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1.
FEBS Lett ; 473(1): 119-22, 2000 May 04.
Article in English | MEDLINE | ID: mdl-10802071

ABSTRACT

The nitration of protein tyrosine residues by peroxynitrous acid has been associated with pathological conditions. Here it is shown, using a sensitive competitive enzyme-linked immunosorbent assay and immunoblotting for nitrotyrosine, that spontaneous nitration of specific proteins occurs during a physiological process, the activation of platelets by collagen. One of the main proteins nitrated is vasodilator-stimulated phosphoprotein. Endogenous synthesis of nitric oxide and activity of cyclo-oxygenase were required for the nitration of tyrosine. The nitration was mimicked by addition of peroxynitrite to unstimulated platelets, although the level of nitrotyrosine formation was greater and its distribution among the proteins was less specific.


Subject(s)
Blood Platelets/chemistry , Blood Platelets/metabolism , Nitrates/metabolism , Platelet Activation , Tyrosine/analogs & derivatives , Aspirin/pharmacology , Blood Platelets/cytology , Blood Platelets/drug effects , Blood Proteins/chemistry , Blood Proteins/metabolism , Blotting, Western , Cell Adhesion Molecules/chemistry , Cell Adhesion Molecules/metabolism , Collagen/antagonists & inhibitors , Collagen/pharmacology , Cyclooxygenase Inhibitors/pharmacology , Cytosol/chemistry , Cytosol/drug effects , Cytosol/metabolism , Enzyme-Linked Immunosorbent Assay , Humans , Membrane Proteins/chemistry , Membrane Proteins/metabolism , Microfilament Proteins , Molecular Weight , NG-Nitroarginine Methyl Ester/pharmacology , Nitrates/pharmacology , Nitric Oxide Synthase/antagonists & inhibitors , Nitric Oxide Synthase/metabolism , Nitrous Acid/metabolism , Nitrous Acid/pharmacology , Oxidants/metabolism , Oxidants/pharmacology , Peroxynitrous Acid , Phosphoproteins/chemistry , Phosphoproteins/metabolism , Platelet Activation/drug effects , Thrombin/pharmacology , Tyrosine/analysis , Tyrosine/metabolism
2.
Atherosclerosis ; 139(1): 57-64, 1998 Jul.
Article in English | MEDLINE | ID: mdl-9699892

ABSTRACT

Atherosclerotic plaques develop in the arterial wall from complex multicellular processes following the early recruitment of circulating monocytes. Infiltration of monocytes is mediated by cell adhesion molecules (CAMs), including vascular cell adhesion molecule-1 (VCAM-1) which is rapidly induced in endothelial cells in response to cytokines. Apolipoprotein E (apo E), a 34-kDa polypeptide, helps protect against atherosclerosis, in part, because apo E phospholipid particles secreted by macrophages may have local protective effects within lesions. Here we have investigated whether purified plasma apo E, complexed with dimyristoyl phosphatidylcholine (DMPC) vesicles, can inhibit cytokine-induced vascular cell adhesion molecule-1 (VCAM-1) expression in human umbilical vein endothelial cells (HUVECs). Expression of VCAM-1 in endothelial cells after exposure to tumour necrosis factor-alpha (TNF-alpha) or interleukin 1beta (IL-1beta) was quantified by ELISA and shown to be partially inhibited by 17beta-estradiol (40-60% inhibition) or by S-nitroso-L-glutathione, a nitric oxide donor (20-25%). However, preincubations with physiological concentrations (10-100 microg protein/ml) of apo E DMPC did not downregulate VCAM-1 expression, even with extended preincubation times. These findings were confirmed using a fluorescence-activated cell sorter (FACS) for analysis which indicated additionally that apo E-DMPC had no effect on sub-populations within the HUVEC cultures. Finally, apo E-DMPC vesicles were also unable to suppress TNF-alpha-induced upregulation of E-selectin or intercellular adhesion molecule-1 (ICAM-1). We conclude that plasma apo E is unlikely to be important in limiting endothelial activation.


