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PubMed1990

Should thrombolytic therapy be administered in the mobile intensive care unit in patients with evolving myocardial infarction? A pilot study.

The growing recognition of the importance of early thrombolysis in evolving myocardial infarction was the basis for the present study, which evaluated the effectiveness, feasibility and safety of prehospital thrombolytic therapy. In a relatively small study, 118 patients were allocated to receive either prehospital treatment with recombinant tissue-type plasminogen activator (rt-PA) in the mobile intensive care unit (group A, 74 patients) or hospital treatment (group B, 44 patients). A total of 120 mg of rt-PA was infused over a period of 6 h. All patients were fully heparinized and underwent radionuclide left ventriculography and coronary angiography during hospitalization. Although group A was treated significantly earlier than group B after onset of symptoms (94 +/- 36 versus 137 +/- 45 min, respectively; p less than 0.001), no significant differences were observed between the groups in 1) extent of myocardial necrosis, 2) global left ventricular ejection fraction at discharge, 3) patency of infarct-related artery, 4) length of hospital stay, and 5) mortality at 60 days. However, a trend to a lower incidence of congestive heart failure at hospital discharge was observed in the prehospital-treated compared with the hospital-treated group (7% versus 16%, respectively; p = NS). No major complications occurred during transportation. It is concluded that myocardial infarction can be accurately diagnosed and thrombolytic therapy initiated relatively safely during the prehospital phase by the mobile intensive care team, thus instituting a beneficial clinical trend in favor of prehospital thrombolysis.

Aged↗
PubMed1996

Subacute stent thrombosis: evolving issues and current concepts.

During percutaneous coronary revascularization, intracoronary stents are effective in the treatment of abrupt vessel closure and improvement of suboptimal angioplasty results, and compared to balloon angioplasty, they reduce stenosis recurrence. Opposing these benefits, subacute thrombosis of stents is associated with a substantial increase in periprocedural morbidity and mortality. To review factors associated with stent thrombosis and to study the impact of evolving procedural techniques on the incidence of stent thrombosis, we reviewed all English articles from MEDLINE (1988 to 1995) with key words "stent" and "thrombosis." Stent registry data and recent abstracts from scientific meetings were also reviewed. Factors related to the clinical setting, the lesion, the stent and the procedural technique that affect the risk of stent thrombosis were identified. Sixty clinical studies were reviewed and include 7,914 patients receiving intracoronary stents. Studies were separated into those reporting stents placed emergently or electively without adjunct high-pressure balloon inflations, stents placed in saphenous vein graft conduits, and stents placed with high-pressure balloon inflations but without subsequent oral anticoagulants. Overall, subacute thrombosis was substantially higher in stents placed emergently (10.1%) compared to those placed electively (4.3%). Among contemporary trials employing high-pressure balloon inflations, the rate of stent thrombosis appears markedly lower (1.3%) despite reduced postprocedural anticoagulation. Taken together, these studies suggest factors associated with a heightened risk of stent thrombosis, many of which can be avoided with proper case selection and contemporary techniques.

Coronary Artery Bypass↗
PubMed1989

Angioplasty after thrombolysis in the treatment of evolving myocardial infarction.

Potent pharmacological agents that rapidly induce coronary thrombolysis reduce morbidity and mortality from evolving myocardial infarction especially when administered early after the onset of ischemia. However, recanalization frequently unmasks residual, high-grade stenoses that can impair reflow, predispose to reocclusion, and limit salvage of myocardium. Coronary angioplasty performed immediately after recanalization induced by thrombolysis reduces the severity of stenosis and can enhance salvage. Unfortunately, complication rates are higher with emergency compared with delayed angioplasty. Thus, mechanical recanalization early after thrombolysis should be reserved for patients with signs or symptoms of recurrent ischemia or for those in whom pharmacological recanalization has failed but a large amount of myocardium remains at risk.

Angioplasty, Balloon↗
PubMed1995

Two karyotypically unrelated clones with 5q- and 20q- in a primary myelodysplastic syndrome patient evolving into acute nonlymphocytic leukemia.

We describe a patient with primary myelodysplastic syndrome (MDS) evolving into acute nonlymphocytic leukemia (ANLL) who had two cytogenetically unrelated abnormal clones. A 68-year-old man presented with refractory anemia with excess of blasts (RAEB) and developed overt ANLL. Two cytogenetically independent clones, one with 5q- and the other with 20q-, were observed when the patient developed ANLL. The clones carrying both 5q- and 20q- were not detected. Leukemic blast cells were positive for peroxidase, naphtol ASD chloroacetate esterase, CD13, CD33, CD34 and HLA-DR, but negative for alpha-naphthyl butyrate esterase, CD14, CD10, CD19, CD20, CD1, CD2, CD3, CD5 and CD7. Although there have been a few reports describing the presence of multiple cytogenetically unrelated clones in one patient with MDS, this is the first case report that the 5q- and 20q- anomalies are derived from independent clones.

