Showing papers by "University of Maryland, Baltimore published in 1990"
TL;DR: The ability of enteropathogenic Escherichia coli to form attaching and effacing intestinal lesions is a major characteristic of EPEC pathogenesis and a chromosomal gene (eae) that is necessary for this activity is identified using TnphoA mutagenesis.
Abstract: The ability of enteropathogenic Escherichia coli (EPEC) to form attaching and effacing intestinal lesions is a major characteristic of EPEC pathogenesis. Using TnphoA mutagenesis we have identified a chromosomal gene (eae, for E. coli attaching and effacing) that is necessary for this activity. A DNA probe derived from this gene hybridizes to 100% of E. coli of EPEC serogroups that demonstrate attaching and effacing activity on tissue culture cells as well as other pathogenic E. coli that produce attaching and effacing intestinal lesions, such as RDEC-1 (an EPEC of weanling rabbits) and enterohemorrhagic E. coli. The predicted amino acid sequence derived from the nucleotide sequence of eae shows significant homology to that of the invasin of Yersinia pseudotuberculosis.
1,141 citations
TL;DR: It is found that those who are older, have longer hospital stays, and are rehospitalized, exhibit poorer recovery, as do those displaying chronic or acute cognitive deficits and depressive symptomatology while hospitalized.
Abstract: This study evaluates predictors of recovery in walking ability, PADLs, and IADLs one year following hospital discharge for hip fracture. The sample consisted of 536 hip fracture patients aged 65 and older admitted from the community to one of seven Baltimore area hospitals between 1984 and 1986 and surviving one year post-hospital discharge. A large proportion of hip fracture patients do not regain pre-fracture PADL and IADL levels; most recovery in walking ability and ability to perform PADL and IADLs occurs by 6 months. Those who are older, have longer hospital stays, and are rehospitalized, exhibit poorer recovery, as do those displaying chronic or acute cognitive deficits and depressive symptomatology while hospitalized. Also, contact with one's social network following hospital discharge is associated with greater recovery. Findings point to the importance of psychosocial factors for recovery and suggest areas where hospital-based interventions and discharge planning efforts should focus.
823 citations
TL;DR: Pyelonephritogenic E. coli strains are more frequently cytotoxic for a putative target, that is, human renal tubular epithelium, than are fecal isolates, and Hemolysin, in some strains, is apparently responsible for this cytotoxicity.
Abstract: Acute pyelonephritis, a complication of Escherichia coli bacteriuria, must represent a bacterial invasion through the kidney epithelium. To study this process, we overlaid bacterial suspensions onto monolayers of cultured human kidney proximal tubular epithelial cells and measured cytotoxicity by release of lactate dehydrogenase (LDH). Thirty-four isolates cultured from patients with acute pyelonephritis were screened for the ability to cause pyelonephritis in CBA mice by transurethral challenge. The eight most virulent strains (greater than or equal to 70% of mice challenged developed greater than or equal to 10(3) CFU/g of kidney after 48 h) were selected for study. Each strain displayed mannose-resistant hemagglutination of human O erythrocytes; three strains were phenotypically and genotypically hemolytic. Pyelonephritogenic strains were significantly more cytotoxic (30.1 +/- 9.5% LDH release after 18 h) than eight fecal control strains (13.5 +/- 11.5% LDH release; P = 0.0068). We selected the most cytotoxic strain, CFT073, for further study. Sterile filtrate from this hemolytic strain was significantly more cytotoxic than was the filtrate of the fecal control strain, FN414. Transposon mutagenesis of CFT073 with TnphoA abolished hemolytic activity and cytotoxicity by both whole cells and sterile filtrate. Southern blot analysis revealed that the Tnphoa insertion mapped to the E. coli chromosomal hly determinant within a 12-kilobase SalI restriction fragment. Transformation of a nonhemolytic strain, CPZ005 with plasmid pSF4000, which carries a cloned hemolysin determinant, resulted in highly elevated cytotoxicity. Light micrographs of proximal tubular epithelial cell cultures demonstrated cell damage by pyelonephritogenic strains that was not induced by a fecal strain or the hemolysin-deficient mutant. Results indicate that pyelonephritogenic E. coli strains are more frequently cytotoxic for a putative target, that is, human renal tubular epithelium, than are fecal isolates. Hemolysin, in some strains, is apparently responsible for this cytotoxicity. Images
544 citations
TL;DR: The ability of five agrammatic and five anomic aphasic patients to produce nouns and verbs was assessed in four tasks, and previous findings for Italian-speaking patient groups, and for several individual cases are replicated.
