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Biomedical subjects

J Hunter

Publications and source records attributed to J Hunter.

At least 109 records · Page 6Linked to original sources
PubMed1995

The phallic child: its emergence and meaning in a clinical setting.

The nature of the drive toward forming and maintaining intense attachments with other human beings has been examined in the light of case material from the play therapy sessions of a ten-year-old boy. The primary question addressed concerns the relationship of the attachment drive to other drive systems. Freudian theory, object relations theory, and attachment theory present competing paradigms for understanding the relationship between the drives. The Freudian paradigm sees human attachment as derivative from other drives, especially the sexual drive. In developing his attachment theory, Bowlby broke from the classical Freudian view. He postulated attachment as a primary and autonomous drive. Object relations theory, by contrast, sees sexuality as one manifestation of a more fundamental drive that is intrinsically relationship seeking. Each of these traditions has contributed to our understanding of human reality. A careful examination of the clinical material, however, strongly suggests that a drive toward relationship is intrinsic to libidinal energy. It is therefore concluded that the understanding of the relationship between the drives based on object relations theory provides us with the most adequate framework within which to understand the clinical material.

Adoption↗
PubMed1994

Outcome of second line therapy in rheumatoid arthritis.

OBJECTIVES: To study the functional outcome in patients with rheumatoid arthritis (RA) who tolerate second line drug therapy for five years. METHODS: We enrolled into prospective controlled trials, 190 patients with rheumatoid arthritis who tolerated 'disease modifying' antirheumatic drug therapy for five years. Demographic data were recorded. Disease activity was measured every six months for two years and annually thereafter, using clinical and laboratory variables. Patient function was measured using the modified Health Assessment Questionnaire. The change in each variable was analysed using paired Wilcoxon tests. RESULTS: Patient function improved significantly compared with baseline. The improvement was maximal after one to two years, and thereafter function started to decline slowly. After five years of treatment the patients' function was still significantly better than before treatment had started. There were highly significant improvements in all variables measured to assess disease activity, which remained well controlled throughout the five year period. CONCLUSION: Good control of disease activity and improved function can be achieved long term in approximately 30% of RA patients treated with injectable gold, sulphasalazine or penicillamine.

Adult↗
PubMed1994

Medical considerations and practice guidelines for the neonatal occupational therapist.

Provision of safe and effective occupational therapy in neonatal intensive care units requires an understanding of neonatal medical conditions and treatment modalities. This article explains basic medical concepts and technology with terminology frequently encountered in neonatal intensive care. Discussions of neonatal thermoregulation, respiratory care, hemodynamic monitoring, and metabolic support are presented as general areas of focus. Equipment usage and precautions are included. Several case studies illustrate the incorporation of medical knowledge into neonatal occupational therapy practice.

Abnormalities, Multiple↗
PubMed1994

The class of '93....

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1994

Preserved cardiac performance with reduced left ventricular mass in conscious exercising spontaneously hypertensive rats.

OBJECTIVES: To investigate whether cardiovascular performance can be modified beneficially with left ventricular hypertrophy reversal and whether the associated sudden afterload increases may adversely affect overall cardiac performance. METHODS: We studied cardiovascular performance with thermodilution techniques at rest and during maximal treadmill exercise after 3 weeks' treatment with the angiotensin converting enzyme inhibitor quinapril (3 mg/kg per day) in 19 male spontaneously hypertensive rats (SHR) aged 20 weeks. RESULTS: Left ventricular mass was reduced significantly, without impairment of exercise performance, demonstrating that left ventricular hypertrophy reversal benefited or at least did not hinder cardiovascular adaptation to physiologic exercise in the SHR. Moreover, decreasing the afterload did not further improve the performance after the reversal of left ventricular hypertrophy.

Animals↗
PubMed1994

The effect of life domains on girls' possible selves.

Adopting a framework of "possible selves," this paper examines the relative importance of life domains by exploring the suggestion that women's work orientation can be identified as careerist, adaptive or home-centered, and that the choices women make about employment are made relatively early (Hakim, 1991). Sixth-form grammar school girls (N = 240) taking advanced level subjects were categorized as careerist or noncareerist, and differences between the two groups in terms of attainment, subject choice, attitudes toward career and family, interests and confidence in traditional and nontraditional occupations, and psychological variables such as general self-efficacy, sex-role orientation, person/object orientation, scholastic competence, autonomy, and self-worth were examined. It is suggested that work orientation and the importance of life domains may be useful factors to consider in girls' possible selves and may add to the wide-ranging debate as to why girls are underrepresented in the higher status, higher earning occupations.

Adolescent↗
PubMed1994

Analysis of surgical movements during suturing in laparoscopy.

Laparoscopic suturing is now recognized as a necessary component of minimally invasive surgery. Until recently it has been avoided due to the lack of proper instrumentation and systematic technique. The principles of magnified surgery are discussed as they apply to the laparoscopic field, with emphasis on visual perception, economy of motion, choreography of movements, and "flawless technique". The principles and techniques of needle loading, handling, and driving are presented, as are the series of movements involved in tying an intracorporeal square-slip knot.

