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Biomedical subjects

E Glass

Publications and source records attributed to E Glass.

At least 19 recordsLinked to original sources

Auditory language comprehension in children with developmental dyslexia: evidence from event-related brain potentials.

In the present study, event-related brain potentials (ERPs) were used to compare auditory sentence comprehension in 16 children with developmental dyslexia (age 9-12 years) and unimpaired controls matched on age, sex, and nonverbal intelligence. Passive sentences were presented, which were either correct or contained a syntactic violation (phrase structure) or a semantic violation (selectional restriction). In an overall sentence correctness judgment task, both control and dyslexic children performed well. In the ERPs, control children and dyslexic children demonstrated a similar N400 component for the semantic violation. For the syntactic violation, control children demonstrated a combined pattern, consisting of an early starting bilaterally distributed anterior negativity and a late centro-parietal positivity (P600). Dyslexic children showed a different pattern that is characterized by a delayed left lateralized anterior negativity, followed by a P600. These data indicate that dyslexic children do not differ from unimpaired controls with respect to semantic integration processes (N400) or controlled processes of syntactic reanalyses (P600) during auditory sentence comprehension. However, early and presumably highly automatic processes of phrase structure building reflected in the anterior negativity are delayed in dyslexic children. Moreover, the differences in hemispheric distribution of the syntactic negativity indicate different underlying processes in dyslexic children and controls. The bilateral distribution in controls suggests an involvement of right hemispherically established prosodic processes in addition to the left hemispherically localized syntactic processes, supporting the view that prosodic information may be used to facilitate syntactic processing during normal comprehension. The left hemispheric distribution observed for dyslexic children, in contrast, suggests that these children do not rely on information about the prosodic contour during auditory sentence comprehension as much as controls do. This finding points toward a phonological impairment in dyslexic children that might hamper the development of syntactic processes.

Child↗

Cerebellar cortical abiotrophy in a beagle.

A beagle puppy was presented with clinical signs indicative of a cerebellar disease. Histopathological evaluation of the cerebellum revealed a diffuse degenerative cortical lesion. The clinical history and the histopathological findings are consistent with a neonatal cerebellar abiotrophy. Furthermore, the breeding history supports the hypothesis of an inherited genetic disorder that is, most likely, an autosomal recessive trait.

Animals↗

Comparison of blue dye and probe-assisted intraoperative lymphatic mapping in melanoma to identify sentinel nodes in 100 lymphatic basins.

OBJECTIVE: To determine whether combining isosulfan blue dye with a radiopharmaceutical agent will increase intraoperative detection of sentinel nodes (SNs) in patients with early-stage melanoma. PATIENTS AND DESIGN: Clinical trial with a consecutive sample. Eighty-seven patients with clinical stage I melanoma underwent preoperative lymphoscintigraphy with 1 of 3 radiopharmaceutical agents to identify the lymphatic basin and the site of the SN. All patients subsequently underwent intraoperative lymphatic mapping and selective lymph node dissection (SLND) with isosulfan blue dye and a radiopharmaceutical agent. A handheld gamma probe determined the radioactive counts over the draining lymph node basins and individual blue-stained lymph nodes before (in vivo) and after (ex vivo) their removal. An irrelevant body site was used as the denominator of a count ratio by which absolute counts were standardized for comparison. Completion lymphadenectomy was undertaken in patients whose SLND specimen had histopathologic evidence of tumor cells. SETTING: Tertiary care cancer center. INTERVENTION: Lymph node sampling. MAIN OUTCOME MEASURE: Accuracy of SN detection by blue dye and radiopharmaceutical techniques. RESULTS: Preoperative lymphoscintigraphic images identified 100 lymph node basins and 135 lymph nodes in 87 patients. All 3 radiopharmaceutical agents were equally effective in imaging the SN before surgery. During SLND, we identified and removed 136 blue-stained and radioactive (hot) SNs and 8 additional non-blue-stained hot nodes from 98 basins (98.0%). Of the 144 excised lymph nodes, 132 nodes (91.7%) from 83 basins had either an in vivo- or an ex vivo-background count ratio of 2:1 or more and 125 nodes (86.8%) from 77 basins had a count ratio of 3:1 or more. Twelve blue-stained SNs had count ratios of less than 2:1. Seventeen SNs (11.8%) from 15 basins contained metastases: 16 were identified with blue dye and probe and 1 was identified with blue dye alone. Four (1.1%) of 377 non-SNs excised during completion lymphadenectomy contained metastases. There have been no lymph node recurrences during mean follow-up of 16.3 months (range, 7-42 months). CONCLUSIONS: The blue dye technique remains the criterion standard for SLND in melanoma. The addition of a radiopharmaceutical tracer serves as a useful adjunct to the visualization of blue-stained SNs.

Female↗

Evaluation of recombinant sporozoite antigen SPAG-1 as a vaccine candidate against Theileria annulata by the use of different delivery systems.