430 citations
TL;DR: ASCOT provides a more precise description of patient physiologic status and injury number, location, and severity than TRISS, and may be useful in relating to other important outcomes not highly correlated with TRISS or the Injury Severity Score (ISS).
Abstract: ASCOT (A Severity Characterization of Trauma) is a physiologic and anatomic characterization of injury severity which combines emergency department admission values of Glasgow Coma Scale, systolic blood pressure, respiratory rate, patient age, and AIS-85 anatomic injury scores in a way that obviates ISS shortcomings. ASCOT values are related to survival probability using the logistic function and regression weights reaffirm the importance of head injury and coma to the prediction of patient outcome. The ability of TRISS and ASCOT to discriminate survivors from non-survivors and the reliability of their predictions, as measured by the Hosmer-Lemeshow statistic, were compared using Major Trauma Outcome Study (MTOS) patient data. ASCOT performance matched or exceeded TRISS's for blunt-injured patients and for penetrating-injured patients. ASCOT performance gains were modest for blunt-injured patients. The Hosmer-Lemeshow statistics suggest that ASCOT reliably predicts patient outcome for penetrating-injured patients and nearly so for blunt-injured patients. Statistically reliable predictions were not achieved by TRISS for either set. ASCOT provides a more precise description of patient physiologic status and injury number, location, and severity than TRISS. The ASCOT patient description may be useful in relating to other important outcomes not highly correlated with TRISS or the Injury Severity Score (ISS) such as disability, length of stay, and resources required for treatment.
382 citations
TL;DR: Generation of sphingoid bases in cells may activate a dual signaling pathway involving regulation of calcium and protein kinase C, comparable perhaps to the phosphatidylinositol and calcium signaling pathway.
Abstract: Soluble and hydrophobic lipid breakdown products have a variety of important signaling roles in cells. Here sphingoid bases derived in cells from sphingolipid breakdown are shown to have a potent and direct effect in mediating calcium release from intracellular stores. Sphingosine must be enzymically converted within the cell to a product believed to be sphingosine-1-phosphate, which thereafter effects calcium release from a pool including the inositol 1,4,5-trisphosphate-sensitive calcium pool. The sensitivity, molecular specificity, and reversibility of the effect on calcium movements closely parallel sphingoid base-mediated inhibition of protein kinase C. Generation of sphingoid bases in cells may activate a dual signaling pathway involving regulation of calcium and protein kinase C, comparable perhaps to the phosphatidylinositol and calcium signaling pathway.
382 citations
TL;DR: Examination of physical interactions between V. cholerae O1 and natural plankton populations of a geographical region in Bangladesh where cholera is an endemic disease showed that four of five clinical V.Cholera O1 strains and endogenous bacterial flora were attached preferentially to zooplankton molts (exuviae) rather than to whole specimens.
Abstract: Vibrio cholerae serogroup O1, the causative agent of cholera, is capable of surviving in aquatic environments for extended periods and is considered an autochthonous species in estuarine and brackish waters. These environments contain numerous elements that may affect its ecology. The studies reported here examined physical interactions between V. cholerae O1 and natural plankton populations of a geographical region in Bangladesh where cholera is an endemic disease. Results showed that four of five clinical V. cholerae O1 strains and endogenous bacterial flora were attached preferentially to zooplankton molts (exuviae) rather than to whole specimens. One strain attached in approximately equal numbers to both exuviae and whole specimens. V. cholerae O1 also attached to several phytoplankton species. The results show that V. cholerae O1 can bind to diverse plankton species collected from an area where cholera is an endemic disease, with potentially significant effects on its ecology.
367 citations
TL;DR: On the basis of data from families of these "constant invariant" tests on thin slabs of myocardium taken from the mid-walls of six canine left ventricles, a new polynomial form of W containing only five material parameters is proposed.
