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Biomedical subjects

P Lane

Publications and source records attributed to P Lane.

At least 55 records · Page 3Linked to original sources
PubMed1996

An evaluation of patient outcomes comparing trauma team activated versus trauma team not activated using TRISS analysis. Trauma and Injury Severity Score.

OBJECTIVE: The purpose of this study was to compare the outcomes of trauma patients with an Injury Severity Score (ISS) > 12 who had the trauma team involved (TTA) in their resuscitative care to those that did not (TTNA). SETTING: Level I regional trauma center teaching hospital with university affiliation. METHODS: All trauma patients admitted between July 1, 1991 and August 31, 1994 with an ISS > 12 were identified through the trauma registry. Burn patients, those who suffered their injury > 24 hours before admission, and deaths in the emergency room were excluded from analysis. The TRISS methodology, which offers a standard approval for evaluating outcomes for different populations of trauma patients, was used to determine whether there was a difference in outcomes between the two groups. To include patients who arrived at the trauma center intubated, a Trauma and Injury Severity Score (TRISS)-like analysis was also conducted on this patient population. MAIN RESULTS: A total of 640 patients were identified; 174 (65.2%) in the TTA group and 223 (34.8%) in the TTNA group. A total of 448 (70%) were eligible for TRISS analysis and 574 (89.7%) were eligible for TRISS-like analysis. Using the TRISS analysis, the TTA group had a Z statistic of 3.36 yielding a W score of 4.27. This compared to the TTNA group whose Z statistic was 0.30. Using the TRISS-like logistic regression equation, the TTA group had a Z statistic of 6.50, yielding a W score of 8.60 compared with the TTNA group whose Z statistic was 0.88. After controlling for differences in the demographics of the two groups, the TTA still had consistently higher Z scores. CONCLUSION: In a Level I trauma center, the outcomes of trauma patients with an ISS > 12 are statistically significantly better if the trauma team is activated than if the patients are managed on an individual service-by-service basis.

Adult↗
PubMed1996

Sociology and nursing.

Changes in society and in patterns of disease have led to changes in nursing practice and nurse education. Sociology can expand nurses' understanding of patients' needs in the context of the social environment.

Holistic Nursing↗
PubMed1995

Economic hardship has put Nicaragua's health care system on the sick list.

Since Nicaraguans elected a conservative government to replace the Sandinistas in 1990, hospitals and health clinics have seen their budgets slashed and staff cut, and medical supplies have grown scarce. The poor are dying of treatable illnesses such as pneumonia and other respiratory infections, and malnutrition and mortality rates are rising. This report from the Central American country outlines how economic hardship has taken its toll on Nicaragua's health system in the 1990s.

Delivery of Health Care↗
PubMed1995

CD40 ligand-independent B cell activation revealed by CD40 ligand-deficient T cell clones: evidence for distinct activation requirements for antibody formation and B cell proliferation.

We report the capacity of CD40 ligand (CD40L)-negative T cell clones to activate human B cells. CD40L-negative T cells induce a level of B cell proliferation 10-20% of that seen with normal T cells. The signal provided by the negative clones is synergistic with that derived from a CD40L transfectant, and restores B cell proliferation to normal levels, showing that CD40L-negative T cell clones are not inherently inhibitory for B cells. Although their capacity to induce proliferation was much reduced, CD40L-negative T cell clones were still strong inducers of B cell differentiation to plasma cells. This differentiation to plasma cells was inhibited by a CD40L transfectant. The data are discussed with regard to the normal in vivo mechanism for maintaining B cell memory and memory antibody responses to T-dependent antigens.

Antibody Formation↗
PubMed1995

Jimpy 4J: a new X-linked mouse mutation producing severe CNS hypomyelination.

This study describes a new sex-linked myelin mutation in the mouse, jimpy 4J (Plpjp-4J), located in or very close to the proteolipid protein (Plp) gene. The Plpjp-4J/Y phenotype includes tremor, seizures, death during the 4th postnatal week, and the most severe central nervous system hypomyelination yet described in any mouse carrying a single myelin mutation. The few myelin sheaths are present in early myelinating areas where they form clusters of thin, usually loosely wrapped membranes which show several variations of morphology at their extracellular leaflets. Numbers of mature oligodendrocytes are sharply reduced; pycnotic glial nuclei and foamy cells are numerous. Astrocytosis is a prominent feature. No PLP protein is detected by immunoblotting in Plpjp-4J/Y brain but in spinal cord a faint band is present. Myelin basic protein and characteristic myelin lipids are also sharply reduced in both brain and spinal cord. Despite the qualitative similarity of the phenotypes reported in these and previous studies, DNA analysis demonstrate that Plpjp-4J is not a recurrence of the well known Plp mouse mutations jimpy (Plpjp) or myelin synthesis deficiency (Plpjp-msd).

Animals↗
PubMed1995

A molecular basis for T-dependent B cell activation.

This review has concentrated on the key molecules which regulate T-dependent B cell activation in the context of the structural architecture within secondary lymphoid tissue where B cell immune responses occur. CD40L clearly plays a key role in driving B cells to proliferate within germinal centers, and although the data is conflicting, there is some evidence that the induction of CD40L is dependent on costimulation through CD28.

Animals↗
PubMed1994

Mice transgenic for a soluble form of murine CTLA-4 show enhanced expansion of antigen-specific CD4+ T cells and defective antibody production in vivo.

