The healthcare ethics committee in the structural transformation of health care: administrative and organization ethics in changing times.
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In tests set up on rats the effect of methandrostenolone on the external secretion of the liver, fermentative activity of the pancreatic tissue and histological and hisochemical findings subsequent to an investigation of internal organs were studied. Introduction of methandrostenolone led to changes in bilification and to a reduced concentration basic components of the bile, to a distinctly pronounced rise in the level of the trypsin inhibitor and to a depressed activity of trypsin in the pancreatic tissue. It also resulted in a change of histochemical and fermentative indices in the tissue of the liver, spleen and other organs.
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Since the upper age for organ donors has been raised, a higher incidence of preexistent organ damage and functional impairment is to be expected. Coronary artery sclerosis increases with age. It can only be diagnosed with certainty by coronary angiography. Since contrast medium administration may cause renal damage when risk factors are present, this study sought to establish whether angiography negatively influenced the early postoperative function of kidney grafts. We compared the clinical courses of 36 recipients of kidneys from donors in whom coronary angiography or levography had been performed with 36 recipients of kidneys from donors who had not been subjected to contrast medium. The results showed that the administration of contrast medium had no influence on renal function at 3 or 6 months after transplantation. In conclusion, fears that donor kidneys might be harmed by contrast medium appeared to therefore be unfounded.
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Adult male Wistar rats were administered acute toxic doses of lead (Pb), triethyl lead (TriEL) or tetraethyl lead (TEL) by gavage. The ability of striatal, hypothalamic and cortical synaptosomes to take up tritiated monoamines was assayed 24 hours later. Pb, TriEL as well as TEL increased dopamine (DA) uptake into striatal synaptosomes at least at some dose level. Pb increased, but TEL decreased 5-hydroxytryptamine(5-HT) uptake into hypothalamic synaptosomes, while TEL increased noradrenaline (NA) uptake into cortical synaptosomes. After a 3 week administration to initially 4 week old rats of even toxic doses of Pb in drinking water, monoamine uptake was not significantly affected. On the contrary, the neurotoxicity of TEL was cumulative in that a much lower dose decreased 5-HT uptake when divided over a 3 week period than acutely. In vitro TriEL inhibited DA uptake (IC50; 0.8 microM) into striatal and 5-HT uptake (5.0 microM) into hypothalamic synaptosomes but TEL and delta-aminolevulinic acid did not. The results suggest that dopaminergic and serotonergic neurones differ in their response to alkyl lead in vivo. The differences could be due to basic differences in the neurochemical behaviour of these two types of nerve endings.
How to prevent medical adverse events and augment the public's confidence in healthcare has become an urgent one of the highest-priority medical policy issues in Japan. Accident reports for administrative organs are very usefully for patient safety, but are not concerned with the legal duty required under the Medical Act Law. Extending previous work, we established the public system following. First, we gave notice all hospital in Tokyo Metropolitan how incidental range should be reported. Second, we established "neutral center for collect incidental reports". Third, we established "Tokyo Metropolitan Patients' Advisory Service" that collects patient's complaints. We convince that cooperative actions with administrative organ, hospital and patients are very usefully for patient safety and should be extending in Japan.
PACS integrated to RIS and HIS will have a significant impact on the hospital operation. This paper describes the current radiological process and indicates at what points PACS may prove to be important, in order to guarantee its successful implementation with the objective to improve patient care by better management of personnel, equipment and information.
