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At least 721 records · Page 40Linked to original sources
PubMed1995

Problems with the fourth-year curriculum of students entering surgical residencies.

BACKGROUND: Because of concerns about the relevance of the fourth-year curriculum of students entering surgical residencies, this study was undertaken to analyze the curriculum, electives, and grades and to compare the students' elective choices with previously documented preferences of surgical educators. METHODS: Computer profiles of all fourth-year students at New York Medical College who entered surgical residencies during a 3-year period were reviewed. The records of 115 students (92 male, 23 female), who were placed in 68 categorical and 47 preliminary positions, comprised the study. Four-week rotations in internal medicine, neurology, and ambulatory medicine were mandatory. An average of 5.1 electives per student, along with time for vacation and interviews, filled the remainder of the year. RESULTS: Students were statistically significantly more likely to receive honors grades in electives. Students, especially those in preliminary positions, frequently selected electives in their eventual specialty choice. CONCLUSIONS: Program directors interviewing prospective candidates for residency should view elective grades with care. Students often take electives that duplicate or do not enhance their career choices. Elective grades are inflated and may be based on subjective evaluations. This issue should be investigated further, and the major surgical education organizations should propose meaningful changes.

Adult↗
PubMed1997

Exposure to soluble nickel in electrolytic nickel refining.

Past and present exposure to nickel was studied in an electrolytic nickel refinery, where an increased incidence of nasal cancer had been reported, using nickel analyses in air, blood and urine. Genotoxic effects were studied using analysis of micronuclei from acridine orange-stained smears from the buccal mucosa of the workers. Workers used respirators or masks in tasks where the exposure was expected to be high. Inside the mask, nickel concentrations were 0.9-2.4 micrograms m-3 in such tasks. In those tasks where masks were not used, nickel concentrations in the breathing zone were 1.3-21 micrograms m-3. Air-borne nickel concentrations (stationary sampling) varied between 230 and 800 micrograms m-3 in 1966-1988 with no systematic change; thereafter lower concentrations (170-460 micrograms m-3) have been observed. After-shift urinary concentrations of nickel were 0.1-2 mumol l-1; they showed no correlation with nickel concentrations in the air. Concentrations of nickel in the urine were still elevated after a 2-4 week vacation. The frequency of micronucleated epithelial cells in the buccal mucosa of nickel refinery workers was not significantly elevated by comparison with referents. No relationship was observed between micronucleus frequencies and levels of nickel in air, urine or blood.

Air Pollutants, Occupational↗
PubMed1997

Occupational exposure to nickel salts in electrolytic plating.

An occupational hygiene survey was made in 38 nickel plating shops in Finland and exposure to nickel was studied by means of biological measurements and, in three shops, by using air measurements. The average after-shift urinary nickel concentration of 163 workers was 0.16 mumol l.-1 (range 0.001-4.99 mumol l.-1). After the 1-5 week vacation the urinary nickel concentration was higher than the upper reference limit of non-exposed Finns indicating that a part of water-soluble nickel salts is accumulated in the body. Urinary nickel concentrations in the shops considered clean in the industrial hygiene walk-through were not different from those observed in the shops considered dirty. The correlation between the concentrations of nickel in the air and in the urine was low, and the amount of nickel excreted in the urine exceeded the calculated inhaled amounts, indicating exposure by other routes such as ingestion.

Adult↗
PubMed1991

Time-resolved magnetic circular dichroism spectroscopy of photolyzed carbonmonoxy cytochrome c oxidase (cytochrome aa3).

Nanosecond time-resolved magnetic circular dichroism (TRMCD) and time-resolved natural circular dichroism (TRCD) measurements of photolysis products of the CO complex of eukaryotic cytochrome c oxidase (CcO-CO) are presented. TRMCD spectra obtained at 100 ns and 10 microseconds after photolysis are diagnostic of pentacoordinate cytochrome a3Fe2+, as would be expected for simple photodissociation. Other time-resolved spectroscopies (UV-visible and resonance Raman), however, show evidence for unusual Fea3(2+) coordination after CO photolysis (Woodruff, W. H., O. Einarsdóttir, R. B. Dyer, K. A. Bagley, G. Palmer, S. J. Atherton, R. A. Goldbeck, T. D. Dawes, and D. S. Kliger. 1991. Proc. Nat. Acad. Sci. U.S.A. 88:2588-2592). Furthermore, time-resolved IR experiments have shown that photodissociated CO binds to CuB+ prior to recombining with Fea3(2+) (Dyer, R. B., O. Einarsdóttir, P. M. Killough, J. J. López-Garriga, and W. H. Woodruff. 1989. J. Am. Chem. Soc. 111:7657-7659). A model of the CcO-CO photolysis cycle which is consistent with all of the spectroscopic results is presented. A novel feature of this model is the coordination of a ligand endogenous to the protein to the Fe axial site vacated by the photolyzed CO and the simultaneous breaking of the Fe-imidazole(histidine) bond.

