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L Angus

Publications and source records attributed to L Angus.

11 recordsLinked to original sources

The narrative processes coding system: research applications and implications for psychotherapy practice.

The Narrative Processes model is focused on the strategies and processes by which a client and therapist transform the events of everyday life into a meaningful story that both organizes and represents the client's sense of self and others in the world. Some investigators have elected to use clients' within session descriptions of relationship events or micronarratives as their unit of narrative analysis. In contrast, we are centrally interested in the development of the macronarrative framework in which the singular events described in a therapy relationship-micronarratives-come to be articulated, experienced, and linked together in such a way that the client's sense of his or her life story-in essence, the sense of self-may be transformed at the conclusion of the therapeutic relationship. The following paper details the Narrative Processes theory of therapy and the coding system that has been developed to identify and evaluate empirically key components of the model. Findings emerging from the analyses of successful psychotherapy dyads are described and the implications for future research and practice are discussed.

Cognitive Behavioral Therapy↗

Nerve-derived trophic factors and DNA elements controlling expression of genes encoding synaptic proteins in skeletal muscle fibers.

The neuromuscular junction represents an excellent model system for studying various critical issues in neurobiology at the molecular, cellular, and physiological levels. Our understanding of the basic events underlying synpase formation, maintenance, and plasticity has progressed considerably over the last few years primarily because of the numerous studies that have focused on this synapse and used sophisticated recombinant DNA technology. Recent data indicate that myonuclei located in the vicinity of the postsynaptic membrane are in a differential state of transcription compared to nuclei of the extrasynaptic sarcoplasm. Thus, renewal of postsynaptic membrane proteins appears to occur via a mechanism involving the local transcriptional activation of genes encoding these specialized proteins and extracellular cues originating from motoneurons. Such interaction between presynaptic nerve terminals and the postsynaptic sarcoplasm indicates that the entire signal transduction pathway is compartmentalized at the level of the neuromuscular junction. Expression of these genes appears less coregulated than originally anticipated, indicating that maintenance of the postsynaptic membrane requires the contribution of multiple extracellular signals, which ultimately urge target transcription factors to distinct DNA regulatory elements via various second messenger systems.

Cell Nucleus↗

Peritoneal lavage white count: a reassessment.

Of 29 blunt trauma victims with a diagnostic peritoneal lavage white blood cell count (DPL:WBC) greater than or equal to 500/mm3 as the sole positive lavage criterion, only four underwent laparotomy at admission, and only one of these had sustained intestinal perforation. Two of the remaining 25 succumbed to extra-abdominal injuries within 24 hours, leaving 23 patients, who were followed clinically for an average of 34.7 days. None was ever discovered to have sustained intestinal perforation. Throughout the study period, 27 patients were seen who had sustained intestinal perforation from blunt abdominal trauma. Nine were explored based upon an initial physical examination suggestive of peritonitis. The remaining 18 underwent DPL: 17 demonstrated gross blood, and only one patient was diagnosed solely by an elevated DPL:WBC. We conclude that DPL:WBC is a nonspecific indicator of intestinal perforation from blunt abdominal trauma, and prospective studies are needed to properly define its role. Sequential determinations of DPL:WBC may be useful in the diagnosis of intestinal perforation.

Abdominal Injuries↗

Starvation and mucosal prostaglandin-E2 in gastric stress ulceration.

To determine whether starvation increases the susceptibility of the gastric mucosa to stress ulceration and whether this effect is linked to a change in the mucosal level of prostaglandin-E2 (PGE2), 100 Holtzman rats were divided into five groups and deprived of food for 0, 12, 24, 48 and 72 h. Then, ten animals within each group were stressed by cold restraint. At the end of the stress period, all these animals as well as their unstressed counterparts were killed, the number of gastric ulcers were counted, and mucosal levels of PGE2 were assayed. Fasting alone caused no ulcerations but a decrease in mucosal PGE2 during the initial 24 h (p less than .05). However, there was a subsequent increase in mucosal PGE2, possibly related to the release of free fatty acids during starvation. Starvation and stress caused a marked and consistent reduction of the mucosal PGE2 and an increase in the number of mucosal ulcerations directly related to the duration of starvation (p less than .05).

Animals↗

High-performance liquid-chromatographic assay for prostaglandins with the use of p-(9-anthroyloxy)phenacyl bromide.

Gastric mucosa of rats and swine was incubated in buffer for 1 min to produce prostaglandins (PGs). After extraction and derivatization with p-(9-anthroyloxy)phenacyl bromide, the prostaglandin esters were determined by high-performance liquid chromatography. A 20-microliter sample was injected into a microparticulate silica gel column with a mobile phase of dichloromethane-acetonitrile-methanol (90:9:1). At a flow-rate of 1.5 ml/min the retention times of the prostaglandin esters were 7.14 min (internal standard), 7.90 min (PGF2), 10.05 min (thromboxane2), 12.26 min (6 alpha-keto-PGF1 alpha) and 13.98 min (PGF2 alpha). In spite of high sensitivity (0.1 ng per sample) for PGE2 and PGF2 alpha, only PGE2 synthesis was observed.

