Prescribing patient information leaflets may be better than prescribing drugs.
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Drug Prescriptions↗
Biomedical subjects
T Kenny
Publications and source records attributed to T Kenny.
Molecular dynamics simulations of silicon-fluorine etching.
Molecular dynamics simulations of the reactions between gaseous fluorine atoms and (SiFx)n adsorbates on the Si(100) - (2 x 1) surface are performed using the SW potential and compared to simulations with the WWC reparameterization of the SW potential. Theoretical and experimental work has demonstrated that the reactive fluorosilyl layer during silicon-fluorine etching is composed of tower-like adspecies of SiF, SiF2 and SiF3 groups. The objective of the simulations is to determine how the chemical composition, mechanism of formation, and energy distribution of the etched gas-phase products depend on the identity of the reacting adsorbate, the incident kinetic energy, and the parameterization of the potential energy function. Three reactions are simulated: F(g) + SiF3(a), F(g) + SiF2-SiF3(a), and F(g) + SiF2-SiF2-SiF3(a). SiF4 is the major product and Si2F6 and Si3F8 are minor products. In Si2F6 and Si3F8, the silicon-fluorine bond that is formed is stronger than the silicon-silicon bond in the molecule and, therefore, the majority of these products have enough energy to dissociate and will fragment before reaching the detector. An SN2-like mechanism is the primary mechanism responsible for the formation of SiF4, Si2F6, and Si3F8. In addition, at higher energies, the simulations have discovered a previously unknown mechanism for the formation of SiF4, which involves an insertion between a silicon-silicon bond. The results of the simulations with the two potentials differ quite substantially in their prediction of the reactivity of the adsorbates. The SW potential predicts a 2- to 3-eV lower energy threshold for reaction and a much higher reaction cross-section, especially for the SiF4 product. These results are explained in terms of the differences in the potential energy functions used to describe the silicon-fluorine interactions. In addition, the results are compared to experimental data on silicon-fluorine etching.
Computer Graphics↗
A subgroup of human VH3 germline genes that encode a high-avidity synovial rheumatoid factor.
We have previously derived and identified a highly avid monoclonal IgM rheumatoid factor (mRF), C6, from unstimulated rheumatoid synovial cells (RSC). At the time, the closet VH germline gene, VH26, demonstrated only 88% homology with C6. To identify the germline counterpart of C6, genomic DNA from the same rheumatoid arthritis (RA) patient from whom C6 was derived was used in the polymerase chain reaction (PCR). Four of the six closely related germline genes that we sequenced had exonic regions that were identical with the VH region of C6 cDNA. These six germline sequences differed in their intronic regions, suggesting that they were distinct, but closely related genomic sequences. To further evaluate the extent of these related genes we identified nine additional germline genes having VH-encoding exons that were 86-97% identical to the C6 cDNA sequence. Furthermore, we examined the polymorphic nature of the C6 VH gene using single strand conformation polymorphism (SSCP), and identified two peaks, confirming the existence of highly homologous genes. The sequence and polymorphism data suggest that: (1) the VH region of the high avidity mRF C6 was derived from an unmutated germline gene; (2) C6 was encoded by a VH gene belonging to a set of homologous genes within the larger VH3 family; and (3) in addition to somatic rearrangements of B-cell genes and antigen-driven somatic mutation, gene duplication and conversion events of germline genes could be important in generating diversity and polyclonality among high-affinity pathogenic autoantibodies.
Amino Acid Sequence↗
Monoclonal IgM rheumatoid factors generated from synovial B cells of rheumatoid arthritis patients react with beta 2-microglobulin. Monoclonal RF react with beta 2m.
