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Biomedical subjects

H Moss

Publications and source records attributed to H Moss.

At least 19 recordsLinked to original sources

Relaxation and complementary therapies: an alternative approach to managing dental anxiety in clinical practice.

Dental anxiety is a widespread problem and has a significant impact on the provision of dental care for the general population. Anxiety leads to avoidance of dental treatment and increased stress for dental practitioners. Traditionally, dental anxiety has been managed using pharmacological techniques. This article reviews alternative treatment approaches, including psychological and complementary therapies which can be used in managing dental anxiety and facilitating dental treatment. Many of these approaches are currently being used within the dental profession. Others are gaining a wider acceptance as to their usage. Where available, the evidence of their efficacy will be reviewed.

Complementary Therapies↗

Unitary vs multiple semantics: PET studies of word and picture processing.

In this paper we examine a central issue in cognitive neuroscience: are there separate conceptual representations associated with different input modalities (e.g., Paivio, 1971, 1986; Warrington & Shallice, 1984) or do inputs from different modalities converge on to the same set of representations (e.g., Caramazza, Hillis, Rapp, & Romani, 1990; Lambon Ralph, Graham, Patterson, & Hodges, 1999; Rapp, Hillis, & Caramazza, 1993)? We present an analysis of four PET studies (three semantic categorisation tasks and one lexical decision task), two of which employ words as stimuli and two of which employ pictures. Using conjunction analyses, we found robust semantic activation, common to both input modalities in anterior and medial aspects of the left fusiform gyrus, left parahippocampal and perirhinal cortices, and left inferior frontal gyrus (BA 47). There were modality-specific activations in both temporal poles (words) and occipitotemporal cortices (pictures). We propose that the temporal poles are involved in processing both words and pictures, but their engagement might be primarily determined by the level of specificity at which an object is processed. Activation in posterior temporal regions associated with picture processing most likely reflects intermediate, pre-semantic stages of visual processing. Our data are most consistent with a hierarchically structured, unitary system of semantic representations for both verbal and visual modalities, subserved by anterior regions of the inferior temporal cortex.

Adult↗

Mutations in endoglin and in activin receptor-like kinase 1 among Danish patients with hereditary haemorrhagic telangiectasia.

Hereditary haemorrhagic telangiectasia (HHT) is a rare disorder with one per 6000-10,000 affected individuals in the general Caucasian population. HHT is genetically heterogeneous, involving at least two loci HHT1 mapping to chromosome 9q34.1 and HHT2 mapping to chromosome 12q31. The loci have been identified as endoglin (ENG) and activin receptor-like kinase 1 (ALK1). In order to gain knowledge of the genotype distribution and prevalence in the Danish population and to establish a reproducible and sensitive molecular genetic test method, we developed a denaturating gradient gel electrophoresis protocol for mutation scanning of the two loci. Twenty-five Danish HHT families were tested. A total of eight new as well as seven previously reported mutations were identified. A founder mutation was characterized present in seven families and possibly introduced around 350 years ago. In one individual, a presumed spontaneous mutation was characterized. The method developed proved to be very sensitive for mutation detection in both ENG and ALK1. Genetic screening in HHT families facilitates an early treatment strategy for silent HHT manifestations in first degree relatives.

Activin Receptors, Type I↗

Hemi-orolingual angioedema and ACE inhibition after alteplase treatment of stroke.

One hundred seventy-six consecutive patients treated with IV tissue plasminogen activator (tPA) for acute ischemic stroke were examined prospectively, and orolingual angioedema was found in nine (5.1%; 95% CI 2.3 to 9.5). The reaction was typically mild, transient, and contralateral to the ischemic hemisphere. Risk of angioedema was associated with angiotensin-converting enzyme inhibitors (relative risk [RR] 13.6; 95% CI 3.0 to 62.7) and signs on initial CT of ischemia in the insular and frontal cortex (RR 9.1; 95% CI 1.4 to 30.0).

Aged↗

Objects and their actions: evidence for a neurally distributed semantic system.

