I. The teaching of medical history in the United States and Canada. Report of a field survey.
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Biomedical subjects
Publications and source records attributed to G Miller.
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In keeping with the theme of this Yale-China symposium, we discuss some unexpected dividends which have been derived from the basic study of five viruses to which man has been exposed. Inquiring into the behavior of these viruses for their own sake has not only produced an increase in basic understanding of biologic processes, but has provided concepts and techniques which will broaden our knowledge of the etiology, pathogenesis, and treatment of human diseases which are unrelated to viruses.
Epstein-Barr virus (EBV) confers upon normal lymphocytes derived from bone marrow the ability to proliferate indefinitely in a test tube. This process, called immortalization, is crucial to the pathogenesis of EBV infections. Inside the immortalized lymphocyte the EBV genome exists as a complete multicopy circular plasmid which is probably not integrated into the cell chromosome. Most of the viral genetic information is not expressed. However, at least six to eight separate regions of the EBV genome encode viral products which are made in the immortalized cell. The identification of the function of these few genes holds some interesting answers to questions concerning the biochemical mechanisms of control of lymphocyte growth and differentiation.
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In addition to traditional risk factors (cigarette smoking, high blood pressure, and elevated cholesterol) psychosocial factors (depression, social isolation, and low socioeconomic status) have an adverse impact on prognosis of patients with CAD. Several studies of psychosocial and behavioral treatments provide encouraging evidence for the clinical efficacy of psychosocial interventions in CAD patients. A new, multicenter clinical trial now underway (see sidebar) will evaluate the impact of psychosocial interventions (compared to usual care) on all-cause mortality and nonfatal MI in post-MI patients with depression or perceived low levels of social support or both.