Subject(s)
Apolipoproteins E/physiology , Cell Adhesion Molecules/biosynthesis , Cytokines/pharmacology , Endothelium, Vascular/metabolism , Apolipoproteins E/administration & dosage , Apolipoproteins E/pharmacology , Cell Separation , Cells, Cultured , Dimyristoylphosphatidylcholine , E-Selectin/biosynthesis , Endothelium, Vascular/drug effects , Enzyme-Linked Immunosorbent Assay , Flow Cytometry , Humans , Intercellular Adhesion Molecule-1/biosynthesis , Interleukin-1/pharmacology , Liposomes , Tumor Necrosis Factor-alpha/pharmacology , Up-Regulation , Vascular Cell Adhesion Molecule-1/biosynthesis
3.
FEBS Lett ; 429(3): 347-50, 1998 Jun 16.
Article in English | MEDLINE | ID: mdl-9662446

ABSTRACT

Peroxynitrite, a reactive oxidising species resulting from a reaction between nitric oxide and the superoxide anion, modifies proteins by nitration of certain amino acids such as tyrosine. Tissue factor (TF), a transmembrane protein, is expressed on cells under inflammatory conditions and initiates the coagulation cascade. The extracellular domain of TF is rich in tyrosine. Exposure of recombinant TF and cellular TF to peroxynitrite was associated with a reduction in procoagulant activity. This was accompanied by an elevated level of nitrotyrosine residues. Peroxynitrite may have a protective role by attenuation of the thrombotic properties of TF.


Subject(s)
Coagulants/metabolism , Nitrates/pharmacology , Oxidants/pharmacology , Thromboplastin/metabolism , Coagulants/chemistry , Membrane Proteins/drug effects , Monocytes/drug effects , Recombinant Proteins/chemistry , Recombinant Proteins/drug effects , Recombinant Proteins/metabolism , Thromboplastin/chemistry , Thromboplastin/drug effects , Tyrosine/analogs & derivatives
7.
Br J Cancer ; 72(2): 257-67, 1995 Aug.
Article in English | MEDLINE | ID: mdl-7543770

ABSTRACT

The tumour vasculature is vital for the establishment, growth and metastasis of solid tumours. Its physiological properties limit the effectiveness of conventional anti-cancer strategies. Therapeutic approaches directed at the tumour vasculature are reviewed, suggesting the potential of anti-angiogenesis and the targeting of vascular proliferation antigens as cancer treatments.


Subject(s)
Neoplasms/blood supply , Neoplasms/therapy , Neovascularization, Pathologic/therapy , Amino Acid Sequence , Animals , Humans , Molecular Sequence Data , Neovascularization, Pathologic/drug therapy
8.
Clin Exp Immunol ; 99(3): 404-11, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7882563

ABSTRACT

Ulcerative colitis (UC) has a proposed autoimmune pathogenesis. A 40-kD antigen (P40) has been isolated from UC colon, bound to immunoglobulin. Tropomyosin has been reported as the target antigen of a MoAb (7E12H12) raised against P40. We set out to investigate whether tropomyosin is the major antigenic determinant for 7E12H12. Formalin-fixed, paraffin-processed and cryostat sections of fresh frozen colon from patients with UC, Crohn's disease and normals, were immunostained with 7E12H12 and commercial anti-tropomyosin antibodies. In addition, the immunoreactivity of 7E12H12 with cytoskeletal components was examined on human endothelial cells (HUVEC) using anti-tropomyosin as a positive control. Con-focal microscopy was used to determine the subcellular localization of signal. An extract of total colonic protein from UC colon was prepared. Using a combination of Western and immunoblotting (dot-blots), the immunoreactivities of both tropomyosin (porcine and chicken) and colon protein extract with either 7E12H12 or commercial anti-tropomyosin were examined. Immunocytochemically, 7E12H12 localized to the apical and basolateral regions of plasma membrane, and to the supranuclear cytoplasm in colonic epithelium. Using anti-tropomyosin antibody it was not possible to identify the cytoskeleton in colonic epithelium. Cytoskeletal components were identifiable in HUVEC cultures with anti-tropomyosin antibody but not with 7E12H12. P40 antigen was identified in the colon protein extract by immunoblotting with 7E12H12. There was clear immunoreactivity between anti-tropomyosin antibody and both chicken and porcine tropomyosin, and the colon protein extract. 7E12H12 did not bind to either chicken or porcine tropomyosin in appropriately controlled systems. We conclude that the pattern of immunostaining with 7E12H12 is not cytoskeletal, and there is no reactivity in immunoblots, between tropomyosin and 7E12H12. Tropomyosin is not the major target antigen of this antibody in ulcerative colitis.


