Four exemplary preceptors' strategies for efficient teaching in managed care settings.

To identify time-efficient and educationally effective methods for teaching in ambulatory care and managed care settings, the authors studied four exemplary preceptors who taught family medicine clerks in managed care clinics. They interviewed all four preceptors and observed three of them. All of these preceptors claimed to practice more efficiently with students than without them.

Membrane topology motifs in the SGLT cotransporter family.

Homologues of the Na+/glucose cotransporter, the SGLT family, include sequences of mammalian, eubacterial, yeast, insect and nematode origin. The cotransported substrates are sugars, inositol, proline, pantothenate, iodide, urea and undetermined solutes. It is reasonable to expect that the SGLT family members share a similar or identical topology of membrane spanning elements, by virtue of their common ancestry and similar coupling of solute transport to downhill sodium flux.

Fibroblast growth factor and epidermal growth factor receptors in ligament healing.

Although recent in vivo studies indicate that basic fibroblast growth factor hastens the healing and strength of the medical collateral ligament after injury, in vitro studies with epidermal growth factor and basic fibroblast growth factor have shown increased fibroblast proliferation with the exogenous administration of these growth factors. Using an established spontaneously healing rabbit injury model, the surgical transection of the medial collateral ligament was undertaken in 12 anesthetized male adult rabbits. Immunohistochemical localization using monoclonal antibodies to the basic fibroblast growth factor receptor and epidermal growth factor receptor were used to identify the distribution and relative concentrations of the individual receptors at 3, 7, 14, and 28 days after surgery.

Multiple left heart obstructions (Shone's anomaly) with mitral valve involvement: long-term surgical outcome.

Background: The outcome of children with multilevel left heart obstructions (Shone's anomaly) is generally poor. Literature is scarce, consisting mainly of case reports. The mitral disease may be the predominant factor affecting outcome.

Estrogen affects the cellular metabolism of the anterior cruciate ligament. A potential explanation for female athletic injury.

Investigations from this laboratory have established the presence of estrogen receptors in the human anterior cruciate ligament. This study further investigates the effects of 17 beta-estradiol on the cellular proliferation and collagen synthesis of fibroblasts derived from the rabbit anterior cruciate ligament. Fibroblast proliferation and collagen synthesis in response to near log concentrations of 17 beta-estradiol (at 0.

Replicative senescence of T cells: does the Hayflick Limit lead to immune exhaustion?

Extensive in vitro research on fibroblasts has defined numerous genetic and phenotypic changes associated with replicative senescence. Identification of T-cell replicative senescence as a feature of human immunodeficiency virus (HIV) disease and ageing suggests this phenomenon merits more careful consideration by immunologists, especially with regard to chronic infection, memory and adoptive immunotherapy.

Arteriovenous obstruction of arm due to venovenous bypass during liver transplantation.

Two cases of arteriovenous obstruction of the right arm due to venovenous bypass during orthotopic liver transplantation are reported. Possible explanation and risk factors for the development of this complication are discussed.

Poliovirus-encoded protease 2APro cleaves the TATA-binding protein but does not inhibit host cell RNA polymerase II transcription in vitro.

Transient expression of the poliovirus-encoded protease 2APro in eukaryotic cells results in inhibition of both cellular transcription and translation. The inhibition of transcription observed in cells expressing 2APro could be due to a primary effect or secondary effect caused by inhibition of translation. Because transcriptional activity of the TATA-binding protein (TBP) is drastically reduced in poliovirus-infected cells, we determined if 2APro is able to cleave TBP in vitro.

TNF-alpha opens a paracellular route for HIV-1 invasion across the blood-brain barrier.

Background: HIV-1 invades the central nervous system early after infection when macrophage infiltration of the brain is low but myelin pallor is suggestive of blood-brain-barrier damage. High-level plasma viremia is a likely source of brain infection. To understand the invasion route, we investigated virus penetration across in vitro models with contrasting paracellular permeability subjected to TNF-alpha.

Carboxyl-directed pegylation of brain-derived neurotrophic factor markedly reduces systemic clearance with minimal loss of biologic activity.

Purpose: Brain-derived neurotrophic factor (BDNF) was modified by carboxyl-directed protein pegylation in order to both retain biologic activity of the neurotrophin and reduce the rate of systemic clearance of this cationic protein in vivo. Since the modification of surface lysine residues of neurotrophins results in loss of biologic activity, the present studies examine the feasibility of placing polyethyleneglycol (PEG) polymers on carboxyl residues of surface glutamate or aspartate residues of BDNF.

Methods: PEG molecules with terminal hydrazide (Hz) moieties of molecular weight 2,000 (PEG2000-Hz) or 5,000 (PEG5000-Hz) Daltons were coupled to BDNF carboxyls using carbodiimide.

Gene transfer into nerve and muscle by isolated limb perfusion or during replantation.

