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Biomedical subjects

R Gardner

Publications and source records attributed to R Gardner.

At least 19 recordsLinked to original sources
PubMed1992

Glucocorticoid receptor binding in three different cell types in major depressive disorder: lack of evidence of receptor binding defect.

1. In order to further understand the apparent glucocorticoid resistance in major depressive disorder, circadian variation in cortisol concentration, dexamethasone suppression and glucocorticoid receptor binding in mononuclear leukocytes, polymorphonuclear leukocytes and cultured skin fibroblasts were measured in rigidly defined major depressive disorder patients and non-depressed psychiatric controls. 2. Mononuclear leukocytes binding to glucocorticoid correlated significantly with polymorphonuclear leukocytes binding to glucocorticoid, but both determinations failed to differentiate major depressive disorder and control subjects. 3. Initial and post-dexamethasone in vitro fibroblast binding to glucocorticoid was not different between major depressive disorder and non-depressed control subjects. 4. The phenomenon of glucocorticoid resistance in major depressive disorder remains unexplained.

Adult↗
PubMed1991

Mutagenesis of the AC3 open reading frame of African cassava mosaic virus DNA A reduces DNA B replication and ameliorates disease symptoms.

Small insertions were made independently at each of four unique restriction sites on African cassava mosaic virus (ACMV) DNA A to disrupt the three overlapping complementary-sense open reading frames (ORFs) herein designated AC1, AC2 and AC3. The DNA A mutants were assayed for their infectivity by agroinoculation of monomeric constructs to Nicotiana benthamiana plants containing chromosomal insertions of ACMV DNA B. Disruption of the AC3 ORF alone resulted in a delay and amelioration of disease symptoms which correlated with reduced replication of DNA B. Normal replication of DNA A still carrying the AC3 ORF mutation was found in extracts from these plants. No ACMV DNA or symptoms were observed in corresponding inoculations with either the simultaneous disruption of the overlapping AC2 and AC3 ORFs or disruption of the AC1 ORF. Complementation by the inoculation of different mutant pairs produced a delay in disease symptoms followed by repair of mutated sites. A DNA A construct with the virus-sense AV1 (coat protein) ORF deleted was infectious producing typical ACMV disease symptoms. A similar construct with a larger deletion encompassing the complementary-sense AC3 ORF produced symptomless infections. The DNA recovered from plants revealed DNA A of normal size where the position of the deleted ORF was replaced with cloning vector DNA. Significantly reduced DNA B replication was observed for the AC3 deletion construct.

Blotting, Southern↗
PubMed1990

Mononuclear leukocyte glucocorticoid receptor binding characteristics and down-regulation in major depression.

Some patients with major depressive disorder (MDD) have elevated plasma cortisol concentrations and show failure to suppress cortisol secretion upon administration of dexamethasone (DEX), yet they do not have Cushingoid features. To study whether this represents glucocorticoid (GC) resistance, [3H]-DEX-binding assays were used to measure, in vitro, the GC receptor affinity (1/Kd) and number (Bmax) in mononuclear leukocytes of 11 MDD patients and 15 control subjects. No receptor abnormalities were detected in the MDD group; thus any cellular defect leading to a lack of responsiveness to GC in the MDD patients, if present, probably lies beyond the initial receptor binding. DEX (1.0 mg orally) was administered to study in vivo GC receptor down-regulation. Compared to the control group, fewer depressed subjects down-regulated Bmax after DEX. By paired t-test, Bmax decreased significantly in the control group but not in the depressed group. Receptor number on the control day did not correlate significantly with the degree of receptor down-regulation, severity of depression or cortisol concentrations across all the subjects. These results do not lend support to previous reports suggesting that GC resistance in MDD results from a GC receptor-binding abnormality, and they emphasize the importance of considering receptor studies in the context of GC-mediated cell processes in order to identify the exact cellular defect(s) leading to GC resistance.

Administration, Oral↗
PubMed1990

Popliteal aneurysm after total knee arthroplasty. Case reports and review of the literature.

Vascular complications after total knee arthroplasty include arterial occlusion, arterial severance, arteriovenous fistula, and arterial aneurysm. Both a false aneurysm and a true aneurysm of the popliteal artery are described. The false popliteal aneurysm resulted from direct surgical trauma and required excision and repair. The true popliteal aneurysm was unsuccessfully treated with excision, transfemoral thrombectomy, and bypass surgery. Many of the vascular complications after total knee arthroplasty may be preventable and the following prudent guidelines are suggested. Careful preoperative evaluation is critical, including past medical history, palpation of pedal pulses, and review of radiographs to identify abnormal calcification in the vessels. Vascular consultation may be necessary. Should a vascular complication occur, immediate intervention with the advice and assistance of a vascular surgeon is imperative.

Aged↗
PubMed1990

Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty.

Twenty-five patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patellar resurfacing. Only patients with advanced patellofemoral disease were included in the study. In all patients, patellar resurfacing had been done in the right knee but not in the left knee. The DePuy porous-coated implant was used in all cases. Subjective criteria were compared with objective criteria, which included range of motion, knee flexion and extension, and roentgenographic evaluation. The findings in this study suggest that patellar resurfacing can offer the patient a superior knee with regard to pain relief and strength.

