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Biomedical subjects

C Evans

Publications and source records attributed to C Evans.

At least 145 records · Page 8Linked to original sources
PubMed1993

Virus-induced immunosuppression. 1. Age at infection relates to a selective or generalized defect.

Viruses that persist must develop strategies to escape immunologic surveillance in order to survive. Investigation of lymphocytic choriomeningitis virus (LCMV)-induced persistence has indicated that this virus avoids immune clearance mainly by aborting the viral specific cytotoxic T lymphocyte (CTL) response, a response that is necessary for terminating viral infection. This study demonstrates that persistence established in immunologically immature newborns selectively depletes the LCMV-specific CTL response but does not hinder CTL responses to the RNA and DNA viruses influenza, vaccinia, or herpes simplex. In contrast, persistence established in immunologically mature adults leads not to selective but rather to generalized immunosuppression during which CTL responses to LCMV, influenza, vaccinia, and herpes simplex viruses are all ablated or down-regulated. These results indicate that the state of maturity of the immune system at the time of virus-induced immunosuppression can result in two distinct phenotypes. These observations may account for the differing patterns of infection caused by hepatitis B virus or human immunodeficiency virus initiated in the neonatal period compared to that initiated in adulthood.

Aging↗
PubMed1993

Rumination: the eating disorder of infancy.

Rumination is a relatively rare, potentially fatal syndrome in infants. This article reviews the historical and current treatment of rumination. Two cases are presented: a six-month-old who narrowly escaped surgery when the disorder was not recognized, and a complicated case from the neonatology intensive care unit. Environmental changes and enhanced mothering are described as being critical to correction of rumination and appropriate weight gain.

Developmental Disabilities↗
PubMed1993

A four-year longitudinal study of bone loss in patients with inflammatory bowel disease.

Serial measurements of spinal trabecular and radial cortical bone density were made over 4 years in 70 patients with inflammatory bowel disease. Mean rates of bone loss for the cohort differed little from rates reported in normal populations; however, some patients showed increased rates of loss, including patients whose bone density at entry to the study was already well below normal. There was a significant correlation between the amount of corticosteroid prescribed and spinal trabecular bone loss in males, but no significant correlation with other clinical parameters. Increased rates of bone loss emphasise the need for bone densitometry and prophylactic measures in patients with inflammatory bowel disease.

Adult↗
PubMed1993

Rat-1 fibroblasts engineered with GAD65 and GAD67 cDNAs in retroviral vectors produce and release GABA.

We have used a retroviral cDNA expression system to drive the expression of the different forms of glutamic acid decarboxylase (GAD65, GAD67, or both). Individual clones of engineered Rat-1 cells make the appropriate GAD mRNAs and GAD polypeptides, show GAD enzymatic activity, and make GABA. Clones expressing GAD65 had higher enzymatic activity than those expressing GAD67. As is the case for brain GADs and for GADs produced in engineered bacteria, the enzymatic activity of GAD65 is more responsive to added pyridoxal phosphate than that of GAD67. Immunostaining for both GADs is scattered throughout the cytoplasm. GAD65 immunostaining is less homogeneous than that of GAD67 and also appears to be associated with the surfaces of large vesicle-like structures. Cells expressing GAD65 and GAD67 showed similar immunostaining patterns with anti-GABA antibodies and contained substantial amounts of GABA (ranging from 7 to 18 pmol of GABA/10(6) cells), which was roughly proportional to their levels of GAD activity. GABA is released from the engineered cells into the surrounding medium under resting conditions, suggesting that cells programmed with GAD cDNAs might serve as effective sources of GABA in cell transplantation experiments.

Animals↗
PubMed1993

Bone loss in normal British women; a 5 year follow-up.

