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Biomedical subjects

R Mulligan

Publications and source records attributed to R Mulligan.

At least 55 records · Page 3Linked to original sources

Mice lacking the gene encoding tissue-type plasminogen activator show a selective interference with late-phase long-term potentiation in both Schaffer collateral and mossy fiber pathways.

The gene encoding tissue-type plasminogen activator (t-PA) is an immediate response gene, downstream from CREB-1 and other constitutively expressed transcription factors, which is induced in the hippocampus during the late phase of long-term potentiation (L-LTP). Mice in which the t-PA gene has been ablated (t-PA-/-) showed no gross anatomical, electrophysiological, sensory, or motor abnormalities but manifest a selective reduction in L-LTP in hippocampal slices in both the Schaffer collateral-CA1 and mossy fiber-CA3 pathways. t-PA-/- mice also exhibit reduced potentiation by cAMP analogs and D1/D5 agonists. By contrast, hippocampal-dependent learning and memory were not affected in these mice, whereas performance was impaired on two-way active avoidance, a striatum-dependent task. These results provide genetic evidence that t-PA is a downstream effector gene important for L-LTP and show that modest impairment of L-LTP in CA1 and CA3 does not result in hippocampus-dependent behavioral phenotypes.

Animals↗

In vivo gene delivery and stable transduction of nondividing cells by a lentiviral vector.

A retroviral vector system based on the human immunodeficiency virus (HIV) was developed that, in contrast to a murine leukemia virus-based counterpart, transduced heterologous sequences into HeLa cells and rat fibroblasts blocked in the cell cycle, as well as into human primary macrophages. Additionally, the HIV vector could mediate stable in vivo gene transfer into terminally differentiated neurons. The ability of HIV-based viral vectors to deliver genes in vivo into nondividing cells could increase the applicability of retroviral vectors in human gene therapy.

Amino Acid Sequence↗

A comparison of alternative methods of screening for dementia in clinical settings.

OBJECTIVE: To compare 3 approaches to screening for dementia: cognitive testing, informant report, and neurovisual assessment in a clinical environment. SETTING: A university hospital in Geneva, Switzerland. PATIENTS: Subjects were 76 patients admitted to the Geriatric Hospital or outpatients assessed at the Memory Clinic of the Hospitals of the University of Geneva School of Medicine in Geneva, Switzerland. Thirty-three met criteria for dementia and 11 for depression based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. MAIN OUTCOME MEASURES: Performance in French-language versions of the Mini-Mental State Examination, the Informant Questionnaire on Cognitive Decline in the Elderly, and the Clinical Antisaccadic Eye Movement Test. RESULTS: All tests significantly discriminated cases of dementia from noncases. The receiver operator characteristic analysis demonstrated that the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly were more efficient screening measures for dementia than the Antisaccadic Eye Movement Test in this setting. Unlike the Mini-Mental State Examination, the Informant Questionnaire on Cognitive Decline in the Elderly was unrelated to patients' educational attainment or premorbid intelligence. The previously reported strong relationship between the Mini-Mental State Examination and the Antisaccadic Eye Movement Test was not replicated in these patients. CONCLUSIONS: Both cognitive testing and informant report are efficient methods of screening for dementia in clinical settings. Factors such as sensorimotor disability or informant availability may dictate the viability of each approach in individual application. The performance of the Antisaccadic Eye Movement Test precludes recommending its use as a screen for dementia without further research into its performance.

Aged↗

Evolving concepts in the diagnosis and treatment of arterial high flow priapism.

PURPOSE: We investigated 2 evolving concepts in the management of arterial priapism: 1) the efficacy of perineal duplex Doppler ultrasound as a diagnostic alternative to arteriography and 2) the therapeutic alternative of expectant management. MATERIALS AND METHODS: We evaluated 10 patients with high flow arterial priapism. RESULTS: Compared to selective internal pudendal arteriography, perineal duplex Doppler ultrasonography was associated with 100% sensitivity and 73% specificity rates. Compared to physical examination, followup duplex ultrasonography had a sensitivity of 75% and specificity of 100%. Followup penile duplex ultrasound demonstrated restoration of antegrade flow in the cavernous artery after embolization. Patients on expectant management remained potent as long as 31 years. CONCLUSIONS: Diagnostic perineal duplex Doppler ultrasonography and expectant management are valuable tools for the treatment of arterial priapism. A new algorithm for patient care is presented.

Adolescent↗

Ovulation efficiency is reduced in mice that lack plasminogen activator gene function: functional redundancy among physiological plasminogen activators.

