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PubMed2001

[Large uterine myoma during pregnancy and delivery - choice of management].

There are scanty of available data about the management of myoma of the uterus during pregnancy and birth. The authors describe two cases of such a pathology--big myoma of the uterus > 10 sm diameter (d.), who were treated conservatively and ended successfully, without serious complications. The pregnant women were done cesarean section and during the operation the myomas were excisiert. There were no complications intra- and postoperationem. The authors suggest that myectomy during pregnancy and cesarean section must not be don routinely.

Adult↗
PubMed2002

[Industrial hand injuries by punch machines: a case-control study].

OBJECTIVE: To identify factors associated with industrial hand injuries by punch machines. METHODS: From September, 1999 to June, 2000, 108 patients of industrial hand injuries by punch machines were collected. For each patient, 2 controls were randomly selected. One was from the same industry; the other was from a big industry with thousands of punch machines. They matched on gender, job and age. In-person interviews were conducted to collect data on demographics, work history, work characteristics, work injuries, work organization, health behaviors, anthropometric and psychological factors. The Eysenck Personality Questionnaire (EPQ) was selected to evaluate the psychological performance. Risk factors were examined via multivariate logistic regression techniques. RESULTS: There were four important factors affecting hand injuries by punch machines: The first was the length of service index (odds ratio [OR] = 0.972, 95% confidence interval [CI] = 0.957, 0.988). The second index was neuroticism (OR = 1.649, 95% CI = 1.264, 2.151). A safety equipment index (OR = 0.260, 95% CI = 0.123, 0.547) and a safety operation criterion index (OR = 0.136, 95% CI = 0.064, 0.286) were also significant factors. CONCLUSIONS: Results suggest that the accident-prone population are those who have shorter service length and neurotic psychological performance. It may reduce the incidence of industrial hand injuries by punch machine to strengthen the appliance of safety equipment and enforcement of safety operation criterion, especially to the accident-prone population.

Accidents, Occupational↗
PubMed1983

[Effect of melatonin on L-leucine aminopeptidase in the hypothalamus and cerebral cortex of the normal and ovariectomized rat].

The effect of melatonin (500 micrograms/kg weight s.c. for 15 consecutive days) on the L-leucine amino peptidase (LAP) activity of the hypothalamus and brain cortex is studied on castrated and nan castrated rats. There was a significant increase in the LAP activity of hypothalamus (p less than 0.001 v.s. saline group) in the non castrated group, however, no changes were observed in the brain cortex. In the ovariectomized group injected from the 15th to 30th after castration, a very big decrease was recorded in the LAP activity in both the hypothalamus and brain cortex which was not modified by melatonin. This data is studied in relationship to the antigonadotrophic effect of melatonin on the non castrated animals since the changes of this activity in the hypothalamus are inversely related to the gonadotrophin secretion, specially luteinizing hormone.

Animals↗
PubMed1993

TNF alpha mRNA expression in bronchoalveolar lavage cells from patients with lung fibrosis and TNF alpha activity in the lavage supernatants.

Tumor necrosis factor alpha (TNF alpha) mRNA expression in bronchoalveolar lavage (BAL) cells from patients with lung fibrosis was studied by a reverse transcription-DNA polymerase chain reaction (RT-PCR). The results indicated that two thirds of the tested samples were TNF alpha mRNA positive. On the other hand, TNF alpha activity was detected in a big part of the BAL supernatants from the patients. Furthermore, recombinant TNF alpha was found to be mitogenic to lung fibroblasts. These data suggest that TNF alpha expression in BAL cells may play a role in the development of lung fibrosis in human.

Base Sequence↗
PubMed1996

Pencil and paper: the simple solution to getting the numbers you need to effectively manage your practice.

Once you have mastered the basics by going through the monitoring exercise once or twice, you will find it takes little time and effort to start finding out just where your practice stands. You only solve a problem after you have found out that there is one and you might find that this simple monitoring exercise shows you areas of your practice where a little attention from you will pay big dividends. Monitoring is like a fine wine: it improves with age. As you begin to compile more and more months of data, you will be able to start comparing this month's performance with last month's, or this quarter with last quarter, this year with last year. One of the most useful things monitoring will do for you is to allow you to compare your practice's performance with that of other practices. Averages, norms, and performance survey results are to be found in a range of practice management publications. Using your monitoring information in this comparative way helps you to identify those areas in your practice management that are holding you back from achieving your true potential. This lets you focus your management time and effort on the truly important issues, which, when solved, will help you turn your practice into a less stressful, more enjoyable, and more profitable place to work.

