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At least 109 records · Page 6Linked to original sources
PubMed1969

Studies on the advent of ureotelism. The effects of bivalent cations on the capacity of the hepatic arginase of the Mexican axolotl to hydrolyse endogenous arginine.

1. The effects of 19 bivalent cations on the activity, stability and capacity to hydrolyse endogenous arginine of axolotl liver arginase were studied. 2. It was found that Fe(2+), Co(2+), Ni(2+) and Zn(2+), as well as Mn(2+), stabilize the enzyme and render it able to hydrolyse endogenous arginine. 3. By using different concentrations of Co(2+) and Ni(2+) it was possible to dissociate the effect of each of the metal ions on the activity and stability of arginase from that on its capacity to hydrolyse endogenous arginine. 4. The effects of Mn(2+), Co(2+) and Ni(2+) on the activity and stability of arginase in the homogenate were also observed with purer preparations of the enzyme. 5. It is suggested that the capacity to hydrolyse endogenous arginine is a consequence of the integration of arginase with the arginine-formation sites.

Animals↗
PubMedDate not supplied

The advent of high-tech home care in Germany.

The purpose of this conceptual paper is to examine the current situation in which high-tech home care is going to materialize in Germany in the beginning of the new millennium. It will be shown that there have been long-standing efforts to bring about a corresponding expansion of home care as can be observed in other countries (e.g., United States). It is apparent, however, that these efforts are still crowned by only modest success. This especially applies to high-tech home care. The introduction of this special form of care is turning out to be a complicated process on a collision course with a great number of obstacles due to the peculiarities of Germany's health care system. If the nursing options related to high-tech home care are to be opened up and put into practice in the future, numerous prerequisites for their development will first have to be created. From a public health nursing viewpoint the three most pressing issues on the list of priorities relevant to high-tech home care are to: (1) increase awareness of the problems associated with this special form of care; (2) eliminate the present information deficits in society; and (3) initiate a debate in Germany about possibilities and limitations of technology-intensive home care, building on international exchange of experiences and ideas.

Biomedical Technology↗
PubMed2006

Randomized EVAR trials and advent of level i evidence: a paradigm shift in management of large abdominal aortic aneurysms?

The recent endovascular aneurysm repair (EVAR) 1 and 2 and Dutch Randomized Endovascular Aneurysm Management (DREAM) trials addressed management of abdominal aortic aneurysms (AAAs) larger than 5.5 cm in diameter. The DREAM and EVAR 1 trials randomized patients appropriate for open repair between endovascular repair (EVAR) and open repair (OR), and the EVAR 2 trial randomized patients unfit for OR between EVAR and conservative nonoperative management (No Rx). The EVAR 1 trial showed a 3% lower initial mortality for EVAR, with a persistent reduction in aneurysm-related death at 4 years. Improvement in overall late survival was not demonstrated. Similarly, the DREAM trial observed an initial mortality advantage for EVAR, but overall 1-year survival was equivalent in both groups. Both trials found significantly higher complication and intervention rates and higher hospital costs with EVAR, and by 1 year a quality of life (QOL) benefit was not evident. The EVAR 2 trial did not demonstrate a survival advantage of EVAR with respect to nonoperative management, while noting that EVAR was associated with greater likelihood of treatment complications, subsequent interventions, and threefold higher costs. Both EVAR trials were limited by long delays between randomization and treatment. Moreover, 27% of patients in EVAR 2 crossed over from nonoperative to endovascular repair, and these patients had a lower procedure mortality from EVAR than those originally assigned to it (2% v 9%). These 47 cases, and the exclusion of 14 patients dying while waiting for EVAR, appears to confer a survival advantage to those receiving EVAR over those receiving no treatment in a post-hoc analysis, but per-protocol analysis of the EVAR 2 trial data performed by the EVAR investigators did not show a significant difference in either all-cause or aneurysm-related mortality. Thus, outcomes of the EVAR 2 trial have not settled the choice between EVAR and no treatment in this scenario to everyone's satisfaction. In patients with large AAAs who are fit for OR, EVAR offers an initial mortality advantage over OR, with a persistent reduction in AAA-related death at 4 years. However, EVAR offers no overall survival benefit, is more costly, and requires more interventions and indefinite surveillance with only a brief QOL benefit. It may or may not offer a mortality benefit over nonoperative management in patients with large AAAs who are unfit for open repair, but the statistical significance of this comparison is inconclusive.

Angioplasty↗
PubMed2005

Imaging of acute thoracic injury: the advent of MDCT screening.

Chest radiography remains the primary screening study for the assessment of victims of chest trauma, but computed tomography (CT), particularly multidetector CT (MDCT), has progressively changed the imaging approach to these patients. MDCT acquires thinner sections with greater speed, allowing higher quality axial images and nonaxial reformations than conventional or single-detector helical CT. The speed of MDCT, both in acquiring data and in reconstructing images, makes the performance of total body surveys in the blunt polytrauma patient practicable. In general, CT has been well documented to offer major advantages over chest radiography in both screening for thoracic injuries and in characterizing such injuries. This capacity has been enhanced by the application of multichannel data acquisition. The greater sensitivity of MDCT has been well demonstrated in diagnosing vascular and diaphragmatic injuries. This article reviews current concepts of diagnostic imaging in acute chest trauma from blunt force and penetrating mechanisms emphasizing the spectrum of diagnostic imaging findings for various injuries, based primarily on radiographic and CT appearances. The advantages of MDCT for selected injuries are emphasized.