An influential model of conceptual knowledge claims that objects are represented in a distributed network of cortical areas that store information about different types of attributes, such as form, colour, and motion (A. Martin et al., 2000, in: The Cognitive Neurosciences, 2nd ed., MIT Press, Cambridge). Two specific claims of this account are that (a) the motions and actions associated with objects (along with other attributes) are automatically activated whenever the object concept is evoked and (b) topographically distinct neural regions are responsible for motion/action attributes pertaining to objects in the categories of tools and animals. We used fMRI to examine the neural activation associated with conceptual processing of nouns referring to animals and tools and for verbs referring to tool-associated actions (e.g., drilling, painting) and biological actions (e.g., walking, jumping). We found that object names and their associated actions activated the same set of neural regions (left fusiform gyrus, superior and middle temporal cortex) consistent with the claim that word tool and animal concepts implicitly activate the actions associated with them. However, there was no evidence of category specificity for either objects or actions, with essentially the same activations for the form and motion attributes of both living and nonliving categories.

Adult↗

Altered response to meta-chlorophenylpiperazine in anorexia nervosa: support for a persistent alteration of serotonin activity after short-term weight restoration.

OBJECTIVE: Patients with anorexia nervosa (AN) have disturbances of appetite and behaviors, such as dysphoria, inhibition, and obsessions, that could be related to altered serotonin activity. To investigate such relationships, we administered meta-chlorophenylpiperazine (m-CPP), a relatively serotonin-specific drug. METHODS: To avoid the confounding effects of malnutrition or weight loss, we studied 12 patients with restricting-type AN between 5 and 17 days after a return to a normal weight and while on a stable dietary intake. We compared them to 12 healthy control women (CW). m-CPP was administered double blind and placebo controlled. RESULTS: Although weight restored, AN women had lower body weight and increased ratings for depression and obsessionality compared with CW. After m-CPP, AN women had an elevation in mood and a reduction in body image distortion when compared with placebo. After m-CPP, groups had similar cortisol, adrenocorticotropin (ACTH), and growth hormone responses whereas AN women had an uncertain reduction in prolactin response. DISCUSSION: These data support other studies that suggest that altered serotonin activity persists after weight restoration in AN patients. The finding that m-CPP temporarily improved mood and reduced body image distortions supports the hypothesis that altered serotonin activity may contribute to the pathophysiology of AN.

Adolescent↗

Structure of the TRFH dimerization domain of the human telomeric proteins TRF1 and TRF2.

TRF1 and TRF2 are key components of vertebrate telomeres. They bind to double-stranded telomeric DNA as homodimers. Dimerization involves the TRF homology (TRFH) domain, which also mediates interactions with other telomeric proteins. The crystal structures of the dimerization domains from human TRF1 and TRF2 were determined at 2.9 and 2.2 A resolution, respectively. Despite a modest sequence identity, the two TRFH domains have the same entirely alpha-helical architecture, resembling a twisted horseshoe. The dimerization interfaces feature unique interactions that prevent heterodimerization. Mutational analysis of TRF1 corroborates the structural data and underscores the importance of the TRFH domain in dimerization, DNA binding, and telomere localization. A possible structural homology between the TRFH domain of fission yeast telomeric protein Taz1 with those of the vertebrate TRFs is suggested.

Amino Acid Sequence↗

High resolution magnetic resonance imaging of atherosclerosis and the response to balloon angioplasty.

OBJECTIVE: To explore the use of high resolution magnetic resonance imaging (MRI) of the popliteal artery in defining atheroscelerotic lesions and to monitor the remodelling response to balloon angioplasty. METHODS: Four patients (aged 49-67) with symptomatic discrete popliteal artery stenoses, as demonstrated by conventional angiography, underwent balloon angioplasty. MRI of the diseased vessel was performed before and one week, one month, three months, and six months after therapeutic balloon angioplasty. Cine phase contrast MRI was used to estimate blood flow just proximal to the lesion before and after angioplasty. RESULTS: In all patients the extent of the atherosclerotic plaque could be defined, such that even in segments of vessel which were angiographically "normal", atherosclerotic lesions with cross sectional areas ranging from 49% to 76% of potential lumen area were identified. Following angioplasty, plaque fissuring and local dissection were easily identified and serial changes in lumen diameter, blood flow. and lesion size could be documented. CONCLUSIONS: High resolution MRI can define the extent of atherosclerotic plaque in the peripheral vasculature and demonstrate the changes that occur with remodelling and restenosis following angioplasty. As a safe, reproducible technique MRI is ideal for assessing plaque and monitoring intervention, but further technological developments will be needed if similar or better images are to be achieved in other vascular beds.

