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PubMed2002

JJ1017 committee report: image examination order codes--standardized codes for imaging modality, region, and direction with local expansion: an extension of DICOM.

The digital imaging and communications in medicine (DICOM) standard includes parts regarding nonimage data information, such as image study ordering data and performed procedure data, and is used for sharing information between HIS/RIS and modality systems, which is essential for IHE. To bring such parts of the DICOM standard into force in Japan, a joint committee of JIRA and JAHIS established the JJ1017 management guideline, specifying, for example, which items are legally required in Japan, while remaining optional in the DICOM standard. In Japan, the contents of orders from referring physicians for radiographic examinations include details of the examination. Such details are not used typically by referring physicians requesting radiographic examinations in the United States, because radiologists in the United States often determine the examination protocol. The DICOM standard has code tables for examination type, region, and direction for image examination orders. However, this investigation found that it does not include items that are detailed sufficiently for use in Japan, because of the above-mentioned reason. To overcome these drawbacks, we have generated the JJ1017 code for these 3 codes for use based on the JJ1017 guidelines. This report introduces the JJ1017 code. These codes (the study type codes in particular) must be expandable to keep up with technical advances in equipment. Expansion has 2 directions: width for covering more categories and depth for specifying the information in more detail (finer categories). The JJ1017 code takes these requirements into consideration and clearly distinguishes between the stem part as the common term and the expansion. The stem part of the JJ1017 code partially utilizes the DICOM codes to remain in line with the DICOM standard. This work is an example of how local requirements can be met by using the DICOM standard and extending it.

Diagnostic Imaging↗
PubMed2003

Inflammation and emerging risk factors in diabetes mellitus and atherosclerosis.

Type 2 diabetes mellitus and atherosclerosis are complex and progressive conditions that share several common antecedents. Recent data suggest that inflammation may play a central role in the origins and complications of cardiovascular disease and, possibly, type 2 diabetes mellitus. C-reactive protein and plasminogen activator inhibitor-1 are circulating markers of low-grade inflammation, thrombosis, and vascular injury. Together with homocysteine, they have been associated with the underlying inflammatory processes and are considered to be "nontraditional" risk factors of atherosclerosis. The role of their measurement in clinical practice remains unclear. In this article, we review the available evidence demonstrating a link between inflammation, cardiovascular disease, and diabetes. We discuss how therapeutic agents used for both cardiovascular disease and diabetes modulate the inflammatory responses and possibly attenuate the complications of these two chronic disorders that cause significant morbidity and mortality.

Arteriosclerosis↗
PubMed1995

Measuring the contribution of randomness, exposure, weather, and daylight to the variation in road accident counts.

Road accident counts are influenced by random variation as well as by various systematic, causal factors. To study these issues, a four-country, segmented data base has been compiled, each segment consisting of monthly accident counts, along with candidate explanatory factors, in the various counties (provinces) of Denmark, Finland, Norway, or Sweden. Using a generalized Poisson regression model, we are able to decompose the variation in accident counts into parts attributable to randomness, exposure, weather, daylight, or changing reporting routines and speed limits. To this purpose, a set of specialized goodness-of-fit measures have been developed, taking explicit account of the inevitable amount of random variation that would be present in any set of accident counts, no matter how well known the accident generating Poisson process. Pure randomness is seen to "explain" a major part of the variation in smaller accident counts (e.g. fatal accidents per county per month), while exposure is the dominant systematic determinant. The relationship between exposure and injury accidents appears to be almost proportional, while it is less than proportional in the case of fatal accidents or death victims. Together, randomness and exposure account for 80% to 90% of the observable variation in our data sets. A surprisingly large share of the variation in road casualty counts is thus explicable in terms of factors not ordinarily within the realm of traffic safety policy. In view of this observation, it may seem unlikely that very substantial reductions in the accident toll can be achieved without a decrease in the one most important systematic determinant: the traffic volume.

Accidents, Traffic↗
PubMed1983

Control of mitochondrial respiration. The contribution of the adenine nucleotide translocator depends on the ATP- and ADP-consuming enzymes.

