Family factors have been implicated clinically in the nonpsychotic psychopathology of adolescents (Berkowitz et al. 1974; Feldman and Guttman 1984; Gunderson et al. 1980; E. Shapiro et al. 1989; R. Shapiro 1989b). The internal images of the adolescent held by family members appear to reflect healthy as well as pathological functioning of adolescent-family systems (Feldman and Guttman 1984; E. Shapiro 1982; Young 1991).

Adolescent↗

PubMed1994

Molecular forms of beta-endorphin in the canine pituitary gland.

Acid extracts of anterior and intermediate lobes of the pituitary gland from 4 dogs were fractionated by cation-exchange high-performance liquid chromatography and analyzed by radioimmunoassay, using 2 antibodies: one specific for the midregion of beta-endorphin (beta-end) and the other specific for the N-terminal region of N-acetylated beta-END. Identification of peaks of canine beta-END immunoreactivity was based on the retention times relative to those of synthetic human beta-END standards, with predicted variations attributable to differences in the beta-END amino acid sequences between the 2 species. The canine anterior lobe was found to contain almost exclusively beta-END (1-31). By contrast, the intermediate lobe contained substantial amounts of N-acetylated and C-terminally shortened forms of beta-END. The predominant forms of beta-END in canine intermediate lobe were, in decreasing order of abundance: beta-END (1-27), beta-END (1-31), beta-END (1-26), Ac beta-END (1-27), Ac beta-END (1-26) and Ac beta-END (1-31). Individual beta-END immunoreactivity profiles varied, but the general pattern was consistent among the 4 dogs.

Amino Acid Sequence↗

PubMed1993

Stereospecific assignments of the leucine methyl resonances in the 1H NMR spectrum of Lactobacillus casei dihydrofolate reductase.

A general method is described for the stereospecific assignment of methyl resonances in protein NMR spectra based on selective deuteration procedures. A selectively deuterated dihydrofolate reductase from L. casei was prepared by incorporating stereoselectively deuterated L-leucine, (2S,4R)[5,5,5-2H3]leucine. By comparing the COSY spectra of the dihydrofolate reductase-methotrexate complexes formed using deuterated and non-deuterated enzyme the stereospecific assignments for resonances of all 13 leucine residues were obtained by noting the absence of cross-peaks in spectra from the deuterated proteins.

Bacterial Proteins↗

PubMed1993

Psoriasis: therapeutic aspects.

Some of the more common features of psoriasis are reviewed here as an introduction to therapeutic modalities that can be employed in the management of this disorder in the New Zealand situation. An approximate indication of costs for the various therapies is included. This article is sponsored by the therapeutics section of the Department of Health, however, the views of the contributors do not necessarily reflect departmental policies.

Adrenal Cortex Hormones↗

PubMed1993

Chronic pulmonary aspiration in children.

According to established diagnostic and therapeutic guidelines for chronic pulmonary aspiration, clinical suspicion is raised by coughing and choking with feeding, coughing during sleep, recurrent pneumonia, failure to thrive, and radiologic signs of chronic lung injury. The upper gastrointestinal series accurately defines anatomy and function, can differentiate between direct and reflux aspiration, and identifies conditions that predispose to aspiration. Gastroesophageal scintigraphy lacks anatomic detail but increases observation time, may differentiate between direct and reflux aspiration, and identifies delayed gastric emptying and gastroesophageal reflux. The lipid-laden macrophage index improves identification of aspiration, but cannot differentiate between direct and reflux aspiration. The esophageal pH probe identifies gastroesophageal reflux. Treatment options include medical therapy (thickened feedings, prone positioning, and metoclopramide) and surgical intervention (gastrostomy, fundoplication, and definitive correction of predisposing conditions). Therapy is determined by severity of illness and results of diagnostic evaluation.

Bethanechol↗

PubMed1993

Maturation of insulin and glucose responses to normal feeding in foals.