PURPOSE: Recently, our laboratory group has reported that rats with Type 1 diabetes have decreased plasma homocysteine and cysteine levels compared to non-diabetic controls and that organic vanadium treatment increased plasma homocysteine concentrations to non-diabetic concentrations. However, to date, no studies have been done investigating the effects of organic vanadium compounds on plasma homocysteine and its metabolites in Type 2 diabetic animal model. These studies examined the effect of organic vanadium compounds [bis(maltolato)oxovanadium(IV) and bis(ethylmaltolato)oxovanadium(IV); BMOV and BEOV] administered orally on plasma concentrations of homocysteine and its metabolites (cysteine and cysteinylglycine) in lean, Zucker fatty (ZF) and Zucker diabetic fatty (ZDF) rats. ZF rats are a model of pre-diabetic Type 2 diabetes characterized by hyperinsulinemia and normoglycemia. The ZDF rat is a model of Type 2 diabetes characterized by relative hypoinsulinemia and hyperglycemia. METHODS: Zucker lean and ZF rats received BMOV in the drinking water at a dose of 0.19 +/- 0.02 mmol/kg/day. Lean and ZDF rats received BEOV by oral gavage daily at dose of 0.1 mmol/kg. The treatment period for both studies was 21 days. At termination, animals were fasted overnight (approximately 16 h) and blood samples were collected by cardiac puncture for determination of plasma glucose, insulin and homocysteine levels. Plasma homocysteine and its metabolites levels were determined using high-pressure liquid chromatography. Plasma glucose was determined using a Glucose Analyzer 2. Plasma insulin levels were determined by radioimmunoassay. Plasma triglycerides were determined by an enzymatic assay methodology. RESULTS: ZF (n = 4) and ZDF (n = 10) rats had significantly lower plasma homocysteine as compared to their respective lean groups (ZF 0.78 +/- 0.1 micromol/L vs. Zucker lean 2.19 +/- 0.7 micromol/L; ZDF 1.71 +/- 0.2 micromol/L vs. Zucker lean 3.02 +/- 0.3 micromol/L; p < 0.05). BMOV treatment in ZF rats restored plasma homocysteine levels to those observed in lean untreated rats (ZF treated: 2.04 +/- 0.2 micromol/L; lean 2.19 +/- 0.7 micromol/L). There was a modest effect of BMOV treatment on plasma glucose levels in ZF rats. BEOV treatment significantly decreased the elevated plasma glucose levels in the ZDF rats (lean 7.9 +/- 0.1 mmol/L; lean + vanadium 7.7 +/- 0.2 mmol/L; ZDF 29.9 +/- 0.4 mmol/L; ZDF + vanadium 17.4 +/- 0.3 mmol/L, p < 0.05). Organic vanadium treatment reduced cysteine levels in both ZF and ZDF rats. No differences in total plasma cysteinylglycine concentrations were observed. CONCLUSION: Plasma homocysteine levels are significantly reduced in a pre-diabetic model of Type 2 diabetes, which was restored to lean levels upon vanadium treatment; however, this restoration of plasma homocysteine levels was not seen in ZDF Type 2 diabetic rats following vanadium treatment. In the latter case vanadium treatment may not have totally overcome the insulin resistance seen in these animals.
The phospholipid composition and the antioxidative activity (AOA) of lipids from liver, heart and brain of F1(CBA X C57Bl) mice change significantly after intraperitoneal injection of adriamycin (7 mg/kg). All tissues studied are characterized by a drastic fall in the phosphatidylethanolamine (PEA) content and the AOA of lipids with a minimum on the 2nd-4th days and a subsequent return to normal values on the 10th-14th days. These results are consistent with the hypothesis on the intensification of adriamycin-induced lipid peroxidation and the predominant expenditure of readily oxidized phospholipids, including PEA.
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A novel magnetic microsphere-methotrexate (MM-MTX) drug delivery system was synthesized and evaluated in rats bearing rat glioma-2 (RG-2) tumors. Methotrexate was linked to the surface of the magnetic particle via an aminohexanol linker that would release free drug following hydrolysis. Male Fischer 344 rats bearing RG-2 tumors were administered 3 mg/kg of methotrexate (MTX) either as MM-MTX or as a solution (MTX-S) over 5 min. A 6000 gauss magnetic field was applied for 15 min from the end of MM-MTX administrations. Serial sacrifices were conducted at 15 min, 30 min and 45 min after drug administrations, organs collected, and analyzed for total MTX by a radioassay. At all times, MTX right brain (ipsilateral), brain tumor, and left brain concentrations were approximately 3.5 to 5-fold greater in the MM-MTX group compared to the MTX-S group. MTX concentrations in all other organs were less following administration of MM-MTX than MTX-S except in lung at 30 and 45 min. The targeting efficacy, an index for site-specificity, for both MM-MTX and MTX-S were similar and indicated some enhancement in MTX localization in brain tumor. Confocal and conventional light microscopic analyses demonstrated a diffuse distribution of MM-MTX in tumor consistent with extravascular uptake, whereas a predominant capillary distribution of MM-MTX was observed in normal brain. Following 45 min, the animals treated with MM-MTX died possibly due to redistribution of particles to the lung. This toxicity was dose-dependent. High brain MTX concentrations coupled with extravascular uptake of MM-MTX provide a basis for further investigations with this novel drug delivery system.
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