Biomedical subjects

L Starr

Publications and source records attributed to L Starr.

15 recordsLinked to original sources

PubMed1999

A comparative evaluation of a fibromyalgia rehabilitation program.

OBJECTIVE: To compare an evidence-based clinical fibromyalgia program, referred to as Fibro-Fit, with results of controlled clinical trials. METHODS: An interdisciplinary group education and exercise program with 36 sessions over 12 weeks was used. Demographic, clinical, and outcome variables were collected on 149 participants, of whom 71% completed the program. Outcomes included measures of self-efficacy, pain, physical fitness, function, and coping skills. RESULTS: Results of the prospective before-after evaluation showed statistically significant (P < 0.005) improvements in all outcomes except for grip strength. These results were comparable with controlled clinical trials found in the literature. Data suggest that smoking, fibromyalgia support groups, and medications may be important modifiable factors. CONCLUSIONS: Results suggest that Fibro-Fit was effective in improving physical impairments and function. Further investigation is required to refine the effective components of these programs and determine how modifiable factors can be used to improve outcomes.

Activities of Daily Living↗

PubMed1999

The program for rheumatic independent self-management: a pilot evaluation.

The 'Program for Rheumatic Independent Self-Management' (PRISM) is an interdisciplinary programme that integrates group education and individualised treatment using the principles of self-management, adult learning, case management and self-efficacy enhancement. This study is a before-after evaluation of 57 individuals who attended PRISM. Outcome measures were selected to measure self-efficacy, disability, pain and ability to cope. The mean self-efficacy score increased immediately following the programme and this improvement was maintained at 6-month follow-up. Disability decreased from baseline to 6-month follow-up. There was a decrease in the mean level of pain from post-class to 6-month follow-up. All of these changes were statistically significant. These preliminary findings suggest that PRISM may be effective in enhancing self-efficacy, and reducing disability and pain.

Adolescent↗

PubMed1998

Laminin-5 coating enhances epithelial cell attachment, spreading, and hemidesmosome assembly on Ti-6A1-4V implant material in vitro.

Enhancement of epithelial cell attachment to laminin-5-coated titanium alloy (Ti-6Al-4V) implant material was evaluated in vitro. Protein analysis showed that Ti-6Al-4V has a high affinity for laminin-5 and adsorbed significantly more laminin-5 than laminin-1. DNA analysis showed that laminin-5 enhanced attachment of normal human epidermal keratinocytes (NHEK) to Ti-6Al-4V significantly more than did laminin-1 or uncoated controls. The effect of passivation on laminin-5 adsorption and activity on Ti-6Al-4V also was evaluated. Passivation had no significant effect on the amount of protein adsorbed; however, AFM, ESCA, and ToF-SIMS analyses suggested that passivation affects the conformation of adsorbed laminin-5. Although laminin-5 coating significantly enhanced rapid attachment of epithelial cells to both passivated and unpassivated Ti-6Al-4V, surface area measurements showed that cells spread on laminin-5-coated passivated Ti-6Al-4V covered a significantly larger surface area than cells spread on laminin-5-coated unpassivated samples. TEM analysis showed that cells formed significantly more hemidesmosomes on the surface of laminin-5 coated passivated than on the surface of laminin-5 coated unpassivated titanium alloy. The enhancement of rapid cell attachment, spreading, and hemidesmosome assembly on laminin-5-coated passivated samples may reflect better integration between epithelial cells and titanium alloy and thus may be predictive of long-term implant stability.

Cell Adhesion↗

PubMed1993

A new isoform of the laminin receptor integrin alpha 7 beta 1 is developmentally regulated in skeletal muscle.

Within the integrin family, there are two groups of receptors that bind laminin. One of these groups comprises the heterodimers alpha 3 beta 1, alpha 6 beta 1, and alpha 7 beta 1, all of which bind the E8 fragment of laminin, and whose alpha subunits show significant homology at the amino acid sequence level. alpha 3 and alpha 6 exist as isoforms with distinct cytoplasmic domains (termed A and B), suggesting that they may couple laminin adhesion to distinct cellular responses. We report the identification of a new alpha 7 mRNA which encodes an alpha 7 protein isoform with an alternative cytoplasmic domain. Based on homology with alpha 3 and alpha 6 isoforms, this new isoform is classified as alpha 7A and the previously published one as alpha 7B. This result extends the similarity between alpha 3, alpha 6, and alpha 7 laminin receptor subunits and suggests a common ancestral gene. The alpha 7 beta 1 laminin receptor was proposed to be involved in myogenic differentiation. However, alpha 7 isoforms were not investigated in that context. We detected the alpha 7B isoform mRNA in all tissues and cell types tested, including myocardial and skeletal muscle. In contrast, the alpha 7A isoform was detectable exclusively in skeletal muscle, not in myocardial muscle or cells or any other tissues or cell lines tested. Furthermore, the differentiating skeletal muscle cell line C2C12 expressed only alpha 7B at the replicating myoblast stage and acquired alpha 7A expression upon induction of differentiation and fusion. Splicing of alpha 7B mRNA in C2C12 occurred shortly after myogenin expression and could be an indicator of progression through the program of skeletal muscle differentiation.

