Research on the perception of indexical properties of speech in normal-hearing listeners has revealed that speech perception and spoken word recognition involve not only encoding of the linguistic message, but also processing and storage of talker-specific "indexical" properties of the speech signal, such as age, gender, and dialect. The perceptual processing of talker-specific information in speech has also been shown to affect the speech perception abilities of pediatric and adult cochlear implant users. In the current study, "Mr. S.", a post-lingually deafened adult cochlear implant user with 8 years of implant experience participated in a six-alternative forced-choice perceptual dialect categorization task without training or feedback. Normal-hearing adults can categorize unfamiliar talkers by regional dialect of American English with about 30% accuracy in a six-alternative forced-choice task. While this performance is poor, it is statistically above chance. Like the normal-hearing listeners, "Mr. S."'s performance was also statistically above chance and his scores were within one standard deviation of the mean performance of 30 normal-hearing controls. The present results suggest that "Mr. S." was able to perceive and encode non-linguistic talker-specific information from the speech signal that he received through his implant and use that information in an explicit test of dialect categorization.
We investigated the predictive relations between pre-implant visuomotor integration ability and subsequent oral speech/language outcomes in prelingually deaf children who use cochlear implants (CIs). Prior to implantation, children were given a task that tested their accuracy in copying geometric forms. Performance on this task predicted speech perception, sentence comprehension, and speech intelligibility outcomes over 3 years of CI use. We conclude that individual differences in visuomotor integration ability are predictive of some audiological outcome measures in deaf children with CIs.
Magnetoencephalography (MEG) was recorded while 5-7 year-old children were performing a visual-spatial memory recognition task. Full-term children showed greater gamma-band (30-50 Hz) amplitude in the right temporal region during the task, than children who were born extremely preterm. These results may represent altered brain processing in extremely preterm children who escape major impairment.
In this study, we report analyses of nonword repetition responses from 76 experienced pediatric cochlear implants users. Nonword repetition performance reflects the participants' reliance on their phonological system, which has been found to be related to phonological awareness skills and reading in normal-hearing children. We found that nonword repetition performance was strongly correlated with several measures of reading readiness and reading in deaf children with cochlear implants. Correlations between nonword repetition performance and reading indicate that the children relied on their knowledge of phonology to complete the reading tasks.
Recent findings on learning, memory and cognitive processes in deaf children following cochlear implantation are reviewed. The contribution of demographic factors is discussed and the results of several studies using "process" measures of performance are presented. In the first study, results from an investigation of the "Stars" showed that the exceptionally good implant users differed from the low performers in several important ways reflecting their ability to rapidly encode sound patterns into phonological representations. In the second set of studies, several new measures of information-processing performance are reported. Speaking rate, a measure shown in other populations to correlate well with an individual's verbal rehearsal speed for items in immediate memory was found to be strongly correlated with measures of a child's immediate memory capacity as well as open-set spoken word recognition scores. Additional evidence revealed atypical reproductive memory spans for auditory as well as visual sequences. Deaf children with cochlear implants also showed less benefit from simple repetition of a familiar sequence than age-matched normal-hearing children. Variation in children's success with cochlear implants reflects differences in the operation of elementary information-processing skills used in a wide range of language-processing tasks that draw on phonological coding and verbal rehearsal processes.
This study examined the effects of perceptual learning on nonword repetition performance of normal-hearing listeners who were exposed to severely degraded auditory conditions that were designed to simulate the auditory input of a cochlear implant. Twenty normal-hearing adult listeners completed a nonword repetition task using an eight-band, frequency-shifted cochlear implant simulation strategy both before and after training on open- and closed-set word recognition tasks. Feedback was provided during training. The nonword responses obtained from each participant were digitally recorded and played back to normal-hearing listeners. These listeners rated the nonword repetition accuracy in comparison to the original unprocessed target stimuli using a seven-point scale. The mean nonword accuracy ratings were significantly higher for the non words repeated after training than for non words repeated prior to training. These results suggest that the word recognition training tasks encouraged auditory perceptual learning that generalized to novel, nonword auditory stimuli. The present findings also suggest that adaptation and learning from the degraded auditory stimuli produced by a cochlear implant simulation can be achieved even in a difficult perceptual-motor task such as nonword repetition which involves both speech perception and production of an auditory stimulus that lacks any lexical or semantic representation.
The errors made by 37 pediatric cochlear implant users and age-matched normal- hearing children during forward and backward digit span recall were analyzed. All children were between 8 and 10 years old. The children who used implants had at least 4.5 years of experience with their device. Error classification was made using four categories: item, order, omission, or combination errors. Recall of digits not presented on a given trial was classified as item errors. The recall of all correct digits in an incorrect order was considered to be an order error. Results from a univariate ANOVA revealed main effects for error type, recall condition, and hearing ability. In addition, the error type by recall condition interaction revealed that order errors increased more in backward digit span recall than any other type of error for both normal-hearing children and children with cochlear implants. The present results are consistent with previous studies, suggesting that the shorter digit spans of children using cochlear implants are not primarily related to perceptual difficulties but appear to reflect memory processing problems related to slower subvocal verbal rehearsal and serial scanning of items in short-term memory.
The communication modalities used, and the articulation and aural-only receptive vocabulary skills were investigated in 19 prelingually profoundly deaf infants who initially utilized Total Communication and who were implanted between the ages of 12 and 29m. Results revealed the children overwhelmingly tended to use voice only modality for an expressive task. Additionally articulation and receptive vocabulary skills approached those of normal hearing peers. Implications of these findings and suggestions for future studies are provided.