The consequence of the complexity of the metabolic network on the amount of control strength of adenine nucleotide translocator was investigated with isolated rat liver mitochondria. Two experimental systems were compared: (i) mitochondria in the presence of yeast hexokinase (hexokinase system) and (ii) the same system plus additional pyruvate kinase (pyruvate kinase system). In both systems the control strength was analysed for the adenine nucleotide translocator by inhibitor titration studies with carboxyatractyloside and for the hexokinase or pyruvate kinase by changing their relative activities. Experimental results were compared with computer simulation of these systems and that of a third one, where the extramitochondrial ATP/ADP ratio was held constant by perifusion (perifusion system). The results demonstrate quite different flux-dependent control strength of the translocator in the three systems. In the hexokinase system the control strength of the translocator on mitochondrial respiration was zero up to respiration rates of about 60 nmol O2/mg protein per min. For higher rates, the control strength increased until the maximum value (0.45) was reached in the fully active state. Here, the same value was also found in the pyruvate kinase system. In all other states of respiration the translocator exerts a higher control strength in the pyruvate kinase system than in the hexokinase system. This different behaviour was attributed to the various changes in the adenine nucleotide pattern caused by partial inhibition of the translocator in the hexokinase and pyruvate kinase system. The data clearly show that the sharing of control strength depends not only on the respiration rate but also on the complexity of the metabolic system.

Adenosine Diphosphate↗
PubMed1979

A program package for simulation and parameter estimation in pharmacokinetic systems.

A set of programs is presented which has been developed for parameter estimation and simulation of models arising from pharmacokinetic applications. The programs can accommodate linear and nonlinear models with multiple inputs and multiple outputs. When the model is defined by differential equations, non-uniform repetitive dosage regimens can be handled. The model may also be entered in integrated form when single dose studies or uniform multiple dose studies are being considered. The programs employ a variable-step, variable-order integration routine to solve the model differential equations, and the Nelder-Mead simplex procedure to determine the parameter values which minimize a weighted least squares criterion. The programs have been written for an interactive time-sharing environment with the experimental data and model equations stored in files for future use.

Computers↗
PubMed1992

Capsaicin-like effect of (6)-shogaol on substance P-containing primary afferents of rats: a possible mechanism of its analgesic action.

The effects of (6)-shogaol, a pungent component of dried ginger with a capsaicin-like chemical structure, on the release of immunoreactive substance P from the spinal dorsal horn were examined by in vitro superfusion of the dorsal-half slices of the spinal cord of the rat. (6)-Shogaol (30 microM to 1 mM) increased dose-dependently the release of immunoreactive substance P. The maximum effect of (6)-shogaol was observed at a concentration of 100 microM and less than a half of the effect of 10 microM capsaicin. The effect of (6)-shogaol (100 microM) was attenuated in slices from rats with dorsal rhizotomy and abolished by elimination of calcium ions from the perfusion medium. Pretreatment with (6)-shogaol in vitro inhibited the capsaicin-evoked release of immunoreactive substance P. On the other hand, systemic administration of (6)-shogaol (160 mg/kg) produced antinociception in rats, with a peak effect between 15 and 30 min and a smaller dose of 80 mg/kg was without effect. Treatment of rats with (6)-shogaol, at a dose of 160 mg/kg but not at 80 mg/kg, for 20 min significantly decreased release of immunoreactive substance P, evoked by capsaicin (10 microM), from the slices of cord. These data suggest that (6)-shogaol shares the sites of action with capsaicin, on the terminals of substance P-containing primary afferents, to release of the neuropeptide and inhibit the release of substance P, by subsequent stimulation of the primary afferents. The latter action of (6)-shogaol might be relevant to its analgesic effect.

Analgesics↗
PubMed1990

Widening potential for Ca2+ antagonists: non-L-type Ca2+ channel interaction.

In addition to their well characterized interaction with the alpha 1 subunit of the voltage-dependent L-type Ca2+ channel, certain Ca2+ antagonists have been reported to modulate an increasing number of cellular functions as diverse as extrusion of cytotoxic substances, or cleavage of cAMP by phosphodiesterase. Some of these interactions (such as the reversal of multidrug resistance by Ca2+ antagonists for the treatment of lymphoma patients) have already been exploited clinically; some (such as protection of ischemic tissue by Ca2+ antagonists interacting with mitochondrial sites) open new therapeutic issues. In this survey of the non-L-type channel Ca2+ antagonist target structures known to date, Gerald Zernig evaluates the available data and emphasizes common characteristics shared by the seemingly diverse target structures. Research on these sites might help to understand yet unexplained effects of Ca2+ antagonists and possibly lead to the development of novel drugs with higher selectivity for non-L-type Ca2+ channel structures.

