Biomedical subjects
L Young
Publications and source records attributed to L Young.
Sexual abuse and the problem of embodiment.
In this paper, trauma, sexual abuse, and some of the potential resulting long-term effects, are explored in terms of the problem of embodiment and the formation of personal identity and psychological integrity. That is, what effect does severe sexual abuse have on an individual's, particularly a child's, sense of living in his or her body and, by extension, living in the world? First, trauma and dissociation are analyzed and linked to the development and maintenance of a "posttraumatic" sense of personal identity. Then, several disorders associated with sexual abuse--dissociation, multiple personality disorder, eating disorders, somatization disorder, self-mutilation, suicide, and suicide attempts--are examined in terms of their phenomenological coherence and relation to the problem of embodiment. This conceptual framework may be of use to clinicians and researchers assessing and treating the survivors of sexual abuse.
Asthma prevalence and management in Australian adolescents: results from three community surveys.
Three population surveys of asthma, conducted as part of a community-based asthma education program in southwestern Sydney, Australia, illustrate the relationship between health behaviors and asthma morbidity. The first survey was carried out in five secondary schools (n = 2514, 52% participation rate); the second survey, in eight schools (n = 4550, 82% participation rate); and, the third survey was conducted among patients who attended 38 general practices in the region (n = 633 adolescents, 72% participation rate). The prevalence of diagnosed asthma in Australian adolescents across all three studies was 16.5% (95% CI, 15.7%-17.3%). Asthma prevalence declined in males, but increased in females from ages 12-15 years. It was noted that smoking prevalence was similar in asthmatic adolescents, compared with nonasthmatics, and that the adoption of smoking occurred at similar ages. Further, behavioral self-management of asthma was infrequent in this group, with low levels of preventive practice and preventive medication use. We present a conceptual model of the barriers to optimal asthma management among asthmatic adolescents. The results of these surveys have led to community-wide efforts to improve asthma management and decrease smoking prevalence among these adolescents.
Asthma under-recognition and under-treatment in an Australian community.
In a study in south-western Sydney, we examined asthma symptoms in a random sample of 4239 schoolchildren aged five-12 years. The prevalence of current wheeze and cough was 17.1% (95% CI 16.0-18.2%). Interviews were conducted with the parents of all 214 symptomatic children from two of the six schools. Only 60% of these children had ever been labelled as asthma, and only 20% were using appropriate asthma treatment. Fewer than 6% had ever had their airway function assessed. There was a socio-economic difference, with better levels of asthma recognition and management in children attending the school in the more affluent region. The findings suggest that asthma recognition, assessment and management in the Australian community, as in New Zealand and the UK, may need to be improved.
Plasma elimination and urinary excretion of procaine after administration of different products to standardbred mares.
Plasma and urinary concentrations of procaine were examined in Standardbred mares after subcutaneous administration of various doses (80 mg to 1600 mg) of procaine hydrochloride. Regardless of dose, peak plasma procaine values occurred within 1 h, but remained detectable in a dose-dependent manner, with procaine present at 1 h with the 80 mg dose and 6 h at the 1600 mg dose. Similarly, peak urinary procaine concentrations were attained within 1.5 to 3 h, irrespective of dose, while detection time was dose-dependent, being 23 h for 80-200 mg doses but as long as 30-54 h with the 1600 mg dose. When mares were given a single intramuscular injection of a penicillin G-procaine preparation (Ethacillin, Cillimycin, Penamycin, Derapen A, Azimycin or Diathal), peak plasma procaine concentrations varied and were reached from 10 min to 3 h in all cases, with detection from 3 to 20 h after drug administration. Although the peak urinary levels of procaine occurred between 30 mins and 6 h, detection in urine in most cases was as long as 78-120 h except for Diathal for which detection was limited to 54 h. Daily administration of a penicillin G-procaine preparation (Pen-Di-Strep) for 5 days produced a biphasic peak in plasma procaine at 3 and at 6-9 h with detection from 16 to 23 h after drug treatment. Although peak urinary procaine values were reached at similar times after single or multiple injections, the duration of detection was markedly longer (425 h) after the multiple-dose regimen.(ABSTRACT TRUNCATED AT 250 WORDS)
Reactive arthritis and group G streptococcal pharyngitis.
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A 22-month-old victim of near drowning.
