Panel report: History of psychoanalysis on the West Coast.
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Biomedical subjects
Publications and source records attributed to G Allison.
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In addition to neuromodulation, endogenous opioids serve as growth factors. The naturally occurring opioid peptide, [Met5]enkephalin, termed opioid growth factor (OGF), has been found to be a potent and tonic inhibitor of processes related to growth and renewal, particularly cell proliferation. OGF mediates its actions through the zeta (zeta) opioid receptor. In order to determine if OGF and/or the zeta receptor are present in human corneal epithelium, immunocytochemistry was utilized. Immunoreactivity with regard to OGF and to the zeta receptor could be detected in the cortical cytoplasm of both basal and suprabasal epithelial cells, but was not associated with the cell nucleus. Investigation of the ubiquity of OGF and zeta receptor in the vertebrate cornea showed that both elements are present in a wide variety of classes of the phylum Chordata, including mammalia, aves, reptilia, amphibia, and osteichthyes. These results suggest that an endogenous opioid system related to growth may have originated as early as 300 million years ago, and that the function of this system in cellular renewal and homeostasis is a requirement of the vertebrate corneal epithelium.
Ninety preselected children, aged between 8 and 14 years, living in two rural West African (Gambian) villages, were randomly divided into three groups, matched for age and sex. One group received a placebo (lactose) tablet, one received riboflavin (5 mg) on 5 d every week, which was sufficient to correct an endemic riboflavin deficiency, and one received a multivitamin supplement (Protovit; Hoffmann La Roche), on 5 d every week, together with FeSO4 (200 mg) once weekly, and the supplements were given for 1 year. Neuromuscular tests, including arm tremor and manipulative skills, were performed on three occasions: once just before the introduction of the supplements; again 6 weeks after commencing the supplements; and again 1 year later. Venous blood samples were collected at the same time as the first two sets of neuromuscular tests. These samples were used for haematology and nutrient status indices: plasma ferritin, ascorbic acid, cyanocobalamin and pyridoxal phosphate, and erythrocyte tests for folate status, for riboflavin status (erythrocyte glutathione reductase activation coefficient) and thiamine status (erythrocyte transketolase activation coefficient). The riboflavin in both supplements achieved a clear-cut response in biochemical status, which was dose-dependent. The pyridoxine, ascorbic acid and Fe components of the multivitamin also affected the associated biochemical indices. Although overall the arm tremor and related neuromuscular function tests did not respond significantly to the supplements, significant improvement was seen in the boys for the arm-tremor test in both the supplemented groups.
The chemical mutagen ethylmethanesulphonate (EMS) has been used to generate mutants of Erwinia carotovora subspecies carotovora which are defective in the secretion of pectinases (Pel) and cellulases (Cel) but unaltered for protease (Prt) secretion. Such mutants, called Out-, still synthesize Pel and Cel but these enzymes accumulate within the periplasm. Cosmid clones carrying wild-type E. carotovora ssp. carotovora DNA, identified by their ability to restore the Out+ phenotype when transferred to some Out- mutants, were classified into six complementation groups using cosmids and cosmid derivatives. Analysis of the nucleotide sequence of a 12.7 kb DNA fragment, encompassing complementing cosmid inserts, revealed a coding capacity for 13 potential open reading frames (ORFs), and these were designated outC-outO. Some of the out gene products were visualized using a T7 gene 10 expression system. The predicted Out proteins are highly similar to components of extracellular enzyme secretion systems from a diverse range of eubacteria including Erwinia chrysanthemi, Klebsiella oxytoca, Aeromonas hydrophila, Pseudomonas aeruginosa and Xanthomonas campestris. Lower levels of similarity exist between Ecc Out proteins and components of macromolecular trafficking systems from Bacillus subtilis, Haemophilus influenzae, Agrobacterium tumefaciens, Yersinia pestis and a protein involved in the morphogenesis of filamentous bacteriophages such as M13.
Following the diagnosis of a case of miliary tuberculosis in a ward of 30 psychogeriatric patients, a further seven patients required treatment for active tuberculosis, and an additional four received prophylactic therapy. Tuberculosis contributed significantly to the deaths of three patients during the outbreak. This report highlights the particular risks of both reactivation and primary tuberculosis among geriatric patients receiving long term residential care. Late diagnosis contributed to the extent of the outbreak. Previous studies indicate that occult transmission of tuberculosis is relatively common in this group. An active policy of screening and prophylactic treatment is advised.
Ten patients were reconstructed with the microvascular osteocutaneous groin flap for oromandibular defects with the objective of improving function. The flap was based on the superficial and deep circumflex iliac vessels for optimal positioning of the bone and contouring of the skin. Patients with major glossectomies and arch resections had intelligible speech and were able to eat a soft diet without aspirating. Cineradiographic studies to evaluate swallowing in selected patients showed that the shape of the intraoral flap and the location of the bone graft played an important role in swallowing and prevention of aspiration.
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Since 1979, the SMAS (Superficial Muscular Aponeurotic System) has been used in over 100 parotidectomies to ameliorate the sunken facial appearance, and to prevent Frey's Syndrome. The procedure involves a rhytidectomy incision followed by variations including superior rotation, posterior advancement and plication of the SMAS. Appropriateness of such variations considers the defect from the surgery, and the histology of the tumor.
The current study reports complications from thyroidectomy in 253 consecutive patients from 1988 to 1992. There were 10 temporary cases of hypoparathyroidism. After total thyroidectomy, one of 34 patients (3.2%) developed permanent hypoparathyroidism. Complications of recurrent laryngeal nerve (RLN) injury or hypoparathyroidism were no more common following completion thyroidectomy than total thyroidectomy. Unplanned RLN injury was seen in 13 patients of which 7 were permanent (2.1% of 334 nerves at risk). All 13 patients with RLN injury experienced a reduction in speech "loudness", but only 3 reported "hoarseness". The RLN may be injured without serious vocal disability. Eleven of 171 right RLN's at risk were injured as compared to 2 of 163 left RLN's. The volume of thyroid tissue resected was positively associated with RLN injury (p < 0.05) and not hypoparathyroidism. These findings are discussed. Hypoparathyroidism, not "symptomatic" RLN injury, is the most problematic complication impacting on the decision whether or not to perform total or completion thyroidectomy.