Budgets↗
PubMed1996

[A documentation procedure for community social psychiatry services--a pilot project in Bielefeld and Minden].

The status of health reporting (on community levels) has improved considerably during recent years. It is being increasingly used as an instrument for planning, controlling and evaluating political processes. In addition to individual studies the statistics within the departments of the health authorities are an important factor for meaningful health reporting on a local level. The IDIS (from Jan. 1st, 1995 LOGD) and the social psychiatric services on the Minden-Lübbecke district and the city of Bielefeld have developed a programme for automation-aided management of the statistics for social psychiatric services on a local level. Details on the personal situation and illnesses of the clients as well as on the activities of the services staff are recorded and analysed. Based on the WHO programme EPI-info 6.01 the documentation programme SPD-STAT was developed. This programme is menudriven and, in addition to the functions for the statistical data input and retrieval of fixed table sets, also offers the possibility of processing data with the full functionality of the ANALYSIS-module of EPI-Info. Thus interactive ad-hoc evaluations for current questions are made possible. Using SPD-STAT in as many local regions in NRW as possible may be a big step forward for health reporting on local levels as well as for health reporting on a state level.

Community Health Planning↗
PubMed1998

A weapon-related injury surveillance system in New York City.

CONTEXT: Assault injuries and deaths are a major public health problem in New York City but they are poorly understood because there is a dearth of information concerning them. OBJECTIVE: Develop and implement a low-cost, efficient, permanent weapon-related injury surveillance system (WRISS) for the city. DESIGN: WRISS was established, using a hierarchical exclusionary model, to capture all weapon-related (gunshot, stab, blunt instrument trauma) mortality and morbidity. SETTING: The five boroughs of New York City: The Bronx, Brooklyn, Manhattan, Queens, and Staten Island. PARTICIPANTS: NYC Vital Statistics Office, New York State hospital discharge database, Statewide Planning and Research Cooperative Systems (SPARCS), hospital emergency departments, and the police department. MAIN OUTCOME MEASURES: Surveillance system simplicity, acceptability, flexibility, cost. RESULTS: NYC WRISS is a simple surveillance system depending on both existing data sources and active data collection, and is therefore acceptable to providers. It is flexible and has allowed assault injuries without weapons to be added to better reflect domestic assaults. The cost is low, less than $60,000 per year. CONCLUSIONS: NYC WRISS is an efficient, cost-effective surveillance system, particularly suited to big cities with many assault injuries. Its low cost and obvious importance as a public health tool have allowed for its institutionalization, reflected by a permanent health department position, and annual reports alongside the more traditional public health surveillance systems. Analyses of data from 1990 to 1996 have lent new understanding to the decrease in homicides and assaults in New York City during that period.

Adolescent↗
PubMed1999

4-chloro-o-phenylenediamine induces a dose-related increase in G:C > T:A transversions and one major DNA adduct in the liver of Big Blue mice after 26 weeks in feed treatment.

The monocyclic aromatic amine 4-chloro-o-phenylenediamine (4-C-o-PDA), a known mutagen and mouse hepatocarcinogen, was tested for its in vivo mutagenic potential in the Big Blue transgenic mouse assay system. Genomic DNA was isolated from liver tissue of control and treated animals and lacI mutants were recovered. In an initial 2-week study 4-C-o-PDA was administered daily per os to groups of male and female C57BL/6 Big Blue mice at doses of 0 and 200 mg/kg for 2 weeks (on working days) followed by a treatment free expression time of 10 days. Only a weak increase in the mutant frequencies in females was observed. In a 26-week study, where 4-C-o-PDA was given to groups of male and female Big Blue mice in feed at dietary concentrations of 0, 5,000 and 10,000 ppm, 4-C-o-PDA was found to induce a pronounced dose-dependent increase in mutant frequencies in either sex. In the present work, we analyzed the mutation spectrum by automated DNA sequencing of lacI mutants from both studies. Following the 2-week administration of 4-C-oT:A transversions in both sexes. In addition, upon 26-week treatment with 4-C-o-PDA, one major DNA adduct was detected by 33P postlabelling and subsequent multidimensional thin layer chromatography. It is concluded that 4-C-oT:A transversions after 26 weeks in feed treatment. This result indicates that the sensitivity of the Big Blue transgenic assay system, in detecting a unique chemically induced mutation spectrum, is dependent on experimental parameters, such as treatment time. The data suggest that the formation of one major DNA adduct upon 4-C-o-PDA treatment may be critical for its mutagenicity.