Abstract: The specific aim of this study is to determine a constitutive relation for non-contracting myocardium in terms of a pseudostrain-energy function W whose form is guided by both theory and experiment. We assume that the material symmetry of myocardium is initially and locally transversely-isotropic, and seek a W which depends upon only two coordinate invariant measures of the finite deformation. The specific functional form of such a W is inferred directly from experimental protocols in which one invariant is held constant while the other is varied, and vice versa. On the basis of data from families of these "constant invariant" tests on thin slabs of myocardium taken from the mid-walls of six canine left ventricles, we propose a new polynomial form of W containing only five material parameters.
349 citations
TL;DR: In this article, the authors demonstrate that cyclic material flow and certain distributed scheduling policies can lead to instability in the sense that the required buffer levels are unbounded, even when the set-up times for changing part types are zero.
Abstract: The paper concerns policies for sequencing material through a flexible manufacturing system to meet desired production goals for each part type. The authors demonstrate by examples that cyclic material flow and certain distributed scheduling policies can lead to instability in the sense that the required buffer levels are unbounded. This can be the case even when the set-up times for changing part types are zero. Sufficient conditions are then derived under which a class of distributed policies is stable. Finally, a general supervisory mechanism is presented which will stabilize any scheduling policy (i.e. maintain bounded buffer sizes at all machines) while satisfying the desired production rates. >
337 citations
TL;DR: The isolation and cloning of a 1-kilobase fragment from the plasmid ofEAggEC strain 17-2 is described, which should greatly facilitate epidemiologic studies assessing the importance of EAggEC as a diarrheal pathogen.
Abstract: The epidemiologic significance of enteroaggregative Escherichia coli (EAggEC) as a diarrheal pathogen has only recently come under study. Although EAggEC has been associated with persistent diarrhea in infants in some developing countries, additional studies are clearly needed. Until now, the only means of identifying EAggEC strains has been the cumbersome HEp-2 cell adhesion assay. The isolation and cloning of a 1-kilobase fragment from the plasmid of EAggEC strain 17-2 is described. This probe is 89% sensitive and 99% specific for EAggEC identification. Thus, this probe should greatly facilitate epidemiologic studies assessing the importance of EAggEC as a diarrheal pathogen.
334 citations
TL;DR: The paradigms explored at the level of the ovary have broad implications for endocrinology, in general, in that similar phenomena are likely to be operational in other highly regulated systems.
Abstract: ELUCIDATING the secrets of intraovarian intercellular communication constitutes a central area of investigation. Whereas most attention has been directed thus far at the somatic cellular components of the ovary, the potential role(s) and relative importance of resident ovarian white blood cell types have received relatively limited attention. Efforts are currently underway to reconcile traditional ovarian physiology with observations relevant to intraovarian components of the white blood cell series. In so doing, the already formidable task of analyzing intraovarian interactions stands to be further complicated. In many ways, the paradigms explored at the level of the ovary have broad implications for endocrinology, in general, in that similar phenomena are likely to be operational in other highly regulated systems. Although the present scientific literature may only provide limited information as it pertains to resident ovarian white blood cell types, the mere implications of these relatively new develop...
TL;DR: Discussion sur the possible existence d'un espace intracellulaire proche de la membrane ou la diffusion des ions Na + et Ca ++ serait freinee.
Abstract: Etude de la pompe Na + -Ca ++ dans les cellules excitables, notamment les cellules du muscle cardiaque, et de son influence sur les concentrations de calcium intracellulaire et la contraction. Suite aux publications recentes d'autres auteurs, discussion sur la possible existence d'un espace intracellulaire proche de la membrane ou la diffusion des ions Na + et Ca ++ serait freinee
TL;DR: Best-fit values of the material parameters are determined from biaxial data using a nonlinear least-squares regression and shown to be well-determined, and the final constitutive relation is shown to have good predictive capabilities.
Abstract: In the first paper of this series, we proposed a new transversely isotropic pseudostrain-energy function W for describing the biomechanical behavior of excised noncontracting myocardium. The specific functional form of W was inferred directly from biaxial data to be a polynomial function of two coordinate invariant measures of the finite deformation and five material parameters. In this paper, best-fit values of the material parameters are determined from biaxial data using a nonlinear least-squares regression. These values of the parameters are shown to be well-determined, and the final constitutive relation is shown to have good predictive capabilities. Since the proposed constitutive relation describes much broader classes of in-vitro biaxial data than previously proposed relations, it may be better applicable to analyses of stress in the passive heart.