Four of 15 monoclonal human IgM rheumatoid factors (RF) derived from synovial B cells of patients with rheumatoid arthritis showed positive ELISA reactions with human beta 2-microglobulin. These findings were different from those previously noted using IgM RF derived from monoclonal Waldenstrom's paraproteins or the IgM components of mixed cryoglobulins, and resembled the anti-beta 2 microglobulin specificity of polyclonal IgM RF from patients with rheumatoid arthritis. Reactions of monoclonal IgM synovial RF with overlapping 7-mers of beta 2m sequence indicated major regions of positive reactivity at positions 57-64 and 89-95 which were maintained in the presence of high salt (300 mM NaCl) conditions. Glycine substitution of each residue within RF-reactive beta 2m regions indicated that tryptophanes at position 60 and 95, lysine at 58, phenylalanine at 62, valine at 93 and arginine at 97 constituted important single amino acids for the reactive epitopes. These findings indicate that clonally restricted human IgM RF derived from diseased tissues of patients with RA show anti-beta 2m reactivity similar to polyclonal RF from the same patients. This particular fine specificity is not present in monoclonal RF derived from patients with Waldenstrom's or mixed cryoglobulins showing anti-gamma-globulin activity.
Amino Acid Sequence↗
Human monoclonal rheumatoid factor derived from rheumatoid synovial cells monospecific for rabbit IgG.
Rheumatoid factors (RF) in rheumatoid arthritis (RA) are polyclonal autoantibodies directed against antigenic epitopes located in the Fc portion of the IgG molecule. Hybridoma technology has overcome the difficulty of their polyclonality, so that monoclonal RF (mRF) can be examined for their individual binding specificities and genetics. We isolated a monoclonal IgM RF secreting hybridoma (designated H4) from the rheumatoid synovial cells (RSC) of a patient with RA. H4 bound specifically with rabbit IgG (RIgG) and had no human IgG (HIgG) reactivity. By direct binding ELISA and absorption experiments, 6% of the RIgG reactive RSC RF in this patient with RA was monospecific for RIgG. H4 was tested against RIgG F(ab')2 and pFc' fragments, and bound only to the pFc' fragment (CH3 domain). Moreover, H4 mRF had high avidity for RIgG in a capture ELISA. Total RNA was extracted and the variable region heavy (VH) and light (VL) chain cDNA were amplified using polymerase chain reaction technology. Sequence analysis of the IgM RF VH and VL chain genes indicated usage of the VH26 germline gene (VhIII gene family) and a new V lambda germline gene. Our results suggest preferential use of restricted germline genes in the formation of autoantibodies in human autoimmune diseases. The pathological significance of RIgG specific RF is still unclear. However, this finding suggests that all RSC RF production may not necessarily be induced by autologous IgG.
Amino Acid Sequence↗
Allotype-dependent stimulation of peripheral blood and synovial lymphocytes by IgG3 in rheumatoid arthritis.
The immunopathologic process of rheumatoid arthritis (RA) is primarily expressed in the synovium where rheumatoid factor (RF) synthesis is concentrated. We hypothesized that RF synthesized by rheumatoid synovial cells (RSC) may be driven via a T cell-mediated immune response developed against IgG3 epitopes. To identify and characterize specific RSC RF epitopes and T cell antigens, two 28 amino acid peptides homologous with the C-terminus of IgG1 (P1) and IgG3 [G3m(5)] (P3) were synthesized and used in RF-binding studies and lymphocyte proliferation assays. Our results indicate that (i) the C-terminus of the CH3 domain contains epitopes for IgG3-reactive RSC RF; (ii) IgG3-reactive RSC RF binds primarily to IgG3 [G3m(5)]; (iii) P3 stimulated proliferation of T lymphocytes from both RA peripheral blood and RSC; and (iv) RF production was enhanced by P3 in selected RA cell cultures. These observations suggest that the C-terminus of IgG3 allotype G3m(5) may be important in T cell activation and RF production in RA.
Amino Acid Sequence↗
Characterization and epitope mapping of human monoclonal antibodies to PDC-E2, the immunodominant autoantigen of primary biliary cirrhosis.
