51
|
McCormack J, Thomas J. Better outcomes--a case study. Aust Fam Physician 2004; 33:943-5. [PMID: 15584337] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
It is estimated that mental health problems will affect more than 20% of the Australian adult population in their lifetime. The 2001 Australian Commonwealth budget provided dollars 120.4 million over 4 years to improve the quality of care provided through general practice to Australians with a mental health illness. The Better Outcomes in Mental Health Care (BOMHC) initiative--which forms part of the National Mental Health Strategy--began in 2001 and aimed to improve the quality of care provided through general practice to patients with a mental health problem. This article reviews the uptake of education and training initiatives of the BOMHC initiative and good uptake by general practitioners across Australia. Well over 3600 GPs have completed the first 'level' of training associated with the initiative, representing 16.5% of the GP population. Access by consumers to mental health trained and registered GPs also significantly improved, with one in four practices employing a GP registered with the BOMHC initiative.
Collapse
Affiliation(s)
- Julie McCormack
- QA&CPD Program, The Royal Australian College of General Practitioners, Victoria.
| | | |
Collapse
|
52
|
McCormack J. Management of the HIV-infected patient. Intern Med J 2003. [DOI: 10.1046/j.1445-5994.2003.00445.x] [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: 11/20/2022]
|
53
|
Abstract
The present study examined the perceptions of early interpersonal experiences of sexual offenders (child molesters and rapists) and two criminal comparison groups. A grounded theory approach was applied to a comprehensive list of responses provided by the participants to questions about their early interpersonal experiences. The raw data was collapsed into 14 basic categories by grouping together responses of similar meanings. The categories were responsiveness, consistency, acceptance, boundaries, emotional regulation, autonomy, self-evaluation, developmental trauma, sexual abuse and deviation, physical abuse, loss, conflict, safety, and positive mediating interactions. In the second part of the study, the four groups were compared using the categories and the differences noted. All four groups experienced significantly negative early interpersonal experiences.
Collapse
Affiliation(s)
- Tony Ward
- Department of Criminology, University of Melbourne, 234 Queensberry Street, Melbourne 3010, Australia.
| | | | | |
Collapse
|
54
|
Abstract
The present study examined the perceptions of early interpersonal experiences of sexual offenders (child molesters and rapists) and two criminal comparison groups. A grounded theory approach was applied to a comprehensive list of responses provided by the participants to questions about their early interpersonal experiences. The raw data was collapsed into 14 basic categories by grouping together responses of similar meanings. The categories were responsiveness, consistency, acceptance, boundaries, emotional regulation, autonomy, self-evaluation, developmental trauma, sexual abuse and deviation, physical abuse, loss, conflict, safety, and positive mediating interactions. In the second part of the study, the four groups were compared using the categories and the differences noted. All four groups experienced significantly negative early interpersonal experiences.
Collapse
Affiliation(s)
- Tony Ward
- Department of Criminology, University of Melbourne, 234 Queensberry Street, Melbourne 3010, Australia.
