Physicians' perceptions and responses to patient emotion: implications for social work practice in health care.

Physicians serve a pivotal role in today's health systems, as they are often the first professional patients must contact for emotion problems. This study surveyed 225 practicing physicians to understand how they perceive patient emotion and the actions they would then take in response to these perceived emotions. In reply to nondescript "emotion complaints" from a patient vignette, these physicians perceived the patient as experiencing anxiety, followed by fear, anger and sadness.

Oxandrolone in trauma patients.

Study Objective: To determine the effect of oxandrolone administration on nutritional and clinical outcomes after multiple trauma.

Design: Prospective, randomized, double-blind, placebo-controlled study.

Setting: Level 1 trauma center in a university teaching hospital.

Growth inhibition of prostate cancer by an adenovirus expressing a novel tumor suppressor gene, pHyde.

It has been estimated that there will be > 180,400 new cases of prostate cancer and 31,900 prostate cancer deaths in the United States this year. New therapeutic strategies against locally advanced prostate cancer are desperately needed. A novel gene (pHyde) was identified by an improved cDNA competition hybridization technique for Dunning rat prostate cancer cell lines.

Comparative efficacy and potency of long-term therapy with glipizide or glyburide in patients with type 2 diabetes mellitus.

Background: Long-term studies on the comparative efficacy and relative potency of glipizide and glyburide are sparse and controversial.

Methods: In a randomized prospective trial, we compared the effectiveness and relative potency of glipizide and glyburide over a 15-month period in 18 patients with type 2 diabetes mellitus (DM2) (9 on glyburide and 9 on glipizide) who were unresponsive to diet therapy. Glycemic control was assessed using 4 methods: 1) quarterly fasting plasma glucose (FPG), and 2-hour postprandial plasma glucose after a standard breakfast; 2) insulin and glucose response to Sustacal (test meal) challenge every 3 to 6 months; 3) quarterly hemoglobin A1c; and 4) intravenous glucose tolerance testing every 6 months to measure first and second phase insulin secretion.

Review of immunosuppressive usage in pancreas transplantation.

Throughout 1997, nearly 10,000 pancreas transplants have been performed worldwide, with 88% being simultaneous kidney transplants (SKPT). The current 1 yr patient survival rate exceeds 90% and pancreas graft survival (complete insulin independence) rate exceeds 80% for SKPT, 70% for sequential pancreas after kidney transplant (PAKT), and 65% for pancreas transplant alone (PTA). According to registry data, rejection accounts for 32% of graft failures in the first year after pancreas transplantation.

Immunosuppression in pancreas transplantation: progress, problems and perspective.

Through 1997, over 10,000 pancreas transplants have been performed world-wide, with 88% being simultaneous kidney-pancreas transplants (SKPTs). Current 1-year patient survival exceeds 90% and pancreas graft survival (complete insulin independence) exceeds 80% for SKPT, 70% for sequential pancreas after kidney transplant (PAKT), and 65% for pancreas transplant alone (PTA). According to Registry data, rejection accounts for 32% of graft failures in the first year after pancreas transplantation.

Demyelinating neuropathy in a patient with multiple sclerosis and genotypical HMSN-1.

Patients with multiple sclerosis (MS) may develop a peripheral neuropathy, sometimes attributed to nutritional deficiency. Other patients present with a demyelinating neuropathy which is presumed to be the result of an autoimmune process that affects both the central and peripheral nervous systems. We report a case of concurring MS and demyelinating neuropathy, without a positive family history, in whom genetic testing proved the neuropathy to be hereditary and not autoimmune.

Evidence for the preferential localization of glutamate receptor-1 subunits of AMPA receptors to the dendritic spines of medium spiny neurons in rat striatum.

Although immunohistochemical studies have typically found the perikarya of striatal projection neurons to be devoid of immunohistochemical labelling for the GluR1 AMPA type glutamate receptor subunit, the striatal neuropil is rich in GluR1 immunolabelling and in situ hybridization histochemistry has indicated the presence of GluR1 message in many striatal neurons. To explore the possibility that GluR1 subunits may be synthesized by many striatal projection neurons, but selectively localized to their dendrites, we have used light-microscopic and electron-microscopic immunohistochemistry in combination with single-cell reverse transcription-polymerase chain reaction. Light-microscopic immunohistochemical studies confirmed the presence of abundant GluR1 immunoreactivity in the striatal neuropil in rats.

Attenuation of recombinant vesicular stomatitis viruses encoding mutant glycoproteins demonstrate a critical role for maintaining a high pH threshold for membrane fusion in viral fitness.

A plasmid-based recovery system was used to generate four unique vesicular stomatitis virus (VSV) mutants that encode glycoproteins (G proteins) with single or double amino acid substitutions in two conserved acidic residues adjacent to the putative G protein fusion domain. Previously we demonstrated that three of the mutant G proteins (D137-L, E139-L, and DE-SS) have slightly reduced pH thresholds for membrane fusion activity. In this report we show that even though the viruses encoding D137-L, E139-L, and DE-SS were recovered with high efficiency, these mutants were attenuated for growth in cell culture.

The effect of alpha-adrenergic antagonism upon nitrogen loss during endotoxemia.

Sixty male Sprague-Dawley rats were randomized to receive parenteral nutrition (PN) only; PN plus continuous infusion of Escherichia coli 026:B6 lipopolysaccharide (PN + LPS) at 6 mg.kg-1.d-1; or PN plus LPS plus a continuous infusion of the alpha-adrenergic antagonist phentolamine (PN + LPS + PHEN) at 5 mg.

Viral infections of the oral mucosa in children: a clinical review.