To assess the rates of loss, forearm and spinal bone mineral were remeasured in 16 out of 18 peri- and post-menopausal women aged 45 to 60 years who had taken part in a previously reported cross-sectional study. The mean interval between measurements was 4.8 years (range 4.2-5.3 years). The mean (95% confidence interval (CI)) annual change in radial bone mineral density was -0.78%/year (-1.73 to +0.18%; not significant) and in spinal bone mineral -2.41%/year (-3.55 to 1.27%; p < 0.001). There was considerable variation in the rate of change in radius and spine, and between individuals. There was no significant correlation between rates of bone loss at either site, or between rates of loss and the initial bone density at either the radius or spine. There was no significant correlation between the rates of change and the age or number of years post-menopause of the women. There was no significant change in the Z score for the forearm (mean -0.20; 95% CI -0.65 to +0.25) or for the spine (mean -0.04; 95% CI -0.30 to +0.22). There have been no previous longitudinal studies of the changes of bone density in normal British women. These results show considerable variation between individuals, and rates of change at one site cannot be predicted from measurements at another site. Untreated, some normal individuals have high rates of loss that cannot be predicted from baseline values, age or number of years post-menopause.

Absorptiometry, Photon↗
PubMed1993

Skin surgery.

Explore the source record for details and available documents.

Anesthesia, Local↗
PubMed1992

Intramedullary spinal cord metastases from epithelial ovarian carcinoma.

A patient with poorly differentiated serous cystadenocarcinoma of both ovaries who had undergone extensive medical treatment presented with nonspecific neurologic complaints. With the aid of magnetic resonance imaging, a metastatic lesion in the intramedullary area of the spinal cord was diagnosed. Rapidly instituted high-dose steroids and radiotherapy resulted in resolution of her symptoms. Intramedullary spinal cord metastasis is an unusual metastatic site. This is the first reported case of epithelial ovarian carcinoma metastatic to the intramedullary spinal cord.

Combined Modality Therapy↗
PubMed1992

The Separation-Individuation Inventory. Association with borderline phenomena.

The Separation Individuation Inventory (SII; Christenson and Wilson, J. Nerv. Ment. Dis., 173:561-565, 1985) was designed to assess adult psychopathology construed in terms of the concepts of separation and individuation (Mahler, Pine, and Bergman, The Psychological Birth of the Human Infant: Symbiosis and Individuation, 1975). Its reported use is confined to the original authors' paper, which compared scores of 20 subjects with borderline personality disorder with the scores of staff control subjects. We report the association of the SII with two self-report measures of borderline personality diagnosis and phenomenology. Our British samples, from the staff and residents in a therapeutic community for severely personality-disordered clients, thus complement the original American work. The SII was found to have good internal consistency, respectable screening parameters, and high correlations with indications of trait psychopathology. We suggest a slight modification to the scoring of the inventory and two main areas for additional research.

Adult↗
PubMed1992

Could 'objective, experimental' analysis of human motivation really improve psychotherapy?

Cattell is a founding father of modern, multivariate psychological method and his paper is a fine introduction to his views on motivation which have perhaps received less attention in Britain than they deserve. However, it was the unanimous opinion of three referees that it needed to be followed by a dissenting voice. In this counterargument I suggest that Cattell's presentation is: (1) ingenuously confident of the power of multivariate statistical methods; (2) naïve about the interactive nature of the clinical relationship.

Awareness↗
PubMed1992

Human immunodeficiency virus type 1 envelope gene structure and diversity in vivo and after cocultivation in vitro.