Acute Disease↗
PubMed1986

On the advent and necessity of molecular biology in the clinical management of lung cancer.

The very rapidly expanding knowledge and technologies of molecular biology are reviewed with special reference to problems in the clinical management of lung cancer. Genetic events, tumor-associated antigens, production of murine and human monoclonal antibodies, culture of cell lines, intratumoral phenotypic diversity and squamous-lung-cancer-associated antigens are discussed and related to possible therapeutical approaches. A monoclonal antibody with high specificity for squamous cell lung cancer reacted positively in blood samples and tissue extracts in about 80%. Its use as a marker during follow-up after surgical treatment is demonstrated by examples. It is concluded that there will be limiting factors in the therapeutic use of monoclonal antibodies, such as intratumoral phenotypic diversity. Genetic analysis might be a method for selecting a high risk group of individuals in whom exposure to carcinogenic factors, such as cigarette smoking, would be fatal. Murine monoclonal antibodies can be used in vitro for screening, for histological examination and for prognostic studies. Human monoclonal antibodies should be used for in vivo purposes as well as for the screening of primary tumor and metastases for the therapy. To achieve usable results, the monoclonal antibodies should be raised against the cell membranes that, in particular, are expressed on the stem cells of the neoplastic cell population.

Forecasting↗
PubMed1997

Values in conflict: neurology before and after the advent of managed care.

The transformation of American medicine now taking place is fundamentally driven by money. As the pendulum swings from the excesses of fee-for-service medicine (under which system the physician was paid more for doing more), to the equally egregious excesses of managed care (according to which the physician is paid more for doing less), it is the patient--especially the vulnerable patient with a debilitating neurological disease--who stands to lose the most. A survey of the historical roots of this transformation highlights the ethical dilemmas under the course of the pendulum. The ethical principles that should guide both the profession and the business of medicine are explored in search of a common ground on which both physicians and managers can work in concert for the benefit of the patients as well as the society whom both serve. The perils that beset that search must be recognized and avoided if the commons are to be preserved. This is especially true for neurology, where care must be patient, not profit, oriented; must have quality, not cost, as its primary aim; and must not be rationed until there is a floor of universal coverage, with participation by all in allocation decisions.

Conflict of Interest↗
PubMed1997

High-precision 40Ar/39Ar geochronology and the advent of North America's Late Cretaceous terrestrial fauna.

A densely sampled, diverse new fauna from the uppermost Cedar Mountain Formation, Utah, indicates that the basic pattern of faunal composition for the Late Cretaceous of North America was already established by the Albian-Cenomanian boundary. Multiple, concordant 40Ar/39Ar determinations from a volcanic ash associated with the fauna have an average age of 98.39 +/- 0.07 million years. The fauna of the Cedar Mountain Formation records the first global appearance of hadrosaurid dinosaurs, advanced lizard (e.g., Helodermatidae), and mammal (e.g., Marsupialia) groups, and the first North American appearance of other taxa such as tyrannosaurids, pachycephalosaurs, and snakes. Although the origin of many groups is unclear, combined biostratigraphic and phylogenetic evidence suggests an Old World, specifically Asian, origin for some of the taxa, an hypothesis that is consistent with existing evidence from tectonics and marine invertebrates. Large-bodied herbivores are mainly represented by low-level browsers, ornithopod dinosaurs, whose radiations have been hypothesized to be related to the initial diversification of angiosperm plants. Diversity at the largest body sizes (>10(6) g) is low, in contrast to both preceding and succeeding faunas; sauropods, which underwent demise in the Northern hemisphere coincident with the radiation of angiosperms, apparently went temporarily unreplaced by other megaherbivores. Morphologic and taxonomic diversity among small, omnivorous mammals, multituberculates, is also low. A later apparent increase in diversity occurred during the Campanian, coincident with the appearance of major fruit types among angiosperms, suggesting the possibility of adaptive response to new resources.

Animals↗
PubMedDate not supplied

Neural integration at the mesoscopic level: the advent of some ideas in the last half century.

History seen by a professional historian, based only on the documented record, always incomplete and liable to bias, can be unreliable. Modern history seen by a protagonist must surely be among the most unreliable. Yet, I must try, in a limited scope, to show the human drama as well as the flood on which we are floating, unable to dump the baggage of past biases. Our points of view, priorities, and positions on all the controversial issues and even the well established, noncontroversial ones, are not as rational as we would like to think but are strongly conditioned by where we came from. I wil depend on selected vignettes of the way things looked when I was a student, a young postdoctoral fellow and an Assistant Professor, to compare with the way they look now, in each of half a dozen mesoscopic domains--those in between the most basic subcellular or molecular and the higher levels of learning and cognition. The half dozen constitute, of course, anything but a representative fraction of neuroscience. But they add up to a nontrivial segment of the big picture with respect to the integrative aspects of our science. Most of the fronts that grew into today's popular branches are not represented, but a small set of particular interest and probability of further surprises.

History, 20th Century↗