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1.
J Small Anim Pract ; 64(5): 359-362, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36720228

RESUMO

A 5-month-old castrated male Smooth Fox Terrier presented for a 1-month history of right thoracic limb lameness. Physical examination revealed right elbow pain on extension and mild soft tissue swelling of the distal antebrachium. Radiographs and computed tomography showed elongated focal radiolucent regions in the distal radial metaphysis. There was incongruity of the right elbow with a short radius. Bone biopsy and histopathology of the regions confirmed a retained cartilaginous core characterised by bony trabeculae with frequently retained central cartilaginous cores. A dynamic proximal ulnar ostectomy was performed to improve elbow congruity. The owner was instructed to restrict activity to short leash walks for 8 weeks followed by a gradual activity increase. On follow-up examination 16 weeks after operatively, the lameness and elbow pain were resolved. Radiographs at that time showed a healed ulnar ostectomy, proper elbow congruity, and resolved retained cartilaginous core.


Assuntos
Doenças do Cão , Rádio (Anatomia) , Cães , Masculino , Animais , Rádio (Anatomia)/cirurgia , Rádio (Anatomia)/patologia , Coxeadura Animal/cirurgia , Coxeadura Animal/patologia , Ulna/cirurgia , Ulna/patologia , Radiografia , Tomografia Computadorizada por Raios X/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Doenças do Cão/patologia
2.
Hear Res ; 349: 4-12, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28153668

RESUMO

The purpose of this study was to describe the prevalence of hearing loss and tinnitus in a cohort of Iraq and Afghanistan Veterans (IAV) with common post-deployment conditions, including traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and other typical post-concussive conditions such as headaches and vertigo/dizziness. This retrospective observational study used data from the national Veterans Health Administration (VA) data repository from fiscal years 2001-2014. Veteran data was included if there were at least three years of VA care, with one or more years of care in 2007 or after. We identified comorbidities that may be associated with post-deployment hearing loss or tinnitus including TBI, PTSD, depression, and common post-concussive symptoms using International Classification of Diseases, 9th Revision, Clinical Modification codes. A multinomial logistic regression analysis was used to examine conditions associated with hearing loss or tinnitus. Among IAV, 570,332 were included in the final analysis. Of these, 7.78% of these were diagnosed with hearing loss alone, 6.54% with tinnitus alone, and 6.24% with both hearing loss and tinnitus. Comorbid TBI, PTSD, and depression were significantly associated with increased rates of hearing loss, tinnitus, or both conditions together. Older individuals, males, and those with TBI, PTSD, or vertigo/dizziness were significantly more likely to have hearing loss, tinnitus, or both. In order to provide more holistic post-deployment support, this myriad of conditions should be carefully considered in the planning of clinical care and beyond.


Assuntos
Campanha Afegã de 2001- , Perda Auditiva/epidemiologia , Guerra do Iraque 2003-2011 , Zumbido/epidemiologia , Saúde dos Veteranos , Adulto , Lesões Encefálicas Traumáticas/epidemiologia , Distribuição de Qui-Quadrado , Comorbidade , Depressão/epidemiologia , Feminino , Audição , Perda Auditiva/diagnóstico , Perda Auditiva/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Fatores de Tempo , Zumbido/diagnóstico , Zumbido/fisiopatologia , Estados Unidos/epidemiologia
3.
Hear Res ; 349: 13-20, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27768901

