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Lord S, Geary S, Lord G. Application of a Low-cost, High-fidelity Proximal Phalangeal Dislocation Reduction Model for Clinician Training. West J Emerg Med 2023; 24:839-846. [PMID: 37788023 PMCID: PMC10527832 DOI: 10.5811/westjem.59471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/19/2023] [Accepted: 04/16/2023] [Indexed: 10/04/2023] Open
Abstract
Introduction: Patients present to the emergency department (ED) relatively commonly with traumatic closed proximal interphalangeal joint (PIPJ) dislocations, an orthopedic emergency. There is a paucity of teaching models and training simulations for clinicians to learn either the closed dislocated dorsal or volar interphalangeal joint reduction technique. We implemented a teaching model to demonstrate the utility of a novel reduction model designed from three-dimensional (3D) printable components that are easy to connect and do not require further machining or resin models to complete. Methods: Students watched a two-minute video and a model demonstration by the authors. Learners including emergency medicine (EM) residents and physician assistant fellows assessed model fidelity, convenience, perceived competency, and observed competency. Results: Seventeen of 21 (81%) participants agreed the model mimicked dorsal and volar PIPJ dislocations. Nineteen of 21 (90%) agreed the model was easy to use, 21/21 (100%) agreed the dorsal PIPJ model and 20/21 (95%) agreed the volar PIPJ model improved their competency. Conclusion: Our 3D-printed, dorsal and volar dislocation reduction model is easy to use and affordable, and it improved perceived competency among EM learners at an academic ED.
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Affiliation(s)
- Spencer Lord
- Albany Medical Center, Department of Surgery and Department of Emergency Medicine, Albany, New York
- Massachusetts General Hospital, Department of Surgery, Boston, Massachusetts
| | - Sean Geary
- Albany Medical Center, Department of Surgery and Department of Emergency Medicine, Albany, New York
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Young P, Pinto DB, Asher S, DeSanctis S, Gardner K, Geary S, Long H, Pelesz J, Peltier D, Thibodeau L, Pauze D. An Intensive Approach to Improving Diversity, Equity, and Inclusion in an Academic Emergency Department. West J Emerg Med 2022; 23:557-563. [PMID: 35980422 PMCID: PMC9391005 DOI: 10.5811/westjem.2022.3.55007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/11/2022] [Indexed: 11/11/2022] Open
Abstract
A healthcare workforce that demonstrates cultural competence and humility while reflecting the diversity of the surrounding community has the potential to significantly benefit the patient population it serves. In this context and given numerous societal influences and the events of 2020, the leadership of the Department of Emergency Medicine at Albany Medical Center recognized the need to promote diversity, equity, and inclusion (DEI) in multiple areas. These included premedical education, medical education, postgraduate medical education, faculty development, staff satisfaction, and patient care. The department formed a DEI taskforce that developed an ongoing, multipronged, interdisciplinary approach to address these important aspects of our work and clinical environment with the goals of improving staff wellbeing, reducing burnout, and promoting the health of our community. Our experience is shared here to illustrate how a small, dedicated team can implement a variety of DEI initiatives quickly and with relatively little cost at a large academic medical center.
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Affiliation(s)
- Pamela Young
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | | | - Shellie Asher
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Sara DeSanctis
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Karen Gardner
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Sean Geary
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Heather Long
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Jennifer Pelesz
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - David Peltier
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Lorraine Thibodeau
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
| | - Denis Pauze
- Albany Med Health System, Department of Emergency Medicine, Albany, New York
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Abstract
Introduction Pericardiocentesis is a high-risk/low-frequency procedure important to emergency medicine (EM). However, due to case rarity it is not often performed on a patient during residency training. Because the coronavirus disease 2019 pandemic limited cadaver-based practice, we developed a novel, low-cost, low-fidelity pericardiocentesis model using three dimensional-printing technology to provide advances on prior home-made models. Methods Residents watched a 20-minute video about performing a pericardiocentesis and practiced both a blind and ultrasound-guided technique. We assessed model fidelity, convenience, and perceived provider competence via post-workshop questionnaire. Results A total of 24/26 (93%) individuals practicing on the ultrasound-guided model and 22/24 (92%) on the blind approach model agreed or strongly agreed that the models reasonably mimicked a pericardial effusion. Conclusion Our low-cost, low-fidelity model is durable, mimics the clinical case, and is easy to use. It also addresses known limitations from prior low-fidelity models.
