Seronegative neuroborreliosis.
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Biomedical subjects
Publications and source records attributed to A M Turner.
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The most abundant phosphorus-containing polypeptide in the purple non-sulphur bacterium Rhodomic-robium vannielii has been identified by a combination of immunoprecipitation and sucrose density gradient centrifugation as the large subunit of ribulose 1,5-bisphosphate carboxylase/oxygenase. The covalent modification of the large subunit involves the phosphorylation of one or more tyrosine residues and appears to occur prior to assembly of the large subunit into the mature enzyme. In addition, the phosphorylated form of the large subunit was found to exist in at least two distinct protein complexes of Mr 410,000 and 440,000.
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The bulk of the evidence indicating that different experiences can lead to differences in synapse numbers involves inference from measures of postsynaptic surface (spines and dendrites) in Golgi impregnated tissue. The capriciousness of Golgi impregnation and the absence of direct evidence regarding changes in afferents mandate confirmation of synapse changes by electron microscopy. We calculated the ratio of synapses per neuron in layers I-IV of occipital cortex of rats reared in complex (EC), social (SC), or isolated (IC) environments. Synaptic density estimates were derived from electron micrographs of osmium-uranyl-lead stained tissue and neuronal density estimates were derived from toluidine blue stained semithin sections using stereological methods which correct for group differences in the sizes of synapses and neuronal nuclei. The ratio of these densities, synapses per neuron, was highest in complex environment rats, intermediate in socially reared rats and lowest in isolates, in accordance with predictions from prior Golgi studies. The bulk of the differences were attributable to neuronal density, which was highest in IC rats and lowest in ECs. Synaptic density did not differ statistically across groups. These results indicate, at least within this area and paradigm, that differences in dendritic measures in Golgi impregnated tissue reflect differences in the number of synapses per neuron.
Radioimmunoassay (RIA) techniques have been employed to determine prostaglandin (PG) levels in the cerebrospinal fluid (CSF) from multiple sclerosis (MS) patients in remission and relapse and in subjects with other neurological diseases (OND). PGE and PGF2 alpha concentrations in spinal fluid from MS patients in relapse were significantly lower than values estimated during remission and in individuals with OND of the central nervous system (CNS). These observations are discussed in relation to the clinical state of patients with demyelinating disease together with a consideration of the concept that disordered immune mechanisms contribute a central role in the pathogenesis of MS.
Cyclosporin A (CsA), an immunosuppressant which acts selectively on antigen-responding T cells, was tried in the treatment of experimental allergic encephalomyelitis (EAE). The drug was highly effective in preventing the appearance of clinical and pathological signs of EAE in rats, guinea pigs and monkeys. Treatment of the established disease also reduced the incidence and severity of symptoms, and significantly reduced the number of inflammatory lesions in the central nervous system.
Nuclear magnetic resonance spectroscopy has been used to examine the conformations of cobalamins in solution. The perturbation of the resonances in the n.m.r. spectra by lanthanide probes provided particularly valuable information. Except for minor details the conformations are the same as those in the crystalline state. The temperature dependence of the conformation has been reassessed.
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This double-blind, randomized, placebo-controlled, parallel-group, multicenter study assessed the efficacy, acceptability, safety, and tolerability of subcutaneous sumatriptan 6 mg administered using a novel cartridge system self-injector for the acute treatment of migraine. Eighty-six patients treated one migraine attack at home with sumatriptan or placebo. A second identical injection was available after 1 hour for inadequate relief or if the headache recurred. Rescue medication was available 1 hour later. The primary end point was headache relief (improvement in headache from moderate or severe to mild or no pain) within 60 minutes of the first injection. Secondary end points included the acceptability of the self-injector, requirement for and efficacy of a second dose, relief of nonheadache symptoms, use of rescue medication, and adverse events. Significantly more patients taking sumatriptan than placebo reported headache relief 1 hour after the first injection (88% vs 11%, P < 0.001). The device was well accepted by patients; about 90% found it easy to use and wanted to take further medication using it. Significantly fewer patients taking sumatriptan than placebo required a second injection (33% vs 92%, P < 0.001) or rescue medication after the second injection (35% vs 67% P < 0.05). Significantly more patients taking sumatriptan than placebo reported headache relief after the second injection (83% vs 32%, P < 0.01), and resolution of nonheadache migraine symptoms (54% vs 23%, P < 0.01). Sumatriptan was generally well tolerated. Subcutaneous sumatriptan 6 mg self-administered using the novel self-injector is an effective, well accepted, and well tolerated acute treatment of migraine.
