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PubMed1994

Examination of tooth-drying techniques: evaluation in-vitro of a prototype warm-air tooth dryer.

A prototype, rechargeable, warm-air tooth dryer is evaluated and its capabilities compared with those of an established mains electricity powered dryer (Handi-Dri). The evaluation includes warm-up cycle, maximum temperature and constancy of temperature of air output, battery discharge profile, time required to dry etched enamel, ability to dry wet filter paper, flow rate and pressure of air output, convenience and ease of use. Selected tests were also applied to a dental 3-in-1 syringe. Alternative methods of drying the tooth surface are also reviewed. The prototype was found to be suitable for tooth drying; it was considered safer and more convenient than the Handi-Dri and offered advantages over other methods.

Air Pressure↗
PubMed1997

Prototype expert system to assist with the stabilization of neonates prior to transport.

The transport of sick or premature newborns from community hospitals to acute care facilities is often necessary for the infants to receive the level of care required. Prior stabilization of these infants is imperative to a successful transport. The knowledge required to treat and stabilize sick and premature newborns is specialized and may not be available in community hospitals. "The S.T.A.B.L.E. Assistant" is a prototype rule based decision support system based on the educational program "Transporting Newborns the S.T.A.B.L.E. Way". "The S.T.A.B.L.E. Assistant" accepts clinical information related to an infant's breathing status, blood glucose status and selected lab values and provides instructions as to what interventions are needed to stabilize and prepare the infant for transport. The computerized program was evaluated using data collected from 19 charts of newborns requiring transport from a community hospital to a tertiary care center. Patient data were entered into the computerized program and the subsequent instructions were reviewed by a group of neonatology and neonatal transport experts. Reviewers evaluated "The S.T.A.B.L.E. Assistant" for the safety of the program, the extent to which the computerized program follows the educational program guidelines and the degree to which the instructions generated are within the scope of community caregivers' practice. Results were positive, indicating "The S.T.A.B.L.E. Assistant" prototype is safe, and within the guidelines of neonatal clinical practice.

Decision Support Systems, Clinical↗
PubMed1998

Prototypes of intrafamily homicide and serious assault among insanity acquittees.

Public concern with societal violence is intensified when persons who have been found not guilty by reason of insanity (NGRI) of having committed a homicide or serious assault are returned to the community. Successful management of such acquittees in the community requires a sophisticated understanding of the person and the illness within the larger context of the violent incident, the family, the community, and the culture. In this article, we present an analysis of psychotic violence within a family context. A qualitative study of 64 subjects who were found NGRI of killing or seriously injuring a family member resulted in four prototypes of intrafamilial homicide/assault: Till Death Us Do Part; Overwhelming Burden, Elimination of the Limit Setter; and Family-Focused Delusional Killing. The prototypes are presented as a model for developing management strategies both for future risk assessment and for successful transition of the insanity acquittee into the community.

Adolescent↗
PubMed1998

The attributes of medical event-reporting systems: experience with a prototype medical event-reporting system for transfusion medicine.

OBJECTIVE: To design, develop, and implement a prototype medical event-reporting system for use in transfusion medicine to improve transfusion safety by studying incidents and errors. METHODS: The IDEALS concept of design was used to identify specifications for the event-reporting system, and a Delphi and subsequent nominal group technique meetings were used to reach consensus on the development of the system. An interdisciplinary panel of experts from aviation safety, nuclear power, cognitive psychology, artificial intelligence, and education and representatives of major transfusion medicine organizations participated in the development process. Setting.- Three blood centers and three hospital transfusion services implemented the reporting system. RESULTS: A working prototype event-reporting system was recommended and implemented. The system has seven components: detection, selection, description, classification, computation, interpretation, and local evaluation. Its unique features include no-fault reporting initiated by the individual discovering the event, who submits a report that is investigated by local quality assurance personnel and forwarded to a nonregulatory central system for computation and interpretation. CONCLUSIONS: An event-reporting system incorporated into present quality assurance and risk management efforts can help organizations address system structural and procedural weakness where the potential for errors can adversely affect health care outcomes. Input from the end users of the system as well as from external experts should enable this reporting system to serve as a useful model for others who may develop event-reporting systems in other medical domains.