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Affiliation(s)
- Spencer Lord
- Albany Medical Center, Department of Emergency Medicine and Department of Surgery, Albany, New York
| | | | - Sean Geary
- Albany Medical Center, Department of Emergency Medicine and Department of Surgery, Albany, New York
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Gross J, Kim S, Wagner S, Grover A, Geary S, Pankuch M, Gondi V, Woodruff T. The Role of Proton Therapy to Preserve Ovarian Function and Reserve in Mice. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leelakanok N, Geary S, Salem A. Fabrication and Use of Poly(d,l-lactide-co-glycolide)-Based Formulations Designed for Modified Release of 5-Fluorouracil. J Pharm Sci 2017; 107:513-528. [PMID: 29045885 DOI: 10.1016/j.xphs.2017.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 12/14/2022]
Abstract
5-fluorouracil (5-FU) is a chemotherapeutic agent that has been used for the treatment of a variety of malignancies since its initial introduction to the clinic in 1957. Owing to its short biological half-life, multiple dosings are generally required to maintain effective 5-FU plasma concentrations throughout the therapeutic period. Clinical studies have shown that continuous 5-FU administration is generally superior to bolus injection as exhibited by lower toxicities and increased therapeutic efficacy. Optimal therapeutic efficacy, however, is often compromised by the limiting therapeutic index. Whilst oral formulations are also used, these suffer from the drawbacks of variable bioavailability and first-pass metabolism. As a result, sustained release formulations of 5-FU have been investigated in an effort to mimic the kinetics of continuous infusion particularly for situations where local delivery is considered appropriate. The biocompatible, biodegradable, and highly tunable synthetic polymer, poly(d,l-lactide-co-glycolide) (PLGA), is widely used as a vector for sustained drug delivery, however, issues such as insufficient loading and inappropriate burst release kinetics have dogged progress into the clinic for small hydrophilic drugs such as 5-FU. This review provides introductory information about the mechanism of action, pharmacokinetic and physicochemical properties, and clinical use of 5-FU that have contributed to the development of PLGA-based 5-FU release platforms. In addition, this review provides information on fabrication methods used for a range of 5-FU-loaded PLGA formulations and discusses factors affecting the release kinetics of 5-FU as well as the in vitro and in vivo antitumor or antiproliferative efficacy of these platforms.
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Affiliation(s)
- Nattawut Leelakanok
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Iowa City, Iowa 52242
| | - Sean Geary
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Iowa City, Iowa 52242
| | - Aliasger Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Iowa City, Iowa 52242.
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Shin K, Acri T, Geary S, Salem AK. Biomimetic Mineralization of Biomaterials Using Simulated Body Fluids for Bone Tissue Engineering and Regenerative Medicine<sup/>. Tissue Eng Part A 2017; 23:1169-1180. [PMID: 28463603 DOI: 10.1089/ten.tea.2016.0556] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Development of synthetic biomaterials imbued with inorganic and organic characteristics of natural bone that are capable of promoting effective bone tissue regeneration is an ongoing goal of regenerative medicine. Calcium phosphate (CaP) has been predominantly utilized to mimic the inorganic components of bone, such as calcium hydroxyapatite, due to its intrinsic bioactivity and osteoconductivity. CaP-based materials can be further engineered to promote osteoinductivity through the incorporation of osteogenic biomolecules. In this study, we briefly describe the microstructure and the process of natural bone mineralization and introduce various methods for coating CaP onto biomaterial surfaces. In particular, we summarize the advantages and current progress of biomimetic surface-mineralizing processes using simulated body fluids for coating bone-like carbonated apatite onto various material surfaces such as metals, ceramics, and polymers. The osteoinductive effects of integrating biomolecules such as proteins, growth factors, and genes into the mineral coatings are also discussed.
