Where you think you stand determines what you think you see.
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Biomedical subjects
Publications and source records attributed to G L Engel.
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The aqueous solution chemistry of the C-3'-acetoxy moiety of cephalothin sodium (1b) was examined with the use of isotopically labeled H2(18)O and [2-13C]acetate anion. The 18O incorporation studies indicate that the hydrolysis (at pH 4.7 +/- 0.1) of 1b to the deacetyl derivative of cephalothin (2b) proceeds via two pathways: alkyl-oxygen bond cleavage (55-63%) and acyl-oxygen bond cleavage accounting for the remainder. The incorporation of [2-13C]acetate into 1b suggests that the alkyl-oxygen cleavage pathway is a reversible reaction.
"What Happened to Pity?," a BBC documentary on the grief responses to the Aberfan disaster in 1966, powerfully affects viewers and is an effective tool for the study of sadness. Observations in the classroom and in the laboratory demonstrate that the great majority of viewers experienced some degree of sadness along with anger and sympathy. Subjects classified as high loss/grief experienced more intense and extended sadness than did those who had not had significant losses. They also displayed more apprehension, anger, shame-guilt, giving-up, anxiety, and irritation. Subjects experiencing the most sadness, compared with those less affected, were more initiating and talkative and their relationships in the laboratory were closer, more gratifying, task-oriented, therapeutic, and trusting. With the film they displayed more sympathy, role-identification, personalization, and like, but felt more drained. With respect to stable personality features they were warm, sharing, introspective, dependent, and more personally (than monetarily) motivated to volunteer for the study.
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An increase in the hydrolysis rate of the formyl moiety of cefamandole nafate was observed when the commercial product was reconstituted in 5% dextrose in water relative to the rate when the formulation was dissolved in water for injection or in 0.9% saline. The increase in ester cleavage was the result of nucleophilic attack of glucose on the formyl ester moiety. This transesterification produced small amounts of D-glucose-6-formate and other D-glucose diformates. The formation of these products is of no clinical significance since the antibiotic potency and stability of cefamandole are unaffected and no toxicological differences were observed in animal studies or in clinical trials when formulated cefamandole nafate was administered with or without glucose.
How physicians approach patients and the problems they present is much influenced by the conceptual models around which their knowledge is organized. In this paper the implications of the biopsychosocial model for the study and care of a patient with an acute myocardial infarction are presented and contrasted with approaches used by adherents of the more traditional biomedical model. A medical rather than psychiatric patient was selected to emphasize the unity of medicine and to help define the place of psychiatrists in the education of physicians of the future.
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