| | | | | |
Collapse
|
55
|
|
56
|
Wolter J, Seeney S, Bell S, Bowler S, Masel P, McCormack J. Effect of long term treatment with azithromycin on disease parameters in cystic fibrosis: a randomised trial. Thorax 2002; 57:212-6. [PMID: 11867823 PMCID: PMC1746273 DOI: 10.1136/thorax.57.3.212] [Citation(s) in RCA: 376] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Relentless chronic pulmonary inflammation is the major contributor to morbidity and mortality in patients with cystic fibrosis (CF). While immunomodulating therapies such as prednisolone and ibuprofen may be beneficial, their use is limited by side effects. Macrolides have immunomodulatory properties and long term use dramatically improves prognosis in diffuse panbronchiolitis, a condition with features in common with the lung disease of CF. METHODS To determine if azithromycin (AZM) improves clinical parameters and reduces inflammation in patients with CF, a 3 month prospective randomised double blind, placebo controlled study of AZM (250 mg/day) was undertaken in adults with CF. Monthly assessment included lung function, weight, and quality of life (QOL). Blood and sputum collection assessed systemic inflammation and changes in bacterial flora. Respiratory exacerbations were treated according to the policy of the CF Unit. RESULTS Sixty patients were recruited (29 men) of mean (SD) age 27.9 (6.5) years and initial forced expiratory volume in 1 second (FEV1) 56.6 (22.3)% predicted. FEV1% and forced vital capacity (FVC)% predicted were maintained in the AZM group while in the placebo group there was a mean (SE) decline of -3.62 (1.78)% (p=0.047) and -5.73 (1.66)% (p=0.001), respectively. Fewer courses of intravenous antibiotics were used in patients on AZM (0.37 v 1.13, p=0.016). Median C reactive protein (CRP) levels declined in the AZM group from 10 to 5.4 mg/ml but remained constant in the placebo group (p<0.001). QOL improved over time in patients on AZM and remained unchanged in those on placebo (p=0.035). CONCLUSION AZM in adults with CF significantly improved QOL, reduced CRP levels and the number of respiratory exacerbations, and reduced the rate of decline in lung function. Long term AZM may have a significant impact on morbidity and mortality in patients with CF. Further studies are required to define frequency of dosing and duration of benefit.
Collapse
Affiliation(s)
- J Wolter
- University Department of Medicine and Department of Infectious Disease, Mater Adult Hospital, Brisbane, Australia
| | | | | | | | | | | |
Collapse
|
57
|
|
58
|
Abstract
A case in which a home peak expiratory flow (PEF) monitoring device was recommended led us to review the evidence examining this intervention. The clinical question to be answered was: should these devices be consistently recommended to all patients with asthma? A comprehensive search revealed eight randomized controlled trials, one review and one consensus report. Four trials provided all subjects with asthma education and compared patient-specific action plans based on symptoms to those based on PEF readings. Four trials compared usual asthma care to peak flow monitoring (PFM) and varied in both their content and intensity of asthma education. Six out of eight studies showed improvement in some selected markers of asthma morbidity with home PFM-based action plans. Improvements were also observed in patients using a symptom-based action plan. These studies did not demonstrate any obvious advantage of PFM compared with symptom-based monitoring but did suggest that a monitoring plan with predetermined actions based on PEF measurements or symptoms can lead to improved asthma control. Although not specifically studied, PFM may be more appropriate and effective for patients who have difficulty identifying worsening of asthma control through symptom monitoring.
Collapse
Affiliation(s)
- A M McGrath
- College of Pharmacy, Dalhousie University, Halifax, Canada
| | | | | |
Collapse
|
59
|
|
60
|
McCormack J. Medically unexplained symptoms in secondary care. Doctors in secondary care should respect general practitioners. BMJ 2001; 323:397. [PMID: 11548691 PMCID: PMC1120989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
|
61
|
McCormack J. Absolute vs. relative numbers in evaluating drug therapy. Am Fam Physician 2001; 63:1913-4, 1916. [PMID: 11388707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
|
62
|
McCormack J, Levine M. Dual blockade of renin-angiotensin system. Data do not support claimed benefit of combination over single treatment. BMJ 2001; 322:1183. [PMID: 11379586 PMCID: PMC1120298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
|
63
|
|
64
|
McCormack J. Seeing what you want to see in randomized controlled trials: versions and perversions of UK Prospective Diabetes Study data. West J Med 2001. [DOI: 10.1136/ewjm.174.2.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
65
|
McCormack J. Online continuing nursing education opportunities created as partners with DigiScript, Inc. Interview by Tanya Gorman. Tenn Nurse 2001; 64:14-5. [PMID: 16136872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
|
66
|
Fine KD, Do K, Schulte K, Ogunji F, Guerra R, Osowski L, McCormack J. High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol 2000; 95:1974-82. [PMID: 10950045 DOI: 10.1111/j.1572-0241.2000.02255.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Celiac sprue is associated with specific HLA-DQ genes (mainly DQ2). Because there are epidemiological and histopathological similarities between celiac sprue and microscopic colitis, we hypothesized that these syndrome may share an HLA genetic predisposition and pathogenesis. METHODS The HLA-DQ genes of 25 patients with celiac sprue, 53 patients with the microscopic colitis syndrome, and 429 normal controls were typed and compared. Serum was analyzed for antigliadin and antiendomysial antibodies. Small intestinal biopsies were analyzed for signs of histopathology. RESULTS HLA-DQ2 or DQ1,3 (the latter as DQ1,7,DQ1,8, or DQ1,9) were seen more frequently in both patient groups relative to controls. In patients with the microscopic colitis syndrome, serological tests for celiac sprue were weakly positive in 17%; mild inflammation of the small intestine without villous atrophy was present in 43%, and inflammation plus partial or subtotal villous atrophy was present in 27%. CONCLUSIONS A shared set of predisposing HLA-DQ genes account for the epidemiological overlap of celiac sprue and microscopic colitis. Mild to moderate mononuclear cell inflammation of the small intestine, often accompanied by partial or subtotal villous atrophy, is frequent in patients with the microscopic colitis syndrome. Although further studies will be necessary to determine if this enteropathy is induced by dietary gluten, we speculate that the small intestinal but not colonic histopathology in patients with microscopic colitis is caused by immunological gluten sensitivity.