Global descriptors of the cognitive phenotype of Turner syndrome are well established and are thus commonly referred to. For example, Turner syndrome is a proposed etiology of the nonverbal learning disability - because of reported relative strengths in verbal skills, and relatively weaker nonverbal skills - particularly in arithmetic, select visuospatial skills, and processing speed. This profile is observed throughout and beyond the school age years. Reliance on this gross level description of the cognitive profile (e.g., nonverbal learning disability) may be helpful as a starting point when determining whether an individual with Turner syndrome has educational needs, but it carries limited practical significance when determining the specific nature of these needs. The limitations stem from the fact that the severity of the cognitive profile is highly variable among individuals with Turner syndrome; that the "nonverbal" difficulties are specific rather than widespread; and that any individual with Turner syndrome may also manifest cognitive characteristics independent of Turner syndrome. In view of the increased risk for specific cognitive difficulties, a detailed assessment prior to the onset of formal schooling (or at the time of diagnosis, when diagnosis occurs after 5 years of age) can play an important role in determining school readiness and potential need for educational support among individual girls with Turner syndrome.
We present a method to register individual cortical surfaces to a surface-based brain atlas or canonical template using labeled sulcal curves as landmark constraints. To map one cortex smoothly onto another, we minimize a thin-plate spline energy defined on the surface by solving the associated partial differential equations (PDEs). By using covariant derivatives in solving these PDEs, we compute the bending energy with respect to the intrinsic geometry of the 3D surface rather than evaluating it in the flattened metric of the 2D parameter space. This covariant approach greatly reduces the confounding effects of the surface parameterization on the resulting registration.
To assess the possible effect of family planning fertility was examined by 3 variables (race, age, parity) in 2 groups of matched counties in rural Georgia, one with family planning programs (test group); one without (controls). Women in need of public contraceptive services were defined as fecund (age 18-44), household income less than $3000, and desired to avoid pregnancy. Characteristics of contraceptive users in the study area were: 90% Negro, 83% between 15-34 years, 65.9% married, 94.1% had children, 55% used the IUD, and 36.7%, oral contraceptives. Negro fertility declined in both groups at the same rate between 1960-1966 but in 1966-1968, the rate declined more (3 times greater) in the study group. Negro fertility declined more in all age groups of the study area than that of the control (50% decline for the women 25-39). The decline in fertility was greater for active contraceptors going to family planning clinics. More frequent and precise measurements of population characteristics will be needed to show the impact of family planning services.
The current study investigated the effects of propofol on P2X4 receptors expressed in Xenopus oocytes using two-electrode voltage clamp. We also tested the effects of 100 mM ethanol on the same oocytes used to test propofol. Propofol potentiated ATP-gated currents in a concentration dependent manner in P2X4 receptors. In agreement with our previous findings, ethanol inhibited P2X4 receptors. The opposite effects of propofol and ethanol on P2X4 receptor function suggest that these anesthetics act via different sites/mechanisms in P2X receptors as has been suggested for GABA(A) and glycine receptors.
In this paper, we describe the design, modeling, simulation and implementation of an entertainment robot named "Jumping Joe". Jumping Joe, an artistic and agile robot, can perform several rapid movements such as fast wake up, jumping and somersault. In order to realize acrobatic movements, four different actuators which can create the high-speed movements are developed. Jumping Joe with eight DOF, which are two DOF in each hip joint and one DOF in each knee joint and each foot, can also perform the routine movements of a legged robot such as standing, walking etc. First we describe the principle of the developed actuators. Second we investigate the feasibility of the special movements performed by our artistic robot through simulations using 3D dynamical analysis software. Next we show experimentally that a prototype of our artistic robot "Jumping Joe" can demonstrate all the above rapid movements
On the basis of statistical mechanics of the Q-Ising model, we formulate the problem of inverse-halftoning using the maximizer of the posterior marginal (MPM) estimate for halftone images obtained by the threshold mask method. Then, we estimate the performance of the method in terms of the mean square error and the histogram of the gray-level using the Markov-chain Monte Carlo simulation. The simulation for a set of snapshots of the Q-Ising model reveals the results that the MPM estimate works effectively for the problem of inverse-halftoning, if we appropriately set the parameters of the model prior expressed by the Boltzmann factor of the Q-Ising model. We then clarify that the model prior shifts the gray-level images from both sides to the middle range of the gray-level in the procedure of inverse-halftoning. Also, these properties are confirmed by the MCMC method even for real-world images.
This Essay was written after September 11, in the hope of better understanding the minds of those who made their bodies explode in order to shatter other bodies in the name of God. As analysts do not meet, in their practice, such individuals, the author put under scrutiny, three well-known authors and, for two of them, also film directors, Foucault, Pasolini and Mishima, in whom one may find a blending of sadism, extremist political views (whether on the right or on the left leading to an admiration for cruel leaders, such as Hitler, Staline or Khomeiny), a more or less unconscious identification with Christ, Jean Genet and others, although not present in this paper, fit with the psychic organization here described, to which, it is necessary to add suicidal ideas, attempts or accomplishments. The unconscious fantasy here at stake seems to be that the dismantling of one's own body, together with the shattering of other bodies, provokes a corresponding dislocation of the world and a final apotheosis resulting with a fusion with God.
This poster presents an update and initial findings from an ongoing survey of 1000 visually impaired people in Great Britain.Methods
The project started in March 2004. It aims to develop a random sample of 1000 registered visually impaired people (with weighted stratification for age). The process of recruitment is underway. The recruited participants will be surveyed for their needs, circumstances and opinions on a number of topics. The intention is that this survey will build upon work carried out by the RNIB, except in this case the sample will be maintained with the aim of collecting longitudinal data. The year 1 survey is designed to collect general demographic information, including that related to their self-reported level of vision, health, and access to services. Uniquely, there are also a series of questions related to the broad areas of employment, ILS, ICT, leisure, travel and transport, and education. Through these questions participants will comment about their participation in society and any barriers to this participation. The results of the year 1 ‘generative questions’ will enable priorities for future questions to be set.Results and conclusionThe data is in the process of being collected and this poster presentation will give an opportunity to share early findings of this large scale ongoing survey.
