ABSTRACT
The TRIM family of genes is largely studied because of their roles in development, differentiation and host cell antiviral defenses; however, roles in cancer biology are emerging. Loss of heterozygosity of the TRIM3 locus in â¼20% of human glioblastomas raised the possibility that this NHL-domain containing member of the TRIM gene family might be a mammalian tumor suppressor. Consistent with this, reducing TRIM3 expression increased the incidence of and accelerated the development of platelet-derived growth factor -induced glioma in mice. Furthermore, TRIM3 can bind to the cdk inhibitor p21(WAF1/CIP1). Thus, we conclude that TRIM3 is a tumor suppressor mapping to chromosome 11p15.5 and that it might block tumor growth by sequestering p21 and preventing it from facilitating the accumulation of cyclin D1-cdk4.
Subject(s)
Carrier Proteins/metabolism , Cyclin-Dependent Kinase Inhibitor p21/metabolism , Glioblastoma/metabolism , Tumor Suppressor Proteins/metabolism , Animals , Carrier Proteins/genetics , Cell Line , Cell Line, Transformed , Cell Line, Tumor , Cyclin-Dependent Kinase Inhibitor p21/genetics , Gene Expression Regulation, Neoplastic , Glioblastoma/genetics , Glioblastoma/pathology , Humans , Immunoblotting , Loss of Heterozygosity , Mice , Mice, Knockout , Mutation , Protein Binding , RNA Interference , RNA, Messenger/genetics , RNA, Messenger/metabolism , Tumor Suppressor Proteins/geneticsABSTRACT
Standard antipsychotics are ineffective in some geriatric patients. In addition, they are not helpful for apathy and withdrawal. Studies have demonstrated that 5HT2 antagonists improve affective symptoms and anxiety; therefore, the efficacy of risperidone on agitation and withdrawal was considered. The literature on risperidone was reviewed, and the efficacy and limitations of risperidone observed in two geriatric patients, one with agitation and another with apathy and withdrawal. Risperidone proved to be effective in controlling disruptive behavior in geriatric patients. Combined antagonism of D2 and 5HT2 receptors might be effective in improving agitation and withdrawal. Risperidone, with both D2 and 5HT2 antagonistic properties, seems to have potential as an alternative agent in controlling agitation and withdrawal in geriatric patients. Caution and need for further observation is recommended.
Subject(s)
Antipsychotic Agents/therapeutic use , Mental Disorders/drug therapy , Risperidone/therapeutic use , Aged , Antipsychotic Agents/administration & dosage , Clonazepam/administration & dosage , Clonazepam/therapeutic use , Dose-Response Relationship, Drug , Drug Therapy, Combination , Humans , Hypotension, Orthostatic/chemically induced , Male , Mental Disorders/psychology , Psychomotor Agitation/drug therapy , Risperidone/administration & dosage , Risperidone/adverse effects , Treatment OutcomeABSTRACT
A comprehensive review of the world literature confirms that malignant catatonia continues to occur and is reported and discussed in psychiatric community. It is associated with affective disorders as well as schizophrenia. The pathophysiology is still unclear but most reports suggest a hypodopaminergic state. Its reported mortality has declined from 75-100% in the preneuroleptic era to 31% during the review period (1986-1992). Bomocriptine, dantrolene, and benzodiazepines have been used with success but ECT has been found to be life-saving. The present review supports earlier reports that neuroleptics are frequently lethal in some patients with malignant catatonia.
