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Biomedical subjects

D Lowe

Publications and source records attributed to D Lowe.

At least 91 records · Page 5Linked to original sources

IRS pleckstrin homology domains bind to acidic motifs in proteins.

Using a yeast two-hybrid system, we identified several proteins that interact with the PH domains in IRS-1 and IRS-2, including Lon protease, myeloblast protein, and nucleolin. Although the roles of these molecules in insulin action are not yet known, each protein contained an acidic motif that interacted with the PH domain of IRS-2. However, only the acidic motif in nucleolin bound to IRS-1, suggesting that the PH domain in IRS-1 and IRS-2 are not identical. Moreover, synthetic peptides based on the acidic motif in Lon protease and myeloblast protein inhibited the binding of nucleolin to the PH domain of IRS-2 but not to the PH domain of IRS-1, confirming the selectivity of these PH domains. The ability to bind acidic motifs may be a specific function of the PH domain in IRS proteins, because the PH domains in betaARK, phospholipase Cgamma, or spectrin did not bind nucleolin. In 32D cells, nucleolin bound to both IRS-1 and IRS-2, and expression of the acidic motif of nucleolin inhibited insulin-stimulated tyrosine phosphorylation of IRS-1 and IRS-2. These results suggest that the binding of acidic motifs to the PH domain of IRS-1 and IRS-2 disrupts coupling to the activated insulin receptor. Our results are consistent with the hypothesis that the PH domain in the IRS proteins may ordinarily bind acidic peptide motifs in membrane proteins or other acidic membrane elements that couple IRS proteins to activated membrane receptors.

ATP-Dependent Proteases↗

Cardiovascular effects of verapamil enantiomer combinations in conscious dogs.

We examined the systemic and coronary hemodynamic effects of five combinations of R- and S-verapamil enantiomers (R/S; 100/0, 90/10, 80/20, 50/50, and 20/80%, respectively) in conscious dogs chronically instrumented for measurement of aortic and LV pressure, +dP/dt, subendocardial segment length, coronary blood flow velocity, and aortic blood flow. Dogs received escalating doses (0.1, 0.2, and 0.4 mg kg(-1)) of each verapamil combination over 2 min at 30 min intervals on different experimental days and peak changes in hemodynamics were recorded 2 min after each dose. All verapamil combinations increased heart rate, mean aortic blood flow, and coronary blood flow velocity and decreased calculated systemic and coronary vascular resistance. Alterations in coronary hemodynamics were most pronounced with 20/80 R/S verapamil. Racemic and 20/80 R/S verapamil decreased mean arterial and left ventricular systolic pressure, in contrast to combinations with greater concentrations of the R enantiomer. Left ventricular function was unchanged during administration of 100/0, 90/10, and 80/20 R/S verapamil. Direct negative inotropic and lusitropic effects occurred with 50/50 and 20/80 R/S verapamil. The high dose of 20/80 R/S verapamil also increased left ventricular end-diastolic pressure and the regional chamber stiffness constant, consistent with diastolic dysfunction. The results indicate that combinations of R- and S-verapamil produce differential hemodynamic and left ventricular functional effects in conscious, unsedated dogs that are dependent on the relative ratio of these enantiomers.

Animals↗

Propofol, but not thiopentone or etomidate, enhances isoflurane-induced coronary vasodilatation in dogs.

