Impact of environment on state university hospital performance. An explanatory model.

This article, by means of a path model, shows the impact of environment on state university hospital performance. The state environment is shown to affect systematically the intensity of local competition, the reputation of the medical school, the financial independence of the parent university, the allocation of indigent care dollars, the nature of governance and management, and the performance of the hospital. Results show that while certain environments are predictably more supportive of universities and university hospitals, these environments tend also to attract health care competition.

Sequence determination of the capsid protein gene and flanking regions of tobacco etch virus: Evidence for synthesis and processing of a polyprotein in potyvirus genome expression.

The nucleotide sequence of the 3'-terminal portion of the tobacco etch virus (TEV) genome was determined. The 2324-nucleotide sequence represented approximately one-fourth of the TEV genome and included the capsid protein gene and flanking regions. An open reading frame of 2135 nucleotides and an untranslated region of 189 nucleotides adjacent to a polyadenylate tract were identified.

Bromhexine in the treatment of otitis media with effusion.

In a double blind randomised trial of 95 children aged 3-8 years with otitis media with effusion (OME), the efficacy of the mucolytic agent bromhexine hydrochloride (Bisolvon) was compared with a placebo. Each child received two 4 week courses of either bromhexine or placebo in a random fashion. One hundred and ninety ears were available for analysis, i.

Effects of histamine, serotonin, and norepinephrine on circulation of dog lungs.

The action of histamine (H), serotonin (5-HT), and norepinephrine (NE) on the lung vasculature was evaluated in isolated blood-perfused dog lung lobes using isogravimetric techniques. Pre- and postcapillary resistances, isogravimetric capillary pressure (Pc,i), capillary filtration pressure (Pc,f), capillary filtration coefficient (Kf,c), and vascular pressure-volume relationships were measured. For constant-flow conditions, all drugs induced marked increases in both pre- and postcapillary resistances and increased Pc,f.

Effect of edema and hemodynamic changes on extravascular thermal volume of the lung.

The extravascular thermal volume of the lung (ETV) has been measured in dogs as the difference between mean transit time (t) volumes for heat and indocyanine green dye across the pulmonary circulation, calculated as the product of thermal dilution cardiac output (CO) and the difference in t for aortic indicator-dilution curves generated by right and left atrial injections. ETV measurements were compared with the extravascular lung mass (ELM): in 21 normal dogs, ETV/ELM = 1.11 +/- 0.

Effect of naloxone on gastric emptying during labour.

The rate of gastric emptying was studied in 30 women during labour. All the women had received pethidine 100 mg i.m.

Concerning the equilibrium exchange kinetics and mechanism of the sheep brain glutamine synthetase reaction.

Isotope exchange measurements of sheep brain glutamine synthetase have yielded conflicting experimental findings and interpretation, leaving in doubt the question of whether the enzyme operates via ordered or random pathways of enzyme-substrate interactions. We now report new experimental evidence that demonstrates the earlier discrepant results may be attributed to the choice of reaction conditions used to achieve equilibration of the chemical reaction prior to addition of isotopic tracer. A random kinetic mechanism, perhaps not of the rapid-equilibrium type, is most compatible with the exchange data.

Pulmonary sequestration: a review of 12 cases.

A review of patients over a twenty-three year period with a diagnosis of pulmonary sequestration was undertaken. Of the twelve patients with this diagnosis, ten had intralobar sequestrations, and two had the extralobar variety. The most common presenting complaint, in six of the patients, was an unresolving localised chest infection.

Effect of air embolism on the measurement of extravascular lung thermal volume.

To determine the accuracy of thermal-dye indicator-dilution measurements of lung water during perfusion abnormalities, we embolized air into the lungs of 10 dogs anesthetized with pentobarbital and mechanically ventilated. A control period was followed by a period of air injection (10 ml) and subsequent air infusion (E1), a second period of air injection and infusion (E2), and a recovery period. Thermal and dye-dilution curves were obtained during each period, and cardiac output (CO), total thermal volume, intravascular volume, and extravascular thermal volume (ETV) were calculated.

Effects of consumption of choline and lecithin on neurological and cardiovascular systems.

This report concerns possible adverse health effects and benefits that might result from consumption of large amounts of choline, lecithin, or phosphatidylcholine. Indications from preliminary investigations that administration of choline or lecithin might alleviate some neurological disturbances, prevent hypercholesteremia and atherosclerosis, and restore memory and cognition have resulted in much research and public interest. Symptoms of tardive dyskinesia and Alzheimer's disease have been ameliorated in some patients and varied responses have been observed in the treatment of Gilles de la Tourette's disease, Friedreich's ataxia, levodopa-induced dyskinesia, mania, Huntington's disease, and myasthenic syndrome.

Interconversion of leukotrienes catalyzed by purified gamma-glutamyl transpeptidase: concomitant formation of leukotriene D4 and gamma-glutamyl amino acids.

The reversible conversion of leukotriene C4 to leukotriene D4 and of the latter to leukotriene E4 were studied with highly purified homogeneous preparations of gamma-glutamyl transpeptidase, dipeptidase, and aminopeptidase M. The conversion of leukotriene C4 to leukotriene D4, catalyzed by gamma-glutamyl transpeptidase, is significantly more rapid when carried out in the presence of an amino acid mixture a closely approximating that found in blood plasma and is accompanied by gamma-glutamyl amino acid formation. Because gamma-glutamyl transpeptidase is bound to the external surface of cell membranes and thus is readily accessible to plasma amino acids, it appears that conversion of leukotriene C4 to leukotriene D4 under physiological conditions is coupled with the formation of gamma-glutamyl amino acids.

Response to aminoglutethimide after tamoxifen therapy in advanced breast cancer.

We describe sequential response to aminoglutethimide after eventual failure of treatment with tamoxifen in a patient with metastatic breast cancer. We suggest that aminoglutethimide is the next logical hormone therapy for such patients.

Edema affects intra-alveolar fluid pressures and interdependence in dog lungs.

The pressures in occluded, fluid-filled segments of lung were measured in closed-chest supine dogs ventilated with positive pressure at a constant tidal volume. Segment fluid pressures decreased in response to lung inflation and were used with esophageal and airway pressures to calculate an index of bronchiolar-parenchymal interdependence. Animals were subjected to three sequential 5% body wt infusions of Tyrode's solution followed by a 20- to 30 min-recovery period after each infusion.

Evidence that transpeptidation is a significant function of gamma-glutamyl transpeptidase.

gamma-Glutamyl transpeptidase (purified from rat kidney) was incubated with glutathione and a mixture of amino acids that closely approximates the amino acid composition of blood plasma, and the relative extents of transpeptidation and hydrolysis were determined by quantitative measurement of the products formed (glutamate, cysteinylglycine, gamma-glutamyl amino acids). At pH 7.4, in the presence of 50 microM glutathione and the amino acid mixture, about 50% of the glutathione that was utilized participated in transpeptidation.