Animals↗
PubMedDate not supplied

Neurobehavioral test strategies for environmental exposures in pediatric populations.

The Agency for Toxic Substances and Disease Registry convened a workshop in Atlanta, GA, that evaluated approaches and methods to ascertain whether there are neurobehavioral sequelae to children and adults exposed to hazardous substances in the environment. This article, developed from that workshop, addresses the feasibility of employing extant neurobehavioral tests to screen pediatric populations. A matrix lists basic functions to be assessed during eight developmental periods ranging from birth to high school. The best of these neurobehavioral tests for pediatric populations and the types of assessment tools that are still needed are discussed. We make 10 specific recommendations to establish a hazardous substances neurobehavioral screen for pediatric populations, including appointing a review panel, developing a structured questionnaire, convening a conference on design and analysis, addressing minority and socially disadvantaged populations, coordinating adult and child assessment methods, information sharing among Federal agencies, baseline data, methodology research, research associated with hazardous worksites, and establishment of a pediatric databank.

Adolescent↗
PubMed1989

Developmental potential of avian trunk neural crest cells in situ.

To analyze the developmental potential of individual neural crest cells or their precursors, we have microinjected a vital dye, lysinated rhodamine dextran (LRD), into single cells in the dorsal neural tube. The phenotypes of the descendants that inherited the LRD from the injected cells were evaluated based upon their position, morphology, and neurofilament expression. Individual neural crest cells labeled before or as they emigrated from the neural tube gave rise to both sensory and sympathetic neurons as well as nonneuronal cells, some of which had the morphological characteristics of Schwann cells or pigment cells. In numerous cases, the descendants of a single cell included both neural crest- and neural tube-derived neurons, suggesting that some cells of the peripheral and central nervous systems share a common lineage. Our data demonstrate definitively that both emigrating and premigratory trunk neural crest cells can be multipotent, giving rise not only to cells in multiple neural crest derivatives, but also to both neuronal and nonneuronal elements within a given derivative.

Animals↗
PubMed2006

Approaches to patient health information exchange and their impact on emergency medicine.

Regional health information organizations and electronic health information exchange may have an important impact on the practice of emergency medicine in the United States. Regional health information organizations are local or regional information-sharing networks that enable electronic data interchange among stakeholders in a given geographic area. These stakeholders may include hospitals, skilled nursing facilities, clinics, private physicians' offices, pharmacies, laboratories, radiology facilities, health departments, payers, and possibly the patients themselves. Regional health information organizations are being formed across the country to improve the safety and efficiency of clinical care; improve public health efforts, biosurveillance, and disaster management response; and potentially create large databases of deidentified aggregate data for research. Because of the unique need for rapid access to information and the acuity of the clinical environment, few areas of the health care delivery system stand to change and benefit more from health information exchange than our nation's emergency departments. This article will explain the motivation for the development of regional health information organizations, identify some of the important issues in their formation, and discuss how their development might affect the practice of emergency medicine.

Confidentiality↗
PubMed2006

Patterning the developing diencephalon.

The diencephalon is the embryonic precursor to the caudal forebrain. The major diencephalic derivative is the thalamus, which functions as a relay station between the cortex and lower nervous system structures. Although the diencephalon has been recognized as a vital brain region, our understanding of its development remains superficial. In this review, we discuss recent progresses in understanding one essential aspect of diencephalic development, diencephalic patterning. Signaling centers identified in the zona limitans intrathalamica and along the dorsal and ventral midlines have emerged as essential organizers in diencephalic patterning. The cumulative data reveal that the diencephalon shares some developmental principles with more caudal brain regions, whereas other mechanisms are unique to this region.

Animals↗
PubMed2005

Stem cells are units of natural selection in a colonial ascidian.

