Biomedical subjects
Publications and source records attributed to L Moss.
The development of the enzymes of sulfate activation, ATP-sulfurylase and APS-kinase has been studied in rat cerebrum and, for comparison, in rat liver as well. Cerebrum contains a species of ATP-sulfurylase which can be inhibited by phenylalanine. The activity of this form of ATP-sulfurylase is high in oligodendroglial cells and parallels the rate of myelination.
Obsessive-compulsive disorder (OCD) is a severe psychiatric illness that is difficult to treat. The effects of trazodone hydrochloride treatment were studied, both with and without the addition of a monoamine oxidase inhibitor, in OCD patients. Changes in symptoms correlated with changes in local cerebral metabolic rates for glucose (LCMRGlc), as measured by positron emission tomography and the 18F-fluorodeoxyglucose method. All patients whose OCD responded favorably to drug treatment showed a relative increase in glucose metabolism in the heads of the caudate nuclei compared with the metabolic rate in the ipsilateral hemisphere as a whole (ratio LCMRGlc caudate/LCMRGlc hemisphere). Patients who did not respond to treatment did not show an increase in this ratio, and the difference between responders and nonresponders was significant (p less than 0.03). Changes in the ratio LCMRGlc caudate/LCMRGlc hemisphere correlated with changes on OCD and depression rating scales.
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An assay method for ATP-sulfurylase is described, based on the incorporation of 35SO4(2-) into adenosine-5'-phosphosulfate (and 3-phosphoadenosine-5'-phosphosulfate) and the separation of these compounds by HPLC. Since the enzyme is easily inactivated at temperatures above 20 degrees C during the assay, the reaction time should not exceed 10 min.
Effects of body size on the kinetics of glucose metabolism were examined. In trial 1, steers were fed 6 kg of an 80:20 concentrate:roughage diet daily across a weight range of 226 to 470 kg. In trial 2, steers were fed 4.5 kg of a 45:55 concentrate:roughage diet daily across a weight range of 134 to 390 kg. Glucose irreversible loss averaged 820 +/- 32 and 461 +/- 13 mg/min for trials 1 and 2 and was not affected by body size. Thus, glucose irreversible loss seems to be regulated by feed intake when intake is above maintenance. Body size had no effect on glucose total entry rate, recycling or pool size. Blood glucose concentration and glucose space decreased at 0.004 mg X ml-1 X kg-1 and 0.002 fractional units body wt X kg-1 as body size increased. Digestible energy and nitrogen balance were measured in trial 2. Digestibility of energy increased at 0.0054 Mcal X d-1 X kg-1 as body size increased. Nitrogen retention averaged 28.2 g X d-1 and was not influenced by body size even though energy intake approached maintenance amounts at the end of the trial. On the basis of urinary nitrogen excretion data, we conclude that the maximum net contribution of amino acid carbon to glucose synthesis was 8% of glucose carbon.
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In 41 of 55 patients in whom the gallbladder lumen was not identified by static sonography, a specific image was observed with dynamic scanning. This consisted of two parallel arcuate echogenic lines separated by a thin anechoic space with distal acoustic shadowing: the "double-arc-shadow" sign. The proximal arc represents the near wall of the gallbladder, the anechoic space is bile in the gallbladder lumen, and the distal arc represents the gallstone(s) responsible for the acoustic shadowing. Of the two additional sonographic patterns observed, the "'echo-shadow" pattern, which was seen with static scanning in 44 and with dynamic scanning in eight patients was an accurate, indirect indicator for cholelithiasis. On the other hand, "nonvisualization" was an unreliable sign. Of 11 such patients scanned with static and six with dynamic scanning, four proved to have a normal gallbladder. Comparing static with dynamic cholecystosonography in patients with nonphysiologically contracted gallbladders, the accuracy rate for cholelithiasis increased from 86.3% (44 of 51 patients) to 96% (49 of 51). In 41 of these patients (80%) the double-arc-shadow pattern positively identified the gallbladder lumen, increasing the confidence of the examiner. Furthermore, these images can be produced in a fraction of the time required for complete evaluation with static scanning.
Prescriber, pharmacist, and patient interpretations of commonly used prescription directions were assessed. Results indicated that: 1) Attempts to make directions more time-specific without indicating actual hours for ingestion of the medication tends to lead to patient confusion and potential compliance problems; 2) Some prescribers do not understand the potential interpretation of their own directions; 3) Patients tend to base drug ingestion time on their lifestyles, and unless directions are actually time-specific (e.g., one at 8 a.m., 1 p.m., and 7.p.m.), compliance problems will probably continue; and 4) The prescribed and the pharmacist cannot assume understanding on the part of the patient for nonspecific directions. They must not only reinforce directions, but must also determine the patient's level of understanding, so that actual compliance with the directions intended has a chance for success.
The authors compared the diagnostic accuracy of gray-scale static scanning and high-resolution real-time ultrasonography in the evaluation of gallbladder disease in 339 patients. With real-time scanning, the gallbladder was seen in 97.6% of cases and gallstones were unequivocally demonstrated in 94.5% of patients with cholelithiasis, compared to 89.5% and 78.8%, respectively, with static scanning. Real-time scanning is more accurate because it can show the contracted, stone-filled gallbladder. It is also faster and more convenient to both patient and examiner, making it the procedure of choice in the primary evaluation of gallbladder disease.
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Pathologic hair-pulling (trichotillomania) has been described in the dermatologic and psychiatric literature for the last century, but has become the focus of increased attention in the last few years. Once thought to be either a wholly benign condition or a symptom of obsessive-compulsive disorder, more recently hair-pulling has been noted in the context of numerous types of psychopathology, and has been reported to respond to several different types of intervention, both psychological and somatic. Estimates of its prevalence have varied widely. Because of the disparate conclusions of the literature on this condition, a more careful assessment of diagnostic validity is recommended.