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61.
E.Paul Kirk MB BS J. Santa MD T. Heckler MBA M. Collins MD 《American journal of obstetrics and gynecology》1998,178(6):1222-1228
OBJECTIVE: Our purpose was to assess whether legislative action influenced the role of obstetrician-gynecologists as primary care physicians. STUDY DESIGN: An observational study was performed on the basis of a questionnaire sent to 410 obstetrician-gynecologists and 27 medical directors of managed-care organizations. RESULTS: Of 67% of obstetrician-gynecologists and 96% of medical directors who responded, there was agreement as to the content of primary care, but a minority (38%) of obstetrician-gynecologists identified themselves as primary care providers. A minority of medical directors (35%) felt that obstetrician-gynecologists should serve in that role. Both obstetrician-gynecologists and medical directors felt that legislation had little impact. CONCLUSION: The reticence of obstetrician-gynecologists to assume a major role in primary care appears to be the result of an uneasiness with accepting a more comprehensive role in patient management and gatekeeping. They appear comfortable with the more traditional roles but feel that training and experience has not prepared them well for the management of more complex medical problems. (Am J Obstet Gynecol 1998;178:1222-8.) 相似文献
62.
David S. Park Paul Manowitz Stanley Stein Ronald D. Poretz 《Alcoholism, clinical and experimental research》1996,20(2):234-239
Several electrophoretic forms of human platelet arylsulfatase A (ASA), including variant type IIIa and normal type IVa , have been identified by nondenaturing polyacrylamide gel electrophoresis. An alcoholic population that we have analyzed is enriched in variant type IIIa compared with nonalcoholic psychiatric and normal controls. Individuals with the IIIa enzyme possess greatly reduced levels of ASA activity. To understand further the structural basis for the differences and their potential biological consequences, the nature of the ASA variant expressed by fibroblasts from different individuals was explored. The electrophoretic patterns of fibroblast ASA from the IIIa and IVa individuals differ in degree of phosphorylation. Furthermore, fibroblast ASA from IIIa individuals lacks an N -linked glycan found in ASA from IVa individuals. In addition, differences in peptide and/or posttranslational modification unrelated to the N -linked carbohydrate or phosphorylation exist between the fibroblast ASA from IIIa and IVa individuals. The finding that both fibroblasts and platelets exhibit related electrophoretic isoform patterns characteristic of the donor's ASA type allows for the use of fibroblasts to study the impact of ethanol on the metabolism of cells possessing different ASA types. 相似文献
63.
64.
This study examined the relations betweensociotropy, autonomy, and stress severity ratings forhypothetical life events that were objectivelycategorized as interpersonal or achievement-related infocus. The hypothesis that sociotropy and autonomyserve as vulnerability factors to dysphoria in thepresence of life stress that matches the theme of thevulnerability was also examined in 6-week and 12-week follow-up evaluations. Results provided onlypartial support for the predicted relations amongsociotropy, autonomy, and perceived stress severityratings of interpersonal and achievement-related events. Longitudinal results failed to support thehypothesis that sociotropy and autonomy serve asvulnerability factors for matching interpersonal andachievement-related stress. It was concluded thatobjectively categorizing life events as interpersonal orachievement-related is problematic given that themeaning of life events can vary across individuals, andthat these meanings are likely to vary partly as a function of sociotropy and autonomy. 相似文献
65.
Kevin G Becker Insong J Lee James W Nagle Rachel D Canning Ameer M Gado Rosarelis Torres Mihael H Polymeropoulos Paul T Massa WilliamE Biddison Paul D Drew 《International journal of developmental neuroscience》1997,15(7):73
We describe a novel human zinc finger cNDA, C2H2-171. This cDNA represents an mRNA which encodes a protein of 484 amino acids and a calculated molecular weight of 54 kD. Four zinc finger-like domains are found in the C-terminal end of the protein. At the N-terminus, C2H2-171 contains a POZ/tramtrack-like domain similar to that found in the tumor associated zinc finger proteins LAZ-3/BCL-6 and PLZ-F, as well as in non-zinc finger proteins. C2H2-171 RNA is preferentially expressed in the brain, and increases during the course of murine development, with maximal expression in the adult. C2H2-171 RNA is differentially expressed in brain regions, with the highest level of expression in the cerebellum. C2H2-171 RNA was expressed at high levels in primary cerebellar granule cell neurons compared to astrocytes. The gene encoding C2H2-171 is highly conserved in vertebrates, and maps to the terminus of human chromosome 1 (1q44-ter). This chromosomal location is associated with a number of cytogenetic aberrations including those involving brain developmental anomalies and tumorigenesis. These data suggest that C2H2-171 may play an important role in vertebrate brain development and function. 相似文献
66.