Aged↗

Role of computed tomographic scanning of the thorax prior to bronchoscopy in the investigation of suspected lung cancer.

BACKGROUND: Fibreoptic bronchoscopy (FOB) is the usual initial investigation of choice in patients with suspected endobronchial carcinoma, but it is often non-diagnostic. Once a positive diagnosis has been made, many patients undergo staging by computed tomographic (CT) scanning to assess the extent of the disease and its suitability for radical treatment. To determine whether initial CT scanning before FOB is a cost effective way of reducing subsequent unnecessary or unhelpful invasive diagnostic procedures, a study was undertaken in 171 patients with suspected endobronchial carcinoma. METHODS: A randomised two group study was performed with all patients undergoing an initial CT staging scan. In group A the CT scans were reviewed before FOB, allowing cancellation or a change to an alternative invasive procedure if considered appropriate. In group B all patients proceeded to FOB with the bronchoscopist blinded to the result of the CT scan until after the procedure. RESULTS: In group A six of 90 patients (7%) required no further investigations as the CT scan was either normal, consistent with benign disease, or consistent with widespread metastatic disease. Of the remainder, bronchoscopy was diagnostic in 50 of 68 (73%) in group A compared with 44 of 81 (54%) in group B (p = 0.015). Overall, a positive diagnosis was made after a single invasive investigation in 64 of 84 patients (76%) in group A compared with only 45 of 81 patients (55%) in group B (p = 0.005). Only seven of 90 patients (8%) in group A required more than one invasive investigation compared with 15 of 81 patients (18.5%) in group B. In patients with malignancy, bronchoscopy was more likely to be diagnostic in group A (50 of 56 patients (89%)) than in group B (44 of 62 (71%); p = 0. 012), and the diagnosis was more frequently made on the initial invasive investigation (group A, 63 of 70 (90%); group B, 44 of 62 (71%); p = 0.004). Because of the lower number of invasive procedures performed in group A than in group B, the cost of performing CT scans before FOB in all patients in group A would have equated to a projected cost of performing CT scans in 60% of patients after FOB in group B. CONCLUSIONS: Performing initial CT thoracic scans before bronchoscopy in patients with suspected endobronchial malignancy is a cost effective way of improving diagnostic yield from invasive diagnostic procedures and occasionally may obviate the need for any further investigation.

Adult↗

Mammalian telomeres end in a large duplex loop.

Mammalian telomeres contain a duplex array of telomeric repeats bound to the telomeric repeat-binding factors TRF1 and TRF2. Inhibition of TRF2 results in immediate deprotection of chromosome ends, manifested by loss of the telomeric 3' overhang, activation of p53, and end-to-end chromosome fusions. Electron microscopy reported here demonstrated that TRF2 can remodel linear telomeric DNA into large duplex loops (t loops) in vitro. Electron microscopy analysis of psoralen cross-linked telomeric DNA purified from human and mouse cells revealed abundant large t loops with a size distribution consistent with their telomeric origin. Binding of TRF1 and single strand binding protein suggested that t loops are formed by invasion of the 3' telomeric overhang into the duplex telomeric repeat array. T loops may provide a general mechanism for the protection and replication of telomeres.

Animals↗

Family and peer correlates of behavioral self-regulation in boys at risk for substance abuse.