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Affiliation(s)
- Kyungsup Shin
- 1 Department of Orthodontics, College of Dentistry and Dental Clinics, University of Iowa , Iowa City, Iowa
| | - Timothy Acri
- 2 Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa , Iowa City, Iowa
| | - Sean Geary
- 2 Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa , Iowa City, Iowa
| | - Aliasger K Salem
- 2 Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa , Iowa City, Iowa
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Do AV, Akkouch A, Green B, Ozbolat I, Debabneh A, Geary S, Salem AK. Controlled and Sequential Delivery of Fluorophores from 3D Printed Alginate-PLGA Tubes. Ann Biomed Eng 2017; 45:297-305. [PMID: 27234816 PMCID: PMC5124557 DOI: 10.1007/s10439-016-1648-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/13/2016] [Indexed: 12/14/2022]
Abstract
Controlled drug delivery systems, that include sequential and/or sustained drug delivery, have been utilized to enhance the therapeutic effects of many current drugs by effectively delivering drugs in a time-dependent and repeatable manner. In this study, with the aid of 3D printing technology, a novel drug delivery device was fabricated and tested to evaluate sequential delivery functionality. With an alginate shell and a poly(lactic-co-glycolic acid) (PLGA) core, the fabricated tubes displayed sequential release of distinct fluorescent dyes and showed no cytotoxicity when incubated with the human embryonic kidney (HEK293) cell line or bone marrow stromal stem cells (BMSC). The controlled differential release of drugs or proteins through such a delivery system has the potential to be used in a wide variety of biomedical applications from treating cancer to regenerative medicine.
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Affiliation(s)
- Anh-Vu Do
- Division of Pharmaceutics and Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa, IA, USA
- Department of Chemical and Biochemical Engineering, College of Engineering, University of Iowa, Iowa, IA, USA
| | - Adil Akkouch
- Center for Computer-Aided Design, College of Engineering, University of Iowa, Iowa, IA, USA
| | - Brian Green
- Department of Chemical and Biochemical Engineering, College of Engineering, University of Iowa, Iowa, IA, USA
| | - Ibrahim Ozbolat
- Center for Computer-Aided Design, College of Engineering, University of Iowa, Iowa, IA, USA
- Department of Engineering Science and Mechanics, Penn State University, State College, PA, USA
- The Huck Institutes of the Life Sciences, Penn State University, State College, PA, USA
| | - Amer Debabneh
- Center for Computer-Aided Design, College of Engineering, University of Iowa, Iowa, IA, USA
| | - Sean Geary
- Division of Pharmaceutics and Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa, IA, USA
| | - Aliasger K Salem
- Division of Pharmaceutics and Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa, IA, USA.
- Department of Chemical and Biochemical Engineering, College of Engineering, University of Iowa, Iowa, IA, USA.
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Urushihara H, Noguchi Y, Sakata Y, Daidoji K, Sumitomo K, Ishii M, Geary S. 1015 Trends in the incidence of thyroid cancer and fine needle aspiration screening: Analysis of Japanese claims data. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30441-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Geary S, Selvi F, Chuang SK, August M. Identifying dental panoramic radiograph features for the screening of low bone mass in postmenopausal women. Int J Oral Maxillofac Surg 2014; 44:395-9. [PMID: 25480009 DOI: 10.1016/j.ijom.2014.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 11/04/2014] [Accepted: 11/12/2014] [Indexed: 11/16/2022]
Abstract
A retrospective cohort study was performed to evaluate the use of panoramic radiographs as a screening tool for low bone mass in postmenopausal women. Female subjects aged ≥50 years were included. The predictor variables were gonial angle, antegonial angle, mandibular cortical bone integrity, periodontal disease status, and number of remaining teeth. The primary outcome variable was bone mineral density status. Descriptive and logistic regression statistics were computed; P<0.05 was considered significant. The sample was composed of 273 subjects, aged 50-89 years. Visual assessment of mandibular cortical bone integrity demonstrated a statistically significant correlation with low bone mass diagnosis on univariate logistic regression (P=0.019), but lost significance on multivariate analysis with age, body mass index, and number of remaining teeth (P=0.6). A visual estimation of the mandibular cortical bone integrity from panoramic radiographs may be useful for identifying postmenopausal women at high risk for osteoporosis.
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Affiliation(s)
- S Geary
- Harvard School of Dental Medicine, Boston, MA, USA
| | - F Selvi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - S-K Chuang
- Harvard School of Dental Medicine, Boston, MA, USA
| | - M August
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.