PURPOSE: To test the hypothesis that thiopentone, propofol, and etomidate alter the coronary vascular effects of abruptly administered isoflurane. METHODS: Dogs (n = 6) received inspired isoflurane 5% in the presence of thiopentone (20 mg.kg-1 induction dose and 20 mg.kg-1.hr-1 infusion), propofol (5 mg.kg-1 induction dose and 40 mg.kg-1.hr-1 infusion), etomidate (2 mg.kg-1 induction dose and 5 mg.kg-1.hr-1 infusion), or isoflurane (1.0 MAC) anaesthesia in a random fashion. Haemodynamics were assessed in the conscious state, during baseline anaesthesia, and at 30 sec intervals for five minutes after beginning isoflurane 5%. RESULTS: Rapidly administered isoflurane caused greater (P < 0.05) reductions in coronary vascular resistance in thiopentone- or propofol--than in isoflurane-anaesthetized dogs. Isoflurane produced greater (P < 0.05) increases in the ratio of coronary blood flow velocity to pressure-work index (an index of myocardial oxygen consumption; +109 +/- 19% during isoflurane alone vs +182 +/- 27% change from baseline during propofol and isoflurane) consistent with relatively greater direct coronary vasodilatation during baseline propofol than during baseline isoflurane anaesthesia. Isoflurane caused larger increases in coronary blood flow velocity in dogs anaesthetized with etomidate concomitant with higher coronary perfusion pressure and pressure-work index than in those anaesthetized with isoflurane alone. CONCLUSIONS: The results suggest that thiopentone, propofol, and etomidate each uniquely modify the coronary vascular responses to abrupt administration of high inspired concentrations of isoflurane in chronically instrumented dogs.

Anesthetics↗

The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients.

OBJECTIVE: To investigate the effects of N-acetylcysteine (NAC) when given as an early treatment to critically ill patients on the serum total anti-oxidant potential (TAP) and urine micro-albumin:creatinine (M:Cr) ratio. DESIGN: Prospective, placebo controlled double blinded clinical trial. SETTING: General intensive care unit in a teaching hospital. PATIENTS: Sixty critically ill patients were recruited but ten were withdrawn due to less than 48 h of ICU stay. INTERVENTIONS: After envelope randomisation, patients received either NAC (n = 23): a bolus of 150 mg/kg in 250 ml of 5% dextrose followed by a continuous infusion of 12 mg/kg per h in 500 ml of 5% dextrose over 24 h or, as controls (n = 27), the equal volume of placebo. Treatment lasted for a minimum of 3, up to a maximum of 5, days. Blood and urine samples were collected on admission (0 h) and then 6 hourly up 18 h. MEASUREMENTS AND RESULTS: There was no significant difference between NAC and placebo groups regarding the required length of inotropic support, mechanical ventilation and ICU stay. There was no significant difference in TAP or M:Cr ratio over 18 h or between the groups. CONCLUSIONS: Our results suggest that NAC had no significant effects on the progress of the TAP and the urinary albumin excretion in our patients, which may suggest that NAC at the given dose has no clinical relevance as an early treatment in the critically ill.

Acetylcysteine↗

Hepatitis B and hepatitis C virus infections: risk factors among drug users in Northwest England.

OBJECTIVES: to identify the risk factors for hepatitis B (HBV) and hepatitis C (HCV) virus infections in drug users attending two drug treatment centres in Northwest England, and to evaluate the effect of both needle exchange and hepatitis B vaccination on the prevalence of hepatitis B and hepatitis C infections. METHODS: a retrospective, cross-sectional study performed at the Regional Infectious Disease Unit and a Primary Care Centre for drug users in Liverpool. The study population included 773 drug users who had hepatitis serology performed between January 1992 and April 1996. Information on risk factors was obtained from clinical records; hepatitis serology data were obtained from the Liverpool Public Health Laboratory database. RESULTS: the overall seroprevalences of exposure markers for HBV (anti-HBc antibody) and HCV (anti-HCV antibody) were 48% and 67%, respectively. Duration of injecting drug use was the strongest predictor of HCV infection, with a crude odds ratio of 8.9 (95% confidence interval (CI): 4.5-17) for >10 compared to <3 years of injecting, and was also a strong predictor of HBV infection, with an adjusted odds ratio (controlled for the effects of HBV vaccination) of 5.7 (95% CI: 3.2-10) for >10 compared to <3 years' injecting. Vaccination against HBV was associated with greatly reduced HBV seroprevalence (crude odds ratio 0.11, 95% CI: 0.06-0.18). Overall, HCV was acquired earlier in the injecting career than HBV, but drug users who were not vaccinated against HBV acquired markers for HBV even more rapidly than for HCV. We found no independent protective effect for either anti-HBc or anti-HCV acquisition after the introduction of a needle-exchange scheme. CONCLUSIONS: hepatitis C is highly prevalent among Merseyside drug users and is likely to prove difficult to control because of rapid acquisition early in the injecting career. Vaccination against hepatitis B is the best means of protecting drug users from hepatitis B, and should be offered before injecting is commenced.

