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Biomedical subjects

B Luna

Publications and source records attributed to B Luna.

At least 19 recordsLinked to original sources

Oculomotor abnormalities parallel cerebellar histopathology in autism.

OBJECTIVE: To investigate cerebellar function in autism by measuring visually guided saccades. METHODS: A visually guided saccade task was performed by 46 high-functioning individuals with autism with and without delayed language acquisition, and 104 age and IQ matched healthy individuals. RESULTS: Individuals with autism had increased variability in saccade accuracy, and only those without delayed language development showed a mild saccadic hypometria. Neither autistic group showed a disturbance in peak saccade velocity or latency. CONCLUSIONS: The observed saccadic abnormalities suggest a functional disturbance in the cerebellar vermis or its output through the fastigial nuclei, consistent with reported cerebellar histopathology in autism. The pattern of mild hypometria and variable saccade accuracy is consistent with chronic rather than acute effects of cerebellar vermis lesions reported in clinical and non-human primate studies, as might be expected in a neurodevelopmental disorder. The different patterns of oculomotor deficits in individuals with autism with and without delayed language development suggest that pathophysiology at the level of the cerebellum may differ depending on an individual's history of language development.

Adolescent↗

Neocortical system abnormalities in autism: an fMRI study of spatial working memory.

OBJECTIVE: To test the hypothesis that deficits in spatial working memory in autism are due to abnormalities in prefrontal circuitry. METHODS: Functional MRI (fMRI) at 3 T was performed in 11 rigorously diagnosed non-mentally retarded autistic and six healthy volunteers while they performed an oculomotor spatial working memory task and a visually guided saccade task. RESULTS: Autistic subjects demonstrated significantly less task-related activation in dorsolateral prefrontal cortex (Brodmann area [BA] 9/46) and posterior cingulate cortex (BA 23) in comparison with healthy subjects during a spatial working memory task. In contrast, activation of autistic individuals was not reduced in other regions comprising the neural circuitry for spatial working memory including the cortical eye fields, anterior cingulate cortex, insula, basal ganglia, thalamus, and lateral cerebellum. Autistic subjects also did not demonstrate reduced activation in any brain regions while performing visually guided saccades. CONCLUSION: Impairments in executive cognitive processes in autism may be subserved by abnormalities in neocortical circuitry as evidenced by decreased activation in prefrontal and posterior cingulate circuitry during a spatial working memory task.

Adult↗

Oral agents in the management of type 2 diabetes mellitus.

Despite exhaustive efforts to better manage patients with type 2 diabetes mellitus (formerly known as non-insulin-dependent diabetes mellitus), attempts at maintaining near normal blood glucose levels in these patients remains unsatisfactory. This continues to pose a real challenge to physicians as the prevalence of this disease in the United States continues to rise. Type 2 diabetes is defined as a syndrome characterized by insulin deficiency, insulin resistance and increased hepatic glucose output. Medications used to treat type 2 diabetes are designed to correct one or more of these metabolic abnormalities. Currently, there are five distinct classes of hypoglycemic agents available, each class displaying unique pharmacologic properties. These classes are the sulfonylureas, meglitinides, biguanides, thiazolidinediones and alpha-glucosidase inhibitors. In patients for whom diet and exercise do not provide adequate glucose control, therapy with a single oral agent can be tried. When choosing an agent, it is prudent to consider both patient- and drug-specific characteristics. If adequate blood glucose control is not attained using a single oral agent, a combination of agents with different mechanisms of action may have additive therapeutic effects and result in better glycemic control.

Benzamides↗

Stimulus-response incompatibility activates cortex proximate to three eye fields.