TL;DR: The barriers in organization and financing of care (categoric and third party financing, including the special problem of diagnosis-related groups limitations) are reviewed and strategies to enhance the delivery of appropriate treatment are proposed.
Abstract: Among the frustrations of managing the dual disorders of chronic mental illness and alcohol and drug abuse is the fact that knowing what to do (by way of special programming) is insufficient to address the problem. The system problems are at least as intractable as the chronic illnesses themselves. Organizing and financing care of patients with comorbities is complicated. At issue are the ways in which we administer mental health and alcohol and drug treatment as well as finance that care. Separate administrative divisions and funding pools, while appropriate for political expediency, visibility, and administrative efficiency, have compounded the problems inherent in serving persons with multiple disabilities. Arbitrary service divisions and categorical boundaries at the State level prevent local governments and programs from organizing joint projects or creatively managing patients across service boundaries. When patients cannot adapt to the way services are organized, we risk reinforcing their overutilization of inpatient and emergency services, which are ineffective mechanisms for delivering the care these patients need. This article reviews the barriers in organization and financing of care (categoric and third party financing, including the special problem of diagnosis-related groups limitations) and proposes strategies to enhance the delivery of appropriate treatment.
TL;DR: The basic mechanisms underlying regulation of steroidogenesis within the fetoplacental unit during primate pregnancy appear similar, in important ways, to those of widely used laboratory animals, such as the rat and rabbit.
Abstract: Substantial advances in our understanding of placental function have resulted from recent establishment of in vitro approaches, such as cell culture, and application of molecular methods to study placental steroidogenesis. Insight into the processes of placental cell differentiation and hormonal function has been gained from culture of relatively pure preparations of cytotrophoblast. Various factors, e.g. cAMP and peptide growth factors, have been shown to have striking effects on progesterone and estrogen formation by placental tissue under in vitro conditions. Using advanced molecular approaches, the genes governing specific enzymes critical to placental steroidogenesis have been identified. Regulation of the mRNAs encoding specific enzyme peptides and thus expression of the genes by factors, such as cAMP, have been elucidated by Northern analysis and other techniques. It is critical that these contemporary approaches continue to be implemented aggressively to further elucidate placental function. However, it is clear from a survey of the literature, particularly of the past decade, that the vast majority of investigation in the area has been conducted in vitro. It is essential to determine whether the factors that have been observed to regulate placental endocrine function in vitro are operable in vivo. It is only with in vivo study that the dynamics of steroidogenesis and the complex functional relationships between placenta, fetus, and mother will be uncovered and understood. It is increasingly evident that the regulation of placental steroidogenesis involves autocrine and/or paracrine mechanisms, similar to those integral to hormone biosynthesis within other reproductive organs, e.g. ovary and testis. For example, as discussed above, estrogen regulates LDL uptake and P-450scc, and thus apparently is involved in generating substrate for progesterone production within the placenta. Conversely, progesterone has effects on 17 beta-hydroxysteroid oxidoreductase and thus the metabolism of estradiol, while androgens exert marked inhibitory effects on placental progesterone formation, at least in vitro. Not surprisingly, the regulation of placental progesterone and estrogen formation also is multifactorial. Thus, aromatase activity is stimulated synergistically by cAMP and phorbol esters, an effect that is suppressed by peptide growth factors. Therefore, the autocrine/paracrine and multifactorial regulation of hormone biosynthesis that has been relatively well documented in other tissues should be recognized as important in the primate placenta. Finally, the basic mechanisms underlying regulation of steroidogenesis within the fetoplacental unit during primate pregnancy appear similar, in important ways, to those of widely used laboratory animals, such as the rat and rabbit.(ABSTRACT TRUNCATED AT 400 WORDS)
TL;DR: The amino acid sequence is conserved among ureases with one, two, and three distinct subunits, suggesting a common ancestral urease gene.