Behavioral self-regulation (BSR), defined herein as the degree to which one can control one's own activity and reactivity to environmental stimuli, has been posited to be salient to the onset of adolescent substance abuse. The goal of this study was to clarify particular family and peer correlates of BSR in at-risk sons. Subjects were 10-through 12-year-old sons of substance-abusing fathers (high-average risk [HAR]; n = 176) and normal controls (low-average risk [LAR]; n = 199). A BSR latent trait was developed using multiple measures and multiple informants. Analyses included separate hierarchical linear regressions for HAR and LAR groups. In the hierarchical linear model for HAR sons, family dysfunction and deviant peer affiliation were significantly associated with BSR, whereas for LAR sons, only peer affiliation was significantly associated with BSR. The above family and peer correlates differed in proportions of variance explained for BSR in HAR and LAR sons. These findings extend previous studies by showing that, in a hierarchical linear model, BSR in HAR sons is associated with specific interpersonal, family, and peer factors. These findings suggest that empirical, theory-guided interventions to prevent worsening of BSR in HAR boys should address specific interpersonal, family, and peer factors.

Adult↗

Asymptomatic intussusception of the appendix due to endometriosis.

We present the case of a 29-year-old woman with an asymptomatic intussuscepted appendix found incidentally during surgical evaluation for a pelvic mass in a patient with endometriosis. This case represents the rare nature of this presentation and the need to fully evaluate the gastrointestinal tract in patients with endometriosis.

Adult↗

Alterations in serotonin activity and psychiatric symptoms after recovery from bulimia nervosa.

BACKGROUND: Women with bulimia nervosa (BN) have disturbances of mood and behavior and alterations of monoamine activity when they are bingeing and purging. It is not known whether these alterations are secondary to pathological eating behavior or traits that could contribute to the pathogenesis of BN. METHODS: To avoid the confounding effects of pathological eating behavior, we studied 30 women after long-term recovery (>1 year with no bingeing or purging, normal weight, and regular menstrual cycles) from BN. Subjects were compared with 31 healthy volunteer women. We assessed psychiatric diagnoses and symptoms to determine whether there was any persistent disturbance of behavior after recovery. We measured cerebrospinal fluid (CSF) levels of the major metabolites of serotonin (5-hydroxyindoleacetic acid [5-HIAA]), dopamine (homovanillic acid [HVA]), and norepinephrine (3-methoxy-4-hydroxyphenylglycol [MHPG]) as well as hormonal and behavioral response to m-chlorophenylpiperazine (m-CPP), a serotonin-specific agent. RESULTS: Women who were recovered from BN had mild to moderate negative moods and obsessions with perfectionism and exactness and exaggerated core eating disorder symptoms compared with healthy volunteer women. Recovered BN women had increased levels of CSF 5-HIAA compared with control women (117 +/- 33 vs 73 +/- 15 pmol/mL; P< or =.001) but normal CSF HVA and MHPG concentrations. Recovered BN women had an anxious and disorganized behavioral response to m-CPP but a normal hormonal response. CONCLUSIONS: Persistent serotonergic and behavioral abnormalities after recovery raise the possibility that these psychobiological alterations might be trait-related and contribute to the pathogenesis of BN.

Adolescent↗

A preliminary study of factors associated with psychological adjustment and disease course in school-age children infected with the human immunodeficiency virus.

This study consisted of a longitudinal examination (baseline and approximately 2-yr follow-up) of factors associated with psychological adjustment in a sample of 24 school-age children infected with the human immunodeficiency virus (HIV). Measures of depression, anxiety, and self-concept were administered to the children, and measures of behavioral problems, social functioning, and negative life events were administered to the parents. Generally, psychological adjustment seemed stable, though a decrease in positive social self-concept over time was observed. Negative life events were significantly associated with greater adverse psychological and behavioral outcomes at both baseline and follow-up. An additional component to the study investigated factors associated with survival. Examination of an additional five children who died within 12 months of baseline indicated that they experienced significantly more adverse life events, were less resilient, and had greater disease progression. The sample size was small and requires that these findings be considered as preliminary and suggestive rather than conclusive.

Adaptation, Psychological↗