Characterization of the expression and function of N-methyl-D-aspartate receptor in keratinocytes.

The N-methyl-D-aspartate (NMDA) receptor is expressed on neural tissue where it gates calcium ion entry upon stimulation. Using immunohistochemistry, it has been demonstrated in this study that the NMDAR1 receptor is also expressed on keratinocytes (KCs) in normal human skin and inflamed psoriatic skin in vivo. Furthermore, the NMDA receptor was functional as demonstrated by the ability of this receptor to trigger Ca++ influx in KCs. Incubation of cultured, human KCs with MK-801 decreases the cell growth and induces an increase in apoptosis. These findings demonstrate that the KC expression of NMDA receptor is a mechanism through which the influx of Ca++ into the cell can be regulated and suggest that the expression of this receptor may play a role in the regulation of KC growth and differentiation.

Pharmacological induction of HSP27 attenuates intimal hyperplasia in vivo.

OBJECTIVES: intimal hyperplasia (IH) is a major cause of re-stenosis post-vascular intervention. Induction of heat shock proteins (HSPs), by thermal pre-conditioning, reduces IH. Our aim was to investigate the effect of the pharmacological HSP inducer herbimycin A on IH in the rat carotid balloon injury model. MATERIALS AND METHODS: thirty male Sprague-Dawley rats were randomized into three groups. All groups underwent balloon injury to the left carotid artery. Stress proteins were induced 18 h pre-operatively by heat shock or herbimycin A. Two weeks post-operatively, animals were sacrificed and carotid intima/media area ratio (I/M ratio) calculated using computerized planimetry. Neo-intimal proliferation was assessed immunohistochemically with PCNA (proliferating cell nuclear antigen). Western blot and immunohistochemistry for arterial HSP70 and HSP27 were performed. RESULTS: heat stress and herbimycin significantly reduced the I/M ratio (p < 0.05 vs balloon injury alone). Neo-intimal proliferation was significantly reduced in the heat stress and herbimycin groups (p < 0.05 vs balloon injury alone). Heat stress induced arterial HSP70 and HSP27. Herbimycin A increased arterial HSP27. CONCLUSION: herbimycin A significantly attenuates IH after balloon injury. HSP27 may be the HSP involved in mediating this response. Pharmacological inducers of HSPs may have a therapeutic role to play in preventing re-stenosis post-vascular intervention.

Cyclo-oxygenase inhibition reduces tumour growth and metastasis in an orthotopic model of breast cancer.

The effect of selective and non-selective cyclo-oxygenase inhibition on tumour growth and metastasis in an orthotopic model of breast cancer was investigated. 4T1 mammary adenocarcinoma cells were injected into the mammary fat pad of female BALB/c mice. When tumours reached a mean tumour diameter of 8.4+/-0.4 mm, mice were randomised into three groups (n=6 per group) and received daily intraperitoneal injections of the selective cyclo-oxygenase-2 inhibitor, SC-236, the non selective cyclo-oxygenase inhibitor, Indomethacin, or drug vehicle. Tumour diameter was recorded on alternate days. From 8 days after initiation of treatment, tumour diameter in animals treated with either SC-236 or indomethacin was significantly reduced relative to controls. Both primary tumour weight and the number of lung metastases were significantly reduced in the SC-236 and indomethacin treated mice. Microvessel density was reduced and tumor cell apoptosis increased in the primary tumour of mice treated with either the selective or non-selective cyclo-oxygenase inhibitor. In vitro, cyclo-oxygenase inhibition decreased vascular endothelial growth factor production and increased apoptosis of tumour cells. Our results suggest that cyclo-oxygenase inhibitors will be of value in the treatment of both primary and metastatic breast cancer.

Is shared governance still relevant?

Is shared governance still relevant in this era of significant changes in healthcare? Requisites to support nurses and others are more important now than ever before. Shared decision-making is not only relevant, it is essential. The road to empowerment is not easy. Many patterns of organization and relationship must be changed forever through commitment and leadership today.

Beyond the walls: nursing in the entrepreneurial world.

