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Biomedical subjects

P Cramer

Publications and source records attributed to P Cramer.

At least 19 recordsLinked to original sources

Structural and energetic responses to cavity-creating mutations in hydrophobic cores: observation of a buried water molecule and the hydrophilic nature of such hydrophobic cavities.

We have solved the 2.0-A resolution crystal structures of four cavity-creating Ile/Leu-->Ala mutations in the hydrophobic core of barnase and compare and contrast the structural responses to mutation with those found for Leu-->Ala mutations in T4 lysozyme. First, there are rearrangements of structure of barnase that cause the cavities to collapse partly, and there is an approximately linear relationship between the changes in stability and the volume of the cavity similar to that found for the mutants of T4 lysozyme. Second, although it is currently accepted that hydrophobic cavities formed on the mutation of large hydrophobic side chains to smaller ones are not occupied by water molecules, we found a buried water molecule in the crystal structure of the barnase mutant Ile76-->Ala. A single hydrogen bond is formed between the water molecule and a polar atom, the carbonyl oxygen of Phe7, in the hydrophobic cavity that is formed on mutation. A survey of hydrophobic cavities produced by similar mutations in different proteins reveals that they all contain a proportion of polar atoms in their linings. The availability of such polar sites has implications for understanding folding pathways because a solvated core is presumed present in the transition state for folding and unfolding. Notably, the hydrogen bond between the cavity-water and the carbonyl group of Phe7 is also a marked early feature of very recent molecular dynamics simulations of barnase denaturation [Caflisch, A., & Karplus, M. (1995) J. Mol. Biol. 252, 672-708]. It is possible that cavities engineered into the hydrophobic cores of other proteins may contain water molecules, even though they cannot be detected by crystallographic analysis.

Amino Acid Sequence

The fibronectin gene as a model for splicing and transcription studies.

The fibronectin (FN) gene has become paradigmatic to illustrate genome evolution by exon shuffling, generation of protein diversity by alternative mRNA splicing, and topological coordination between transcription and splicing. Alternative splicing in three sites of the primary transcript gives rise to multiple FN polypeptides. This process is cell type-, development- and age-regulated. The different FN variants seem to play specific roles in FN dimer secretion, blood clotting, adhesion to lymphoid cells, skin wound healing, atherosclerosis, and liver fibrosis. This review focuses on function assignment to the alternatively spliced segments, as well as on the external signals and cis-acting sequences that control the mechanisms of alternative splicing. We also discuss FN transcriptional regulation in response to viral transformation, growth factors, and cyclic AMP in the light of promoter architecture and its interaction with specific transcription factors. The relevance of FN RNA "tracks" as assembly lines of coordinated transcription and RNA processing is also addressed.

Alternative Splicing

A one year prospective study of the effect of life events and medication in the aetiology of schizophrenic relapse.

BACKGROUND: We set out to determine whether and to what degree life events independent of illness increase the risk of relapse in schizophrenia following withdrawal from medication in the previous 6 months, either by triggering a relapse in the following 4 weeks or by acting cumulatively over time. METHOD: Seventy-one patients fulfilling DSM-III-R criteria for schizophrenia with chronic illness were followed for 48 weeks and assessed on the LEDS scale. Half were treated with regular neuroleptic medication and half had been recently withdrawn from medication. A subgroup was randomised double-blind to treatment or placebo. RESULTS: A proportional hazards regression model showed that life events made a significant cumulative contribution over time (P < 0.05) to the risks of relapse and that ceasing medication made an independent contribution. The risk of relapse increased in proportion to the number of life events but no interaction between medication status and events could be detected, i.e. life events were not more closely associated with relapse on medication than off medication. For those of the sample exposed to the mean rate of life events during the study period, it was estimated that 23% of the relapse risk could be attributed to life events, and for those with twice the mean rate of events, 41%. In contrast, patients who continued on regular medication had 80% less risk of relapse than those who had been withdrawn from medication either by choice or under double-blind controlled conditions. CONCLUSIONS: A contribution of life events to the risk of relapse in schizophrenia was confirmed by this study but the hypothesis that life events trigger relapse was not supported, nor was the hypothesis that life events are more relevant to relapse in patients on maintenance medication than in patients off medication.

Adult

Effects of apomorphine and L-dopa on the parkinsonian bladder.