Collapse
Affiliation(s)
- K D Fine
- Intestinal Health Institute, Dallas, Texas, USA
| | | | | | | | | | | | | |
Collapse
|
67
|
Abstract
It has been recognized for some time that the risk of producing maleless clutches should select for a lower than binomial variance in the sex ratio of organisms with female-biased sex ratios, small clutches and breeding groups containing the clutch of a single female. However, to date, precise sex ratios have only been reported for organisms with haplodiploid sex determination, a system which allows direct control of the sex of individual offspring. In contrast, under heterogametic sex determination chance is expected to play a crucial role in determining the sex composition of any one family, in particular when males are the heterogametic sex. Here, we present evidence of precise or underdispersed primary sex ratios in the Neotropical social spider Anelosimus domingo Levi. We show that this diplodiploid species with male heterogamety has not only beaten the odds of meiosis by producing mostly daughters, but has also attained relative precision in the proportion of sons and daughters produced in any one clutch. The latter finding suggests the existence of mechanisms that allow sorting of the two types of sperm in this spider species.
Collapse
Affiliation(s)
- L Avilés
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson 85721, USA.
| | | | | | | |
Collapse
|
68
|
McCormack J, Greenhalgh T. Seeing what you want to see in randomised controlled trials: versions and perversions of UKPDS data. United Kingdom prospective diabetes study. BMJ 2000; 320:1720-3. [PMID: 10864554 PMCID: PMC1127485 DOI: 10.1136/bmj.320.7251.1720] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2000] [Indexed: 11/03/2022]
Affiliation(s)
- J McCormack
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada V6T 1W5.
| | | |
Collapse
|
69
|
McCormack J. Standard bearers cite progress. Health Data Manag 2000; 8:98, 100, 102. [PMID: 11183073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
70
|
McCormack J. Y2K bug teaches CIOs valuable lessons. Health Data Manag 2000; 8:68, 70-2, 74-6. [PMID: 11183070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
71
|
McCormack J. The Internet reroutes electronic records. Health Data Manag 2000; 8:50-1, 54-6, 58-62. [PMID: 11183069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
72
|
Troxell ML, Gopalakrishnan S, McCormack J, Poteat BA, Pennington J, Garringer SM, Schneeberger EE, Nelson WJ, Marrs JA. Inhibiting cadherin function by dominant mutant E-cadherin expression increases the extent of tight junction assembly. J Cell Sci 2000; 113 ( Pt 6):985-96. [PMID: 10683147 DOI: 10.1242/jcs.113.6.985] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [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: 12/11/2022] Open
Abstract
Previous studies have shown that induction of cadherin-mediated cell-cell adhesion leads to tight junction formation, and that blocking cadherin-mediated cell-cell adhesion inhibits tight junction assembly. Here we report analysis of tight junction assembly in MDCK cells overexpressing a mutant E-cadherin protein that lacks an adhesive extracellular domain (T151 cells). Mutant E-cadherin overexpression caused a dramatic reduction in endogenous cadherin levels. Despite this, tight junction assembly was extensive. The number of tight junction strands observed by freeze-fracture electron microscopy significantly increased in T151 cells compared to that in control cells. Our data indicate that the hierarchical regulation of junctional complex assembly is not absolute, and that inhibition of cadherin function has both positive and negative effects on tight junction assembly.