RESUMO

Hearing loss is the second most common disability awarded by the U.S. Department of Veterans Affairs (VA) to former members of the U.S. uniformed services. Hearing readiness and conservation practices differ among the four largest uniformed military services (Air Force, Army, Marine Corps, and Navy). Utilizing a data set consisting of all hearing loss claims submitted to the VA from fiscal years 2003-2013, we examined characteristics of veterans submitting claims within one year of separation from military service. Our results indicate that having a hearing loss disability claim granted was significantly more likely for men, individuals over the age of 26 years at the time of the claim, individuals most recently serving in the U.S. Army, and those with at least one hearing loss diagnosis. Importantly, individuals with at least one test record in the Defense Occupational and Environmental Health Readiness System-Hearing Conservation (DOEHRS-HC) system were significantly less likely to have a hearing loss disability claim granted by the VA. Within the DOEHRS-HC cohort, those with at least one threshold shift or clinical hearing loss diagnosis while on active duty were more than two and three times more likely to have a hearing loss disability claim granted, respectively. These findings indicate that an established history of reduced hearing ability while on active duty was associated with a significantly increased likelihood of an approved hearing loss disability claim relative to VA claims without such a history. Further, our results show a persistent decreased rate of hearing loss disability awards overall. These findings support increased inclusion of personnel in DoD hearing readiness and conservation programs to reduce VA hearing loss disability awards.


Assuntos
Avaliação da Deficiência , Perda Auditiva Provocada por Ruído/diagnóstico , Testes Auditivos , Audição , Militares , Doenças Profissionais/diagnóstico , United States Department of Defense , United States Department of Veterans Affairs , Ajuda a Veteranos de Guerra com Deficiência , Veteranos , Adulto , Fatores Etários , Fadiga Auditiva , Percepção Auditiva , Definição da Elegibilidade , Feminino , Perda Auditiva Provocada por Ruído/epidemiologia , Perda Auditiva Provocada por Ruído/fisiopatologia , Perda Auditiva Provocada por Ruído/psicologia , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Militares/psicologia , Ruído Ocupacional/efeitos adversos , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Doenças Profissionais/psicologia , Exposição Ocupacional/efeitos adversos , Valor Preditivo dos Testes , Fatores Sexuais , Fatores de Tempo , Estados Unidos/epidemiologia , Veteranos/psicologia
4.
J Comp Pathol ; 151(4): 410-9, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25306158

RESUMO

Over the past two decades, highly virulent strains of Mycobacterium tuberculosis have emerged and spread rapidly in man, suggesting a selective advantage based on virulence. A similar scenario has not been described for Mycobacterium bovis infection in cattle (i.e. bovine tuberculosis). An epidemiological investigation of a recent outbreak of bovine tuberculosis in a USA dairy indicated that the causative strain of M. bovis (strain 10-7428) was particularly virulent, with rapid spread within the herd. In the present study, the virulence of this strain (10-7428) was directly compared in the target host with a well-characterized strain (95-1315) of relevance to the USA bovine tuberculosis eradication programme. Aerosol inoculation of 10(4) colony forming units of M. bovis 95-1315 (n = 8) or 10-7428 (n = 8) resulted in a similar distribution and severity of gross and microscopical lesions of tuberculosis as well as mycobacterial colonization, primarily affecting the lungs and lung-associated lymph nodes. Specific cell-mediated and antibody responses, including kinetics of the response, as well as antigen recognition profiles, were also comparable between the two treatment groups. Present findings demonstrate that M. bovis strains 95-1315 and 10-7428 have similar virulence when administered to cattle via aerosol inoculation. Other factors such as livestock management practices likely affected the severity of the outbreak in the dairy.


Assuntos
Mycobacterium bovis/patogenicidade , Tuberculose Bovina/patologia , Administração por Inalação , Aerossóis , Animais , Bovinos , Masculino , Tuberculose Bovina/imunologia , Virulência
5.
J Virol ; 86(1): 420-6, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22013033