Eleven polymorphic systems were analysed in 107 trios comprising the alleged father, mother and child. PI, Residual PI (RPI), and the respective distribution descriptive parameters were obtained. In cases in which the exclusion of paternity was determined, the exclusion percentage was evaluated for each system and was compared with the calculated Exclusion Power. Only three PI values were observed to be inside the RPI value curve, although this only occurs for 2.5% of cases. Like other authors regarding other populations, we conclude that in this population, more polymorphic systems must be analyzed when PI values under 1000 are observed. Total Exclusion Power for this polymorphic system was 0.99973 and D13S317 was the system with highest Exclusion Power (0.6183). However, the highest real exclusion rate in this population was observed in the F13A01 system (0.7000), calculated over the number of F13A01 exclusions over the total paternity exclusions observed.
SAMP6 is a substrain of senescence-accelerated mice (SAM) that exhibits decreased bone mass due to impaired bone formation. Bipotential bone marrow stromal cells from SAMP6 showed enhanced adipogenesis and suppressed osteoblastogenesis. These abnormalities of stromal cells were cured by addition of an anti-adipogenic cytokine, interleukin (IL)-11, expression of which was decreased in SAMP6. We further demonstrated that IL-11 transcription was largely dependent on AP-1 transcription factors and that DNA binding activity of AP-1, especially Jun D, was reduced in SAMP6 marrow stromal cells. These results suggest that reduced AP-1-mediated transcription of IL-11 is a mechanism causing impaired bone formation in SAMP6. Interestingly, reduced AP-1 activity and a resultant decrease in IL-11 expression was also observed in aged mice of ordinary ICR strain. Moreover, transgenic mice over-expressing IL-11 showed increased bone mass due to enhanced bone formation and were protected from aging-associated bone loss. Based on these findings, we propose that IL-11 is a physiological stimulator of bone formation and that the aging-associated decline in stromal expression of IL-11 may be a general mechanism of impaired bone formation in the aged.
Background: S-(−)[11C]CGP-12177 is reported to be a useful PET ligand for β-adrenoreceptor in the heart and lung. Its pharmacokinetic properties, however, have not been fully examined due to difficulty in S-(−)[11C]CGP-12177 production. Recently, we have developed a simple and improved synthesis of S-(−)[11C]CGP-12177 with high yields and high specific activity. The aim of this study is to determine pharmacokinetic properties of high specific activity S-(−)[11C]CGP-12177 in vitro and in vivo using rats. Methods: In vitro studies: S-(−)[11C]CGP-12177 (final concentration, 1 nM) with various concentrations of (±)CGP-12177, (±)propranolol, or (−)timolol was added in vitro to rat myocardial slices (n=4 in each condition). Incubation was performed at 30 °C for 90 min. The radioactivity in the myocardial slices was determined at the end of incubation. In vivo studies: Control and (±)propranolol-pretreated (7 μmol/kg, i.v., 5 min prior to S-(−)[11C]CGP-12177 injection) rats (n=4 in each group) were given S-(−)[11C]CGP-12177 (0.4 nmol/kg) intravenously. Radioactivity in tissues was measured at 20 min after injection of S-(−)[11C]CGP-12177. Results: In vitro studies: Uptake of S-(−)[11C]CGP-12177 in the myocardial slices was significantly decreased, depending on the concentration of the β-adrenoreceptor antagonists. S-(−)[11C]CGP-12177 uptake was 26%, 31%, and 36% of the control value, respectively, at 5×10−6 M (±)CGP-12177, (±)propranolol, and (−)timolol. In vivo studies: In the control group, uptake of S-(−)[11C]CGP-12177 was highest in the lung (10.3±0.5% ID/g), followed in decreasing order by the heart (2.4±0.1 %ID/g), kidneys, and liver. Pretreatment with (±)propranolol significantly reduced S-(−)[11C]CGP-12177 uptake in the lung and heart, to 11% and 17% of the control value, respectively (p<0.0001 for both tissues). Conclusions: The accumulation of S-(−)[11C]CGP-12177 in the heart and lung can be largely ascribed to the specific binding of the compound to β-adrenoreceptors, providing further evidence for the feasibility of high specific activity S-(−)[11C]CGP-12177 as an imaging agent for β-adrenoreceptors.
Information about myocardial perfusion and function has limitations in the assessment of disease severity and prognosis in patients with heart failure. Information about myocardial biochemistry may actually be more important in patient management. In vivo assessment of myocardial biochemistry, which started from the use of positron emission tomography, is now becoming a reality with the use of single-photon emission tomography (SPET). 123I-BMIPP as a fatty acid tracer and 123I-MIBG as a norepinephrine (NE) tracer are already used for clinical assessment here in Japan. In this chapter, based on our experiences, we introduce the utilities of these two tracers in assessing disease severity, the effects of medical treatment and prognosis in patients with heart failure. In 123I-BMIPP imaging, we could not characterize metabolic abnormalities specific for idiopathic dilated cardiomyopathy, but we identified utility in differentiating ischemic from idiopathic dilated cardiomyopathy based on a high prevalence of regional myocardial 123I-BMIPP defects in ischemic cardiomyopathy. In 123I-MIBG imaging, we recognized the utility of the washout rate (WR) of 123I-MIBG from the heart as an index of sympathetic activation. It showed good correlations with the plasma NE concentration and the left ventricular ejection fraction. In addition, we recognized important utilities of WR in evaluating the effectiveness of β-blocker treatment and prognosis in patients with idiopathic dilated cardiomyopathy.