Postprandial insulin and glucose concentrations were measured in 3 Arabian and 3 Thoroughbred foals at 1 day, 1 week, 1 month and 3 months of age. Prefeeding serum insulin concentrations were similar in foals at 1 day (25.9 +/- 5.1 pmol/L), 1 week (32.4 +/- 5.8 pmol/L), and 1 month (38.2 +/- 7.9 pmol/L), but had increased significantly to 131.0 +/- 20.2 pmol/L at 3 months of age (P < 0.05). There was significantly increased serum insulin secretion after a feed in foals at 3 months of age (P < 0.05) when compared with that at younger ages. Prefeeding serum glucose concentrations ranged from 6.0 +/- 0.7 mmol/L at 1 day, to 5.9 +/- 0.9 mmol/L at 1 week, 4.9 +/- 1.7 mmol/L at 1 month, and 4.4 +/- 1.5 mmol/L at 3 months of age. There were lower postprandial glucose concentrations with advancing age. It appeared that there was a period of maturation in pancreatic beta-cell function after birth in foals, which reached adult levels by 3 months of age.

Animals↗

PubMed1993

Managing the stages of hospital cost accounting.

Since the institution of diagnosis-related group-based reimbursement by the Medicare program and the rise of managed care, hospitals have had to examine the costs incurred by patients and patient groups, analyze the cost behavior of individual departments, and implement strategies to contain costs. Hospitals have been hampered in these efforts by inadequate cost-accounting systems. To meet the challenges of the 1990s, hospitals need to follow a four-stage approach to cost-accounting: Stage 1, improve overall cost-accounting systems; Stage 2, separate variable and fixed costs; Stage 3, identify factors that drive costs, the ways these factors can be controlled, and redefine departments as profit or cost responsibility centers; and Stage 4, reconfigure administrative systems that cut across traditional organizational lines.

Accounting↗

PubMed1992

Soluble interleukin-2 receptors in retinal vasculitis.

Soluble interleukin-2 receptor (sIL-2R) levels were measured in the serum of 27 patients with retinal vasculitis, 16 with vasculitis purely isolated to the eye (RV) and 11 with vasculitis associated with a systemic inflammatory disease (RV+SID). Levels of sIL-2R were statistically significantly increased (mu 986, SD 845 U/ml, p = 0.013) only in the RV+SID group as compared to healthy controls. The highest levels being found in patients with sarcoidosis (mu 1436, SD 1083 U/ml). There was no correlation with disease activity or with systemic corticosteroid therapy. Serum sIL-2R measurements appear to be of limited use in the management of patients with retinal vasculitis, but may be of value in those patients with sarcoidosis. Longitudinal measurements with larger numbers of patients are required to confirm this. Serum sIL-2R levels were also statistically significantly increased (mu 843, SD 171 U/ml, p less than 0.0001) in 21 patients with Fuchs' heterochromic cyclitis. As this is a chronic condition with mild inflammatory activity and no associated systemic disease, the explanation for this finding is unknown.

Adolescent↗

PubMed1992

General medicine and ophthalmology: common interests.

A conference entitled 'General Medicine and Ophthalmology' was held at the Royal College of Physicians on 1 June, 1992. Eye diseases are frequently a manifestation of systemic conditions; it is therefore in the patient's best interest for ophthalmologists and physicians to co-operate in their management. Without such co-operation there is the risk that patients fall between stools and neither condition is adequately treated. Medical specialties in which eye conditions are particularly prominent include dermatology, endocrinology, neurology, rheumatology, and cardiovascular diseases. The advantages of joint clinics in medicine and ophthalmology were demonstrated by Professors Alex Crombie and Pat Kendall-Taylor for Graves' disease, by Mr Philip Murray and Dr David Young for uveitis, and by Professor Eva Kohner for diabetes. These included more expert assessments of patients leading to quicker and more complete diagnoses, earlier recognition of complications, and access to a wider range of investigations and treatments, opportunities for collaborative research, improved education for patients and doctors, increased patient convenience, and a stimulus for better control of factors which can worsen the disease.

