Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Lecture”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,225 records · Page 68Linked to original sources
PubMed2000

1998 Distinguished Lecture: biomechanics of the microcirculation, an integrative and therapeutic perspective.

The microcirculation, integratively speaking, is distensible and contains 40%-50% of the total blood volume. Other than the mission of mass transport, the microcirculation and its endothelial cells have the role of regulation, signal transduction, proliferation, and repair. In this article, the emphasis is on the integrative role of the microcirculation on circulatory control and its therapeutic role on blood volume compensation. To introduce this topic, I first summarize the morphometry data on the blood volume distribution in the coronary, pulmonary, and mesentery circulation and then review the methodology developed in my laboratory to assess the microvascular volume change or shift of blood volume from microcirculation to macrocirculation. Evidence obtained through these studies indicates that the microcirculation can play a more important role as a reservoir to compensate for blood volume loss than the venous system. Reanalysis of published data also indicates that microvascular pooling, not hypovolemia, is the likely factor causing endotoxin shock or hypotension for hemodialysis patients. Understanding of the role of the microcirculation could lead to more effective diagnosis of cardiovascular deficiency and therapy for hypotension or low cardiac output with intervention through the microcirculation.

Animals↗
PubMed1999

Iris cysts in children: classification, incidence, and management. The 1998 Torrence A Makley Jr Lecture.

BACKGROUND: Iris cysts in children are uncommon and there is relatively little information on their classification, incidence, and management. METHODS: The records of all children under age 20 years who were diagnosed with iris cyst were reviewed and the types and incidence of iris cysts of childhood determined. Based on these observations recommendations were made regarding management of iris cysts in children. RESULTS: Of 57 iris cysts in children, 53 were primary and four were secondary. There were 44 primary cysts of the iris pigment epithelium, 34 of which were of the peripheral or iridociliary type, accounting for 59% of all childhood iris cysts. It was most commonly diagnosed in the teenage years, more common in girls (68%), was not recognised in infancy, remained stationary or regressed, and required no treatment. The five mid-zonal pigment epithelial cysts were diagnosed at a mean age of 14 years, were more common in boys (83%), remained stationary, and required no treatment. The pupillary type of pigment epithelial cyst was generally recognised in infancy and, despite involvement of the pupillary aperture, also required no treatment. There were nine cases of primary iris stromal cysts, accounting for 16% of all childhood iris cysts. This cyst was usually diagnosed in infancy, was generally progressive, and required treatment in eight of the nine cases, usually by aspiration and cryotherapy or surgical resection. Among the secondary iris cysts, two were post-traumatic epithelial ingrowth cysts and two were tumour induced cysts, one arising from an intraocular lacrimal gland choristoma and one adjacent to a peripheral iris naevus. CONCLUSIONS: Most iris cysts of childhood are primary pigment epithelial cysts and require no treatment. However, the iris stromal cyst, usually recognised in infancy, is generally an aggressive lesion that requires treatment by aspiration or surgical excision.

Adolescent↗
PubMedDate not supplied

How the past teaches the future: ACMI distinguished lecture.

More than 30 years of experience in developing a computer-based patient record system, The Medical Record (TMR), in multiple settings, in multiple specialty groups, and at multiple sites has taught us many lessons. Lessons related to computer-based patient records include the importance of a data model in which input, storage, and planned use are independent; separation of patient-specific data from metadata; a modular design to localize the program code that deals with a set of data; redundant storage to optimize tasks and response time; and integration of decision support into work process. Lessons related to medical informatics include the importance of a clinical-technical partnership, control of tools at the leading edge, and rapid prototyping in the real world. Finally, changes in technology move the challenges but do not eliminate them.

History, 20th Century↗
PubMed1997

Cochrane Lecture 1997. What evidence do we need for evidence based medicine?

As presently understood, evidence based medicine aims to advance practice from its traditional unverifiable mix of art and science to rational use of measurable inputs and outputs. In practice, however, its advocates accept uncritically a desocialised definition of science, assume that major clinical decisions are taken at the level of secondary specialist rather than primary generalist care, and ignore the multiple nature of most clinical problems, as well as the complexity of social problems within which clinical problems arise and have to be solved. These reductionist assumptions derive from the use of evidence based medicine as a tool for managed care in a transactional model for consultations. If these assumptions persist, they will strengthen reification of disease and promote the episodic output of process regardless of health outcome. We need to work within a different paradigm based on development of patients as co-producers rather than consumers, promoting continuing output of health gain through shared decisions using all relevant evidence, within a broader, socialised definition of science. Adoption of this model would require a major social and cultural shift for health professionals. This shift has already begun, promoted by changes in public attitudes to professional authority, changes in the relation of professionals to managers, and pressures for improved effectiveness and efficiency which, contrary to received wisdom, seem more likely to endorse cooperative than transactional clinical production. Progress on these lines is resisted by rapidly growing and extremely powerful economic and political interests. Health professionals and strategists have yet to recognise and admit the existence of this choice.

Decision Making↗
PubMed1997

Gordin Kaplan Award Lecture. Building a relationship: science and the community.

An appreciation for the intrinsic relationship that exists among science, scientists, and the public must be established. Both practitioners of science and the public should be made more aware that science is part of everyday life and that the definition of a scientist should be more encompassing. It is generally accepted that the public supports but often does not understand the goals of the scientific community. This is often due to lack of effective communication. The scientific community has accepted accountability to the public and attempts have been made to improve our image. Programs by groups and individuals to interact with the public, particularly school children, have grown. However, there is still a need to expand this area. It is our responsibility to find our niche in science awareness programs as speakers, mentors, or facilitators. Participation in these programs is an essential part of a professional scientist's career and should be encouraged by administration. Interaction with the public improves our ability to explain science in lay terms and the relevance of our work to the community. End points should be established to measure success: not just numbers of students entering "scientific" careers but also science literacy. Developing this strategy will not only improve the image of the scientific community with the public but also build a lasting relationship where needs and aspirations will be mutually appreciated.

