Carbohydrate carbocyclization by a zinc-mediated tandem reaction and ring-closing enyne metathesis.

Methyl 5-deoxy-5-iodo-pentofuranosides are reductively ring-opened and propargylated in a tandem fashion in the presence of zinc. The 1,7-enynes thus obtained are subjected to ring-closing enyne metathesis with catalyst B to produce functionalized 1-vinyl cyclohexenes. By adding BnNH(2) to the tandem reaction, an amino group can be introduced in the 1,7-enyne products.

Population-specific histological age-estimating method: a model for known African-American and European-American skeletal remains.

Previously developed histological age-estimating methods have been based on samples lacking interpopulation variability. A comparison of age-associated rib histomorphometrics between an European-American sample and an African-American sample indicates that ethnicity can have a significant effect on osteon population density (OPD), osteon cross-sectional area (On.Ar), and relative cortical area (Ct.

Usefulness of a pediatric colonoscope for routine colonoscopy in women who have undergone hysterectomy.

Background: Colonoscopy can be difficult in some women who have undergone hysterectomy, which can be associated with a fixed, angulated sigmoid colon caused by postoperative pelvic adhesions. Our goal was to determine whether colonoscopy is easier and more comfortable for women after hysterectomy when performed with a pediatric colonoscope, which is thinner in diameter and more flexible than a standard "adult" colonoscope.

Methods: One hundred women with a history of hysterectomy undergoing outpatient colonoscopy were randomized in unblinded fashion to colonoscopy with a standard colonoscope (CF-100L or CF-Q140L, Olympus) or with a pediatric colonoscope (PCF-100, Olympus).

Interpretation of flow cytometric measurement of lymphocytes after fluorescein angiography.

Purpose: By use of flow cytometry (FCM), lymphocyte subsets were evaluated with fluorochrome-labeled monoclonal antibodies (MoAbs). Recent fluorescein angiography (FA) produces temporary elevation of serum background fluorescence at certain wavelengths of light, producing falsely decreased lymphocyte subset quantitations. The authors evaluated the duration of this effect on one subset of lymphocytes after FA.

Transthoracic defibrillation of dogs with Edmark, biphasic, and quadriphasic waveforms.

Patients with high transthoracic impedance are reported to be at higher risk of poor outcomes when treated by present defibrillators. This study evaluates the defibrillation efficacy of biphasic truncated exponential (BTE), quadriphasic truncated exponential (QTE), and Edmark waveforms at simulated low, average, and high impedance levels. Waveforms were tested at 2 energy levels in random order in anesthetized dogs (n = 15, 16.

Using telemedicine to avoid transfer of rural emergency department patients.

Access to emergency treatment in rural areas can often mean the difference between life and death. Telemedicine technologies have the potential of providing earlier diagnosis and intervention, of saving lives and of avoiding unnecessary transfers from rural hospital emergency departments to urban hospitals. This study examined the hypothetical impact of telemedicine services on patients served by the emergency departments of two rural Missouri hospitals and the potential financial impact on the affected hospitals.

Predicting mortality in nursing home residents with lower respiratory tract infection: The Missouri LRI Study.

Context: Lower respiratory tract infection (LRI) is a leading cause of mortality and hospitalization in nursing home residents. Treatment decisions may be aided by a clinical prediction rule that identifies residents at low and high risk of mortality.

Objective: To identify patient characteristics predictive of 30-day mortality in nursing home residents with an LRI.

Clinical findings associated with radiographic pneumonia in nursing home residents.

Objective: Subtle presentation and the frequent lack of on-site physicians complicate the diagnosis of pneumonia in nursing home residents. We sought to identify clinical findings (signs, symptoms, and simple laboratory studies) associated with radiographic pneumonia in sick nursing home residents.

Study Design: This was a prospective cohort study.

Randomized clinical trial of a quality improvement intervention in nursing homes.

Purpose: The purpose of the study was to determine if simply providing nursing facilities with comparative quality performance information and education about quality improvement would improve clinical practices and subsequently improve resident outcomes, or if a stronger intervention, expert clinical consultation with nursing facility staff, is needed.