Aged↗
PubMed1989

CA 125 levels in endometriosis patients before, during and after treatment with danazol or LHRH agonists.

The levels of CA 125 in the serum of 54 patients with endometriosis were measured before, during and after treatment with Danazol or LHRH analogues. Patients with minimal and mild endometriosis had mean pre-treatment values significantly higher than control subjects in the luteal phase of the cycle or postmenopausal women (p less than 0.05), but levels were within the overall control range. In contrast, 78.6% of patients with moderate or severe endometriosis had levels in excess of 30 mu/ml and the mean values for these groups were significantly elevated (p less than 0.005). Levels of CA 125 fell, to those found in normal controls, during treatment, but rose again following cessation of treatment. Six of 12 subjects whose follow-up values of CA 125 exceeded 30 U/ml had a proven recurrence of endometriosis, whilst only 2 of 31 patients with values less than 30 U/ml had laparoscopically proven recurrence.

Adult↗
PubMed1989

Biology of family systems and mood disorders.

Ethology offers psychiatry and family therapy an alternative perspective for understanding hierarchical dysfunction and individual psychopathology and the relation between them. Dominance and submission behaviors--descriptions from ethology--represent communicational mechanisms that play pivotal roles in maintaining the stability of the family group. When conflict becomes acute, dominant and submissive states are experienced as euphoria and mild depression respectively. Smooth functioning of these communicational mechanisms at the individual level enhances cohesion at the group level. Feelings of inadequacy and inferiority may be manifestations of submissive patterns and may function to maintain negative or corrective feedback loops, which preserve group stability. However, these communicational mechanisms may exhibit positive feedback runaway effects such that family crises result. These and other clinical implications of the model are explored.

Affective Disorders, Psychotic↗
PubMed1989

Zoladex versus danazol in the treatment of pelvic endometriosis: effects on plasma lipid risk factors.

Plasma lipid risk markers for coronary heart disease (CHD) are influenced by sex steroid concentrations. Therapies that alter sex hormone levels have the potential to affect CHD risk. Zoladex had no effect on plasma lipids, but increased high density lipoprotein (HDL) subfraction 3, a lipoprotein of uncertain clinical significance. Danazol increased low density lipoprotein and decreased HDL concentrations to give a lipid profile associated with increased risk of CHD.

Buserelin↗
PubMed1989

A comparison of the skeletal effects of goserelin and danazol in premenopausal women with endometriosis.

The skeletal effects of two therapies for endometriosis that produce hypo-oestrogenism in 23 premenopausal women have been studied. Eleven women received goserelin 3.6 mg monthly by subcutaneous implant and 12 women received danazol 600 mg daily, orally, both for 6 months. Goserelin causes a small decline in spinal bone density, but a greater loss of density in the proximal femur. Preliminary results show no evidence that bone loss is reversible after stopping therapy. Danazol treatment is not associated with loss of bone. Prolonged or repeated courses of treatment with goserelin alone could lead to a clinically significant adverse effect on the skeleton.

Adult↗
PubMed1979

Implementing a consultation-liaison service in a psychiatrically underserved area.

Most multidisciplinary consultation-liaison services are developed in settings where there are both psychiatric residents and an adequate psychiatric liaison faculty. In this paper, the authors report some of the obstacles and attempts at overcoming them in the implementation of such services in an underserved area in which there is a scarcity of both residents in training and psychiatric liaison faculty. The process of collaboration between a primary-care-oriented medical school and a community general hospital is described, and roles of program participants are defined. Special attention is paid to funding problems.

Curriculum↗
PubMed1978

Consultation-liaison scheme for self-poisoned patients in a general hospital.

In a prospective clinical trial 276 self-poisoned patients consecutively admitted to hospital were randomly allocated to medical teams or to psychiatrists for an initial psychiatric assessment and a decision about "disposal." Junior doctors and nurses received instruction in this work. While awaiting the outcome of the trial the randomisation was continued for 13 months and 729 allocations were made altogether. Physicians requested psychiatric opinions for roughly one in five of their patients. In other respects medical teams performed similarly to psychiatrists. Provided that due attention is given to teaching junior staff and to ensuring that psychiatric treatment and social-work support are available once patients have been assessed, such a consultation-liaison scheme could be adopted in other hospitals. This would help to change unfavourable attitudes towards self-poisoned patients and contribute to the general training of doctors and nurses.

Education, Medical, Continuing↗
PubMed1978

Two immunofluorescent methods compared with a radial immunodiffusion method for measurement of serum immunoglobulins.

We found high correlations when the values for immunoglobulins G, A, and M, obtained from the analysis of a group of 50 or more human sera by a measured-time radial immunodiffusion method, were compared to values found by two new commercial immunofluorescent methods. The Fiax and the Immuno-Fluor systems make use of fluorescently labeled antibodies and solid-phase immunoadsorbents and offer simple, precise, and objective methods for immunoglobulin quantitation. The Fiax procedure is less time consuming than is the Immuno-Fluor and gives IgG and IgA concentrations that are in close agreement with those found by radial immunodiffusion and IgM values that are significantly lower than the radial immunodiffusion values. The IgG results determined by the Immuno-Fluor method compare well with the radial immunodiffusion results, uhile the IgA values are significantly higher and IgM values significantly lower than those obtained by radial immunodiffusion.

Evaluation Studies as Topic↗