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Geary S, Spencer T, Tilney PVR. A 47-year-old woman with an intracerebral hemorrhage. Air Med J 2014; 33:88-91. [PMID: 24787509 DOI: 10.1016/j.amj.2014.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/10/2014] [Indexed: 06/03/2023]
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Geary S, Selvi F, Chuang S, August M. Identifying Dental Panoramic Radiographic Features for the Screening of Osteoporosis in Post-Menopausal Women. J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.joms.2013.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hughes M, Geary S, Dransfield E, McSweeney P, O'Neill E. Characterization of peptides released from rabbit skeletal muscle troponin-T by μ-calpain under conditions of low temperature and high ionic strength. Meat Sci 2001; 59:61-9. [DOI: 10.1016/s0309-1740(01)00052-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2000] [Revised: 01/28/2001] [Accepted: 02/04/2001] [Indexed: 10/17/2022]
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Nashimoto M, Wesemann DR, Geary S, Tamura M, Kaspar RL. Long 5' leaders inhibit removal of a 3' trailer from a precursor tRNA by mammalian tRNA 3' processing endoribonuclease. Nucleic Acids Res 1999; 27:2770-6. [PMID: 10373595 PMCID: PMC148487 DOI: 10.1093/nar/27.13.2770] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Mammalian tRNA 3' processing endoribonuclease (3' tRNase) can remove a 3' trailer from various pre-tRNAs without 5' leader nucleotides. To examine how 5[prime] leader sequences affect 3' processing efficiency, we performed in vitro 3' processing reactions with purified pig 3' tRNase and pre-tRNAArgs containing a 13-nt 3' trailer and a 5[prime] leader of various lengths. The 3' processing was slightly stimulated by 5[prime] leaders containing up to 7 nt, whereas leaders of 9 nt or longer severely inhibited the reaction. Structure probing indicated that the 5' leader sequences had little effect on pre-tRNA folding. Similar results were obtained using pre-tRNA(Val)s containing a 5' leader of various lengths. We also investigated whether 3'tRNase can remove 3' trailers that are stably base-paired with 5' leaders to form an extended acceptor stem. Even such small 5' leaders as 3 and 6 nt, when base-paired with a 3' trailer, severely hindered removal of the 3' trailer by 3' tRNase.
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Affiliation(s)
- M Nashimoto
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602, USA.
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Abstract
Mammalian tRNA 3' processing endoribonuclease (3' tRNase) can recognize and cleave any target RNA that forms a precursor tRNA-like complex with another RNA. Various sets of RNA molecules were tested to identify the smallest RNA that can direct target RNA cleavage by 3' tRNase. A 3' half tRNAArgwas cleaved efficiently by 3' tRNase in the presence of small 5' half tRNAArgvariants, the D stem-loop region of which was partially deleted. Remarkably, 3' tRNase also cleaved the 3' half tRNAArgin the presence of a 7 nt 5' tRNAArg composed only of the acceptor stem region with a catalytic efficiency comparable with that of cleavage directed by an intact 5' half tRNAArg. The catalytic efficiency of cleavage directed by the heptamer decreased as the stability of the T stem-loop structures of 3' half tRNAArg variants decreased. No heptamer-directed cleavage of a 3' half tRNAArg without T stem base pairs was detected. A heptamer also directed cleavage of an HIV-1 RNA containing a stable hairpin structure. These findings suggest that in the presence of an RNA heptamer, 3' tRNase can discriminate and eliminate target RNAs that possess a stable hairpin adjacent to the heptamer binding sequence from a large complex RNA pool.
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Affiliation(s)
- M Nashimoto
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602, USA.
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Fischbein NJ, Ciricillo SF, Barr RM, McDermott M, Edwards MS, Geary S, Barkovich AJ. Endoscopic third ventriculocisternostomy: MR assessment of patency with 2-D cine phase-contrast versus T2-weighted fast spin echo technique. Pediatr Neurosurg 1998; 28:70-8. [PMID: 9693335 DOI: 10.1159/000028624] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine if fast spin-echo T2 (FSE) is of equal value to flow-sensitive 2D cine phase-contrast (CPC) to assess patency of endoscopic third ventriculocisternostomies (VC). PATIENTS AND METHODS We reviewed clinical charts and MR scans of 27 patients who underwent third VC for treatment of obstructive hydrocephalus. Thirty-nine postoperative scans included both sequences and were assessed for the presence or absence of flow-related signal changes. RESULTS In 28 cases, FSE, CPC, and clinical findings suggested patency. In 1 case, CPC and FSE suggested occlusion, which was confirmed clinically and operatively. In the remaining cases, FSE showed better clinical correlation than did CPC. CONCLUSION The assessment of third VC patency with FSE, a sequence available on most clinical scanners without a requirement for special hardware and software, is at least as sensitive in the qualitative assessment of VC function as CPC.
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Affiliation(s)
- N J Fischbein
- Department of Radiology, University of California at San Francisco, USA.
