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Biomedical subjects

K S Thompson

Publications and source records attributed to K S Thompson.

At least 55 records · Page 3Linked to original sources
PubMed1993

Training residents for community psychiatric practice: guidelines for curriculum development.

There is a critical need to recruit and retain more psychiatrists with the required skills and interest to work with seriously mentally ill and/or socially disadvantaged patients within organized programs in community settings. More residency training programs having the capacity to prepare psychiatrists for community practice can help to meet this need. A consensus definition of the clinical, administrative, consultative and academic areas of contemporary community psychiatric practice developed by the American Association of Community Psychiatrists is used to determine the goals of the training curriculum described in this paper. A comprehensive list of knowledge, skill, and attitude objectives, as well as suggestions for structuring clinical training assignments are provided as guidelines for curriculum development.

Adult↗
PubMed1993

A comparison of the effects of two putative diuretic hormones from Locusta migratoria on isolated locust malpighian tubules.

Previous work has shown that a peptide related to arginine vasopressin is present in the suboesophageal ganglion of the locust, Locusta migratoria. This peptide was determined to be an anti-parallel dimer of the nonapeptide Cys-Leu-Ile-Thr-Asn-Cys-Pro-Arg-Gly-NH2 and was reported to stimulate cyclic AMP production and fluid secretion in a combined Malpighian tubules and midgut preparation from locusts. For these reasons the peptide has been called the arginine-vasopressin-like insect diuretic hormone (AVP-like IDH). Recently, a second diuretic peptide (Locusta-DP), which is related to corticotropin releasing factor, has been identified: this is a potent stimulant of fluid secretion and cyclic AMP production by isolated locust tubules. Because water balance in insects is likely to be controlled by a cocktail of hormones acting on both Malpighian tubules and hindgut, this study directly compares the activity of these two peptides in fluid secretion and cyclic AMP production bioassays on one target organ, the isolated Malpighian tubule of Locusta migratoria. Locusta-DP was synthesised directly, whereas the dimeric AVP-like IDH was obtained by oxidation of a synthetic nonapeptide monomer. Products were separated by RP-HPLC and their structures unequivocally confirmed by enzymatic digestion, sequence analysis and electrospray mass spectrometry. We show that Locusta-DP causes strong stimulation of fluid secretion and cyclic AMP production, whereas the AVP-like IDH has no effect in either assay. These findings are discussed in the light of recent work on the anatomy and physiology of the vasopressin-like immunoreactive (VPLI) neurones in the suboesophageal ganglion of Locusta migratoria, the proposed source of the AVP-like peptide.

Amino Acid Sequence↗
PubMed1992

Correlation of filiform hair position with sensory afferent morphology and synaptic connections in the second instar cockroach.

An attempt is made to relate the distribution of filiform hairs on the cercus of the second instar cockroach, Periplaneta americana, to the morphology and patterns of synaptic connectivity of their afferents. We studied the most distal 25 of the 39 filiform hairs which are commonly present. Filiform afferent arborizations were stained by cobalt filling from the cell body in the cercus. Three fundamental arbor types were found, two similar to those of the first instar medial (M) and lateral (L) afferents, and a third, novel type. L-type arbors could be divided into four subtypes. The most obvious correlate of arbor type is the circumferential position of the hair on the cercus. The proximodistal position of the sensillum within each cercal segment is also a determinant of its arbor. By comparison of hair positions and afferent morphologies, we were able to ascribe homologies between the second instar hairs and members of adult longitudinal hair columns. The patterns of monosynaptic connections between afferents and giant interneurons (GIs) 1, 2, 3, 5, and 6 were determined by recording synaptic potentials in GIs evoked by direct mechanical displacement of individual filiform hairs. Latency from stimulus onset to the rise phase of the first excitatory postsynaptic potential (EPSP) was used as the criterion of monosynapticity. The EPSP amplitudes of the two original L and M afferents are halved in the second instar, in the absence of a significant decrease in GI input resistance. The other afferents can be divided into two basic classes: those which input to GI5 (M-type), and those which input to GI3 and GI6 (L-type). The former is correlated with a central or medial position, while the latter is associated with a group of afferents situated laterally on the cercus. In segments 3 and 4, input to GIs 1 and 2 also correlates with a medial cercal position, however, in the more proximal segments 5 and 6, afferents at all positions input to these interneurons. The occurrence of afferents of identical morphology and similar connectivity in equivalent positions in different segments suggests that each sensory neuron is determined by its two-dimensional position within a segment. The presence of afferents with the same morphology which display proximodistal differences in synaptic connectivity, and of other afferents which have M-type connectivity despite L-type morphology, means that anatomy is generally a poor predictor of synaptic connectivity.