RESUMO

La Crosse virus (LACV) and Jamestown Canyon virus (JCV), family Bunyaviridae, are mosquito-borne viruses that are endemic in North America and recognized as etiologic agents of encephalitis in humans. Both viruses belong to the California encephalitis virus serogroup, which causes 70 to 100 cases of encephalitis a year. As a first step in creating live attenuated viral vaccine candidates for this serogroup, we have generated a recombinant LACV expressing the attachment/fusion glycoproteins of JCV. The JCV/LACV chimeric virus contains full-length S and L segments derived from LACV. For the M segment, the open reading frame (ORF) of LACV is replaced with that derived from JCV and is flanked by the untranslated regions of LACV. The resulting chimeric virus retained the same robust growth kinetics in tissue culture as observed for either parent virus, and the virus remains highly infectious and immunogenic in mice. Although both LACV and JCV are highly neurovirulent in 21 day-old mice, with 50% lethal dose (LD50) values of 0.1 and 0.5 log10 PFU, respectively, chimeric JCV/LACV is highly attenuated and does not cause disease even after intracerebral inoculation of 10³ PFU. Parenteral vaccination of mice with 10¹ or 10³ PFU of JCV/LACV protected against lethal challenge with LACV, JCV, and Tahyna virus (TAHV). The chimeric virus was infectious and immunogenic in rhesus monkeys and induced neutralizing antibodies to JCV, LACV, and TAHV. When vaccinated monkeys were challenged with JCV, they were protected against the development of viremia. Generation of highly attenuated yet immunogenic chimeric bunyaviruses could be an efficient general method for development of vaccines effective against these pathogenic viruses.


Assuntos
Quimera/imunologia , Vírus da Encefalite da Califórnia/genética , Encefalite da Califórnia/prevenção & controle , Expressão Gênica , Vírus La Crosse/imunologia , Proteínas do Envelope Viral/imunologia , Animais , Anticorpos Antivirais/imunologia , Linhagem Celular , Quimera/genética , Quimera/crescimento & desenvolvimento , Encefalite da Califórnia/imunologia , Encefalite da Califórnia/virologia , Humanos , Vírus La Crosse/genética , Vírus La Crosse/crescimento & desenvolvimento , Macaca mulatta , Camundongos , Vacinação , Proteínas do Envelope Viral/genética , Vacinas Virais/genética , Vacinas Virais/imunologia
7.
Endocrinology ; 136(1): 283-8, 1995 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-7828542

RESUMO

Mitogen-regulated protein (MRP/PLF; also called proliferin) is a member of the PRL-GH family expressed by the placenta in mid-gestation. This report describes an MRP/PLF receptor in uterine membrane preparations from pregnant mice. Peak receptor activity occurred at 11 days of gestation with a dissociation constant of 6 x 10(-10) M and maximal binding capacity of 86 fmole MRP/PLF/mg membrane protein. PRL, PL-I, and mannose-6-phosphate did not compete for binding, and GH competed weakly only at high concentrations. Primary cells cultured from uteri taken at days 8-11 of gestation responded to MRP/PLF with increases in DNA synthesis. Uterine cells from later stages of gestation did not respond to MRP/PLF. This is the first reported evidence of a function mediated by MRP/PLF and suggests a role for this protein in maternal-fetal interactions during reproduction. Thus, it seems that MRP/PLF is a placentally derived growth factor, which stimulates proliferation in the uterus in a developmentally defined period to coordinate uterine growth with fetal development.


Assuntos
Receptores de Fatores de Crescimento/metabolismo , Animais , Ligação Competitiva , DNA/biossíntese , Feminino , Idade Gestacional , Glicoproteínas/farmacologia , Substâncias de Crescimento/farmacologia , Peptídeos e Proteínas de Sinalização Intercelular , Cinética , Membranas/metabolismo , Camundongos , Gravidez , Prolactina , Útero/metabolismo
8.
J Med Chem ; 37(4): 431-8, 1994 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-8120862

RESUMO

The three-dimensional structure of 4'-azidothymidine has been determined for the solid state and in solution. X-ray crystal analysis indicates the presence of two independent molecules (A and B) having the following conformational parameters: Phase angles, PA = 13.7 degrees, PB = 12.6 degrees (C3'-endo envelope); puckering amplitude psi mA = 32.4 degrees, psi mB = 37.2 degrees; glycosyl torsion angle chi A = -88.2 degrees, chi B = -71.2 degrees; 4'-5' torsion angle gamma A = 58.5 degrees, gamma B = 36.0 degrees. The solution conformation was determined from NMR coupling constants in D2O. Analysis using the computer programs PSEUROT and DAERM yielded phase angles (P) of 53.2 degrees (C4'-exo envelope) (major conformer) and 63 degrees (C4'-exo envelope), respectively, with corresponding puckering amplitudes (psi m) of 34.9 degrees and 45.8 degrees. A gated 13C NMR experiment was used to determine the 1H-13C vicinal coupling constants used to calculate the solution glycosyl torsion angle (chi) to be either -80 degrees or -160 degrees and a 4'-5' torsion angle, gamma, of ca. 180 degrees. These studies show that 4'-azidothymidine is conformationally exceptional among the antiretroviral nucleosides both as a solid and in solution. The C3'-endo (northern) conformation determined by X-ray crystallography is rare among HIV-inhibitory nucleosides which usually exist in the solid state in a southern conformation. The solution structure is even more peculiar in that it exists in the extremely rare 4'-exo envelope conformation.


