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Appropriate Position (appropriate + position)
Selected AbstractsThe trivialization of diagnosis,JOURNAL OF HOSPITAL MEDICINE, Issue 2 2010Irving Kushner MD Abstract Although it is widely recognized that diagnosis plays a central role in clinical medicine, in recent years the primacy of diagnosis has come under attack from several sources. 1. "Billable terms" are replacing traditional medical diagnoses. The former are based on International Classification of Diseases lists, which include many non-diagnoses such as symptoms and signs. 2. Diagnosis often gets short shrift because of the perceived urgency of discharge. 3. The problem oriented record, in practice, has frequently led to a shift in emphasis from synthesis of findings to fragmentation of problems. 4. Presumptive diagnoses frequently metamorphose into established diagnoses in medical records, even if incorrect. 5. A number of authors have apparently disparaged the importance of diagnosis. Nonetheless, it is clear that diagnosis must continue to play a central role in clinical medicine. We propose several ways by which we can resist these forces and assure that diagnosis retains its appropriate position of primacy. Journal of Hospital Medicine 2010;5:116,119. © 2010 Society of Hospital Medicine. [source] Structure of isochorismate synthase in complex with magnesiumACTA CRYSTALLOGRAPHICA SECTION D, Issue 5 2008James F. Parsons The electron carrier menaquinone is one of many important bacterial metabolites that are derived from the key intermediate chorismic acid. MenF, the first enzyme in the menaquinone pathway, catalyzes the isomerization of chorismate to isochorismate. Here, an improved structure of MenF in a new crystal form is presented. The structure, solved at 2.0,Å resolution in complex with magnesium, reveals a well defined closed active site. Existing evidence suggests that the mechanism of the reaction catalyzed by MenF involves nucleophilic attack of a water molecule on the chorismate ring. The structure reveals a well defined water molecule located in an appropriate position for activation by Lys190 and attack on the substrate. [source] Outcomes of dental implants placed in a surgical training programmeAUSTRALIAN DENTAL JOURNAL, Issue 4 2009LP Smith Abstract Background:, This study evaluates surgical outcomes and survival rates of implants placed in a multidisciplinary implant teaching programme. Methods:, A retrospective review of all implant surgery performed over a 6-year period by accredited oral and maxillofacial surgery trainees at the Royal Dental Hospital of Melbourne was undertaken. Patients were reviewed for a minimum of 6 months post-implant placement. Implant survival was defined as those implants which were not removed, were clinically integrated as assessed by torque testing and in an appropriate position to receive a subsequent prosthesis. Kaplan-Meier analysis was used to assess overall survival and univariate factors affecting survival. Multivariate analysis used Cox proportional hazards models. Results:, Over 6 years, 127 patients were treated. Follow-up data were present for 105 patients with 236 implants placed. Survival of implants at 1 and 5 years was 94 per cent and 92.8 per cent, respectively. The only univariate and multivariate factor which affected implant survival was perioperative bone grafting. All failed implants were single stage. Other factors such as patient age, smoking status, implant site, anaesthetic type, immediate or delayed placement, implant length and diameter, and medical comorbidities did not significantly affect implant survival. Conclusions:, A satisfactory implant survival rate was found in a tertiary teaching centre. Perioperative bone grafting significantly increased the risk of implant failure. [source] New potent hGH-RH analogues with increased resistance to enzymatic degradationJOURNAL OF PEPTIDE SCIENCE, Issue 7 2002Professor Jan Izdebski Abstract Four hGH-RH analogues containing homoarginine (Har) and/or D -Arg were obtained by solid-phase methodology using Boc-chemistry. To introduce Har residues, a Lys(Fmoc) protected Lys derivative was incorporated in the appropriate positions (11, 12, 20, 21 or 29); after assembly of the peptide chain the Fmoc group was removed and the peptide-resin was guanidinylated by treatment with N, N,-bis(tert -butoxycarbonyl)- S -methylisothiourea. The peptides were cleaved from the resin by treatment with liquid HF, and the products were purified by RP-HPLC. The peptides were subjected to digestion by trypsin, and the course of the reaction was followed by HPLC and ESI-MS. It was found that peptide bonds formed by the carboxyl group of Har are completely stable to trypsin. The course of cleavage at Lys or Arg residues depends on the position of Har in the sequence. All the analogues investigated stimulate the release of GH in rats after subcutaneous administration, and were about 50,100 times as potent as rGH-RH itself. The analogues had no effect on PRL, LH and FSH levels. Copyright © 2002 European Peptide Society and John Wiley & Sons, Ltd. [source] Rational Design, Synthesis, and Optical Properties of Film-Forming, Near-Infrared Absorbing, and Fluorescent Chromophores with Multidonors and Large Heterocyclic AcceptorsCHEMISTRY - A EUROPEAN JOURNAL, Issue 35 2009Min Luo Abstract A new series of film-forming, low-bandgap chromophores (1,a,b and 2,a,b) were rationally designed with aid of a computational study, and then synthesized and characterized. To realize absorption and emission above the 1000,nm wavelength, the molecular design focuses on lowering the LUMO level by fusing common heterocyclic units into a large conjugated core that acts an electron acceptor and increasing the charge transfer by attaching the multiple electron-donating groups at the appropriate positions of the acceptor core. The chromophores have bandgap levels of 1.27,0.71,eV, and accordingly absorb at 746,1003,nm and emit at 1035,1290,nm in solution. By design, the relatively high molecular weight (up to 2400,g,mol,1) and non-coplanar structure allow these near-infrared (NIR) chromophores to be readily spin-coated as uniform thin films and doped with other organic semiconductors for potential device applications. Doping with [6,6]-phenyl-C61 butyric acid methyl ester leads to a red shift in the absorption only for 1,a and 2,a. An interesting NIR electrochromism was found for 2,a, with absorption being turned on at 1034,nm when electrochemically switched (at 1000,mV) from its neutral state to a radical cation state. Furthermore, a large Stokes shift (256,318,nm) is also unique for this multidonor,acceptor type of chromophore, indicating a significant structural difference between the ground state and the excited state. Photoluminescence of the film of 2,a was further probed at variable temperatures and the results strongly suggest that the restriction of bond rotations certainly helps to diminish non-radiative decay and thus enhance the luminescence of these large chromophores. [source] | |||||||||||||