Further to define the epitopes of PDC-E2, the major autoantigen in primary biliary cirrhosis (PBC), we have developed and characterized five human monoclonal antibodies. These antibodies were derived by fusing a regional hepatic lymph node from a patient with PBC with the mouse human heterohybrid cell line F3B6. Previous studies of epitope mapping of PDC-E2 have relied on whole sera and have suggested that the immunodominant epitope lies within the inner lipoyl domain of the molecule. However, selective absorption studies using whole sera and a series of overlapping recombinant peptides of PDC-E2 have suggested that the epitope may also include a large conformational component. Moreover, several laboratories have suggested that autoantibodies against the 2-oxo acids dehydrogenase autoantigens are cross-reactive. The five monoclonal antibodies generated included three IgG2a and two IgM antibodies and were studied for antigen specificity using recombinant PDC-E2, recombinant BCKD-E2, histone, dsDNA, IgG (Fc), collagen and a recombinant irrelevant liver specific control, the F alloantigen. The antibodies were also used to probe blots of human, bovine, mouse and rat mitochondria. Finally, fine specificity was studied by selective ELISA and absorption against overlapping expressing fragments of PDC-E2. All five monoclonals, but none of the other mitochondrial autoantigens were specific for PDC-E2. In fact, although affinity purified antibodies to PDC-E2 from patients with PBC cross-reacted with protein X, the human monoclonals did not, suggesting that protein X contains an epitope distinct from that found on PDC-E2. Additionally, all three IgG2 monoclonals recognized distinct epitopes within the inner lipoyl domain of PDC-E2.
Animals↗
Characterization of monoclonal IgG antibodies produced by hybridomas derived from rheumatoid synovial cells.
IgM rheumatoid factors (RF) are the predominant autoantibody found in rheumatoid arthritis. They are polyclonal, fix complement, and are directed against epitopes in the Fc portion of IgG. One hypothesis regarding the induction and persistence of RF production in rheumatoid arthritis is that the Fc of IgG is somehow altered, rendering it antigenic. In this study, to better understand the derivation and pathogenicity of RF in rheumatoid arthritis, monoclonal IgG (mIgG) constitutively secreting hybridomas were established by fusing rheumatoid synovial mononuclear cells (RSC) from patients with a mouse/human heteromyeloma cell line, F3B6. To clarify the primary structure of IgG Fc constant regions produced locally by RSC, we amplified the cDNA corresponding to the CH2 and CH3 domains of an IgG1-, IgG2-, and an IgG3-producing hybridoma derived from RSC. The amplified DNA segments were cloned in M13 vectors and sequenced. Interestingly, very few differences in the nucleotide sequences were observed, and the deduced amino acid sequences were identical, except for the allotype, with those encoded by the human germline genes GEA and CL. Thus, the primary structure of the IgG1, IgG2, and IgG3 Fc regions produced by RSC were not altered when compared with those encoded by the unmutated human germline gene. These results suggest that factors other than altered IgG induce and sustain high avidity RF production in rheumatoid arthritis.
Amino Acid Sequence↗
Anorexia nervosa--a nursing challenge that can bring results.
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Adolescent↗
The Pediatric Early Elementary Examination: sensitivity and specificity.
Evaluated the sensitivity and specificity of the Pediatric Early Elementary Examination (PEEX), a test designed to identify children at risk for learning problems. Using a sample of 299 seven- to nine-year-old "disadvantaged" children, the number of "areas of concern" identified by the PEEX and a school record indicating whether a child was receiving special educational services were used to compute test sensitivity and specificity. For two areas of concern, the sensitivity was 76.9% and specificity was 59.9%. The findings indicate that the PEEX correctly identified only 64.3% of children receiving special educational services. The test has a high rate of false positives while still failing to identify 6-7.5% of the children receiving special education services. Other issues relating to the utility of the PEEX are discussed.
Child↗
Erosion of individuality in care of elderly people in hospital--an alternative approach.
This paper will identify and analyse those factors which contribute to the erosion of individuality and identity for those elderly people who are admitted to hospital for care on 'elderly wards'. There is a need to focus attention on and consider the effects of the present system of care provided for the elderly while in hospital as this care can perpetuate the development of dependency and iatrogenesis among the elderly and in the process erodes their self esteem, identity and individuality. The contention of this essay will be that the proposition and usage of King's model of nursing, which advocates greater patient participation through mutual goal setting, keener awareness of the patient's perception and the establishment of an equal, reciprocal and collaborative relationship between nurse and client, can help ameliorate or prevent the development of iatrogenic problems.