Amino Acid Sequence↗

PubMed1993

APA's expert panel in the congressional review of the USS Iowa incident.

In 1989, an explosion aboard the USS Iowa killed 47 sailors. The Navy attributed the explosion to the intentional suicidal acts of Gunners Mate Clayton Hartwig, a conclusion supported primarily by an "equivocal death analysis" conducted by the Federal Bureau of Investigation (FBI). The U.S. House of Representatives Armed Services Committee (HASC) was highly critical of the FBI's report and the Navy's conclusions, in part because of the peer review provided by 12 psychologists organized by the American Psychological Association (APA). This article (a) reviews the nature of equivocal death analysis and related reconstructive psychological evaluations, (b) describes the nature of APA's consultation and involvement with the HASC, (c) discusses the conclusions reached by the HASC and the influence of the APA panelists, and (d) suggests limitations on the use of equivocal death analysis and related procedures in light of scientific concerns and ethical considerations.

Adult↗

PubMed1993

An empirical study of the reports of APA's peer review panel in the congressional review of the U.S.S. IOWA incident.

The U.S. House of Representatives Armed Services Committee (HASC) review of the US. Navy's investigation of the U.S.S. IOWA incident provides a case study of the problems with reconstructive psychological evaluations. The US. Navy attributed the explosion on board the U.S.S. IOWA to the intentional suicidal acts of Gunner's Mate Clayton Hartwig, a conclusion supported primarily by an Equivocal Death Analysis (EDA) conducted by the FBI. Systematic analysis of the reports of the expert panelists who consulted to the NASC reveals that 11 of the 14 panelists were critical of the conclusions reached by the Navy/FBI. There was considerable variability among the judgments of the panelists, who reached consensus only for broad categories. Because the reliability and validity of postmortem psychological reconstructions such as EDA and psychological autopsy have not been established, clinicians are urged to exercise caution in the use of such procedures and to be sensitive to ethical obligations to consumers when using such techniques.

Journal Article↗

PubMed1992

Application of a filamentous phage pVIII fusion protein system suitable for efficient production, screening, and mutagenesis of F(ab) antibody fragments.

We describe the application of a novel filamentous phage vector system suitable for efficient screening and production of F(ab) antibody fragments. The vector system can concurrently produce free F(ab) fragments and F(ab) displayed on the surface of M13 bacteriophage via a VHCH1-pVIII fusion protein. When expressed in a supO (nonsuppressor) strain of Escherichia coli free F(ab) can be produced. Antibody F(ab) fragments are secreted into culture medium at concentrations up to 0.3 mg/liter and conveniently subjected to detailed analysis with little or no purification. Higher concentrations of F(ab) (approximately 10 mg/liter) were found to accumulate in the periplasmic space. In this report the vector system is shown to produce correctly folded and assembled F(ab) fragments of chimeric L6, a mAb against a tumor-associated Ag expressed by many human carcinomas.

Antibodies, Monoclonal↗

PubMed1992

An efficient and reliable method for cloning PCR-amplification products: a survey of point mutations in integrin cDNA.

A highly efficient, non-labor-intensive method for cloning DNA fragments produced by PCR amplification was used to carry out a rapid survey of potential point mutations in integrin alpha 6 cDNA from 17 different cell-type sources. The method includes glass powder purification of the PCR reaction mixture, followed by simultaneous treatment with T4 polynucleotide kinase and DNA polymerase I, and another glass powder purification. Sequences from multiple subclones of each cell type were readily generated, aligned and checked for mismatches. Several commonly used alternative procedures were compared for cloning efficiency and size-fidelity of inserted DNA fragments.

Amino Acid Sequence↗

PubMed1990

Complete amino acid sequence of a novel integrin beta subunit (beta 6) identified in epithelial cells using the polymerase chain reaction.