Collapse
Affiliation(s)
- M L Troxell
- Department of Molecular Physiology, Beckman Center B109, Stanford University School of Medicine, Stanford, CA 94305-5426, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
73
|
McCormack J. www.educatingpatients.com? Health Data Manag 2000; 8:99-100, 102, 104-6. [PMID: 11066229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
|
74
|
McCormack J. Hard(ware) lessons. Health Data Manag 2000; 8:62-4, 66-8, 70-2. [PMID: 11066228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
|
75
|
McCormack J. Ready, and wired, for anything. Health Data Manag 2000; 8:82-4, 86. [PMID: 11183669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
76
|
McCormack J. Goodbye ball & chain. Health Data Manag 2000; 8:54-6, 58-60, 62-4. [PMID: 11183666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
77
|
Levy MF, Crippin J, Sutton S, Netto G, McCormack J, Curiel T, Goldstein RM, Newman JT, Gonwa TA, Banchereau J, Diamond LE, Byrne G, Logan J, Klintmalm GB. Liver allotransplantation after extracorporeal hepatic support with transgenic (hCD55/hCD59) porcine livers: clinical results and lack of pig-to-human transmission of the porcine endogenous retrovirus. Transplantation 2000; 69:272-80. [PMID: 10670638 DOI: 10.1097/00007890-200001270-00013] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Whole organ extracorporeal perfusion of a genetically modified humanized (transgenic) pig liver has been proposed as a technology that may sustain patients with severe liver failure while awaiting human liver transplantation. METHODS We report on two cases of successful extracorporeal perfusion of a transgenic pig liver in patients awaiting transplantation for fulminant hepatic failure. The pig livers used were transgenic for human CD55 (decay-accelerating factor) and human CD59. These transgenic modifications are designed to reduce or eliminate the hyperacute rejection inherent in pig-to-primate xenotransplants. We also report on the results of serial surveillance testing for presence of the porcine endogenous retrovirus (PoERV) in these two patients. RESULTS Extracorporeal perfusion in two patients was performed for 6.5 and 10 hr, respectively, followed by the successful transplantation of a human liver and resultant healthy patients (18 and 5 months later as of this writing). The porcine livers showed evidence of synthetic and secretory function (decreasing protime and bilirubin, bile production). Serial polymerase chain reaction analysis of these patients' peripheral blood mononuclear cells has failed to show presence of PoERV DNA sequences. CONCLUSIONS The CD55/CD59 transgenic porcine liver appears capable of safely "bridging" a patient to liver transplantation. Human PoERV infection from these livers has yet to be demonstrated.