Equipment Design↗
PubMed1993

Transepithelial secretion, cellular accumulation and cytotoxicity of vinblastine in defined MDCK cell strains.

Transepithelial vinblastine secretion in two defined MDCK strains displays saturation kinetics; (Strain 1) Km = 2.8 +/- 0.6 microM (six experiments), Vmax 35.9 +/- 1.93 pmol/cm2 per h (six experiments), Strain 2 Km 0.78 +/- 0.36 microM (three experiments), Vmax 12.1 +/- 4.5 pmol/cm2 per h (three experiments). Concentrations of vinblastine > 1 microM are associated with an increased passive vinblastine permeability (PA-B). This correlates with an increased transepithelial conductance/decreased permselectivity, suggesting that this may in part result from increased paracellular conductance. Verapamil inhibits vinblastine secretion, half-maximal inhibition of basal-to-apical flux (JB-A) is observed at 3.4 +/- 0.3 and 1.7 +/- 0.05 microM verapamil for Strain-1 and Strain-2 epithelial layers, respectively. Cellular accumulation of vinblastine across the apical membrane is small with respect to that across the basolateral surfaces. This polarity is unaffected by verapamil. The apical membranes, therefore, possess a low intrinsic permeability to vinblastine. Inhibition of cell growth by vinblastine is enhanced by verapamil. Both the effect of vinblastine, and its enhancement by verapamil, upon cell growth are reduced as initial cell seeding density increases.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1993

Functional expression of P-glycoprotein in apical membranes of human intestinal Caco-2 cells. Kinetics of vinblastine secretion and interaction with modulators.

The functional expression of P-glycoprotein has been studied in confluent epithelial layers of human Caco-2 cells, a polarized, highly differentiated cell line demonstrating an intestinal absorptive cell phenotype. Expression of P-glycoprotein was localized, by indirect immunofluorescence with monoclonal antibody MRK16, to the apical brush-border, approximately 20 microns above the base of the cells. Functional, high capacity expression of P-glycoprotein in Caco-2 cell layers was demonstrated by the saturable secretion of vinblastine, a typical substrate, from basolateral to apical surfaces: Km 18.99 +/- 5.55 microM, Vmax 1285.9 +/- 281.2 pmol.cm-2 h-1. The direct correlation of apical P-glycoprotein expression with vinblastine net secretory flux was demonstrated by the reduction of this flux after treatment with MRK16 antibodies. Vinblastine secretory flux was also reduced by treatment with verapamil (R- and S-isomers with equal affinity), nifedipine, taxotere, and 1,9-dideoxyforskolin. Kinetic analyses suggest that the inhibition of vinblastine secretory flux by verapamil and nifedipine was competitive, while that by dideoxyforskolin was non-competitive, in nature. The polarized expression and activity of P-glycoprotein in Caco-2 cells is direct evidence for its secretory detoxifying function in the intestine, subserving at least one role of the gastrointestinal epithelial barrier.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1993

Drug absorption limited by P-glycoprotein-mediated secretory drug transport in human intestinal epithelial Caco-2 cell layers.

The hypothesis was tested that the operation of an ATP-dependent export pump localized at the apical (brush border) surface of the intestinal epithelium may limit substrate absorption kinetics. Human intestinal Caco-2 cell-layers display saturable secretion of vinblastine from basal to apical surfaces (Km, 18.99 +/- 5.55 microM; Vmax, 1285.9 +/- 281.2 pmol cm-2 hr-1) that is inhibited by verapamil, consistent with the expression of the ATP-dependent P-glycoprotein drug efflux pump at the apical brush border membrane. Inhibition of P-glycoprotein by a variety of modulators (verapamil, 1,9-dideoxyforskolin, nifedipine, and taxotere) is associated with an increased vinblastine absorptive permeability. Vinblastine absorption displayed a nonlinear dependence upon luminal (apical) vinblastine concentration, and vinblastine absorption increased markedly at concentrations where vinblastine secretory flux was saturated (> 20 microM). Upon inhibition of P-glycoprotein by verapamil and 1,9-dideoxyforskolin, vinblastine absorption increased and was linearly dependent on vinblastine concentration. The limitation of P-glycoprotein substrate absorption by active ATP-dependent export via P-glycoprotein is discussed, together with the possibility that other classes of substrate may be substrates for different ATP-dependent export pumps.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1993

Mental health aspects of HIV infection.

Of the multiple causes of mental disturbance in HIV infection, it is generally safest to consider organic causes first, including opportunistic infections, tumours, medications, and HIV encephalopathy. The psychological stress of the illness will cause different or overlapping presentations that include anxiety and depression. When managing these situations, one should also pay attention to the effects of stress on the social network of the infected person.

AIDS Dementia Complex↗
PubMed1993

Combination therapy in rheumatoid arthritis--no benefit of addition of hydroxychloroquine to patients with a suboptimal response to intramuscular gold therapy.

