The epidemiology of leg ulcers.
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Biomedical subjects
Publications and source records attributed to B Gibson.
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Histidine-tRNA synthetase is one of the smallest bacterial aminoacyl-tRNA synthetases. It is less than one-half the size of the largest aminoacyl-tRNA synthetases. The entire nucleotide sequence of the Escherichia coli hisS locus was determined. The coding region is comprised of 424 codons, and the sequence was determined for 200 nucleotides on the 5'- and 3'-sides of the coding region. The translated nucleotide sequence was confirmed extensively by independent amino acid sequence information obtained by Edman degradations of purified peptides and by measurements of peptide masses by fast atom bombardment mass spectrometry. A significant sequence alignment of four bacterial aminoacyl-tRNA synthetases was reported recently (Webster, T., Tsai, H., Kula, M., Mackie, G., and Schimmel, P. (1984) Science 226, 1315-1317). Although the four enzymes vary considerably in length, this match occurs within the first 100 amino acids of each of the four enzymes and is in the segment believed to be part of the catalytic core. But no strong alignment could be found of the histidine sequence with these four tRNA synthetase sequences. This enzyme may be derived, therefore, from a different progenitor. Previous work suggested that three places in the hisS 5'-noncoding sequence could be promoter sites for RNA polymerase (Eisenbeis, S. J., and Parker, J. (1982) Gene 18, 107-114). We detected a 1400-nucleotide RNA species by RNA blot analysis with a hisS-specific probe. S1 nuclease mapping demonstrated a 5'-end to the RNA species occurs at -67 +/- 1, relative to the first nucleotide of the coding region. This position coincides with the predicted start site for transcription from one of the previously proposed promoter sites.
First described by Hutchinson in 1878, erythema elevatum diutinum (EED) is a rare disease characterized by persistent red, raised nodules and plaques in a symmetrical, acral distribution. The disease occurs equally in the sexes, primarily in the 30- to 60-year age group. We report a representative case of EED which responded to current agents, and briefly review the status of the disease.
1. The lack of a general agreement on the definition of PE makes the interpretation of laboratory findings in different series of these patients difficult. 2. Thrombocytopenia is the most common hemostatic abnormality in patients with PE and is caused by platelet consumption. 3. There is little concrete evidence that thrombin mediates the thrombocytopenia in most of these patients. 4. Immune mechanisms or severe vasospasm with resultant endothelial damage may contribute to the thrombocytopenia in some patients.
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The recognition of traumatic splenic rupture in an 11-year-old severely affected haemophilic boy was delayed for over five weeks. Splenectomy was carried out successfully after the demonstration of splenic rupture by an isotope spleen scan. Splenic rupture is difficult to differentiate from more simple causes of retroperitoneal haematomata in haemophiliacs when there is no massive acute peritoneal bleeding, but it may be identified with isotopic spleen scans so long as the possibility of rupture is borne in mind.
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The effect of systemically administered propranolol was determined on spontaneous activity of neurons in the central nucleus (CeA) of the amygdala, a brain site implicated in fear-related learning and memory. Extracellular recordings of single units in the CeA were obtained in vivo from rats administered saline or the centrally and peripherally acting beta-adrenergic receptor blocker propranolol (4, 7, 10 mg/kg i.p.). The high dose (10 mg/kg) of propranolol markedly increased spontaneous activity of CeA neurons. In contrast, the low (4 mg/kg) and intermediate (7 mg/kg) doses of propranolol significantly decreased spontaneous CeA activity, with the suppressant effect of propranolol on CeA firing rates weakening as the dosage increased from 4 to 7 mg/kg. These results suggest that (1) spontaneous activity of CeA neurons is tonically influenced by competing excitatory and inhibitory modulatory circuits, and (2) propranolol's effect on the two modulatory circuits is dose dependent: the high dose increasing spontaneous CeA activity by preferentially blocking an inhibitory circuit, the low dose decreasing spontaneous CeA activity by preferentially blocking an excitatory circuit, and the intermediate dose weakly suppressing CeA activity by blocking both the excitatory and inhibitory modulatory circuits. Disinhibition of CeA activity by the high dose of propranolol may explain the enhancement of retention observed in the passive-avoidance task when this dose of the drug is administered systemically, and may have implications for the use of propranolol clinically in treating aversive-memory-related anxiety disorders such as posttraumatic stress syndrome.
South Riverdale in Toronto, Canada, underwent a lead-abatement program. In 1988, lead-contaminated soil was replaced at 970 properties, and in 1989, professional housecleaning for lead removal was conducted in 717 households. The effect of "abatement" on blood lead levels in young children was investigated. Data were analyzed from 12 cross-sectional blood-screening surveys that were conducted during an 8-y period in South Riverdale and in two comparison areas. Responses regarding behavioral, household, lifestyle, neighborhood, and environmental factors, all of which were gleaned from associated questionnaires, were also analyzed. Response rates varied between 32% and 75%. During the years between 1984 and 1992, blood lead decreased in all study areas. There appeared to be a minimal blood lead level of 2-3 micrograms/dl for urban Ontario children who were less than 6 y of age. The significant difference between South Riverdale and the control areas disappeared by 1992. Although abatement activity in South Riverdale was associated with an accelerated decline in blood lead levels, it was difficult to distinguish this from effects of decreased Toronto air lead levels or decreased smelter emissions. Within South Riverdale, abatement appeared to be associated with a slower decline in blood lead levels over time, likely the result of selection bias, soil mixing, or recontamination from the smelter. No difference was observed between the separate effects of housecleaning or soil replacement. The findings could neither strongly support nor refute beneficial effects of abatement.
Haemophilic children's perceptions of their own social and school function and their concerns about illness and expectations for the future were compared with those of diabetic and healthy children of the same age and social background. All three groups had similar anticipations about making friends, getting married, finding satisfactory employment and having children. Haemophilic and diabetic children were no more concerned than healthy children about being ill in the future and worried less about passing an illness on to others. Haemophilic, but not diabetic, children felt they were less able to run and play than others. The small sub-group of HIV-positive haemophiliacs differed only in that none of them envisaged having children.
This article provides an overview of personality disorders, before focusing on borderline personality disorder. The role of mentalisation in the development of borderline personality disorder is explored. It is suggested that mentalisation-based treatment can greatly improve outcomes for patients.
Providing psychosocial care to patients with cancer and their families is a formidable task given the current fiscal environment in hospitals. As the pool of available resources shrinks and populations shift from inpatient to outpatient, psychosocial staff are challenged to find creative, versatile, and efficient ways to deliver quality services and programs. This article describes the efforts to plan and implement psychosocial care at a cancer center facing the constraints of limited staff and decreasing resources. The background of the project, the development and implementation of a strategic plan, and a 1-year evaluation of the attainment of the objectives in the plan are described. The success of this approach and implications for psychosocial staff at other institutions are discussed.
Arterial/ischaemic ulcers occur in up to 20% of the leg ulcer population. Accurate diagnosis is essential to ensure that the correct treatment is initiated. Choosing the appropriate dressing and offering adequate pressure and pain relief will contribute to patient comfort and promote healing.
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