Blood Transfusion↗
PubMed1990

Retrovirus from human T-cell leukemia virus type I-associated myelopathy is the same strain as a prototype human T-cell leukemia virus type I.

A retrovirus was isolated from a T-cell line that was established from lymphocytes in the cerebrospinal fluid of a patient with human T-cell leukemia virus type I-associated myelopathy (HAM), and its genome was sequenced. The nucleotide sequence of the 3' half of the total genome was identical in 99.5% of the nucleotides to that of the prototype human T-cell leukemia virus type I that was derived from a patient with adult T-cell leukemia. These results indicate that the same retrovirus human T-cell leukemia virus type I is associated with both a neurological disease, HAM, and a lymphoproliferative disease, adult T-cell leukemia.

Amino Acid Sequence↗
PubMed1995

Assessing the competency of patients with Alzheimer's disease under different legal standards. A prototype instrument.

OBJECTIVE: To assess empirically the competency of patients with Alzheimer's disease (AD) to consent to medical treatment under different legal standards (LSs). DESIGN: Comparison of normal older subjects and patients with AD on measures of competency to consent to medical treatment. SETTING: University medical center. SUBJECTS: Normal older control subjects (n = 15) and patients with probable AD (n = 29 [15 with mild and 14 with moderate AD]). MAIN OUTCOME MEASURES: Two specialized clinical vignettes were developed that test a subject's capacity to consent to medical treatment under five well-established LSs for this competency: LS1, evidencing treatment choice; LS2, making the reasonable choice; LS3, appreciating consequences of choice; LS4, providing rational reasons for choice; and LS5, understanding treatment situation and choices. Performance on the LSs was compared across control and AD groups using Student's t test, chi 2, and analysis of variance. Demented subjects were categorized as competent, marginally competent, or incompetent under each LS by using a cutoff score derived from normal control performance. RESULTS: No differences between groups emerged for LS1 and LS2. Control subjects performed significantly better than patients with mild AD on LS4 and LS5, and significantly better than patients with moderate AD on LS3, LS4, and LS5. Patients with mild AD performed significantly better than patients with moderate AD on LS4 and LS5. With respect to competency status, patients with AD showed a consistent and progressive pattern of compromise (marginal competence or incompetence) related to dementia severity and stringency of the LS. CONCLUSIONS: A reliable prototype instrument validly discriminated the competency performance and classified the competency status of control subjects and patients with mild and moderate AD under five LSs for competency to consent to medical treatment. While the groups performed equivalently on minimal standards requiring merely a treatment choice (LS1) or the reasonable treatment choice (LS2), patients with mild AD had difficulty with more difficult standards requiring rational reasons (LS4) and understanding treatment information (LS5), and patients with moderate AD had difficulty with appreciation of consequences (LS3), rational reasons (LS4), and understanding treatment (LS5). The results raised the concern that many patients with mild AD may not be competent to consent to treatment and supported the value of standardized clinical vignettes for assessment of competency in dementia.

Aged↗
PubMed1998

Soft tissue rapid prototyping in neurosurgery.

As part of our research into the fluid hydrodynamics of the human ventricular system, a fused deposition model of the human ventricular system was made using magnetic resonance imaging (MRI) data. This article describes the manufacturing of a positive cast of the ventricles as a first step in the construction of a hollow model. After decryption of the original MRI file (ACR-Nema format), the MRI slices were reassembled semiautomatically and a rapid prototyping station produced a resin model. Because of its ease and speed, this method harbors great potential for teaching purposes, research, and preoperative planning in complex three-dimensional soft tissue targets.

Cerebral Ventricles↗
PubMed1996

Multicenter clinical experience with the development of a novel short coronary stent and its prototype device.