Abstract: Urease of Helicobacter pylori (formerly Campylobacter pylori) is believed to represent a critical virulence determinant for this species. Ammonia generated by hydrolysis of urea may protect the acid-sensitive bacterium as it colonizes human gastric mucosa. An H. pylori strain, cultured from a gastric biopsy of a patient with complaints of abdominal pain and a history of peptic ulcer disease, was isolated on selective medium and cultured in Mueller-Hinton broth supplemented with 4% fetal calf serum. Whole cells were ruptured by French pressure cell lysis, and soluble protein was chromatographed on DEAE-Sepharose, phenyl-Sepharose, Mono-Q, and Superose 6 resins. Purified urease represented 6% of the soluble protein of crude extract, was estimated to have a native molecular size of 550 kilodaltons (kDa), and was composed of two distinct subunits of apparent molecular sizes of 66 and 29.5 kDa. On the basis of subunit size, a 1:1 subunit ratio as measured by scanning densitometry of Coomassie blue-stained sodium dodecyl sulfate-polyacrylamide gels, and estimated native molecular size, the data are consistent with a stoichiometry of (29.5 kDa-66 kDa)6 for the structure of the native enzyme. Km for urea was estimated at 0.2 mM. By N-terminal analysis, the 29.5-kDa subunit of H. pylori urease was found to share significant amino acid sequence similarity with the smallest of three subunits of the Proteus mirabilis and Morganella morganii ureases, as well as to the amino terminus of the unique jack bean subunit. The 66-kDa subunit also shared up to 80% similarity with the largest of three subunits of P. mirabilis, M. morganii, and Klebsiella aerogenes ureases and to internal sequences (amino acids 271 to 285) of the jack bean urease subunit. Thus, the amino acid sequence is conserved among ureases with one, two, and three distinct subunits, suggesting a common ancestral urease gene. Also, urease subunits of M. morganii and jack bean were specifically recognized by antisera raised against the 66-kDa subunit of H. pylori urease, demonstrating that at least some antigenic determinants were conserved among ureases from different species.
TL;DR: Testing of this predictive model on data from 323 additional patients with multiple trauma who had pelvic fracture as their index injury showed it to be a highly significant early predictor of outcome.
Abstract: • The importance of admission physiological and biochemical variables was modeled on data from 185 patients with blunt liver trauma with regard to their significance in prediction of mortality. The variables used were admission Glasgow Coma Score, base excess (or deficit), arterial lactate, injury Severity Score, and initial 24-hour volume of blood required for replacement. Each variable was modeled as a predictor of survival alone and in combination, using a linear logistic model. In any two-variable combination, Glasgow Coma Score had a high likelihood ratio for prediction representing the influence of brain injury. But as a single variable reflecting the probability of death, both base excess (LD 50 = -11.8 mmol/L) and initial 24-hour volume of blood (LD 50 =5.4 L) were highly significant. A combined logistic model of admission Glasgow Coma Score and base excess had the greatest likelihood of accurate prediction of outcome: P death = eλ/l + eλ; where λ= -0.21(Glasgow Coma Score)-0.147(base excess) + 0.285. Testing of this predictive model on data from 323 additional patients with multiple trauma who had pelvic fracture as their index injury also showed it to be a highly significant early predictor of outcome. ( Arch Surg . 1990;125:498-508)
TL;DR: In this article, a three-valued description of anatomic injury is presented and a logistic function model relating AP components and the Injury Severity Score (ISS) to survival probability is presented.
Abstract: A three-valued description of anatomic injury is presented. Anatomic profile (AP) components A, B, and C summarize serious injuries (greater than AIS 2) to the head/brain or spinal cord; to the thorax or front of the neck; and all remaining serious injuries. Relationships between AP components and survival rate reaffirm the seriousness of head injury. Logistic function models relating AP components and the Injury Severity Score (ISS) to survival probability were based on 20,946 Major Trauma Outcome Study (MTOS) patients (9.2% mortality rate) submitted through 1986. Model performance comparisons were based on 5,939 MTOS patients (7.8% mortality rate) submitted during 1987. The AP better discriminated survivors from nonsurvivors and provided a 31% increase in sensitivity when compared with the ISS. Neither the ISS nor the AP alone reliably predict patient outcome. The predictive power of methods for estimating patient survival probability which include physiologic indices or profiles, patient age, and an anatomic profile should be compared with current methods. The AP, which is based on the severity and location of all serious injuries, provides a more rational basis for comparing patient samples than the ISS.
University of Maryland, Baltimore1, Detroit Receiving Hospital2, Howard University3, Rush University Medical Center4, Virginia Commonwealth University5, University of Texas Health Science Center at Houston6, Medical University of South Carolina7, Veterans Health Administration8, Louisiana State University9
TL;DR: Atenolol, captopril, and verapamil sustained release therapy was associated with goal blood pressure achievement during the first treatment period and during the second treatment period, and side effects were minimal and comparable for all three drugs.