Binding Sites↗
PubMed2002

Aspects of human parasites in which surgical intervention may be important.

Until recently, physicians and surgeons in developed countries only occasionally encountered patients with parasitic protozoan and helminthic infections. High-speed travel, immigration and the popularity of the tropics as vacation areas have increased the number of people at risk for parasitic disease. This chapter examines the significant literature on a select number of protozoan and helminthic parasites for which surgical intervention is important in the diagnosis, treatment or cure of the disease. Although traditional surgical approaches are covered, emphasis is placed on recent advances in the areas of transplantation and minimally invasive surgery. Combining the disciplines of parasitology and surgery, this chapter covers three protozoan and seven helminthic parasites for which surgery is a valid treatment option based on the frequency of cases reported in the literature. Following coverage of the selected parasites, a table is included listing additional helminths for which surgery contributes to patient management. Physicians in the USA, UK, and Europe need to be more aware of the presentation and treatment of parasitic infections. It is our sincere hope that this review accomplishes that goal, and ultimately benefits the patients we serve.

Adolescent↗
PubMed2002

A mechanism of regulating transmembrane potassium flux through a ligand-mediated conformational switch.

The regulation of cation content is critical for cell growth. However, the molecular mechanisms that gate the systems that control K+ movements remain unclear. KTN is a highly conserved cytoplasmic domain present ubiquitously in a variety of prokaryotic and eukaryotic K+ channels and transporters. Here we report crystal structures for two representative KTN domains that reveal a dimeric hinged assembly. Alternative ligands NAD+ and NADH block or vacate, respectively, the hinge region affecting the dimer's conformational flexibility. Conserved, surface-exposed hydrophobic patches that become coplanar upon hinge closure provide an assembly interface for KTN tetramerization. Mutational analysis using the KefC system demonstrates that this domain directly interacts with its respective transmembrane constituent, coupling ligand-mediated KTN conformational changes to the permease's activity.

Amino Acid Sequence↗
PubMed2004

Martin Winckler.

Martin Winckler, born Marc Zaffran in 1955, is a French family doctor, a writer, a translator, and a cultural critic. Since the publication of La Vacation (Paris: POL, 1989), a novel based on his experience in an abortion clinic, he has published more than 20 books (fiction and non-fiction), including a user's manual of contraceptive devices (Contraceptions mode d'emploi. Vauvert: Le Diable Vauvert, 2003). His novel La maladie de Sachs has been translated into English as The Case of Dr Sachs (New York: Seven Stories Press, 2000). Winckler was recently a guest speaker at the Joint Meeting of the American Society of Bioethics and Humanities and the Canadian Society of Bioethics in Montreal, Canada. He will be a guest speaker at the Royal College of General Practitioners' Spring Symposium, in April this year in Bournemouth, UK.

France↗
PubMed1975

Hearing acuity in young people exposed to pop music and other noise.

An investigation by questionary, otological examination, and audiometry has been carried out on 505 students in higher education. Statistically significant hearing losses were found in the group that admitted frequent attendance at pop-music entertainment compared with a control group. Losses associated with vacation employment in loud noise or with gunfire exposure were also identified. Thses losses were unrecognised before investigation and indicate the need for preventive action.

Adolescent↗
PubMed1976

Dopamine acetylcholine imbalance in Parkinson's disease. Possible regenerative overgrowth of cholinergic axon terminals.

