Comparisons of oxidative metabolism and reductive capacity in sulfonamide-tolerant and -intolerant patients with human immunodeficiency virus.

Hypersensitivity reactions to trimethoprim/sulfamethoxazole occur with a high frequency in human immunodeficiency virus (HIV)-infected patients. This study tested whether differences in oxidative metabolism and plasma reductive capacity correlate with sulfonamide intolerance in patients with HIV. Eighteen stable outpatients with HIV were prospectively studied.

Incomplete reentry and epicardial breakthrough patterns during atrial fibrillation in the sheep heart.

Background: The mechanisms underlying atrial fibrillation and its initiation are not fully understood. Our hypothesis is that atrial fibrillation results from complex activation involving the subendocardial muscle network.

Methods And Results: We have used video imaging to study the sequence of activation on the surface of the right atrium of the Langendorff-perfused sheep heart during pacing, atrial fibrillation, and its initiation.

Chronic post-traumatic headaches classified and compared with natural headaches.

This study sought to determine whether chronic post-traumatic headaches are different from or identical to the naturally occurring headaches. The chronic post-traumatic headaches of 48 patients were classified, as if they were natural headaches, by the diagnostic criteria of the International Headache Society. Thirty-six patients' headaches (75%) were chronic tension-type headache, 10 (21%) were migraine without aura, and 2 (4%) were unclassifiable.

Identification of LIM3 as the principal determinant of paxillin focal adhesion localization and characterization of a novel motif on paxillin directing vinculin and focal adhesion kinase binding.

Paxillin is a 68-kD focal adhesion phosphoprotein that interacts with several proteins including members of the src family of tyrosine kinases, the transforming protein v-crk, and the cytoskeletal proteins vinculin and the tyrosine kinase, focal adhesion kinase (FAK). This suggests a function for paxillin as a molecular adaptor, responsible for the recruitment of structural and signaling molecules to focal adhesions. The current study defines the vinculin- and FAK-interaction domains on paxillin and identifies the principal paxillin focal adhesion targeting motif.

Postoperative assessment of a modified surgical approach to repair of tetralogy of Fallot. Long-term follow-up.

Background: After repair of tetralogy of Fallot, right ventricular (RV) dilation has been associated with increased risk of ventricular arrhythmias and sudden death. To address this, a modified repair was developed.

Methods And Results: We followed two postoperative groups: group 1 (n = 20) received repair of tetralogy of Fallot with the modified technique with transatrial ventricular septal defect closure, a short infundibular incision with avoidance of muscle resection, and patch expansion of the RV outflow tract; group 2 (n = 22) received repair of tetralogy of Fallot by the traditional technique with ventricular septal defect closure through a ventriculotomy with resection of obstructing muscle.

Pudendal nerve somatosensory evoked potentials in patients with voiding and/or erectile dysfunction: correlating test results with clinical findings.

Purpose: We evaluated the diagnostic efficacy of pudendal nerve somatosensory evoked potential testing in patients with voiding and/or erectile dysfunction.

Materials And Methods: A total of 55 consecutive patients with voiding and/or erectile dysfunction underwent pudendal nerve somatosensory evoked potential testing during a 2.5-year period.

Immunoblot analysis of anti-Ureaplasma urealyticum antibody in pregnant women and newborn infants.

The purpose of the present study was to determine the frequency in which antibody reactive to Ureaplasma urealyticum could be detected in a population of pregnant women and newborn infants. Serum samples from a prospective cohort of 80 healthy, U. urealyticum culture-positive and culture-negative pregnant women and a retrospective cohort of 522 infants born at between 25 and 42 weeks of gestation were studied by immunoblot analysis.

Managed care. Past, present, and future.

Managed care is now the driving force of the emerging health care provision systems in the United States. It has 2 well-recognized features: (1) its payers (business and government) seem to be pleased with it and (2) its customers and employees (patients and providers) are concerned with its health care provisions and financial practices.

Some important details in the technique of percutaneous dilatational tracheostomy via the modified Seldinger technique.

Study Objective: The percutaneous dilatational tracheostomy can be performed with a low complication rate if several important technical details are followed. This study delineates our experience and recommends changes in the operative technique.

Design And Setting: Patients requiring tracheostomy were selected for percutaneous dilatational tracheostomy based on previously reported criteria.

Wild-type and mutant vacuolar membranes support pH-dependent reassembly of the yeast vacuolar H+-ATPase in vitro.

Treatment of the yeast vacuolar proton-translocating ATPase (H+-ATPase) with 300 mM KI in the presence of 5 mM MgATP results in a 90% inhibition of ATPase activity accompanied by removal of at least five of the peripheral subunits of the enzyme from the membrane. Functional reassembly of the enzyme, as indicated by reattachment of the peripheral subunits and a partial (30-70%) recovery of ATPase activity, could be achieved by dialysis of the stripped wild-type membranes to remove the KI and MgATP, but proved to be strongly pH-dependent, with optimal reassembly and recovery of activity occurring after dialysis at pH 5.5.

Retinoic acid induction of the tissue transglutaminase promoter is mediated by a novel response element.

We recently cloned and sequenced two kilobases of the upstream flanking region of the mouse tissue transglutaminase gene. Transfection experiments showed that this region of the transglutaminase flanking sequence was sufficient to mediate a 4-fold induction in reporter gene expression by retinoic acid. The goal of these studies was to identify retinoid receptor binding sites within this proximal 2 kilobase sequence and then to determine if these binding sites had ligand-dependent enhancer activity.