CD4+ T cell responses were analyzed in transgenic mice expressing a soluble form of murine CTLA-4, mCTLA4-H gamma 1, which blocks the interaction of the T cell activation molecules CD28 and CTLA-4 with their costimulatory ligands. Consistent with previous reports (Linsley, P. S., P. M. Wallace, J. Johnson, M. G. Gibson, J. L. Greene, J. A. Ledbetter, C. Singh, and M. A. Tepper. 1992. Science (Wash. DC). 257:792), T cell-dependent antibody production was profoundly inhibited in mCTLA4-H gamma 1 transgenic mice immunized with a protein antigen. Surprisingly, however, transgenic mice could generate quantitatively and qualitatively normal primary T cell responses, as measured by limiting dilution assays and lymphokine production. In addition, in vivo expansion of antigen-specific T cells after secondary or tertiary immunization was enhanced in mCTLA4-H gamma 1 transgenics as compared with normal mice. Although unable to deliver cognate help to B cells in vivo, T cells from mCTLA4-H gamma 1 transgenic mice were not anergic as they could help B cells to produce specific antibodies when adoptively transferred into nude hosts. Taken together, these data suggest that the engagement of CD28 and/or CTLA-4 may not be required for the induction of T cell responses, as is currently understood, but rather for the expression of T cell effector function such as the delivery of T cell help to B cells.

Abatacept↗
PubMed1994

B cell function in mice transgenic for mCTLA4-H gamma 1: lack of germinal centers correlated with poor affinity maturation and class switching despite normal priming of CD4+ T cells.

This report outlines the B cell phenotype of transgenic mice that overexpresses the mouse CTLA-4-human gamma 1 (mCTLA4-H gamma 1) protein. Despite the fact that these mice prime CD4+ T cells (Ronchese, F., B. Housemann, S. Hubele, and P. Lane. 1994. J. Exp. Med. 179:809), antibody responses to T-dependent antigens are severely impaired. In contrast, T-independent responses are normal which suggests mCTLA4-H gamma 1 does not act directly on B cells, but acts indirectly by impairing T cell help. The impaired antibody defect is associated with impaired class switching, with low total immunoglobulin (Ig)G and antigen-specific IgG responses, and an absence of germinal center formation in spleen and lymph nodes but not gut-associated tissues. The defective germinal center formation is associated with a reduction in the degree of somatic mutation in hybridomas made from transgenic mice in comparison with those made from normal mice. It seems likely that mCTLA4-H gamma 1 exerts its effect by blocking an interaction between T and B cells that induce T cell help for B cells.

Abatacept↗
PubMed1994

Professional presentation of antigen by activated human T cells.

Activated human T cells express class II molecules, but their capacity to present soluble antigens and stimulate T cells has been repeatedly questioned. Two lines of evidence indicate that T cells may indeed function as professional antigen-presenting cells. First, T cells that have been recently activated can efficiently capture, process and present tetanus toxoid to class II-restricted T cell clones. This capacity correlates with the rate of class II synthesis. Second, activated T cell clones express high levels of B7, are powerful stimulators in mixed lymphocyte reactions, and their stimulatory capacity is inhibited by soluble CTLA4 or anti-B7 antibody. Furthermore, expression of B7 can be detected in vivo on T cells from biopsies of patients with liver disease. Presentation of soluble antigen by activated T cells may play a role in the amplification of the specific response, and possibly in immunopathological states.

Antigen-Presenting Cells↗
PubMed1994

Psychiatric problems experienced by primary care patients who misuse alcohol.

Of 1936 primary care patients screened using the alcohol portion of the Diagnostic Interview Schedule, 100 met criteria for "alcohol abuse and/or dependence." Sixty of the individuals who misused alcohol were matched to 60 who did not. All 160 patients answered questions about psychiatric symptoms and psychotropic drug use. The lifetime prevalence of depression, suicidal thoughts, suicidal attempts, violent behavior, and trouble concentrating was consistently higher for those who misused alcohol. Depression and trouble concentrating were more likely to be experienced by alcohol misusers during the past month. Gender differences were also noted for prevalence of psychiatric symptoms.

Adult↗
PubMed1993

Soluble CD40 ligand can replace the normal T cell-derived CD40 ligand signal to B cells in T cell-dependent activation.

We have constructed a soluble chimeric fusion protein between the mouse CD8 alpha chain and the mouse CD40 T cell ligand. This protein binds to both human and mouse B cells. By itself it induced a modest degree of B cell proliferation, but together with anti-immunoglobulin (anti-Ig) antibody it greatly stimulated B cell proliferation, as determined by both [3H]thymidine uptake and increase in cell numbers. These data are evidence that the CD40 ligand on T cells provides a signal that drives B cell proliferation. This signal is synergistic with that delivered by anti-Ig antibody.

Animals↗
PubMed1993

Blunt cardiac trauma: survival after bichamber rupture.

Rupture of cardiac chambers after nonpenetrating blunt thoracic trauma is being recognized with increasing frequency. Despite a high mortality rate, survival after repair of a single-chamber rupture is widely reported. Bichamber cardiac rupture is less frequent, and we report a patient who survived this injury.

Adult↗
PubMed1993

Using adult education techniques to teach--not to train--home care aides.

With much to learn in a short time, home care aide students need teachers to maximize learning by conducting a course that is student centered, the way home care is client centered. Standard adult education techniques emphasize recognizing the characteristics of adult learners; they also promote the self-respect of home care aides as they prepare for their increasing responsibilities.

Adult↗
PubMed1993

Expression and functional properties of mouse B7/BB1 using a fusion protein between mouse CTLA4 and human gamma 1.

We report the construction and expression of a fusion protein made from the extracellular portion of the mouse CTLA-4 gene and the constant region of human IgG1. This fusion protein behaves like an antibody to mouse B7/BB1, binding to activated B cells and purified dendritic cells. In addition, we found it to bind to activated T cells. The fusion protein interfered with the ability of antigen-pulsed antigen-presenting cells to induce proliferation of T-cell clones, although the degree of inhibition varied. These findings are discussed in the light of the physiological activation of T cells in secondary lymphoid organs.

Abatacept↗