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991.
S Sacchi HM Kantarjian S O'Brien M Beran C Koller S Pierce S Kornblau E Estey MJ Keating M Talpaz 《Canadian Metallurgical Quarterly》1997,11(10):1610-1616
The aim of this analysis was to evaluate the efficacy of alpha-interferon (alpha-IFN) regimens in late chronic phase (diagnosis >12 months) chronic myelogenous leukemia (CP-CML). Long-term follow-up results were evaluated in 137 patients with Philadelphia chromosome (Ph)-positive late CP-CML. The alpha-IFN programs were sequential studies with human leukocyte alpha-IFN (seven patients), recombinant alpha-IFN alone (15 patients) or with IFN-gamma (29 patients), hydroxyurea (HU) (19 patients), or low-dose cytarabine (Ara-C) (67 patients). Overall, 57% of the patients achieved complete hematological response (CHR), and 7% obtained partial hematological response. Nineteen patients (15% of the 123 evaluable patients) had a cytogenetic response which was major (Ph-positive <35%) in 10 patients (8%). A trend for better responses was observed with shorter disease duration. The median overall survival from start of therapy was 49 months, with an estimated 5-year survival rate of 41%. Some common pretreatment prognostic factors associated with response did not show statistical associations when applied in late CP-CML; however, characteristics such as smaller spleen size, and lower percentages of peripheral blood and marrow blasts and basophils were associated with better survival experience. When patients were subgrouped according to risk, no significant differences in the incidence of cytogenetic response and in survival outcomes were observed among various risk groups. This study confirms that alpha-IFN-based regimens have a modest activity in late CP-CML, and supports the need to develop investigational strategies aimed at improving patient prognosis in this phase. 相似文献
992.
The research on long-term care for seniors clearly demonstrates that efforts to integrate urban case management services with elderly people living in rural settings have not been successful. Presenting findings of the Rural Seniors Assisted Living Study conducted in northwestern Ontario, Canada, this article demonstrates the complexity of providing health and social services for seniors living in small rural communities, services that are often vastly different from those provided in urban communities. The article proposes a specialized Rural Case Management approach with rural elderly clients and identifies four intervention roles: providing direct service, consulting extensively with specialists of other disciplines, constructing and supporting natural helping networks, and resource management. The approach also requires that the rural case manager assume a leadership role at the community level in the development of services for seniors. Having a locally based case manager rather that a case manager who travels out to rural areas from an urban center is essential to the success of this rural case management approach. Finally, the article contends that rural case management differs from urban case management by requiring specialized knowledge, skills and educational programs. 相似文献
993.
JJ LoTurco DF Owens MJ Heath MB Davis AR Kriegstein 《Canadian Metallurgical Quarterly》1995,15(6):1287-1298
We have found that, during the early stages of cortical neurogenesis, both GABA and glutamate depolarize cells in the ventricular zone of rat embryonic neocortex. In the ventricular zone, glutamate acts on AMPA/kainate receptors, while GABA acts on GABAA receptors. GABA induces an inward current at resting membrane potentials, presumably owing to a high intracellular Cl- concentration maintained by furosemide-sensitive Cl- transport. GABA and glutamate also produce increases in intracellular Ca2+ in ventricular zone cells, in part through activation of voltage-gated Ca2+ channels. Furthermore, GABA and glutamate decrease the number of embryonic cortical cells synthesizing DNA. Depolarization with K+ similarly decreases DNA synthesis, suggesting that the neurotransmitters act via membrane depolarization. Applied alone, GABAA and AMPA/kainate receptor antagonists increase DNA synthesis, indicating that endogenously released amino acids influence neocortical progenitors in the cell cycle. These results demonstrate a novel role for amino acid neurotransmitters in regulating neocortical neurogenesis. 相似文献
994.