Aged↗
PubMed1994

Evolving self-image, pubertal manifestations, and pubertal hormones: preliminary findings in young adolescent girls.

PURPOSE: Recent studies indicate that negative self-image increases in white females during early adolescence. This study was designed to examine the effects of physical and hormonal change during puberty on evolving self-image. METHODS: The study sample consisted of 54 girls aged 10-14 yrs (mean 12.2 +/- 0.9). Evaluations at baseline and one-year follow-up included the Self-Image Questionnaire for Young Adolescents (SIQYA), physical examination, and assays of serum FSH, LH, estradiol, testosterone, and DHEAS. Tanner stage was assessed separately for breast and pubic hair, and the girls were classified as early-, mid-, or late-maturers for each. RESULTS: Pearson correlations between baseline and follow-up scores on the nine SIQYA scales ranged from 0.28-0.72 (P < 0.05); three scales demonstrated declining function (P < 0.05). At baseline, 39 girls (72%) were pre-menarcheal compared to 27 (50%) at follow-up. Mean body mass index (BMI) increased from 18.62 +/- 2.38 to 19.01 +/- 1.84 (P < 0.001), Tanner stages each increased by one, and pubertal timing did not change. LH and testosterone increased (P < 0.05) over the year, DHEAS decreased (P < 0.01), and FSH and estradiol did not change. Stepwise linear regression revealed that change in breast stage was positively correlated with change in Body Image score and change in Adjustment score (beta weights 0.46 and 0.41, respectively). Change in testosterone was negatively correlated with change in Adjustment score (beta weight of -0.46). After controlling for baseline score, change in breast stage was positively correlated and FSH was negatively correlated with follow-up Body Image score (beta weights of 0.40 and -0.24, respectively). CONCLUSION: We conclude that the rate of breast development and FSH level have independent, opposite effects on body image during early adolescence.

Adolescent↗
PubMed2004

Value of electrocardiographic algorithm based on "ups and downs" of ST in assessment of a culprit artery in evolving inferior wall acute myocardial infarction.

Acute myocardial infarction (AMI) of the inferoposterior wall is due to occlusion of the right coronary artery (RCA) or the left circumflex (LCx) coronary artery. The outcome of patients depends mainly on the culprit artery. Therefore, the presumptive prediction of a culprit artery based on the electrocardiogram recorded at admission is of clinical importance. The aim of this study was to develop a sequential algorithm based on the "ups and downs" of the ST segment in different leads to predict the culprit artery (RCA vs LCx) in cases of inferoposterior AMI. We analyzed electrocardiographic and angiographic findings of 63 consecutive patients with an evolving AMI with ST elevation in the inferior leads (II, III, and aVF) and a single-vessel occlusion. Specificity, sensitivity, and positive and negative predictive values of different electrocardiographic criteria (ups and downs of the ST segment) were studied individually and in combination to find an algorithm that would best predict the culprit artery. The following electrocardiographic criteria were included in the 3-step algorithm: (1) ST changes in lead I, (2) the ratio of ST elevation in lead III to that in lead II, and (3) the ratio of the sum of ST depression in precordial leads to the sum of ST elevation in inferior leads [( summation operator downward arrow ST in leads V(1) to V(3))/( summation operator upward arrow ST in leads II, III, and aVF)]. Application of this sensitive algorithm suggested the location of the culprit coronary artery (RCA vs LCx) in 60 of 63 patients (>95%). The few patients in whom this algorithm did not work were those with a very dominant LCx that presented ST depression of > or =0.5 mm in lead I. In conclusion, careful sequential analysis of an electrocardiogram of an inferoposterior AMI with ST elevation may lead to the identification of a culprit artery.

Algorithms↗
PubMed2006

Relation of QT interval measurements to evolving automated algorithms from different manufacturers of electrocardiographs.