Collapse
Affiliation(s)
- M F Levy
- Transplantation Services, Baylor University Medical Center, Dallas, Texas 75246, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
78
|
McCormack J. Group practices find their way to the Internet. Health Data Manag 2000; 8:46-8, 50, 51-2. [PMID: 11183081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
79
|
McCormack J. The top 10 ways the Internet is changing health care I.T. Health Data Manag 1999; 7:34-6, 38-9. [PMID: 11066217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
|
80
|
McCormack J. Wooing physicians. Provider organizations are using a variety of strategies to persuade physicians to adopt electronic records in ambulatory care settings. Health Data Manag 1999; 7:56-8, 60, 62 passim. [PMID: 10622925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
81
|
McCormack J. The missing link. Health Data Manag 1999; 7:72-4, 76, 78 passim. [PMID: 10621042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
82
|
McCormack J. CIOs compete for cash. Health Data Manag 1999; 7:46-8, 50, 52-6. [PMID: 10557701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
|
83
|
McCormack J. Obstacles and lessons on the road to a bug-free Y2K. Health Data Manag 1999; 7:70, 72, 74-5. [PMID: 10539179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
84
|
McCormack J. A worldwide network of supplies. Health Data Manag 1999; 7:54-60. [PMID: 10539177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
85
|
Francis SA, Kelly JM, McCormack J, Rogers RA, Lai J, Schneeberger EE, Lynch RD. Rapid reduction of MDCK cell cholesterol by methyl-beta-cyclodextrin alters steady state transepithelial electrical resistance. Eur J Cell Biol 1999; 78:473-84. [PMID: 10472800 DOI: 10.1016/s0171-9335(99)80074-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.0] [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: 11/19/2022] Open
Abstract
The role of plasma membrane lipids in regulating the passage of ions and other solutes through the paracellular pathway remains controversial. In this study we explore the contribution of cholesterol (CH) in maintaining the barrier function of an epithelial cell line using the CH-solubilizing agent methyl beta-cyclodextrin (MBCD) to stimulate CH efflux. Inclusion of 20 mM MBCD in both apical and basolateral media reduced CH levels by 70-80% with no significant effect on cell viability. Most of that decrease occurred during the first 30 min of incubation. Recovery of CH content to initial values was nearly complete 22 h after removal of MBCD. Within 30 min of adding MBCD to the culture medium, transepithelial electrical resistance (TER) increased, reaching maximum values 30-40% above controls. This early rise in TER occurred when MBCD was added to either side of the monolayer. The later rapid decline in TER was observed only when MBCD bathed the basolateral surface from which, coincidentally, CH efflux was most rapid. Freeze fracture replicas and transmission electron microscopy of monolayers exposed to MBCD for only 30 min revealed no increase in either the average tight junction (TJ) strand number or the dimensions of the lateral intercellular space. There was a statistically significant increase in the number of TJ particles associated with the E fracture face at this time. This raises the interesting possibility that during CH efflux there is a change in the interaction between TJ particles and underlying cytoskeletal elements. There was no change in staining for occludin and ZO-1. After exposing the basolateral surface to MBCD for 2 h, TER fell below control levels. The accompanying increase in mannitol flux suggests strongly that the decrease in TER resulted from an increase in the permeability of the paracellular and not the transcellular pathway. A decrease in immuno-staining for occludin and ZO-1 at TJs, a striking accumulation of actin at tri-cellular areas as well as a decline in the number of parallel strands, as seen in freeze fracture replicas, suggest that changes in cytoskeletal organization during long incubations with MBCD had physically disrupted the TJ network. Data are presented which suggest that the observed changes in paracellular permeability during CH efflux may be related to increased levels of lipid-derived second messengers, some of which may trigger changes in the phosphorylation status of TJ proteins.
Collapse
Affiliation(s)
- S A Francis
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA
| | | | | | | | | | | | | |
Collapse
|
86
|
McCormack J. Will group practices meet the Y2K deadline? Health Data Manag 1999; 7:102-6, 108. [PMID: 10538208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
87
|
McCormack J. Reaching out to rural providers. A tertiary care hospital uses information technology to lure new partners. Health Data Manag 1999; 7:48-50, 52. [PMID: 10538213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
88
|
McCormack J. Ringing out the century with a whimper. How the top health care software vendors are trying to make the best of a market besieged by worries. Health Data Manag 1999; 7:56-62, 64-5. [PMID: 10538214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
89
|
McCormack J. Hospitals weigh a growing number of hardware options. Choosing the right devices can determine the success of inpatient point-of-care computing initiatives. Health Data Manag 1999; 7:66-8, 72, 74 passim. [PMID: 10387706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
|
90
|
McCormack J. Wringing out the costs. Preferred provider organizations are using technology to get the job done. Health Data Manag 1999; 7:76-8, 80-1, 84 passim. [PMID: 10351308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The thin margins in the PPO business mean that these managed care plans must make sure they are deploying information technology in ways that improve efficiency. Information technology professionals at PPOs also are being called upon to develop initiatives that will give their organizations a competitive edge.
Collapse
|
91
|
McCormack J. Group practices explore EDI options. Health Data Manag 1999; 7:94-8, 101-3. [PMID: 10351309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Although physician groups have been relatively slow to take advantage of electronic commerce, more are discovering the benefits. Once group practice administrators get beyond their initial trepidation and realize that EDI is efficient, many are pleased with the results. And some are automating other transactions, including verifying patient eligibility for insurance coverage, gaining insurance authorization for referrals to specialists and checking the status of claims.