Subject(s)
Antibodies, Monoclonal/immunology , Autoimmune Diseases/immunology , Colitis, Ulcerative/immunology , Immunodominant Epitopes/immunology , Tropomyosin/immunology , Blotting, Western , Fluorescent Antibody Technique , Humans , Immunoenzyme Techniques , Microscopy, Confocal
9.
Dig Dis Sci ; 39(9): 1909-17, 1994 Sep.
Article in English | MEDLINE | ID: mdl-8082497

ABSTRACT

Evidence of a humoral immune response to endothelium was sought in the sera of patients with inflammatory bowel disease. In an ELISA, IgG binding to human umbilical vein endothelial cells was found in 21% of Crohn's disease sera, 10% of ulcerative colitis sera, 6% of sera from patients with acute infective diarrhea, and 8% of normal control sera. The increased prevalence in Crohn's disease sera was significant (P < 0.05). IgG-endothelial cell binding was cell specific, was not Fc-mediated, and did not mediate complement-dependent cell lysis. It was not increased by pretreatment of cells with interleukin-1 or tumor necrosis factor. Endothelial cell binding was retained by IgG F(ab')2 fragments from one of three reactive Crohn's sera, but none of three nonreactive sera. The low prevalence of this interaction, even in patients with immunohistochemically confirmed vasculitis, makes it unlikely that Crohn's disease is determined by a humoral autoimmune response to endothelium.


Subject(s)
Colitis, Ulcerative/immunology , Crohn Disease/immunology , Diarrhea/immunology , Endothelium, Vascular/immunology , Immunoglobulin G/blood , Adult , Antibody Formation/immunology , Cells, Cultured , Complement Activation , Enzyme-Linked Immunosorbent Assay , Female , Humans , Inflammatory Bowel Diseases/immunology , Male , Middle Aged , Umbilical Veins/immunology
10.
Urology ; 36(4): 350-2, 1990 Oct.
Article in English | MEDLINE | ID: mdl-2219618

ABSTRACT

Mouse bladder epithelium has been successfully transplanted to the bladders of syngeneic mice and has survived for at least twenty weeks. The fate of the transplanted tissue was followed using a fluorescein label. The recipient bladders were prepared by stripping the urothelium either by a surgical or a chemical method. The possibility of adopting a comparable technique for the treatment of early bladder cancer in man is discussed.


Subject(s)
Urinary Bladder/transplantation , Animals , Cyclophosphamide/pharmacology , Epithelium/drug effects , Epithelium/pathology , Epithelium/physiology , Hyperplasia , Male , Mice , Mice, Inbred CBA , Regeneration , Urinary Bladder/drug effects , Urinary Bladder/pathology
11.
Histopathology ; 17(3): 237-42, 1990 Sep.
Article in English | MEDLINE | ID: mdl-2242851

ABSTRACT

The immunoreactivity of a new monoclonal antibody to endothelium. QBEND/10, in formalin-fixed, paraffin-embedded sections from a variety of vascular and lymphatic tumours is described and compared to that of two other endothelial markers, von Willebrand factor and Ulex europaeus agglutinin, type 1. All the benign tumours of blood vascular origin showed immunoreactivity whereas only five out of eight lymphangiomas demonstrated a weak focal reaction with QBEND/10. Primitive lumina in epithelioid and spindle cell haemangioendotheliomas were highlighted in all the cases. Tumour cells in angiosarcoma forming vasoformative areas and solid areas showed immunopositivity to QBEND/10 in 17/23 and 13/24 cases respectively, and complementary immunoreactivity for von Willebrand factor was observed. Proliferating vessels and the majority of spindle cells in Kaposi's sarcoma were positive in all 40 cases. Only one of 54 cases of carcinoma showed luminal reaction to QBEND/10. However, 17 of 45 spindle cell tumours displayed a positive reaction. QBEND/10 is an additional marker for demonstrating endothelial differentiation and has some advantages over currently available antibodies.