Our initial experience with the Micro Stent PL and its prototype intracoronary stent is described. A total of 206 stents were implanted in 84 patients for threatened closure or restenosis following balloon angioplasty. The stenting procedure was successful and uncomplicated in 83 of 84 patients. Potential advantages of this particular stent relate to its short length, low surface area, expandability over a range of diameters, radiopacity, low profile, and ease of delivery.

Angioplasty, Balloon, Coronary↗
PubMed1999

A prototype pathogen bound ex vivo to human erythrocyte complement receptor 1 via bispecific monoclonal antibody complexes is cleared to the liver in a mouse model.

Immune complexes (IC) bound to the primate erythrocyte (E) complement receptor (CR1) are cleared from the circulation of primates and localized to the liver. IC can be bound to E CR1 either via C3b opsonization or with cross-linked mAb complexes (heteropolymers, HP) which contain an mAb specific for CR1 and a mAb specific for a prototype pathogen. The long-term goal of our work is to apply the HP to the treatment of human diseases associated with blood-borne pathogens. Therefore we have investigated the feasibility of a non-primate model by studying clearance in mice of bacteriophage phiX174 bound via HP to primate E. E-HP-phiX174 complexes were prepared in vitro and infused into the circulation of mice under conditions allowing short term survival of E in the circulation. By radioimmunoassays and flow cytometry, we found that phiX174 is removed from E and cleared from the circulation coincident with loss of HP and CR1, and that the majority of cleared phiX174 is localized to the liver. Through the use of HP constructed with Fab' fragments, we verified the requirement for the Fc portion of the mAb in clearance; inhibition of C3 activation delayed clearance, suggesting a role for complement. The present findings in the mouse confirm previous observations in the non-human primate model.

Animals↗
PubMed1978

Responses given by A and B quasi-therapists to differing sexual roles in an intropunitive-neurotic prototype: an analogue study.

Twenty-four male undergraduate students were selected on the basis of their A--B status. Six Ss of each type were assigned randomly to one of two videotaped stimulus conditions, an adequate or an inadequate sexual role variant of an intropunitive neurotic prototype. Two dependent measures, response time and number of confrontations, were used and conceptualized in terms of an approach-avoidance continuum. Differential responding on the basis of the Ss' A--B status was not supported in this study.

Adolescent↗
PubMed1990

Human rheumatoid factor cross-idiotypes. III. Bla monoclonal rheumatoid factor, prototype of the BLA cross-idiotype group, has distinct kappa chains related to the V kappa III subgroup and VH4 heavy chains.

The BLA cross-idiotype (XId) is present on a unique subset of rheumatoid factors (RF) that cross-react with DNA-histone. In this study, prototype Bla monoclonal RF was shown from serologic investigations and N-terminal amino acid sequence analysis to have distinct kappa chains related to the V kappa III subgroup and VH4 heavy chains. The amino terminus of the heavy chain was cyclized, rendering the protein resistant to Edman degradation and providing a possible investigator bias to the published Ig sequence data to date. This appears to be the first definitive report of a serum IgM that expresses the VH4 gene. RF with DNA cross-reactivity have been reported to be produced by human and mouse cloned cells that have the VH4 or homologous mouse Vh36-60 gene.

Amino Acid Sequence↗
PubMed1999

Licensed recombinant hepatitis B vaccines protect chimpanzees against infection with the prototype surface gene mutant of hepatitis B virus.