Adolescent↗

The contribution of the rostral ventromedial medulla to the antinociceptive effects of systemic morphine in restrained and unrestrained rats.

Although there are numerous opioid-sensitive structures in the central nervous system, the contribution of each to the analgesic effect of systemically administered morphine is controversial. One such structure is the rostral ventromedial medulla. In the present study, we tested the hypothesis that the rostral ventromedial medulla is necessary for the full expression of systemic morphine-induced antinociception. Additionally, we examined whether the modulatory effect of the rostral ventromedial medulla on tail-flick latency is dependent on the behavioral state of the animal. In unrestrained rats, inactivation of the rostral ventromedial medulla with either lidocaine (0.5 microl of 4%) or muscimol (50 ng) had no effect on tail-flick latency. In contrast, in restrained rats, inactivation of the rostral ventromedial medulla with either lidocaine (0.5 microl of 4%) or muscimol (50 ng) significantly decreased tail-flick latency. In both conditions, microinjection of morphine (5 microg) into this region significantly increased tail-flick latency. Additionally, in unrestrained rats, muscimol (50 ng) and cholecystokinin tetrapeptide (0.5 ng) infusion into the rostral ventromedial medulla completely reversed systemic morphine-induced analgesia, while lidocaine (0.5 microl of 4%) and cholecystokinin octapeptide (0.25 ng) infusion partially reversed systemic morphine-induced analgesia. These findings demonstrate that the rostral ventromedial medulla does not tonically modulate tail-flick latency in unrestrained rats, but does modulate tail-flick latency when animals are stressed via restraint. These findings also strongly support the hypothesis that the rostral ventromedial medulla is necessary for the full analgesic effects of systemically administered morphine.

Analgesics, Opioid↗

The impact of surgery for oral cancer on quality of life as measured by the Medical Outcomes Short Form 36.

Quality of life evaluation is an important measure of outcome following the treatment of head and neck cancer. The aim of this study was to evaluate the quality of life of patients undergoing primary surgery for oral and oropharyngeal squamous cell carcinoma. 50 consecutive patients with previously untreated oral cancer were assessed using two questionnaires, the Medical Outcomes Short Form 36 (SF-36) and University of Washington Head and Neck Questionnaire (UW-QOL) at four time intervals; pretreatment, and 3, 6, 12 months. At the time of presentation, patients with oral cancer scored lower than norms, particularly for physical role limitation, mental role limitation, and social functioning. At 3 months following surgery, there was a considerable deterioration in physical functioning, limitation of physical role, energy and general health perception. By 12 months postoperatively patients approached pretreatment scores. The SF-36 and UW-QOL provide outcome information suitable for international comparison.

Adult↗

A comparison between the University of Washington Head and Neck Disease-Specific measure and the Medical Short Form 36, EORTC QOQ-C33 and EORTC Head and Neck 35.

