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At least 1,693 records · Page 94Linked to original sources
PubMed2002

Kinematic and kinetic gait analysis in the sagittal plane of trans-femoral amputees before and after special gait re-education.

A special gait-training programme, combining a psychological therapeutic approach with methods in physiotherapy and body awareness, was used to re-educate nine unilateral trans-femoral amputees. All were rehabilitated trauma or tumour amputees with an age of 16-60 years. They had worn prostheses for more than 18 months. The re-education aimed at integrating the prosthesis in normal movements and increasing body awareness. Gait was measured before and after treatment and at 6 months follow-up with a three-dimensional motion analysis system. Results showed almost normalised gait speed and increased symmetry in the hip joints with increased muscle work on the amputated side both immediately and at follow-up. At follow-up there were significant differences in almost all parameters between the two legs of the subjects and when compared to a reference group of 18 healthy volunteers of similar age. Thus, the intact leg compensates for loss of function in the amputated leg and thereby works differently compared to the reference group. For example, during shock absorption the extension moment in the intact knee increased from 0.6 Nm/kg before to 1.0 Nm/kg after treatment and at follow-up compared to 0.4 Nm/kg in the reference group. The eccentric power of quadriceps increased from 0.6 w/kg before to 1.8 w/kg after treatment and 1.7 w/kg at follow-up compared to 0.4 w/kg in the reference group. The limp of amputees is usually observed in the frontal plane, but the authors' special focus on the sagittal plane here illustrates gait propulsion influences. The positive training results remained after six months.

Adolescent↗
PubMed2003

Medical specialization, profession, and mediating beliefs that predict stated likelihood of alcohol screening and brief intervention: targeting educational interventions.

Practitioner-level educational approaches that promote screening and brief intervention (SBI) seldom consider providers' profession and medical specialization. Strategies that consider these variables may be better equipped to affect change in beliefs and behavior. The aim of this study was to identify beliefs that predict stated likelihood of practicing SBI by specialty and health profession in order to guide the direction of educational strategies. Physicians and nurse practitioners were studied that specialized in family, internal, obstetric gynecology (ObGyn), and pediatric medicine. The results indicated that independent of amount of previous postgraduate alcohol education and knowledge, self-rated competence mediated between specialty and likelihood of practicing SBI. For instance, low self-rated competence for ObGyn was a barrier that suppressed likelihood of practicing SBI. Other findings were that role legitimacy mediated the association between profession and likelihood of SBI, so that lack of role legitimacy was a barrier for physicians but not for nurse practitioners. We suggest that targeted educational strategies for ObGyn and pediatric clinicians may prove more effective than the prevalent one-size-fits all approaches aimed at general adult populations.

Alcoholism↗
PubMed2005

Reliability in assigning ICF codes to children with special health care needs using a developmentally structured interview.

PURPOSE: The purpose of this study was to determine if two teams of raters could reliably assign codes and performance qualifiers from the Activities and Participation component of the International Classification of Functioning, Disability, and Health (ICF) to children with special health care needs based on the results of a developmentally structured interview. METHOD: Children (N = 40), ages 11 months to 12 years 10 months, with a range of health conditions, were evaluated using a structured interview consisting of open-ended questions and scored using developmental guidelines. For each child, two raters made a binary decision indicating whether codes represented an area of need or no need for that child. Raters assigned a performance qualifier, based on the ICF guidelines, to each code designated as an area of need. Cohen's kappa statistic was used as the measure of inter-rater reliability. RESULTS: Team I reached good to excellent agreement on 39/39 codes and Team II on 38/39 codes. Team I reached good to excellent agreement on 5/5 qualifiers and Team II on 10/14 qualifiers. CONCLUSIONS: A developmentally structured interview was an effective clinical tool for assigning ICF codes to children with special health care needs. The interview resulted in higher rates of agreement than did results from standardized functional assessments. Guidelines for assigning performance qualifiers must be modified for use with children.

Activities of Daily Living↗
PubMedDate not supplied

Usage of emergency medical services by children with special health care needs.