Pharmacological interactions between serotonin and dopamine on behavior in the squirrel monkey 总被引:2,自引:1,他引:1
The behavioral effects of GBR 12909, a selective dopamine uptake inhibitor, were determined in squirrel monkeys trained to
respond under a fixed-interval (FI) schedule of stimulus termination and a second-order schedule of IV drug self-administration.
Intermediate doses of GBR 12909 increased FI response rate markedly, and the highest dose decreased response rate below control
values. The 5HT uptake inhibitors, alaproclate and fluoxetine, and the 5HT agonist, quipazine, attenuated the behavioral-stimulant
effects of GBR 12909, whereas the 5HT2A/2C antagonist, ritanserin, enhanced the behavioral-stimulant effects of the lowest dose. GBR 12909 reliably maintained self-administration,
and ritanserin increased response rate maintained by the highest dose. The dopamine agonist, quinpirole, increased FI response
rate in only one of three subjects, and ritanserin enhanced the behavioral-stimulant effects of quinpirole in that subject.
The dopamine agonist, apomorphine, only decreased FI response rate, and ritanserin did not alter its behavioral effects. The
pharmacological profile of GBR 12909 administered alone and in combination with selective 5HT drugs in the present study was
similar to that obtained previously with cocaine, further demonstrating that 5HT can reliably modulate the behavioral effects
of psychomotor stimulants with prominent dopaminergic actions.
Received: 9 July 1996 / Final version: 22 November 1996 相似文献
67.
Frances Rudnick Levin Judith M. Hess David A. Gorelick Nancy A. Kreiter Paul J. Fudala 《The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions》1993,2(2):109-115
The authors systematically evaluated the frequency patterns of cocaine use in 85 cocaine-dependent outpatients and found four patterns of use: continuous (27%), intermittent patterned (35%), intermittent nonpatterned (25%), and occasional (13%). Few subjects reported consistent cycling between binges and crashes. There were no significant differences in patterns of use associated with gender, race, educational level, route of administration, or recency of heroin use. Continuous users and occasional users were older than intermittent users. Because different contingencies may control patterned vs. nonpatterned cocaine use, pattern of use may have implications for treatment, even in individuals reporting similar amounts of cocaine use. 相似文献
68.
Although a great deal is known about the nature and severity of the recent financial crisis in agriculture, there has been little systematic study of the social and psychological effects of this crisis upon farm operators and their families. Using data from a statewide sample of Iowa farmers, this study tests some hypotheses about correlates of psychological stress. The findings suggest that many farm operators find their situations to be stressful and that such stress is related to the severity of their financial problems. In addition, the life-events perspective is examined in its utility to explain how adverse economic changes impact psychological well-being. 相似文献
69.
70.
A. Zuckermann M.D. M. Grimm Regine Ahner Paul Simon Peter Buxbaum G. Laufer E. Wolner 《European Surgery》1996,28(3):176-177
Summary
Background Pregnancy is prossible in female patients who underwent cardiac transplantation but is associated with unpredictable risks.
Methods A 23-year old female patient underwent cardiac transplantation because of dilatative cardiomyopathy.
Results Against our advice, she became pregnant 4 months after transplantation. Following an uneventful pregnancy, spontaneous vaginal
delivery occurred 13 months after transplantation. The patient gave birth to a healthy new-born in good physical condition.
Thereafter, the patient refused to attend any further routine follow-up control. 9 months after delivery, the patient was
admitted to hospital in severe cardiac shock. Biopsy showed a serious, acute rejection which was treated with a course of
methylprednisolone. Clinically, the patient recovered within 1 week, but died from acute myocardial infarction 1 day after
discharge from hospital.
Conclusions Only women without a history of rejection episodes, with good kidney function, good graft function, and high compliance should
be counselled to become pregnant.
相似文献