The major sporozoite surface antigen of Theileria annulata (SPAG-1) is a candidate for inclusion in a subunit vaccine. In this paper we summarize the results of 4 vaccination experiments using recombinant SPAG-1 expressed in different systems and presented in different adjuvants. The antigen has been presented as either a C terminal 108 amino acid peptide (called SR1) expressed as both beta-galactosidase and hepatitis B core antigen fusions or as a full-length form expressed as a GST fusion with an N terminal His6 tag. We used different adjuvants, namely Freund's, saponin, ISCOMs and a proprietary adjuvant supplied by SmithKline Beecham, which we call SKBA. The data point to the conclusion that SPAG-1 can elicit partial protection and is therefore suitable for inclusion in an eventual multicomponent subunit vaccine.

Animals↗

Subacute necrotising encephalopathy in an Alaskan husky.

A 29-month-old female Alaskan husky was presented recumbent, tetraparetic and in a state of dementia, with blindness and cranial nerve deficits. The dog's progress was followed for over two months, as the signs resolved to an non-progressive mild hypermetria with slight proprioceptive ataxia, a diminished menace response and inability to prehend food. Magnetic resonance imaging (MRI) revealed bilateral cavitation extending from the thalamus to the medulla, with less pronounced degenerative lesions in the caudate nucleus, putamen and claustrum. Cerebrospinal fluid lactate and pyruvate concentrations were in their normal ranges. Necropsy and histological examination confirmed the MRI findings as well as neuronal degeneration of the cerebellar cortex in the vermis and degenerative changes in the neocortex at the depths of the cerebral sulci. In view of the similarity of lesions to subacute necrotising encephalomyelopathy, known as Leigh's disease in humans, a tentative diagnosis of a mitochondrial encephalopathy was made.

Animals↗

Different vaccine strategies used to protect against Theileria annulata.

SPAG-1, a sporozoite surface antigen of T. annulata, has previously been shown to elicit partial protection when used, as an hepatitis B core antigen fusion, to immunize cattle. The objective of this study was to try and improve the protective capacity of this antigen by enlisting different vaccine strategies. Cattle were immunized with SPAG-1, as a fusion protein with a His6 tag, either incorporated into ISCOMs, with or without the merozoite antigens TAMS 1-1 and 1-2, or with RWL as adjuvant three times at monthly intervals. Another group of cattle were immunized with p67, the T. parva sporozoite antigen, in RWL to assess whether any cross-protection could be induced. The animals were then challenged with an estimated LD50 of T. annulata sporozoites, and their ability to resist the infection was investigated. Serum responses and T-cell proliferative responses were analyzed throughout the trial. Post-challenge analyses included lymph node biopsies and blood smears to check for the presence of parasites, routine hematological parameters, and observation for clinical manifestations of the disease. The results of this trial will be discussed.

Animals↗

Intraoperative lymphatic mapping for early-stage melanoma of the head and neck.

BACKGROUND: We previously reported dye-directed intraoperative lymphatic mapping and selective sentinel lymphadenectomy for primary cutaneous melanomas draining to the neck lymph nodes. In this study we determined whether combining the dye with a radiopharmaceutical agent would enhance our rate of sentinel node detection. METHODS: One hundred seventeen patients with primary cutaneous melanomas of the upper chest and head and neck underwent preoperative cutaneous lymphoscintigraphy to confirm lymphatic drainage to neck nodes, followed by intraoperative lymphatic mapping and sentinel lymphadenectomy. In 94 cases, isosulfan blue dye was injected at the primary site; in the remaining 23 cases, a 1:3 mixture of radiopharmaceutical and dye was injected, and a hand-held probe was used to determine the radioactive counts. RESULTS: Preoperative cutaneous lymphoscintigraphy identified 129 drainage basins; 12 patients (10%) had dual-basin drainage. During intraoperative lymphatic mapping and sentinel lymphadenectomy, 183 sentinel nodes were identified and excised from 120 basins (1.5 nodes/basin). The blue dye alone identified sentinel nodes in 93 of 101 basins (92%). The probe identified sentinel nodes in 28 of 28 basins, only one of which failed to reveal blue-staining sentinel nodes; thus, the probe plus dye identified sentinel nodes in 27 of 28 basins (96%). Histopathologic analysis revealed metastasis in sentinel nodes from 11 patients (12%) who underwent sentinel lymphadenectomy with blue dye alone and in 3 patients (13%) who underwent sentinel lymphadenectomy with dye plus probe. There were no same-basin recurrences over a mean follow-up of 46 months (range 1 to 125). CONCLUSIONS: Selective sentinel lymphadenectomy is a highly accurate method of staging the regional nodes in patients with primary tumors of the head and neck. Although we initially demonstrated the utility of this technique with blue dye alone, our results now suggest that the combination of dye and radiopharmaceutical may be a more sensitive method to detect sentinel nodes.

Coloring Agents↗

Long-term low-dose cyclosporine therapy for severe psoriasis: effects on renal function and structure.