The emergence in vaccinated individuals of hepatitis B virus (HBV) mutants with amino acid substitutions within the a determinant of the surface protein has raised the possibility that such variants represent neutralization escape mutants. We previously demonstrated that one such mutant HBV, strain AS, with an arginine substituted for glycine at surface gene codon 145, was infectious and pathogenic in seronegative chimpanzees. In the present study, the protective efficacy of licensed hepatitis B vaccines was evaluated against challenge with this mutant virus. Four chimpanzees were immunized with 1 of 2 licensed recombinant hepatitis B vaccines. Shortly after the chimpanzees developed antibodies to hepatitis B surface antigen (anti-HBs), they were challenged intravenously with mutant HBV strain AS. Two unvaccinated chimpanzees served as positive controls. The 4 vaccinated chimpanzees did not develop evidence of HBV infection or hepatitis during 2 years following virus challenge. In contrast, the 2 unvaccinated chimpanzees developed HBV infection and hepatitis. Serum anti-HBs in the vaccinated chimpanzees reacted not only with wild-type surface antigen, but also with mutant surface antigen by competition enzyme-linked immunosorbent assay (ELISA). Thus, immunization of chimpanzees with licensed recombinant hepatitis B vaccines stimulates anti-HBs that is broadly reactive and affords protection against infection with a surface gene mutant of HBV, suggesting that properly immunized individuals are not at significant risk of infection with this prototype variant strain of HBV.

Animals↗
PubMed1993

Stability studies of the components of a prototype penicillinase (beta-lactamase)-linked ELISA kit.

Penicillinase (beta-lactamase) enzyme-linked immunosorbent assay (ELISA) for various reproductive hormones developed in the laboratory were found to have wide applicability in the fertility check clinic of the Institute. A need was thought to transform these assays into ready-to-use kit forms. Therefore, prototype ELISA kits for these hormones were developed and stability of the individual component was ascertained at various temperatures (room temperature, 37 degrees C and 2-8 degrees C). Stability studies were conducted on previously validated assay for pregnanediol-3 alpha-glucuronide (PdG). The studies showed that immunosorbents (antibody coated plates) are stable at room temperature for a period of 2 weeks, at 37 degrees C for 1 week and at 2-8 degrees C for a period of 9 months when preserved after treatment with glycerol solution. The lyophilised conjugate, standard and immunoassay buffer, colour reagent, and its substrate were stable at 37 degrees C up to 1 week and at room temperature up to 2 weeks and at 2-8 degrees C for a period of 6 months, during which the stability was studied.

Enzyme Stability↗
PubMed1999

Sphingosine 1-phosphate: a prototype of a new class of second messengers.

Sphingosine 1-phosphate (SPP) is an important sphingolipid-derived second messenger in mammalian cells that acts to promote proliferation and to inhibit apoptosis. Various growth factors increase the intracellular concentration of SPP by activating sphingosine kinase, the molecular cloning of which has revealed that it defines a new type of lipid kinase. Cell fate is influenced by the balance between the intracellular concentration of SPP and that of ceramide, a pro-apoptotic sphingolipid metabolite. The observation that a similar "rheostat" is a determinant of cell survival in yeast cells exposed to heat shock indicates that it is an evolutionarily conserved mechanism of stress regulation. SPP also acts extracellularly to inhibit cell motility and to influence cell morphology, effects that appear to be mediated by the G protein-coupled receptor EDG1. These observations indicate that SPP is the prototype of a new class of lipid mediators that exert both intracellular and extracellular actions.

Animals↗
PubMed1988

Circulating interferon in the guinea pig infected with the XJ, prototype Junin virus strain.

The interferon (IFN) induction capacity of the XJ prototype strain of Junín virus (JV) was investigated in the guinea pig model. Circulating alpha IFN was detected in 50% of the animals from days 2 to 9 postinfection (pi) and in 100% at day 11 pi, when all animals were in the premortem stage. Individual levels ranged from 20 to 1,280 guinea pig IFN units (GPIFNU)/ml. A correlation between XJ strain virulence and IFN titers was recorded. A possible role of IFN as a pathogenic factor in the outcome of the disease is discussed.

Animals↗
PubMed1995

Enterovirus 71 isolated from China is serologically similar to the prototype E71 BrCr strain but differs in the 5'-noncoding region.

