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Biomedical subjects

P Gray

Publications and source records attributed to P Gray.

At least 73 records · Page 4Linked to original sources

On transferred permissive or approving superego functions: the analysis of the ego's superego activities, Part II.

The author explores another major anxiety-relieving resistance, namely, the re-externalized and transferred fantasy of authority figures offering affectionate approval, with implicit permission for openness and disclosure. The conditions the patient experiences as safe for exposure of conflictual material are based on fantasy, not on a realistic sense of permission from analysis of resistance. Wider-scope therapeutic attention appears to create natural obstacles to an interest in the analysis of the ego's superego activities from which less vulnerable patients could benefit. The author presents clinical examples of the analysis of this second type of transference of defense and discusses the implications for unifying diverse theories.

Anxiety↗

Increased sensitivity to isoprenaline following digoxin pretreatment in anaesthetised and conscious dogs.

STUDY OBJECTIVE: The aim of the study was to evaluate the effect of chronic digoxin therapy on cardiac sensitivity to isoprenaline. DESIGN: Responses to isoprenaline were examined in both conscious and anaesthetised dogs pretreated with digoxin, and compared with conscious or anaesthetised controls with no digoxin pretreatment. Isoprenaline infusion (0.001-0.1 micrograms.kg-1.min-1) in pretreated groups was performed 7 d after digoxin dosing was stopped, when plasma digoxin concentrations were zero. SUBJECTS: Mongrel dogs of either sex (15-25 kg) were used in the experiments, done under anaesthetic. They were divided into three groups (n = 6 per group): group A were controls; groups B and C were pretreated with digoxin 500-750 micrograms.d-1, for 14 d (B) and 7 d (C). For the experiments in conscious animals, six mongrel dogs (25-30 kg) and two greyhounds (25-30 kg) were used; group D (n = 6) were treated with digoxin for 20-40 d; group E (n = 2) were treated for 7 d. MEASUREMENTS AND RESULTS: Heart rate, blood pressure and myocardial contractility (dP/dt: integrated isometric tension) were measured during isoprenaline infusion. Digoxin pretreatment for 14 d did not significantly change the chronotropic or depressor responses to isoprenaline in anaesthetised dogs but there was a 10-fold increase in inotropic sensitivity to isoprenaline following withdrawal. When the pretreatment period was reduced to 7 d there was no change in any of the responses to isoprenaline. In conscious dogs there was also a significant increase in inotropic sensitivity to isoprenaline after digoxin withdrawal, but this was not so marked as in anaesthetised dogs. In conscious dogs chronotropic sensitivity to isoprenaline was also increased. CONCLUSIONS: It is possible that the inotropic effect maintained during the 2 weeks of digoxin treatment may cause substantial withdrawal of sympathetic tone to the heart, with a consequent increase in beta adrenoceptor number or sensitivity, which could be detected a week after digoxin withdrawal.

Anesthesia, General↗

The nature of therapeutic action in psychoanalysis.

The nature of therapeutic action varies not only with each patient's psychological predilection for utilizing opportunities for change, but also with the manner in which the analyst or therapist presents opportunity for change. Ideally, the therapist bases the latter on personally identifiable theoretical concepts and aims. This inquiry focuses on a relatively narrow field of clinical material in order to provide as close as possible an examination of therapeutic action. The technical approach provides opportunities for change, minimizing alterations resulting from internalizing processes or suggestion. The therapeutic actions arise from analyst and patient sharing observations of the patient's intrapsychic activities of resistance to drive derivatives the patient briefly allowed into consciousness, and represent processes of ego maturation set in motion by intellectually gained and experientially exercised insights.

Adult↗

Ethanol effects on active Na+ and K+ transport in cultured fetal rat hepatocytes.

To define further the influence of ethanol on membranes, its effects on Na+ pump function were studied in monolayer cultures of fetal rat hepatocytes. The effects of ethanol (2 and 4 mg/ml) on total K+ influx, ouabain-sensitive K+ influx, Na+ pump density (from specific [3H]ouabain binding), pump turnover rates and intracellular Na+ were measured following exposure of the cells to ethanol for 1-24 hr. In parallel studies, the effects of ethanol (2 mg/ml) on cell water content and membrane fluidity were measured. Ethanol had no immediate effect on K+ influx, but after 1 hr ethanol in concentrations of 2 and 4 mg/ml decreased the total K+ influx (mumol/10(11) cells/sec) from a control of 8.5 +/- 0.64 to 4.46 +/- 0.50 and 4.09 +/- 0.26 respectively (N = 6 for each experiment; P less than 0.001). This represented the maximum effect of ethanol since after 6 and 24 hr of ethanol treatment the K+ influx had increased towards control levels but remained significantly (P less than 0.01 for 2 mg/ml and P less than 0.001 for 4 mg/ml) below that in control cells even at 24 hr. The decrease in K+ influx reflected a decrease in mean ouabain-sensitive K+ influx from a control of 5.87 to 3.24 and 2.70 (mumol/10(11) cells/sec) after a 1-hr treatment with 2 and 4 mg ethanol/ml medium respectively. Ethanol (2 mg/ml) treatment for 1-hr decreased Na+ pump density (x 10(5) molecules ouabain per cell) from a control of 2.80 +/- 0.30 to 1.70 +/- 0.11 (P less than 0.001). At 6 and 24 hr [3H]ouabain binding showed a pattern similar to that seen with the K+ influx, tending to return to pretreatment levels. There was no change in individual pump turnover rates in the presence of ethanol. Following exposure to ethanol, cellular Na+ content steadily increased over the first 6 hr and then returned to control levels. When corrected for parallel changes in cell volume, however, intracellular Na+ concentration increased by 17% (P less than 0.01) after 1 hr and thereafter remained at this higher level throughout the 24-hr period. Measurements of membrane fluidity showed that it was increased markedly by ethanol at a concentration of 2 mg/ml and that the effect bore a close temporal relationship to the changes in active K+ influx and Na+ pump density. We conclude that ethanol has a depressant effect on hepatic Na+ pump function, resulting in an increase in intracellular Na+ and an eventual gain in cell water.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

The effects of multivitamins and minerals on children with Down syndrome.