Subject(s)
Catatonia/diagnosis , Adult , Aged , Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Bromocriptine/therapeutic use , Catatonia/chemically induced , Catatonia/psychology , Catatonia/therapy , Dantrolene/therapeutic use , Diagnosis, Differential , Electroconvulsive Therapy , Female , Humans , Lorazepam/therapeutic use , Male , Middle AgedABSTRACT
Seeds of sixty four genotypes of Brassica campestris L. (Toria) were analyzed for oil content and fatty acid composition. Oil content varied from 38.9% to 44.6%. Major fatty acids viz. oleic, linoleic, linolenic, eicosenoic and erucic acids exhibited ranges from 10.1% to 17.3%, 5.9% to 14.5%, 5.2% to 15.0%, 7.7% to 13.7% and 39.6% to 59.9%, respectively. Compared to the standard cultivar ITSA, four genotypes contained 5 to 8% lower content of erucic acid; and six genotypes contained significantly higher content of linoleic acid. Oil was positively correlated with erucic acid. The observed inverse relationship between linoleic and erucic acid contents might be utilized in breeding nutritionally better Toria cultivars with both high linoleic and low erucic acid contents.
Subject(s)
Brassica/analysis , Fatty Acids, Monounsaturated/analysis , Plant Oils/analysis , Plants, Edible/analysisABSTRACT
Continuous measurement of mixed venous oxygen saturation (SvO2) has been suggested as an adjunct in monitoring critically ill patients. We evaluated SvO2 monitoring in 24 patients suffering from complicated myocardial infarctions. Cardiac output and arterial lactate levels were measured when there were persistent 5 percent changes in SvO2, and otherwise, every 12 hours or as indicated clinically. Increases in SvO2 by 5 and 10 percent corresponded with an increase in cardiac index in 78.5 percent and 75 percent of measurements, respectively. Decreases in SvO2 by 5 and 10 percent corresponded with decreases in cardiac index in 45.5 percent and 61 percent of measurements. Twenty percent changes in cardiac index showed dissimilar directional changes with SvO2 in 62 percent of cases. Arterial blood lactate levels correlated poorly with SvO2. Survivors had significantly higher mean SvO2 and cardiac indices than nonsurvivors (p less than 0.01). The clinical management of patients with myocardial infarction may not be altered in view of the limitations of SvO2 in reflecting tissue hypoxia. We conclude that continuous monitoring of SvO2 may not be a sensitive measure of cardiac output after acute myocardial infarction.
Subject(s)
Myocardial Infarction/blood , Oxygen/blood , Aged , Aged, 80 and over , Cardiac Output , Humans , Lactates/blood , Middle Aged , Monitoring, Physiologic , Myocardial Infarction/mortalityABSTRACT
Disturbingly low survival rates after CPR prompted us to carry out a series of studies. Of 272 patients receiving CPR at our 600-bed community hospital in 1984, 102 (37.5%) patients survived initial resuscitation and 30 (11%) survived their hospitalization. Of the 102 initial survivors, only 15 patients had received full CPR including cardiac compression and/or defibrillation, endotracheal intubation, and cardiotonic drugs. These data were compared with those for 129 patients admitted to our critical care units in 1982 and 1983 in whom CPR was withheld. These patients had been designated "No CPR" primarily because of their poor response to therapy. There was an 11% survival rate for patients who had received CPR compared to a 16% survival rate for the "No CPR" group. These data suggest that criteria for administering CPR to hospitalized patients should be improved.
Subject(s)
Decision Making , Hospitalization , Outcome and Process Assessment, Health Care , Resuscitation/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Critical Care , Hospital Bed Capacity, 300 to 499 , Humans , Infant , Michigan , Middle Aged , Resuscitation/standardsABSTRACT
Clinical quantitation of water accumulation in the lungs is imprecise. The technique of measuring extravascular lung water (EVLW) with double indicator dilution utilizing cold indocyanine green dye has become practical with the addition of a microprocessor. The technique, insertion of a special thermistor tipped arterial catheter and potential problems are described. Our studies with resuscitation of 27 patients in shock indicate little increase in EVLW at 24 hours. On the other hand 19 patients with Adult Respiratory Distress Syndrome (ARDS) had marked increases in EVLW from normal of 5-8 ml/kg to 10.7 to 14.4 ml/kg. No further increases in EVLW were observed in eight ARDS patients requiring fluid resuscitation for associated hypovolemia and hypoperfusion. We feel that measurement of EVLW in critically ill patients offers an opportunity to study the pathophysiology of pulmonary failure.
