Angiotensin II-induced NADPH oxidase activation impairs insulin signaling in skeletal muscle cells.

The renin-angiotensin system (RAS) and reactive oxygen species (ROS) have been implicated in the development of insulin resistance and its related complications. There is also evidence that angiotensin II (Ang II)-induced generation of ROS contributes to the development of insulin resistance in skeletal muscle, although the precise mechanisms remain unknown. In the present study, we found that Ang II markedly enhanced NADPH oxidase activity and consequent ROS generation in L6 myotubes.

Determination of death by neurological criteria.

Until 1968, when an ad hoc Harvard Medical School Committee published a landmark paper calling for determination of death using neurological rather than cardiovascular criteria, death was considered to have occurred when the heart irreversibly ceased beating. Since that time, every jurisdiction in the country has come to accept through law or court decision neurological criteria to define death. The authors review the issue of death by neurological criteria in light of current guidelines and recent advances.

Centrifugal pump support for distal aortic perfusion during repair of traumatic thoracic aortic injury.

Paraplegia from ischemic injury of the spinal cord and renal failure from inadequate perfusion of the kidneys may occur from aortic cross-clamping during repair of traumatic thoracic aortic injuries. After Institutional Review Board approval, we retrospectively reviewed the charts of 26 patients surgically treated for traumatic transection of the descending thoracic aorta during a 14 year period (1987-2001), using centrifugal pump (Sarns) support for distal aortic perfusion. The study group comprised 19 males and 7 females, whose ages ranged from 15 to 69 years.

Postablative risk of endometrial carcinoma in New Zealand white rabbits given high-dose estrogen.

Objective: To follow a population at high risk for endometrial carcinoma after endometrial ablation, to determine if ablation alters the incidence or detection of endometrial pathology.

Study Design: The animal model included 33 New Zealand white rabbits. Of this cohort, 17 underwent surgical ablation of the endometrium via laparotomy, while 16 served as controls.

Adequacy in dialysis: intermittent versus continuous therapies.

A vital conceptual difference between intermittent and continuous dialysis therapies is the difference in the relationship between Kt/V urea and dietary protein intake. For a given level of protein intake the intermittent therapies require a higher Kt/V urea due to the reasons mentioned above. The recently released adequacy guidelines by DOQI for intermittent and continuous therapies are based on these assumptions.

Oral rehydration solution therapy in the management of children with rotavirus diarrhea.

Rotavirus infections are the most common cause of gastroenteritis among children younger than 3 years of age and are associated with sporadic outbreaks of diarrhea in elderly and immunocompromised patients. Oral rehydration solutions (ORS) are formulated to correct dehydration and acidosis. Currently, ORS do not promote intestinal healing; however, investigators are examining the role of nutrition in promoting intestinal healing.

Ocular manifestations of cat-scratch disease.

Bartonella henselae has only recently been isolated, characterized, and found to be the principal cause of cat-scratch disease (CSD). The availability of specific serologic investigations has allowed the recognition of a spectrum of ocular CSD syndromes that previously were ill defined and considered idiopathic. The primary inoculation complex causing regional lymphadenopathy is represented in the eye by Parinaud's oculoglandular syndrome; B.

Neuropsychological impairments, vocational outcomes, and financial costs for individuals with traumatic brain injury receiving state vocational rehabilitation services.

Objective: To determine the relationship among neuropsychological variables, vocational outcomes, and vocational costs for Missouri Division of Vocational Rehabilitation (MO-DVR) clients with traumatic brain injury (TBI).

Design: Clients referred for neuropsychological evaluations were followed until DVR case closure. Subjects were grouped according to the following DVR status at case closure: Successfully Employed, Services Interrupted, and No Services Provided.

Rheumatoid pannus of the cervical spine: a case report of an unusual cause of dysphagia.

Dysphagia as an initial complaint in rheumatoid arthritis is rare. We describe the case of a 69-year-old woman with rheumatoid arthritis who presented with a 2-day history of acute dysphagia. Our evaluation revealed the cause of the dysphagia was the presence of rheumatoid pannus that involved the anterior cervical spine and compressed the esophagus.

The usefulness of the Brief Symptom Inventory in the neuropsychological evaluation of traumatic brain injury.

Changes in the health care delivery system are forcing clinicians to use less timely and more cost efficient measures. In rehabilitation, more efficient measures of emotional-behavioural functioning are being administered to patients with traumatic brain injury (TBI), including the Brief Symptom Inventory (BSI), a 53 item short version of the Symptom Checklist-90 that assesses nine different dimensions of emotional-behavioural functioning. Because the BSI was developed for use with psychiatric populations, research of the measure with TBI populations is needed.

The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri).

Objective: To determine the weight loss associated with resolution of papilledema from idiopathic intracranial hypertension (IIH).

Design: A retrospective study.

Participants: Fifteen consecutive female patients with IIH associated with obesity were studied.

Ehrlichia chaffeensis in Missouri ticks.

A nested polymerase chain reaction specific for Ehrlichia chaffeensis was used to attempt to amplify DNA from extracts of 100 individual ticks collected from 13 counties in central Missouri. Seventeen of 59 Amblyomma americanum and six of 41 Dermacentor variabilis ticks exhibited the characteristic 389-basepair product. This supports the hypothesis that these tick species may be vectors of human monocytic ehrlichiosis.