Parkinson's disease is characterised by an imbalance between acetylcholine and dopamine which probably results from the degeneration of a dopaminergic nigrostriatal pathway. A new hypothesis is proposed to explain the development of this imbalance. Applying the concept that degeneration of nerve-fibres in the central nervous system can lead to collateral sprouting of uninjured fibres, it is suggested that the death of dopaminergic nigrostriatal neurons results in sprouting of axons of cholinergic interneurons in the caudate nucleus. This overgrowth could result in the cholinergic innervation of neuronal membranes vacated by degenerated dopaminergic terminals. Thus, the apparent changes in the activity of dopaminergic and cholinergic systems can be accounted for by faulty regeneration in the central nervous system.

Acetylcholine↗
PubMed1989

Male-related chemical cues promote sexual receptivity in the female musk shrew.

The role of conspecific chemical cues in the activation of sexual behavior was investigated in the female musk shrew (Suncus murinus). In Experiment 1, virgin female musk shrews were exposed to either clean cages or cages recently vacated by an adult male. Regardless of whether the male used for the sexual behavior test was "familiar" to the female (having spent the 24 h exposure in his vacant cage) or "unfamiliar," females exposed to male-related cues received mounts from males significantly sooner than females exposed to clean cages. In Experiment 2, females housed for 24 h in a cage soiled by an adult male allowed males to mount significantly sooner than females housed in a cage soiled by a castrated male, another female, or a clean cage. These results demonstrate that chemical cues, produced exclusively by adult males, promote sexual receptivity in female musk shrews.

Animals↗
PubMed1997

Vibrio cholerae non-O1 septicaemia in a patient with liver cirrhosis and Billroth-II-gastrectomy.

This report deals with the first diagnosed case of Vibrio cholerae non-O1 septicaemia in Austria. After a vacation in Tunisia, a 51-year-old male patient with liver cirrhosis and Billroth-II-gastrectomy was admitted to hospital because of abdominal pain, growing ascites, and jaundice. Four days later, the patient developed a single peak of high fever (39.6 degrees C). A blood culture was drawn and treatment with amoxycillin/clavulanic acid commenced. The blood culture yielded Gram-negative comma-like rods which were identified as V. cholerae non-O1.

Abdominal Pain↗
PubMed1983

Group practice--trend for the future.

Group practices in various forms and combinations appear to set the trend for small animal practice management. By pooling their financial resources, energies, and talents, veterinarians can share the burden of increasing overhead costs and enjoy the benefits of specialization, new technologies, continuing education, consultations and referrals, peer review, applied research and publication, and fringe benefits such as paid vacation and sick leave, profit sharing, and pension. Group practices preserve ownership continuity at fair market value and afford opportunities for the utilization of expert business consultants. There are prerequisites to establishing a successful group practice: An adequate personal income base, a sufficient pet population, and business associates with compatible practice philosophy. Special considerations must be given to the social, economic, and psychological forces at work in a group practice environment. Professional and personal interactions can make or break a group practice. The group concept, MIP treatment of clients and their pets, and personalized appointments are important features which must be emphasized. The law of supply and demand and the law of diminishing returns must be kept in focus at all times. In tandem, they dictate the fortunes of all business enterprises and group practices can be particularly vulnerable to them. Long-term business commitment is a condition of group practice ownership and may pose a conflict with other interests. A predetermined buy-sell agreement and deferred compensation plan may provide the answer in case of dissolution, termination, or early retirement. A system of animal and material transport and transfer of business transactions and medical records must be set up between satellite clinics and the base hospital. A hospital-owned-and-operated shuttle service appears to offer the greatest flexibility and convenience. Cost-effectiveness of a shuttle service depends on the volume of referral cases generated for the base hospital. Computers may provide the answer to rapid and reliable transfer of data between satellite clinics and central or base hospitals in the near future. New approaches to small animal medicine and practice management must be explored and adopted. Prepaid pet medical insurance seems to be the answer to rapidly growing sophistication and escalating cost of small animal patient care. Human and companion animal interactions have been given a fresh impetus by veterinary educators, clinical psychologists, psychiatrists, humane societies, organizations for the mentally and physically handicapped, gerontologic centers, and others.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2001

The emergence test: effects of psychotropic drugs on neophobic disposition in Wistar Kyoto (WKY) and Sprague Dawley rats.

