

The exit interview can be an important source of data on how employees view their employer--information nurse administrators can use to improve relations between the hospital or agency and nurses and thus to decrease turnover. This article presents a rationale for the exit interview as a serious tool of nursing management and not just a perfunctory routine. It points out both the obvious and hidden costs of employee termination and replacement. Tips on eliciting answers that are informative and useful for improving future operations are given.

Interviews as Topic↗
PubMed1984

A dynamic analysis of women's employment exits.

This research examines women's rates of leaving a job to become nonemployed (unemployed or out of the labor force) using a stochastic, continuous-time model. The data consist of employment histories of white women constructed from the National Longitudinal Survey of Young Women (1968-1973). The results demonstrate the importance of examining the underlying processes in women's employment. Several differences are found between the determinants of employment exits and what might be expected from the cross-sectional and panel literature on female labor force participation. The findings also provide evidence of the interdependence of fertility and employment, with young children increasing rates of employment exits and with high wages on a job decreasing rates of leaving a job because of a pregnancy. Finally, involuntary employment terminations are examined, and their transition rates are found to decrease with job wages and job tenure and to increase when a woman has children.

Adolescent↗
PubMed1978

Electrophysiologic testing in patients with sinus pauses and/or sinoatrial exit block.

28 symptomatic patients with documented episodes of sinus pauses and/or sinoatrial exit block underwent electrophysiologic study. Abnormal responses to electrophysiologic testing were observed in 23/28 patients (82%). Abnormal prolongation of the maximum sinus node recovery time (SNRT max) occurred in 17/28 (61%) patients, of postpacing cycles 2.10 (secondary pauses) occurred in 21/28 (75%), and of estimated sinoatrial conduction time occured in 15/28 (54%). The incidence of abnormal responses to rapid atrial pacing (prolonged SNRT max or secondary pauses) (22/28, 79%) was higher than the incidence of abnormal responses to premature atrial stimulation (15/28, 54%) (P less than 0.005). Life-threatening cardiac arrhythmias were observed, prior to electrophysiologic study, in 5 out of 28 (18%) patients. Symptomatic patients with sinus pauses and/or sinoatrial exit block frequently (23/28, 82%) showed abnormal responses to electrophysiologic testing and have a relatively high incidence of life-threatening arrhythmias.

Adult↗
PubMed1978

[Exit block: a postoperative complication of pacemaker implantation (author's transl)].

Exit block occurs in 7% of cases following implantation of a pacemaker for the first time and appears to be a serious and unpredictable occurrence which cannot be prevented by the selection of a particular technique or type of electrode of pacemaker. Therapeutic measures in patients who are not dependent on a pacemaker consist primarily of exchanging the intracardial lead. In all patients, as well as in those cases with recurrence of exit block, a pulse width-adjustable pulse generator should be implanted without resorting to other methods of questionable efficacy. The implantation of such a pulse generator was successful in all our cases.

Cardiac Pacing, Artificial↗
PubMed1994

Rapid exit from G0/G1 phases of cell cycle in response to stem cell factor confers on umbilical cord blood CD34+ cells an enhanced ex vivo expansion potential.

Currently, the most commonly used grafts of progenitor and stem cells for patients undergoing bone marrow transplantation (BMT) are derived from large collections of autologous or allogeneic adult human bone marrow (BM). The feasibility of using human umbilical cord blood (HUCB), normal peripheral blood (PB), and smaller collections of BM as sources of hematopoietic stem cell grafts for adult patients remains questionable. We investigated the ex vivo proliferative potential of HUCB CD34+ cells as a means of expanding HUCB grafts, thereby making them more acceptable for clinical transplantation. HUCB-derived CD34+HLA-DR+ cells, maintained for 5 days in suspension cultures supplemented with 10% HUCB plasma and a combination of stem cell factor (SCF) and interleukin-3 (IL-3), displayed a 10-fold increase in the total number of CD34+ cells. In contrast, only a four-fold increase was observed in identical cultures initiated with BM-derived CD34+HLA-DR+ cells. Whereas BM CD34+ cells failed to proliferate in response to SCF alone, HUCB CD34+ cells expanded 5.6-fold by day 5, thus demonstrating an enhanced response to SCF. When the effects of SCF on the exit of HUCB cells from G0/G1 phases of cell cycle were investigated, we found that although HUCB CD34+HLA-DR+ cells were more quiescent than BM CD34+HLA-DR+ and BM CD34+HLA-DR- cells (97.5% of HUCB CD34+HLA-DR+ in G0/G1 vs. 88.6% of BM CD34+HLA-DR+ and 92.0% of BM CD34+HLA-DR- [p < 0.005]), HUCB CD34+HLA-DR+ cells exited from dormancy more rapidly than BM cells, such that by 36 to 48 hours following exposure to SCF, only 55% remained in G0/G1. Furthermore, an 8.4-fold increase in the number of HUCB CD34+ cells still residing in G0/G1 was observed on day 5 in cultures supplemented with SCF and IL-3, suggesting the generation of large numbers of primitive hematopoietic progenitor cells (HPC) in vitro. When the contribution of HUCB plasma to the exist of HUCB CD34+HLA-DR+ cells from G0/G1 phases of cell cycle was investigated, it was found that in serum-free media supplemented with only SCF or IL-3, HUCB cells did not exist G0/G1 as rapidly as when HUCB plasma or SCF plus IL-3 was present. In contrast, when HUCB plasma was added to any cytokine combination, it did not enhance the exist of BM CD34+HLA-DR+ cells from G0/G1 phases of cell cycle.(ABSTRACT TRUNCATED AT 400 WORDS)