We present the frequency distributions of 13 Y-specific STR polymorphisms (DYS19, DXYS156, DYS385, DYS389 I and II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439 and YCAII) and the frequency of the combination of these haplotypes in Vietnamese males.
Age is a potent modifier of thyroid cancer. The short latency for the development of thyroid cancer in the post-Chernobyl cases proposes that we need to be sure of the thyroid susceptibility to internal exposure, especially at young ages. We started a large-scale carcinogenesis project 6 years ago with the purpose to evaluate the carcinogenic potential of 131I when irradiated at young ages. First, we established a method to estimate the absorbed doses in the thyroid of different age groups. Irradiation at 1 week of age caused heavier exposure than at 4 and 9 weeks of age by eight times, while damages of the thyroid tissue were more obvious in the 4-week-old groups than in the 1-week-old groups. Second, we tested the responsiveness of thyroid epithelium to radiation. Apoptosis was not detected in the 1-week-old-thyroid epithelium, however, it did appear in the 4-week-old thyroid epithelium. While the proliferating cell nuclear antigen (PCNA)-labeling index was vice versa. Third, the carcinogenesis of 131I has been tested. Papillary carcinomas have developed in rats internally irradiated with 131I at the age of 1 week. A very low dose rate of irradiation by 131I could induce thyroid carcinomas with a short latency.
Intron 40 of the vWF gene is known to harbor three different STRs, which were separately reported by Kimpton et al. (vWA), by Peake et al. (vWF-P), and by Ploos van Amstel et al. (vWF-A). En bloc detection of the three STRs (F8VWF) and sequencing of the F8VWF alleles revealed novel base substitutions, tetranucleotide insertions, and tetranucleotide repeats.It is noted that the nucleotide substitutions and insertions were observed exclusively in those F8VWF alleles having the vWA allele 14.
To improve the knowledge on influenza and respiratory syncytial virus (RSV) infections burden on paediatric population, a cohort of 1600 Italian children was prospectively followed up during the 2001–2002 and 2002–2003 winters. Specimens from each influenza-like illness (ILI) were collected and tested for influenza viruses and RSV by PCR and cell cultures. Two hundred sixty-eight and 440 episodes of ILI were registered during 2001–2002 and 2002–2003, with a cumulative incidence of 16.8% and 27.5%, respectively. A comparison between the morbidity data of this well-studied cohort and those of the national network (Influnet) and the one between different swabs and different detection methods was performed. Considering the high variability of respiratory epidemics in different areas, the cumulative morbidity is not far from that observed in the Liguria region by the national network (21.1% and 24.6%). Fifty-nine (22%) and 22 (8.3%) out of 268 specimens collected during 2001/2002 season and 60 (13.6%) and 34 (7.2%) out of 440 during 2002/2003 were influenza and RSV-PCR positive, respectively. During the former winter, influenza B virus was prominent, while during the last season A/H3N2 predominated. RSV circulation preceded influenza detection in both seasons. PCR confirmed higher sensitivity than cell culture in influenza virus detection; the combination of a paediatric sentinel-based network with virological surveillance performed by reverse transcription polymerase chain reaction (RT-PCR) for influenza and RSV seem a good way for the control of respiratory tract diseases.
Objectives: To shorten the scanning protocol for quantification of cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2), a new method has been developed using 15O-CO2, CO, O2 and PET. Methods: Fifteen patients with carotid occlusion or stenosis were employed. One-minute inhalation of 15O-CO and 3-min static scanning and blood sampling was performed to measure cerebral blood volume (CBV). With 2-min inhalation of 3 GBq 15O-CO2, serial dynamic scanning and arterial blood sampling was performed for 6 min. With 15-min inhalation of 15O-O2, steady state O2 image was scanned for 5 min, and arterial blood and plasma were sampled to measure oxygen extraction fraction (OEF) and CMRO2. In addition, to compare with conventional method, steady state CO2 image was scanned for 5 min with 15-min inhalation of 7.5 GBq 15O-CO2 and arterial blood and plasma sampling. CBF and partition coefficient of water in the brain were estimated by non-linear curve fitting to the tissue time-activity curves. A new method was developed to measure OEF and CMRO2 using the known ratio of arterial H2O and O2 concentration in O2 steady state. The method does not require measuring the plasma counts. For each subject, about 2000 regions of interest (ROIs) were positioned, estimates calculated from a new method (newCBF, newOEF, newCMRO2) were correlated with those from conventional steady state method (ssCBF, ssOEF, ssCMRO2). Results: newCBF, newOEF and newCMRO2 presented significant correlation with those from steady state method, respectively (newCBF (ml/min/100 g)=1.07 ssCBF (ml/min/100 g)+3.17, r=0.934, p<0.001; newOEF=0.77 ssOEF−0.01, r=0.707, p<0.001; newCMRO2 (ml/min/100 g)=0.95 ssCMRO2 (ml/min/100 g)+0.04, r=0.856, p<0.001). The length of the scanning period was reduced 20 min and cut to 35 min for each patient to perform the new protocol study to measure CBF, OEF and CMRO2 without arterial plasma sampling. New method was able to reduce 4.5 GBq of 15O-CO2 inhalation compared with the steady state method. Conclusion: We have developed a new method that permits quantitative measurement of CBF, OEF and CMRO2 with a short period acquisition time without arterial plasma sampling. The method also reduces radiation exposure of patients. This protocol may be of great value in clinical brain PET using 15O gas.