Collapse
|
92
|
McCormack J. Why build an interactive site? Health Data Manag 1999; 7:78, 80, 82-3. [PMID: 10350823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
93
|
McCormack J. Are your systems really ready for year 2000? Health Data Manag 1999; 7:66-75. [PMID: 10345795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
94
|
McCormack J, Bassett K. The evidence for insulin lispro. CMAJ 1998; 159:1353-5. [PMID: 9861200 PMCID: PMC1229846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
|
95
|
McCormack J. Intranet strategies: how organizations' approaches are evolving. Health Data Manag 1998; 6:32-6. [PMID: 10187487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
96
|
McCormack J. Winning over physicians. Health Data Manag 1998; 6:52-4, 56. [PMID: 10187489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
97
|
McCormack J. Checking up on physicians. Health Data Manag 1998; 6:92, 94-5. [PMID: 10185900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
98
|
Suda T, McCarthy K, Vu Q, McCormack J, Schneeberger EE. Dendritic cell precursors are enriched in the vascular compartment of the lung. Am J Respir Cell Mol Biol 1998; 19:728-37. [PMID: 9806737 DOI: 10.1165/ajrcmb.19.5.3214] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [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: 11/24/2022] Open
Abstract
The vast mucosal interface separating external from internal compartments of the lung is under the surveillance of a population of blood-borne, bone marrow-derived dendritic cells (DC) characterized by constant turnover. Because these sentinel cells process foreign antigens that have penetrated the epithelial barrier and transport them to local lymph nodes, they require continuous replenishment by blood-borne cells. In the present study, the phenotype and function of DC and their precursors isolated from the vascular compartment of the lung were examined and compared with those in vena cava blood. Intravascular leukocytes were retrieved by exhaustive perfusion of the lung vasculature. Leukocytes harvested from the subdiaphragmatic vena cava of the same animal served as a source of DC in prepulmonary blood. Typical, large, major histocompatibility class II+ antigen (MHC II+) DC constituted < 1% of leukocytes from either vascular compartment. These cells expressed intercellular adhesion molecule [ICAM]-1 and lymphocyte function-associated antigen [LFA]-1 and many were ED1(+) (lysosomal antigen in monocytes, macrophages, and some DC). No ED2(+) cells (macrophages) were identified. Very few of the circulating DC expressed the alpha-like subunit of integrin recognized by the OX62 monoclonal antibody. A striking difference appeared when neutrophil-depleted leukocytes were cultured with granulocyte macrophage colony-stimulating factor (GM-CSF) for 3 d; the number of MHC II+ DC generated from pulmonary vascular leukocytes was 76% greater than that from the vena cava population. After pulse-labeling with tritiated thymidine ([3H]TdR) followed by 3 d of culture with GM-CSF, DC from either source remained virtually unlabeled, as determined by autoradiography. On the day of harvest, DC and their precursors obtained from either vascular compartment were poor stimulators of the mixed leukocyte reaction and required GM-CSF for development of their full accessory cell capability. These data suggest that, relative to leukocytes in vena cava blood, those in the lung vascular compartment are enriched in a population of mononuclear cells that are capable of differentiating into MHC II+ DC when exposed to the appropriate growth factors, including GM-CSF. This enriched population of DC precursors could represent a source from which lung DC may be readily recruited not only to replenish the normally turning-over mucosal DC, but also to participate in inflammatory reactions occurring in the lung.
Collapse
Affiliation(s)
- T Suda
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | | | | | | |
Collapse
|
99
|
McCormack J. Improving the odds. Health Data Manag 1998; 6:58-60, 62, 64-7. [PMID: 10185895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Health care providers are using information systems to gather and analyze data that will help make entering capitated managed care contracts less of a gamble.
Collapse
|
100
|
McCormack J. More motivation for automation. Health Data Manag 1998; 6:100, 102, 104-6. [PMID: 10185881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|