Jewish Hospital

About: Jewish Hospital is a healthcare organization based out in Cincinnati, Ohio, United States. It is known for research contribution in the topics: Antigen & Population. The organization has 3881 authors who have published 3414 publications receiving 123044 citations.

Anesthesia for Laparoscopic Cholecystectomy Is Nitrous Oxide Contraindicated

Abstract: Since it has been suggested that the use of nitrous oxide (N2O) may contribute to bowel distention, we evaluated the effects of N2O on operating conditions during laparoscopic cholecystectomy in 50 healthy patients using a double-blind protocol design. All patients received the same preanesthetic medication (midazolam, 2 mg intravenously) and induction of anesthesia consisted of intravenously administered fentanyl 1.5 micrograms.kg-1, thiopental 4-6 mg.kg-1, and a nondepolarizing muscle relaxant. For maintenance of anesthesia, patients were randomly assigned to one of two treatment groups: group 1 (n = 26) received isoflurane with 70% N2O in oxygen (O2), whereas group 2 (n = 24) received isoflurane in an air/O2 mixture. The surgeon (blinded to the anesthetic technique) estimated the degree of technical difficulty before beginning the operation using a five-point scale. At 15-min intervals throughout the operation, the surgeon was asked to evaluate both "overall operating conditions" and degree of "bowel distension" using independent five-point scales. At the end of the operation, the surgeon was asked whether or not N2O had been used as part of the anesthetic technique. There were no significant intraoperative differences between the two groups with respect to operating conditions or bowel distension. More importantly, there was no time-related change in either variable during the course of the operation. Finally, the incidence of postoperative nausea and vomiting was similar in both treatment groups. The surgeon was able to correctly determine that N2O had been administered only 44% of the time. Thus, N2O had no clinically apparent deleterious effects during laparoscopic cholecystectomy.

PTH elevates inositol polyphosphates and diacylglycerol in a rat osteoblast-like cell line.

Abstract: Parathyroid hormone (PTH)-stimulated signal transduction through mechanisms alternate to adenosine 3',5'-cyclic monophosphate (cAMP) production were studied in UMR 106-01 cells, a cell line with an osteoblastic phenotype. PTH produced transient, dose-related increases in cytosolic calcium [( Ca2+]i), inositol trisphosphates, and diacylglycerol (DAG). Both inositol 1,4,5-trisphosphate (Ins-1,4,5P3) and inositol 1,3,4-trisphosphate (Ins-1,3,4P3) production were rapidly stimulated by PTH. Consistent with the production of Ins-1,3,4P3, rapid stimulation of late eluting inositol tetrakisphosphate was observed. The effects on the inositol phosphates were induced rapidly, consistent with roles as signals for changes in [Ca2+]i. In saponin-permeabilized UMR 106-01 cells, Ins-1,4,5P3 stimulated 45Ca release from a nonmitochondrial intracellular pool. Thus the hypothesis that PTH-stimulated Ins-1,4,5P3 production initiates Ca2+ release and contributes to transient elevations of [Ca2+]i is supported. Pretreatment of UMR 106-01 cells with pertussis toxin had no effect on PTH stimulation of inositol phosphates. Pertussis toxin reduced PTH-stimulated elevations of [Ca2+]i, but cAMP analogues had an even greater effect than pertussis toxin. These data suggest that stimulation of cAMP production during PTH stimulation may negatively affect production of rises in [Ca2+]i during PTH stimulation. The inactivation of the inhibitory G protein of adenylate cyclase by pertussis toxin could explain its action similar to cAMP analogues. Cyclic nucleotides diminish the effects of PTH on [Ca2+]i, probably interacting on a biochemical step subsequent to or independent of Ins-1,4,5P3 release.

Treatment of Disease Due to Mycobacterium intracellulare

Abstract: During eleven and one-half years, 122 patients with M. intracellulare disease were treated at National Jewish Hospital and Research Center, Denver, Colorado. Of the 81 patients treated with multiple drug chemotherapy, 63 (78%) were considered to be treatment successes. On follow-up (averaging 55 months) 40 of the 63 patients had remained clinically stable or improved and 12 had grown worse. Ten of these 63 patients had relapsed. Of the 63 patients considered to be treatment successes, 23 (36.5%) had died during follow-up, mostly of pulmonary disease. Of the 18 patients who failed to respond to chemotherapy, 2 were later successfully treated with surgery, 5 patients were clinically worsening, and 8 (44%) had died during a follow-up period averaging 43 months. A group of 41 patients had indeterminate results with chemotherapy. Eight had died while in the hospital. Follow-up information after an average of 43 months indicated that 9 patients became treatment successes (5 with chemotherapy, 4 with surgery), 12 were clinically stable or improving, and an additional 13 had died for a total of 21 deaths (51%). The overall success of treatment in the 122 patients was 61%. Fifty-two (43%) died during the study. Many patients will respond to drug therapy and remain clinically well for years. Because of the potential seriousness of this disease in some patients, multiple drug chemotherapy should be used.

Proliferative index of breast carcinoma by thymidine labeling: prognostic power independent of stage, estrogen and progesterone receptors.

Abstract: We studied cellular proliferation by measuring the tritiated thymidine labeling index (TLI) in slices of primary invasive breast carcinomas. Estrogen receptor (ER) and progesterone receptor (PgR) were measured by ligand-binding assay. The TLI was a strong independent predictor of survival and relapse-free survival in women with or without axillary lymph nodal metastases and in American Joint Committee stage I. In operable node-negative women treated surgically, predicted survival at 5 years was 89 ± 4% (probability±standard error) for 81 patients with low TLI (⩽3%), 64 ± 7% for 101 with mid TLI (3.1 – 8%), and 66 ± 6% for 86 with high TLI (>8%) (P = 0.001). Probabilities of survival for patients with positive axillary nodes were 79 ± 6% for 86 with low, 71 ± 7% for 71 with mid, and 52 ± 6% for 89 with high TLI (P = 0.0002). In stage I patients (tumor diameter not exceeding 2 cm), 5-year survival probabilities were 93 ± 4% in 70 with low, 72 ± 8% in 43 with mid, and 58 ± 10% in 35 with high TLI, (P = 0.0005). The TLI was predictive for survival and relapse-free survival within subgroups positive and negative for ER and positive for PgR (P<0.05) in stage I patients, and a predictive trend was observed in the PgR-negative subgroup (P = 0.16). TLI also predicted within different categories of vascular invasion and nuclear grade. A stepwise Cox proportional hazards model selected TLI, number of positive axillary lymph nodes, and maximum diameter of the breast carcinoma as independent variables predictive of relapse, and added ER as a fourth variable for prediction of survival.