In the past few years, short tandem repeat (STR) typing has become the method of choice for many, if not most, laboratories to perform paternity testing. The aim of this study was to show that a set of carefully chosen and well-known STR loci may provide as reliable results as Restriction Fragment Length Polymorphism (RFLP) typing does. We analyzed the Paternity Index (PI) and Residual Paternity Index (RPI) obtained in 67 non-exclusion cases and 22 exclusion cases typed by 10 STR loci, and in 61 non-exclusions and 14 exclusions typed by four RFLP loci. PI was calculated for the trios and also for child and alleged father in motherless cases using local frequency tables and it was assigned to one out of six categories. The 10 STR locus analysis for paternity testing led to conclusive results for all trio cases. In paternity tests lacking a mother, more than 10 STRs should be analyzed to get similar results.
Oral mucosal cells such as epithelial cells and fibroblasts are the first cells encountered by bacteria in our body. In addition to acting as a physical barrier, oral mucosal cells appear to express adhesion molecules and secrete many proinflammatory mediators, implying that the cells actively participate in mucosal immunity. Oral epithelial cells express a precursor form of interleukin (IL)-18, an important regulator of innate and acquired immune responses. An active form of IL-18 was secreted from the cells on co-stimulation with neutrophil proteinase 3 (PR3) and lipopolysaccharide after interferon-γ-priming. Subsequently, it was evident that neutrophil serine proteases including PR3 activate oral mucosal cells through protease-activated receptor-2 (PAR-2) pathway and play a critical role in IL-18 induction in vivo. These results indicate that induction of IL-18 and PAR-2 activation by neutrophil serine proteases may be critical in regulation of oral mucosal immunity.
Justus von Liebig (1803–1873), one of the great 19th century chemists, did much basic work in chemistry. By applying the knowledge of organic chemistry to animal and human physiology and to agricultural science, he became the founder of physiological chemistry and agricultural chemistry. von Liebig is well known until today as inventor of “Liebig's Beef Extract” and chemical fertilizer. Through his analytical research on ether and chloroform in the 1830s, he has made remarkable contributions relevant for the discovery and development of anaesthesia. When Edward Everett (1794–1865) sent his famous letters to Europe in November 1846 to inform about the introduction of ether anaesthesia, the only letter to Germany was addressed to von Liebig. The original letter has not yet been found, but we can conclude that von Liebig did receive this letter. A short article about the discovery appeared in his journal on February 6, 1847. This means that von Liebig's journal presumably had been the first scientific journal in Germany to have published the news of the discovery of ether anaesthesia. Further studies will be necessary to shed more light upon how von Liebig had been involved in the spread of the news of ether anaesthesia to Germany.
An old operation register from the West Suffolk Hospital was discovered recently at a local jumble sale, documenting the surgical procedures undertaken at the hospital during the early 1900s. It tells not only its own story, but bears witness to concurrent historical events. This article attempts to recreate what may have been the experiences of patients undergoing anaesthesia and surgery at that time (both in Suffolk and in other parts of the world) using medical literature written during this era. Were they prepared for anaesthesia with a cup of “strong beef-tea” as suggested beneficial for maximal “vitality” by Dudley Wilmot Buxton, or perhaps “a little good brandy” and a “few cheery words”?
The first and subsequent spinal anesthesias were for operations on the lower extremity. Within 2 years, Tuffier used spinal to operate on the abdomen and kidney. Other surgeons began to explore the possibility of using deliberate total spinal anesthesia. In 1901, Morton described the use of spinal anesthesia for operations on all regions of the body. Le Filliâtre in 1901, Chaput in 1907, Jonnesco in 1908 and Koster in 1928 also used high levels of analgesia in what was called general spinal anesthesia. This was meant as distinctive from general inhalation anesthesia. It is remarkable that large series of operations on the thorax, neck and head were performed with deliberate total spinal anesthesia. After 1930, with admonition from Forgue and Basset, the use of total spinal anesthesia declined. They stated that the safety of spinal anesthesia resided in lower levels and suggested no total spinal, not even a high spinal, should be administered. The first anesthesiologists who used total spinal anesthesia for purposes of deliberate hypotension and decreased blood loss were Griffith and Gillies.
The objective of this study was to find out factors of work and work organization and lifestyle which were associated to early retirement. A total of 3815 persons replied to four cross-sectional questionnaires in 1981, 1985, 1992 and 1997. At the end of the follow-up, all of the subjects had retired (65% old-age pension, 20% early pension, 15% disability pension). The effects of occupational variables, functioning and activity level on transition to early pension (compared to old-age pension) were analyzed by logistic regression. The results indicate that spouse's retirement and morbidity increase the “risk” of early retirement, whereas possibilities for development and influence at work, responsibility for others, satisfaction with the work time system and meaningful work all reduced the risk. Also good functioning and involvement in activities prevented early retirement. The results of the present study confirm the fact that work-related factors play an important role in the retirement process. Furthermore, the importance of free-time activities indicates that they might serve as a preventive factor against early exit from work.
The manuscript presents results of the radiogenic thyroid cancer risk analysis in the Bryansk and Oryol regions among children and adolescents at exposure (0–17 years of age). A total of 170 cases of thyroid cancer were diagnosed from 1991 to 1998. Of these, 106 cases were in the Bryansk and 64 in the Oryol region. The size of the exposed population under study is 374 447 persons in the Bryansk region and 207 592 persons in the Oryol region (data of the 1989 census). The mean thyroid dose from incorporated isotopes of 131I for children and adolescents at exposure is 0.071 Gy in the Bryansk region and 0.013 Gy in the Oryol region. The method of maximum likelihood for nonstationary Poisson series of events was used for risk calculation.
