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1.
Katharine R. Owen Mollie Donohoe Sian Ellard Andrew T. Hattersley 《Diabetic medicine》2003,20(10):823-827
Background Familial partial lipodystrophy (FPLD) is a monogenic form of diabetes characterised by a dominantly inherited disorder of adipose tissue associated with the loss of subcutaneous fat from the limbs and trunk, with excess fat deposited around the face and neck. The lipodystrophy causes severe insulin resistance, resulting in acanthosis nigricans, diabetes, dyslipidaemia, and increased risk of cardiovascular disease. Preliminary results from animals and man suggest that increasing subcutaneous fat by treatment with thiazolidinediones should improve insulin resistance and the associated features of this syndrome. Case report We report a 24-year-old patient with FPLD caused by a mutation in the LMNA gene (R482W) treated with 12 months of rosiglitazone. Subcutaneous fat increased following rosiglitazone treatment as demonstrated by a 29% generalised increase in skin-fold thickness. Leptin levels increased from 5.8 to 11.2 ng/ml. Compared with treatment on Metformin, there was an increase in insulin sensitivity (HOMA S% 17.2–31.6) but no change in glycaemic control. The lipid profile worsened during the follow-up period. Conclusion This initial case suggests that, for modification of cardiovascular risk factors, there are no clear advantages in treating patients with FPLD with rosiglitazone despite increases in subcutaneous adipose tissue. Larger series will be needed to identify moderate beneficial effects and treatment may be more effective in patients with generalised forms of lipodystrophy. 相似文献
2.
Alexander R Grier Katharine L Grier 《The Journal of the Canadian Chiropractic Association》1992,36(1):22-28
Chiropractic fee negotiations in Saskatchewan utilize the Chiropractic Compensation Review Committee with recourse to the Chiropractic Consultation Committee. Health care professionals who practise on a fee for service basis provide the government with a budgetary problem. Although the fees are set, the health care provider can determine his own income by deciding how many visit services he/she wishes to provide. In the fiscal years 1981-82 to 1990-91, chiropractors earned $699.00 per year more than one would expect given the increases in fee schedules. Each chiropractor earned $2,329.00 per year more than was necessary to make up for losses due to inflation. The allegation that unnecessary treatments were performed on patients is countered by analysis of the services per discrete patient values by mode of practice. The increased earnings of chiropractors was accomplished by treating an increasing percentage of the population who sought health care. Comparative information was obtained from the four western provinces. 相似文献
3.
Comfort management is a priority for patients in all settings. Comfort theory provides a foundational and holistic approach to comfort management. This article reviews comfort theory and presents the application of comfort theory in the perianesthesia setting. OBJECTIVES: -Based on the content of the following article, the reader will be able to (1) define comfort; (2) identify comfort interventions; and (3) discuss the importance of a goal for enhanced comfort in patients. 相似文献
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Robert C Stanton Lisa D Mayer Nancy E Oriol Katharine K Treadway Daniel C Tosteson 《Academic medicine》2007,82(5):516-520
An excellent physician must be aware of the countless issues that affect each patient's health. Many medical education programs expose students to a broad spectrum of disparate knowledge and hope they will integrate all the pieces into a coherent whole. The authors describe an explicit approach to integration used at Harvard Medical School since 2003 that aims to enhance students' learning in medical school and throughout their medical careers: the Mentored Clinical Casebook Project (MCCP). The MCCP is constructed on the premise that such integration does not occur suddenly but, rather, is an unending process. A first-year student is assigned to one clinician and follows one patient for one year. The student is expected to spend as much time with the patient as possible, in both clinical and nonclinical settings, seek help from the clinician, and consult other experts and sources to develop a complete picture of the patient's life. The student must produce a casebook that includes, but is not limited to, the patient's history; basic science, clinical, socioeconomic, and cultural issues; and self-reflection. The MCCP is intended to allow students to develop a deeper and more diverse understanding of what comprises a patient's health care life, to discern the patient as a person and the person as a patient. This educational project has been popular with students since its inception, providing them with a personal framework from which to address the needs of future patients and introducing them to how much they will continue to learn from their patients. 相似文献
6.