Abstract: A double-blind, positively controlled, forced dose titration study comparing the efficacy and safety of atenolol, captopril, and verapamil sustained release as single agents in the treatment of black patients with mild to moderate hypertension (diastolic blood pressure, 95 to 114 mm Hg) was conducted. A total of 394 patients were randomized to one of the three therapies. Mean blood pressures during a 2- to 4-week placebo treatment period (baseline) ranged from 100.4 to 100.7 mm Hg diastolic and 151.7 to 152.5 mm Hg systolic for the three groups. Of the patients, 355 (of whom 345 had assessable data) completed the first treatment period, which consisted of therapy with either 50 mg/d of atenolol, 25 mg every 12 hours of captopril, or 240 mg/d of verapamil sustained release. During the second 4-week treatment period, which 319 patients completed (307 assessable), half of the patients had their antihypertensive medication increased and the other half continued the same dose. Goal blood pressure was defined as a supine diastolic pressure of less than 90 mm Hg or a 10—mm Hg or greater drop in supine diastolic blood pressure from pretreatment levels. Atenolol, captopril, and verapamil sustained release therapy was associated with goal blood pressure achievement during the first treatment period 55.1%, 43.8%, and 65.2% of the time, respectively, and during the second treatment period 59.6%, 57.1%, and 73.0% of the time. Side effects were minimal and comparable for all three drugs. (Arch Intern Med.1990;150:1707-1713)
TL;DR: The urease activity of H. pylori may play an important role in its pathogenicity, and inhibition of this enzyme activity may have therapeutic potential.
Abstract: A human gastric adenocarcinoma cell line was used to evaluate the contribution of urease from Helicobacter (formerly Campylobacter) pylori to its cytotoxicity. Gastric cells cultured in medium supplemented with 20 mM urea were exposed to 5 x 10(6) CFU of H. pylori per ml with or without the addition of a urease inhibitor, acetohydroxamic acid. Viabilities of cells exposed to H. pylori for 2, 24, and 48 h, assessed by incorporation of neutral red dye, were 60, 27, and 16%, respectively; however, the viabilities of cells exposed to both H. pylori and acetohydroxamic acid were 92, 46, and 20% after 2, 24, and 48 h, respectively, (P less than 0.001). Therefore, the urease activity of H. pylori may play an important role in its pathogenicity, and inhibition of this enzyme activity may have therapeutic potential.
TL;DR: Findings support the utility of deficit symptoms for defining a more homogeneous subgroup of schizophrenia.
Abstract: The authors propose using primary and enduring negative or deficit symptoms for dichotomizing schizophrenic patients into two groups, deficit and nondeficit. The validity of this approach was examined by comparing 17 deficit and 17 nondeficit patients for differences in premorbid adjustement and degree of neurological impairment
TL;DR: These data emphasize the apparent importance of capsule in the virulence of V. vulnificus and indicate that utilization of transferrin-bound iron is independent of encapsulation.
Abstract: Translucent, avirulent spontaneous phase variants of Vibrio vulnificus MO6-24 reverted back to the original opaque, encapsulated phenotype under both in vivo and in vitro conditions. Two translucent, acapsular mutants, which did not show phase variation, were constructed by using the transposon Tn5 IS50L::phoA (TnphoA). Loss of capsule was accompanied by decreases in virulence, hydrophilicity, and serum resistance. The ability to utilize transferrin-bound iron for growth was lost in only one of the two unencapsulated mutants. Our data emphasize the apparent importance of capsule in the virulence of V. vulnificus and indicate that utilization of transferrin-bound iron is independent of encapsulation. Images
TL;DR: During the 15 years from 1971 through 1985, 114 patients with rupture of the thoracic aorta caused by blunt trauma were admitted to the Shock Trauma Center of the Maryland Institute for Emergency Medical Services Systems, and there was no advantage to using or not using a shunt in preventing paraplegia.
TL;DR: A consecutive series of 8 patients who developed a manic episode after a brain injury suggest a major role for the basal region of the right temporal lobe in the modulation of mood.