The University of Washington Head and Neck Disease-Specific questionnaire (UW-QOL) is potentially a suitable routine measure of outcome in head and neck cancer because it is quick and simple for patients to complete and is easy to process. The aim of this study was to compare the UW-QOL with three validated instruments in a group of patients having primary surgery for oral cancer. Between May and December 1995, 34 consecutive patients with previously untreated oral and oropharyngeal squamous cell carcinoma underwent primary surgery. Patients self-completed the following questionnaires: UW-QOL, Medical Outcomes Short Form 36 (SF-36), the European Organisation for Research and Treatment of Cancer (EORTC) QOQ-C33 and the EORTC Head and Neck (H&N35). Questionnaires were distributed at four time intervals: pre-operatively, and at 3, 6 and 12 months. Patients were withdrawn if they developed recurrent disease. 29 patients agreed to participate in this prospective study and cross-sectional comparisons were made on baseline data and trends over time for longitudinal comparisons. This study emphasises the difficulties of one questionnaire to adequately evaluate quality of life. However, it would appear that the UW-QOL is a broad measure suitable for routine "low cost" assessment of disease-specific functional status.

Activities of Daily Living↗

Outcome of the depressed elderly living in the community in Liverpool: a 5-year follow-up.

BACKGROUND: Comparatively little is known about the long-term natural history of depressive disorders in the elderly living in the community. This is a follow-up of a subsample of the Continuing Health in the Community study random sample of the elderly population living in Liverpool. METHODS: The investigators followed up 120 cases of depression identified by a semi-structured interview schedule (GMS) for a period of 5 years. A similar number of other subjects defined as subcases of depression, other cases of mental illness and a random selection of non-cases were also included. RESULTS: The 5-year outcome for the cases of depression was worse than the outcome of the non-cases (relative mortality risk of 2.1, 95% confidence interval 1.1 to 3.9). Thirty-four per cent of the cases of depression died and 28% had dropped out during the follow-up. Of the 46 cases of depression who had a complete follow-up, 22% recovered from their symptoms, 30% were found to be AGECAT cases at one of the three follow-up waves, 24% were AGECAT cases at two of the three follow-up waves and the remaining 24% were AGECAT cases at each follow-up wave. Fifteen per cent of the surviving cases of depression were organic cases at the follow-up. Their anxiety comorbid state and depression score were identified as predictors of poor outcome. CONCLUSION: The findings of this study indicate that depressive disorders (most of which were untreated) found in the elderly community have a poor prognosis.

Activities of Daily Living↗

Prognostic significance of the bcl-2 apoptotic family of proteins in primary and recurrent cervical cancer.

bcl-2 is one of a family of genes that control the apoptotic threshold of a cell. bcl-2 protein and its anti-apoptotic homologue, mcl-1, with the pro-apoptotic protein, bax, are thought to function by forming homo- and heterotypic dimers that then control the progression to apoptosis. p53 is also involved as a down-regulator of bcl-2 and a promoter of bax. To determine the effect of these apoptotic mechanisms, we used immunohistochemistry to determine the prognostic significance of the expression of bcl-2, mcl-1, bax and p53 in primary and recurrent cervical cancer. Tissues from 46 patients with primary cervical cancer and 28 women with recurrent carcinoma were stained for bcl-2, mcl-1, bax and p53. Kaplan-Meier survival analysis was performed using the log-rank test for differences between groups. In the primary disease group, positive staining for bcl-2 was associated with a better 5-year survival (bcl-2 +ve, 84% vs bcl-2 -ve, 53%, P = 0.03). Positive staining for p53 was associated with a survival disadvantage (p53 +ve, 4-year survival 38% vs p53 -ve, 4-year survival 78%, P = 0.02). mcl-1 and bax staining were not useful as prognostic indicators in primary disease. No marker was prognostic in recurrent disease. Positive bcl-2 staining defines a group of patients with primary disease with a good prognosis. p53, an activator of the bax promoter, identifies a group with a worse outcome. In recurrent disease, none of the markers reflected prognosis.

Adult↗

Detection of drug use in a methadone maintenance clinic: sweat patches versus urine testing.