Design And Methods: Nursing facilities (n = 113) were randomly assigned to one of three groups: workshop and feedback reports only, workshop and feedback reports with clinical consultation, and control. Minimum Data Set (MDS) Quality Indicator (QI) feedback reports were prepared and sent quarterly to each facility in intervention groups for a year.

Temperature effect on nausea during fluorescein angiography.

Purpose: Nausea is the most common adverse effect of fluorescein angiography (FA). Warming of fluorescein dye before injection has been reported anecdotally to decrease nausea frequency. We examined the effect of warmed fluorescein dye on the frequency of adverse effects of FA.

Efficient synthesis of enantiopure conduritols by ring-closing metathesis.

Two short synthetic approaches to enantiopure conduritols are described starting from the chiral pool. In both cases, the cyclohexene ring is assembled via ring-closing olefin metathesis. The terminal diene precursers for the metathesis reaction are prepared either from octitols or from tartaric acids.

A convenient route to higher sugars by two-carbon chain elongation using Wittig/dihydroxylation reactions.

The combination of a Wittig olefination and a dihydroxylation reaction constitutes a facile synthetic protocol for the transformation of unprotected carbohydrates into higher sugars. The Wittig reaction is carried out with tert-butyl or diphenylmethyl ester stabilized phosphoranes to give (E)-configured alpha,beta-unsaturated esters as the only products in most cases. These are dihydroxylated in a diastereoselective fashion using OsO(4)/NMO.

Engineering the pH-optimum of a triglyceride lipase: from predictions based on electrostatic computations to experimental results.

The optimisation of enzymes for particular purposes or conditions remains an important target in virtually all protein engineering endeavours. Here, we present a successful strategy for altering the pH-optimum of the triglyceride lipase cutinase from Fusarium solani pisi. The computed electrostatic pH-dependent potentials in the active site environment are correlated with the experimentally observed enzymatic activities.

Real compliance and how to achieve it.

Regulatory compliance is designed to comply with regulations and guidelines to avoid regulatory citations. While it is designed to minimize compliance problems, it can actually create them by causing a company to aim at constantly moving targets, domestically and internationally. This type of compliance substantially increases costs.

Prognostic importance of the soluble plasminogen activator receptor, suPAR, in plasma from rectal cancer patients.

Colorectal cancer is one of the most common tumour types with approximately one third of the tumours located within the rectum. Rectal cancer differs somewhat from colon cancer, e.g.

Prevalence, incidence, management, and predictors of venous ulcers in the long-term-care population using the MDS.

Objective: To describe the prevalence, incidence, management, and predictors of venous ulcers in residents of certified long-term-care facilities using the Minimum Data Set.

Design: Retrospective cohort study.

Setting And Participants: 32,221 residents admitted to long-term-care facilities in Missouri between January 1, 1996, and October 30, 1998.

An evaluation of satisfaction with telemedicine among health-care professionals.

A survey was conducted among non-doctor health-care professionals in six rural counties in Missouri. The purpose of the survey was to establish baseline data to evaluate the effect of changes in the health-care sector, especially technology changes, on the job satisfaction, career satisfaction, relationships and communication activities of health professionals. The survey included three rural counties in which integrated telecommunication and interactive video telemedicine services were being installed, but before significant activities had begun, and three comparator counties without substantial integrated telecommunications infrastructure and telemedicine services.

[Acute pancreatitis caused by Ascaris lubricoides].

Ascaris lumbricoides as the etiology to acute pancreatitis has never been described in Denmark, whereas in India it is a common cause. In most cases symptoms lead to investigations with high diagnostic sensitivity end specificity. Treatment with antihelminthics and ERCP is efficient.

Use of GHb (HbA1c) in screening for undiagnosed diabetes in the U.S. population.

Objective: To evaluate the use of GHb as a screening test for undiagnosed diabetes (fasting plasma glucose > or =7.0 mmol/l) in a representative sample of the U.S.