Animals↗
PubMed1992

Homeless mentally ill or mentally ill homeless?

Mainstream psychiatry conceptualizes people who are homeless and mentally ill as distinct from other homeless persons because it is thought that their status stems from their mental disorder and the poor implementation of deinstitutionalization. The authors believe this dichotomy is illusory. They present data indicating that recent socioeconomic and political shifts contributed greatly to homelessness among all groups, regardless of mental illness; that those with and without mental illness have similar biographical and demographic profiles; that high levels of mental distress are common to all homeless persons; and that few mentally ill homeless persons require involuntary hospitalization. This perspective suggests novel responses that de-emphasize clinical solutions and focus on empowerment, consumerism, entitlement, community-level interventions, and closer alliances with other advocates for the homeless.

Ill-Housed Persons↗
PubMed1991

Localization of the carbohydrate response element of the rat L-type pyruvate kinase gene.

Pyruvate kinase is a major regulatory enzyme of glycolysis. Transcription of the L-type pyruvate kinase (L-PK) gene in rat liver is induced by feeding a carbohydrate-rich diet. To investigate the regulatory DNA sequences required for this response, primary hepatocytes were transfected with plasmids containing the 5'-flanking sequence of the rat L-PK gene fused to the chloramphenicol acetyltransferase (CAT) gene. Sequences from -4300 to +12 of the L-PK gene directed an increase in CAT activity when hepatocytes were switched from media containing 10 mM lactate to 25 mM glucose. Average induction was 17-fold (n = 13; S.E. = 2.9). Addition of fructose to the media also induced CAT activity. Carbohydrate regulation of the L-PK promoter was retained with 5'-deletions to -197, but constructs deleted to -96 were completely unresponsive. The 101-base pair fragment from -197 to -96 of the L-PK gene can confer carbohydrate regulation when fused in either orientation to the heterologous thymidine kinase promoter, thus defining a carbohydrate response element in this region. Expression of the transfected gene was regulated by insulin and glucagon in a pattern similar to that seen for the endogenous L-PK gene, suggesting that control of L-PK promoter activity was responsible for carbohydrate-mediated changes in L-PK mRNA production.

Animals↗
PubMed1991

Positional information determines the anatomy and synaptic specificity of cockroach filiform hair afferents using independent mechanisms.

Mutant first instar cockroaches (Periplaneta americana) with supernumerary filiform hair sensilla on their cerci were used to study the effects of cell body position on axonal morphology and synaptic connections. The wild-type cercus has two hairs, one lateral (L) and the other medial (M), each with an underlying sensory neuron. Silver-intensified cobalt fills show that the supernumerary lateral neuron (SIN) in the mutant has the same shape of arborization as L, and electrophysiological recording shows that it forms synaptic connections with the same subset of giant interneurons (GIs) as L in the terminal ganglion: GI3 and GI6. The supernumerary medial neuron (SuM) has the same axonal morphology as M and synapses with the same GIs as does M: ipsilateral GIs 1 and 2 and contralateral GIs 1, 2, 3, 5 and 6. In 0.1% of approximately 8000 animals screened, a supernumerary hair arose on the cercal midline (C hair). The C neuron sends its axon to the CNS in the same branch of the cercal nerve as the L and SIN, and has a similar arborization. However, the C neuron forms synapses with the same GIs as do M and SuM. Electron microscopy of horseradish peroxidase-injected neurons was used to confirm that the C afferent forms a monosynaptic connection to GI2. It was concluded that the position of the sensory neuron cell body does control its axonal morphology and synaptic connectivity, but that these characteristics are produced by independent mechanisms.

Animals↗
PubMed1991

The vasopressin-like immunoreactive (VPLI) neurons of the locust, Locusta migratoria. I. Anatomy.