Community-Institutional Relations↗
PubMed1996

Boehringer Mannheim award lecture 1995. La conference Boehringer Mannheim 1995. De novo design of alpha-helical proteins: basic research to medical applications.

The two-stranded alpha-helical coiled-coil is a universal dimerization domain used by nature in a diverse group of proteins. The simplicity of the coiled-coil structure makes it an ideal model system to use in understanding the fundamentals of protein folding and stability and in testing the principles of de novo design. The issues that must be addressed in the de novo design of coiled-coils for use in research and medical applications are (i) controlling parallel versus antiparallel orientation of the polypeptide chains, (ii) controlling the number of helical strands in the assembly (iii) maximizing stability of homodimers or heterodimers in the shortest possible chain length that may require the engineering of covalent constraints, and (iv) the ability to have selective heterodimerization without homodimerization, which requires a balancing of selectivity versus affinity of the dimerization strands. Examples of our initial inroads in using this de novo design motif in various applications include: heterodimer technology for the detection and purification of recombinant peptides and proteins; a universal dimerization domain for biosensors; a two-stage targeting and delivery system; and coiled-coils as templates for combinatorial helical libraries for basic research and drug discovery and as synthetic carrier molecules. The universality of this dimerization motif in nature suggests an endless number of possibilities for its use in de novo design, limited only by the creativity of peptide-protein engineers.

Amino Acid Sequence↗
PubMed1996

Merck Frosst award lecture 1995. La conference Merck Frosst 1995. Structural studies of lipoproteins and their apolipoprotein components.

Lipid transport processes via the circulatory system of animals are a vital function that utilizes highly specialized lipoprotein complexes. These complexes of protein and lipid impart solubility to otherwise insoluble lipids. The apoprotein components of lipoprotein complexes serve to stabilize the lipid components and modulate particle metabolism and function as ligands for receptor-mediated endocytosis of lipoproteins. We have used an insect (Manduca sexta) model system for studies of lipid transport. In this system, flight activity elicits a dramatic increase in the demand for glycerolipid fuel molecules by flight muscle tissue. These lipids are mobilized from a storage organ and transported through the hemolymph (blood) to the flight muscle by the lipoprotein, lipophorin. This system possesses the unique property that lipids are loaded onto pre-existing high density lipophorin through the action of a lipid transfer particle (LTP). LTP is a high molecular weight hemolymph component that facilitates net vectorial lipid transfer from fat body tissue to lipophorin. The increase in lipid content of the lipoprotein induces association of a low molecular weight amphipathic exchangeable apolipoprotein, apolipophorin III (apoLp-III). ApoLp-III is a 18 kDa protein that normally exists as a water-soluble monomeric hemolymph protein. The structural properties of apoLp-III have been investigated by X-ray crystallography. ApoLp-III from Locusta migratoria adopts a five helix bundle conformation wherein each of the amphipathic helices orients with its hydrophobic face directed toward the interior of the bundle. It has been hypothesized that lipid association requires a dramatic conformational change wherein the helix bundle opens about putative hinge domains located in the loops between helices. The data accumulated support the concept that apoLp-III is a member of the broad class of exchangeable apolipoproteins and structural information learned from this system is directly applicable to analogous proteins in higher organisms.

Animals↗
PubMed1999

Jeanne Mannery Fisher Memorial Lecture 1998. Structure-function studies of the sodium pump.

The Na+, K+-ATPase is an ubiquitous plasma membrane protein complex that belongs to the P-type family of ion motive ATPases. Under normal conditions, it couples the hydrolysis of one molecule of ATP to the exchange of three Na+ for two K+ ions, thus maintaining the normal gradient of these cations in animal cells. Despite decades of investigation of its structure and function, the structural basis for its cation specificity and for conformational coupling of the scalar energy of ATP hydrolysis to the vectorial movement of Na+ and K+ have remained a major unresolved issue. This paper summarizes our recent studies concerned with these issues. The findings indicate that regions(s) of the amino terminus and first cytoplasmic (M2/M3) loop act synergistically to affect the steady-state conformational equilibrium of the enzyme. Although carboxyl- or hydroxyl-bearing amino acids comprise the cation-binding and occlusion sites, our experiments also suggest that these interactions may be modulated by juxtapositioned cytoplasmic regions.

Chimera↗
PubMed2006

Thin-section CT of the secondary pulmonary lobule: anatomy and the image--the 2004 Fleischner lecture.

The secondary pulmonary lobule is a fundamental unit of lung structure, and it reproduces the lung in miniature. Airways, pulmonary arteries, veins, lymphatics, and the lung interstitium are all represented at the level of the secondary lobule. Several of these components of the secondary lobule are normally visible on thin-section computed tomographic (CT) scans of the lung. The recognition of lung abnormalities relative to the structures of the secondary lobule is fundamental to the interpretation of thin-section CT scans. Pathologic alterations in secondary lobular anatomy visible on thin-section CT scans include interlobular septal thickening and diseases with peripheral lobular distribution, centrilobular abnormalities, and panlobular abnormalities. The differential diagnosis of lobular abnormalities is based on comparisons between lobular anatomy and lung pathology.

Humans↗