Low rate of cetuximab hypersensitivity reactions in Northeast Tennessee: An Appalachian effect?

Purpose: Cetuximab is a monoclonal antibody with a known risk of hypersensitivity reactions. Early studies showed hypersensitivity reaction rates of 3%, but there appears to be a higher incidence in the southeastern United States. To confirm the findings from nearby institutions that cetuximab-associated hypersensitivity reactions occur in approximately 20% of patients in the southeastern United States.

Successful implementation of process review in ophthalmology services.

Explains that considerable recent publicity has been given to the claim that around 70 per cent of business process re-engineering exercises are unsuccessful, mainly because of failure to take human factors into account. Outlines the work undertaken in a single specialist surgical service, within an acute services National Health Service Trust, and the outcomes achieved. Suggests that there are points arising from the project to be learned both by the Trust and by other health-care employers contemplating similar exercises: in particular, deciding objectives; the preparation undertaken prior to the project; and detailed post-implementation benefit analysis.

A novel interactive demonstration in clinical gastroenterology for first-year medical students.

A unique clinical correlation in gastroenterology for first-year medical students is described. This interactive demonstration is conducted in a clinical setting and is designed to introduce the student to a broad range of topics in clinical gastroenterology while complementing lecture material in gastrointestinal (GI) physiology. Faculty and fellows of the Department of Internal Medicine at Texas Tech University Health Sciences Center present minilectures and demonstrations at five different stations held in endoscopy rooms of the GI Diagnostic Center (GI Lab).

Vasoactive properties of a parathyroid hormone-related protein in the rat aorta.

Parathyroid hormone-related protein (PTHrP) or its mRNA transcripts have been documented in a variety of normal tissues, including vascular smooth muscle. A synthetic amino-terminal fragment of PTHrP, PTHrP(1-34), was tested a) for its vasoactive properties in a perfused rat aorta and b) its ability to stimulate cAMP accumulation in cultured rat aorta smooth muscle cells; PTHrP(1-34) was a potent vasodilator and increased cAMP accumulation. The results confirm the potent vasorelaxant properties of PTHrP(1-34), and show that the peptide stimulates adenylate cyclase in vascular smooth muscle cells per se, suggesting, but not proving, linkage of cAMP accumulation to vasorelaxation.

Beta-adrenergic responsiveness in cultured aorta smooth muscle cells. Effects of subculture and aging.

beta-Adrenoceptor-mediated vasorelaxation is diminished in vessels from a variety of aged species including humans. This phenomenon was studied for the first time in cultured aorta smooth muscle cells (ASMC) from young (4- to 6-month) and old (24- to 26-month) F-344 rats. Cyclic AMP (cAMP) accumulation was assessed following isoproterenol and forskolin stimulations in primary cultures and after 1-4 passages of aorta smooth muscle cells.

Use of a new pulsatile perfused rat aorta preparation to study the characteristics of the vasodilator effect of parathyroid hormone.

Both the native hormone and the aminoterminal 1-34 peptide of parathyroid hormone [PTH-(1-34)] are potent vasodilators of the coronary and hepatic circulations and, relatedly, produce marked hypotensive effects in a variety of animal species. In this report, a new technique for studying vasoactive substances was used to determine the nature of the vasodilator response of the aminoterminal peptide. The technique, an alternative to classical cylindrical segment or helical strip approaches, involved perfusion of a 4 to 5 cm segment of rat thoracic aorta at a constant flow rate with a circumferentially applied pulsatile "systolic" pressure of 100 mm Hg.

Vasorelaxant effect of parathyroid hormone on isolated segments of porcine coronary artery.

Parathyroid hormone and it's aminoterminal 1-34 fragment, PTH-(1-34), are potent vasodilators of the coronary circulation in vivo. In order to fully characterize the mechanism of this effect on coronary vascular resistance, it was necessary to determine whether isolated coronary arteries would respond to the action of PTH-(1-34) in vitro. Porcine coronary arteries were cut into cylindrical segments, mounted in a muscle bath containing physiological salt solution, and precontracted with prostaglandin F2.

Effects of parathyroid hormone on blood flow in different regional circulations.