QT-interval measurements have clinical importance for the electrocardiographic recognition of congenital and acquired heart disease and as markers of arrhythmogenic risk during drug therapy, but software algorithms for the automated measurement of electrocardiographic durations differ among manufacturers and evolve within manufacturers. To compare automated QT-interval measurements, simultaneous paired electrocardiograms were obtained in 218 subjects using digital recorders from the 2 major manufacturers of electrocardiographs used in the United States and analyzed by 2 currently used versions of each manufacturer's software. The 4 automated QT and QTc durations were examined by repeated-measures analysis of variance with post hoc testing. Significantly larger automated QT-interval measurements were found with the most recent software of each manufacturer (12- to 24-ms mean differences from earlier algorithms). Systematic differences in QT measurements between manufacturers were significant for the earlier algorithms (11-ms mean difference) but not for the most recent software (1.3-ms mean difference). Similar relations were found for the rate-corrected QTc, with large mean differences between earlier and later algorithms (15 to 26 ms). Although there was a <2-ms mean difference between the most recent automated QTc measurements of the 2 manufacturers, the SD of the difference was 12 ms. In conclusion, reference values for automated electrocardiographic intervals and serial QT measurements vary among electrocardiographs and analysis software. Technically based differences in automated QT and QTc measurements must be considered when these intervals are used as markers of heart disease, prognosis, or arrhythmogenic risk.

Algorithms↗
PubMed2006

Sperm motion characteristics of GarolexMalpura sheep evolved in a semi-arid tropical environment through introgression of FecB gene.

The arid and semi-arid tropical climates of India are endowed with vast diversity of non-prolific sheep breeds. The GarolexMalpura sheep has been evolved in a semi-arid tropical environment by introgression of FecB gene via artificial insemination of Malpura ewes using diluted semen of prolific microsheep Garole and subsequently multiplied by inter se mating among GarolexMalpura halfbreds. The aim of the present study was to identify FecB mutation in sexually mature GarolexMalpura rams by forced RFLP-PCR of BMPR-1B gene and evaluate: (i) semen production and sperm motion characteristics of GM rams and (ii) influence of age and FecB genotype on their semen attributes. Semen was collected during autumn season from 12 donor rams by artificial vagina on 8 occasions at weekly interval. The overall means of traits which did not differed significantly with age or FecB genotyping were volume (0.72 ml), mass motility (4.44), sperm concentration (2721.56 x 10(6)ml(-1)), curvilinear velocity (134.51 microm/s), motility (81.3%), amplitude of lateral head displacement (6.24 microm), beat frequency (44.43 Hz), sperm head elongation (48.9%) and sperm head area (10.01 microm(2)). The FecB genotyping had a significant effect (P<0.05) on percent linearity and rapid motile sperms, which did not vary significantly with age. Although sperm concentration was higher in FecB(BB) and FecB(B+), compared to FecB(++) genotypes but the effect was non-significant. The age and FecB genotyping had significant effects (P<0.05) on straightness, average path velocity, straight-line velocity and percentage of medium or slow motile sperms. It is concluded that GarolexMalpura rams with introgressed FecB gene are capable of producing good quality semen in a semi-arid tropical climate.

Aging↗
PubMed2006

ACRM's evolving mission: opportunities to promote rehabilitation research.

This presidential address reflects on the history and mission of the American Congress of Rehabilitation Medicine (ACRM) and considers the benefits derived from joint ownership of Archives of Physical Medicine and Rehabilitation with the American Academy of Physical Medicine and Rehabilitation (AAPM&R). Much of ACRM's history has been distinguished by collaboration with AAPM&R on essential concerns. Evolving organizational priorities have resulted in distinct association missions that have consequences for joint ownership of Archives. The journal has grown in important ways in the past 86 years from a solo editor to an editorial board and to joint ownership and sponsorship of alternating issues. The quality of Archives has improved substantially in the past decade, with an improving impact factor and an increasing number of manuscript submissions. A new contract with the publisher provides an opportunity to consider the relationship between the Congress and Archives and what kind of benefit ACRM desires it to be for its members, to the larger community of physical medicine and rehabilitation (PM&R), and to the persons with disabilities we as PM&R professionals seek to serve. Archives is well positioned to fulfill ACRM's focus on promoting rehabilitation research and facilitating information dissemination and technology transfer. An internationally respected journal is an excellent means to disseminate rehabilitation research that promotes health, independence, productivity, and quality of life for people with disabling conditions. This new chapter in the relationship between Archives and the Academy and Congress provides several opportunities for rehabilitation research leadership. More than ever, Archives provides a premier mechanism to fulfill the Congress's mission and to promote our sense of community.

Biomedical Research↗
PubMed2006

Evolving self-care in individuals with schizophrenia and diabetes mellitus.