Stem cells are highly conserved biological units of development and regeneration. Here we formally demonstrate that stem cell lineages are also legitimate units of natural selection. In a colonial ascidian, Botryllus schlosseri, vascular fusion between genetically distinct individuals results in cellular parasitism of somatic tissues, gametes, or both. We show that genetic hierarchies of somatic and gametic parasitism following fusion can be replicated by transplanting cells between colonies. We prospectively isolate a population of multipotent, self-renewing stem cells that retain their competitive phenotype upon transplantation. Their single-cell contribution to either somatic or germline fates, but not to both, is consistent with separate lineages of somatic and germline stem cells or pluripotent stem cells that differentiate according to the niche in which they land. Since fusion is restricted to individuals that share a fusion/histocompatibility allele, these data suggest that histocompatibility genes in Botryllus evolved to protect the body from parasitic stem cells usurping asexual or sexual inheritance.

Animals↗
PubMed2006

A secure web-based approach for accessing transitional health information for people with traumatic brain injury.

A web-based transitional health record was created to provide regional healthcare professionals with ubiquitous access to information on people with brain injuries as they move through the healthcare system. Participants included public, private, and community healthcare organizations/providers in Eastern Ontario (Canada). One hundred and nineteen service providers and 39 brain injury survivors registered over 6 months. Fifty-eight percent received English and 42% received bilingual services (English-French). Public health providers contacted the regional service coordinator more than private providers (52% urban centres, 26% rural service providers, and 22% both areas). Thirty-five percent of contacts were for technical difficulties, 32% registration inquiries, 21% forms and processes, 6% resources, and 6% education. Seventeen technical enquiries required action by technical support personnel: 41% digital certificates, 29% web forms, and 12% log-in. This web-based approach to clinical information sharing provided access to relevant data as clients moved through or re-entered the health system. Improvements include automated digital certificate management, institutional health records system integration, and more referral tracking tools. More sensitive test data could be accessed on-line with increasing consumer/clinician confidence. In addition to a strong technical infrastructure, human resource issues are a major information security component and require continuing attention to ensure a viable on-line information environment.

Brain Injuries↗
PubMed2004

An examination of dental development in Graecopithecus freybergi (=Ouranopithecus macedoniensis).

This study examined enamel thickness and dental development in Graecopithecus freybergi (=Ouranopithecus macedoniensis), a late Miocene hominoid from Greece. Comparative emphasis was placed on Proconsul, Afropithecus, Dryopithecus, Lufengpithecus, and Gigantopithecus, fossil apes that vary in enamel thickness and patterns of development. In addition, comparisons were made with Paranthropus to investigate reported similarities in enamel thickness. Several sections of a right lower third molar were generated, from which enamel thickness and aspects of the enamel and dentine microstructure were determined. Data from parallel sections shed light on the effects of section obliquity, which may influence determination of both enamel thickness and crown formation time. Graecopithecus has relatively thick enamel, greater than any fossil ape but less than Paranthropus, with which it does show similarity in prism path and Hunter-Schreger band morphology. Aspects of enamel microstructure, including the periodicity and daily secretion rate, are similar to most extant and fossil apes, especially Afropithecus. Total crown formation time was estimated to be 3.5 years, which is greater than published values for modern Homo, similar to Pan, and less than Gigantopithecus. Data on dentine secretion and extension rates suggest that coronal dentine formation was relatively slow, but comparative data are very limited. Graecopithecus shares a crown formation pattern with several thick-enamelled hominoids, in which cuspal enamel makes up a very large portion of crown area, is formed by a large cell cohort, and is formed in less than half of the total time of formation. In Paranthropus, this pattern appears to be even more extreme, which may result in thicker enamel formed in an even shorter time. Developmental similarities between Paranthropus and Graecopithecus are interpreted to be parallelisms due to similarities in the mechanical demands of their diets.

Animals↗
PubMed2026

Opposing kinase signaling may underlie the inverse relationship between cancer and Alzheimer's disease.

