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81.
This article reports the results of a randomized trial of a team of case managers who are mental health consumers compared to a team of nonconsumer. Using a repeated measures MANOVA design, consumer case managers were found to be as effective as a team of nonconsumer case managers in maintaining the stability of severely mentally disabled clients served over a 2-year period. Implications for the employment of consumers in mental health services and the vocational capacity of persons with mental illness are discussed. 相似文献
82.
Dephosphorylation of cyclin-dependent kinases by type 2C protein phosphatases 总被引:9,自引:0,他引:9 下载免费PDF全文
Activating phosphorylation of cyclin-dependent protein kinases (CDKs) is necessary for their kinase activity and cell cycle progression. This phosphorylation is carried out by the Cdk-activating kinase (CAK); in contrast, little is known about the corresponding protein phosphatase. We show that type 2C protein phosphatases (PP2Cs) are responsible for this dephosphorylation of Cdc28p, the major budding yeast CDK. Two yeast PP2Cs, Ptc2p and Ptc3p, display Cdc28p phosphatase activity in vitro and in vivo, and account for approximately 90% of Cdc28p phosphatase activity in yeast extracts. Overexpression of PTC2 or PTC3 results in synthetic lethality in strains temperature-sensitive for yeast CAK1, and disruptions of PTC2 and PTC3 suppress the growth defect of a cak1 mutant. Furthermore, PP2C-like enzymes are the predominant phosphatases toward human Cdk2 in HeLa cell extracts, indicating that the substrate specificity of PP2Cs toward CDKs is evolutionarily conserved. 相似文献
83.
Neoplastic involvement of the pericardium resulting in an effusion and subsequent tamponade is an emergency requiring prompt decompression, generally safely accomplished by subxiphoid pericardiectomy. However, the current case report describes a patient with florid pericardial tamponade who underwent surgical decompression with transient hemodynamic improvement, who then rapidly developed progressive, heart failure and death. This paradoxical response to pericardial decompression, similar to that seen occasionally with pericardiectomy in constrictive pericarditis, may be more frequent than currently appreciated. Its cause may relate to the sudden removal of the chronic external ventricular support from the effusion resulting in ventricular dilatation and failure. 相似文献
84.
PURPOSE: The majority of graduating medical students will become primary care physicians. We discuss what urological topics primary care physicians need to know, proficiency in urological skills of primary care physicians and undergraduate urological curriculum recommendations that would serve the needs of primary care physicians. MATERIALS AND METHODS: A written survey instrument was mailed to all 452 family practice residency directors in the United States. Subjects rated how well family practice physicians need to know urological topics and how proficient they must be in urological skills. RESULTS: A total of 329 responses were received (response rate 73%). Respondents indicated that they need to know urinary tract infection, sexually transmitted disease, epididymitis, benign prostatic hyperplasia diagnosis, hematuria and erectile dysfunction diagnosis very well. They indicated a greater need to know diagnostics than staging or management of prostate, bladder, renal or testis cancer (p <0.05). Among diagnostics respondents indicated that generalists should be highly proficient in urinalysis interpretation. Proficiency was ranked greater for interpretations of semen analysis than excretory urogram, abdominal computerized tomography or magnetic resonance imaging, or renal ultrasound (p <0.05). Proficiency in catheter insertion and circumcision was ranked highly, and vasectomy was ranked moderately. CONCLUSIONS: Primary care physicians need to know and be proficient in many urological topics and skills. They need to know diagnostics better than staging and management information, and urological infectious topics better than urological cancers. They need to be proficient in physical examination, urinalysis interpretation, catheter insertion, circumcision and vasectomy. Undergraduate medical education should reflect these needs. 相似文献
85.
Fernandez AP Aronson S Toledano A Winkelmann J Saldivar J Feinstein SB 《Echocardiography (Mount Kisco, N.Y.)》1996,13(5):489-498
Videodensitometric analysis of myocardial contrast echocardiography is traditionally performed off line. Recently, an online contrast ultrasound analysis system, Acoustic Densitometry (Hewlett-Packard), was introduced. We compared pixel intensities acquired with Acoustic Densitometry to pixel intensities derived from videodensitometry. A tissue phantom was imaged in phase I using three transducer frequencies (2.5, 3.5, and 5.0 MHz). In phase II, an in vitro flowing tube model with various concentrations of Albunex® was imaged at two flow rates, 0.6 and 1.2 m/sec, and at two transducer frequencies, 2.5 and 3.5 MHz. The relationship between pixel intensities yielded by the two systems for identical ultrasound signals was determined with linear regression. Intensities derived with Acoustic Densitometry strongly correlated with those derived from the offline videodensitometry system. The intensities were related by a predictive multiplicative factor based on display characteristics of the two systems. These results suggest that semiquantitative, online perfusion analysis with Acoustic Densitometry is as sensitive as analysis offline with videodensitometry. 相似文献
86.
Purpose
The aim of this clinical report is to describe a case of unintentional intraoperative awareness during sufentanil anaesthesia in a patient undergoing elective aortocoronary bypass grafting.Clinical findings
After premedication with morphine (5 mg) and scopolamine (0.2 mg), this 51-yr-old woman received sufentanil (10 μg · kg?1), midazolam (4 mg) and isoflurane (0.3–0.4% end-tidal). The patient recalled specific events and discussions which took place in the operating room during surgery. This patient’s report was clear and corroborated by operating room personnel. The patient denied having felt pain, anxiety or emotional distress.Conclusion
Although awareness during opioid anaesthesia has been previously described with morphine and fentanyl, as far as we know this is the first clinical report of awareness with sufentanil. Given that recent efforts of early extubation in cardiac surgery patients may involve a reduction in the amount of opioid administered, this report serves as a reminder of the ever present potential for this disturbing complication. 相似文献87.
I Segal A A Dubb L O Tim A Solomon M C Sottomayor E M Zwane 《British medical journal》1978,1(6111):469-472
The number of Africans in Johannesburg presenting with duodenal ulcers has steadily increased over the past 50 years. The characteristics of 105 patients with duodenal ulcer who presented a Baragwanath Hospital were compared with those of matched and unmatched samples of patients without gastrointestinal conditions in the same hospital. Men with duodenal ulcers were found to be significantly better educated than their controls, most had been born in the town, and more of them were employed at higher, though not the highest, educational levels. These data were used to test Susser's proposition that duodenal ulcers are associated with "early urbanisation." Johannesburg blacks with duodenal ulcer did seem to fit the pattern, but the relation between stress and duodenal ulcer remains unclear. 相似文献
88.
89.
In rat adipose tissue, insulin (100 muU./ml.) increases the activity of cyclic AMP (but not cyclic GMP) phosphodiesterase (PDE). Radioisotopic assay, autoradiography, and histochemical stains demonstrated that cyclic nucleotide PDE activity is associated with multiple bands of protein separable by polyacrylamide gel electrophoresis. The insulin activation of cyclic AMP PDE, however, was limited to a single band corresponding to the "low" Km enzyme specific for cyclic AMP; insulin had no effect on the "high" Km enzyme or on PDE bands with activity directed toward cyclic GMP. These data support the concept that insulin may modulate the activity of at least one of the cyclic AMP phosphodiesterases. 相似文献
90.