Adenine↗
PubMed2004

Rejuvenation of the lithosphere by the Hawaiian plume.

The volcanism responsible for creating the chain of the Hawaiian islands and seamounts is believed to mark the passage of the oceanic lithosphere over a mantle plume. In this picture hot material rises from great depth within a fixed narrow conduit to the surface, penetrating the moving lithosphere. Although a number of models describe possible plume-lithosphere interactions, seismic imaging techniques have not had sufficient resolution to distinguish between them. Here we apply the S-wave 'receiver function' technique to data of three permanent seismic broadband stations on the Hawaiian islands, to map the thickness of the underlying lithosphere. We find that under Big Island the lithosphere is 100-110 km thick, as expected for an oceanic plate 90-100 million years old that is not modified by a plume. But the lithosphere thins gradually along the island chain to about 50-60 km below Kauai. The width of the thinning is about 300 km. In this zone, well within the larger-scale topographic swell, we infer that the rejuvenation model (where the plume thins the lithosphere) is operative; however, the larger-scale topographic swell is probably supported dynamically.

Journal Article↗
PubMed2002

Skin as a potential organ for ectopic monoclonal antibody production.

The therapeutic potential of monoclonal antibodies for treating a variety of severe or life-threatening diseases is high. Although intravenous infusion appears the simplest and most obvious mode of administration, it is not applicable to many long-term treatments. It might be advantageously replaced by gene/cell therapies, however, rendering treatments cost-effective and eliminating the short- and long-term side-effects associated with injection of massive doses of antibodies. We have tested whether skin can potentially be used as an organ for production and systemic delivery of ectopic antibodies. Normal human primary keratinocytes were shown to be capable of synthesis and secretion of a model monoclonal antibody directed against human thyroglobulin upon retroviral gene transduction in vitro. Neo- epidermis reconstructed in vitro, either in cell culture inserts or on dermal substrates, from such modified keratinocytes also produced the monoclonal antibody. Interestingly, the latter could cross the epidermis basal layer and be released in culture fluids. Finally, grafting of epidermis reconstituted in vitro on dermal substrates to SCID mice permitted sustained monoclonal antibody delivery into the bloodstream to be achieved. Our data thus show that genetically engineered keratinocytes can potentially be used for genetic antibody-based immunotherapies. They also indicate that proteins as big as 150 kDa, after release by engineered keratinocytes into skin intercellular spaces, can migrate to the general circulation, which is potentially important for a number of other gene-based therapies.

Animals↗
PubMed1998

[Evaluation of oral health in the adult population from ages 35-44 in Poland].

The aim of the paper has been to provide objective data comparable to world literature, on the status of masticatory organ in the population of adults aged 35-44 years in Poland. As many as 1380 subjects were studied in 9 voivodeships with due consideration to three inhabited environments: big town, small town and village. The studies were performed in artificial lighting, using a probe and dental mirror, on the basis of methodology found in the WHO instruction of 1986 (Fig. 1.). The status of periodontium and the therapeutic requirements in that respect were assessed by resorting to CPITN index and WHO 621 periodontologic probe. The data concerning the status of dentition reveal a high frequency of caries, claiming 99.8%, as well as high intensity of caries expressed by mean number of DMF equal to 18.6. Despite the fact that the provided index values are comparable to values reached by the majority of developed countries, in case of Polish population aged 35-44 years there is, unlike those countries, very unfavourable distribution for components of D, M and F. The highest value (10.5) is requested by the mean number of missing teeth (M), by mean number of carious teeth (D) with 4.1, while, unfortunately, the lowest being the mean number of filled teeth (F), which is hardly 4.0. So high means of numbers for missing teeth and carious ones indicate that despite the low percentage of toothless subjects in the studied population (1.0%), it will be impossible to reach the 4th health target launched by WHO in the year 2000, it means a 50% reduction in the number of toothless subjects aged 35-44 years. It is evident from data concerning the status of dentition that in the oral cavity of each subject studied there were on the average 21 teeth whereof only 37.2% were made up of healthy teeth. The presence of healthy teeth was recorded more frequently in mandible than in maxilla and most frequently these were incisors and lower canines. Missing teeth (regardless of cause) were disclosed more frequently in maxilla than in mandible. The analysis of the missing teeth according to individual group of teeth reveals their very unfavourable distribution primarily in the lateral segments, it means in zone of support of the masticatory organ. That results in its far reaching consequences with regard to parodontial diseases and temporo-mandibular joints. The established results of studies covering parodontium disclose that it is unrealistic to achieve the 2nd periodontological target of health fixed by WHO for the year 2000, assuming that 75.0% of population aged 35-44 years should possess at least 3 healthy sextants, while deep periodontal pockets (6 mm) were detected in 15.0% of the examined subjects. The poor status of parodontal health is accompanied by colossal need of treatment in this respect. Almost 100% of subjects required instructions with regard to brushing as well as professional procedure in removing dental deposits, whereas 15.0% of the studied demanded specialistic periodontal treatment. The health status of parodontium and the therapeutic demands in this respect for Polish population are also unfavourable against the background of the population residing in the developed countries. The considerable dental losses revealed in the investigation exerted an influence on the prosthetic state of requirements closely related to the above finding. The analysis of data points to high percentages of persons not using removable dentures, particularly the lower ones. It was simultaneously noted that women were more frequent users of movable dentures both upper and lower. No therapeutic requirements involving the upper removable denture were evidenced in a higher percentage of the studied subjects than in the case of lower movable dentures. More persons asked for partial upper denture than lower. As concerns complete denture the situation is found to be reversed. It appears from the data concerning the temporo-mandible joints that in 70.6% of