Neurogenic bladder frequently occurs in Parkinson's disease. Detrusor hyperreflexia is a consequence of nigrostriatal dopamine depletion, whereas the cause of hyporeflexia remains unclear. We compared the results of cystometry and urethral profilometry with and without apomorphine (and L dopa) in 12 idiopathic parkinsonians with urinary disorders free of dopaminergic treatment. Whereas hyperreflexic patients improved with apomorphine, and to a lesser extent with L dopa, these drugs had no effect on hyporeflexic patients. These results confirm the role of dopaminergic lesions in the occurrence of bladder hyperreflexia and the possible implication of nondopaminergic lesions in the occurrence of hyporeflexia.

Aged

The safety and efficacy of zolpidem in insomniac patients: a long-term open study in general practice.

The safety and efficacy of 10 or 20 mg/day zolpidem, a new hypnotic belonging to the imidazopyridine class, were studied over a 180-day period in 96 patients with sleep disorders. The treatment was continued for a further 180 days by 49 of these patients. Follow-up information from 21 patients who discontinued treatment after 180 days showed no rebound insomnia or withdrawal signs. Efficacy of treatment with respect to reduction of sleep onset latency and number of nocturnal wakenings, and improvement in duration of sleep, quality of sleep and morning wakenings was found in nearly 90% of patients and was maintained in those patients who continued treatment for 360 days. This efficacy was achieved with a stable percentage of patients receiving 10 mg/day and 20 mg/day zolpidem from day 30 to the final visit. Zolpidem, therefore, has been shown to be an effective and safe hypnotic, and to be devoid of rebound and withdrawal effects.

Family Practice

Schizophrenics and social judgement. Why do schizophrenics get it wrong?

Videotaped social interactions were shown to a population of schizophrenics and controls who were asked to comment on the emotional state of the principal protagonist. Their free responses were subjected to a content analysis to examine which of three possible explanations of known schizophrenic inaccuracies on this task were responsible: formal thought disorder, selective avoidance of psychological factors, or perceptual/attentional deficits. Neither selective avoidance nor marked thought disorder were found to explain these errors. The schizophrenics as a group rated much the same, irrespective of clinical profile. Their judgements of personality were less clear-cut than the controls.

Adult

[Effect of apomorphine on the bladder of parkinsonian patients].

Neurogenic bladder frequently occurs in Parkinson's disease. Detrusor hyperreflexia is a consequence of nigrostriatal dopamine depletion whereas mechanism of hyporeflexia remains unclear. We compared the results of cystometry and urethral profilometry with and without apomorphine (and L dopa) in 12 idiopathic parkinsonians with urinary disorders off dopaminergic treatment. Hyperreflexic patients improved with apomorphine and to a lesser extent with L dopa, whereas these drugs had no effect on hyperreflexic patients. These results confirm the role of dopaminergic lesions in the occurrence of bladder hyperreflexia and the possible action of non dopaminergic lesions in the occurrence of hyporeflexia.

Aged

Anger and the use of defense mechanisms in college students.

It was hypothesized that experimentally induced anger would result in an increased use of defense mechanisms in college students. As predicted from the theory of defense mechanism development, the Thematic Apperception Test (TAT) stories of angered students showed a higher level of use of projection and identification, and the use of these defenses was significantly correlated with the presence of aggressive content in the stories. The results were consistent with previous studies in showing that the predominant defenses of late adolescents are projection and identification, and that men use more projection than women.

Adult

Correlation between seric antitumor activity and concomitant resistance in mice bearing nonimmunogenic tumors.

Serum from mice bearing five weakly immunogenic or nonimmunogenic tumors inducing concomitant resistance exhibited a growth-inhibitory activity on in vitro proliferation of the tumor cells. This activity was proportional to the intensity of concomitant resistance and correlated with the capacity to restrain metastatic development. It was not attributable to cytotoxic antibodies, was relatively nonspecific, and operated through a cytostatic and reversible mechanism. All attempts to transfer antitumor resistance in vivo by serum inoculation have failed, but this could be attained by parabiosis. Physical and chemical serum treatments suggest that heat-, acid-, and alkali-resistant peptide(s) with molecular weights ranging from 1000 to 3000 could account for this inhibitory effect.

Animals

Children's defensive responses and emotional upset following a disaster: a projective assessment.

Projective stories were used to assess the defense mechanisms of 27 preadolescent boys who were victims of a lightning strike in which one boy died. Denial, projection, and identification, in combination, were found to be inversely related to clinical upset, as was the age and sex-appropriate individual defense of projection. In addition, low-defensive boys' self-reports of fears agreed more often with their parents' reports of sleep and somatic disturbances than did high-defensive boys' self-reports. The findings provide support for the validity of the Defense Mechanism Manual (Cramer, 1982) and raise the issue of defense mechanisms as moderator variables in self-report questionnaires.