OBJECTIVE: To describe the usage of emergency medical services (EMS) by children with special health care needs (CSHCN). METHODS: All EMS runs and related hospital records for children aged 0-17 years in Utah in 1991-92 were linked. The CSHCN status was determined from ICD-9 diagnoses using three available definitions. The amounts of EMS usage were compared between CSHCN and other children. A pediatric intensive care practitioner determined CSHCN status by chart review for 915 children transported by EMS to a pediatric tertiary care hospital, and his classification was compared with the CSHCN status assigned by the three ICD-9-based definitions. RESULTS: The three definitions assigned CSHCN status for 2% to 24% of children using EMS. When compared with other children, CSHCN were more likely to be admitted to the hospital, more likely to use EMS for transfer between health care facilities, and more likely to receive prehospital procedures such as intravenous therapy. In the group of children whose charts were reviewed individually, one ICD-9-based definition most closely agreed to determination of CSHCN status by a pediatric intensive care practitioner. CONCLUSIONS: Children with special health care needs who use EMS are more likely to receive advanced life support service, to receive prehospital procedures, and to be transferred from one health care facility to another. There is need for a specific and measurable definition of CSHCN that can be applied to existing health data.

Adolescent↗
PubMedDate not supplied

Children with special health care needs: a template for prehospital protocol development.

There are 12 million children in the United States with special health care needs. Improvements in medical technology, managed care, and changing social views about the institutionalization of children have all contributed to an increasing number of children with special health care needs (CSHCN) residing primarily in their home communities. Because of the dynamic and fragile nature of the medical conditions typically borne by CSHCN, the need for emergency care is not uncommon and prehospital providers are increasingly likely to encounter this population. Few states have initiated emergency medical services (EMS) protocols addressing field assessment, management, and stabilization of CSHCN and existing model protocols have not yet incorporated a distinct CSHCN component. With the support of grant funding from the federal Emergency Medical Services for Children (EMSC) program, a project was undertaken by investigators in the Center for Prehospital Pediatrics at Children's National Medical Center to develop prehospital protocols for CSHCN. This report details the protocol development process, discusses suggestions for their use, and presents the detailed protocols. The protocols are intended to serve as a resource template for the development and/or revision of jurisdiction-specific, customized practice guidelines.

Child↗
PubMedDate not supplied

Dengue fever with hemorrhagic features in a special forces soldier.

Military operations are conducted in a variety of settings. Some settings provide significant U.S. resources for preventive, primary, urgent, and emergency or trauma care. Other operations consist of small numbers of personnel relying on limited internal, improvised, and/or host nation resources. Special Forces often conduct their missions in rural, austere, and remote settings with a small "medical footprint." Often the supported government has difficulty providing essential services, including medical care. To address this, U.S. Special Forces select and train highly motivated individuals to perform medical duties in an exceptionally austere environment devoid of resources. This case highlights those services and the medical decision-making process required to provide medical care to approach the standard of care in the United States. In this case, the affected individual had dengue fever.

Adult↗
PubMed2004

Core curriculum and special study modules at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak.

INTRODUCTION: The Faculty of Medicine and Health Sciences (FMHS), follows a problem-based learning, integrated and community-based curriculum which reflects the specific needs of doctors working in Sarawak. Using paediatrics as an example, this paper describes the process of development of core content (knowledge, procedural and communication skills, attitudes), additional knowledge and special study modules at the FMHS. OBJECTIVES: In 2003, the Department of Paediatrics and Child Health conducted a workshop to evaluate and update its 5-year-old curriculum. METHODS: The wise-men approach was adopted. Local and guest academicians (including members of the Department of Community Medicine and Basic Health Sciences), consultants, registrar, house officer and nursing staff of the Paediatric Department of Sarawak General Hospital (SGH), paediatric nursing lecturer and members of Medical Education Unit were involved. The review was based on three approaches: Problem/Task-based learning; Spiral curriculum; Outcome-based education. RESULTS: Core content and additional knowledge topics were modified. The special study modules were retained, but their duration was reduced. It was recommended that the curriculum should be reviewed at regular intervals. DISCUSSION: To select the core content and additional knowledge topics, clear and specific criteria were developed. Some topics were dropped, others were added, and some were moved from core to the additional knowledge section. CONCLUSION: It was a rewarding activity. The reviewed curriculum was received well by both the students and faculty. The enthusiasm and cooperation extended, especially by the faculty at SGH in the implementation of this curriculum, was remarkable.

Curriculum↗
PubMed1990

Special considerations for conducting permeation testing of protective clothing materials with gases and chemical vapors.

Testing the permeation resistance of protective clothing materials against chemical gases and vapors requires attention to additional factors over conventional material permeation testing with liquids. Permeation testing factors relevant to gas and vapor challenges are described, and results for testing various material-gas combinations are reported. Challenging protective clothing materials with gases presents a series of special problems including gas delivery, cell integrity, sufficient analytical detection, and disposal. The concentration and other properties of gases and vapors are very sensitive to small changes in temperature and pressure. The method of delivering gases or vapors to the test cell must provide for careful regulation of these variables and maintain homogeneous contact of the chemical with the material over the test period. While many organic vapors are easily and directly detectable by gas chromatographic methods, several gases require special collection media and analytical procedures to achieve detection limits below 1 ppm. Handling of exhaust gas from the challenge chamber of the test cell must reflect safe laboratory practices without creating unnecessary chemical waste. Recommended procedures and results are presented for the six new gases added to ASTM Standard Guide F1001, Selection of Chemical Liquids and Gases to Evaluate Protective Clothing Materials, as well as for other difficult test gases used in evaluating protective clothing materials.