Enterovirus 71 H (E71 H), an isolate from an adult patient with hand-food-mouth disease (HFMD) in China, was serologically similar to the prototype strain E71 BrCr, which was isolated from a patient with aseptic meningitis. The study further analyzed the similarity of E71 H to E71 BrCr at the 5'-noncoding region (NCR), a location in genomic RNA that recently was found to be related to neurovirulence in poliovirus and Venezuelan equine encephalitis virus. Using a reverse transcription-polymerase chain reaction (RT-PCR) technique and a unique primer pair I, a 397 bp product was detected from E71 BrCr, Cox A9 (Griggs), Cox A16 (NIH), Cox B1 (HA antigen 201-468), Cox B5 (wild type), and ECHO 11 (Gregory), but not from E71 H, Cox A24 (Joseph), and ECHO 5 (Noyce). However, all of the viruses generated a 154 bp product using a universal enterovirus primer pair II. Further comparative analysis using primer-directed sequencing of both the E71 H and E71 BrCr 154 bp products revealed that they differed by 12 bases. The variations between the two viruses were clustered in two loci, one in the region of nucleotides 43-61 with eight variations, and the other in the region of nucleotides 120-133 with three variations. The differences within the 5'-NCR between the E71 H (HFMD) and the E71 BrCr (aseptic meningitis) viruses might provide a clue to explain why E71 was associated with two different clinical patterns: polio-like disease in the United States. Australia, and Eastern Europe, HFMD in China, Japan, and Singapore.

Adult↗
PubMed2001

Modulation of susceptibility and resistance to an autoimmune model of multiple sclerosis in prototypically susceptible and resistant strains by neutralization of interleukin-12 and interleukin-4, respectively.

Experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis, is mediated by Th1 cells. The major Th1 inducer, IL-12, enhances EAE, while its blockade suppresses it. IL-4 suppresses EAE. Here, we determined IFN-gamma and IL-4 production by myelin basic protein-stimulated lymphocytes from prototypically EAE-susceptible SJL/J and EAE-resistant BALB/c mice, 9 days after immunization with spinal cord homogenate. While lymphocytes from SJL/J mice produce IFN-gamma and no IL-4, lymphocytes from BALB/c mice produce IL-4 and no IFN-gamma. Since early endogenous production of IL-12/IFN-gamma or IL-4 is linked to Th1 or Th2 responses, respectively, we determined whether neutralization of IL-12 or IL-4 at immunization modifies susceptibility or resistance to EAE. SJL/J mice given neutralizing anti-IL-12 mAb are protected from EAE. BALB/c mice given neutralizing anti-IL-4 mAb develop EAE, while those treated with control antibody remain resistant. These studies confirm the pivotal role of IL-12 in EAE development and show that endogenous IL-4 is important for determining the genetic resistance to EAE.

Animals↗
PubMed1996

A model of the immune network with B-T cell co-operation. I--Prototypical structures and dynamics.

Hitherto, "second generation" network models of the immune system have all been restricted to B-lymphocytes and the Ig molecules they produce. These models have not so far been able to provide a convincing mechanism for the distinction between a "Central Immune System" (CIS) composed of a connected network of lymphocyte clones which couple with "self" antigens in a tolerant mode, and a "Peripheral Immune System" (PIS) composed of clones with little or no supra-clonal organization and which produce classical immune responses when interacting with "non-self" antigens. Here, we present a new network model which explicitly incorporates B-T cell co-operation. In this model, B-cell activation is dependent on T-cell help, and activated T-cells are down-regulated by engagement of their TCRs by soluble Ig. We discuss the underlying biology on which we base the system of ordinary differential equations which defines the present network model. We then illustrate some basic features of the model by examining several prototypical situations with a small number of clones. Depending on the idiotypic connectivity structure, the model exhibits two distinct modes of coupling with antigens: an "immune response" mode in which T- and B-cell clones grow exponentially; and a "tolerant" mode in which T-cell clones are controlled by inclusion of all TCRs in the repertoire of an idiotypic B-cell network. Finally, we discuss the simplifying assumptions of the present model and argue that its range of validity is indeed the region of the state-space of the system where the discrimination between the CIS and the PIS take place.

B-Lymphocytes↗