Antigens, CD↗
PubMed1994

Clinical significance of exit-site infections due to Xanthomonas in CAPD patients: a comparison with Pseudomonas infection.

We have assessed the clinical significance of exit-site infections secondary to Xanthomonas maltophilia in continuous ambulatory peritoneal dialysis (CAPD) patients, and compared them with episodes due to Pseudomonas. The study was a retrospective survey of all episodes of Xanthomonas and Pseudomonas-related exit-site infections (ESI) in all patients treated in our unit between 1984 and 1992. Thirteen episodes of Xanthomonas-related ESI were observed in eight patients and 17 episodes of Pseudomonas-related ESI were seen in 15 patients. Xanthomonas-related ESI was frequently associated with other microorganisms, while Pseudomonas-related ESI was not (66% versus 5%, P < 0.02). Only one episode of Xanthomonas-related ESI resulted in peritonitis and subsequent catheter removal, after 15 months of resistant colonization. Another case was considered to be chronic and indolent, as the Xanthomonas-related ESI continued after 23 months of local treatment. The other 11 episodes were resolved either without treatment or with an antibiotic cream after 7-120 days. However, all but two episodes of Pseudomonas-related ESI required intravenous antibiotics (usually ceftazidime); seven patients developed peritonitis, and 11 required surgical catheter manipulation (five external cuff extrusion, and six catheter removal) (1/13 Xanthomonas-related versus 11/17 Pseudomonas-related ESI, P < 0.03). Most Xanthomonas-related ESI do not lead to peritonitis, and constitute a mild condition, easily treatable without parenteral antibiotics or catheter replacement. The appearance of other associated organisms and the favourable evolution with local treatment suggest a saprophytic behaviour for Xanthomonas in our CAPD patients. On the contrary, Pseudomonas-related ESI is usually severe, requires parenteral antibiotics, frequently leads to peritonitis, and requires catheter replacement.

Adult↗
PubMed1995

p53 involvement in control of G2 exit of the cell cycle: role in DNA damage-induced apoptosis.

DNA damage in proliferating mammalian cells induces a complex cellular response comprising perturbation of the cell cycle and programmed cell death. The relationship between p53-dependent and p53-independent apoptotic cell death, as well as the cell cycle checkpoints induced by DNA damaging agents were explored in hematopoietic cells, using M1 myeloblastic leukemia cells, which are null for p53 expression, genetically engineered M1 variants, expressing p53ts and bcl-2 transgenes, as well as myeloblast enriched bone-marrow cells obtained from wild type p53 (wt p53) and p53-deficient mice. It is shown that gamma-irradiation of M1p53ts cells activated a function of the temperature sensitive mutant transgene p53 (p53ts), promoting increased apoptosis relative to parental, null p53 M1 cells. It is also shown that the kinetics of apoptotic cell death induced by gamma-irradiation correlated with the rapidity of exit from gamma-ray-induced G2 arrest for all the different hematopoietic cell types indicated above. Finally, data has been obtained to demonstrate that, in addition to a role in apoptosis and G1 arrest, wild-type p53 positively modulated the exit from the gamma-ray-induced G2 checkpoint. Taken together, these findings indicate that this new function for p53 is a component of the physiological pathway by which p53 exerts its role in apoptosis.

Animals↗
PubMed1994

Portal films for relative exit dose determinations.

Portal films are radiographic images taken regularly in external photon beam radiotherapy in order to verify geometrical set-up. However, they also contain quantitative dose information. Absolute dosimetry with film is possible but the desired accuracy of +/- 5% is difficult to achieve. However, relative dosimetry with film would be useful in combination with a point determination of absolute dose, though a dose response linearisation is required for relative dosimetry over the range of doses given to portal films in routine clinical practice. For this purpose, a technique for the rapid dose response linearisation of portal films is investigated in simulated treatment situations and evaluated in terms of the ability to yield relative exit dose distributions from the portal films. A combination of such distributions with a single determination of radiation transmission with diodes should generate full two-dimensional transmission information. Distributions obtained from two anthropomorphic phantoms provided results consistent with distributions obtained from a treatment planning system to generally within +/- 5%, and most often within +/- 2%. It is concluded that the extraction of exit dose information from portal films would be useful for mantle, compensated, or other unusual treatment situations.