Individuals with schizophrenia have higher rates of diabetes mellitus as compared with the general population, but little is known about their diabetic self-care. This grounded theory study was conducted to develop a theory of self-care for individuals with comorbid schizophrenia/schizoaffective disorder and diabetes. Twenty-six interviews were conducted among 11 respondents with varying degrees of ability to care for these coexisting illnesses. Respondents identified psychiatric symptoms as a major barrier to diabetic self-care. The resulting theory of Evolving Self-Care describes the process by which respondents developed self-care health beliefs over time to help them successfully manage their psychiatric disorder and diabetes. Categories include mastering mental illness, accommodating diabetes, and striving for health. When providing care to patients with schizophrenia/schizoaffective disorder and diabetes, advanced registered nurse practitioners are encouraged to provide education about the negative consequences of psychosis on diabetes self-care.

Adolescent↗
PubMed2006

Evolved to satisfy our immediate needs: self-control and the rewarding properties of food.

Evolutionary explanations of overeating in modern society emphasize that humans have evolved to eat to their physiological limits when food is available. The present paper challenges the idea that eating is driven by the availability of food only and proposes that it is regulated by strategic anticipatory behaviour in service of the most profitable long-term scenario as well. Our alternative explanation emphasizes the interaction between the reward system that regulates the liking and wanting of food and the role of self-control, which is involved in maintaining the best outcome in the long run.

Eating↗
PubMed2004

Recent pulsed EPR studies of the photosystem II oxygen-evolving complex: implications as to water oxidation mechanisms.

The pulsed electron paramagnetic resonance (EPR) methods of electron spin echo envelope modulation (ESEEM) and electron spin echo-electron nuclear double resonance (ESE-ENDOR) are used to investigate the structure of the Photosystem II oxygen-evolving complex (OEC), including the paramagnetic manganese cluster and its immediate surroundings. Recent unpublished results from the pulsed EPR laboratory at UC-Davis are discussed, along with aspects of recent publications, with a focus on substrate and cofactor interactions. New data on the proximity of exchangeable deuterons around the Mn cluster poised in the S(0)-state are presented and interpreted. These pulsed EPR results are used in an evaluation of several recently proposed mechanisms for PSII water oxidation. We strongly favor mechanistic models where the substrate waters bind within the OEC early in the S-state cycle. Models in which the O-O bond is formed by a nucleophilic attack by a Ca(2+)-bound water on a strong S(4)-state electrophile provide a good match to the pulsed EPR data.

Electron Spin Resonance Spectroscopy↗
PubMed2006

Drastic changes in the ligand structure of the oxygen-evolving Mn cluster upon Ca2+ depletion as revealed by FTIR difference spectroscopy.

A Fourier transform infrared (FTIR) difference spectrum of the oxygen-evolving Mn cluster upon the S(1)-to-S(2) transition was obtained with Ca(2+)-depleted photosystem II (PSII) membranes to investigate the structural relevance of Ca(2+) to the Mn cluster. Previously, Noguchi et al. [Biochim. Biophys. Acta 1228 (1995) 189] observed drastic changes in the carboxylate stretching region of the S(2)/S(1) FTIR spectrum upon Ca(2+) depletion, whereas Kimura and co-workers [Biochemistry 40 (2001) 14061; ibid. 41 (2002) 5844] later claimed that these changes were not ascribed to Ca(2+) depletion itself but caused by the interaction of EDTA to the Mn cluster and/or binding of K(+) at the Ca(2+) site. In the present study, the preparation of the Ca(2+)-depleted PSII sample and its FTIR measurement were performed in the absence of EDTA and K(+). The obtained S(2)/S(1) spectrum exhibited the loss of carboxylate bands at 1587/1562 and 1364/1403 cm(-1) and diminished amide I intensities, which were identical to the previous observations in the presence of EDTA and K(+). This result indicates that the drastic FTIR changes are a pure effect of Ca(2+) depletion, and provides solid evidence for the general view that Ca(2+) is strongly coupled with the Mn cluster.

Calcium↗
PubMed2006

The affinity concept in bioseparation: evolving paradigms and expanding range of applications.

The meaning of the word affinity in the context of protein separation has undergone evolutionary changes over the years. The exploitation of molecular recognition phenomenon is no longer limited to affinity chromatography modes. Affinity based separations today include precipitation, membrane based purification and two-phase/three-phase extractions. Apart from the affinity ligands, which have biological relationship (in vivo) with the target protein, a variety of other ligands are now used in the affinity based separations. These include dyes, chelated metal ions, peptides obtained by phage display technology, combinatorial synthesis, ribosome display methods and by systematic evolution of ligands by exponential enrichment (SELEX). Molecular modeling techniques have also facilitated the designing of biomimetic ligands. Fusion proteins obtained by recombinatorial methods have emerged as a powerful approach in bioseparation. Overexpression in E. coli often result in inactive and insoluble inclusion bodies. A number of interesting approaches are used for simultaneous refolding and purification in such cases. Proteomics also needs affinity chromatography to reduce the complexity of the system before analysis by electrophoresis and mass spectrometry are made. At industrial level, validation, biosafety and process hygiene are also important aspects. This overview looks at these evolving paradigms and various strategies which utilize affinity phenomenon for protein separations.