Air Pollutants↗
PubMed2000

Genetic divergence at the SODA locus of six different formae speciales of Pneumocystis carinii.

Genetic divergence at the SODA (manganese-dependent superoxide dismutase, MnSOD) locus were compared in six Pneumocystis carinii formae speciales isolated from mouse, rabbit, human, macaque and pig. A degenerate oligonucleotide primer strategy was designed to amplify 85-90% of the full-length SODA gene from P. carinii genomic DNA isolates. DNA sequence analysis revealed an A/T bias in the nucleotide composition (71-77.2%) and the presence of seven small introns (41-142 bp), interrupting each P. carinii open reading frame (ORF) at the same position. The MnSOD deduced amino acid sequences from all P. carinii isolates shared residues which were conserved within the MnSOD family and which are required for enzymatic activity and binding of the cofactor metal. Phylogenetic analysis including MnSOD sequences from representatives of the fungal phyla Basidiomycota and Ascomycota indicated that the P. carinii formae speciales form a monophyletic group that is related to the budding yeasts (subphylum Saccharomycotina, previously called class Hemiascomycetes) in the Ascomycota. In the whole Pneumocystis group, P. carinii f. sp. hominis, P. carinii f. sp. macacae and P. carinii f. sp. oryctolagi MnSOD sequences clustered together, as did the rat-derived P. carinii and P. carinii f. sp. muris sequences.

Amino Acid Sequence↗
PubMed1998

The genomic sequences bound to special AT-rich sequence-binding protein 1 (SATB1) in vivo in Jurkat T cells are tightly associated with the nuclear matrix at the bases of the chromatin loops.

Special AT-rich sequence-binding protein 1 (SATB1), a DNA-binding protein expressed predominantly in thymocytes, recognizes an ATC sequence context that consists of a cluster of sequence stretches with well-mixed A's, T's, and C's without G's on one strand. Such regions confer a high propensity for stable base unpairing. Using an in vivo cross-linking strategy, specialized genomic sequences (0.1-1. 1 kbp) that bind to SATB1 in human lymphoblastic cell line Jurkat cells were individually isolated and characterized. All in vivo SATB1-binding sequences examined contained typical ATC sequence contexts, with some exhibiting homology to autonomously replicating sequences from the yeast Saccharomyces cerevisiae that function as replication origins in yeast cells. In addition, LINE 1 elements, satellite 2 sequences, and CpG island-containing DNA were identified. To examine the higher-order packaging of these in vivo SATB1-binding sequences, high-resolution in situ fluorescence hybridization was performed with both nuclear "halos" with distended loops and the nuclear matrix after the majority of DNA had been removed by nuclease digestion. In vivo SATB1-binding sequences hybridized to genomic DNA as single spots within the residual nucleus circumscribed by the halo of DNA and remained as single spots in the nuclear matrix, indicating that these sequences are localized at the base of chromatin loops. In human breast cancer SK-BR-3 cells that do not express SATB1, at least one such sequence was found not anchored onto the nuclear matrix. These findings provide the first evidence that a cell type-specific factor such as SATB1 binds to the base of chromatin loops in vivo and suggests that a specific chromatin loop domain structure is involved in T cell-specific gene regulation.

Base Composition↗
PubMed1999

The junction-associated protein AF-6 interacts and clusters with specific Eph receptor tyrosine kinases at specialized sites of cell-cell contact in the brain.

The AF-6/afadin protein, which contains a single PDZ domain, forms a peripheral component of cell membranes at specialized sites of cell-cell junctions. To identify potential receptor-binding targets of AF-6 we screened the PDZ domain of AF-6 against a range of COOH-terminal peptides selected from receptors having potential PDZ domain-binding termini. The PDZ domain of AF-6 interacts with a subset of members of the Eph subfamily of RTKs via its COOH terminus both in vitro and in vivo. Cotransfection of a green fluorescent protein-tagged AF-6 fusion protein with full-length Eph receptors into heterologous cells induces a clustering of the Eph receptors and AF-6 at sites of cell-cell contact. Immunohistochemical analysis in the adult rat brain reveals coclustering of AF-6 with Eph receptors at postsynaptic membrane sites of excitatory synapses in the hippocampus. Furthermore, AF-6 is a substrate for a subgroup of Eph receptors and phosphorylation of AF-6 is dependent on a functional kinase domain of the receptor. The physical interaction of endogenous AF-6 with Eph receptors is demonstrated by coimmunoprecipitation from whole rat brain lysates. AF-6 is a candidate for mediating the clustering of Eph receptors at postsynaptic specializations in the adult rat brain.