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Affiliation(s)
- L Bingham
- Timpview High School, Provo, Utah 84604, USA
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Abate VM, Overdorf GW, Huang T, Geary S. The determination of free urinary catecholamines using LCEC. Am Clin Lab 1995; 14:15, 18. [PMID: 10150374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- V M Abate
- Bioanalytical Systems, Inc., W. Lafayette, IN 47906, USA
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Affiliation(s)
- T Barry
- National Diagnostics Centre/BioResearch Ireland
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Abstract
Preoperative instruction has been found to decrease postoperative complications; however, the mechanisms through which preoperative instruction exerts its effects remain unknown. In this study, the relationship between preoperative self-efficacy and postoperative behaviors was investigated. Subjects were 68 cholecystectomy patients. Subjects' scores on the efficacy expectations subscale were related significantly to postoperative deep breathing, ambulation, and recall of expected events; scores on the outcome expectations subscale were related significantly to postoperative requests for pain medication. Self-efficacy theory provided a link between self perceptions and behavior and may be the mechanism through which preoperative instruction exerts its effects.
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Cottam HB, Kazimierczuk Z, Geary S, McKernan PA, Revankar GR, Robins RK. Synthesis and biological activity of certain 6-substituted and 2,6-disubstituted 2'-deoxytubercidins prepared via the stereospecific sodium salt glycosylation procedure. J Med Chem 1985; 28:1461-7. [PMID: 2995666 DOI: 10.1021/jm00148a015] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A number of 6-substituted and 2,6-disubstituted pyrrolo[2,3-d]pyrimidine 2'-deoxyribonucleosides were prepared by the direct stereospecific sodium salt glycosylation procedure. Reaction of the sodium salt of 4-chloro-6-methyl-2-(methylthio)pyrrolo[2,3-d]pyrimidine (6a) or 4,6-dichloro-2-(methylthio)pyrrolo[2,3-d]pyrimidine (6b) with 1-chloro-2-deoxy-3,5-di-O-p-toluoyl-alpha-D-erythro-pentofuranose (9) provided the corresponding N7 2'-deoxy-beta-D-ribofuranosyl blocked derivatives (8a and 8c) which, on ammonolysis, gave 4-amino-6-methyl-2-(methylthio)-7-(2-deoxy-beta-D-erythro-pentofuranosyl )pyrrolo[2,3-d]pyrimidine (11a) and 4-amino-6-chloro-2-(methylthio)-7-(2-deoxy-beta-D-erythro-pentofuranosyl )pyrrolo[2,3-d]pyrimidine (11b), respectively. Dethiation of 11a and 11b afforded 6-methyl-2'-deoxytubercidin (10a) and 6-chloro-2'-deoxytubercidin (10b), respectively. Dehalogenation of 10b provided an alternate route to the reported 2'-deoxytubercidin (3a). Application of this glycosylation procedure to 4,6-dichloro and 4,6-dichloro-2-methyl derivatives of pyrrolo[2,3-d]pyrimidine (15a and 15b) gave the corresponding blocked 2'-deoxyribonucleosides (18a and 18b), which on ammonolysis furnished 10b and 4-amino-6-chloro-2-methyl-7-(2-deoxy-beta-D-erythro- pentofuranosyl)pyrrolo[2,3-d]pyrimidine (17), respectively. This stereospecific attachment of the 2-deoxy-beta-D-ribofuranosyl moiety appears to be due to a Walden inversion at the C1 carbon by the anionic heterocyclic nitrogen. Controlled deacylation of 4-chloro-7-(2-deoxy-3,5-di-O-p-toluoyl-beta-D-erythro-pentofuranosyl) pyrrolo[2,3-d]pyrimidine (20a) gave 4-chloro-7-(2-deoxy-beta-D-erythro-pentofuranosyl)pyrrolo[2,3-d] pyrimidine (20b). Dehalogenation of 20b gave the 2'-deoxynebularin analogue 7-(2-deoxy-beta-D-erythro-pentofuranosyl)pyrrolo[2,3-d]pyrimidine (19), and reaction of 20b with thiourea gave 7-(2-deoxy-beta-D-erythro-pentofuranosyl)pyrrolo[2,3-d]pyrimidine-4(3H)- thione (21). All of these compounds were tested in vitro against certain viruses and tumor cells. Only compounds 12a, 20b, and 21 showed significant activity against measles in vitro, and the activity is comparable to that of ribavirin. Although compounds 3a and 12b are slightly more active than ribavirin against HSV-2 in vitro, they are relatively more toxic to Vero cells. Compounds 3a and 20b exhibited moderate cytostatic activity against L1210 and P388 leukemia in vitro but are considerably less active than 2-chloro-2'-deoxyadenosine (1).
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