Subject(s)
Antibodies, Monoclonal , Endothelium, Vascular/immunology , Neoplasms, Vascular Tissue/diagnosis , Biomarkers, Tumor/immunology , Diagnostic Errors , Evaluation Studies as Topic , Humans , Immunohistochemistry , Neoplasms, Vascular Tissue/immunology , Neoplasms, Vascular Tissue/pathology
12.
Blood ; 75(12): 2417-26, 1990 Jun 15.
Article in English | MEDLINE | ID: mdl-1693532

ABSTRACT

All seven of a set of CD34 monoclonal antibodies that recognize epitopes on an approximately 110 Kd glycoprotein on human hemopoietic progenitor cells also bind to vascular endothelium. Capillaries of most tissues are CD34 positive, as are umbilical artery and, to a lesser extent, vein, but the endothelium of most large vessels and the endothelium of placental sinuses are not. Angioblastoma cells and parafollicular mesenchymal cells in fetal skin are also CD34 positive, as are some stromal elements. An approximately 110 Kd protein can be identified by Western blot analysis with CD34 antibodies in detergent extracts of freshly isolated umbilical vessel endothelial cells, and CD34 mRNA is present in cultured umbilical vein cells as well as other tissues rich in vascular endothelium (breast, placenta). These data indicate that the binding of CD34 antibodies to vascular endothelium is to the CD34 gene product, and not to crossreactive epitopes. Despite the presence of CD34 mRNA in cultured, proliferating endothelial cells, the latter do not bind CD34 antibodies. In addition, CD34 antigen cannot be upregulated by growth factors. We conclude that under these conditions, CD34 protein is downregulated or processed into another form that is unreactive with CD34 antibodies. Electron microscopy of umbilical artery, breast, and kidney capillary vessels reveals that in all three sites, CD34 molecules are concentrated on membrane processes, many of which interdigitate between adjacent endothelial cells. However, well-established endothelial cell contacts with tight junctions are CD34 negative. CD34 may function as an adhesion molecule on both endothelial cells and hematopoietic progenitors.


Subject(s)
Antigens, CD/genetics , Antigens, Differentiation/genetics , Endothelium, Vascular/physiology , Antibodies, Monoclonal/immunology , Antigens, CD/immunology , Antigens, CD34 , Antigens, Differentiation/immunology , Blotting, Northern , Blotting, Western , Cell Compartmentation , Cells, Cultured , Flow Cytometry , Gene Expression , Hematopoietic Stem Cells/immunology , Humans , Immunohistochemistry , Microscopy, Electron , RNA, Messenger/genetics
13.
Lab Invest ; 62(6): 690-6, 1990 Jun.
Article in English | MEDLINE | ID: mdl-1694254

ABSTRACT

It has been reported that the human haemopoietic progenitor cell antigen CD34 is also expressed by vascular structures. To investigate its precise vascular localization, we have studied the cellular and subcellular distribution of CD34 in normal tissues and pathologic tissues with neovascularization. In normal resting tissues, anti-CD34 antibodies, ICH3 and QBEND-10 predominantly stain the luminal endothelial membrane, whereas the abluminal membrane is negative or weakly positive. In contrast, a striking staining of endothelial abluminal microprocesses (EAM) was found in the tumor stroma. These structures, measuring up to 20 microns in length, could be observed in thick vibratome sections both at the tips of vascular sprouts and, also frequently, on fully formed microvessels. The number of vascular sprouts and EAM varied widely between different tumors. CD34-stained EAM were sparsely present in fetal tissue of 10 weeks gestation, but they could not be demonstrated in granulation tissue of wound healing. By immunoelectron microscopy, the EAM were continuous with the cytoplasm of endothelial cells showing an immature phenotype as seen in regeneration. In cultured human umbilical vein endothelium, CD34 was preferentially found on a small subset of cells with the morphologic appearance of migrating cells. These findings suggest that CD34 is an endothelial marker for EAM present during angiogenesis.


Subject(s)
Antigens, Differentiation/immunology , Antigens, Surface/immunology , Colonic Neoplasms/immunology , Antibodies, Monoclonal/immunology , Antigens, CD34 , Endothelium, Vascular/immunology , Endothelium, Vascular/ultrastructure , Humans , Immunoenzyme Techniques , Neovascularization, Pathologic , Tumor Cells, Cultured , Umbilical Veins/immunology
14.
Acta Med Austriaca ; 16(3-4): 50-4, 1989.
Article in English | MEDLINE | ID: mdl-2558482

ABSTRACT

The distribution and clearance of intraperitoneally injected 198-Au colloid were investigated in mice. 49% of the radioactivity persisted throughout the first 8 hours after injection and 9% were measured after 7 days. The highest concentrations were then measured within the greater omentum and the mesenteric lymph nodes.