Nested-primer polymerase chain reaction (PCR) has been applied to the molecular cloning of 4.6-kb half-genome fragments of human immunodeficiency virus type 1 (HIV-1) taken directly from the peripheral blood mononuclear cells (PBMC) of an individual with neurological symptoms of HIV-1 infection. In a similar manner, gp120-coding portions of the envelope gene were cloned after PBMC from the same blood sample were cocultivated with uninfected PBMC for 28 days. The complete 1.6-kb nucleotide sequence of the gp120 gene was determined from each of 35 clones examined. Two of 13 (15%) PBMC-derived gp120 genes and 3 of 22 (14%) coculture-derived gp120 genes were defective as a result of frameshifts and an in-frame stop codon(s). Mean diversity between individual gp120-coding sequences in PBMC was fivefold greater (3.24%) than after coculture (0.65%). A predominant sequence of "strain" was found after coculture that was distinct from the diverse viral genotypes detected in vivo and therefore was selectively amplified during in vitro propagation. Multiple distinct third variable (V3) regions encoding the principal neutralizing domain of the envelope protein were detected in PBMC-derived genes, suggesting the presence of immunologic diversity of HIV env genes in vivo not reflected in the cocultured virus sample. The large size of the HIV fragments generated in this study will permit analysis of the diversity of immunologic reactivity, gene function, and pathogenicity of HIV genomes present within infected individuals, including the functional significance of the loss of diversity that occurs upon coculture.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Therapeutic community treatment for personality disordered adults: changes in neurotic symptomatology on follow-up.

Personality disordered patients are important as they place high continuing demands on services and are often refractory to traditional treatments. Often personality disorders may co-exist with neurotic symptomatology, worsening prognosis of the latter. This paper reports change in neurotic symptomatology following intensive, long term, therapeutic community treatment for such patients. Sixty two subjects with personality disorder were followed up for eight months after discharge (response rate 65%). Results showed a highly significant reduction in symptomatic distress as measured by the SCL-90R questionnaire. Investigation of the reliability and clinical importance of the change in individual subjects demonstrated that 55% of subjects had improved reliably, and in 32% this change was also clinically significant, whilst only 6.5% of subjects had deteriorated reliably.

Adolescent↗
PubMed1992

Multiple self-damaging behaviour among alcoholic women. A prevalence study.

Among patients being treated for specific behaviour-control problems, there exists an important subgroup of 'multi-impulsive' patients whose treatment might be facilitated if the full range of their problems were recognised and dealt with as one general issue of impulse control. In women in particular, loss of control of eating may be prevalent and easily concealed from staff, and may thwart treatment. This survey of 50 women attending an alcoholic-treatment unit explored the prevalence of behavioural-control problems other than those of alcohol. Three-quarters of the women also had other behavioural problems. Over half the sample had thought of taking an overdose and just under half had actually taken one; about a quarter had cut themselves deliberately; half described impulsive physical violence; half acknowledged a period of 'promiscuity'; and at least 16% had had a clinically diagnosable eating disorder. More research is needed but we believe that all self-damaging behaviour should be addressed simultaneously to prevent 'revolving door' relapses as emotional distress is transferred from one behaviour to another.

Adult↗
PubMed1992

Evaluation of surgical procedures. Changing patterns of patient selection and costs in heart transplantation.

During the past 4 years we have observed a marked increase in costs of heart transplantation in our center. This trend coincides with a shift in our recipient population toward the more severely ill patients. The percentage of patients bound for the intensive care unit has doubled. In analyzing the components of cost, we find that the length of stay, both in special care and regular nursing units, accounts for most of the cost increase. In our study of outcomes we find no significant difference in survival, at 1 month and 1 year, between recipients operated on from the intensive care unit and those not in intensive care. We find that at 1 year after transplantation, approximately 80% of patients are rehabilitated, which we define as the ability to work or to go to school. Only 20% of patients are off disability rolls, however, primarily because of problems related to insurance and the cost of continuing care, including drugs. We conclude that the comprehensive evaluation of surgical procedures requires an approach that balances costs with results on a continuing and long-term basis.

Costs and Cost Analysis↗
PubMed1991

Synthesis of a gene for rat liver fatty-acid-binding protein and its expression in Escherichia coli.

A gene coding for rat liver fatty-acid-binding protein (FABP) has been constructed by the single-step ligation of ten synthetic oligonucleotides. The gene has been cloned into the bacterial expression vector pKK223-3. Induction of protein synthesis from this gene results in over expression of an FABP that is indistinguishable in its structure and binding properties with that isolated from rat liver.

Amino Acid Sequence↗