We used functional magnetic resonance imaging (fMRI) to investigate cortical activation during the performance of three oculomotor tasks that impose increasing levels of cognitive demand. (1) In a visually guided saccade (VGS) task, subjects made saccades to flashed targets. (2) In a compatible task, subjects made leftward and rightward saccades in response to foveal presentation of the uppercase words "LEFT" or "RIGHT." (3) In a mixed task, subjects made rightward saccades in response to the lowercase word "left" and leftward saccades in response to the lowercase word "right" on incompatible trials (60%). The remaining 40% of trials required compatible responses to uppercase words. The VGS and compatible tasks, when compared to fixation, activated the three cortical eye fields: the supplementary eye field (SEF), the frontal eye field (FEF), and the parietal eye field (PEF). The mixed task, when compared to the compatible task, activated three additional cortical regions proximate to the three eye fields: (1) rostral to the SEF in medial frontal cortex; (2) rostral to the FEF in dorsolateral prefrontal cortex (DLPFC); (3) rostral and lateral to the PEF in posterior parietal cortex. These areas may contribute to the suppression of prepotent responses and in holding novel visuomotor associations in working memory.

Adult↗

Maturation of widely distributed brain function subserves cognitive development.

Cognitive and brain maturational changes continue throughout late childhood and adolescence. During this time, increasing cognitive control over behavior enhances the voluntary suppression of reflexive/impulsive response tendencies. Recently, with the advent of functional MRI, it has become possible to characterize changes in brain activity during cognitive development. In order to investigate the cognitive and brain maturation subserving the ability to voluntarily suppress context-inappropriate behavior, we tested 8-30 year olds in an oculomotor response-suppression task. Behavioral results indicated that adult-like ability to inhibit prepotent responses matured gradually through childhood and adolescence. Functional MRI results indicated that brain activation in frontal, parietal, striatal, and thalamic regions increased progressively from childhood to adulthood. Prefrontal cortex was more active in adolescents than in children or adults; adults demonstrated greater activation in the lateral cerebellum than younger subjects. These results suggest that efficient top-down modulation of reflexive acts may not be fully developed until adulthood and provide evidence that maturation of function across widely distributed brain regions lays the groundwork for enhanced voluntary control of behavior during cognitive development.

Adolescent↗

The removal of bacteria by modified natural zeolites.

The removal effect of natural and modified zeolites containing different heavy metals (Ni2+, Zn2+, Fe3+ and Cu2+) on pure cultures of Escherichia coli and Staphylococcus aureus in a solid medium was evaluated in this work. These experiments were carried out in a continuous mode treating municipal wastewater. Faecal coliform species and Pseudomonas aeruginosa were identified. The rate constants of heavy metal lixiviation were determined using a first order kinetic model. The removal effect of modified natural zeolites in both a solid medium and in continuous mode showed an increased elimination of the bacterial population. The results established a decreasing order of the removal effect as follows: Cu2+ > Fe3+ > Zn2+ > Ni2+. The best performance of columns was obtained for inlet bacterial concentrations below 10(6) cells/100 ml. Most of the identified bacterial species were affected by copper modified zeolites, although Serratia marcescens presented the highest sensitivity and Klebsiella pneumoniae the greatest resistance.

Escherichia coli↗

Studies of brain and cognitive maturation through childhood and adolescence: a strategy for testing neurodevelopmental hypotheses.

Although neurodevelopmental models of schizophrenia are now widely accepted, there is minimal direct human evidence of dysmaturation in schizophrenia to support this theory. This is especially the case regarding maturational changes during late childhood and adolescence, which immediately precede the typical age of onset of the disorder. By integrating new noninvasive methods of functional magnetic resonance imaging with techniques of developmental cognitive neuroscience, it is now possible to begin systematic research programs to directly test hypotheses of neurodevelopmental abnormalities in schizophrenia. In this article, we describe strategies for characterizing developmental changes taking place during the critical period of adolescence that can elucidate dysmaturation processes in schizophrenia. We emphasize the need for studies characterizing normal development before examining at-risk or clinical populations, and the potential value of using neurobehavioral and neuroimaging approaches to directly characterize the dysmaturation associated with schizophrenia.

