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Biomedical subjects

J H Stephens

Publications and source records attributed to J H Stephens.

11 recordsLinked to original sources

The interaction of RNA polymerase II with the adenovirus-2 major late promoter is precluded by phosphorylation of the C-terminal domain of subunit IIa.

Mammalian RNA polymerase II contains at the C terminus of its largest subunit an unusual domain consisting of 52 tandem repeats of the consensus sequence Tyr-Ser-Pro-Thr-Ser-Pro-Ser. The phosphorylation of this domain is thought to play an important role in the transition of RNA polymerase II from a preinitiation complex to an elongating complex. The unphosphorylated form of RNA polymerase II is designated IIA, whereas the phosphorylated form is designated IIO. In an effort to determine the consequence of C-terminal domain phosphorylation on complex formation, 32P-labeled RNA polymerases IIA and IIO were prepared and examined for their ability to form a stable preinitiation complex on the adenovirus-2 major late promoter in the presence of a reconstituted HeLa cell transcription extract. Preinitiation complexes were formed in the absence of ATP and purified from free RNA polymerase II by chromatography on Sepharose CL-4B. The state of phosphorylation of the largest subunit was monitored by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and the transcriptional activity was determined by assaying specific transcript formation upon the addition of nucleotides and a competing DNA template. RNA polymerase IIA was recovered in transcriptionally active complexes in reactions in which the input enzyme was RNA polymerase IIA. In reactions with RNA polymerase IIO as the input enzyme, no IIO was recovered in excluded fractions that normally contain preinitiation complex. In reactions with equimolar amounts of RNA polymerases IIO and IIA, purified preinitiation complexes contained almost exclusively RNA polymerase HA. These results support the idea that RNA polymerase II containing an unphosphorylated C-terminal domain preferentially associates with the adenovirus-2 major late promoter. The state of phosphorylation of the C-terminal domain can, therefore, directly influence preinitiation complex formation. We also report here the presence of an activity in HeLa cell extracts that catalyzes dephosphorylation of the C-terminal domain, thereby converting RNA polymerase IIO to IIA. This C-terminal domain phosphatase is specific in that it does not catalyze the dephosphorylation of a serine residue phosphorylated by casein kinase II. The presence of a C-terminal domain phosphatase in in vitro transcription reactions containing RNA polymerase IIO results in the formation of RNA polymerase IIA. This RNA polymerase IIA associates preferentially with preinitiation complexes.

Amino Acid Sequence

Characteristics and long-term follow-up of patients hospitalized for mood disorders in the Phipps Clinic, 1913-1940.

From a sample of 2809 mood disorder patients hospitalized between 1913 and 1940, we selected for detailed study 914 patients with at least a 5 year follow-up and 103 patients who committed suicide within 5 years of discharge. Patients with clearly mood incongruent delusions or an onset associated with a physical illness were excluded. Based on the presence or absence of manic symptoms, this cohort of 1017 cases was divided into 297 bipolar and 945 unipolar patients. Bipolar patients had an earlier age of onset and admission and were more likely to be delusional and hallucinated. They also had more sudden onsets, more previous admissions, worse premorbid characteristics, and more problems with alcohol, but more patients were discharged as recovered. Unipolar patients were more often female and married, more likely to have made previous suicidal attempts, and more likely to have experienced a precipitating event. On a mean follow-up of 13.5 years, only 11% of the bipolar and 22% of the unipolar patients experienced no further episodes of mania or depression. Of the bipolar group, 77% had to be rehospitalized, as did 56% of the unipolars. Only 2% of the sample had manic episodes with no lifetime depressions; this small group had the best outcome. One third of all the patients were rated unimproved on follow-up. Thirteen percent committed suicide, usually within 1 year of discharge. Bipolar patients had the worst outcome, with 43% rated unimproved. The sample was split by odd or even case number and one half was used to construct a prognostic scale significantly correlated with long-term outcome. It was cross-validated on the other half of the sample with little shrinkage. Patients with non-drug-treated affective disorders hospitalized half a century ago were found to have polyepisodic illnesses with a frequently chronic course.

Adult

Tunga penetrans.

We describe a patient who acquired tungiasis while traveling in an area where the condition is endemic. The pathogenesis, diagnosis, and treatment of this tropical disease are presented.

Adolescent

Inpatient diagnoses during Adolf Meyer's tenure as director of the Henry Phipps Psychiatric Clinic, 1913-1940.