Assuntos
Antivirais/química , Zidovudina/análogos & derivados , Antivirais/farmacologia , Cristalografia por Raios X , HIV/efeitos dos fármacos , Espectroscopia de Ressonância Magnética , Conformação Molecular , Estereoisomerismo , Zidovudina/química , Zidovudina/farmacologia
9.
J Med Chem ; 34(2): 705-17, 1991 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-1671705

RESUMO

Analogues of the potent alpha 2-adrenoceptor antagonist (8aR,12aS,13aS)-5,8,8a,9,10,11,12,12a,13,13a- decahydro-3-methoxy-12-(methylsulfonyl)- 6H-isoquino[2,1-g][1,6]naphthyridine (1b) were prepared and evaluated for alpha 1- and alpha 2-adrenoceptor affinity. Affinity for alpha 2-adrenoceptors was assessed by displacement of [3H]yohimbine from rat cerebral cortical membranes and although 1b and close structural analogues demonstrated high affinity, none were selective for the alpha 2A or alpha 2B subtypes reputedly present in this tissue. All of the high affinity alpha 2-adrenoceptor ligands were, however, selective with respect to [3H]prazosin (alpha 1) binding. Affinity for [3H]yohimbine-labeled alpha 2-adrenoceptors was found to be highly dependent on the stereochemistry of the tetracyclic system. The 8a beta,12a alpha,13a alpha diastereomer of 1 (56) had moderate affinity for alpha 2-adrenoceptors while the 8a beta,12a beta,13a alpha diastereomer (55) had very low affinity. The affinity and selectivity of these agents for alpha 2-adrenoceptors was found to correspond to that observed for several isomeric yohimbine analogues which have similar relative and absolute stereochemistries. Deviation from the structure of 1 by opening the B ring, changing the position of the sulfonamide nitrogen, or changing the attachment of the D ring led to a dramatic decrease in alpha 2-adrenoceptor affinity. High binding affinity was found to correlate with functional antagonism in the guinea pig ileum. The reversal of clonidine-induced mydriasis in the rat was used to assess bioavailability and indicated that 1b was a potent alpha 2-adrenoceptor antagonist in vivo.


Assuntos
Antagonistas Adrenérgicos alfa/síntese química , Naftiridinas/síntese química , Antagonistas Adrenérgicos alfa/metabolismo , Antagonistas Adrenérgicos alfa/farmacologia , Animais , Fenômenos Químicos , Química , Cobaias , Masculino , Músculo Liso/efeitos dos fármacos , Naftiridinas/metabolismo , Naftiridinas/farmacologia , Ratos , Ratos Endogâmicos , Receptores Adrenérgicos alfa/efeitos dos fármacos , Receptores Adrenérgicos alfa/metabolismo , Estereoisomerismo , Relação Estrutura-Atividade
10.
Steroids ; 48(3-4): 197-211, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3445279

RESUMO

We have synthesized alpha- and beta-anomers of tigogenin cellobioside and have determined their effects on intestinal absorption of [1,2-3H]cholesterol in rats. We demonstrated that the loss of tritium label likely to occur in the conversion of cholesterol to coprostanone was minimal. Dose response studies showed that both anomers depressed intestinal absorption of cholesterol but the depression was greater with the beta-anomer.