In this study, the authors tested the feasibility of adenovirus vectors transferring functional genetic material into relevent soft-tissue structures during replantation of mouse hindlimbs. An adenovirus vector was constructed encoding the marker gene LacZ and CMV promoter and titered by plaque forming assay to 5 x 10(9) particles/ml. C3H mouse hindlimbs were divided into three groups.

Impact of declining reimbursement and rising hospital costs on the feasibility of total hip arthroplasty.

Total hip arthroplasty, although a very successful clinical treatment, remains an expensive procedure in an era of constrained health care resources. Hospitalization cost, charge, and reimbursement data were compared between all patients who underwent elective, primary, unilateral total hip arthroplasty in 1988 and 1993 at the UCLA Medical Center. Although length of hospitalization decreased by 36%, increases both in unit supply costs and in the intensity of hospital services prevented a statistically significant reduction in total hospitalization cost.

Tuberous sclerosis in a 20-week gestation fetus: immunohistochemical study.

We report an autopsy case of tuberous sclerosis complex (TSC) in a 20-week gestational age female fetus. The brain showed lesions suggestive of early cortical tubers and subependymal hamartomatous nodules. The large cells within these nodular clusters were variably immunoreactive for glial fibrillary acidic protein (GFAP) and vimentin and negative for synaptophysin and neurofilament.

The Turner biopsy needle facilitates seminal vesicle aspiration.

Transrectal ultrasonography and seminal vesicle aspiration with or without vesiculography have become an integral part of the evaluation and management of the infertile male with ejaculatory duct obstruction. We have found that the Echo Tip Turner Biopsy Needle used in conjunction with ultrasound guidance greatly facilitates these transrectal procedures.

Polyhedral protein cages encase synaptic vesicles and participate in their attachment to the active zone.

In an effort to elucidate the interactions between synaptic vesicles and the membrane of the active zone, we have investigated the structure of interneuronal asymmetric synapses in the neocortex of adult rats using thin-sectioning, freeze-fracture, and negative staining electron microscopy. We identified three subtypes of spherical synaptic vesicles. Type I were agranular vesicles of 47.

In vitro assays for activities of retroviral integrase.

Integration of retroviral DNA, an essential step during the retroviral life cycle, is mediated by the viral protein integrase. Simple in vitro assays for measuring integrase activities are described, including catalysis (3'-end processing, 3'-end joining, disintegration), juxtaposition of viral DNA ends, DNA binding, and target site selection. The described assays will be useful in elucidating the molecular mechanism of retroviral integration and screening for integrase inhibitors as potential anti-retroviral drugs.

Specific dynamic action of a large carnivorous lizard, Varanus albigularis.

Varanus albigularis inhabits grasslands of southern and eastern Africa and experiences months of fasting during the dry season (May-December) followed by voracious feeding during the wet season (January-April). Previous studies have found that sit-and-wait foraging snakes, which also experience long intervals between large meals, exhibit unprecedented increases in post-feeding metabolism, which reflects the added cost of up-regulating a previously quiescent gut and digesting a large meal. Hence we measured pre- and post-prandial oxygen consumption rates (VO2) of adult V.

Quantification of the process of hair cell loss and recovery in the chinchilla crista ampullaris after gentamicin treatment.

The degree of ototoxic drug sensitivity and hair cell repair was determined in the chinchilla horizontal crista ampullaris after intraotic administration of gentamicin. Histological evaluation was made of 22 cristae ampullaris from one normal and six post-treatment (PT) animal groups killed at 1, 4, 7, 14, 28, and 56 days. New hair cell production was quantified, using the dissector technique.

Use of the in-situ lesser saphenous vein bypass from popliteal to peroneal artery.

Lesser saphenous vein grafts have become an important element in limb salvage surgery. Their location frequently dictates that the graft be translocated for use. This incurs the disadvantages of ischemia and increased manipulation of the graft and loses the advantages of an in-situ bypass.

Efficacy of topical povidone-iodine during the first week after ophthalmic surgery.

Purpose: In the first postoperative day, povidone-iodine ophthalmic solution prevents an increase in conjunctival bacterial colony-forming units and decreases the species compared with antibiotic. We sought to determine whether these beneficial effects of povidone-iodine could be sustained during the first postoperative week.

Methods: In 42 eyes of 35 consecutive patients, one or two drops of either a broad-spectrum antibiotic (polymyxin B sulfate-neomycin sulfate-gramicidin) or povidone-iodine 1.

Correlates of hypoalbuminemia in community-dwelling older persons.

To identify easily ascertainable sociodemographic and health characteristics that are associated with hypoalbuminemia in community-dwelling older persons, we used data from the first National Health and Nutrition Examination Survey. This population-based stratified probability sample survey included 4728 persons aged 55-74 y. We defined hypoalbuminemia in two ways: < 35 g/L (1.