6-Ketoprostaglandin F1 alpha↗

Picogram measurement of prostaglandin E2 synthesis by gastric mucosa by high-performance liquid chromatography.

Prostaglandin biosynthesis by gastric mucosa was determined by a 1-min incubation, solvent extraction, and reaction with panacyl bromide. The prostaglandin ester was measured by normal-phase high-performance liquid chromatography. The prostaglandin E2 levels of normal gastric mucosa of rats and swine were 90.6 +/- 31.0 and 79.8 +/- 39.8 pg/min/mg tissue, respectively. This method was sensitive to 40 pg and specific for prostaglandin E2.

Animals↗

Arachidonic acid protection of rat mucosa against stress ulceration.

To evaluate the effect of arachidonic acid (AA), a prostaglandin precursor, on the mucosal level of PGE2 and its possible protective role against stress ulcerations, 40 Holtzman rats were divided into four groups: Group I intragastrically receiving 1 ml of normal saline (NS); Group II, NS pretreatment followed by stress; Group III, intragastric AA pretreatment without stress; and Group IV, intragastric AA followed by stress. AA was administered as a 120 mM solution in a nonionic detergent, adjusted to a pH of 8.0. Stress was provided by the cold-restraint method. After sacrifice, the number of gastric mucosal ulcerations were counted. Specimens of nonulcerated mucosa were assayed for PGE2 by derivatization with panacyl bromide and by using high-performance liquid chromatography. The animals in Groups I, III, and IV developed no gastric ulcerations and their mucosal prostaglandin E2 remained at a normal level, while those in Group II had a significant reduction of mucosal PGE2 (P less than 0.05) and a significantly increased number of gastric ulcerations (P less than 0.002). These data indicate that stress-induced mucosal ulcerations are associated with significant decreases in the gastric mucosal levels of PGE2. Intragastric administration of arachidonic acid prevents the formation of stress mucosal ulcerations and maintains a normal level of mucosal PGE2.

Animals↗

Disseminated intravascular coagulation as a result of supraceliac clamping: implications for thoracoabdominal aneurysm repair.

Massive coagulopathy and bleeding continues to play a major role in the operative mortality and perioperative multi-system failure of patients requiring elective thoracoabdominal aneurysm repair. It was the purpose of this study to determine the coagulation defect that occurs with supraceliac aortic clamping and the effects of increasing aortic cross-clamp time (AXCT) on the coagulation system and its recovery. Through a standard thoracoabdominal incision, 16 mongrel dogs had their aortas cross-clamped simultaneously just above the diaphragm and at the aortic bifurcation. Animals were divided into four groups of four animals each; sham operation, 30 minute AXCT, 60 minute AXCT, and 90 minute AXCT. Central venous blood was sampled prior to aortic cross clamping (AXC), during AXC and 1 hour, 2 hours, 5 hours, 7 hours, 12 hours, and 24 hours after the clamp was removed. All samples were assayed for platelets, fibrinogen, fibrin split products, prothrombin time (PT) and partial thromboplastin time (PTT). Platelets and fibrinogen decreased as PT and PTT increased with increasing AXCT consistent with disseminated intravascular coagulation (DIC) (P less than .001). Fibrin split products were positive in the 90 minute AXCT group only. The drop in platelets was greater for increasing AXCT and continued to fall in the 30, 60 and 90 minute AXCT groups at 24 hours (p less than .001). Fibrinogen dropped to the lowest levels between two and twelve hours after AXC and returned to normal at twenty-four hours in the 60 and 90 minute AXCT groups (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Complicated urinary infection in spinal injury patients: fleroxacin compared with ciprofloxacin.

The efficacy and safety of fleroxacin and ciprofloxacin were evaluated in a single-centre, prospective, randomised, blinded study of patients with complicated urinary infection in a spinal injury unit. Patients were randomised to receive oral fleroxacin 400 mg once daily (n = 68) or oral ciprofloxacin 500 mg twice daily (n = 65) for 10 days. Clinical cure assessed 5-9 days after therapy was obtained in 41 of 42 (98%) assessable patients in the fleroxacin group, and in 41 of 43 (95%) of the ciprofloxacin group, and was maintained at the 6-week follow-up visit in all but 1 patient in each group. Bacteriological eradication rates 5-9 days after therapy exceeded 88% in the fleroxacin group and 86% in the ciprofloxacin group, and 69 and 65%, respectively, 6 weeks after completion of therapy. Adverse events occurred in a similarly low percentage of patients (19 and 20%) in both treatment groups, and consisted primarily of nausea. Once daily fleroxacin appears to be as safe and effective as twice daily ciprofloxacin and both represent efficacious treatment in complicated urinary infection in spinal injury patients.

Administration, Oral↗