Outcome assessment of an in-hospital cross-functional wound care team.

A multidisciplinary wound care team was developed at the Medical College of Pennsylvania Hospital in 1993 to standardize wound management, appropriately allocate resources, prevent the occurrence of hospital-acquired decubitus ulcers, and effectively manage existing pressure ulcers. This report presents 4 years of prevalence survey data (n = 690 patients over 4 years), which affords an outcome analysis regarding the efficacy of the multidisciplinary wound care team. A significant reduction in the number of patients with pressure ulcers, hospital acquired pressure ulcers, and patients with hospital acquired ulcers occurred.

Arthroscopic microdiscectomy and selective fragmentectomy.

A prospective outcome study to determine the efficacy and complications associated with posterolateral arthroscopic discectomy was initiated in April 1988. One hundred seventy-five patients with symptoms consistent with a lumbar disc herniation and correlative imaging studies were treated operatively, and 169 were available for followup evaluation. Fifty-nine patients with a central herniation or a nonmigrated sequestered fragment were treated using bilateral biportal posterolateral access, whereas 116 patients with radiographic evidence of a paramedial, foraminal, or extra-foraminal herniation were treated using the unilateral uniportal approach.

Improved emergency department efficiency with a three-tier trauma triage system.

This pilot study was carried out to determine whether converting from a two-tier to a three-tier in-hospital trauma triage system improves the efficiency of emergency department (ED) care and minimizes inappropriate triage. Patients at an urban, Level 1 trauma centre were triaged using either a two-tier (months 1-3; n = 197) or three-tier (months 4-6; n = 240) trauma response system. Patients were assessed for triage type, age, sex, injury severity score, Glasgow coma score, post-ED disposition, total ED time, survival, complication rate, probability of survival and unexpected death.

Compensatory and excess retrieval: two types of endocytosis following single step depolarizations in bovine adrenal chromaffin cells.

1. Endocytosis following exocytosis evoked by single step depolarizations was examined in bovine adrenal chromaffin cells using high resolution capacitance measurements in perforated-patch voltage clamp recordings. 2.

CT angiogram sign: incidence and significance in lobar consolidations evaluated by contrast-enhanced CT.

Objective: The CT angiogram sign--that is, the ability to see normal pulmonary vasculature within parenchymal consolidations--was initially reported as specific for the diagnosis of bronchioloalveolar cell carcinoma. Our purpose was to establish the frequency of this sign in lobar consolidations of varied causes as revealed by contrast-enhanced CT. We also sought to determine if the presence of this sign contributed to the specificity of radiographic diagnosis.

Asparagine-linked carbohydrate chains of inducible rat parotid proline-rich glycoprotein contain terminal beta-linked N-acetylgalactosamine.

Rats treated with daily injection of DL-isoproterenol for 10 consecutive days (25 mg kg(-1) body weight) showed marked induction of a proline-rich glycoprotein (GPRP) of 220 kDa. Proteinase K digestion of GPRP produced a homogeneous glycopeptide with an average chemical composition as follows (residues per mol): Pro4, Glx3, Asx2, Gly1, His1, Thr1, Arg1, GlcNAc5, GalNac1, Man3, Gal2-3, and Fuc1. The structural analysis of the asparagine-linked carbohydrate unit was performed by methylation, periodate oxidation and enzymatic degradation.

Mechanism of galanin-induced contraction of longitudinal smooth muscle of the rat jejunum.

Intact and alpha-toxin-permeabilized longitudinal smooth muscle were mounted for measurement of force and myosin light chain phosphorylation. Galanin contracted intact jejunum with a half-maximum effective concentration of 9.2 +/- 0.

Carotid artery bifurcation: multiple-flip-angle, three-dimensional, time-of-flight MR angiographic technique.

Multiple-flip-angle, three-dimensional, time-of-flight magnetic resonance (MR) angiography was performed in vitro and in vivo in the carotid artery bifurcation. Composite MR angiographic images were created from multiple data sets. Compared with images obtained with a low (20 degrees) flip angle, composite images obtained with flip angles of 20 degrees and 60 degrees demonstrated improved image quality and statistically significant improvement in signal-to-noise ratio (P < .

Sex hormone-binding globulin and insulin resistance in African-American women.

Sex hormone-binding globulin (SHBG) binds testosterone, determining the level of free, biologically active hormone, and is a sensitive indicator of androgen status in women. SHBG is strongly correlated with high-density lipoprotein (HDL), central obesity, and insulin sensitivity in Caucasian and Mexican-American women, thereby acting as a biologic marker for cardiovascular disease risk. The purpose of this study was to determine if SHBG was a significant correlate of metabolic cardiovascular risk factors in African-American women.

A comparison of polydipsia prevalence among chronic psychiatric patients using three measurement approaches.

Many previous prevalence studies of polydipsia (PD) have utilized single and often non-biologic measures. In this study we estimated prevalence using specific gravity of urine (SPGU), normalized diurnal weight gain (NDWG), and staff identification (staff ID). Agreement between these two biologic and one behavioral measure was assessed.

Pneumocystis carinii glycoprotein A inhibits surfactant phospholipid secretion by rat alveolar type II cells.

