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31.
OBJECTIVE--To investigate the current problems and needs of terminally ill cancer patients and their family members, and to discover their views of hospital, community, and support team services. DESIGN--Prospective study of patients and families by questionnaire interviews in the patients'' homes. SETTING--Inner London and north Kent (London suburbs). SUBJECTS--65 Patients, each with a member of their family or a career. MAIN OUTCOME MEASURES--Ratings of eight current problems and ratings and comments on three services-hospital doctors and nurses, general practitioners and district nurses, and the support team staff-obtained after a minimum of two weeks'' care from palliative care support teams. RESULTS--Effect of anxiety on the patient''s nearest career. and symptom control were rated as the most severe current problems by both patients and families; a few patients and families identified other severe problems. Families'' ratings of pain control, symptom control, and effect of anxiety on the patient were significantly worse than the patients'' ratings (p less than 0.05). Support teams received the most praise, being rated by 58 (89%) patients and 59 (91%) of family members as good as excellent. General practitioners and district nurses were rated good or excellent by 46 (71%) patients and 46 (71%) family members, but six (9%) in each group rated the service as poor or very bad, and ratings in the inner London district were significantly worse than those in the outer London district. Hospital doctors and nurses were rated good or excellent by 22 (34%) patients and 35 (54%) of family members, and 14 (22%) patients and 15 (23%) family members rated this service as poor or very bad. Negative comments referred to communication (especially at diagnosis), coordination of services, the attitude of the doctor, delays in diagnosis, and difficulties in getting doctors to visit at home. Family members were more satisfied with the services than were patients. CONCLUSIONS--Palliative care needs to include both the patient and family because the needs of the family may exceed those of the patient. Support teams and some hospital and community doctors and nurses met the perceived needs of dying patients and families, but better education and organisation of services are needed. 相似文献
32.
33.
Marijo G. Kent Robert N. Shoffner Allan Hunter Keith O. Elliston Wesley Schroder Elizabeth Tolley Stephen S. Wachtel 《Human genetics》1988,79(4):321-328
Summary An inherited genetic disorder causes XY embryos of the horse to develop as mares. On the basis of our study of 38 such mares, we have identified four grades or classes of XY sex reversal according to this scheme: class I, nearly normal female, of which some are fertile; class II, female with gonadal dysgenesis, normal mullerian development; calss III, intersex mare with gonadal dysgenesis, abnormal mullerian development, enlarged clitoris; class IV, virilized intersex characterized by high levels of testosterone. In general, class I and calss II mares were typed H-Y antigen-negative whereas class III and class IV mares were typed H-Y antigen-positive. 相似文献
34.
Akhlaq A. Farooqui Tahira Farooqui Allan J. Yates Lloyd A. Horrocks 《Neurochemical research》1988,13(6):499-511
Protein kinase C has recently attracted considerable attention because of its importance in the control of cell division, cell differentiation, and signal transduction across the cell membrane. The activity of this enzyme is altered by several lipids such as diacylglycerol, free fatty acids, lipoxins, gangliosides, and sulfatides. These lipids may interact with protein kinase C either directly or through calcium ions and produce their regulatory effect (activation or inhibition) on the activities of the enzymes phosphorylated by this kinase. These processes widen our perspective of the regulation of intercellular and intracelluular communication.Abbreviations used (PK-C)
Protein kinase C
- (cAMP-PK)
cAMP dependent protein kinase
- (DAG)
diacylglycerol
- (PtdSer)
phosphatidylserine
- (InsP
3)
inositol 1,4,5-trisphosphate
- (PtdIns 4,5-P2)
inositol 4,5 bisphosphate
- (FFA)
free fatty acid
- (MBP)
myelin basic protein
- (ATP)
adenosine triphosphate
- (GTP)
guanine triphosphate
- (TPA)
12-tetradecanoylphorbol-13-acetate
- (EGF)
epidermal growth factor
- (PDGF)
platelet derived growth factor
- (NeuNAc)
and N-acetylneuraminic acid 相似文献
35.
We describe practical, effective, office-based methods for physicians to use to assist patients to stop smoking that do not require special training or support personnel. Brief counseling achieves smoking cessation in a small percent of well patients but is more effective in patients with smoking-related illnesses or abnormal laboratory test results. Routine prescribing of nicotine gum without participation by the patient in a smoking-cessation program does not increase smoking cessation, and we do not recommend it. The prevention of smoking relapse can probably be enhanced by scheduling follow-up office visits after the patient has quit. Failure to quit on initial attempts should not discourage physicians and patients, since most successful abstainers usually must make several attempts to quit. We outline for physicians two approaches, one brief and one more intensive, to help patients stop smoking. 相似文献
36.