OBJECTIVE: To critically examine the role of androgens as part of postmenopausal hormone replacement therapy. STUDY DESIGN: Examination of original reports and reviews obtained by electronic database searches and supplemented by manual search of bibliographies. RESULTS: As compared to estrogens alone, estrogen-androgen therapy may better protect against osteoporosis and increase libido, energy levels and general sense of well-being. However, estrogen-androgen replacement also reduces the beneficial increases in high-density lipoprotein induced by estrogens alone, although this effect may be offset at least partially by decreases in atherogenic triglycerides. The long-term net effect of estrogen-androgen replacement on cardiovascular disease remains unknown. CONCLUSION: Although the literature includes relatively few clinical trials or well-controlled studies and is further limited by the subjective nature of outcomes, such as sexual and psychological function, the available data suggest that for many postmenopausal women, estrogen-androgen replacement may provide benefits beyond those provided by estrogen-only replacement therapy. 相似文献
995.
GA Boorman S Botts TE Bunton JW Fournie JC Harshbarger WE Hawkins DE Hinton MP Jokinen MS Okihiro MJ Wolfe 《Canadian Metallurgical Quarterly》1997,25(2):202-210
Women residing in villages in three districts of Pakistan were recruited, trained to deliver primary care and mobilize their communities for health, assigned to limited catchment areas, provided with supervisory and managerial support, and remunerated. Their comprehensive activities substantially reduced infant, child and maternal mortality within a year and generated positive perceptions of family planning in the communities. The programme was cost-effective and appeared suitable as a model for reforming the organization and provision of health care services. 相似文献
996.
997.
K Luo S Sangadala L Masson A Mazza R Brousseau MJ Adang 《Canadian Metallurgical Quarterly》1997,27(8-9):735-743
The relationship between Bacillus thuringiensis Cry1Aa, Cry1Ab and Cry1Ac delta-endotoxin binding and pore formation was investigated using a purified 170 kDa aminopeptidase N (APN) from Heliothis virescens brush border membranes. Aminopeptidases with molecular sizes of 110, 140 and 170 kDa were eluted from a Cry1Ac toxin affinity column using N-acetylgalactosamine. The 140 kDa aminopeptidase has a cross-reacting determinant typical of a cleaved glycosyl-phosphatidylinositol anchor. After mild base treatment to de-acylate the glycosyl-phosphatidylinositol linkage and incubation in phosphatidyl inositol phospholipase C, anti-cross-reacting determinant antibody recognized the 170 kDa protein. Kinetic binding characteristics of Cry1A toxins to purified 170 kDa APN were determined using surface plasmon resonance. Cry1Aa, Cry1Ab and Cry1Ac, but not Cry1C and Cry1E toxins recognized 170 kDa APN. Each Cry1A toxin recognized two binding sites: a high affinity site with KD ranging from 41 to 95 nM and a lower affinity site with KD in the 325 to 623 nM range. N-acetylgalactosamine inhibited Cry1Ac but not Cry1Aa and Cry1Ab binding to 170 kDa APN. When reconstituted into phospholipid vesicles, the 170 kDa APN promoted toxin-induced 86Rb+ release for Cry1A toxins, but not Cry1C toxin. Furthermore Cry1Ac, the Cry protein most toxic to H. virescens larvae, caused 86Rb+ release at lower concentrations, and to a greater extent than Cry1Aa and Cry1Ab toxins. The correlation between toxin-binding specificity and 86Rb+ release strongly suggests that the purified 170 kDa APN is the functional receptor A in the H. virescens midgut epithelial cell brush border membranes. 相似文献
998.
999.
1000.
Urinary incontinence imposes a significant financial burden on individuals, their families, and healthcare organizations. For individuals 65 years of age and older these costs are substantial, increasing from $8.2 billion (1984 dollars) to $16.4 billion (1993 dollars). Both of these cost-of-illness estimates, however, relied on data and factors that have changed over time. This study updates these cost estimates. The 1995 societal cost of incontinence for individuals aged 65 years and older was $26.3 billion, or $3565 per individual with urinary incontinence. Limitations, implications, and directions for future research are also discussed. 相似文献