Between 1936 and 1950, detailed abstracts were prepared on all patients admitted to The Phipps Psychiatric Clinic from its opening in 1913 through 1950. Of these abstracts, 74% contained follow-up reports. Except for four papers on schizophrenia and affective disorders published between 1939 and 1943, none of this material has ever been analyzed. The present paper, the first of a series, examines the 8172 first admissions from 1913 through 1940, the period of Adolf Meyer's tenure as Clinic Director. Based on discharge diagnoses, we have sorted the patients into eight diagnostic groups with the following frequencies; schizophrenia, 17%; paranoid state, 3%; manic-depressive, 7%; depression, 27%; organic, 20%; neuroses, 15%; substance abuse, 6%; psychopath, 5%. Our manic-depressive group contains cases discharged primarily as hyperthymergasia, mania, or manic depressive insanity (MDI). Of the 349 cases diagnosed MDI at discharge, 10 had neither a history of nor present symptoms of mania, and these were put in the depression group. Frequencies for most of the diagnoses remained remarkably stable over the 28-year period. Only 9% were discharged recovered, whereas 43% were rated unimproved. Mean length of hospitalization was 76 days, with 10% of the patients readmitted. The mean length of follow-up was 9 years. Correlations of diagnoses, year of admission, length of stay, condition at discharge, age, sex, readmissions, change of diagnoses, somatic treatment, length of follow-up, and deaths in the clinic are presented. Meyer's influence on diagnostic practice is discussed.

Biological Psychiatry

An attempted integration of information relevant to schizophrenic subtypes.

The usefulness and validity of traditional subtypes are questionable. The subtypes described in earlier years no longer emerge with the clarity previously described. The four classical subtypes cannot be reliably distinguished and have not been shown to have predictive validity. Subtypes classified along course or prognostic lines may be more clinically useful. Attempts to subdivide schizophrenia along biologic and genetic lines offer promise. Recent efforts to describe new subdivisions of schizophrenia are readily justified, but new descriptive subtypes are likely to prove useful only when validated by biological, genetic, treatment response, and outcome data.

Adult

Long-term prognosis and followup in schizophrenia.

The long-term course or natural history of schizophrenia is correlated with differing diagnostic criteria and commonly agreed upon prognostic variables. A review of 38 long-term followup studies of hospitalized schizophrenics reveals that unspecified or Kraepelinian-type schizophrenia has a much worse prognosis than atypical schizophrenia, schizoaffective psychosis, reactive psychosis, or other good premorbid types. Diagnoses based on longitudinal as well as cross-reactional data are more predictive of outcome than cross-sectionally based diagnoses. Drug and psychosocial treatment results must be evaluated in terms of prognostic variables, many of which are incorporated in some currently employed diagnostic criteria. There is no firm evidence that maintenance medication is indicated in some good prognosis patients. The paucity of long-range followups, the inadequacies of outcome assessments, and diagnostic disagreements limit our understanding of the effects of drug treatment, a treatment which is not without dangerous neurological side effects in many patients.

Antipsychotic Agents

The Edinburgh spleen: source of a validated Kveim-Siltzbach test material.

Although it is true that some Kveim-Siltzbach test suspension may for reasons unknown behave in a totally nonspecific way and so be useless in the confirmation of active sarcoidosis, the experience with the Edinburgh spleen has shown that it is also true that a preparation can be made which acts specifically in the sarcoid context and fulfils all the Siltzbach criteria. The active principle probably resides in the membrane components of sarcoid tissue cells.

Antigens

An optimum A-B scale of psychotherapist effectiveness.

On the basis of the original Whitehorn-Betz data collected over a 16-year period, it is shown that all previously derived A-B scales of psychotherapist effectiveness using Strong Vocational Interest Blank (SVIB) items are deficient in terms of correlation with the original criterion and, frequently, in terms of reliability as well. The reasons for these deficiencies are discussed, and a new experimental A-B scale is formulated and tested for adequacy. This scale is shown to possess substantial internal consistency reliability and to have a high degree of correlation with the criterion even after the removal of possible contaminating factors such as use ofancillary teatments, differences in patient prognosis, and changing practices and interest over time. It is further shown that none of the A-B scales has any validity with respect to female therapists in the original data pool. Exploration of the factor-analytic structure of this new scale and two other widely used A-B measures in terms of the occupationa scales of the SVIB reveals differential loadings on four dimensions labeled verbal/comceptual vs. manual/practical, scientific vs. sales, social concern, and artistic vs. business-oriented. It is concluded that although male therapists' scores on the best of the A-B scales may , under certain circumstances,be related to short term judged improvement in patients treated, there is little evidence that high scoring therapists are more likey than low scoring ones to have a favorable, long range impact on diagnosed schizophrenics.

Efficiency

Differential effects of person in the dog and in the human.

People have marked effects on dog's heart rate, with great individual variations for different persons. Apparently people to which the dog is attached have the greatest effect upon heart rate. Replications of the animal experiments using the psychotherapist and two other people revealed no effects upon the heart rate of a schizophrenic human. In the human the effects of people are probably best demonstrated in connection with verbal communication.

Animals