Animals↗
PubMed1973

Membrane specialization at an insect myoneural junction.

Myoneural junctions were examined in the asynchronous basalar flight muscle of the beetle Pachnoda ephippiata. The outer surface of the postjunctional membrane exhibits an array of prominent projections spaced at approximately 200 A intervals which arise directly from the outer dense lamina of the plasma membrane and extend part way across the junctional cleft. The projections follow irregularities in the contour of the postjunctional membrane precisely and they end abruptly near the edge of the junctional region. No separation can be resolved between the projections and the underlying trilaminar plasma membrane after a variety of preparative methods, and the projections therefore appear to be a component part of the membrane. This specialization, which is distinctly different from that at desmosomes and hemidesmosomes, occurs nowhere else on the surface of the muscle and is interpreted as a mosaic of specialized membrane subunits which probably include the receptor sites for the transmitter.

Animals↗
PubMed1983

Specialization of the macrophage plasma membrane at sites of interaction with opsonized erythrocytes.

We incubated mouse peritoneal macrophages for 3-8 min at 37 degrees C with antibody-coated sheep erythrocytes and examined regions of close interaction between the two cell types by electron microscopy. At sites of focal macrophage-erythrocyte contact we observed a distinctive specialization of the macrophage plasma membrane consisting of a prominent subplasmalemmal band of electron-dense material, approximately 25-35 nm in thickness. In many instances, this band showed a periodic substructure similar to that seen in clathrin coats. Moreover, many slender erythrocyte processes penetrated into invaginations of the macrophage surface which were bristle-coated at their blind extremity. As previously shown for clathrin-coated pits, the segments of the macrophage plasma membrane beneath which the defense material was found were selectively resistant to the membrane-perturbing effect of the antibiotic, filipin. This structural specialization of the macrophage plasma membrane at sites of ligand-receptor interaction during immune phagocytosis of antibody-coated erythrocytes may represent the morphological counterpart of the zipper mechanism of phagocytosis previously demonstrated by functional studies.

Animals↗
PubMed1984

Early cytoplasmic specialization at the presumptive acetylcholine receptor cluster: a meshwork of thin filaments.

Postsynaptic differentiation can be experimentally induced in cultured Xenopus myotomal muscle cells by polyornithine-coated latex beads (Peng, H. B., and P.-C. Cheng, 1982, J. Neurosci., 2:1760-1774). In this study, we examined the time course of this process. Small, punctate acetylcholine receptor (AChR) clusters were detectable as early as 1.5 h after the addition of the beads. Subsequently, both the size and the number of the clusters increased with time until a saturation level was reached between 8-24 h. Because the onset and the site of the AChR clustering could be precisely marked, we were able to examine the early structural specializations associated with presumptive AChR clusters. At 1 h, when less than 20% bead-muscle contacts displayed AChR clusters, 70% of the contacts already exhibited a meshwork of 5-6-nm filaments, which were of the same size as the thin filaments within the myofibrils and thus may contain actin. A system of cisternae similar to the smooth endoplasmic reticulum was suspended within this meshwork, but other organelles were excluded from it. This meshwork, being the earliest cytoplasmic specialization at the presumptive AChR clusters and appearing before the clusters, may be a mechanism for the clustering process.

Animals↗
PubMed2001

Isolation and characterization of dermal lymphatic and blood endothelial cells reveal stable and functionally specialized cell lineages.