Subject(s)
Gold Colloid, Radioactive/pharmacokinetics , Peritoneum/diagnostic imaging , Animals , Gold Colloid, Radioactive/administration & dosage , Injections, Intraperitoneal , Male , Mice , Mice, Inbred Strains , Radionuclide Imaging , Tissue Distribution
15.
J Urol ; 139(2): 405-9, 1988 Feb.
Article in English | MEDLINE | ID: mdl-3339761

ABSTRACT

The temporal and spatial regeneration of denuded mouse bladders was characterized using antibody markers to mucosal and submucosal elements in bladder tissue. Mechanical stripping of bladder mucosa resulted in a plane of cleavage in the submucosa leaving the muscle layers intact. Fully regenerated bladders were observed after 14 to 21 days although submucosal elements showed abnormal vacuolation. Implantation of immortalized epithelial cell line BBN3 into denuded bladders resulted in solid tumor formation while, in contrast, transplantation of MB331 showed cystic structures with no indication of invasion. Confirmation of the epithelial and implanted origin of cells lining the lumina of implanted bladders were shown using different keratin antibodies. The benign behavior of MB331 in vivo is suggestive of a cell line representing a preneoplastic stage in carcinogenesis and demonstrates an approach to assess the in vivo phenotype of cell parameters established in vitro.


Subject(s)
Regeneration , Urinary Bladder/transplantation , Animals , Cell Line , Epithelial Cells , Epithelium/pathology , Epithelium/transplantation , Male , Mice , Mice, Inbred C57BL , Time Factors , Urinary Bladder/cytology , Urinary Bladder/pathology , Urinary Bladder Neoplasms/etiology , Urinary Bladder Neoplasms/pathology
16.
Leukemia ; 1(5): 417-26, 1987 May.
Article in English | MEDLINE | ID: mdl-2444831

ABSTRACT

Monoclonal antibodies My10, BI.3C5, 12.8, and ICH3 identify a monomeric cell surface glycoprotein (HPCA-1) of 100-120 kD, which is selectively expressed on human hemopoietic progenitor cells. Other tissues are nonreactive with the exception of capillary endothelia and basement membrane in some sites. In addition, the antigen can be detected on cell lines that exhibit characteristics associated with early T cell precursors. HPCA-1 is therefore associated with myeloid, B, and T lineage precursors. Sequential immunoprecipitation and Western blotting studies demonstrate that BI.3C5, ICH3, My10, and an antibody directed against endothelial cells, 188.27, all react with the same glycoprotein species, although the epitopes involved may be distinct. The epitope recognized by BI.3C5 is sialic acid dependent, whereas that recognized by ICH3 is not. The My10 epitope has partial sensitivity to neuraminidase. Competitive/additive binding experiments suggest that these epitopes, although probably distinct, may be closely associated.


Subject(s)
Antigens, Differentiation/analysis , Hematopoietic Stem Cells/immunology , Membrane Glycoproteins/immunology , T-Lymphocytes/immunology , Antibodies, Monoclonal , Carbohydrates/immunology , Cell Line , Epitopes , Genes, Immunoglobulin , Humans , Receptors, Antigen, T-Cell/genetics , Tissue Distribution , Tumor Cells, Cultured/immunology
17.
J Neurooncol ; 3(1): 23-33, 1985.
Article in English | MEDLINE | ID: mdl-2987425

ABSTRACT

Eighteen cases of cerebral tumour composed partly or totally of primitive embryonal cells are reported. These lesions comprise 2.8% of all primary cerebral hemisphere tumours in the histopathology files of The Royal Marsden Hospital between 1971 and 1980 inclusive. Most exhibited some degree of differentiation towards neuronal or glial elements and, as more than one type of differentiation was often present in the same lesion, we agree with others that the term primitive neuroectodermal tumour (PNET) is more appropriate to describe these lesions than terms based on histogenesis. The extent of the primitive component varied, but usually accounted for more than 80% of the tumour. Although the tumours bear some similarities to posterior fossa medulloblastomas, they exhibit important differences in histology, immunohistology, natural history and response to treatment. Nearly all PNETs examined expressed some glial fibrillary acidic (GFAP) both in primitive areas and zones of astrocytic differentiation. GFAP staining may thus be of value in distinguishing PNETs from undifferentiated non-neurogenic tumours. Of 14 patients referred for radiotherapy, the survival rate at 3 years was 29% (4/14) and 5 years 25% (3/12). Patients with tumours in which at least 90% of the tissue was undifferentiated exhibited an extremely poor prognosis with none of 9 patients still alive at 3 years in contrast to 3 of 5 patients (60%) with tumours showing less than 90% undifferentiation. Radical tumour removal, where feasible, followed by irradiation of the whole cerebrospinal axis is recommended. Adjuvant chemotherapy with such agents as CCNU and Vincristine may be of value: the 3 long term survivors in the present series (7-11 years), including one who presented disseminated intracranial disease, received such adjuvant treatment.