Adolescent↗

Agents for treatment of invasive fungal infections.

The incidence of fungal infections continues to rise as the population of immunocompromised individuals increases. Despite the enlarging numbers of infections, there are only a few antifungal agents for treatment of deep-seated, invasive infections. These agents include amphotericin B, flucytosine, terbinafine, and several azoles. Progress has been made in understanding the role of these agents in a variety of infections and this article examines in detail these agents and their prophylactic, empiric, and therapeutic uses in invasive mycoses. This article focuses on general concepts of antifungal therapies and provides a detailed review of each antifungal agent available for treatment of deep-seated mycoses.

Antifungal Agents↗

Pursuit tracking impairments in schizophrenia and mood disorders: step-ramp studies with unmedicated patients.

BACKGROUND: Eye tracking abnormalities are highly prevalent in schizophrenia, and are among the most promising phenotypic familial markers for the disorder. The neurophysiologic mechanisms underlying these disturbances and their diagnostic specificity for schizophrenia are not yet well characterized. METHODS: This study assessed eye tracking deficits using foveopetal and foveofugal step-ramp tasks (ramps moving toward and away from central fixation after an initial step respectively) across a range of target velocities in anti-psychotic-naive schizophrenia patients, previously treated but currently unmedicated chronic schizophrenia patients, unmedicated patients with either bipolar or unipolar mood disorders, and healthy volunteers. RESULTS: All patient groups demonstrated reduced pursuit gain in open loop and closed loop visual tracking conditions. There were no significant group differences in the latency or accuracy of catch-up saccades on foveofugal ramp tasks. CONCLUSIONS: These findings indicate that open and closed loop pursuit eye movements are impaired during acute episodes of schizophrenia and mood disorders. The intact accuracy of saccades to moving targets in all patient groups indicates that an adequate representation of motion information is available to the saccade system. Therefore, pursuit disturbances in mood disorders and schizophrenia seem to result, at least in part, from a disturbance in sensorimotor integration in the pursuit system after the initial extraction of sensory motion information. No eye movement abnormalities observed during performance of step ramp tasks were specific to schizophrenia.

Adult↗

Oculomotor evidence for neocortical systems but not cerebellar dysfunction in autism.

OBJECTIVE: To investigate the functional integrity of cerebellar and frontal systems in autism using oculomotor paradigms. BACKGROUND: Cerebellar and neocortical systems models of autism have been proposed. Courchesne and colleagues have argued that cognitive deficits such as shifting attention disturbances result from dysfunction of vermal lobules VI and VII. Such a vermal deficit should be associated with dysmetric saccadic eye movements because of the major role these areas play in guiding the motor precision of saccades. In contrast, neocortical models of autism predict intact saccade metrics, but impairments on tasks requiring the higher cognitive control of saccades. METHODS: A total of 26 rigorously diagnosed nonmentally retarded autistic subjects and 26 matched healthy control subjects were assessed with a visually guided saccade task and two volitional saccade tasks, the oculomotor delayed-response task and the antisaccade task. RESULTS: Metrics and dynamics of the visually guided saccades were normal in autistic subjects, documenting the absence of disturbances in cerebellar vermal lobules VI and VII and in automatic shifts of visual attention. Deficits were demonstrated on both volitional saccade tasks, indicating dysfunction in the circuitry of prefrontal cortex and its connections with the parietal cortex, and associated cognitive impairments in spatial working memory and in the ability to voluntarily suppress context-inappropriate responses. CONCLUSIONS: These findings demonstrate intrinsic neocortical, not cerebellar, dysfunction in autism, and parallel deficits in higher order cognitive mechanisms and not in elementary attentional and sensorimotor systems in autism.

Adolescent↗

Cortical networks subserving pursuit and saccadic eye movements in humans: an FMRI study.