Anaesthesiology is a relatively new medical specialty in Spain. Since the introduction of inhalatory anaesthetics, the practice of its delivery has produced many changes in the surgical teams, which we shall try to summarise.
Ether is not the ideal anesthetic in terms of comfort. However, it demonstrates safety unparalleled by other anesthetics.The modern halogenated agents offer rapid induction and fast recovery with less nausea vomiting but require technical support to render its safe use. Ether anesthesia can be provided with open, semi-open or semi-closed system with spontaneous respiration throughout the surgical procedure. The slow changes of depth of anesthesia and wide margin of safety offer additional safety in the hands of the less experienced.In Surabaya, Indonesia, the teaching of ether anesthesia is compulsory for Anesthesiology residents and medical students. Ether was administered using gas machine, EMO or gauze mask; with or without oxygen. The cost difference between 2-hour anesthesia done under ether and halothane-NMBA-fentanyl is considerable. For a small country in Africa with 50,000 anesthetics annually, the cost saving will be tremendous. Isolated places where transportation of gas cylinders and continuous medical supply is difficult may benefit from ether.The same situation may also occur after a major earthquake, tsunami or other devastation wipes out modern medical facilities, oxygen (piped and cylinders) and electricity.
Rat liver l-tryptophan 2,3-dioxygenase (TDO) with a histidine tag at the N-terminus was expressed in Escherichia coli JM109 harboring plasmid pUC18 carrying the full-length cDNA of TDO. The recombinant enzyme was purified to near homogeneity by employing conventional purification methods including nickel-chelate immobilized resin column chromatography. The purified enzyme had a turnover number per heme 303 min−1 with similar spectral properties to those of native rat liver enzyme. SDS-PAGE of purified TDO preparation showed two distinct bands with molecular masses of 49 and 46 kDa. N-terminal sequence analysis of the components revealed that the 46-kDa species is shorter than the 49-kDa one by 19 amino acid residues including six histidine residues at the end. Thus, a limited proteolysis appeared to occur between Tyr13 and Thr14 of the original polypeptide chain. The construct of recombinant TDO with deletion of the N-terminal 13 residues gave a single band on SDS-PAGE with a molecular mass of about 46 kDa. The N-terminal truncation had no effect on the catalytic activity nor on the spectral properties.
Indoleamine 2,3-dioxygenase (IDO) catalyzes the first and rate-limiting step in the major metabolic pathway of tryptophan (Trp) in mammals. In healthy conditions, IDO is modestly expressed in many tissues but highly up-regulated locally or systemically by immune activation and inflammation. Considerable attention has been focused on IDO because of its detrimental effects in a variety of diseases. The activity of IDO plays a role in: 1) the cytokine (IFN-γ/IL-12) cascade inducing dangerous systemic Trp depletion that possibly results in a reduction of serotonin synthesis, 2) the escape of malignant tumors from immune surveillance by inducing immune tolerance through localized Trp depletion and production of immunosuppressive Trp metabolites, 3) neurodegenerative disorders such as Alzheimer`s disease via aberrant production of the neurotoxin, quinolinic acid, and 4) age-related cataract due to “Kynurenilation,” a novel post-translational modification of lens proteins with Trp-derived UV filters. Therefore IDO is an ideal pharmacological target for intervention in these diseases. The properties of currently available IDO inhibitors are also described.
Increased levels of several tryptophan metabolites have been demonstrated in various neurological disorders and were postulated to be secondary to induction of indoleamine 2,3-dioxygenase (IDO) and other enzymes of the l-tryptophan-kynurenine pathway. Previous reports have proposed that l-tryptophan metabolites (e.g., kynurenine, 3-hydroxykynurenine, quinolinic acid) may be involved in mediating neuronal damage in certain CNS disorders. On the other hand, recent studies have suggested that marked increases in IDO could suppress immune response by locally depleting l-tryptophan and/or accumulation of kynurenine pathway metabolites in various immune-related diseases. In fact, accumulation of kynurenine pathway metabolites in experimental autoimmune encephalomyelitis has been considered to relate to the onset of symptoms; however, recent studies demonstrated that inhibition of IDO by 1-methyl-tryptophan significantly exacerbated disease scores. Furthermore, our study demonstrates that inhibition of IDO significantly exacerbated the loss of pyramidal neurons in the hippocampus following transient ischemia. In this review, the role of IDO and kynurenine pathway metabolites in the pathogenesis of various CNS diseases, especially both beneficial and deleterious effects, were discussed.
Introduction: Fantoni's translaryngeal tracheostomy (TLT) is the most recent alternative to surgical tracheostomy. Its originality consists of the retrograde tracheal dilatation achieved using a single device. This allows for: preservation of the integrity of the posterior tracheal wall, no traumatism of the peritracheal tissues, tight adherence of the stoma to the tracheostomic canula, irrelevant bleeding. A flexible fiberoptic bronchoscope (FFB) instead of a rigid tracheoscope (RCT) can be used in difficult intubation. This study was designed to analyse procedural, intermediate and late complications. Patients and methods: The TLT was performed, using the Mallinckrodt kit, on 200 patients aged 16–81 years: on 152 an RCT was used, on 48 the FFB was utilised. Results: There where no procedural complications. In 20 patients, we observed superficial infection of the stoma and in one patient significant purulence at the stoma side, 135 were decannulated and 5 were retracheostomized with the TLT technique during a second ICU stay. Fifty patients consented to the follow-up procedure at 3 and 6 months after decannulation. Follow-up has not evidenced either cosmetic or functional alterations. Conclusions: TLT is a simple and safe bedside technique, which can be used even in patients with coagulation disorders or neck deformities. The use of RCT is preferable, whenever possible, due to its inherent advantages.