AIMS: To evaluate the novel use of sweat patches in outpatients attending a methadone maintenance clinic. DESIGN: Assessment of inter-patch reliability and validity of patch results compared to urine tests at the start and end of the patch period. Semi-structured questionnaire on patients' opinion of the patches. Randomized cross-over trial comparing illicit drug use during the week that the patch was worn with a control period. SETTING: Methadone maintenance outpatient clinic in a deprived urban area. PARTICIPANTS: Forty-eight patients with a diagnosis of opiate addiction prescribed methadone for a median of 5 years. MEASUREMENTS: Analysis of urine and patch tests by standard methods for methadone, opiates, morphine (heroin metabolite) and benzoylecgonine (cocaine metabolite). FINDINGS: There was good inter-patch reliability between arm and side patches for methadone (all positive), opiates (k = 0.8) and morphine (k = 1.0) but only moderate agreement for benzoylecgonine (k = 0.49). There was good agreement between the sweat patches and urine tests for methadone (all positive), opiates (k = 1.00) and morphine (k = 0.8), but again only moderate agreement for benzoylecgonine (k = 0.50). The patches were well tolerated and the main side effect was minor irritation. The majority of men preferred a urine test while more women preferred a sweat patch. There was no evidence of reduced use of illicit drugs the period that the patch was worn. CONCLUSION: Sweat patches are reliable and give valid results for patients on maintenance methadone. There are few side effects and it is practical to use them in busy outpatient clinics. They are preferred by some patients but there was no evidence that they altered behaviour.

Adult↗

Etomidate adversely alters determinants of left ventricular afterload in dogs with dilated cardiomyopathy.

UNLABELLED: We tested the hypothesis that etomidate produces similar alterations in left ventricular (LV) afterload in dogs with normal LV function or dilated cardiomyopathy. Dogs were instrumented for LV and aortic pressures, and aortic blood flow. LV afterload was measured with aortic input impedance and quantified with a three-element Windkessel model. In one group of experiments, dogs (n = 6) were paced at 240 bpm for 18 +/- 2 days (mean +/- SEM). Hemodynamic data were recorded in sinus rhythm in the conscious state and during etomidate anesthesia (5, 10, and 20 mg x kg(-1) x h(-1)). Identical experiments were conducted in a separate group of chronically instrumented dogs not subjected to LV pacing (n = 6). No changes in heart rate and arterial and LV pressures were observed during etomidate anesthesia in cardiomyopathic dogs. There were decreases in arterial and LV systolic pressure during the administration of 20 mg x kg(-1) x h(-1) etomidate to dogs with normal LV function. Etomidate significantly (P < 0.05) increased total arterial resistance (R; 3220 +/- 290 dynes x s x cm(-5) during control to 6110 +/- 790 dynes x s x cm(-5) during 10 mg x kg(-1) x h(-1)) and characteristic aortic impedance (Zc; 141 +/- 22 dynes x s x cm(-5) during control to 161 +/- 23 dynes x s x cm(-5) during 20 mg x kg(-1) x h(-1)) and decreased total arterial compliance (C; 0.70 +/- 0.15 mL/mm Hg during control to 0.45 +/- 0.07 mL/mm Hg during 10 mg x kg(-1) x h(-1)) in cardiomyopathic but not healthy dogs. Etomidate markedly reduced mean aortic blood flow (2.26 +/- 0.17 L/min during control to 1.39 +/- 0.20 L/min during 10 mg x kg(-1) x h(-1)) and increased the time constant of LV relaxation (54 +/- 3 ms during control to 74 +/- 9 ms during 20 mg x kg(-1) x h(-1)) in dogs with LV failure. Arterial pressure is maintained during etomidate anesthesia in the presence of LV dysfunction as a result of increases in R and Zc and decreases in C. These deleterious increases in LV afterload further compromise LV systolic and diastolic performance in dogs with dilated cardiomyopathy. IMPLICATIONS: The results of this investigation indicate arterial pressure is maintained during etomidate anesthesia as a consequence of increases in left ventricular (LV) afterload that further diminish LV systolic and diastolic performance in the presence of impaired LV function.

Anesthetics, Intravenous↗

Cardiovascular effects of propofol in dogs with dilated cardiomyopathy.