1. The Emergence Test (ET), a variation of the open field test in which the rat is not handled, and is purported to measure neophobia, was applied to Wistar Kyoto (WKY) and Sprague Dawley (S-D) rats. 2. While no-stress control WKY rats were less active in the ET, pre-treatment with shock stress exacerbated strain differences. WKY rats, previously exposed to shock, did not emerge from the home cage start box during repeated testing, whereas previously stressed S-D rats vacated the home cage quickly and revealed increasing behavioral agitation. 3. Diazepam reduced emergence latency only in S-D rats, whereas nomifensine significantly increased head poke responses in WKY rats. 4. WKY rats responded to the ET with characteristically depressive behavior, whereas S-D rats responded to the same ET with behavioral agitation and anxiety. The implications of these behavior patterns for discriminating between anxiety and depressive behavior are presented.

Animals↗
PubMed2001

Electrostatic effects on the free-energy balance in folding a ribosome-inactivating protein.

Electrostatics of globular proteins provides structural integrity as well as specificity of biological function. This dual role is particularly striking for ricin A-chain (RTA), an N-glycosidase which hydrolyzes a single adenine base from a conserved region of rRNA. The reported X-ray crystallographic structure of the RTA mutant E177A demonstrated a remarkable rescue of charge balance in the active site, achieved by the rotation of a second glutamic acid (Glu-208) into the vacated space. To understand this conformational reorganization, molecular-dynamics simulations were applied to estimate relative free energies that govern the thermodynamic stability of E177A together with mutants E177Q and E177D. The simulations anticipate that while E177A is a non-conservative substitution, the protein is more stable than the other two mutants. However, the structural plasticity of the RTA active site is not obtained penalty-free, rather E177A among the mutants shows the largest unfavorable net change in the electrostatic contribution to folding. Of the E177A folded state, reorganization of Glu-208 lowers the electrostatic cost of the free-energy change, yet interestingly, protein interactions oppose the rotational shift, while solvent effects favor the transition.

Chemical Phenomena↗
PubMed2002

Effect of hydrophobic surfactant protein SP-C on binary phospholipid monolayers. Molecular machinery at the air/water interface.

Fluorescent and modified dark-field microscopies were used to investigate the phase behavior of physiologically relevant lipid/protein monomolecular films containing surfactant protein C(SP-C). Synthetic human SP-C(1-34) was labeled at its N-terminus using the fluorescent probe 6-(((4(4,4-difluoro-5-(2-thienyl)-4-bora-3a,4a-diaza-s-indacene-3-yl)phenoxy)acetyl)amino)hexanoic acid (BODIPY/TR-X). Using dual fluorescent labeling (lipid and protein) in the monolayers, we have correlated (at physiologically small concentrations of the protein) the lipid phase separation and protein distribution in situ. A comparison of the lipid and protein dye fluorescent micrographs indicates that SP-C(1-34) is preferentially associated with the disordered lipid phase. Three concepts arise from our results. (1) The presence of SP-C alone does not result in the complete dissolution of condensed phase domains in a fashion that we have previously reported for the entire hydrophobic surfactant protein (SP-B/C) fraction (Biophys. J. 77 (1999) 903). Rather, the use of relatively high amounts ( approximately 10 wt.%) of the labeled SP-C protein is needed to reproduce the fluorescence monolayer morphology previously observed for small concentrations ( approximately 1 wt.%) of the natural SP-B/C mixture. (2) Scattered light, dark-field microscopy performed using grazing angle laser illumination reveals the presence of surface-associated, three-dimensional (3D) structures of micrometer-sized dimensions when the labeled BODIPY/TR-X:SP-C(1-34) protein is included in the monolayer, as previously observed with the naturally isolated SP-B/C mixture. The 3D structures are associated exclusively with the presence of the SP-C protein in disordered monolayer phases. (3) To explain these results, we have derived a molecular model accounting for the structure and physico-chemical properties of the SP-C protein in terms of its energetics. The molecular events involved in the SP-C-mediated production of the 3D surface particles are explained using the analogy of a simple molecular machine, namely a loaded spring. This interpretation is supported by an energetic analysis that suggests the major factor contributing to the formation of the 3D particles is the energy liberated by re-expansion of the surrounding phospholipid film into the area vacated by the SP-C protein as it re-orients away from the surface.