The evolution of influenza B viruses is poorly understood. The viral mechanisms of escape from immunological pressure include insertion–deletion in the hemagglutinin (HA) and co-circulation of different lineages, but this last epidemiological picture was observed only in SE Asia in the last decade. Virological surveillance conducted in Italy during the 2001/2002 and 2002/2003 seasons and molecular and antigenic characterization of 107 isolates allowed to detect the co-circulation of strains belonging to the Victoria and Yamagata lineage during the former season. Yamagata-like strains belonged to the two sub-lineages, B/Harbin/7/94 and B/Sichuan/379/99, while Victoria-like strains were B/Hong Kong/330/01-like viruses. During the 2002/2003 season, all isolates belonged to the B/Shangdong/7/97 cluster. In conclusion, during the last two seasons, viruses belonging to the two lineages and the four sub-lineages were isolated. In consideration of the distinct HI test pattern of the two lineages and amino acid changes over the antigenic sites inter- and intra-sub-lineage, these findings could play an important role in choosing the composition of the vaccine and in the evaluation of its efficacy.
The Institute of Physiology and Pathology of Hearing in Warsaw is a reference center for diagnosis, treatment and rehabilitation of hearing and speech disorders in Poland. There is a large amount of clinical material: in the year 2001, almost 4000 hospitalizations, over 38,000 patients in ambulatory follow-up, 48,000 school age children screened in Program “I can hear” allow for epidemiological and statistical analysis. This is also a very strong background for the creation of therapeutic strategies and algorithms. In our opinion, reference centers must supervise early detection programs and provide complex therapy for all patients with advanced pathologies. An adequate level of medical service can be secured, thanks to close cooperation of multidisciplinary teams and regular training in most modern diagnostic and therapeutic methods and tools.
From January to November 2002, a total of 510 respiratory secretions were collected from patients, 0 to 70 years of age, with acute respiratory illness living in the southeast and central east regions of Brazil. Virus isolation attempts were realized in cell cultures of MDCK, Vero, Hep-2 and embryonated hen's eggs. IFI assay using monoclonal antibodies was performed for identification of the isolates. Influenza virus 86 (17.13%) was identified. Among them, 12 (13.95%) were characterized as B/Hong Kong/330/2001; 3 (3.49%) as B/Hong Kong/1351/2002; 1 (1.16%) as B/Sichuan/379/99; 1 (1.16%) as B/Shizuoka/5/2001 and 2 (2.32%) as B/Brisbane/32/2002. In addition, influenza A/Panama/2007/99-like (H3N2) strain 22 (25.58%) was also detected, but influenza A (H1N1) was not detected in the analyzed samples during the 2002 influenza season. On the other hand, among the samples collected from January to September 2003 influenza virus A (H1N1) circulating has already been demonstrated. During influenza season 2003, a total of 393 respiratory secretions were collected from patients, 0 to 70 years of age, with acute respiratory illness living in the southeast and central east regions of Brazil. Influenza virus 45 (13.76) has been isolated. Among them, influenza A/Panama/2007/99-like (H3N2) (24.44%), influenza A/New Caledonia/20/99-like (H1N2) (6.66%), A/Korea/770/2002-like (H3N2) (6.66%) have already been characterized. In contrast to the influenza virus season of 2002, influenza virus type B has not been detected yet.
Waterfowl are the natural reservoir for all influenza A viruses, and these viruses are usually nonpathogenic in wild aquatic birds. In late 2002, an outbreak of H5N1 influenza virus caused death among waterfowl in two Hong Kong nature parks. Genetic analysis showed that these viruses were novel H5N1 genotypes. In February 2003, a closely related H5N1 was isolated from human patients. This study aims to answer two questions: (1) Are the novel H5N1 antigenically different from the H5N1 viruses of 1997 and 2001? (2) Are they more pathogenic to ducks than previous genotypes?Antigenic analysis of the new isolates showed a different reactivity pattern from previous H5N1 isolates, suggesting antigenic drift has occurred. The new 2002 isolates caused acute disease in mallard ducks, including severe neurological symptoms and death. In contrast, previous H5N1 isolates and a 2003 human isolate did not cause any disease. Since 1961, this is the first time that influenza virus is reported to kill wild aquatic birds.
Planning for an effective and vital Operating Room of the Future (ORF) is necessary for ensuring improved and safer surgical practice in the coming decades. A workshop was held in March 2004 that drew together 100 clinicians, engineers, and scientists to identify needed clinical and technical requirements for the improved ORF. Six working groups assessed specific needs in these areas: operational efficiency and workflow; systems integration and technical standards; telecollaboration; surgical robotics; intraoperative diagnosis and imaging; and surgical informatics. This paper will provide an introduction to the ORF workshop, a summary of the working groups' assessments; a compilation of 5 broad areas of technology requirements; and a review of 5 conclusions/priorities attained by the working groups, including the need for standards in all areas of the operation of an effective ORF, the pressing need for interoperability of devices to ensure improved care and throughput, and the development of advanced, surgery-specific imaging and display.