A differential efficiency of adenovirus-mediated in vivo gene transfer into skeletal muscle cells of different maturity 总被引:8,自引:0,他引:8
Acsadi Gyula; Jani Agnes; Massie Bernard; Simoneau Maude; Holland Paul; Blaschuk Katharine; Karpati George 《Human molecular genetics》1994,3(4):579-584
High titre (10111012 pfu/ml) suspensions of autonomouslyreplication-defective type 5 human adenovirus (AV) recombinantswith different reporter gene inserts (CMV-Luciferase (Lux),CMV-ß-galactosidase (Lac Z), RSV-Lux and RSV-Lac Z)were injected Into intact quadrlceps muscles of 15 dayold (Group 1) or 3545 day old (Group 2) normal mice,as well as regenerating adult mouse muscles (Group 3) and 35day old mdx muscles (Group 4). The expression of the reportergenes was quantitated 10 days and 2 months later. At 10 dayspostinjection all reporter gene expression was very high inthe neonatally injected (Group 1) muscles. In Group 2 musclesthe transduction was markedly less. In Group 3 muscles the geneexpression was significantly better than in the Group 2 muscles.In adult mdx muscles (Group 4) where spontaneous regenerationis usually present, the results were similar to those in Group3 animals. At 2 months post-injection in Group 1 animals, theRSV-Lux expression was even higher than at 10 days postinjection.The cell surface density of 相似文献
7.
We describe a protocol for the synchronisation of normal and tumour cells grown in suspension cultures using 3-hydroxypyridin-4-one iron chelators. These compounds inhibit ribonucleotide reductase, one of the rate limiting enzymes in DNA synthesis, and so block the cell cycle in late G1 phase. After removal of the chelator or repletion of cellular iron, cells progress through the cycle and remain synchronised for at least one full cell cycle. Cell viability is unaffected for at least 72 hours post-incubation and chelator treatment has no effect on RNA and protein synthesis. This method of synchronisation has been successful with all cell lines tested including normal and leukaemic human cell lines. 相似文献
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9.
Katharine J. Foster Stephanie Q. Zhang Stephen R. Braddock Rashmi Chikarmane Cirilo Sotelo‐Avila Jose Greenspon 《American journal of medical genetics. Part A》2019,179(5):817-821
Retinoic acid receptor beta (RARB) variants are heavily linked to pathologies of neural crest cell migration. The purpose of this report is to present a 23‐month‐old male with the previously described R387C RARB gain‐of‐function variant whose gastrointestinal issues and long‐term constipation lead to the discovery of colonic hypoganglionosis. This case further delineates the pattern of malformation associated with RARB variants. The findings are also consistent with the known etiology of aganglionic colon due to failed neural crest cell migration. 相似文献
10.
Neurons have ion channels that are directly gated by voltage, ligands and temperature but not by light. Using structure-based design, we have developed a new chemical gate that confers light sensitivity to an ion channel. The gate includes a functional group for selective conjugation to an engineered K(+) channel, a pore blocker and a photoisomerizable azobenzene. Long-wavelength light drives the azobenzene moiety into its extended trans configuration, allowing the blocker to reach the pore. Short-wavelength light generates the shorter cis configuration, retracting the blocker and allowing conduction. Exogenous expression of these channels in rat hippocampal neurons, followed by chemical modification with the photoswitchable gate, enables different wavelengths of light to switch action potential firing on and off. These synthetic photoisomerizable azobenzene-regulated K(+) (SPARK) channels allow rapid, precise and reversible control over neuronal firing, with potential applications for dissecting neural circuits and controlling activity downstream from sites of neural damage or degeneration. 相似文献