High-field (3 Tesla) functional magnetic resonance imaging (MRI) was used to investigate the cortical circuitry subserving pursuit tracking in humans and compare it to that for saccadic eye movements. Pursuit performance, relative to visual fixation, elicited activation in three areas known to contribute to eye movements in humans and in nonhuman primates: the frontal eye field, supplementary eye field, and intraparietal sulcus. It also activated three medial regions not previously identified in human neuroimaging studies of pursuit: the precuneus and the anterior and posterior cingulate cortices. All six areas were also activated during saccades. The spatial extent of activation was similar for saccades and pursuit in all but two regions: spatial extent was greater for saccades in the superior branch of the frontal eye field and greater for pursuit in posterior cingulate cortex. This set of activations for smooth pursuit parallels the network of oculomotor areas characterized in nonhuman primates and complements recent studies showing that common cortical networks subserve oculomotor functions and spatial attention in humans.

Adolescent↗

The use of insulin secretagogues in the treatment of type 2 diabetes.

Secretatogues are a class of agents that achieve their hypoglycemic effects through stimulating insulin release. They include the sulfonylureas, repaglinide, and the investigational agent glucagon-like peptide. The secretagogue agents have been studied extensively as monotherapy and in conjunction with other classes of oral agents, including alpha-glucosidase inhibitors, bijuanides, and thiazolidinediones, for the treatment of type 2 diabetes. This article reviews the pharmacodynamic and pharmacokinetic differences of the secretagogues, as well as the most recent clinical trials. Such information should be helpful when deciding which agent or agents will yield the best glycemic control for an individual patient.

Acarbose↗

Cognitive functional magnetic resonance imaging at very-high-field: eye movement control.

The oculomotor system, which optimizes visual interaction with the environment, provides a valuable model system for probing the building blocks of higher-order cognition. Attention shifting, working memory, and inhibition of prepotent responses can be investigated in healthy individuals and patients with brain disorders. Although the neurophysiology of the oculomotor system has been well characterized at the single-cell level in nonhuman primates, its functional architecture in humans determined by evoked response procedures and studies of patients with focal lesions has been limited. Available evidence points to a widely distributed set of neocortical and subcortical brain regions involved in the control of eye movements, including brain stem, cerebellum, thalamus, striatum, and parietal and frontal cortices. The advent of functional magnetic resonance imaging provides a noninvasive manner of localizing, at high spatial resolution, the brain systems that subserve different aspects of sensory and cognitive processes in humans. Functional magnetic resonance imaging studies have already delineated the brain systems subserving sensorimotor and cognitive control of eye movements in adult and pediatric populations. Hence, the combination of functional magnetic resonance imaging and eye movement procedures can be used to probe the integrity of the brain in neurological and psychiatric disorders as well as provide a window into the changes in brain function subserving cognitive development.

Adult↗

A thermal physiological comparison of two HAZMAT protective ensembles with and without active convective cooling.

Wearing impermeable garments for hazardous materials (HAZMAT) cleanup can often present a health and safety problem for the wearer. Even short duration cleanup activities can produce heat-stress injuries in HAZMAT workers. It was hypothesized that an internal cooling system might increase worker productivity and decrease the likelihood of heat-stress injuries in typical HAZMAT operations. Two HAZMAT protective ensembles were compared during subjects' treadmill exercise. The different ensembles were created using two different suits: a Trelleborg vapor protective suit representative of current HAZMAT suits and a prototype suit developed by engineers at the National Aeronautics and Space Administration (NASA). The two life-support systems used were a current-technology Interspiro Spirolite breathing apparatus and a liquid air breathing system that also provided convective cooling. Twelve local members of a HAZMAT team served as test subjects. They were fully instrumented to allow a complete physiological comparison of their theramal responses to the different ensembles. Results showed that cooling from the liquid air system significantly decreased thermal stress. The results of the subjective evaluations of new design features in the prototype suit were also highly favorable. Incorporation of these new design features could lead to significant operational advantages in the future.

Adult↗

Eye tracking abnormalities in schizophrenia: evidence for dysfunction in the frontal eye fields.