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Sampling bias in asthma surveys of patients attending general practitioners in south-western Sydney.
Results from asthma surveys in patients attending general practitioners were compared with data from population-based samples. The prevalence of asthma symptoms and optimal asthma management were more common in the GP attenders. Attention should be paid to potential sources of sampling bias in chronic disease prevalence research in primary care settings.
Impaired neuropsychological functioning in symptomatic volunteers with schizotypy: preliminary findings.
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Restricted Epstein-Barr virus protein expression in Burkitt lymphoma is due to a different Epstein-Barr nuclear antigen 1 transcriptional initiation site.
Epstein-Barr virus (EBV) expresses six nuclear antigens (EBNAs) and three integral latent membrane proteins (LMPs) in latently infected growth-transformed B lymphoblastoid cell lines (LCLs). In contrast, EBV protein expression in Burkitt lymphoma tissue or in newly established Burkitt lymphoma cell lines is frequently restricted to the EBV genome maintenance protein, EBNA-1. EBNA-1 expression in the absence of other EBNAs and LMP-1 has been an enigma since, in LCLs, all EBNA mRNAs are processed from a single transcript. We now show that the basis for restricted EBV expression in Burkitt lymphoma cells is selective EBNA-1 mRNA transcription from a hitherto unrecognized promoter that is 50 kb closer to the EBNA-1-encoding exon than previously described EBNA-1 promoters. Infected cells with EBNA-1-restricted expression could preferentially persist in vivo in the face of EBV-immune T-cell responses, which are frequently directed against other EBNAs and are also dependent on LMP-1 expression.
Asthma among adolescents: a new issue?
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Observation of preferred direction melting in a lattice model of poly(dA-dC).poly(dG-dT).
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Radiotherapy and breast reconstruction: clinical results and dosimetry.
Immediate or delayed reconstruction using implants or autologous tissue transfer is increasingly offered to women undergoing mastectomy for breast cancer. Some patients require radiotherapy for prevention of local/regional relapse, and some for post-surgical local/regional recurrence. Others with augmented breasts may opt for conservative surgery and irradiation. At Washington University, 70 breast cancers were irradiated in 66 patients following mastectomy with reconstruction (N = 61) or wide local excision of an augmented breast (N = 5). Two patients elected to have a second reconstruction after an unsatisfactory initial result. Thus, 72 breasts were evaluated after radiotherapy for tumor control, complications, cosmesis, and patient satisfaction. Locoregional failure occurred in only five patients, one following adjuvant radiotherapy after mastectomy with reconstruction and four following radiotherapy for recurrent breast cancer within a reconstructed breast. Grade 2 or 3 complications occurred in 34 patients (51%). The complication rate was highest in autologous tissue transfer reconstructions. Cosmetic results were evaluated good/excellent in 49% by physicians and 67% by patients. Immediate reconstructions had fewer good/excellent physician evaluations (32%) compared with reconstructions performed at least 6 weeks after radiotherapy (55%). Transverse rectus abdominis flaps had the best cosmesis scores, followed by permanent silicone prostheses, tissue expanders, latissimus dorsi, and gluteal flaps. Only 48% of patients would choose to have the same reconstructive procedure again. Phantom interface dosimetry with a parallel plate chamber and TLD measurements was performed. Radiotherapy and reconstruction are not incompatible, but careful consideration of their relative timing and technique appear to be important in optimizing cosmesis while minimizing complications.
Prospective serial study of viral change in the cervix and correlation with human papillomavirus genome status.
OBJECTIVE: To observe in serial fashion the histological changes of human papilloma virus (HPV) infection of the cervix and to correlate these with the detection of HPV genomes. DESIGN: A prospective longitudinal study to perform colposcopy and at 0, 9 and 18 months to obtain a smear, a biopsy for histology and HPV-16 genome detection by DNA/DNA hybridization. SETTING: Glasgow Family Planning Centre. SUBJECTS: Eighty-two women recruited on the basis of a routine smear showing viral change without dyskaryosis. INTERVENTIONS: Women found to have CIN 3 were treated with laser. MAIN OUTCOME MEASURES: Cytology and cervical biopsy results and HPV-16 DNA detection by Southern blotting obtained serially from individual subjects. RESULTS: Of 82 women recruited, 10% were positive for HPV-16 detection by Southern blotting. Detection of HPV-16 genomes did not correlate with either CIN or viral infection assessed histologically and serial hybridizations in a given individual showed fluctuation in HPV-16 detection. Polymerase chain reaction in a subset of samples revealed 46% positive for HPV DNA. CONCLUSION: No clear correlation exists between HPV genome detection and the histological appearance. HPV-16 genome detection alone may not be a useful predictor of precancerous progression.