Nursing is a dynamic and exciting profession. The future of practice is built on the shoulders of those who have gone before and laid firm foundations upon which to construct the future. One person's career is simply a small part of the complex of variables that contribute to the growth and success of the profession. However, it is precisely this commitment, energy, and contribution that assure a viable and meaningful future and every nurse is called to add his or her individual gifts to its creation.

Collective bargaining: the union as partner. Part 3.

Here, learn success strategies for leading positively in a collective bargaining environment.

Intraoperative measurement of spinal cord blood flow in syringomyelia.

The role of spinal cord ischemia in the pathophysiology of syringomyelia remains undetermined. Previous reports in the literature suggest that shunting of syringes can improve spinal cord blood flow. In order to determine the effects of syrinx decompression on spinal cord blood flow in patients with syringomyelia, we prospectively measured regional spinal cord blood flow (RSCBF) intraoperatively pre and post shunting in patients with symptomatic syringomyelia using laser doppler flowmetry. Six patients with MRI documented syringomyelia were studied (three with Arnold Chiari I malformation and associated syrinx and three with post-traumatic syringomyelia). Surgery was performed on all patients with either a syringopleural or syringoperitoneal shunt. Laser doppler blood flow and somatosensory evoked potentials were monitored prior to myelotomy and after shunt insertion. Results indicate that there was a significant increase in RSCBF after decompression of the syrinx. This study supports the hypothesis that spinal cord ischemia is important in the pathophysiology of syringomyelia and confirms previous reports in the literature regarding RSCBF in syringomyelia.

Shared Governance within the market-oriented health care system of New Zealand.

The New Zealand health reforms, announced in 1991 and implemented over the 3-year period 1992-1994, were market-oriented, following a competitive model that had been applied across New Zealand's public sector. Consideration is given to the effects of the health reforms on nursing and midwifery at Capital Coast Health Limited (CCHL), with the introduction of a market/economic model of health care and its accompanying managerialism. The market model, or the economic era of health care, as some describe it, created an environment where nurses felt powerless. All the directors of nursing and on-going hospital educational programs were disestablished in the public sector; nurses were disheartened, confused and lacked representation at senior management. Integral to, and accompanying, corporatization is managerialism. With corporatization, came managers from the non-health care sector who had no understanding of the complexities of health care. Accompanying managerialism is the notion that any able manager was capable of managing any agency, whether public or private. Naturally, there was an underlying conflict between the caring relationships and their related work in the clinical environment, and the desire for efficiency and economy. It seemed that we were dealing with contrasting themes of 'the market' and 'humanity' This led to further confusion and disempowerment, as the dollar gained prominence, for nursing has always been grounded in the 'humanities'. It was into this environment, after 5 years of the health reforms, that a Nurse Executive was appointed and the concept of Shared Governance was introduced. This article describes why Shared Governance was considered an appropriate model to introduce at CCHL, and identifies some of the tangible benefits being realized 18 months post implementation. Discovering that membership in cross-organizational teams provides a mechanism for networking and creating a broader understanding of the organization has been but one of the major benefits.

Nursing leaders predict top trends for 2000.

Nursing Management's Editorial Advisory Board predicts the top 10 trends that will impact nurse leaders in 2000. Use them to lead in the new millennium.

Verrucous carcinoma arising in hidradenitis suppurativa.

There are many reported cases of squamous carcinoma complicating hidradenitis suppurativa, but only one previous mention of verrucous carcinoma in this setting. We describe a case of verrucous carcinoma arising in hidradenitis suppurativa of the anal margin in a non-immunosuppressed man. This is the second report of verrucous carcinoma arising in a lesion of hidradenitis suppurativa. Although hidradenitis suppurativa can involve multiple intertriginous sites, malignant degeneration occurs mostly in the anogenital region. This suggests a role for a regional factor which, when combined with chronic inflammation, predisposes to malignant degeneration. A likely candidate for this factor is human papillomavirus; our case showed histologic evidence for this, but the specimen did not show viral DNA by polymerase chain reaction in situ hybridization. The ability of anogenital hidradenitis suppurativa to form squamous and verrucous cancers reinforces the argument for early and complete resection.