BACKGROUND: The authors tested the hypothesis that propofol improves left ventricular diastolic function in dogs with dilated cardiomyopathy by reducing left ventricular preload and afterload. METHODS: Seven dogs were instrumented for left ventricular and aortic pressures, aortic blood flow, and subendocardial segment length. Left ventricular afterload and contractility were quantified with aortic input impedance and preload recruitable stroke work, respectively. Diastolic function was evaluated with a time constant of left ventricular relaxation (tau); segment-lengthening velocities and time-velocity integrals during early left ventricular filling (dL/dtE and TVI-E, respectively) and atrial systole (dL/dtA and TVI-A, respectively); and a regional chamber stiffness constant (K). Dogs were paced at 240 beats/min for 18 +/- 3 days, and hemodynamics were recorded in sinus rhythm in the conscious state. Anesthesia was induced with propofol (5 mg/kg) and maintained with propofol infusions at 25, 50, and 100 mg x kg-1 x h-1, and hemodynamics were recorded after 15 min of equilibration at each dose. RESULTS: Propofol decreased mean arterial pressure, left ventricular end-diastolic pressure, and K but did not change heart rate. Propofol reduced total arterial resistance and increased total arterial compliance derived from aortic input impedance. Propofol also reduced preload recruitable stroke work. The lowest dose of propofol decreased tau. Propofol decreased dL/dtE and TVI-E and reduced the dL/dt-E/A and TVI-E/A ratios. CONCLUSIONS: Propofol reduces left ventricular preload, afterload, and regional chamber stiffness, causes direct negative inotropic effects, and impairs early-diastolic left ventricular filling in dogs with dilated cardiomyopathy.

Anesthetics, Intravenous↗

Non-compliance with treatment in patients suffering from schizophrenia: a study to evaluate possible contributing factors.

BACKGROUND: Various factors have been associated with non-compliance with treatment in schizophrenia. The aim of this study was to examine this association using standardised measures. METHOD: Compliance was determined and socio-demographic and illness variables recorded. Insight, subjective response to medication and relative's knowledge and attitude about schizophrenia were measured. RESULTS: Non-compliant patients were younger, had shorter durations of illness, had an episodic course of illness, reported side-effects less frequently, made incorrect attributions to current positive symptoms more frequently and had a more negative subjective response to medication. Key relatives of non-compliant patients were more often employed. CONCLUSIONS: Patients need to experience for themselves the merits of taking medication before accepting the need to take them long-term. Psychoeducational and cognitive-behavioral interventions need to be targeted at changing attributions to current positive symptoms. The presence of a key person in the community is crucial to improve compliance.

Adult↗

Synthesis and evaluation of some masked phosphate esters of the anti-herpesvirus drug 882C (netivudine) as potential antiviral agents.

A number of symmetric and asymmetric 5'-phosphate esters of the potent anti-varicella-zoster virus (VZV) agent 1-(beta-D-arabinofuranosyl)-5-prop-1-ynyluracil (882C; netivudine) were prepared as potential lipophilic, membrane-soluble prodrugs of the bio-active phosphate forms. The compounds were prepared by the base-catalysed coupling of various phosphorochloridates with the free nucleoside analogue. Compounds were fully characterized by a range of spectroscopic and analytical methods and were studied for their inhibition of several viruses in tissue culture. All of the phosphate esters were inactive against human cytomegalovirus, herpes simplex virus type 2, VZV, human immunodeficiency virus type 1 and influenza A virus (EC50 > 100 microM) except the 5'-(4-nitrophenyl phenyl) phosphate, which inhibited influenza A virus. The relative rate of esterase-mediated hydrolysis of one of the lead target structures was measured in order to rationalize the poor antiviral action, and data were collected on possible metabolites in support of this analysis. Cell-specific esterases are implicated as key determinants of the antiviral potency of prodrugs of this type.