Antiserum to arginine-vasopressin has been used to characterise the pair of vasopressin-like immunoreactive (VPLI) neurons in the locust. These neurons have cell bodies in the suboesophageal ganglion, each with a bifurcating dorsal lateral axon which gives rise to predominantly dorsal neuropilar branching in every ganglion of the ventral nerve cord. There are extensive beaded fibre plexuses in most peripheral nerves of thoracic and abdominal ganglia, but in the brain, the peripheral plexuses are reduced while neuropilar branching is more extensive, although it generally remains superficial. An array of fibres runs centripetally through the lamina-medulla chiasma in the optic lobes. Lucifer Yellow or cobalt intracellular staining of single VPLI cells in the adult suboesophageal ganglion shows that all immunoreactive processes emanate from these two neurons, but an additional midline arborisation (that was only partially revealed by immunostaining) was also observed. Intracellularly staining VPLI cells in smaller larval instars, which permits dye to reach the thoracic ganglia, confirms that there is no similar region of poorly-immunoreactive midline arborisation in these ganglia. It has been previously suggested that the immunoreactive superficial fibres and peripheral plexuses in ventral cord ganglia serve a neurohaemal function, releasing the locust vasopressin-like diuretic hormone, F2. We suggest that the other major region of VPLI arborisation, the poorly immunoreactive midline fibres in the suboesophageal ganglion, could be a region where VPLI cells receive synaptic input. The function of the centripetal array of fibres within the optic lobe is still unclear.

Animals↗
PubMed1991

The vasopressin-like immunoreactive (VPLI) neurons of the locust, Locusta migratoria. II. Physiology.

The two vasopressin-like immunoreactive (VPLI) neurons of the locust, Locusta migratoria, have cell bodies in the suboesophageal ganglion and extensive arborizations throughout the CNS. One of the two peptides responsible for AVP-like immunoreactivity is a vasopressin-related peptide with putative 'diuretic hormone' properties. These neurons also have FLRF-like immunoreactivity, probably due to the FMRF-amide-related peptide. SchistoFLRF-amide, isolated from Schistocerca gregaria. This peptide has cardioinhibitory activity and a dual potentiation/inhibition of slow motoneuron induced muscle-twitch tension. Although haemolymph AVP-like peptide titre fluctuates under various conditions, the mechanism that regulates neurohaemal release of this peptide is not understood. Very little is known of the release of SchistoFLRF-amide. We have used intracellular recording from VPLI neurons in vivo to reveal synaptic inputs that lead to changes in their level of spiking activity, and probably, release of both the AVP-like peptides and SchistoFLRF-amide. This pair of neurosecretory cells has a major, common excitatory input whose sustained rate of activity is inversely related to light intensity; VPLI spiking activity, driven by this input, is greater in the dark than in light. This input is from a pair of descending brain interneurons. Their light-sensitivity persists after ablation of compound eyes, optic lobes and ocelli, showing them to be part of an extra-ocular photoreceptor system. Attempts to record from, and individually stain, the descending neuron have been unsuccessful, although its axon location and diameter in the circumoesophageal connective have been determined. Possible locations for its cell body have been identified; one region, close to the pars intercerebralis, is known to be photosensitive in some insects. Mechanosensory stimuli also lead to brief increases in VPLI spiking activity via the descending interneuron, though this modality rapidly habituates. We detect no changes in VPLI spiking activity that consistently correlate with the osmolality of perfusion salines; such changes might have been expected from their previously proposed role in water homeostasis. Alternative roles for VPLI cells are discussed.

Animals↗
PubMed1991

Development of a special care unit for chronically critically ill patients.

Intensive care units (ICUs) are recognized as one of the most expensive services provided by hospitals. Within these ICUs are a growing population of patients whose stays are extensively prolonged because of complications or underlying chronic health conditions that are exacerbated by a critical illness. These patients can be described as "chronically critically ill" and are costly to hospitals both in terms of actual dollars and in terms of the burden of care to nurses and physicians. This article describes the creation of a special care unit (SCU) designed specifically to meet the needs of chronically critically ill patients. The SCU environment is composed of a physical design that accommodates limited technology and care aimed at family involvement and rehabilitation, a case management practice model, and a shared governance management model. This structure is in contrast to traditional ICU environments, which include physical layouts that allow for high technology and close monitoring of patients, a primary nursing delivery system, and a bureaucratic management model. A research project to compare the effects of the SCU with the effects of the traditional ICUs on nurse and patient outcomes is described.

Adult↗
PubMed1990

Specificity of filiform hair afferent synapses onto giant interneurons in Periplaneta americana: anatomy is not a sufficient determinant.

