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Biomedical subjects

P Marshall

Publications and source records attributed to P Marshall.

At least 91 records · Page 5Linked to original sources

Molecular characterization by high-resolution isoelectric focusing of the products encoded by the class II region loci of the major histocompatibility complex in humans. I. DR and DQ gene variants.

We describe a new approach to the analysis of the structural polymorphism of the DR beta, DQ alpha, and DQ beta polypeptide chains of human histocompatibility class II antigens. In comparison to conventional two-dimensional gel studies, this method provides sharper definition of the protein bands and side-by-side comparisons within the same gel, thereby permitting the detection of minor differences in the isoelectric points of the protein chains. Using this methodology we have analyzed the IEF polymorphism and the variability in the number of the DR beta chains encoded by different DR haplotypes. Twenty DR beta chain variants, which include the products of no less than two separate DR beta loci, have been thus far identified. Alleles at one of these loci are assumed to code for DR beta chains carrying the DR alloespecificities DR1, DR2, DR3, DR4, DR5, DRw6, DR7, and DR8. Alleles at a second DR beta locus encode DR beta chains that may be shared by serologically DR-different haplotypes and carry supertypic serologic specificities (i.e., DRw52 and DRw53). We also demonstrate here that the structural polymorphisms of the DQ alpha and DQ beta chains are more extensive than previously thought, report the characterization of 14 DQ beta variants, and define their relationship to the previously described DQw serologic specificities. In addition, we describe the class II haplotype associations observed for the different DR and DQ variants characterized.

Alleles↗

Human interleukin 2. Quantitation by a sensitive radioimmunoassay.

Using polyclonal and monoclonal antibodies to human recombinant IL-2 (rIL-2), we developed a sensitive radioimmunoassay (RIA) for quantitation of human IL-2. In this assay, microtitration plates pre-coated with an anti-rIL-2 monoclonal antibody (35H10), recognizing residues 59-72 of human IL-2, are incubated with serial dilutions of test samples. Captured IL-2 is quantitated by adding an affinity-purified rabbit anti-rIL-2 antibody followed by an 125I-labeled goat anti-rabbit IgG. Antibodies to chemically synthesized IL-2 peptides could replace the polyspecific rabbit anti-rIL-2 antibody as the second specific reagent in the assay. This configuration was more sensitive than others tested, approaching the level of detection of the conventional IL-2 bioassay, thus allowing detection of as little as 100-200 pg IL-2. Serum or plasma fluids, however, inhibited the assay, reducing its sensitivity by approximately 5-fold. This RIA correlated well with the conventional bioassay in measuring IL-2 levels in sera from IL-2-treated patients. This, and similar, RIAs may serve as a useful adjunct or alternative to the conventional IL-2 bioassay in detecting and quantitating human IL-2 in culture supernatants and clinical samples.

Animals↗

Increase in proliferation and cytotoxic cell development in human mixed lymphocyte cultures in the presence of very low concentrations of LPS: role of IL-1 and prostaglandin E2.

Lipopolysaccharide (LPS) added to human allogeneic mixed lymphocyte cultures (MLC), even at very low concentrations, increased the level of specific cytotoxicity that developed. Proliferation was also increased by LPS in MLC but no increase was detectable when the allogeneic stimulus was absent. LPS enhanced only low cytotoxic responses while having little effect on naturally high responses. Significant enhancement in cytotoxic response was found within the picogram-nanogram per milliliter range of concentrations of LPS and only when it was added at the initiation of cultures. This early action of low concentrations of LPS suggested that IL-1 was involved. Indeed, a supernatant from silica-treated human mononuclear cells containing IL-1 activity also enhanced cytotoxic and proliferative responses. Aside from increasing IL-1 secretion we also found that LPS significantly increased synthesis and secretion of PGE2 which had a selective inhibitory effect. Namely, addition of indomethacin or flurbiprofen to MLC further enhanced the cytotoxicity of LPS-treated but not that of untreated cultures without increasing the proliferative response. These results suggest a key role for macrophage-derived IL-1 and PGE2 in the regulation of proliferative and cytotoxic responses of T cells. They also suggest that very low amount of LPS may reach the immune system and contribute to the expression of cell-mediated immune responses.

Adult↗

The unreliability of nocturnal penile tumescence recording as an outcome measurement in the treatment of organic impotence.