Calibration↗
PubMed1996

Radicicol inhibits tyrosine phosphorylation of the mitotic Src substrate Sam68 and retards subsequent exit from mitosis of Src-transformed cells.

Sam68 (Src-associated in mitosis 68 kDa) is a protein that associates with and is tyrosine phosphorylated by Src in a mitosis-specific manner, thereby raising the possibility of a role for Src in the regulation of the cell cycle. This study examines the effects of radicicol, a Src tyrosine kinase inhibitor, upon both the phosphorylation of Sam68 and mitotic progression in Src-transformed mouse fibroblasts. Radicicol reversibly inhibits the mitosis-specific tyrosine phosphorylation of Sam68 in vivo, as determined by antiphosphotyrosine immunoblotting. Radicicol inhibits the tyrosine phosphorylation of both free and Src-associated Sam68, suggesting the presence of two intracellular pools of tyrosine phosphorylated Sam68 in mitotic cells. In addition, radicicol treatment has no effect on the ability of cells to enter mitosis, indicating that tyrosine phosphorylation of Sam68 is probably not important for cells to enter mitosis. However, radicicol reversibly retards the exit of cells from mitosis, as determined by flow cytometric analyses. Radicicol mediated inhibition of Sam68 tyrosine phosphorylation, and its concurrent ability to block mitotic exit suggests the possibility of a significant role for Src kinase and this unique mitotic substrate, Sam68, in cell cycle regulation.

3T3 Cells↗
PubMedDate not supplied

New trends in exit interviews.

Yes, healthcare settings are changing, and so are the reasons nurses give for leaving their positions. Exit interviews are showing that the restructuring changes are taking a toll on the nurses and dissatisfaction with workloads, professional climate, and support services are increasing. This author describes the recent changes she has found in exit interviews.

Employment↗
PubMed1997

Metastatic head and neck cancer to the percutaneous endoscopic gastrostomy exit site: a case report and review of the literature.

Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure and is an important supportive treatment adjunct for patients with head and neck cancer. We report a case in which squamous cell carcinoma of the larynx implanted at a PEG exit site. This was resected for cure. In this case, and in five others reviewed in the literature, the PEG placement method was the "pull" technique. It is unknown whether other methods of PEG placement may reduce metastatic implants at the PEG exit site, but the possibility of this complication must be considered.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Natural history of Staphylococcus aureus nasal carriage and its relationship to exit-site infection.

OBJECTIVE: To study the natural history of nasal carriage of Staphylococcus aureus (SA) and its impact on exit-site infection (ESI). SETTING: A teaching hospital single-center study. DESIGN: A prospective cohort study in prevalent continuous ambulatory peritoneal dialysis (CAPD) patients. PATIENTS: 153 patients (76 male, 77 female; mean age 46 years) with a mean duration of CAPD of 2.4 years. METHODS: Nasal swabs were taken at approximately 2-month intervals over the mean period of follow-up of 22.6 months and cultured for SA. RESULTS: An average of 69% of patients received systemic antibiotics for therapy of ESI, peritonitis, and other infections during the period of the study, but none received local nasal antibiotics. Four groups of patients were identified according to their nasal carriage history: chronic, intermittent, occasional, and noncarriers. The intermittent and chronic carriers had significantly higher SA ESI than the occasional and noncarrier groups. The intermittent group also had the highest percentage of non-SA ES infections. CONCLUSION: Although this study shows that only half of our CAPD patients with nasal carriage were at risk of developing ESI, we recommend that patients with a positive nasal swab at the start of CAPD therapy should be treated with nasal antibiotics or local antibiotics at the exit site.

Catheters, Indwelling↗
PubMed2025

Targeting Mitotic Exit in Malignant Cells.

In order to sustain genomic stability by correct DNA replication and mitosis and thus avoid malignant transformation of cells, the cell cycle is a strictly regulated process. Aberrant cell cycle regulation and defects in mitosis in malignant cells are targets of various cancer therapies. Cancer cells may survive antimitotic treatment due to mitotic slippage with a residual activity of the ubiquitin ligase anaphase-promoting complex (APC/C) and a continuous slow ubiquitin-proteasome-dependent cyclin B-degradation leading to mitotic exit. The combination of antimitotic chemotherapeutics with proteasome inhibitors to block cyclin B-proteolysis or with targeted inhibitors of the APC/C and the antiapoptotic protein Mcl-1 seems a promising approach to improve treatment response in different malignancies by enhancing mitotic arrest and apoptosis.The influence of conventional spindle poisons and new targeted substances and of their combinations on mitosis and apoptosis has not yet been conclusively clarified. Most models have been verified on cell lines whose biology may differ from that of tumors growing in vivo. To study the impact of various antimitotic substances on cell proliferation, especially detect onset of apoptosis depending on different cell cycle phases and thus to identify a possibly entity-dependent mechanism of those agents and their combinations, a combined approach with live-cell imaging and soft-agar colony assays in cultured patient-derived xenografts (PDX) was established.

Humans↗