The synapses between the filiform hair sensory afferents and giant interneurons (GIs) 1-6 of embryonic and first instar cockroaches, Periplaneta americana, were used to investigate the role of neuronal anatomy in determining synaptic specificity. The pattern of afferent-to-GI synapses was first determined by intracellular recording of excitatory postsynaptic potentials (EPSPs). The lateral (L) axon synapses only with GIs 3, 4, and 6, while the medial (M) axon synapses with the contralateral dendrites of all six GIs but with the ipsilateral dendrites only of GIs 1, 2, and 4. The three-dimensional anatomy of the filiform afferents and GIs was determined by injection of cobalt. There is little anatomical segregation of the filiform afferents; consequently, there is no correlation between the anatomy of the GIs and their synaptic inputs. The M axon and ipsilateral GI3 were studied in more detail by light and electron microscopy. Despite the presence of an anterior M axon branch which loops around the ipsilateral GI3 neurite at a distance of 2 microns, no synapses are formed between them. This lack of synapses is not due to the presence of physical barriers. Investigation of filiform afferents and GIs in embryonic ganglia shows that at no stage are the afferents sufficiently separated for their anatomy to be an important factor in determining the specificity of the synaptic inputs of the GIs. It was postulated that two pairs of complementary cell surface labels would be sufficient to code for this specificity, and that, in GIs 3, 5, and 6, spatial differences in the expression of these labels allow the M axon to distinguish ipsilateral dendrites from contralateral.

Animals↗
PubMed1990

A historical review of the Madison model of community care.

The community-based mental health care programs developed by Stein, Test, and their colleagues in Madison, Wisconsin, have had a profound impact on the delivery of mental health services to the severely mentally ill. The authors trace the development of the model from its late-1960s emphasis on improving Mendota State Hospital and providing intensive post-discharge care through the phases of releasing patients early to the community, preventing hospitalization, providing continuous community care for young schizophrenics, maintaining difficult patients in the community, and organizing a system of care. Throughout its evolution the model has changed significantly in response to changing circumstances, reflecting the assertive adaptability of the approach. Program planners attempting to incorporate elements of the Madison model in their own settings must be aware of current pressures that are likely to force further adaptations.

Community Mental Health Services↗
PubMed1981

Comparison of fresh-frozen plasmas thawed in a microwave oven and in a 37 degrees C water bath.

Fresh-frozen plasma can be thawed rapidly in a microwave oven without loss of function of coagulation factors and with no adverse effects to the patients. In patients receiving fresh-frozen plasma thawed in a microwave oven, the prothrombin time was decreased by an average of 2.9 sec per unit, and the activated partial thromboplastin time was decreased by an average of 9.6 sec per unit, compared with decrease of 2.6 sec and 6.3 sec for patients receiving fresh-frozen plasma thawed in a water bath at 37 degrees C.

Blood Preservation↗
PubMed1976

A computer package to facilitate compliance with utilization review requirements.

The Cumberland County CMHC in Fayetteville, North Carolina, developed a series of computer programs to produce the information that is required by area regional utilization review committees. There is a total of eight programs. The first establishes a master file and prints out all the information that has been gathered on all the clients. The other seven programs retrieve various portions of the data stored in the master file. The system does not require elaborate in-house computer equipment. It is easy to operate and benefits clients by enabling clinical staff to spend less time on documentation and more time on direct treatment.

Community Mental Health Services↗
PubMedDate not supplied

Long-term outcomes of morbidly obese patients treated with gastrogastrostomy.

Long-term outcomes in 123 morbidly obese patients who had undergone gastrogastrostomy were studied to determine weight losses 19 to 47 months after surgery. Follow-up data were available for 84% (103) of the patients. Overall, 58% of these (60 of 103) had maintained losses of greater than or equal to 30% excess weight. Using a best case/worst case analysis, between 49% and 65% of patients had achieved losses of greater than or equal to 30% excess weight. Six patients had gained weight. Eighty-seven per cent of the patients reported increased or stable energy levels; job status was stable or improved for 95%; and 20% had been rehospitalized. Use of antihypertensive medication and use of insulin had decreased. Over two thirds (69%) of the patients stated they would recommend gastrogastrostomy to a friend, and 54% were either very satisfied or satisfied with the operation. Energy level and degree of satisfaction were related to amount of weight lost. Gastrogastrostomy achieved long-term moderate weight losses in three fifths of morbidly obese patients, without causing serious adverse health outcomes.

Body Weight↗
PubMedDate not supplied

Subclavian steal syndrome in anomalous connection of the left subclavian artery to the pulmonary artery in d-transposition of the great arteries.

Several reports have documented the occurrence of an isolated left subclavian artery in association with both tetralogy of Fallot and double-outlet right ventricle. In certain cases a congenital subclavian or pulmonary artery steal syndrome exists in which the left subclavian artery is connected to the main pulmonary artery via a ductus arteriosus. We describe a subclavian steal syndrome secondary to anomalous origin of the left subclavian artery from the pulmonary artery in d-transposition of the great arteries in a patient with Spondylocostal dysostosis (SCD). Cardiac anomalies are rare in SCD and this constellation of findings have not previously been described.

Coronary Vessel Anomalies↗