The integrin family of adhesion receptors consists of several heterodimeric glycoproteins, each composed of one alpha and one beta subunit. Three different mammalian beta subunits, beta 1, beta 2, and beta 3, have been sequenced, but recent evidence suggests the existence of several others. Amplification of guinea pig airway epithelial cell cDNA with oligonucleotide primers designed to recognize consensus integrin beta subunit sequences led to the identification of a novel partial cDNA sequence. Clones containing portions of this sequence were used to screen cDNA libraries constructed from the human pancreatic carcinoma cell line FG-2 and identified a series of overlapping clones encoding the full-length sequence of the human homologue of this protein. This sequence of 788 amino acids is 43, 38, and 47% identical to the sequences of beta 1, beta 2, and beta 3, respectively. Features shared between this novel protein and the previously sequenced beta subunits include the positions of all 56 cysteine residues in the extracellular domain, the single putative transmembrane domain, and the short putative cytoplasmic domain. However, a unique 11-amino acid extension at the carboxyl terminus, not present in any of the other beta subunits, is suggestive of distinctive interactions with cytoplasmic components. Comparison of the human and guinea pig sequences reveals a high degree (94%) of cross-species conservation. Because this protein is clearly distinct from the two other recently described integrins beta 4 and beta 5, we propose to designate it beta 6.

Amino Acid Sequence↗

PubMed1990

Epithelial integrin alpha 6 beta 4: complete primary structure of alpha 6 and variant forms of beta 4.

The integrin alpha 6 beta 4 is a heterodimer predominantly expressed by epithelia. While no definite receptor function has yet been assigned to it, this integrin may mediate adhesive and/or migratory functions of epithelial cells. We have determined the complete primary structure of both the alpha 6 and beta 4 subunits from cDNA clones isolated from pancreatic carcinoma cell line libraries. The deduced amino acid sequence of alpha 6 is homologous to other integrin alpha chains (18-26% identity). Antibodies to an alpha 6 carboxy terminus peptide immunoprecipitated alpha 6 beta 4 complexes from carcinoma cells and alpha 6 beta 1 complexes from platelets, providing further evidence for the association of alpha 6 with more than one beta subunit. The deduced amino acid sequence of beta 4 predicts an extracellular portion homologous to other integrin beta chains, and a unique cytoplasmic domain comprised of greater than 1,000 residues. This agrees with the structures of the beta 4 cDNAs from normal epithelial cells (Suzuki, S., and Y. Naitoh. 1990. EMBO [Eur. Mol. Biol. Organ.] J. 9:757-763; Hogervost, F., I. Kuikman, A. E. G. Kr. von dem Borne, and A. Sonnenberg. 1990. EMBO [Eur. Mol. Biol. Organ.] J. 9:765-770). Compared to these structures, however, the beta 4 cDNAs that we have cloned from carcinoma cells contain extra sequences. One of these is located in the 5'-untranslated region, and may encode regulatory sequences. Another specifies a segment of 70 amino acids in the cytoplasmic tail. Amplification by reverse transcription-polymerase chain reaction of mRNA indicated that multiple forms of beta 4 may exist, possibly due to cell-type specific alternative splicing. The unique structure of beta 4 suggests its involvement in novel cytoskeletal interactions. Consistent with this possibility, alpha 6 beta 4 is mostly concentrated on the basal surface of epithelial cells, but does not colocalize with components of adhesion plaques.

Amino Acid Sequence↗

PubMed1988

Information explosion in radiology.

We studied the increase in the number of articles in the radiologic literature in the years 1970, 1978, and 1985 using the Medlars program which provides reproducibility, a recognized bibliographic pool, and a wide coverage of the medical literature. A dramatic increase in the number of articles was found; the increase has both positive and negative implications for the profession. A similar analysis of monographs using the Catline file and the same subject headings also showed a significant increase in the volume of material relating to certain radiologic subspecialties. The problems arising from the attempt to identify and extract relevant information from this overwhelming mass of radiological data should be addressed.

Books↗

PubMed1987

The herpes simplex virus origins of DNA synthesis in the S component are each contained in a transcribed open reading frame.