Visual pathway hemorrhage associated with alcohol-induced coagulopathy.

Hemorrhage confined to the optic pathways is rare. We describe a patient with diffuse hemorrhage of the intracranial optic nerves, optic chiasm, and optic tracts, attributed to alcohol-induced coagulopathy. The hemorrhage resolved completely as the patient's vision improved, and subsequent neuroimaging studies showed atrophy of the affected structures.

Counseling needs of women with breast cancer: what the women tell us.

Research has demonstrated that some women treated for breast cancer are at risk for significant and persistent emotional distress and disrupted quality of life. Factors identified that appear to make women psychologically vulnerable include younger age at diagnosis, a history of high life stress or depression prior to diagnosis, and more advanced disease. Research has quickly moved to develop and implement psychological interventions to help these women, although little is known about the patients' perceptions of their need for, and use of, such services.

A case of a naval aviator on quinidine for lone atrial fibrillation.

While neither atrial fibrillation (AF) nor the therapeutic use of quinidine represent medical contraindications for civil aviation in the United States, they have both been indications for permanent grounding in the U.S. armed forces.

Comparative review of the adverse effects of sedatives used in children undergoing outpatient procedures.

Children often fear medical procedures and interventions. Sedative agents enhance the care of these children who undergo outpatient procedures by decreasing anxiety, increasing cooperativity, and providing amnesia. Although higher dosages and intravenous administration of sedatives often produce improved sedation, adverse effects and complications are more frequent.

Hypertonic treatment reversibly increases the ratio of giant skew-miniature endplate potentials to bell-miniature endplate potentials.

Miniature endplate potentials were recorded from single frog muscle fibers before, during and after treatment with hypertonic saline (200-500 mM NaCl or Na gluconate added to frog saline). Miniature endplate potential amplitude distributions were plotted from small muscle fibers so that the modes and ratios of the skew-miniature endplate potential to bell-miniature endplate potential classes could be defined. Muscle fibers were voltage clamped with two electrodes to determine the input resistance before, during and after treatment.

Pharmacologic prevention of colonic neoplasms. Effects of calcium, vitamins, omega fatty acids, and nonsteroidal anti-inflammatory drugs.

Dietary supplements of calcium, vitamins A, C, and E, carotenoids, and omega-3 fatty acids can reduce the yield of experimental cancers in animals and reverse the pattern of abnormal epithelial proliferation in animals and humans. Epidemiological studies indicate that diets containing high amounts of these agents convey a protective effect against the development of colon cancer. Moreover, regular aspirin use in humans appears to reduce the risk of colon cancer and sulindac causes regression of polyps in patients with familial polyposis.

Differential expression of C-protein isoforms in the developing heart of normal and cardiac lethal mutant axolotls (Ambystoma mexicanum).

Regulated assembly of contractile proteins into sarcomeric structures, such as A- and I-bands, is still currently being defined. The presence of distinct isoforms of several muscle proteins suggests a possible mechanism by which myocytes regulate assembly during myofibrillogenesis. Of several muscle isoforms located within the A-band, myosin binding proteins (MyBP) are reported to be involved in the regulation and stabilization of thick filaments during sarcomere assembly.

Talking to teens about family problems. An opportunity for prevention.

Most pediatricians do not screen for family problems as part of routine adolescent health care. This study documents fears, worries, and concerns about family issues expressed by 147 teenagers on a confidential questionnaire during consecutive initial visits to an adolescent medicine clinic in a university hospital setting. Among the salient findings, 44% had thought about running away from home, 42% reported having been subjected to some form of abuse, and 33% had felt like hurting themselves or someone else.

Photophobia in patients with traumatic brain injury: Uses of light-filtering lenses to enhance contrast sensitivity and reading rate.

Patients who have sustained traumatic brain injury (TBI) often experience a new, intense and chronic photophobia. Photophobia, an intolerance to light, is an incompletely understood, subjective symptom, which has been divided into ocular and central types. Various commercial sources of light-filtering lenses have been developed, which have proven to be successful in diminishing visual symptoms expressed by patients who are photophobic.

Neoadjuvant chemotherapy before surgery in cervical cancer.

Eighteen phase II clinical trials have demonstrated the relative ease of administering intravenous neoadjuvant chemotherapy before radical surgery in patients with cervical cancer. Toxicity has been modest, with the exception of occasional severe bleomycin-induced pulmonary toxic effects. All regimens tested have been cisplatin based with no clearly superior combination.

Creatine analogue beta-guanidinopropionic acid alters skeletal muscle AMP deaminase activity.

Dietary supplementation of the creatine analogue beta-guanidinopropionic acid (beta-GPA) decreases in vitro skeletal muscle AMP deaminase (AMP-D) activity in rats. Downregulation of AMP-D activity was progressive and greater in fast-twitch muscles (70-80%) than in the slow-twitch soleus muscle (approximately 50%). The loss in AMP-D activity had little effect on inosine 5'-monophosphate accumulation in mixed-fiber muscle with intense tetanic contractions.

Evolving therapies for peptic ulcer disease: Helicobacter pylori treatment.

In the era of Helicobacter pylori, our concepts about peptic ulcer disease have undergone a major paradigm shift. New ways of thinking about the etiology of ulcers are leading to new treatment modalities. Treating peptic ulcers with antibiotics is an idea that would have been laughed at a mere decade ago, yet it has become the standard of care for H.