Mortality from lower respiratory infection in nursing home residents. A pilot prospective community-based study.

Background: Lower respiratory infections (LRI) are an important cause of morbidity, mortality, and hospitalization of nursing home residents, yet treatment recommendations have primarily been based on the minority who are hospitalized. We sought to prospectively evaluate risk factors for mortality from LRI in community nursing home residents.

Methods: We studied residents of 10 central Missouri nursing homes (910 beds) from January 1994 to September 1994.

Retroviral vectors for gene therapy.

Although there are many hurdles to overcome for successful gene therapy, there is a vast potential to permanently incorporate genes into cells to correct genetic disorders and to combat viral infections. Retroviruses, inspite of some limitations, offer the best hope in this direction and lentiviral vectors, which infect nondividing cells, may be the choice in the future, especially in gene therapy for central nervous system disorders.

An RNA oligonucleotide corresponding to the polypyrimidine region of the rat alpha 1(I) procollagen promoter forms a stable triplex and inhibits transcription.

In this report we demonstrate formation of a triplex structure by an antiparallel RNA oligonucleotide corresponding to the 21 bp polypurine-pyrimidine stretch from -141 to -162 of the rat alpha 1(I) procollagen promoter with a Kd of 0.1-0.2 microM.

Wound coverage using modified tissue expansion.

We describe the use of a "lacing apparatus" across large and complex wounds to accomplish wound closure. This technique utilizes the principles of tissue expansion (exploiting inherent extensibility of the skin, mechanical creep, and biologic creep) but is able to employ them in situations in which traditional tissue expansion (utilizing implantable expanders) is not practical. After preparation, the wounds are laced with large nylon suture, which is tightened on a daily basis, typically allowing closure of even massive wounds within 8 to 10 days.

Obsessional disorders during recovery from severe head injury: report of four cases.

Four cases of transient obsessional disorders following severe head injury are described within the context of recovery from acute traumatic brain injury (TBI). Obsessional features following TBI have important treatment implications in brain injury rehabilitation settings, since emergence of this disorder in the acutely brain injured patient poses a significant obstacle to interdisciplinary rehabilitation. Although the numbers of patients described here and in previous reports are too small to draw conclusions about the incidence of obsessional disorders following TBI, these cases illustrate the importance of correctly identifying and treating obsessional symptoms in the brain injured patient.

The effects of normal ageing on neuropsychological functioning following traumatic brain injury.

Increasing age is associated with greater absolute neuropsychological impairment (e.g. slower processing speed, diminished memory), although it is unclear if older individuals with traumatic brain injury (TBI) show greater relative impairment than younger individuals with TBI.

Screening for problem drinking: does a single question work?

Background: Brief interventions with problem drinkers have been shown to be effective, but physicians often do not ask about alcohol use. If a single question could effectively screen for problem drinking, it might facilitate intervention with problem drinkers.

Methods: A cross-sectional study was undertaken to address the clinical utility of the question, "On any single occasion during the past 3 months, have you had more than 5 drinks containing alcohol?" Placing it between questions about tobacco and seat-belt use, we presented the three questions in writing to 1435 patients; 95.

Correlation of 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced apoptotic cell death in the embryonic vasculature with embryotoxicity.

Vertebrate embryos are particularly sensitive to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Identification of tissues that are susceptible to the adverse effects of TCDD is requisite for understanding the embryo toxic effects of TCDD. The objective of the present study was to quantitate the temporal appearance of and dose dependence of apoptosis in TCDD-exposed medaka embryos (Oryzias latipes).

An analysis of objective quality indicators on Year Book citations: implications for MEDLINE searchers.

Purpose: This study is an analysis of Mosby Year Book citations from Ovid Online's Comprehensive Core Medical Library (CCML). The purpose of this study was twofold: (1) to determine whether Year Book citations were more likely to be judged "key" than non-Year Book citations by clinicians; and (2) to determine whether the MEDLINE record of Year Book citations evaluated as key contained objective quality indicators that searchers might use to target key articles.

Background: As part of the MEDLINE/Full-Text Research Project, health care professionals evaluated search output from CCML on a five-point scale.

An Sp1-binding site and TATA element are sufficient to support full transactivation by proximally bound NS1 protein of minute virus of mice.

The minute virus of mice (MVM) P38 Sp1-binding site and TATA box, inserted in an otherwise heterologous plasmid background, could be transactivated to high levels by the MVM NS1 protein targeted proximally to these sequences, demonstrating that these core promoter regulatory elements are sufficient to support essentially wild-type levels of NS1-transactivated expression and suggesting that NS1 may act directly or indirectly with Sp1 and or elements of the general transcription machinery. Accordingly, we show that bacterially generated NS1 can interact strongly, independent of nucleic acid bridging, and most likely directly with Sp1 in vitro and can associate, in a nucleic acid-independent manner, with endogenous Sp1 as it exists in a complex transcriptionally active murine nuclear extract NS1 achieves the same fold activation of an isolated TATA element over its low basal level and can also be demonstrated to interact efficiently and specifically with the general transcription factors TBP and TFIIA (alpha, beta) in vitro.