Ambulatory Care Facilities↗

PubMed1991

Recovery from adult respiratory distress syndrome after high dose corticosteroids.

Explore the source record for details and available documents.

Adult↗

PubMed1991

The antineutrophil antibody in uveitis.

Ninety eight patients with uveitis of various types were tested for the presence of the antineutrophil antibody or ANCA by an indirect immunofluorescence method. This antibody is found in patients with diseases associated with small vessel vasculitis, including Wegener's granulomatosis and microscopic polyarteritis. Eleven true positive cases were found. A positive test was not associated with the anatomical site of the uveitis but was related to the time course of the disease. In particular single/repeated rather than nonrecurrent uveitis was associated with a positive test. Three groups of patients seem more likely to have positive tests: those with bilateral chronic posterior uveitis; a group with an anterior uveitis which is single/repeated who were younger than 46 at disease onset and had isolated eye disease; and an older group, aged 60 years or more at onset, with single/repeated uveitis and systemic features.

Adult↗

PubMed1991

Family factors in failure of psychotherapy.

Family factors involved in the failure of psychotherapy for some adolescents and young adults are explored. These treatment failures are distinguished by expulsion of the therapist(s) and by reunification of the previously adversarial patient and parents. Such abrupt terminations may occur when treatment challenges the family's habitual image and understanding of the identified patient. The revolution against therapy appears to result from: (a) an intolerable threat to the family's heretofore stable delineation of the patient, along with (b) the therapist's failure to empathically engage the parents and ease their commitment to that delineation. It is shown how a parallel process can lead to failure in individual, adult psychotherapy. When therapy threatens the patient's familiar but dystonic self-image, and calls for change to a new image that is discordant with the family image of him/her, separation anxiety may precipitate a regressive flight from treatment. Clinical implications are discussed.

Adolescent↗

PubMed1991

Planning and controlling health capital: attaining an appropriate balance between regulation and competition.

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Capital Expenditures↗

PubMed1991

The relationship between autoantibodies to triiodothyronine (T3) and thyroglobulin (Tg) in the dog.

The relationship between T3 autoantibodies (T3AA) and thyroglobulin autoantibodies (TgAA) in dogs was investigated by determining the inhibitory effect of triiodothyronine (T3), thyroxine (T4) and thyroglobulin (Tg) on T3AA and TgAA binding activity and by determining the pattern of occurrence of the two activities in canine serum samples. Strong similarity in binding characteristics between the two activities, as one might expect if T3AA activity were merely a cross-reactivity of TgAA, was not observed. Canine T3AA activity exhibited a cross-reactivity to purified canine Tg that was intermediate between that of T3 and T4, indicating an antigenic relationship to an epitope of Tg. Average affinity constants of canine T3AA (N = 11) for T3, Tg and T4 were 1.76 x 10(10) M-1, 2.29 x 10(9) M-1, and 1.02 x 10(8) M-1, respectively. Canine TgAA activity, however, did not cross-react significantly with T3 or T4. Canine TgAA (N = 21) binding to canine Tg was not inhibited by T4 or T3 at concentrations up to 2 x 10(-4) M. Each of 23 canine serum samples containing T3AA also exhibited TgAA activity, although there was poor correlation between the magnitudes of the two activities. Neither T3AA nor TgAA activity was observed in serum samples from 16 euthyroid dogs; however, 46.7% of the samples from 15 hypothyroid dogs had detectable TgAA activity. T3AA is so rare that is was not observed in this small population of samples from hypothyroid dogs. The [125I] T3 binding in serum from hypothyroid dogs was elevated compared to that in euthyroid dogs, but was considerably lower than in samples generally designated as containing T3AA. These results suggest that T3AA found in occasional canine serum samples are due to the presence of autoantibodies recognizing a T3 containing epitope of Tg that is different from the epitopes involved in eliciting the predominant population of canine Tg autoantibodies.

Animals↗