A plexus of lymphatic vessels guides interstitial fluid, passenger leukocytes, and tumor cells toward regional lymph nodes. Microvascular endothelial cells (ECs) of lymph channels (LECs) are difficult to distinguish from those of blood vessels (BECs) because both express a similar set of markers, such as CD31, CD34, podocalyxin, von Willebrand factor (vWF), etc. Analysis of the specific properties of LECs was hampered so far by lack of tools to isolate LECs. Recently, the 38-kD mucoprotein podoplanin was found to be expressed by microvascular LECs but not BECs in vivo. Here we isolated for the first time podoplanin(+) LECs and podoplanin(-) BECs from dermal cell suspensions by multicolor flow cytometry. Both EC types were propagated and stably expressed VE-cadherin, CD31, and vWF. Molecules selectively displayed by LECs in vivo, i.e., podoplanin, the hyaluronate receptor LYVE-1, and the vascular endothelial cell growth factor (VEGF)-C receptor, fms-like tyrosine kinase 4 (Flt-4)/VEGFR-3, were strongly expressed by expanded LECs, but not BECs. Conversely, BECs but not LECs expressed VEGF-C. LECs as well as BECs formed junctional contacts with similar molecular composition and ultrastructural features. Nevertheless, the two EC types assembled in vitro in vascular tubes in a strictly homotypic fashion. This EC specialization extends to the secretion of biologically relevant chemotactic factors: LECs, but not BECs, constitutively secrete the CC chemokine receptor (CCR)7 ligand secondary lymphoid tissue chemokine (SLC)/CCL21 at their basal side, while both subsets, upon activation, release macrophage inflammatory protein (MIP)-3alpha/CCL20 apically. These results demonstrate that LECs and BECs constitute stable and specialized EC lineages equipped with the potential to navigate leukocytes and, perhaps also, tumor cells into and out of the tissues.

Adult↗
PubMed1975

Reflections on fifty years of publications on the history of general biology and special embryology.

The publications of fifty years (1925-1974) of the histroy of biology and embryology are surveyed. In America, the earliest background for work during this period was provided by the collectors, mainly physicians, of books into extensive private libraries. The collectors, for instance Osler, Cushing, and Fulton in this country and Geoffrey Keynes abroad, became expert technical bibliographers during the early part of the half-century under consideration. High standards for medical, thus biological history, insofar as these fields overlap, were also set earlier by Sudhoff's Institut für Geschichte der Medizin in Leipzig, and American historical studies benefited when Sigerist came from Leipzig to Baltimore in the early 1930's. Textbooks of medical history are omitted from discussion here, but a number of more or less general histories of biology published within the specified period are briefly evaluated. The discussion next turns to histories of embryology, general and special. Recent monographs on the classical embryologists, Wolff and von Baer, are enumerated, as are a number of biographies and autobiographies of important embryologists published here or abroad during our half-century. Then general histories of embryology are discussed, and finally some specialized ones. Needham, Roger, and Adelmann are singled out as the most important contributors to the history of embryology, in the West, during the period covered. Few of the contributors to the history of biology and medicine during the years of 1925 through 1974 were trained as historians while students. It is concluded that the History of Science Society has performed an important contribution in professionalizing the history of biology and embryology, but it is pointed out that a great new challenge faces it in the necessity to counteract anti-historical and anti-intellectual moods and movements of today.

Bibliographies as Topic↗
PubMed2006

Ecological specialization and adaptive decay in digital organisms.

The transition from generalist to specialist may entail the loss of unused traits or abilities, resulting in narrow niche breadth. Here we examine the process of specialization in digital organisms--self-replicating computer programs that mutate, adapt, and evolve. Digital organisms obtain energy by performing computations with numbers they input from their environment. We examined the evolutionary trajectory of generalist organisms in an ecologically narrow environment, where only a single computation yielded energy. We determined the extent to which improvements in this one function were associated with losses of other functions, leading to organisms that were highly specialized to perform only one or a few functions. Our results show that as organisms evolved improved performance of the selected function, they often lost the ability to perform other computations, and these losses resulted most often from the accumulation of neutral and deleterious mutations. Beneficial mutations, although relatively rare, were disproportionately likely to cause losses of function, indicating that antagonistic pleiotropy contributed significantly to niche breadth reductions in this system. Occasionally, unused functions were not lost and even increased in performance. Here we find that understanding how the functions were integrated into the genome was crucial to predictions of their maintenance.

Adaptation, Biological↗
PubMed2001

A monte carlo study of dose rate distribution around the specially asymmetric CSM3-a 137Cs source.

The CSM3 137Cs type stainless-steel encapsulated source is widely used in manually afterloaded low dose rate brachytherapy. A specially asymmetric source, CSM3-a, has been designed by CIS Bio International (France) substituting the eyelet side seed with an inactive material in the CSM3 source. This modification has been done in order to allow a uniform dose level over the upper vaginal surface when this 'linear' source is inserted at the top of the dome vaginal applicators. In this study the Monte Carlo GEANT3 simulation code, incorporating the source geometry in detail, was used to investigate the dosimetric characteristics of this special CSM3-a 137Cs brachytherapy source. The absolute dose rate distribution in water around this source was calculated and is presented in the form of an along-away table. Comparison of Sievert integral type calculations with Monte Carlo results are discussed.

Algorithms↗