BACKGROUND: Eye tracking deficits are robust abnormalities in schizophrenia, but the neurobiological disturbance underlying these deficits is not known. METHODS: To clarify the pathophysiology of eye tracking disturbances in schizophrenia, we tested 12 first-episode treatment-naive schizophrenic patients and 10 matched healthy individuals on foveofugal and foveopetal step-ramp pursuit tasks. RESULTS: On foveopetal tasks, the initiation of pursuit eye movements was delayed in schizophrenic patients, and their steady-state pursuit gain was reduced particularly at slower target speeds (8 and 16 deg/sec). In foveofugal step-ramp tasks, their primary catch-up saccades were normal in latency and accuracy, but their postsaccadic pursuit in the first 100 msec after the primary catch-up saccade was significantly reduced even relative to their slow steady-state pursuit, especially during and immediately after an acute episode of illness. CONCLUSIONS: These observations indicate that motion-sensitive areas in posterior temporal cortex provide sufficiently intact information about moving targets to guide accurate catch-up saccades, but that the sensory processing of motion information is not being used effectively for pursuit eye movements. Low-gain pursuit after the early stage of pursuit initiation suggests that the use of extraretinal signals about target motion (e.g., anticipatory prediction) only partially compensates for this deficit. The pattern of low-gain pursuit, impaired pursuit initiation, and intact processing of motion information for catch-up saccades but not pursuit eye movements, was consistent in the schizophrenic patients tested at five time points over a 2-year follow-up period, and implicates the frontal eye fields or their efferent or afferent pathways in the pathophysiology of eye tracking abnormalities in schizophrenia.

Adult↗

Long-term grating acuity and visual-field development in preterm children who experienced bronchopulmonary dysplasia.

Grating acuity, visual-field extent, and recognition acuity were examined in 77 children who had bronchopulmonary dysplasia (BPD), 101 children who had hyaline membrane disease (HMD), and 77 healthy preterm (HPT) children. None of the subjects had significant retinopathy of prematurity (ROP) or neurological abnormalities. Grating acuity and field extent were tested at 0 to 1, 4, 9, 12, 17, 24, 30, 36, and 48 months corrected age and recognition acuity was tested at 36 and 48 months corrected age. Ophthalmological examinations indicated that a greater proportion of subjects in the BPD group than in the HMD or in the HPT group had strabismus or high refractive error. However, grating acuity and field extent in the BPD group did not significantly differ from the HMD group or from the HPT group at any test age. Recognition acuity was poorer in the BPD and HMD groups than in the HPT group at both 36 and 48 months, but the difference was significant only at 36 months. These results suggest that children who experienced BPD with no significant ROP and no neurological complications show grating acuity and visual-field development comparable to that of healthy preterm children, but that recognition acuity, or the skills required to perform a recognition-acuity task, may be delayed in this BPD population.

Bronchopulmonary Dysplasia↗

Grating acuity and visual-field development in children with intraventricular hemorrhage.

Visual development was studied in 171 preterm children who had intraventricular hemorrhage (IVH) and in 73 healthy preterm (HPT) children who did not develop IVH. Binocular grating acuity was assessed at age 1 month; monocular grating acuity and binocular visual-field extent were assessed at 4, 8, 12, 17, 24, 30, 36, and 48 months; and monocular H, O, T, V letter recognition acuity was tested at 36 and 48 months. A significantly greater proportion of IVH subjects than HPT subjects had ocular abnormalities. IVH subjects had significantly poorer grating acuity than HPT subjects at 1, 4, 8, 36, and 48 months, poorer recognition acuity than HPT subjects at 36 and 48 months, and smaller average field extent than HPT subjects at 4, 12, and 17 months. Acuity deficits were not related to grade of IVH or to the presence of periventricular leukomalacia, but may have been associated with the presence of ocular abnormalities or cerebral palsy in some IVH subjects.

Case-Control Studies↗