Adult↗
PubMed2002

Echidna IgA supports mammalian unity and traditional Therian relationship.

IgA is found only in birds and mammals where it is the principal immunoglobulin class found in secretions, providing protection at mucosal surfaces. The structure of IgA in birds is different from that of marsupials and eutherians. The avian heavy-chain constant region of IgA (Ca) consists of four domains, while marsupial and eutherian Ca consists of three domains plus a hinge. Here we describe the cloning and characterization of the heavy chain of IgA from the short-beaked echidna, Tachyglossus aculeatus, and report that monotreme Ca is composed of three domains plus a hinge, making it similar to its therian counterparts. The amino acid sequence identity of echidna Ca is approximately 47% with the therians and 30% with birds. Phylogenetic analysis of the Ca sequences provides strong support for the Theria hypothesis, which proposes that monotremes diverged prior to the separation of marsupial and eutherians, and directly contradicts the results of the mitochondrial data, which support a "Marsupionta" relationship which has marsupials and monotremes closer to each other. The characterization of the heavy chain of IgA from monotremes, in conjunction with the recent description of monotreme IgG and IgE nucleotide sequence, confirms that the "second big bang" of immunoglobulin evolution predated the divergence of extant mammals.

Amino Acid Sequence↗
PubMed2005

Endogenous estrogen status, but not genistein supplementation, modulates 7,12-dimethylbenz[a]anthracene-induced mutation in the liver cII gene of transgenic big blue rats.

A growing number of studies suggest that isoflavones found in soybeans have estrogenic activity and may safely alleviate the symptoms of menopause. One of these isoflavones, genistein, is commonly used by postmenopausal women as an alternative to hormone replacement therapy. Although sex hormones have been implicated as an important risk factor for the development of hepatocellular carcinoma, there are limited data on the potential effects of the estrogens, including phytoestrogens, on chemical mutagenesis in liver. Because of the association between mutation induction and the carcinogenesis process, we investigated whether endogenous estrogen and supplemental genistein affect 7,12-dimethylbenz[a]anthracene (DMBA)-induced mutagenesis in rat liver. Intact and ovariectomized female Big Blue rats were treated with 80 mg DMBA/kg body weight. Some of the rats also received a supplement of 1,000 ppm genistein. Sixteen weeks after the carcinogen treatment, the rats were sacrificed, their livers were removed, and mutant frequencies (MFs) and types of mutations were determined in the liver cII gene. DMBA significantly increased the MFs in liver for both the intact and ovariectomized rats. While there was no significant difference in MF between the ovariectomized and intact control animals, the mutation induction by DMBA in the ovariectomized groups was significantly higher than that in the intact groups. Dietary genistein did not alter these responses. Molecular analysis of the mutants showed that DMBA induced chemical-specific types of mutations in the liver cII gene. These results suggest that endogenous ovarian hormones have an inhibitory effect on liver mutagenesis by DMBA, whereas dietary genistein does not modulate spontaneous or DMBA-induced mutagenesis in either intact or ovariectomized rats.

Amino Acids↗
PubMed1994

Modeling large RNAs and ribonucleoprotein particles using molecular mechanics techniques.