We investigated the degree of congruence between outcome measures used to evaluate pharmacological treatment of impotence. After a comprehensive multidisciplinary assessment 17 patients were treated with an adrenergic blocker during an 8-week interval. Nocturnal penile tumescence recordings were made before treatment (as part of the assessment procedure) and at its conclusion. As part of a larger study the use of nocturnal penile tumescence monitoring has been examined as a possible outcome measure. Patient and partner self-reports also were used to evaluate treatment outcome. A comparison of patient and partner self-reports with nocturnal penile tumescence records showed little agreement between the 2 measures. These findings suggest that despite its intuitive appeal as an index of erectile function nocturnal penile tumescence recording is not a reliable index of therapeutic effectiveness. Furthermore, these findings lend support to the hypothesis that nocturnal penile tumescence and sexual erections may be separate phenomena, perhaps under the control of different mechanisms.

Adult↗

Evaluation of the urological assessment in impotence: findings with a new diagnostic rating scale.

We report the findings of a critical evaluation of urological assessment in impotence. Initially, a rating scale (Q scale) was developed, which included the individual elements of the urological assessment, such as testicular size, serum testosterone level and so forth. The items in the scale were derived from the files of patients with erectile dysfunction and were scaled according to predetermined categories. Following this, the rating scale was applied to 67 impotent patients in whom the etiology had been established clearly using criteria that were independent of the urological assessment (that is a psychiatric interview and nocturnal penile tumescence evaluation). Statistical analysis of the results indicated that the 2 diagnostic groups differed significantly on a number of the individual scale items. However, no single item by itself could be used as a reliable indicator of etiology. Further analysis indicated that when the items were considered in combination, rather than singly, etiology was identified correctly in 95 per cent of the patients in the sample. Replication of these findings in a cross-validation study will help to standardize the urological assessment and to promote the development of a common language to facilitate communication in this field.

Adult↗

Importance of electromyographic data in interpreting nocturnal penile tumescence.

The use of home monitoring of nocturnal penile tumescence has potential advantages if it can reliably replace full somnographic recording. However, little is known of the relationship between home monitoring and full somnographic recording. The present study compared 26 records from 13 patients. Each record was scored independently by two evaluators, and the results indicate that home monitoring can lead to overestimation of NPT and errors in etiologic diagnosis.

Adult↗

Developmental differences in Bender-Gestalt recall of children with learning and behavior problems.

To investigate the visual-memory ability of children referred for psychological evaluations of academic and/or behavior problems, 135 children were administered the Bender-Gestalt and then asked to reproduce as many designs from memory as they could. Analysis indicated that the number of designs recalled increased with age and Performance IQ but not Full Scale IQ. Results were discussed in terms of the importance of considering developmental level when evaluating children and the establishment of rough cut-off scores on recall of the Bender-Gestalt designs.

Adolescent↗

Diagnostic significance of penile erections during sleep.

The evidence for the validity of nocturnal penile tumescence as a means of differentiating between psychogenic and organic impotence is reviewed. Five necessary stages in the validation process are described, and the relevance of the research literature to each stage is examined. Problems and issues in the clinical application of NPT recording are discussed, including (1) the need to validate NPT against independent diagnostic criteria; (2) the high probability of misdiagnosis when the absolute magnitude of NPT is used to determine cause; and (3) the need for follow-up studies to establish that NPT can be of value in the diagnoses of those patients who do not clearly belong to either the psychogenic or organic categories. We conclude that further validation studies are required before the clinical utility of NPT can be determined.

Diagnosis, Differential↗

The role of nocturnal penile tumescence in differentiating between organic and psychogenic impotence: the first stage of validation.

A study was conducted to assess the validity of nocturnal penile tumescence (NPT) as a means of distinguishing between psychogenic and organic erectile failure (impotence). On the basis of independent clinical criteria, patients were assigned to one of four diagnostic categories--organic impotence, psychogenic impotence, mixed etiology, and uncertain etiology. The NPT characteristics of the patients in the organic and psychogenic groups were compared and decision rules formulated in order to provide optimal discrimination between the two diagnostic categories. A decision rule based on the maximum erectile response observed for each patient led to the correct diagnosis in 80% of cases. Accuracy was increased to 95% when a decision rule based on the maximum frequency of nocturnal erections was employed. The clinical value and limitations of NPT as a diagnostic procedure are discussed.

Adult↗

Unreliability of nocturnal penile tumescence recording and MMPI profiles in assessment of impotence.

The authors describe a multidisciplinary approach to the assessment of impotence that includes the recording of nocturnal penile tumescence and analysis of the patient's MMPI profile. Ten patients were studied who, on the basis of physical and psychiatric assessment, were identified as being organically or psychogenically impotent. In each case, the application of decision rules based on either nocturnal penile tumescence or the MMPI would have led to misdiagnosis.

Diagnostic Errors↗

Uranium.

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Australia↗