Assuntos
Colesterol/farmacocinética , Absorção Intestinal/efeitos dos fármacos , Espirostanos/farmacologia , Animais , Relação Dose-Resposta a Droga , Isomerismo , Espectroscopia de Ressonância Magnética , Masculino , Ratos , Ratos Endogâmicos , Trítio
11.
Prostaglandins Leukot Med ; 16(2): 131-46, 1984 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-6597446

RESUMO

Prostaglandin D2 spontaneously decomposes at physiological pH and temperature to 9-deoxy-delta 9-PGD2 (designated PGJ2). We developed a TLC procedure for the isolation of PGJ2 which was identified by both proton-NMR and mass spectrometry. Freshly prepared PGJ2 was active in inhibiting aggregation induced by ADP in citrated human platelet rich plasma. As reported by Fukushima et al. (1). PGJ2 was less active (x 0.1-0.25) than PGD2 as an inhibitor. Concentrations of PGJ2 that markedly inhibited aggregation of human platelets were generally incapable of inhibiting aggregation of rat or guinea pig platelets. Using a heterologous system of human platelets mixed with guinea pig plasma samples (2), it was shown that the ability of PGJ2 to inhibit platelet aggregation was lost immediately following intravenous injection in anesthetized guinea pigs. This apparent rapid uptake and/or degradation of PGJ2 might also explain why PGJ2 had no effect on blood pressure of anesthetized guinea pigs. PGJ2 was potent in inhibiting proliferation of cultured vascular smooth muscle cells, mouse melanoma cells and mouse fibroblasts. Less potent anti-proliferative effects were seen with two other degradation products of PGD2, one of which was the delta 12 metabolite reported (3,4) to be formed from PGJ2 in a reaction catalyzed by serum albumin.


Assuntos
Prostaglandinas D/análise , Difosfato de Adenosina/farmacologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Linhagem Celular , Células Cultivadas , Dinoprostona , Cobaias , Humanos , Espectroscopia de Ressonância Magnética , Masculino , Espectrometria de Massas , Agregação Plaquetária/efeitos dos fármacos , Prostaglandina D2 , Prostaglandinas D/farmacologia , Prostaglandinas E/farmacologia
12.
J Med Chem ; 24(11): 1320-8, 1981 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7310808

RESUMO

Forty-three new 1-oxa-3,8-diazaspiro[4,5]decan-2-ones optionally substituted with 2-(3-indolyl)ethyl, 3-(2-methoxyphenoxy)-2-hydroxypropyl, or 2-(1,4-benzodioxan 2-yl)-2-hydroxyethyl at the 8 position were prepared for screening as antihypertensive agents in the spontaneous hypertensive rat. For the 8-[2-(3-indolyl)ethyl] compounds the most active were those substituted in the 4 position, where activity was at maximum with the 4-ethyl compound (1). The 8-[3-(2-methoxyphenoxy)-2-hydroxypropyl] compounds were less active than their 1,4-benzodioxane counterparts, which were tested as mixtures of erythro and threo diastereoisomers. Both the 4-ethyl-8-[2-(1,4-benzodioxan-2-yl)-2-hydroxyethyl]-substituted 38 and (S)-3-methyl-8-[3-(2-methoxyphenoxy)-2-hydroxypropyl]-substituted 42 were designed as mixed alpha- and beta-adrenergic receptor blockers. Bother compounds lowered blood pressure, but they gave no evidence of working as beta-adrenergic blockers. Examination of 8-[2-(3-indolyl)ethyl]-1-oxa-3,8-diazaspiro[4.5]-decan-2-one (8) and 3 methyl-8-[2-(1,4-benzodioxan-2-yl)-2-hydroxyethyl]-1-oxa-3,8-diazaspiro[4,5]decan-2-one (29) in the dog showed them to be alpha-adrenergic blockers. Compound 29 was primarily an alpha 2-adrenoceptor antagonist, while 8 was more skewed toward alpha 1-adrenoceptor antagonism. Tilt-response studies for evaluating the potential for producing orthostatic hypotension showed that both 8 and 29 had little potential for avoiding orthostatic hypotension at therapeutically effective doses.