Several lines of indirect evidence suggest that plasminogen activation plays a crucial role in degradation of the follicular wall during ovulation. However, single-deficient mice lacking tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), or PA inhibitor type 1(PAI-1) gene function were recently found to have normal reproduction, although mice with a combined deficiency of tPA and uPA were significantly less fertile. To investigate whether the reduced fertility of mice lacking PA gene function is due to a reduced ovulation mechanism, we have determined the ovulation efficiency in 25-day-old mice during gonadotropin-induced ovulation. Our results reveal that ovulation efficiency is normal in mice with a single deficiency of tPA or uPA but reduced by 26% in mice lacking both physiological PAs. This result suggests that plasminogen activation plays a role in ovulatory response, although neither tPA nor uPA individually or in combination is obligatory for ovulation. The loss of an individual PA seems to be functionally complemented by the remaining PA but this compensation does not appear to involve any compensatory up-regulation. Our data imply that a functionally redundant mechanism for plasmin formation operates during gonadotropin-induced ovulation and that PAs together with other proteases generate the proteolytic activity required for follicular wall degradation.

Animals↗

The Psychogeriatric Assessment Scales: a multi-dimensional alternative to categorical diagnoses of dementia and depression in the elderly.

The Psychogeriatric Assessment Scales (PAS) provide an assessment of the clinical changes seen in dementia and depression. Principal components analysis and latent trait analysis were used to develop a set of scales to summarize these clinical changes. There are three scales derived from an interview with the subject (Cognitive Impairment, Depression, Stroke) and three from an interview with an informant (Cognitive Decline, Behaviour Change, Stroke). Results are reported on the reliability and validity of these scales using data from clinical samples in Sydney and Geneva and a population sample from Canberra. The scales were found to have excellent validity when judged against clinical diagnoses of dementia and depression and could distinguish Alzheimer's from vascular dementia. Cut-off points were developed to indicate correspondence between scale scores and clinical diagnoses. Percentile rank norms were developed from the Canberra population sample. The PAS is easy to administer and score and can be used by lay interviewers after training. It is intended for application both in research and in services for the elderly.

Activities of Daily Living↗

Transduction of LacZ gene into leukemia cells using viral vectors of retrovirus and adenovirus.

Recent developments in gene therapy techniques enable us to introduce new genetic information into hematopoietic cells. Among the various techniques, we focused on two viral vector systems, one using a retrovirus and the other an adenovirus. By using an adenoviral vector we could transduce and highly express bacterial beta-galactosidase (LacZ) gene under the control of the CAG (cytomegalovirus enhancer with chicken beta-actin promoter) promoter in various hematopoietic cells, although the expression persisted for only two weeks. The retroviral vector (MFG) could transduce the LacZ gene into hematopoietic cells almost as well as the adenoviral vector using the repetitive infection protocol. The retroviral system could maintain the expression of transduced cells quite longer than the adenoviral system. Differential use of these two vector systems may be helpful for the gene transduction into various kinds of hematopoietic cells (Lin et al., manuscript in preparation).

Actins↗

The reliability and validity of the French version of the Canberra Interview for the Elderly.

A French version of the Canberra Interview for the Elderly (CIE) was developed. This instrument is designed for lay administration and, using a computer algorithm, produces diagnoses of dementia and depression according to ICD-10 and DSM-III-R criteria. The reliability of this French version was found to meet or exceed the English version in a test-retest design. Validity, established by comparison with diagnoses made by an experienced clinician, was also found to be acceptable. The CIE is thus an appropriate instrument for the epidemiological study of these disorders in French-speaking populations.

Aged↗

Drugs commonly used by the elderly: a review for dental practice.

Of all medications consumed in the U.S., the percentage used by the elderly is greater than can be justified by their numbers. Many medications have adverse effects. This paper reviews the 50 medications most used by the elderly and discusses adverse reactions which may present in the oral cavity or which have systemic effects with a potential impact on dental care. Composite tables summarizing the adverse reactions of interest to the dental practitioner are included for easy reference.

Aged↗

[Prospective evaluation of specialized consultations in a geriatric university hospital].

In a prospective study carried out over a 3 month period we analysed the views of consultants and residents taking part in 771 consultations to patients admitted to the Geriatric University Hospital of Geneva with the help of visual analogue scales. 27 medical subspecialties were involved. Both consultants and residents agreed that most of the consultations were useful for the elderly patient and for postgraduate teaching and learning. But the residents thought that consultations were more important for the patients' welfare than for the residents' education. Residents showed a tendency to underestimate crucial aspects of geriatric medicine (in particular the autonomy of the elderly patient) in preference to more "classical" medical preoccupations (diagnosis and treatment). Consultants were aware of the specificity of geriatric pathology but restricted their teaching during the intervention to what was requested by the resident.

Aged↗

The changing profile of the HIV/AIDS epidemic.

The HIV/AIDS epidemic has undergone significant changes in the population affected and the opportunistic infections most commonly seen since the disease was first identified. Dental care providers must be aware of the changing profile of this disease in order to provide adequate assessment and treatment of their patients, and appropriate referrals to other healthcare providers.

AIDS-Related Opportunistic Infections↗

A controlled evaluation of computer assisted training simulations in geriatric dentistry.