Pneumocystis carinii pneumonia (PCP) remains a major cause of morbidity in AIDS. The pathogenesis of PCP is poorly understood, but evidence of surfactant abnormalities is mounting. The role of the major surface glycoprotein of P.

Short-term changes in the Ca2+-exocytosis relationship during repetitive pulse protocols in bovine adrenal chromaffin cells.

Stimulus-secretion coupling was monitored with capacitance detection in bovine chromaffin cells recorded in perforated patch mode and stimulated with trains of depolarizing pulses. A subset of stimulus trains evoked a response with a Ca2+-exocytosis relationship identical to that obtained for single depolarizing pulses (Engisch and Nowycky, 1996). Other trains evoked responses with enhanced or diminished Ca2+ efficacy relative to this input-output function.

Multiple signaling pathways direct the initiation of tyrosine hydroxylase gene expression in cultured brain neurons.

Previous studies have demonstrated that the synergistic interaction of acidic fibroblast growth factor (aFGF) and a second co-activator molecule can novelly induce expression of the CA biosynthetic enzyme tyrosine hydroxylase (TH) in non-TH expressing neurons of the striatum. Several co-activators have been identified, including substances present in L6 muscle cell extract (X. Du et al.

Pulmonary function tests: comparison of 95th percentile-based and conventional criteria of normality.

Background: Although 95th percentile-based normal limits are recommended instead of conventional criteria of normality to guide pulmonary function test (PFT) readings, we have found no objective assessment of how the choice of normal limits might influence PFT interpretation.

Methods: We did a retrospective comparison of PFT readings referenced to conventional criteria of normality versus independent repeat assessments influenced by 95th percentile-based normal limits in 166 veterans. We also conducted a nationwide telephone survey of VA Hospital PFT laboratories.

Options for diabetic patients with chronic heel ulcers.

The presence of a heel ulcer in the diabetic patient is usually due to neuropathy, vasculopathy, or both. Diagnostic testing including noninvasive assessment by nerve conduction velocity and Doppler pressure measurements can provide the basis for subsequent treatment. The diagnosis of osteomyelitis is assisted by plain radiographs, isotope definition, and/or magnetic resonance imaging (MRI).

Tau-like proteins in the nervous system of goldfish.

This report describes the presence of a group of tau-like proteins (TLPs) in goldfish central nervous system. The TLPs were immunoreactive with antibodies that recognized the carboxy-terminal domain of mammalian tau, but not with antibodies that recognized the amino-terminus. The TLPs of goldfish exhibited the basic properties of tau proteins including neuronal specificity, structural heterogeneity, heat stability and the ability to co-assemble with tubulin.

Large versus small unilamellar vesicles mediate reverse cholesterol transport in vivo into two distinct hepatic metabolic pools. Implications for the treatment of atherosclerosis.

Phospholipid liposomes are synthetic mediators of "reverse" cholesterol transport from peripheral tissue to liver in vivo and can shrink atherosclerotic lesions in animals. Hepatic disposal of this cholesterol, however, has not been examined. We compared hepatic effects of large (approximately equal to 120-nm) and small (approximately equal to 35-nm) unilamellar vesicles (LUVs and SUVs), both of which mediate reverse cholesterol transport in vivo but were previously shown to be targeted to different cell types within the liver.

Toe amputation in the diabetic patient.

Background: We considered whether it is more practical to amputate the toe of a diabetic patient with osteomyelitis and good circulation or to treat the patient with antibiotics for a prolonged period.

Methods: We undertook a retrospective study of 141 diabetic patients who had undergone a toe-ray amputation for proven or documented osteomyelitis.

Results: The mean ankle/brachial index of all patients was 0.

Purification and characterization of a neutral, bile salt-independent retinyl ester hydrolase from rat liver microsomes. Relationship To rat carboxylesterase ES-2.

A neutral, bile salt-independent retinyl ester hydrolase (NREH) has been purified from a rat liver microsomal fraction. The purification procedure involved detergent extraction, DEAE-Sepharose ion exchange, Phenyl-Sepharose hydrophobic interaction, Sephadex G-100 and Sephacryl S-200 gel filtration chromatographies, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The isolated enzyme has an apparent molecular mass of approximately 66 kDa under denaturing conditions on SDS-PAGE.

Histopathology and clinical assessment correlate with the cysteine-serine-valine-threonine-cysteine-glycine (CSVTCG) receptor of thrombospondin-1 in breast tumors.

Thrombospondin-1 (TSP-1) is a matrix protein implicated in mechanisms of tumor metastasis. TSP-1 has a characteristic Cysteine-Serine-Valine-Threonine-Cysteine-Glycine (CSVTCG) sequence that functions as a tumor cell adhesion domain. Our laboratory has isolated a novel CSVTCG specific tumor cell receptor.

Paraganglioma of the cauda equina with associated intramedullary cyst: MR findings.

The MR imaging features of a paraganglioma of the cauda equina with associated spinal cord cysts are presented. MR imaging showed the tumor to be isointense with the spinal cord on all pulse sequences and to enhance homogeneously. The intramedullary cysts had increased signal intensity on proton density- and T2-weighted images, and involved the cervical and thoracic regions.