An open, multicenter study investigated the long-term efficacy, tolerability, and acceptability to patients of subcutaneous sumatriptan 6 mg, administered using a novel cartridge system self-injector, for the acute treatment of migraine. Eighty patients treated all migraine attacks for 6 months at home with a subcutaneous injection of sumatriptan 6 mg. A second injection could be taken after 1 to 24 hours if relief was inadequate, or if the headache recurred, and rescue medication could be taken 1 hour after the second injection. The primary end point was the percentage of attacks in which headache improved from severe or moderate before treatment to mild or absent at 1 hour after the first injection. A total of 1566 attacks were treated by the 80 patients and 69 patients completed 6 months of treatment. Headache relief was reported 1 hour after the first injection in a mean of 78% of attacks (83% in the first 3 months and 76% in the second 3 months). A second injection was required in a mean of 40% of attacks, and headache was mild or absent 1 hour after the second injection in a mean of 77% of attacks. Rescue medication was required after the second injection in a mean of 14% of attacks. At the end of the study, 87% of patients said that they would take the medication again, and at each clinic visit over 80% said that they found the injector easy to use. Adverse events were similar to those reported previously with sumatriptan and were mostly mild to moderate in intensity, short-lived, and resolved spontaneously. Subcutaneous sumatriptan 6 mg is an effective, well tolerated, and well accepted, long-term, acute treatment for migraine when self-injected by patients using the novel self-injector.
The effectiveness of an enhanced preparation intervention was compared with the standard preparation intervention for accuracy in overnight urine specimen collections. The sample consisted of 179 individuals with type I insulin-dependent diabetes mellitus (IDDM). Subjects were assigned randomly to an enhanced or standard preparation group. The enhanced preparation included written instructions, a reminder to post instructions in the bathroom, a toilet seat cover with a reminder to save urine, and a nurse-initiated telephone call to review the instructions. The standard preparation included written instructions and a telephone number to call with any questions. For subjects without previous collection experience, significantly fewer inaccurate collections were reported in the enhanced preparation group than in the standard group (chi 2 = 4.61, P < .05). There were no differences in collection accuracy between enhanced and standard groups for subjects with collection experience (chi 2 = .4598, P > .05).
The purpose of this research study was to explore personal illness models of preadolescents and adolescents regarding diabetes mellitus. Personal illness models were defined as the adolescents' cognitive representations of their disease. Sixty children ages 10 to 17 years with a diagnosis of insulin-dependent diabetes mellitus were interviewed using a semistructured questionnaire. Data were content analyzed for common themes. Although most participants expressed an understanding that their disease would last a lifetime, they were hopeful for a cure. Participants wanted healthcare professionals to provide strategies for controlling blood glucose to prevent future complications. Family and friends who followed the same diet as the adolescent with diabetes were viewed as supportive. The majority of adolescents were responsible for much of their own disease management. Their greatest fears concerned insulin reactions and long-term complications such as amputation of limbs.
The purpose of this research was to explore personal illness models of parents of preadolescents and adolescents regarding diabetes mellitus. Personal illness models were defined as the parents' cognitive representations of the disease. Fifty-five parents of children ages 10 to 17 years with a diagnosis of insulin-dependent diabetes mellitus were interviewed using a semistructured questionnaire. Data were content analyzed for common themes. Parents attributed the cause of diabetes to genetics coupled with a viral infection. Most believed the diabetes would last a lifetime but they were hopeful for a cure. Parents requested ongoing education for their children, support groups, counseling, one consistent healthcare provider, and intensive insulin therapy. Parents reported that the major problems caused by diabetes were increased structure of daily routines and that their children with diabetes felt different from healthy peers. Parents' fears about diabetes included long-term complications, early death, and severe insulin reactions.