Subject(s)
Brain Neoplasms/pathology , Neoplasms, Germ Cell and Embryonal/pathology , Adolescent , Adult , Astrocytes/ultrastructure , Brain/pathology , Brain Neoplasms/therapy , Cerebellar Neoplasms/pathology , Child , Child, Preschool , Endothelium/pathology , Ependyma/pathology , Female , Glial Fibrillary Acidic Protein/metabolism , Humans , Immunoenzyme Techniques , Infant , Male , Medulloblastoma/pathology , Necrosis , Neoplasms, Germ Cell and Embryonal/therapy , Neurons/ultrastructure , Oligodendroglia/ultrastructure , Reticulin/metabolism
18.
Immunology ; 52(1): 97-105, 1984 May.
Article in English | MEDLINE | ID: mdl-6232209

ABSTRACT

The isoelectric heterogeneity of both IgM and IgG murine anti-sheep red cell serum antibodies has been examined using an adaptation of published methods. It was found that the IgM spectra were restricted in a characteristic manner, implying oligoclonality. In cell transfer experiments, the T cell dependency of the IgM responses was confirmed. Further, helper cells appeared to switch on IgG antibody production and, simultaneously, recruit many novel IgG-forming clones into the response. The pattern of the IgM oligoclonality was attributed in part to the inheritance of genes at, or closely linked to, the Igl heavy chain locus. These findings are discussed in relation to current research on the regulation of diversity.


Subject(s)
Antibody Diversity , Immunoglobulin G/biosynthesis , Immunoglobulin M/biosynthesis , Animals , Clone Cells/immunology , Erythrocytes/immunology , Immunoglobulin M/genetics , Isoelectric Focusing , Male , Mice , Mice, Inbred Strains , Sheep , T-Lymphocytes/immunology , T-Lymphocytes, Helper-Inducer/immunology
19.
Br J Cancer ; 48(6): 819-25, 1983 Dec.
Article in English | MEDLINE | ID: mdl-6652021

ABSTRACT

Five high-grade (3 grade III and 2 grade IV) astrocytoma tumour cell populations were treated with a preparation of Human Leukocyte Interferon either in monolayer cell culture or as multicellular spheroids in vitro or as xenografts growing in immune-deprived mice in vivo. A moderate and transient sensitivity was seen in one grade III tumour when tested in both of the in vitro assays, but no inhibition of growth was seen in vivo. Two tumours which were apparently resistant to Interferon treatment responded to orthodox chemotherapy. When used in conjunction with BCNU, Interferon was not effective in prolonging delay in tumour growth. It is concluded that Interferon is unlikely to be an effective agent in the treatment of malignant brain tumours.


Subject(s)
Astrocytoma/drug therapy , Brain Neoplasms/drug therapy , Interferon Type I/therapeutic use , Adult , Aged , Animals , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carmustine/administration & dosage , Cell Line , Female , Humans , Interferon Type I/administration & dosage , Male , Mice , Mice, Inbred CBA , Middle Aged , Neoplasm Proteins/biosynthesis , Neoplasm Transplantation , Procarbazine/administration & dosage
20.
Alcohol Clin Exp Res ; 3(2): 121-4, 1979 Apr.
Article in English | MEDLINE | ID: mdl-391071

ABSTRACT

Studying alcoholism and chemical dependency among members of the medical profession, the authors discovered that, despite the special problems associated with alcoholic physicians, the number responding to treatment and showing improvement is high, and the overall results are encouraging.


Subject(s)
Alcoholism/therapy , Physicians , Alcoholics Anonymous , Alcoholism/complications , Follow-Up Studies , Humans , Medicine , Specialization , Substance-Related Disorders/complications
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