In the herpes simplex virus 1 genome, the origins of viral DNA synthesis are located in the unique sequences of the L component (Oril) and in the reiterated sequences of the S component (OriS) located between the 5' terminus of the alpha 4 gene and the 5' terminus of either the alpha 22 (left terminus of the S component) or the alpha 47 (right terminus of the S component) gene. Studies prompted by the finding that only one, but not both, OriS sequence is dispensable for growth in cell culture indicate that each OriS sequence is contained in an open reading frame designated as OriSORF. The transcription of OriSORF is initiated approximately 860 nucleotides upstream from that of the alpha 4 gene and 162 nucleotides downstream, but on the opposite strand from the transcription initiation site of the alpha 22 or alpha 47 genes within the inverted repeat c sequence. The OriSORF transcript is 3' coterminal with the mRNA of the alpha 4 gene, polyadenylated but not spliced, transported into the cytoplasm, and capable of directing the synthesis of a 330-amino-acid protein with a translated molecular weight of approximately 34,000. Transcription is cycloheximide but not phosphonoacetate sensitive and is therefore regulated as either a beta or a gamma 1 gene. The implications of the transcription of OriS and of possible functions of the product of OriSORF are discussed.

Animals↗

PubMed1976

On the accumulation of adenosine 3':5'-monophosphate in Ehrlich cells and adenylate cyclase desensitization in response to epinephrine.

The time course of the action of epinephrine on cAMP levels in isolated mouse Ehrlich ascites cells was studied. Following the addition of hormone (10(-7) to 10(-4) M), cAMP levels reached a maximum within 1 min and declined to about 2 fold basal levels within 10-20 min. The decline phase was not due to the metabolism of epinephrine or accumulation of an inhibitor in the medium. Experiments involving timed additions of theophylline to epinephrine-treated cells suggested that the rate of cAMP synthesis declined progressively with time. Cells treated with epinephrine and then washed free of hormone were shown to be refractory to hormonal stimulation of cAMP levels. Adenylate cyclase prepared from epinephrine-treated cells was shown to exhibit decreased sensitivity to the hormone in in vitro incubations. Resensitization of the enzyme could be achieved by washing pretreated cells free of epinephrine and reincubating them for 1/2 to 2 h. Neither desensitization nor resensitization were prevented by cycloheximide or actinomycin D. Desensitization could not be induced by incubating cels with dibutyryl-cAMP. The desensitization phenomenon is considered to be a mechanism whereby cells protect themselves against the possible harmful effects of high levels of cAMP maintained over a long period of time.

Adenylyl Cyclases↗

PubMedDate not supplied

Cost effectiveness of an allergy consultation in the management of asthma.

In a large Denver HMO, a retrospective study of asthma management was reviewed. Seventy moderate to severe asthmatic patients' charts were reviewed through April 1994. All patients admitted to the study had to be followed for at least 1 year by a primary care physician before the allergy evaluation (AE) and for at least one year of followup (F/U) after the AE. All patients had at least two acute care (ER) visits and/or one hospitalization before the AE. All primary care, AE, and F/U were done by staff physicians in the Kaiser Permanente system. The findings included 1) Forty-five percent decrease (308 to 169) in the number of sick care office visits (P = 0.0001); 2) fifty-five percent decrease (266 to 118) in acute care visits (P = 0.0001); 3) sixty-seven percent decrease (34 to 11) in the number of hospitalizations after the AE (P = 0.001); 4) average hospital days before AE were four days and after AE, 2.5 days; 5) estimated cost saving of $145,500, or $2,100 per patient.

Acute Disease↗

PubMedDate not supplied

Consensus creates effective programs. "Quick response service" project reveals importance of stakeholders' input.

In the Hamilton-Wentworth area of Ontario, Canada, three acute care hospitals and a home care program joined together to try to reduce local senior citizens' admissions to hospitals and visits to emergency rooms. They hoped to achieve this by providing seniors with care in their homes. Realizing that the project would have to employ collaborative decision making, its cosponsors selected participants from both the hospitals (for example, administrators and physicians) and the community (for example, consumers and family physicians). The cosponsors chose cochairpersons from the hospital sector and the community sector. The project was complex because it involved so many stakeholders, but the cochairpersons gave it both its stability and its driving force. Decision making was done through consensus, a process that can be tedious and frustrating, especially when based on systemic evaluation, a process in which a group analyzes a full range of advantages and disadvantages to a course of action. Nevertheless, the cosponsors found the process vital to the project's success. By the end of the project, 342 hospital admissions and 70 emergency room visits had been averted. The cosponsors had discovered that because collaborative decision making can facilitate efficiency and "buy-in," it saves both money and time in the long run.

Aged↗