Assuntos
Anti-Hipertensivos/síntese química , Compostos de Espiro/síntese química , Animais , Pressão Sanguínea/efeitos dos fármacos , Fenômenos Químicos , Química , Cães , Epinefrina/antagonistas & inibidores , Indoramina/farmacologia , Masculino , Norepinefrina/antagonistas & inibidores , Oxazóis/síntese química , Oxazóis/farmacologia , Fentolamina/farmacologia , Fenilefrina/antagonistas & inibidores , Ratos , Compostos de Espiro/farmacologia , Relação Estrutura-Atividade
13.
Biochim Biophys Acta ; 568(2): 377-85, 1979 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-486491

RESUMO

A procedure was devised for the preparation of enriched populations of subcellular organelles from homogenized bovine spleen. The fractions obtained were characterized for arylsulfatase, succinate dehydrogenase, UDPgalactosyltransferase and 5'-nucleotidase activities. The distribution of sialidase (acylneuraminyl hydrolase, EC 3.2.1.18) activity directed towards either endogenous substrate or exogenous ganglioside substrate suggests that it is enriched in the plasma membrane/microsomal fractions. Sialidase activity towards exogenous sialoglycoproteins, isolated from erythrocyte membrane, was enriched in the least dense of the plasma membrane/microsomal-containing fractions. The endogenous sialidase substrates were primarily the sialoglycolipids, hematoside and disialogangliosides. At the pH optimum, 3.8, and 37 degrees C, release of endogenous sialic acid was linear with time for 3 h. At the end of this time, 85% or more of the available endogenous substrate was hydrolyzed.


Assuntos
Gangliosídeos/metabolismo , Neuraminidase/metabolismo , Sialoglicoproteínas/metabolismo , Baço/enzimologia , Animais , Bovinos , Humanos , Lipídeos de Membrana/metabolismo , Frações Subcelulares/enzimologia , Especificidade por Substrato
14.
Neurochem Res ; 1(2): 171-80, 1976 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24271340

RESUMO

Neuronal perikarya were isolated, using bulk preparative procedures, from bovine brains. Synaptosomes, neuronal perikarya, and brain homogenates had similar ganglioside patterns, with the synaptosomes containing at least four times more total ganglioside per mg protein than the neuronal perikarya and twice that of the homogenate. Synaptosomes had 26-33 nmol total sialic acid/mg protein, while the neurons had only 15-17 nmol. Determination of ganglioside sialidase activity showed that neuronal perikarya had very low levels (negligible), in comparison with synaptosomes or whole-brain homogenates. Trypsin treatment during the isolation procedure enhanced sialidase activity two-to threefold in the particulate fraction of the whole-brain homogenate. Determination of the distribution of sialidase activity in the fractions obtained during the isolation of the neuronal perikarya showed that the sialidase activity was associated with the myelin, broken-off dendritic processes, and glial-cell fractions that banded in the less dense sucrose.

15.
Neurochem Res ; 1(2): 181-90, 1976 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24271341

RESUMO

Sialidase activity was determined for three different neuroblastoma clonal lines derived from the A/J strain mouse C1300 neuroblastoma line. For each cell line, the endogenous and exogenous activities were less than 1 nmol sialic acid released/mg protein/90 min and 50 min reaction time, respectively. The C1300 tumor had similarly low levels of sialidase activity. The sialidase activity associated with the neuroblastomas is less than that associated with synaptosomes. Each cell line had a distinctly different ganglioside pattern varying in complexity from GM3 to GD1a. Treatment of the cells withVibrio cholerae sialidase under isosmotic conditions showed that cell-surface sialyl residues were susceptible to sialidase activity, with some of the susceptible residues coming from the ganglioside constituents. Of the total number ofV. cholerae sialidase-releasable sialyl residues, 50-60% were released by the neuroblastoma sialidase acting on endogenous substrate.

17.
J Tenn Med Assoc ; 64(5): 418-22, 1971 May.
Artigo em Inglês | MEDLINE | ID: mdl-5091672
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