The effects of high-dosage multivitamin and mineral supplements on 15 children with Down syndrome aged between 7.5 and 63 months were studied in a placebo-controlled crossover trial. Active treatment was associated with decreased developmental progress, and various side-effects were reported by the parents. The only suggestions of benefit were parents' observations of improvement in general appearance and skin freshness. However, the parents were willing to continue using the treatment and to recommend it to other parents, despite the side-effects.

Child, Preschool↗

The structures of human C1r and C1s and their relationship to other serine proteases.

The recent sequencing of the C1 subcomponents has allowed comparison with other molecules of homologous primary structure. Where tertiary structures are available for at least one member of the family it is possible to make further progress by modelling the amino acid sequence of the complement protein into the three-dimensional coordinates of the directly determined structure, thereby obtaining an approximation of the structure of the complement protein. Molecular modelling allows structure-function relationships to be explored and suggests further experiments that may be amenable to techniques such as site-directed mutagenesis.

Amino Acid Sequence↗

Doing well with AIDS: three case illustrations.

This report focuses on the abilities of three people diagnosed with acquired immune deficiency syndrome (AIDS) to maximize their state of well-being. The purpose of this ongoing investigation is to identify factors that may help enhance AIDS patients' states of well-being, ultimately achieving the provision of holistic and life-giving nursing care. A naturalistic approach was used to generate an understanding of the concept, "doing well." Five themes regarding "doing well" with AIDS emerged from the interview data. These themes include: autonomy/mastery over the disease; existential/spiritual journey toward understanding; self-acceptance; staying active and involved; and positive thinking. Nursing implications of these themes are discussed.

Acquired Immunodeficiency Syndrome↗

Fear of AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

Clinical investigations into the modification of the effect of endogenous and exogenous insulin by human proinsulin in type II and type I diabetics.

The investigation on hand leads to the conclusion that HPRO can additively increase the blood glucose lowering effect of endogenous and exogenously administered insulin. Etiologically the prolonged retention time of HPRO in the circulation - compared to HI - must be primarily discussed. In the further course the question arises to what extent traditional retard insulins would have to be replaced or supplemented by HPRO.

Aged↗

Sequence analysis, cellular localization, and expression of a neuroretina adhesion and cell survival molecule.

A cDNA for purpurin, a secreted 20,000 dalton neural retina cell adhesion and survival protein, has been sequenced and expressed in mammalian cells. Purpurin mRNA is found in both embryonic and adult retina, but not the brain, heart, or liver. The protein is highly concentrated in the neural retina between the pigmented epithelium and the outer segments of the photoreceptor cells; it is synthesized by photoreceptor cells. The predicted purpurin sequence contains 196 residues, has approximately 50% sequence homology with serum retinol binding protein, and is a member of the alpha-2 mu-globulin superfamily. Purpurin binds retinol and may play a major role in retinol transport across the interphotoreceptor cell matrix.

Amino Acid Sequence↗

Evidence of beta cell dysfunction which does not lead on to diabetes: a study of identical twins of insulin dependent diabetics.

Ten non-diabetic identical twins of insulin dependent diabetics were studied to see whether they showed changes in insulin secretion. The twins were selected because more than 11 years had elapsed since the diagnosis of the diabetic twin and they were therefore unlikely to develop diabetes, and they had had islet cell antibodies. Despite similar glucose concentrations to the controls the twins had greater total immunoreactive insulin responses to both oral (mean 3280 (SD 699) versus 2338 (1110) pmol/dl at 180 minutes; p less than 0.05) and intravenous (1346 (690) versus 699 (294) pmol/dl at 30 minutes; p less than 0.05) glucose challenge. The C peptide responses to intravenous glucose were also increased consistent with increased insulin secretion. In addition, basal serum proinsulin concentrations in the twins were increased (2.1 (1.2) versus 1.0 (0.3) pmol/dl; p less than 0.01) and remained so throughout both tests. These twins, who were unlikely to develop insulin dependent diabetes, showed evidence of beta cell dysfunction which does not progress to diabetes.

Adolescent↗

Models for costing patient care services. Part 1: Costing diagnostic laboratory services.

Clinical Information Systems that link resource use to clinical decision making are a necessary tool for effective hospital management. This article describes the cost finding research undertaken to develop a model for costing laboratory tests. The method separately calculates direct labour and direct consumable costs and apportions indirect labour, indirect consumable costs and hospital and department overhead costs to each test in each accounting period. The costing model has been computerised as part of the Queen Victoria Medical Centre's Clinical Information System.

Accounting↗

On the technique of analysis of the superego--an introduction.

As a result of Freud's ambiguity (and that of later analysts) regarding the nature of the superego and how to treat it in clinical practice, it has taken many years and many theoreticians to move from Freud's predilection to use it for purposes of "suggestion" in overcoming resistance, toward the concept of the superego as part of the ego's hierarchically mobilized defensive activities in the analytical process. Although much ambiguity persists, an attempt is made here to reduce it so that analytical technique may move forward to allow the superego to be analyzed as an unconscious conflict solution.

Aggression↗