OBJECTIVE: To determine if there is any advantage in adding hydroxychloroquine to intramuscular gold therapy in patients with rheumatoid arthritis (RA) with a suboptimal response to gold after 6 months of treatment. METHODS: Prospective double blind placebo controlled study at the Centre for Rheumatic Diseases, Glasgow Royal Infirmary and Gartnavel General Hospital, Glasgow. Patients--440 patients with RA began intramuscular gold therapy. One hundred forty-two patients with a suboptimal response at 6 months were randomized to receive additional treatment with hydroxychloroquine (400 mg/day) or placebo, and followed for a further 6 months. Outcome measures were erythrocyte sedimentation rate, C-reactive protein, Ritchie articular index, grip strength, visual analog pain score, duration of morning stiffness, health assessment questionnaire, and rate of side effects. RESULTS: There was no difference in outcome in terms of efficacy or toxicity. CONCLUSION: There is no justification for using a combination of intramuscular gold and hydroxychloroquine in patients with RA with a partial response to gold.

Arthritis, Rheumatoid↗
PubMed1992

Polarized efflux of 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein from cultured epithelial cell monolayers.

We have investigated the polarity of the efflux of the intracellular pH fluorochrome 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF) from layers of epithelial Madin-Darby canine kidney (MDCK, Strains I and II) and human intestinal (Caco-2, HCT-8 and T84) cells grown on porous membranes. In Strain I MDCK cells, BCECF efflux was effectively reduced by indomethacin (50% inhibition with 100 microM) and 5-nitro-2-(3-phenylpropyl-amino)-benzoate (NPPB; 50% inhibition with 10 microM). Replacement of external Cl- with bromide, iodide or nitrate did not alter BCECF efflux, while substitution with methanesulphonate resulted in a small but significant reduction. All five cell lines form confluent epithelial layers when grown on porous membranes. Efflux of BCECF from Strain I MDCK epithelial layers into the apical solution was approximately three times greater than into the basal solution. Addition of indomethacin to the apical solution attenuated efflux into the apical but not the basal solution, while basal indomethacin was effective against basal efflux. NPPB has a similar specificity of action. Adrenaline, a stimulant of electrogenic Cl- secretion, did not alter the pattern of BCECF efflux. BCECF efflux was also polarized, with apical efflux greater than basal efflux, in MDCK Strain II and Caco-2 epithelial layers. In contrast, BCECF efflux into the basal and apical media was equivalent in layers formed from HCT-8 and T84 cells. However, indomethacin reduced efflux in all five epithelial lines, although the relative sensitivities of the apical and basal efflux rates to indomethacin varied, as did the sensitivity to the sidedness of application of indomethacin. In MDCK and HCT-8 epithelial layers, transepithelial vinblastine secretion mediated by P-glycoprotein was not inhibited by indomethacin. The data are consistent with the hypothesis that BCECF efflux is a manifestation of a novel ATP-dependent xenobiotic secretory efflux mechanism in renal and gastrointestinal epithelia. The factors regulating the polarity of BCECF efflux, both the indomethacin-sensitive and -insensitive components, have yet to be elucidated.

Animals↗
PubMed1992

Volume-activated Cl- secretion and transepithelial vinblastine secretion mediated by P-glycoprotein are not correlated in cultured human T84 intestinal epithelial layers.

The relationship between the P-glycoprotein-mediated vinblastine secretion and cell-swelling activated Cl- secretion (conductance) in intact epithelial layers of human colonic adenocarcinoma T84 cells has been investigated. Whereas vinblastine secretion is effectively inhibited by 100 microM 1,9-dideoxy-forskolin, volume-stimulated Cl- secretion is unaffected. In contrast, 100 microM 4,4'-diisothiocyanostilbene-2,2'-disulphonic acid (DIDS) inhibited the volume-stimulated Cl- secretion, but was without effect upon transepithelial vinblastine secretion. In addition, it was noted that some epithelial layers failed to express a volume-stimulated Cl- secretion but maintained a normal level of secretory vinblastine flux.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1992

Plasma membrane water permeabilities of human oocytes: the temperature dependence of water movement in individual cells.

Membrane water permeability values were measured in individual fresh human pre-ovulatory oocytes using real time microscopy in a microscope diffusion chamber. The cells were exposed to anisosmotic conditions, their volume responses measured, and from these data the Lp values were computed employing the Kedem-Katchalsky analyses of irreversible thermodynamics. Lp values were measured at four temperatures for each oocyte between 37 degrees C and 10 degrees C, and the temperature-related Arrhenius activation energy (Ea) calculated. It was apparent that individual oocytes exhibited a wide range of Lp values; at 37 degrees C Lp values ranged between 0.33 and 1.80 microns/atm/min. However, each oocyte exhibited the expected inverse linear correlation between Lp and temperature, with high linear correlations (R2 values between 0.73 and 0.96). A mean value for Ea of 8.61 +/- 5.11 Kcal/mol was computed. It is apparent that pre-ovulatory human oocytes express a range of biological diversity in terms of membrane water transport, and this fact needs to be considered when attempting to formulate cryopreservation protocols for storage of these oocytes.

Cell Membrane Permeability↗