Affinity Labels↗
PubMed2006

A platform for evolving intelligently interactive adversaries.

Entertainment software developers face significant challenges in designing games with broad appeal. One of the challenges concerns creating nonplayer (computer-controlled) characters that can adapt their behavior in light of the current and prospective situation, possibly emulating human behaviors. This adaptation should be inherently novel, unrepeatable, yet within the bounds of realism. Evolutionary algorithms provide a suitable method for generating such behaviors. This paper provides background on the entertainment software industry, and details a prior and current effort to create a platform for evolving nonplayer characters with genetic and behavioral traits within a World War I combat flight simulator.

Algorithms↗
PubMed2006

New species in evolving networks--stochastic theory of sensitive networks and applications on the metaphorical level.

In this paper we develop a theory to describe stochastic influences on the fate of new species with non-linear growth rates in evolutionary processes. We develop a theoretical framework based on notions of species, network, innovation, competition, survival and fitness. We introduce a stochastic picture describing the role of fluctuations in the survival of new species in non-linear systems. In particular we consider the fate of new species with non-linear growth. As an application of the general model framework we consider the fate of 'rare species' in early biological evolution. We show that hypercycle systems do not represent the end of the evolutionary process as they may evolve further in small niches. This has implications for different types of applications ranging from biological systems on one level to socio-technological systems on a more metaphoric level.

Biological Evolution↗
PubMed2005

Renal oncocytoma with loss of chromosomes Y and 1 evolving to papillary carcinoma in connection with gain of chromosome 7. Coincidence or progression?

Hybrid tumors of the kidney are not rare. Previous studies of hybrid renal tumors have been valuable for the understanding of the pathogenesis and progression pathways of renal cell neoplasm. In this paper we describe the morphologic, immunohistochemical, and genetic features of 2 oncocytomas with evolving papillary renal cell carcinoma (PRCC) in a nephrectomy specimen of a 60-year old male. The patient was referred for urologic oncology consultation after the incidental discovery of a renal tumor. Nephrectomy was performed and two separate masses were present grossly. The tumors were stained with hematoxylin and eosin, cytokeratin 7 and vimentin. Genetic studies included conventional metaphase cytogenetics and fluorescence in situ hybridization (FISH). Morphologically, both tumors were oncocytomas with numerous microscopic papillary nests and psammoma bodies. Papillary carcinoma nests were highlighted with cytokeratin 7 and vimentin positivity and were more prominent in the larger tumor. Conventional cytogenetics and FISH demonstrated loss of chromosomes Y and 1 and gains of chromosome 7. We postulate that the PRCC represents a neoplastic progression by the gain of chromosome 7 oncocytoma with -Y and -1.

Adenoma, Oxyphilic↗
PubMed2005

Identification and expression of amphioxus beta-microseminoprotein (MSP)-like gene encoding an ancient and rapidly evolving protein in chordates.

The cDNA encoding beta-microseminoprotein-like (beta-MSPL) was identified from the gut cDNA library of amphioxus. It contains a 336 bp open reading frame corresponding to a deduced protein of 111 amino acids and has eight cysteines conserved and located at the same positions as those in the vertebrate beta-MSPs. At amino acid level, it shares 12-20% similarity to the vertebrate beta-MSPs, and seems lacking the signal peptide at the N-terminus. This not only confirms that beta-MSP is a rapidly evolving protein during phylogeny, but also provides further data on the degree of diversity between species of this protein. RT-PCR and Northern blotting show that amphioxus beta-MSPL is expressed in all tissues examined, suggesting that beta-MSPL plays a fundamental role. However, in situ hybridization reveals that positive hybridization signals were present in all blastomeres of the embryos from 4-cell to gastrula stages, while its expression is restricted exclusively to notochord, somites and primitive gut in neurulae and larvae, and disappears in the ectoderm including the neural tube differentiated from the ectoderm. This suggests that beta-MSPL is possibly involved in the differentiation of ectoderm during embryonic development of cephalochordate amphioxus though it is ubiquitously expressed in embryos prior to gastrula stage and in the adult animal.

Amino Acid Sequence↗