There is a growing body of low-resolution structural data that can be utilized to devise structural models for large RNAs and ribonucleoproteins. These models are routinely built manually. We introduce an automated refinement protocol to utilize such data for building low-resolution three-dimensional models using the tools of molecular mechanics. In addition to specifying the positions of each nucleotide, the protocol provides quantitative estimates of the uncertainties in those positions, i.e., the resolution of the model. In typical applications, the resolution of the models is about 10-20 A. Our method uses reduced representations and allows us to refine three-dimensional structures of systems as big as the 16S and 23S ribosomal RNAs, which are about one to two orders of magnitude larger than nucleic acids that can be examined by traditional all-atom modeling methods. Nonatomic resolution structural data--secondary structure, chemical cross-links, chemical and enzymatic footprinting patterns, protein positions, solvent accessibility, and so on--are combined with known motifs in RNA structure to predict low-resolution models of large RNAs. These structural constraints are imposed on the RNA chain using molecular mechanics-type potential functions with parameters based on the quality of experimental data. Surface potential functions are used to incorporate shape and positional data from electron microscopy image reconstruction experiments into our models. The structures are optimized using techniques of energy refinement to get RNA folding patterns. In addition to providing a consensus model, the method finds the range of models consistent with the data, which allows quantitative evaluation of the resolution of the model. The method also identifies conflicts in the experimental data. Although our protocol is aimed at much larger RNAs, we illustrate these techniques using the tRNA structure as an example and test-bed.

Anticodon↗
PubMedDate not supplied

[Total enteral nutrition versus mixed enteral and parenteral nutrition in patients at an intensive care unit].

OBJECTIVE: To compare metabolic, nutritional and epidemiological data in two groups of patients, one receiving total enteral nutrition, via nasoenteric tube, and one receiving both enteral and parenteral nutrition. DESIGN: A prospective, randomized study. SETTING: A general ICU, with both medical and surgical patients, in a big regional University and National Health Service hospital. PATIENTS: 24 patients requiring Intensive Care after major surgery or because suffering from severe head injury or major neurological impairment. INTERVENTIONS: All patients initially received total parenteral nutrition: after 4 days 12 patients were "weaned" to total enteral nutrition and 12 stayed on mixed parenteral and enteral nutrition. LABORATORY INVESTIGATIONS AND OBSERVATIONAL DATA: Blood levels of albumin, prealbumin, transferrin, ALT, AST, bilirubin, blood urea, blood glucose, total linfocite count, and nutritional and epidemiological data such as nitrogen balance, calorie intake, diarrhea incidence, blood and sputum cultures and radiologic evidence of pneumonia are analysed. RESULTS: At T1, NET patients were able to reduce their nitrogen losses (0.27.1 g/kg +/-0.12 vs 0.35 +/- 0.13 at TO; p < 0.05) and improve nitrogen balance (-9 +/- 7 vs -2 +/- 6 at T0; p < 0.05); they also had a better total linfocite count (2034 +/- 304 vs. 1413 +/- 360 of the MISTA group; p < 0.05), and a lower incidence of pneumonia as documented by sputum cultures and radiograms. CONCLUSIONS: Patients fed with both parenteral and enteral nutrition did no better than those on total enteral nutrition as far as nutritional and metabolic indices were concerned; they also seemed more prone to infections than those on total enteral nutrition, indicating that mixed nutrition may result in more stable feeding, but this does not seem to have any beneficial nutritional, immunological and metabolic effect.

Adolescent↗
PubMed2005

Can openEHR Archetypes Empower Multi-Centre Clinical Research?

The Electronic Health Record is of utmost importance to enable the provision of high-quality collaborative care; one prominent development is openEHR. On the other hand, a systematic approach to support the use of routine data for multi-centre clinical research is becoming increasingly important. One example of this is the extensible architecture for using routine data for additional purposes (eardap) which features comprehensive terminological support. However, as experiences in various medical fields have shown, the terminology-based approach is limited to specialized fields and it is argued that a comprehensive terminology is simply too complex and too difficult to maintain. As the openEHR archetype approach does not rely heavily on big standardized terminologies, it offers more flexibility during standardisation of clinical concepts and overcome the shortcomings of terminology-focused approaches. It is unknown, however, how far the more generic openEHR approach can also enable re-use of routinely collected data for clinical research purposes - the use case for which eardap was designed. We therefore explored the feasibility of using the openEHR approach to support multi-centre research in comparison to eardap. Generally speaking, our results show that both eardap and openEHR are suitable to enable the use of routine data for multi-centre clinical research. As the openEHR approach also ensures open, future-proof Electronic Health Records, we conclude that it is highly desirable that multi-centre clinical trials adopt openEHR.

Biomedical Research↗