Animals↗

Increases in salivary lysozyme and IgA concentrations and secretory rates independent of salivary flow rates following viewing of humorous videotape.

Several studies have shown increases in salivary, secretory IgA (sIgA) levels following exposure to humor and various relaxation strategies. However, the use of sIgA as a marker of immunocompetence has been questioned. In this study we investigated the potential of an alternative marker, salivary lysozyme (sLys) in addition to sIgA. sIgA and sLys concentrations and secretion rates were measured from saliva samples collected immediately prior to and alter viewing a humorous (situation comedy) and a control videotape (documentary). sLys concentrations and secretion rates were significantly increased after viewing of the humorous videotape (p = .0007 and p = .009, respectively) but not following viewing of the control video. Similarly, increases were obtained for sIgA (p = .01 and p = .05) following viewing of the humorous tape. sIgA concentration decreased following viewing of the control tape (p = .05). Salivary flow rates did not significantly change following the viewing of either the humorous or the control tapes. Changes following the humorous video were significantly different from changes following the control video for both sLys and sIgA levels (concentration, p = .007 and p = .005; secretory rate p = .02 and p = .03), but not for salivary flow rates. The results suggest an enhancement of the innate and specific mucosal immune parameters following exposure to humor, independent of salivary flow. Use of sLys may serve as a useful additional or alternative marker of the effects of humor on mucosal immunity.

Journal Article↗

The secondary radiation grid; its effect on fluoroscopic dose-area product during barium enema examinations.

The secondary radiation grid is placed between the patient and the image intensifying screen, during fluoroscopy, to attenuate the incident forward scattered radiation. This reduction in scatter improves the radiographic contrast and hence image quality. However, this improved quality is achieved at the expense of greater radiation exposure to the patient, as this higher exposure is required to produce satisfactory image density. Patients scheduled to have a barium enema were randomly allocated into two groups. One group had the procedure performed with the grid in situ throughout the procedure. The second group was examined with the grid removed for fluoroscopy but returned for image acquisition. The fluoroscopic dose-area product (DAP) was recorded for both groups using a dose-area product meter. The DAP was not recorded for spot film acquisition. The results suggest that there is approximately a 50% reduction in DAP to the second group. We can be 95% certain that, on average, the ratio of doses in patients without the grid in situ to those screened with the grid is between 0.40 and 0.58, with the best estimate being 0.48. Multiple regression methods to take account of the effects of weight, sex and time, revised this estimate as 0.57, with 95% confidence interval from 0.52 to 0.63. Sex, weight and exposure time accounted for 61% of variation in dose-area products, with time alone accounting for 41%. Grid status accounted for another 22% of variation, which represents over a half of the remaining variation once sex, weight and exposure time have been allowed for. We therefore recommend that the routine use of an antiscatter grid during fluoroscopy should be abandoned. The use of a grid should be restricted to those patients (usually obese) when poor visualization is obtained in its absence.

Barium Sulfate↗

Long-term positive and negative identity priming: evidence for episodic retrieval.

An episodic retrieval account of negative priming (Neill, 1997; Neill & Valdes, 1992) was evaluated in three experiments. During practice, regular word pairs were presented to subjects differing numbers of times. The subjects named specific target words while they ignored specific distractor words. Following a 5-min retention interval, memory for practice was revealed: Test responses for target words exhibited positive priming that increased with increases in the number of times that the words had been attended. Test responses for distractor words exhibited either positive priming (Experiment 1) or negative priming (Experiments 2-3) that also increased with increases in the number of times that the words had been ignored. The type of priming that distractors exhibited was determined by several contextual similarities between the practice environment, in which distractors were ignored initially, and the test environments, in which they were processed subsequently. Negative priming that spanned a 5-min interval, increased with increases in the number of times that a distractor was ignored, and was sensitive to contextual changes indicated that the direction of the effect was temporally backward because the test probe cued memory for earlier processing of the priming stimulus when the distractor had been ignored.

Adult↗