TENS in chronic angina.
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Angina Pectoris↗
Biomedical subjects
P Marshall
Publications and source records attributed to P Marshall.
Absence of close linkage between maternal genes for susceptibility to pre-eclampsia/eclampsia and HLA DR beta.
To test the possibility that maternally expressed susceptibility genes for pre-eclampsia/eclampsia are closely linked to the HLA region on chromosome 6 of the human genome, members of ten pedigrees with multiple cases of these disorders were typed for HLA DR beta restriction fragment length polymorphisms by means of TaqI digests. The data were analysed by the LIPED program to calculate lod scores, by several programs to detect potential heterogeneity of recombination fraction between pedigrees, and by the affected-sibling and the affected-pedigree-member methods. The results exclude close linkage. If the putative susceptibility genes lie on chromosome 6 they must lie at least 5 centiMorgans, and probably more, from the HLA DR beta loci. No indication of linkage at higher recombination fractions was found. The main maternally expressed genes affecting susceptibility to pre-eclampsia are not in the HLA region.
Adult↗
Adrenaline and nocturnal asthma.
OBJECTIVE: To determine whether the nocturnal fall in plasma adrenaline is a cause of nocturnal asthma. DESIGN: Double blind placebo controlled cross-over study. In the first experiment the nocturnal fall in plasma adrenaline at 4 am was corrected in 10 asthmatic subjects with an infusion of adrenaline after parasympathetic blockade with 30 micrograms/kg intravenous atropine. In the second experiment 11 asthmatic subjects showing similar variations in peak expiratory flow rate had the nocturnal fall in plasma adrenaline corrected by infusion before atropine was given. PATIENTS: Asthmatic subjects with a diurnal variation in home peak expiratory flow rate of greater than 20% for at least 75% of the time in the two weeks before the study. MAIN OUTCOME MEASURES: Peak expiratory flow rate and plasma adrenaline. RESULTS: Correction of the nocturnal fall in plasma adrenaline at 4 am to resting 4 pm levels did not alter peak expiratory flow rate either before or after parasympathetic blockade with atropine. CONCLUSION: A nighttime fall in plasma adrenaline is not a cause of nocturnal asthma.
Adult↗
"Just one more. . .!" A study into the smoking attitudes and behaviour of patients following first myocardial infarction.
A retrospective analysis of smoking behaviour among 43 smokers admitted to a Coronary Care Unit with their first Myocardial Infarction (M.I.) was conducted in order to describe factors which differentiated ex-smokers post M.I. from continued smokers. A multi-factorial questionnaire was devised to measure attitudes, health belief and social support. A significant difference in attitudes was identified. Health beliefs were also identified as a significant variable. In a re-examination of the Health Belief Model, the experience of the M.I. itself proved to be a prime motivator for smoking cessation, whilst emotional symptoms accounted for continued smoking. The implication for health education and the implementation of smoking cessation groups are discussed.
Attitude to Health↗
Calcium antagonists in hypertension.
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Calcium Channel Blockers↗
Molecular characterization by high resolution isoelectric focusing of the products encoded by the class II region loci of the MHC in humans. II. DP alpha and DP beta gene variants.
To characterize the molecular polymorphism of the DP alpha and DP beta gene products, the HLA-DP molecules expressed by more than 200 cell lines were individually immunoprecipitated by using the mAb B7/21 and their neuraminidase-treated DP alpha and DP beta chains analyzed in IEF gels. These cell lines, most of them from members of 32 families, allowed the definition, by segregation analysis, of the IEF patterns of the DP polypeptide chains encoded by 129 distinct haplotypes. Both DP alpha and DP beta chains display polymorphic IEF-banding patterns. Two DP alpha (A and B) and seven DP beta (A, B, C, D, E, F, and G) IEF variants were characterized. The DP alpha B variant was found in linkage disequilibrium with both DP beta B and DP beta D. Linkage disequilibrium was also encountered with alleles at the DR and DQ loci. Finally, the correlations between the IEF DP alpha and DP beta variants and the primed lymphocyte test-defined HLA-DP specificities were determined by using a panel of 24 primed lymphocyte test-typed cell lines.