Cancer and Alzheimer's disease (AD) are leading causes of mortality and exhibit an inverse relationship, where AD patients have reduced cancer risk and vice versa. However, the molecular basis of this relationship remains poorly understood. We reanalyzed published proteomic and phosphoproteomic datasets to investigate this relationship. Differentially abundant proteins were identified in lung adenocarcinoma and glioblastoma samples relative to controls and compared with proteins altered in AD brains, revealing 37 proteins with opposing abundance patterns. Protein-protein interaction and pathway analyses revealed enrichment in kinase signaling and phosphorylation pathways. Phosphoproteomic analysis identified 52 differentially phosphorylated sites with opposing patterns, while kinase-substrate enrichment analysis identified 44 kinases with opposing inferred activity profiles. Integration of kinase activity and phosphosite data identified 29 kinase-phosphosite pairs, including 4 prioritized pairs with opposing patterns relevant to both diseases. Across seven independent cancer cohorts, 17 of 20 statistically significant phosphosite-cohort comparisons (85%) were concordant with the discovery findings, supporting reproducibility of the prioritized phosphosites. Together, these findings highlight opposing kinase signaling as a prominent feature of the inverse relationship and suggest potential biomarkers and therapeutic targets. This study provides a novel systems-level framework for investigating inverse relationships, supported by an R Shiny application for data exploration (https://advscancer.shinyapps.io/advscancer/). SIGNIFICANCE: This study presents an integrated proteomic and phosphoproteomic framework for investigating the inverse relationship between cancer and Alzheimer's disease (AD). By integrating differential protein abundance, phosphosite phosphorylation, inferred kinase activity, and curated kinase-substrate relationships, we identified opposing signaling patterns and prioritized four kinase-phosphosite pairs. Independent evaluation across seven CPTAC cancer cohorts supported the reproducibility of the prioritized phosphosite patterns. These findings provide insight into molecular processes potentially associated with the inverse relationship between cancer and AD, identify candidate biomarkers and therapeutic targets, and demonstrate the value of systems-level, data-driven approaches for investigating shared and opposing disease processes.

Humans↗
PubMed2004

Attitudes and behaviors related to weight control in two diverse populations.

BACKGROUND: Researchers have found that African-American women have concerns about their weight, but are less successful in their weight loss efforts compared to Caucasian women. Reasons for this disparity have not been explored in great detail. Identifying specific attitudes and behaviors that contribute to obesity in these subpopulations will help inform the design of interventions. METHODS: This report compares specific attitudes and behaviors related to diet and exercise in two groups who are trying to lose weight: African-American women in Indianapolis (n = 80) and Caucasian women from the rural Midwest (n = 45). Data are from surveys that shared many common measures, but were otherwise not related to one another. The choice of measures was guided by a conceptual framework of self-management processes. RESULTS: Compared to women in the urban study, women in the rural study report greater social support for behavior change, greater self-efficacy, and outcome expectations, and greater use of every strategy measured. CONCLUSIONS: While there is room for improvement in both groups, these results contribute to our understanding of subgroup differences and similarities in the complex behavioral issues surrounding successful weight management. Larger studies with more representative samples are needed to confirm these findings and inform future interventions.

Black or African American↗
PubMed2006

Comorbidity between and risk factors for severe hearing and memory impairment in older Americans.

OBJECTIVE: Comorbidities complicate our understanding of impairments and their risk factors. The objective of the current study was to assess the comorbidity between hearing impairment (HI) and memory impairment (MI) in older Americans and to assess to what extent they share common risk factors. METHOD: Data were examined from 5252 participants aged 65 years or older from the Third National Health and Nutrition Examination Survey (1988-1994). RESULTS: The prevalence of HI and MI was 21.4 (SE 0.8)% and 8.3 (0.6)%, respectively, but the prevalence of concurrent impairment was only 2.1 (0.2)%. African Americans had higher odds of MI than whites (OR=3.75, 95% CI: 2.81, 5.00), but not of HI (OR=0.62, 95% CI: 0.42, 0.91). Leisure physical activity was associated with lower odds of MI, good lung function was associated with lower odds of HI, and moderate alcohol use was associated with lower odds of both HI and MI. Compared with individuals free of HI, the OR of MI was 1.07 (95% CI: 0.78, 1.47) for individuals with HI. CONCLUSION: Although prevalence was relatively high, comorbidity was surprisingly low, and the two impairments were not significantly associated. In addition to age, other factors appear to play critical but different roles in the development of these impairments.

Aged↗
PubMed1999

A successful practice model for the OR.

A practice model that combines shared governance and patient care teamwork to achieve optimal surgical patient care provided the framework for a successful Joint Commission on Accreditation of Healthcare Organizations visit at the Brigham and Women's Hospital, Boston, a university-affiliated teaching hospital. This article describes ways to implement this practice model. Clinical practice, quality improvement, and development councils are explained, as well as membership criteria for the councils and how they function. The need for more sharing of such quality improvement data from other hospitals is needed to establish national standards for measuring nursing performance.

Adult↗