The oral cavity is a microcosm of the world around us, exposed to a variety of microorganisms present in the local environment. Some of these microorganisms establish a permanent presence in the oral tissues, which serve as a suitable growth medium. These locations include soft and hard tissue, areas of high and low oxygen content, flowing secretions and dryness, and flat or grooved surfaces.

Restoration of endodontically treated teeth: a guide for the restorative dentist.

This article provides a decision flow chart that can serve as a guide to selecting the optimum restorations for endodontically treated teeth. The process begins with an assessment of the endodontically treated tooth to determine its restorability. The restorable tooth is then evaluated for the amount of remaining coronal tooth structure.

State-dependent regulation of neuronal excitability by dopamine.

Since the discovery that the loss of the dopaminergic innervation of the striatum resulted in Parkinson's disease, physiologists have attempted to understand the role of dopamine on striatal activity. Hypotheses relying upon concepts derived from studies of fast synaptic transmission have consistently failed to explain the actions of dopamine or other receptors coupled to G-proteins which modulate the properties of voltage-dependent ionic conductances responsible for synaptic integration and spike activity. Recently, patch clamp studies have revealed that in medium spiny striatal neurons dopamine D1-class receptors modulate voltage-dependent Na+, K+ and Ca2+ channels.

Rural hospital social work: views of physicians and social workers.

The existence of rural hospitals is financially tenuous due to the Prospective Payment system, which differentially reimburses rural facilities at lower rates than urban facilities. Physicians and hospital social workers provide services within these severely cost-conscious organizations to patients from communities, which are also aftercare resource poor. Given these multiple constraints, rural physicians' expectations of hospital social workers is integral to effective collaboration and social service provision.

Differences between blacks and whites in plasma protein binding of drugs.

Objective: Disopyramide and salicylic acid were used as model compounds to characterize racial differences in binding of drugs by alpha 1-acid glycoprotein (AGP) and albumin, respectively. Drug-free plasma was collected from 29 healthy volunteers (15 white, 14 black). Disopyramide and salicylic acid unbound fractions (fu) in plasma were determined by equilibrium dialysis using 14C-disopyramide and 14C-salicylic acid.

Avian homologues of mammalian intralaminar, mediodorsal and midline thalamic nuclei: immunohistochemical and hodological evidence.

This paper presents and reviews data suggesting that the dorsal thalamic zone (abbreviated DTZ) in birds is homologous to the intralaminar, midline, and mediodorsal thalamic nuclear complex (abbreviated IMMC) in mammals. The DTZ is located dorsomedially in the diencephalon of birds and consists of several subnuclei: nucleus dorsomedialis anterior thalami (DMA), nucleus dorsomedialis posterior thalami (DMP), nucleus dorsolateralis anterior thalami, pars medialis (DLM), nucleus dorsointermedius posterior thalami (DIP), nucleus dorsolateralis posterior thalami (DLP), and nucleus subhabenularis lateralis (SHL). Our immunohistochemical studies show that: (1) SHL and medial and dorsal parts of DMA and DMP are relatively rich in GABAergic, enkephalin-containing, substance P-containing, and cholinergic fibers; (2) lateral parts of DMA and DMP are relatively poor in these neurotransmitters; and (3) DIP, DLP, and DLM are moderately rich in cholinergic and substance P-containing fibers.

Cellular distribution of the NMDA receptor NR2A/2B subunits in the rat striatum.

Using immunohistochemical double-labeling with a specific antibody recognizing both NR2A and NR2B subunits, we studied the cellular distribution of the NMDA receptor subunit NR2A/2B on all major known striatal neuron types. Among striatal interneurons, our results showed that none of somatostatin interneurons was labeled for NR2A/2B subunits, 56% of parvalbumin interneurons were double-labeled for NR2A/2B, and all identified cholinergic interneurons were labeled for NR2A/2B. Among striatal projections neurons, 95% of striatonigral neurons, 96% of enkephalin-containing neurons, and 98% of calbindin-containing striatal matrix neurons were double-labeled for NR2A/2B.

Iodinated analogs of trimetoquinol as highly potent and selective beta 2-adrenoceptor ligands.

A series of trimetoquinol (1, TMQ) analogs were designed and synthesized based on the lead compound 2, a diiodinated analog of trimetoquinol which exhibits improved selectivity for beta 2-versus beta 1-adrenoceptors (AR). To determine the influence of 1-benzyl substituents of trimetoquinol on beta 2-AR binding affinity and selectivity, we replaced and/or removed the 3'-, 4'-, and 5'-methoxy substituents of trimetoquinol. Replacement of the 4'-methoxy group of 2 with an amino (21c) or acetamido (15) moiety did not significantly alter beta 2-AR and thromboxane A2/prostaglandin H2 (TP) receptor affinity.

Isolation and characterization of a persistent potassium current in neostriatal neurons.

1. Depolarization-activated, calcium-independent potassium (K+) currents were studied with the use of whole cell voltage-clamp recording from neostriatal neurons acutely isolated from adult (> or = 4 wk old) rats. The whole cell K+ current was composed of transient and persistent components.

Effects of ethanol and cocaethylene on cocaine pharmacokinetics in conscious dogs.

Coingestion of cocaine and ethanol is common among cocaine users, and this combination is reported to enhance the euphoric effects of cocaine. The cardiovascular effects of cocaine are increased in the presence of ethanol, although the mechanism(s) involved in this interaction are poorly understood. Recent studies suggest the enhanced cardiac effects may be caused by ethanol-mediated inhibition of cocaine metabolism leading to higher cocaine plasma concentrations.