Antibodies, Monoclonal↗
Twenty-six DR beta and 16 DQ beta chain IEF variants and their associated HLA-DR, HLA-DQ, and HLA-Dw specificities.
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Antibodies, Monoclonal↗
The clinical medical humanities program at Loyola University of Chicago.
The authors emphasize that an effective medical humanities program must be based on clinically oriented training. They then describe in detail such a program at Loyola University of Chicago Medical Center; the program consists of a four-year required curriculum that is clinically reinforced by having the students accompany attending physicians on rounds and is taught by faculty representing a wide range of disciplines in medicine and other fields. The paper offers several guidelines to the person or persons who would organize and direct a clinical medical humanities program, describes obstacles that the Loyola program faced when it was getting started, presents the purpose, focus, and curricular topics of the program, and discusses its future. The authors conclude that the use of the clinically oriented approach will continue to prevail in medical humanities teaching, both at Loyola and in medical humanities programs overall. This approach challenges good teachers to make their best efforts at reconciling their own disciplines with that of medicine; in this process, a new medical humanities discipline emerges that is not so much an application of the humanities to medicine as it is an evocation of humanities themes from the clinical encounter itself.
Chicago↗
Influence of plasma catecholamines on the lactate threshold during graded exercise.
This investigation examined the relationship among plasma catecholamines, the blood lactate threshold (TLa), and the ventilatory threshold (TVE) in highly trained endurance athletes. Six competitive cyclists and six varsity cross-country runners performed a graded exercise test via two different modalities: treadmill running and bicycle ergometry. Although maximal oxygen consumption (VO2 max) did not differ significantly for the cyclists for treadmill running and cycling (64.6 +/- 1.0 and 63.5 +/- 0.4 ml O2.kg-1-min-1, respectively), both TLa and TVE occurred at a relatively earlier work load during the treadmill run. The opposite was true for the runners as TLa and TVE appeared at an earlier percent of VO2max during cycling compared with treadmill running (60.0 +/- 1.7 vs. 75.0 +/- 4.0%, respectively, TLa). The inflection in plasma epinephrine shifted in an identical manner and occurred simultaneously with that of TLa (r = 0.97) regardless of the testing protocol or training status. Although a high correlation (r = 0.86) existed for the shift in TVE and TLa, this relationship was not as strong as was seen with plasma epinephrine. The results suggest that a causal relationship existed between the inflection in plasma epinephrine and TLa during a graded exercise test. This association was not as strong for TVE and TLa.
Adult↗
The rehabilitation of overuse foot injuries in athletes and dancers.
Overuse injuries in athletes and dancers provide a challenge to the diagnostic acumen and rehabilitative and preventive skills of the medical community. The challenge is intensified when the primary lesion is located in the foot, whose levers, arches, and pulleys are responsible for absorbing shock, as well as converting a mobile adapter into a rigid lever for propulsion. A thorough knowledge of these active and passive mechanisms is essential for the appropriate and expeditious management of overuse syndromes. Sports and dance medicine health practitioners must also explore and comprehend the kinesiology of the sports and/or dance activity prevalent among their clientele. Furthermore, in order to determine the etiology and make judicious recommendations, clinicians must familiarize themselves with the density and inclines of popular running and dancing surfaces within their referral area. Rehabilitation of the foot requires a multifaceted approach. Physical therapists dealing with these problems need to develop expertise in manual techniques, along with clinical competency in laser, electrical, and thermal modalities. Reduction of predisposing factors is of utmost importance in the successful management of overuse injuries, and often requires greater skill and attention than does the treatment of the primary lesion.
Athletic Injuries↗
Ultrastructural localization of molecular subtypes of immunoreactive neural cell adhesion molecule (NCAM) in the adult rodent striatum.