Subject(s)
Extracellular Space/metabolism , Lung/metabolism , Pulmonary Edema/diagnosis , Respiratory Insufficiency/complications , Shock/complications , Catheterization/methods , Dye Dilution Technique , Humans , Prospective Studies , Pulmonary Edema/etiology , Random Allocation , Respiratory Insufficiency/metabolism , Shock/metabolism , ThermodilutionABSTRACT
We investigated the relationship between oxygen delivery (DO2), oxygen consumption (VO2), and influence of oxyhemoglobin dissociation (P50) on VO2 in 40 patients with complicated myocardial infarction. A decrease in VO2 and an increase in P50 were observed as DO2 decreased due to pump failure. In a given range of DO2, VO2 was related to P50 in survivors (r values .472 to .647, p less than .01). Each millimeter of mercury increase in P50 was associated with a 5.2 to 6.5 ml/min X m2 increase in VO2 when DO2 was less than 450 ml/min X m2. No similar correlation was found for nonsurvivors. Lactate was higher in nonsurvivors despite the fact that DO2 and VO2 were similar in the two groups. The lack of compensatory increases in P50 may be pathologic in nonsurvivors. However, the value of VO2 as an indicator of tissue oxygenation or survival in patients with acute myocardial infarction is questionable.
Subject(s)
Myocardial Infarction/metabolism , Oxygen Consumption , Oxygen/blood , Oxyhemoglobins/metabolism , Adult , Cardiac Output , Humans , Lactates/blood , Myocardial Infarction/mortality , Time FactorsABSTRACT
An echodense mass in the right atrium was detected incidentally by two-dimensional echocardiography (ECHO) in a patient with clinical suggestions of cardiogenic shock. Autopsy revealed a cylindrical thrombus extending from the right atrium through a patent foramen ovale, and bilateral massive pulmonary thromboembolism (PTE). Pulmonary thromboembolism should be one of the differential diagnoses in patients with an echodense mass in the right heart.
Subject(s)
Pulmonary Embolism/diagnosis , Diagnosis, Differential , Echocardiography , Heart Atria , Humans , Male , Middle Aged , Pulmonary Embolism/physiopathologySubject(s)
Catheterization/adverse effects , Paralysis/etiology , Aged , Female , Humans , Phrenic Nerve/injuries , Pulmonary ArteryABSTRACT
Cardiovascular failure (shock) associated with acute alcohol ingestion and severe hypothermia (core temperature 23 and 21 degrees C) was studied in 2 patients. In each case, perfusion failure was associated with lactacidemia, severe bradycardia, and agonal respirations. Infusion of fluids and mechanical ventilation reversed shock and prevented a fatal outcome. One case, complicated by renal failure and volume overload with pulmonary edema, was managed with peritoneal dialysis. These findings suggest that perfusion failure associated with severe accidental hypothermia after acute alcohol ingestion is due to a combination of hypovolemia, bradycardia, and respiratory depression.
Subject(s)
Alcoholic Intoxication/complications , Hypothermia/physiopathology , Adult , Fluid Therapy , Humans , Hypothermia/complications , Hypothermia/etiology , Male , Middle Aged , Respiration, Artificial , Shock/etiology , Shock/therapyABSTRACT
A unique colorimetric method for the quantitative determination of phospholipids that does not involve the acid digestion of the lipid is described. The phospholipids, after separation by thin-layer chromatography and elution from the silica gel, are heated with a chromogenic solution that is a modification of a spray reagent formulated by Vaskovsky and Kostetsky (1968, J. Lipid Res., 9: 396). The absorbance of the colored complex was read at 710 nm, and it followed Beer's law in the range of 1-10 micro g of phospholipid phosphorus.