D M McCarthy J H Lin L A Rinckel D C Savage 《Applied and environmental microbiology》1988,54(2):416-422
Lactobacillus isolates able to colonize the surfaces of the nonsecreting epithelia in the stomachs of monoassociated ex-germfree mice were derived from Lactobacillus acidophilus 100-33. Strain 100-33 was originally isolated from pig feces and is unable to colonize the murine gastric epithelium. In experiments involving attempts genetically to transform the capacity to colonize the epithelium, cells of strain 100-33 were treated with muralytic enzymes and mixed with polyethylene glycol and genomic or plasmid DNA extracted from Lactobacillus fermentum RI. Strain RI was originally isolated from a conventional mouse and has the capacity to colonize the nonsecreting gastric epithelium. The mixtures containing cells, polyethylene glycol, and DNA were plated on a regeneration medium. After overnight incubation, the cells were washed from the plates and introduced by gastric gavage into germfree mice. Only mice that received regenerated 100-33 cells previously mixed with genomic DNA from strain RI had layers of gram-positive bacteria on the keratinized epithelia of their stomachs. Six isolates cultured from the washed gastric tissues of these animals were characterized. When a culture of each or a pool of cultures of the six were orally administered to germfree mice, layers of gram-positive bacterial cells were visible on the keratinized gastric epithelia of the animals within 1 to 3 weeks. Cells of all six, but not of strain 100-33, reacted with antibody made in rabbits to L. fermentum RI cells, as determined by an enzyme-linked immunosorbent assay. Nevertheless, all six had fermentation profiles identical to that of strain 100-33.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
37.
Microcystis aeruginosa was grown in light-limited continuouscultures at different growth rates on light-dark cycles at variousphotopenods. Due to the strength of the gas vesicles the organismwas not able to collapse its gas vesicles by turgor pressure.Below the maximal growth rate, the organism was buoyant dueto its high gas vesicle content. The results suggested thatthe rate of gas vesicle synthesis was not regulated. Upon atransition to high irradiance it took several hours before thecells lost their buoyancy due to polyglucan accumulation. Theresults are interpreted in an ecological context and it is suggestedthat Microcystis is an epilimnetic species due to its buoyancyregulation. 相似文献
38.
S A McCarthy E Kaldjian A Singer 《Journal of immunology (Baltimore, Md. : 1950)》1988,141(11):3737-3746
The effector function of most MHC class I allospecific CTL is inhibited by anti-CD8 mAb. In the present study, we report the surprising observation that multi-valent cross-linking of CD8 molecules on precursor cells by specific antibody actively induces the generation of CD8+ class I allospecific CTL whose lytic function is resistant to anti-CD8 antibody inhibition, and actively induces down-modulation of cell surface CD8 expression on these cells. In marked contrast, bi-valent cross-linking of CD8 inhibits the generation of CD8+ CTL from precursor cells and fails to induce down-modulation of cell surface CD8 expression. These results demonstrate that CD8 can transduce net positive signals, but only when the molecule is extensively cross-linked. 相似文献
39.
Bone graft survival in expanded skin 总被引:2,自引:0,他引:2
G S LaTrenta J G McCarthy M Epstein C B Cutting C Orentreich 《Plastic and reconstructive surgery》1988,81(3):406-413
The effect of tissue expansion on iliac bone graft (onlay) survival was studied on the skulls of 35 New Zealand white rabbits. Wet bone weights at the time of grafting and at sacrifice in control animals (group I) were compared to three experimental groups. Histologic sections of the developing and resolving pseudosheath and skin envelope were performed. A self-inflating 5-mil-thick silicone expander was used for soft-tissue expansion over the rabbit snout. Bone grafts were subsequently placed in this site. Elliptical snout excision without expansion (group II) demonstrated no statistically significant difference in bone graft survival when compared to controls (group I) (p = 0.350). Full tissue expansion followed by immediate bone grafting (group III) within the pseudosheath cavity likewise demonstrated no statistically significant difference in bone graft survival when compared to controls (group I) (p = 0.500); however, when full tissue expansion was followed by delayed (2 weeks) bone grafting to allow for resolution of the giant cell inflammatory reaction of the pseudosheath (group IV), a statistically significant increased bone graft survival was achieved (p less than 0.001). The study demonstrates that the increased vascularity in the pseudosheath and in the expanded soft-tissue envelope significantly increased bone graft survival only when bone grafting was delayed. 相似文献
40.
Nonequivalent effects of PKC activation by PMA on murine CD4 and CD8 cell-surface expression 总被引:3,自引:0,他引:3
E Kaldjian S A McCarthy S O Sharrow D R Littman R D Klausner A Singer 《FASEB journal》1988,2(12):2801-2806
The membrane glycoproteins CD4 (L3T4) and CD8 (Lyt2) are expressed on distinct populations of mature murine T lymphocytes, and are thought to be receptors for monomorphic determinants expressed on MHC class II and class I molecules, respectively. Although they differ in their ligand specificity, it has been presumed that CD4 and CD8 perform equivalent functions in the T cells that bear them. Since activation of protein kinase C (PKC) is known to cause rapid down-regulation of various receptors, including the T cell receptor complex (TcR complex), we treated cells with phorbol 12-myristate 13-acetate (PMA), a PKC activator, to determine whether cell-surface expression of CD4 and CD8 would be similarly affected by this intracellular mediator. Brief or relatively prolonged treatment with PMA induced mature murine T cells to reduce their surface expression of the TcR complex and of CD4, but not of CD8. Similarly, PMA rapidly induced transfected L cells to down-regulate surface CD4 expression, but had no effect on surface CD8 expression. Most significantly, PMA treatment induced CD4+CD8+ immature thymocytes to rapidly reduce their surface CD4 expression, but, again, it had no immediate effect on the surface expression of CD8. These results indicate that CD4 and TcR complex cell-surface expression are both sensitive to PKC activation by brief treatment with PMA, whereas CD8 expression is not, and suggest that CD4 and CD8 surface expression levels are regulated by distinct intracellular mechanisms. 相似文献