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21.
Some nonprofit mental health organizations are buying real estate in order to own service delivery sites and to provide housing for clients. Owning real estate generally requires long-term financing to conserve cash. This article explores tax exempt financing methods available to nonprofit mental health organizations.  相似文献   
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Angioid streaks were observed in a 31-year-old man with abetalipoproteinemia. Angioid streaks have now been described in hereditary spherocytosis, beta thalassemia, alpha thalassemia, sickle cell anemia, and acanthocytosis secondary to abetalipoproteinemia and hypobetalipoproteinemia. The nature of the association of angioid streaks and structural defects of hemoglobin and the red blood cell is not understood.  相似文献   
24.
Phosphonoacetic acid (PAA, 1) was coupled with various acyclonucleosides, 2'-deoxyuridines, cytidines, and arabinosyluracils, with 2,4,6-triisopropylbenzenesulfonyl chloride (TPS) or dicyclohexylcarbodiimide (DCCI) as condensing agents, to give a range of phosphonate esters. The carboxylic ester linkage of PAA to the 5'-position of 5-bromo-2'-deoxyuridine (BUdR, 3) was achieved via the mixed anhydride formed from (diethylphosphono)acetic acid and trifluoroacetic anhydride. Phosphonoformic acid (PFA, 2) was coupled with BUdR by using the DCCI method to give the phosphonate ester. Of these compounds only phosphonate esters in the 2'-deoxyuridine series showed significant activity against herpes simplex virus types 1 and 2. The BUdR-PAA derivative and the BUdR-PFA derivative were highly active, especially the latter, which was more active than the parent nucleoside BUdR against the type 2 virus. The active compounds may exert their effects by extracellular or intracellular hydrolysis to the corresponding antiviral agents, but an intrinsic component of antiviral activity may also be involved.  相似文献   
25.
Mental health centers and other government sponsored service organizations need highly effective management techniques. In this era of tightening budgets, the Japanese Management System may be a way of increasing both excellence and employee satisfaction. Managers who choose to explore this system may need a concise, written model as a guide to the ingenious, extensive, and paradoxical Japanese Management System. The System centers around quality control circles—autonomous problem-solving groups that strive for excellence. Composed of hierarchically interlocking groups, it uses a wide selection of group cohesion techniques to inspire esprit de corps, and an interlocking set of rewards governs behavior at every level. Decision making is collective (although supervisors retain veto power), and execution of ideas, once agreed upon, is quick and consistent. The System operates holistically, enthusiastically, with a high degree of excellence and mutual concern.  相似文献   
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Conventional teaching states that the spiral of Tillaux marks the location of the ora serrata. On literature review, no source for this was found. This study explores this anatomic relationship. In 20 cadaver eyes, narrow-gauge needles were placed penetrating the center of each rectus muscle insertion, and distance to the ora was measured. Insertions ranged from 2.25 mm posterior to 2.25 mm anterior to the ora, with 90% within 1 mm of it. In ten eyes, distance from the edge of insertion also was measured. Results indicate that the centers of rectus insertions, especially the lateral rectus, approximately overlie the ora, with the edges of the insertions more posterior and variable.  相似文献   
28.
The reduction of the quinone moiety, which is found in many anti-cancer agents, is still a poorly understood process. It is commonly assumed that the reduction of a quinone by the uptake of two electrons and two protons leads to the active hydroquinone form. For a better understanding of these reactions electrochemical data, obtained for a series of substituted benzoquinones, were analyzed. In addition quantum chemical calculations on the STO-3G level were performed to obtain data for the one- and two-electron reduction.From the electrochemical experiments, thermodynamic data can be obtained which show that the unfavourable free energy of electron uptake is overcome by the favourable binding of protons. Both reactions are influenced by the electronic properties of the substituents, as demonstrated by Hammett-type relationships between the free energy of these reactions and the sigma-para character of these substituents. In these relationships the reaction constant of the electron uptake process has an absolute value which is five times higher than that of the proton uptake.Quantum chemical calculations yielded energy values for the one-electron uptake, as expressed by U(LUMO), and for the total reduction process. Most of the results from these calculations are in accord with the thermodynamic study. The calculations also revealed a conformational change to take place upon reduction of NH2 and N(CH2)2 substituted benzoquinones, which might be important for chemical and biological activity.  相似文献   
29.
We have examined the interaction of procaine, prilocaine, lignocaine, bupivacaine, amylocaine and R(+) and S(-) ropivacaine with L-type voltage-sensitive Ca2+ channels in rat cerebrocortical membranes. Membranes were prepared in Tris HCl 50 mmol litre-1, pH 7.4, by homogenization and centrifugation. Binding assays were performed in 1- ml volumes of Tris HCl 50 mmol litre-1, pH 7.4, for 90 min at room temperature using approximately 200 micrograms of protein. Non-specific binding was defined in the presence of nifedipine 10(-5) mol litre-1, and bound and free radioactivity were separated by vacuum filtration. The effects of local anaesthetics were determined by displacement of [3H]PN200-110 (approximately 0.2 nmol litre-1), a radiolabelled 1,4- dihydropyridine (DHP) L-channel antagonist. The concentration of displacer producing 50% displacement was corrected for the competing mass of [3H]PN200-110 to yield the affinity constant, K50. All local anaesthetics displaced [3H]PN200-110 in a dose-dependent manner with a rank order potency of (K50, mmol litre-1) bupivacaine (0.48), amylocaine (0.74), lignocaine (1.09), prilocaine (2.06) and procaine (2.09). Ropivacaine enantiomers did not show stereo-selective displacement, with K50 values of 0.99 and 0.92 mmol litre-1 for R(+) and S(-) ropivacaine, respectively. There was a significant correlation between pK50 and p (octanol:buffer partition coefficient) (r2 = 0.872, P = 0.020), pK50 and p (local anaesthetic potency) (r2 = 0.816, P = 0.036), pK50 and p (relative conduction blocking potency) (r2 = 0.843, P = 0.028) and between pK50 and p (IC50 for inhibition of cardiac output) (r2 = 0.897, P = 0.015). These data suggest that DHP binding sites may be involved in both the mechanism of local anaesthesia and the cardiotoxicity of these agents.   相似文献   
30.
Co-existence of facial and occipital pain may occur in occipital neuralgia, migraine and cluster headache; suggesting convergence of trigeminal and cervical afferents. Such convergence has been shown in humans and other animals, but the site and extent of this are uncertain. In anaesthetized adult cats, the superior sagittal sinus and occipital nerve were stimulated electrically, and extracellular recordings made in the dorsolateral area of the upper cervical cord using glass-coated tungsten electrodes. Of 49 units in 10 cats, 33 (67%) had input from the superior sagittal sinus and the occipital nerve. Thirteen (27%) had superior sagittal sinus input and 3 (6%) had occipital nerve input. Convergent receptive fields were identified mechanically in 7 units. These experiments in cats show convergent input from occipital nerve and superior sagittal sinus on dorsolateral area units in two-thirds of cases studied. This experimental site of trigeminocervical convergence may relate to referral of pain in occipital neuralgia and other headaches.  相似文献   
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