Disorders of the calcium-sensing receptor

From 1990 to 1995, 12 patients with cavo-atrial renal cell carcinoma underwent resection of the tumor. Circulatory arrest was employed in 11/12 cases. The neoplasm extended to the inferior vena cava in two patients and to the intrahepatic veins or right atrium in five cases. Two severely cardiac compromised patients died perioperatively. Of five patients who showed preoperative suspicion of isolated metastases, 3 patients died postoperatively because of relapsing disease after a mean period of 10.8 months. Five patients are alive and doing well after a mean follow-up of 14.8 months. In our experience myocardial dysfunction determined poor immediate survival. Mid-term survival was influenced by preoperative metastases and lymph-node involvement, but not by intracaval extension. Circulatory arrest appears to be a relatively safe technique to remove renal carcinoma with cavo-atrial extension and should be indicated whenever there are no metastases.     

A disease management case study on asthma

This paper provides an overview of how one pharmacy benefits manager, MedImpact Pharmaceutical Management, Inc. (San Diego, California), approaches its disease management (DM) program for asthma. This group's experience with DM counters the common but fallacious belief that reduction of component costs leads to reduction of total expenditures. In fact, greater expenditures on certain components (in particular, drug therapies and preventive and follow-up visits to physicians) can result in greatly reduced overall expenditures by reducing hospitalizations and emergency department treatments for asthmatic patients. The program addresses four essential components of DM: physician intervention, patient empowerment, health risk management, and pharmaceutical care. For each of these areas, careful statistical analysis, effective education, and integrated management can help improve patient care while reducing overall costs.     

Certain characteristics of lipid metabolism in healthy full-term and premature infants during the first 2 weeks after birth

The experiments on mice of line SHR have shown that in animals, delivered by Cesarean section I hour following intrauterine injection of 40 mg/Kg of DMBA in mothers (a period of maximum concentration of the carcinogen in the tissues of foetuses) and sacrificed one year later, carcinogenesis proceeded much more intensively than in mice, which after transplacental DMBA exposure continued their intrauterine development for 6 hours longer, i.e. till complete disintegration of DMBA. An enhancement of the transplacental carcinogenic effect was manifested in a reliable increase of the total frequency of the appearance of different neoplasms, in more frequent development of lung, ovary and mammary tumors, and also in the appearance of malignant lung tumors-adenocarcinomas. A considerable enhancement of the transplacental blastomogenic effect in these mice was due to exclusion of the detoxication function of the maternal organism.     

The resolution of membrane proteins based upon size, charge, and hydrophobicity

Currently available systems for resolving membrane proteins are based only on size and charge differences. Recently, it has been shown that Triton-urea-acetic acid gels which separate proteins on the basis of charge, size and hydrophobicity are capable of resolving proteins differing only by the substitution of a single neutral amino acid. We have applied this new method to the resolution of bacterial envelope proteins. Conditions for optimal resolution of different bacterial envelope proteins were determined by electrophoresis through transverse urea and Triton X-100 gradient gels. We have also correlated the components resolved in this system with those resolved by classical sodium dodecyl sulfate-gel electrophoresis by using two-dimensional slab gels combining the two systems. Furthermore, envelope protein fractions from different species and strains of bacteria were compared to identify specific proteins. This system appears to be a promising method for investigating envelope proteins which are due to missense mutations.