Neural cell adhesion molecule (NCAM) is a plasma membrane glycoprotein that is thought to mediate adhesion between neuronal elements and play an important role in neural development. Although NCAM has been found in the adult brain, as well as the developing brain, little is known about its function or ultrastructural distribution. A monoclonal antibody which was directed against embryonic (E15-E17) mouse brain and identified 180 and 140 kDa molecular weight forms of NCAM was used to examine the immunohistochemical localization of NCAM in the rodent striatum. Light microscopic results in the adult mouse and rat showed that most NCAM180,140 immunoreactivity was localized to the relatively small population of medium and large-sized aspiny interneurons of the caudate nucleus and to the majority of neurons in the globus pallidus. Ultrastructural analysis revealed that reaction product in aspiny somata was present in discrete, closely spaced patches of cytoplasm along the inner face of the plasma membrane and was also prominent in somatic protrusions which were frequently apposed to synapsing axons. Distal aspiny and pallidal dendrites containing NCAM180,140 received numerous synaptic inputs. Within caudate neuropil NCAM180,140 was also present in spines with thin necks and small spine heads which were postsynaptic to unlabeled axon terminals and in preterminal (unmyelinated) axons and terminal boutons that issued from myelinated bundles and formed asymmetric synapses with unlabeled dendritic spines. This study provides the first evidence in adult brain that NCAM180,140 varies in extent and location within neurons. The heterogeneous distribution of NCAM180,140 in neurons of the basal ganglia may be related to a number of functions such as maintaining or modulating the density and distribution of synaptic inputs and the formation of new contacts on dendritic spines.
Animals↗
Reducing emotional distress associated with childhood illness.
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Adolescent↗
Distribution of glucuronic acid-and-sulfate-containing glycoproteins in the central nervous system of the adult mouse.
The distribution of glucuronic acid-and-sulfate-containing carbohydrate (GSC) epitope recognized by two monoclonal antibodies, HNK-1 and 4F4, was studied by immunocytochemistry in adult mouse brain. Both antibodies recognized proteins ranging in molecular weight from 60 to above 250 kDa in Western blot but no glycolipid was recognized in the adult brain. With both light and electron microscopic study, two patterns of staining are observed: diffuse neuropil staining, and individual neuronal somata staining. The diffuse neuropil staining is concentrated in discrete anatomically defined areas. At the EM level, this immunoreactivity is associated with numerous dendrites or astrocytic processes. At cell somata, most of neurons are stained only at Golgi apparatus (type 2); however, a distinct population of cells showed membranous staining (type 1) as well. Type 1 membranous immunoreactivity is observed only in membrane adjacent to astrocytic processes. In the cerebral cortex, type 1 neurons are found in layers III and V-VIa of somatosensory cortex, but only in layers V-VIa in most other cortical fields. Other areas containing type 1 neurons include the globus pallidus, the thalamic reticular nucleus, the hippocampus, the deep cerebellar nuclei, and a majority of the primary sensory and motor nuclei in the brainstem. The subpopulation of type 1 neurons show an overlap in distribution and morphology with some GABA-containing cells.
Animals↗
Involvement of central alpha- and beta-adrenoceptors in the pressor response to electrical stimulation of the rostral ventrolateral medulla in rats.
1. Electrical stimulation of the C1 area of the rostral ventrolateral medulla in rats elicits an increase in mean arterial pressure (MAP). 2. This increase in MAP is attenuated by intra-hypothalamic and intracisternal administration of the non-selective beta-adrenoceptor antagonist (+/-)-propranolol and the beta 2-selective antagonist ICI 118551. 3. The selective beta 1-antagonist atenolol and (+)-propranolol, which is inactive on beta-adrenoceptors, did not alter the increase in MAP produced by stimulation of the C1 area. 4. The alpha 2-adrenoceptor antagonist idazoxan enhanced the effects of C1 stimulation on MAP when administered either into the posterior hypothalamus or intracisternally. 5. The results indicate that beta 2- and alpha 2-receptors both have a role in the mediation of the rise in MAP during stimulation of the C1 area and that the receptors involved are located both within the hypothalamus and the spinal cord.