Objective: A series of 2086 patients with cerebral arteriovenous malformations (AVMs) were reviewed and 635 patients underwent surgical treatment after 1992. Clinical characteristics and surgical results of patients with cerebral arteriovenous malformations (AVMs) were assessed. Methods: Collected data of 2086 consecutive AVM patients from January 1956 to October 2001 were analyzed. The size of the AVMs ranged from 1 to 9 cm. Patients who underwent surgical treatment were divided into two groups by date of admission: one was from 1992 to 1996 and the other was from 1997 to 2001. The variables assessed for clinical characteristics in our study included: age (at diagnosis), sex, Spetzler–Martin grade, first presentations. The surgical results were assessed by comparing the surgical complications between the two surgical groups. Difference between the two groups was assessed by χ2 test. Results: Cerebral AVMs are more commonly diagnosed at age 20 to 40 years. Hemorrhage (43.4%), headache (24.9%), and seizure (17.3%) were the first three common presentations. There was no difference in age distribution and sex ratio between the two surgical groups. Regarding Spetzler–Martin grading system, the percentage of grade 3 to 5 patients increased while that of grade 1 and 2 patients decreased (P=0.00). But the incidence of main surgical complications (death, hemiparalysis, cranial nerve dysfunction and gastrointestinal hemorrhage) was the same (P=0.796). Conclusions: Cerebral AVM is one of the important reasons for spontaneous intracranial hemorrhage in young patients. Spetzler–Martin grading system is helpful to predict the surgical risk. Microsurgical technique has made surgical treatment safer and become the best choice for cerebral AVM patients. Combination of intraoperative embolisation with surgical resection is a practical method in the treatment of giant cerebral AVMs.
Functional neuroimaging methods have been used widely to elucidate normal brain physiology as well as impaired function in diseased brain. The combination of various approaches, such as electromagnetic signals, signal changes in blood flow, metabolism and the kinetic behavior of radioligands bound to the specific recognition site, will answer the question how each neuron communicates with others. Another key technique is molecular imaging, which aims to visualize the functional changes at a molecular level involving the expression of specific genes. The important advances will be recognized in the next century for the treatment of brain disease by cell biology technique. Radionuclide approach will continue to play an important role in detection of high-risk patients toward the prevention of the disease as well as in planning and monitoring the treatment including cell transplantation.
The objective of the paper was to determine the effect of age, time of employment and time of accidents during the 24-work period, in a group of power industry operators. The data were obtained from the database of the Central Statistical Office. The accidents, which happened in Poland during the last six years (1997–2002), recorded in the Statistical Accident Card, were analysed. A group study of power industry operators is important from the strategic point of view as it determines safety of technological processes. Distribution of the injured was analysed in 4 age groups of ≤ 29, 30–39, 40–49, ≥ 50 years old subjects according to the number of hours worked on that work stand, the time of day and night and the time of employment. The number of accidents in power industry operators is connected with their age, time of the day and night and time of employment. The biggest number of accidents was reported in the group aged 40–49. Operators over 40 constitute a bigger percentage of victims in the morning than at night. There are also a bigger percentage of victims with the longest employment time (more than 20 years) in morning hours. Younger operators, below 29 years old more frequently become victims of accidents at night than in the morning. A bigger accident rate was also found in the workers with employment time shorter than 10 years. The results of the analysis may constitute the base for changes in time schedules in order to reduce accident risk.
ObjectivesCochlear implant comfort level measurements are crucial to the hearing of the cochlear implant user. They influence speech perception and sound quality. Various techniques are currently used to arrive at comfort level.The purpose of this research is to examine the word recognition scores of Nucleus 24 cochlear implant users as a function of the procedure used to obtain maximum acceptable loudness levels.Study designSubjects:□Adults between ages of 21–65 years,□Postlingually deaf,□At least 6 months experience using the Advanced Combination Encoders (ACE) processing strategy.MethodsComfort levels were measured using an Experimenter-adjusted Method and Subject-adjusted (or self-MAPping) Method. Two programs were created, with the measurements obtained using both programming techniques, and downloaded into their speech processor. Word recognition was evaluated at varied signal levels using these two programs. A sound quality questionnaire was then completed by each subject.ResultsData is currently being collected to satisfy our hypothesis that subjects' self-MAPping will result in more accurate comfort level settings, and subsequently optimal cochlear implant programs. Therefore, patients will have better speech perception skills and report improved sound quality.ConclusionIf this hypothesis is correct, we can continue to more confidently apply this technique to the pediatric and adolescent population. It may also give rise to more automated, audiologist-supervised cochlear implant programming.
With infants as young as 12 months receiving cochlear implants that are designed to last more than 70 years, magnetic resonance imaging (MRI) safety at magnetic field strengths >1.5 T is an important consideration, as not only is the likelihood that most people will require an MRI procedure in their lifetime increasing but also the likelihood that this procedure will be at field strengths >1.5 T. Results with Nucleus® 24 indicate that MRI safety at 3.0 T is possible with the implant magnet removed. The effects of torque and demagnetization of the implant magnet at 3.0 T have been shown to be excessive, and currently safety can only be ensured with the implant magnet removed.
The purpose of this study was to investigate the role of 24-h pH monitoring for the diagnosis of otolaryngologic including rhinologic manifestations of GER in children and if possible to correlate the results with the efficacy of medical treatment.This is a retrospective study of 72 children from January 1997 to December 1999. The children were separated into three groups according to the main symptoms (although association of symptoms was frequent): rhinologic (n=28), laryngotracheal (n=28) and pharyngeal-otologic (n=16).With the classical gastroenterologic criterion (≥4.2% of total time at pH<4), the pH monitoring was positive in 56% of the patients. However, this criterion does not seem to be sensitive for otolaryngologic GERD because multiple daytime short reflux episodes are often involved. Indeed, the pH monitoring was positive in 75% of the patients (82% in the rhinologic group) when a number of 40 episodes/24 h was also taken into account. The success rate of medical treatment was about 80% in case of positive pH recording. This study underlines that GER is an important factor in pediatric otolaryngologic diseases.