Abstract: We present a consecutive series of 8 patients who developed a manic episode after a brain injury. Five patients had cortical lesions (4 with damage to the right basotemporal region, and 1 with bilateral damage to the orbitofrontal area). While the other 3 patients had subcortical lesions (white matter of the right frontal lobe, right anterior limb of the internal capsule, and right head of the caudate), a fluorodeoxyglucose positron emission tomography scan showed hypometabolism in the right lateral basotemporal region in all 3 patients. These findings suggest a major role for the basal region of the right temporal lobe in the modulation of mood.
TL;DR: The observed spatial and temporal patterns of origin and propagation of [Ca2+]i waves are consistent with the hypothesis that [Ca1+] i waves arise from propagating Ca2+‐induced release of Ca2+, mediated by diffusion of cytosolic Ca2+.
Abstract: A dual, digital, indo-1 fluorescence imaging system was used to obtain high-speed ratiometric images of [Ca2+]i waves in single voltage-clamped mammalian cardiac cells. The spatiotemporal origin of [Ca2+]i waves in depolarized cells was detected as the spontaneous appearance, over 100-300 ms, of domelike regions of elevated [Ca2+]i, approximately 20 microns in diameter and 300 nM at the center. Images of [Ca2+]i taken at 67-ms intervals during propagation of [Ca2+]i waves revealed that the [Ca2+]i wave front was 1) constant in shape, 2) spatially steep, typically rising from 500 to 1200 nM in about 10 microns, and 3) propagating at constant velocity, typically 100 microns/s at 22 degrees C. The observed spatial and temporal patterns of origin and propagation of [Ca2+]i waves are consistent with the hypothesis that [Ca2+]i waves arise from propagating Ca2(+)-induced release of Ca2+ mediated by diffusion of cytosolic Ca2+. The [Ca2+]i waves are smaller in peak magnitude and can occupy a larger fraction of t...
TL;DR: The liquid formulation of Ty21a is preferable to enteric-coated capsules because it was easy to prepare by mixing lyophilised vaccine with buffer in water and was easily administered, even to the youngest children.
TL;DR: The records of 64 patients with esophageal perforation treated since 1958 were reviewed and 28 patients in the thoracic group survived, compared with 25 patients treated beyond 24 hours with 12 survivors; hence 28 (64%) of the 44 patients in that group survived.
TL;DR: In this article, the effects of three chemically distinct nonsteroidal anti-inflammatory drugs (NSAIDs) on renal function in patients with asymptomatic, mild but stable chronic renal failure were evaluated.
Abstract: Study objective To evaluate the effects of three chemically distinct nonsteroidal anti-inflammatory drugs (NSAIDs) on renal function in patients with asymptomatic, mild but stable chronic renal failure. Design Prospectively randomized, triple-crossover study with at least 1-month washout between each of three treatment periods. Setting Inpatient and outpatient clinical research center of a university teaching hospital. Patients Convenience sample of 12 women with serum creatinine levels between 130 and 270 mumols/L (1.5 and 3.0 mg/dL). Mean glomerular filtration rate +/- standard error was 0.36 +/- 0.03 mL/s.m2 (37 +/- 3 mL/min.1.73 m2); mean effective renal plasma flow was 1.6 +/- 0.18 mL/s.m2 (166 +/- 19 mL/min.1.73 m2). Interventions Patients received ibuprofen, 800 mg three times daily; piroxicam, 20 mg daily; and sulindac, 200 mg twice daily for 11 days. Treatment was discontinued if serum creatinine rose by 130 mumols/L (1.5 mg/dL) or serum potassium exceeded 6 mmol/L (6 mEq/L). Measurements and main results Three patients met our criteria for stopping ibuprofen by day 8; however, all patients completed piroxicam and sulindac therapy. When the three patients in whom ibuprofen was withdrawn were rechallenged with ibuprofen, 400 mg three times daily, two again developed evidence of acute renal deterioration. All three regimens suppressed renal prostaglandin production. Conclusions These findings indicate that a brief course of ibuprofen, a compound widely used on a nonprescription basis, may result in acute renal failure in patients with asymptomatic, mild chronic renal failure. Additional studies are needed to assess the risk of piroxicam and sulindac in patients with more pronounced renal impairment and in patients receiving longer courses of therapy, which, according to our data, may result in drug accumulation.
TL;DR: ERP activity related to short-term storage and retention of information in working memory was recorded and P3b was sensitive to information acquisition processes, but it did not distinguish between memory retention and visual search processes.