Air↗
PubMed1999

Experimental Cochlosoma anatis infections in poultry.

Cochlosoma anatis [Kotlán, A., 1923. Zentralbl. Bakteriol. Parasitenkd. Infektienskr. Hyg. 90, pp. 24-28] is a flagellated protozoan parasite of birds. We have encountered C. anatis in turkeys with enteritis. Experimental oral inoculations of turkeys with 1 x 10(6) to 10 x 10(6) trophozoites consistently reproduced infections in recipients. Trophozoites were most numerous in the jejunum and ileum but could be observed in the duodenum, ceca, colon, and feces. When 12 naive turkeys were placed on contaminated litter vacated by excreting turkeys only one of 12 became infected. When eight naive turkeys were placed in boxes with birds currently excreting trophozoites, seven of eight became infected. Trophozoites could not survive exposure to water or to freezing. Attempts to culture trophozoites in modified Diamond's medium, Kiester's medium, RPMI 1640 medium with 10% fetal bovine serum, or on cultured bovine turbinate cells were not successful. Four of six bobwhite quail and one of eight chickens orally inoculated with 10 x 10(6) to 20 x 10(6) trophozoites had detectable infections. Trophozoites were observed only in the ilea of bobwhite quail and the ceca of the positive chicken. Trophozoites collected from chickens and bobwhite quail remained infectious for turkeys.

Animals↗
PubMed2001

Life threatening burn injuries on holidays: problems of primary care, homeland referral and treatment at a domestic burn centre.

Life threatening burn injuries during vacations abroad raise special problems. Depending on the infrastructure of the country, adequate medical care can be delayed and communication between the patient and the medical staff is frequently impossible due to language barriers. Often the patient finds himself in a critical condition, isolated from supporting relatives and financial difficulties may occur. By summarising three cases referred to our centre, we aim to emphasise particularities of the primary management of burned victims at foreign hospitals, their transport, and following therapy at a domestic burn unit. Primary shock treatment and vital surgical interventions, e.g. escharotomy or treatment of the concomitant trauma, are subject to the facility of the hosting country. After management of the acute phase and initiation of local wound treatment, the next step should be to stabilise and prepare the patient for transport. Aeromedical transportation with physician attendency, as well as contact with a domestic burn centre can be established via responsible organisations. At the domestic hospital, every burn victim from abroad deserves special attention. Wound colonisation with different bacterial species or fungi than the usual spectrum of the centre and the risk of crossinfections should be taken in account of the treating medical team. An structure plan for appropriate and continuing surgical treatment is necessary to prevent deterioration of the patient's condition and to optimise wound closure with autologous skin grafts or allogenic materials.

Adult↗
PubMed1999

Hiring of radiation oncologists by physician groups in 1997.

PURPOSE: To determine the hiring activities of physician groups with respect to radiation oncologists. METHODS AND MATERIALS: A survey was mailed to a stratified, random sample of 589 groups in the fall of 1997. A total of 448 surveys were returned from groups with more than one radiation oncologist or diagnostic radiologist. The response rate was 76%. Responses were weighted to represent the total population of approximately 3286 practices in the United States that have multiple radiation oncologists or diagnostic radiologists. Eighty-seven responding groups had radiation oncologists and are the basis of reported data. Findings were compared to results of similar, previous surveys. RESULTS: In the 12 months prior to the survey, groups sought to hire 289 (SE = 76) radiation oncologists, about the same as in 1996 but well above 1994 and 1995. Almost all the 289 jobs were full-time positions; 70% were to fill expansion positions, 10% were replacements for physicians who had left the profession, and the remaining 20% were replacements for physicians who had moved to other radiation oncology positions. During the year, an additional 83 (SE = 36) positions were vacated that groups did not seek to refill. Private, nonacademic groups offered 26% of their full-time positions on a non-partnership-track basis. Seventy-one percent of available positions were in groups that preferred recently trained radiation oncologists to those with 10-20 years experience. Groups succeeded in hiring 220 (SE = 65) radiation oncologists, 76% of those sought. CONCLUSIONS: In 1997, the number of positions available apparently was approximately equal to the number needed, which is the number of graduates plus the number of experienced radiation oncologists moving to new jobs. However, because our sample was small, there might have been a considerable disparity.

Employment↗