The increasing number of geriatric dental patients and the development of treatment plans that require consideration of complex psychosocial, socioeconomic, and medical/medication factors necessitates a change in the traditional teaching of treatment planning. A computer-assisted instructional program was developed to simulate the dentist-geriatric patient interaction and to train students in clinical decision making for the geriatric patient. This study compared the effects of this program with a more traditional approach based on readings from the geriatric dentistry literature. Twenty third-year dental students were matched on grade point average and randomly assigned to the computer or literature-based groups. They were pretested using a clinical analogue of a geriatric patient and then instructed to use either the computer or literature-based educational units. The students were then post-tested on a second clinical analogue. Students performed similarly at pretest. At post-test, both the computer and literature-based subjects were found to have acquired significantly greater evaluation points, to make fewer errors, and to design more involved treatment plans than at pretest. Comparison of computer and literature-based subjects' performance revealed no significant main or interaction effects regarding type of educational unit used. Consistent nonsignificant trends were noted with the computer-based subjects out-performing literature-based subjects on each outcome variable. In addition, the computer-based subjects had more positive feelings about the educational unit than the literature-based subjects at a statistically significant level. These findings suggest that the computer program is an effective alternative method for developing clinical decision skills in students treating geriatric patients.(ABSTRACT TRUNCATED AT 250 WORDS)

California↗

Identification and regulation of the cystic fibrosis transmembrane conductance regulator-generated chloride channel.

Cystic fibrosis transmembrane conductance regulator (CFTR) generates cAMP-regulated Cl- channels; mutations in CFTR cause defective Cl- channel function in cystic fibrosis epithelia. We used the patch-clamp technique to determine the single channel properties of Cl- channels in cell expressing recombinant CFTR. In cell-attached patches, an increase in cellular cAMP reversibly activated low conductance Cl- channels. cAMP-dependent regulation is due to phosphorylation, because the catalytic subunit of cAMP-dependent protein kinase plus ATP reversibly activated the channel in excised, cell-free patches of membrane. In symmetrical Cl- solutions, the channel had a channel conductance of 10.4 +/- 0.2 (n = 7) pS and a linear current-voltage relation. The channel was more permeable to Cl- than to I- and showed no appreciable time-dependent voltage effects. These biophysical properties are consistent with macroscopic studies of Cl- channels in single cells expressing CFTR and in the apical membrane of secretory epithelia. Identification of the single channel characteristics of CFTR-generated channels allows further studies of their regulation and the mechanism of ion permeation.

Adenosine Triphosphate↗

Pretreatment management of the patient receiving anticoagulant drugs.

This literature review suggests that certain low-risk dental treatment procedures can be performed in patients without altering their anticoagulant medications. Intermediate-risk dental procedures in these patients may be accomplished outside the hospital if the patient's prothrombin time value is within a specified range and if certain techniques are followed. In some cases, temporarily altering the dose of anticoagulant may be necessary. Patients receiving anticoagulant medications should continue to receive high-risk dental treatment in hospitals.

Anesthesia, Dental↗

Rescue of type I collagen-deficient phenotype by retroviral-vector-mediated transfer of human pro alpha 1(I) collagen gene into Mov-13 cells.

A full-length cDNA clone corresponding to the human pro alpha 1(I) collagen gene was isolated and inserted into a retrovirus vector. Cell lines were obtained which produced recombinant viruses transducing the collagen cDNA (HUC virus). To test whether the transduced cDNA was functional, Mov-13 mouse cells were infected with the virus. These cells do not produce any type I collagen due to an insertional mutation of the pro alpha 1(I) gene which blocks transcription. While normal amounts of pro alpha 2(I) RNA were synthesized, no alpha 2(I) collagen chains were detectable in the mutant Mov-13 cells. Infection with HUC virus, however, resulted in the production of stable type I collagen, which was secreted into the medium. Analysis of pepsin-resistant proteins indicated that interspecies heterotrimers consisting of human alpha 1(I) and mouse alpha 2(I) collagen chains were secreted by the infected Mov-13 cells. Our results show that pro alpha (I) collagen chains from species as distant as human and mouse can associate to form stable type I collagen. The availability of a retrovirus vector transducing a functional pro alpha 1(I) collagen gene combined with the Mov-13 mutant system should enable us to study the effect of specific mutations on the synthesis, assembly, and function of type I collagen, not only in tissue culture but also in the animal.

Animals↗

Response to anticoagulant drug withdrawal.

This study evaluated 44 separate medication withdrawal periods in 17 subjects who were attending a hospital anticoagulation clinic for management of anticoagulation medication. The data suggest that when anticoagulant withdrawal is needed for particular dental procedures, a 2-day hold is an effective period of medication withdrawal. No thromboembolic events were observed after any of the withdrawal periods. Further, no posttreatment hemorrhagic episodes were observed when the anticoagulant medication was reinstituted after dental treatment. Prothrombin time blood levels should be determined in the immediate pretreatment period, however, because the prothrombin time can fluctuate even in the best maintained patients.

Adult↗