Animals↗
C3 allotypes in pregnancy hypertension and eclampsia.
C3 allotyping has been performed on 424 Australian women, 203 with normotensive pregnancies, 161 with hypertensive noneclamptic pregnancies and 60 eclamptic women. The frequency of women heterozygous for 'rare' C3 alleles was 1% in the normotensive women and 3.7% in the hypertensive group. Three out of 25 (12%) of the women with proteinuric hypertension in pregnancy carried 'rare' C3 alleles. This suggested the hypothesis that pre-eclampsia/eclampsia is associated with a higher frequency of rare alleles. The sample of 60 eclamptic women collected to test the hypothesis had no rare alleles, refuting the hypothesis. The frequency of the common (C3F, C3S) alleles did not differ significantly between the three groups. We conclude that there is no evidence for any association between susceptibility to eclampsia and allotypes of the C3 complement component.
Complement C3↗
The rehabilitation of overuse foot injuries in athletes and dancers.
Overuse injuries in athletes and dancers provide a challenge to the diagnostic acumen and rehabilitative and preventive skills of the medical community. The challenge is intensified when the primary lesion is located in the foot, whose levers, arches, and pulleys are responsible for absorbing shock, as well as converting a mobile adapter into a rigid lever for propulsion. A thorough knowledge of these active and passive mechanisms is essential for the appropriate and expeditious management of overuse syndromes. Sports and dance medicine health practitioners must also explore and comprehend the kinesiology of the sports and/or dance activity prevalent among their clientele. Furthermore, in order to determine the etiology and make judicious recommendations, clinicians must familiarize themselves with the density and inclines of popular running and dancing surfaces within their referral area. Rehabilitation of the foot requires a multifaceted approach. Physical therapists dealing with these problems need to develop expertise in manual techniques, along with clinical competency in laser, electrical, and thermal modalities. Reduction of predisposing factors is of utmost importance in the successful management of overuse injuries, and often requires greater skill and attention than does the treatment of the primary lesion.
Athletic Injuries↗
Save your skin.
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Dermatitis, Occupational↗
Effect of fish oil concentrates on hemorheological and hemostatic aspects of diabetes mellitus: a preliminary study.
Fish oil concentrates (Max EPA) were given without other diet modification for eight weeks to five insulin-dependent diabetics and five healthy volunteers, in order to determine their effect on possible in vitro indices of thrombosis. Cholesterol, HDL, LDL, fasting blood sugar, hemoglobin A1c, platelet count, and the osmotic fragility of red blood cells were not significantly changed from baseline values after eight weeks of fish oil consumption. Serum triglyceride levels were lowered by the fish oil (diabetics 130 +/- 23 to 89 +/- 26 mg/dl: normals 107 +/- 16 to 57 +/- 5 mg/dl). Nine out of ten subjects required more arachidonic acid to aggregate their platelets, and six out of ten required more collagen. Whole blood viscosity at low shear rates was increased in diabetics before the fish oil ingestion, and was reduced both in normals and in diabetics after eight weeks of treatment. Before fish oil administration, the diabetics had higher levels of von Willebrand Factor (vWF) (208 +/- 31%) than did controls (117 +/- 26%). There was a statistically significant decrease of serum von Willebrand Factor both in diabetics (p less than 0.01) and in normals (p less than 0.05) after six weeks of treatment. Analysis of the multimeric composition of the vWF indicated that the vWF molecule was not altered. Addition of eicosapentaenoic acid (EPA) or crude fish oil to human umbilical cord endothelial cell cultures did not change vWF levels in the supernatant. Whether these changes in platelet aggregation, whole blood viscosity and vWF can actually be translated into an in vivo amelioration of the vascular complications in diabetes remains to be determined in a carefully controlled clinical trial.
Adult↗