Adaptation, Psychological

Use of the TAT to measure change in defense mechanisms following intensive psychotherapy.

Changes in the use of defense mechanisms (denial, projection, and identification) were examined over a period of approximately 15 months of intensive treatment of 90 seriously disturbed young adults who were hospitalized in an intensive, open, long-term treatment setting. Patients independently judged to have primarily an anaclitic or an introjective personality configuration (Blatt, 1974; Blatt & Shichman, 1983) were assessed for psychiatric symptoms and aspects of interpersonal behavior both on admission and after an average of 15 months of treatment. Findings based on an independent assessment of TAT protocols at these two times indicated a significant (p less than .05) decline in total use of defenses for the entire sample, but especially for introjective patients. Further, this decline in total use of defenses in the TAT was significantly associated with a reduction in psychiatric symptoms. Also, sex-incongruent patients (anaclitic men and introjective women) were found to use different defenses and to change in ways different from sex-congruent patients (anaclitic women and introjective men).

Adolescent

Bladder-neck opening test in spinal cord injury patients using a new i.v. alpha-blocking agent, alfuzosin.

A bladder-neck opening test using alfuzosin, a new alpha-adrenoceptor blocking agent, was carried out in 21 patients with spinal cord injury. The efficacy of alfuzosin was assessed with 4 simple urodynamic parameters: micturition, residual urine, posterior urethral pressure and diameter. Both mean urethral pressure and diameter were significantly affected after the administration of 5 mg i.v. alfuzosin. The test was clinically positive in 18 patients: 11 out of 13 patients using intermittent catheterisation or continuous drainage urinated and 6 out of 8 patients already tapping had reduced residual urine volumes. A decrease in posterior urethral pressure was also observed in 2 out of 3 patients who did not respond clinically to alfuzosin. Alfuzosin was well tolerated during this test. Oral alfuzosin should therefore be investigated in patients who gave a satisfactory response to such a test.

Adolescent

Schizophrenia and the perception of emotions. How accurately do schizophrenics judge the emotional states of others?

Audiovisual tapes of emotional situations were shown to 34 schizophrenics and 15 controls who were asked to rate the emotional content of the scenes using an adjective check-list. The schizophrenic patients failed to detect the dominant character of the scenes, and perceived the opposite emotions to those perceived by the controls. Such deviant responses were not related to paranoid symptoms, flattened affect, formal thought disorder, general level of morbidity, or duration of in-patient stay.

Adult

[Open trial of betaxolol in the treatment of arterial hypertension in pregnancy, pilot study].

The efficacy and the safety of betaxolol (BTX), a cardio-selective adrenoceptor blocking agent with a long half life, was tested in 22 hypertensive pregnant women. BTX doses varied from 10 to 40 mg/day. BTX given as monotherapy (n = 19) or associated to dihydralazine (n = 3) led to a satisfactory control of arterial blood pressure (ABP). In the mother, the drug was very well tolerated. (table; see text) The fetal safety, evaluated by mean of cardiotocography and echography was also satisfactory. Fetal heart rythm was significantly slowed following first intake of BTX and remained stable until delivery; there was only one case of intra-uterine growth retardation pre-existing to the pharmacological treatment. Nine deliveries were ceasarian [fetal distress (n = 1); poor control ABPI (n = 1); obstetrical reasons (n = 7)]. Seventeen neonates were full-term and six were premature (twins included). The state of neonates at birth was very satisfactory (Apgar at 5 minutes greater than 9 in 21/23). Glycemia less than 1.66 mmoles/1 in two neonates, was normal within 24 to 48 hours. In conclusion, BTX was very efficacious in controlling increased blood pressure in pregnant women and its safety in the mother, the fetus and the newborn was very good.

Adolescent

Cytogenetic study of myeloid and erythroid colonies in chronic myeloid leukaemia with stable Ph1 mosaicism.

We have investigated two chronic myeloid leukaemic (CML) patients with a stable Ph1 mosaicism to see whether the Ph1 positive cells belonged to more than one lineage. Individual erythroid and granulocytic colonies were cytogenetically examined. Ph1-positive and Ph1-negative colonies were found both in the erythroid and granulocytic lineage supporting the contention that CML with a stable Ph1 mosaicism as well as classical CML involves a pluripotent stem cell.

Bone Marrow