Pyochelin-mediated iron transport in Pseudomonas aeruginosa: involvement of a high-molecular-mass outer membrane protein.
An iron-regulated outer membrane protein of 75,000 daltons was strongly expressed following iron limitation of strains of Pseudomonas aeruginosa which fail to produce pyoverdine. A mutant nonderepressible for this protein (K372) was deficient in pyochelin-mediated iron transport at 150 nM FeCl3, consistent with a role for the 75-kDa protein in ferripyochelin transport. Moreover, ferripyochelin specifically protected the 75-kDa protein against trypsin digestion, supporting an interaction between ferripyochelin and the 75-kDa protein. Previous reports implicated a 14,000-dalton outer membrane protein as the receptor for ferripyochelin (P.A. Sokol and D.E. Woods, Infect. Immun. 40:665-669, 1983) and demonstrated that a mutant (FBP-28) expressing a defective 14-kDa outer membrane protein did not exhibit pyochelin-mediated iron transport (P.A. Sokol, J. Bacteriol. 169:3365-3368, 1987). Nonetheless, we were able to demonstrate (i) that FBP-28 was inducible for the 75-kDa protein under iron-limiting conditions and (ii) that concomitant with the induction of this protein in FBP-28, pyochelin-mediated iron uptake at 150 nM FeCl3 was observed. Interestingly, strain K372 did transport ferripyochelin at higher (750 nM) FeCl3 concentrations, suggesting that a second pyochelin-mediated iron transport system, perhaps involving the 14-kDa outer membrane protein identified previously, operates in P. aeruginosa.
Differential induction of tumor necrosis factor by bacteria expressing rough and smooth lipopolysaccharide phenotypes.
The lipid A portion of the lipopolysaccharide (LPS) molecule of gram-negative bacteria has the ability to turn on the production of tumor necrosis factor (TNF) in macrophage cells. The question addressed in this paper was whether the presence of the polysaccharide moiety on the LPS molecule had any bearing on this ability. The question was asked (i) by using isolated LPS from a series of Salmonella mutants having progressively less polysaccharide attached to the lipid A portion of the molecule and (ii) by using whole bacteria expressing alternatively the smooth or rough LPS phenotype. Isolated LPS and bacteria were examined for their abilities to induce bioactive TNF in the mouse macrophage cell line RAW 264.7. The results indicated that the presence of long- or short-chain polysaccharide moieties had no bearing on the ability of the isolated LPS molecule to induce TNF. However, the presence of long-chain polysaccharides attached to the lipid moiety on the intact smooth bacterium was associated with a decreased ability to induce TNF. To test whether the bacteria were inducing TNF by a cell (bacterium)-to-cell (macrophage) contact mechanism or through a releasable product, the bacteria were removed from direct contact with the macrophage cells by using a Transwell filter insert. Under these conditions the rough bacteria continued to induce TNF, while the smooth bacteria were no longer capable of doing so. When filtrates from the bacteria were examined in the Limulus amebocyte lysate assay, the results showed that the rough bacteria were releasing approximately a log order more Limulus amebocyte lysate activity than the smooth bacteria. The results of this study suggest that rough bacteria may be superior inducers of TNF compared with their smooth counterparts because of a greater propensity to shed their LPS.
Cerebrovascular permeability in acute hypertension: effect of flunarizine.
The pattern of Evans blue extravasation in the brain in norepinephrine-induced acute hypertension is similar to our previous observations using horseradish peroxidase as a tracer. Pretreatment with flunarizine IV resulted in significant reduction of RISA leakage in all regions of the brains of acutely hypertensive rats. The reduction in RISA leakage in the drug-treated hypertensive group is not attributable to differences in the blood pressure elevations which were not significantly different in both groups. These studies suggest a role for calcium in the increased endothelial permeability occurring in cerebral vessels in acute hypertension. Further morphological studies are required to determine whether flunarizine reduces permeability by decreasing pinocytosis.