Parathyroid hormone and, in particular, its 1-34 aminoterminal fragment, PTH-(1-34), are potent vasodilators of the coronary circulation. In addition the hormone exerts a powerful hypotensive effect in a variety of animals, suggesting that the polypeptide hormone is vasoactive in peripheral regional circulations as well. The purpose of this study was to determine the regional circulations that were responsive and the relative sensitivity of each to the vasoactive properties of the hormone fragment.

Parathyroid hormone reduces acute ischemic injury of the myocardium.

Synthetic parathyroid hormone (PTH), particularly the molecular fragment containing amino acids one to 34 (1-34), has been shown to produce coronary vasodilation and systemic vasodilation without tachycardia. On this basis, we tested the hypothesis that PTH(1-34) would favorably affect oxygen balance in acutely ischemic myocardium and reduce the extent of injury after coronary occlusion. Experiments were done upon the left anterior descending coronary artery which was ligated through a thoracotomy in anesthetized dogs subjected to ligation of the left anterior descending coronary artery.

Vasoactive characteristics of calcitonin in coronary and hepatic circulations.

Although parathyroid hormone (PTH) has been shown to possess potent vasodilator and hypotensive properties, little information is available on the cardiovascular effects of the other major calcium-regulating peptide hormone, calcitonin. In the present studies we examined the possibility that calcitonin may be vasoactive in the coronary and hepatic circulations. In anaesthetized open-chest or open-abdomen dogs, salmon calcitonin (sCT) (0.

Cardiovascular responses to parathyroid hormone.

The synthetic amino terminal fragment of parathyroid hormone, PTH-(1-34), is a potent coronary artery vasodilator in the dog. In the present study, using instrumented open-chest dogs, we have performed the initial characterization of this effect and showed other dose-related cardiovascular effects of the hormone. A near-maximal flow response was obtained after intracoronary injection of 0.

Endogenous triacylglycerol metabolism in diabetic heart.

The metabolism of endogenous triacylglycerols (TG) was studied in perfused working hearts of control and 12-day-old streptozotocin-treated diabetic rats. TG synthesis was assessed by the incorporation of exogenous [9,10(-3)H]palmitate. TG lipolysis was assessed by the following two methods: 1) measurement of the decrease in [14C]TG after prior in vivo isotopic prelabeling with [1-14C]palmitate and 2) calculation of the change in TG content as TG synthesis minus TG lipolysis.

Parathyroid hormone: a coronary artery vasodilator.

Injection of synthetic bovine parathyroid hormone (the amino terminal peptide containing the first 34 amino acids) to the coronary circulation of the dog resulted in a marked coronary vasodilation. The vasodilatory response was dose-dependent and amounted to a 161 percent increase over the resting flow rate at a concentration of 1.0 unit per kilogram.

Myocardial triacylglycerol metabolism in ischemia.

The utilization of transmural myocardial triacylglycerols, phospholipids and tissue free fatty acids was studied in dogs with and without left circumflex coronary artery occlusion for time intervals up to 4 hours. Results from 14C-labeling experiments reflected a continuous and dynamic turnover of transmural triacylglycerol fatty acids, phospholipid fatty acids and tissue free fatty acids in control dogs with patent coronary arteries. Coronary artery ligation resulted in markedly diminished glycerolipid utilization.

Regulation of triglyceride metabolism in the isotopically prelabeled perfused heart.

Utilization of 14C-prelabeled endogenous triglycerides was studied in isolated perfused working rat hearts. Lipolysis was estimated by the disappearance of 14C-labeled and total triglycerides. Metabolic 14CO2 production was continuously monitored to evaluate triglyceride fatty acid oxidation.

Reduced high-energy phosphate levels in rat hearts. I. Effects of alloxan diabetes.

Significant alterations in heart carbohydrate and lipid metabolism are present 48 h after intravenous injection of alloxan (60 mg/kg) in rats. It has been suggested that uncoupling of oxidative phosphorylation occurs in the alloxanized rat heart in vivo, whereas normal oxidative metabolism has been demonstrated in alloxan-diabetic rat hearts perfused in vitro under conditions of adequate oxygen delivery. We examined the hypothesis that high-energy phosphate metabolism might be adversely affected in the alloxan-diabetic rat heart in vivo.