Aged↗
Determination of the affinity of monoclonal 19 S IgM rheumatoid factor for IgG by modified immunoassay (ELISA).
In rheumatoid arthritis (RA), the pathogenicity of IgM rheumatoid factor (RF), an autoantibody whose antigen is IgG, is still unclear although RF-IgG complexes appear to be important mediators of immune injury. The polyclonality of RF in RA makes it difficult to characterize certain qualitative properties such as specificity and affinity which may be very important in determining pathogenicity. Monoclonal IgM RF can be used to circumvent this problem. Monoclonal RF secreting cells can be produced via hybridizations with RA B lymphocytes fused with mouse or human myeloma cell lines. Another source of monoclonal RF is the sera of patients with Waldenström's macroglobulinemia (WM). One particular WM IgM RF (Kas) was chosen for our experiments to measure affinities and specificities to eight different monoclonal IgGs (three IgG1s, three IgG3s, one IgG2, and one IgG4). 19 S IgM RF, a pentavalent molecule, was mildly reduced with DTT to make 7 S univalent fragments (7 S IgM RF). 7 S IgM RF was incubated with each of the different IgGs at several different concentrations. These mixtures were allowed to come to equilibrium. An aliquot was then used to determine the amount of free 7 S IgM RF by ELISA. By plotting the reciprocal of the fraction of bound RF versus the reciprocal of the concentration of free antigen at equilibrium, different affinities were determined. The results of these determinations compare favorably with published IgM RF affinities determined by more traditional methods. This method can also be used with proteolytic digest fragments of IgG and short synthetic peptides of the IgG molecule to better locate the antigen binding site. The technique may also help us to determine whether there are select clones of RSC producing RF with different affinities that could complex to a particular type of IgG which, in vivo, could produce greater inflammatory tissue damage. Furthermore, this methodology should be useful in the study of other autoimmune diseases characterized by pathogenic autoantibodies of differing affinities.
Antibodies, Anti-Idiotypic↗
MHC class I expression by developmental tumors: teratocarcinoma stem cells are TCA positive.
We have investigated the expression of antigens recognized by several alloantisera and monoclonal antibodies to class I and class I-like MHC gene products on four developmental tumor cell lines derived from teratocarcinoma and choriocarcinoma. The analysis by cytotoxicity, immunoprecipitation, and Northern blotting analysis was also performed following treatment of the cells with gamma interferon. Three of four of the cell lines apparently do not express polymorphic determinants of HLA-A,B,C class I MHC genes. Immunoprecipitation with antibodies to HLA monomorphic determinants or beta 2m showed that some cell lines express distinct novel class I MHC-like molecules; the latter show molecular sizes different from regular HLA molecules and are associated with beta 2m. The Northern blotting showed class I mRNA present in three out of four of the developmental tumor cell lines but at at least tenfold lower levels than in lymphoid cells; it is possible that the RNAs homologous to class I DNA probes include transcripts of non-HLA-A,B,C genes. The cells were serologically typed for one such locus, TCA, which lies telomeric to HLA-A; the choriocarcinomas are negative and the teratocarcinomas are positive. The relationship between the different antigenic molecules and their possible functional significance is discussed in terms of maternofetal interactions, cancer, and transplantation.
Choriocarcinoma↗
Children's response to their true and distorted mirror images.
In order to study the development of body image, 16 children aged 2 months to 8 years were tested to determine their levels of cognitive development on the basis of Piaget's theory, and their responses to their true and distorted mirror images. The study indicates a definite characteristic response by children according to their levels of cognitive development. This corresponds to infantile anxieties appropriate to the psychoanalytic theory of object relationships. The theoretical and clinical implications of the study are discussed.
Anxiety↗
An ego disturbance model of MBD.
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Achievement↗
Nursing models fail in practice.
Despite an increasing academic interest in the nature of nursing models, nurses do not tend to use them in practice. This article examines the future of nursing models as a framework for delivering client care and questions their effectiveness in a practical setting.
Humans↗