BACKGROUND: The effectiveness of cyclosporine in the treatment of severe psoriasis is well known. OBJECTIVE: We evaluated the efficacy and toxicity of systemic cyclosporine in patients with severe psoriasis, observing short-term (12 weeks) and long-term (3 to 5 years) effects. METHODS: To further elucidate efficacy and safety, 42 patients with severe psoriasis were treated initially with cyclosporine 5 to 6 mg/kg per day for 12 weeks. A subset of 14 patients continued maintenance treatment for 3.5 years to study the long-term effects of cyclosporine on renal function and structure. Renal biopsies were performed after 2.5 years and 3.5 years of treatment. Renal histologic findings were correlated with renal function. RESULTS: By weeks 8 and 12, 64% (n = 27) and 86% (n = 36) of patients, respectively, were rated clear or almost clear of the psoriasis. However, a subpopulation of 15 patients did not respond to 5 mg/kg daily but improved when the dose was increased to 6 mg/kg daily. Clearance or near clearance was achieved in 67% of this subpopulation after 4 weeks. For the 29 patients whose glomerular filtration rate (GFR) was measured, mean GFR fell by 7% from baseline to week 4 (p < 0.05). This change was reversible when dosage was reduced by 1 mg/kg per day in each of these patients. Patients older than 45 years of age experienced significant elevation of mean diastolic blood pressure and had reduced GFR and increased serum creatinine. After 2.5 years, of the 14 patients who continued maintenance treatment, two had biopsy specimens that showed moderate interstitial fibrosis and tubular atrophy. The remainder showed only minimal to mild structural damage. After 3.5 years of cyclosporine treatment, repeat renal biopsy specimens revealed slight increases in structural changes in nine subjects. These changes correlated with increasing age and drug-induced hypertension. CONCLUSION: We conclude that 5 mg/kg of cyclosporine daily is usually an effective initial dose for psoriasis. Patients who do not respond will often benefit from elevation of the dose to 6 mg/kg daily. Older patients experience cyclosporine-induced hypertension and changes in renal function and structure more frequently than do younger patients.

Adult↗

Simulations for FASTPAC and the standard 4-2 dB full-threshold strategy of the Humphrey Field Analyzer.

PURPOSE: This study evaluates the accuracy, reproducibility, and efficiency of FASTPAC, a new fast strategy for automated perimetry using 3-dB steps with single threshold crossing, compared to the standard 4-2 dB full threshold strategy by means of computer simulations. METHOD: An "artificial patient" module was developed to create responses to stimuli by a Monte-Carlo technique from a given probability distribution. The authors performed 10,200 simulations with threshold values ranging from 0 to 50 dB. RESULTS: Results demonstrate an 18% decrease in the number of presentations per threshold determination, which is equal to a similar reduction in testing time. For both strategies, there is a considerable influence of the starting deviation (difference between starting value and actual threshold) on threshold error (difference between estimated threshold and actual threshold): negative starting deviations lead to negative threshold errors and vice versa. This relationship is more pronounced for FASTPAC (slope 0.18 dB/dB, P < 0.0001) than for the full-threshold strategy (slope 0.13 dB/dB, P < 0.0001). In addition, fluctuations of the determined thresholds, described as the distance between the 16th and 84th percentiles of the threshold errors, increase with increasing absolute starting deviations. This is particularly true of FASTPAC: CONCLUSIONS: The influence of the starting value on the threshold determination may lead to a considerable underestimation of visual field defects, accompanied by a higher fluctuation. This is an intrinsic property of both staircase procedures. FASTPAC, however, is more affected than the standard 4-2 dB full-threshold strategy. FASTPAC, therefore, provides time reduction at the expense of accuracy and reliability.

Algorithms↗

Priority ethical issues in oncology nursing: current approaches and future directions.

PURPOSE/OBJECTIVES: To describe ethical issues determined to be highly important to oncology nurses and to discuss strategies by which the Oncology Nursing Society (ONS) can address these priority concerns. DATA SOURCES: Survey on oncology nurses regarding ethical issues; nursing literature. DATA SYNTHESIS: Nine priority ethical issues of oncology nurses are identified. Past, current, and future ONS activities that address these priority issues are discussed. IMPLICATIONS FOR NURSING PRACTICE: ONS must support activities to increase the knowledge, confidence, and involvement of oncology nurses in discussions and decision making related to the ethical issues. CONCLUSIONS: The top three priority ethical issues for oncology nurses are assisted suicide, end-of-life decisions, and pain management. Efforts should be made to increase ethics expertise among the ONS membership.

Bioethical Issues↗

Chronic implantation of nonocclusive catheters and flow probes in the splanchnic and hindlimb vasculature of the rabbit.

Flow probes and nonocclusive catheters were simultaneously implanted in the splanchnic and hindlimb vasculature to measure regional blood flows and arteriovenous differences of individual organs in the conscious rabbit. Pulsed Doppler flow probes were constructed by modifying the technique of Haywood et al., and nonocclusive catheters were designed and constructed from Silastic tubing (0.6- or 0.9-mm OD) and surgical velour. Laparotomy was performed on rabbits under anesthesia, and the renal, mesenteric, iliac, or hepatic artery and portal vein were isolated and instrumented with a flow probe. A nonocclusive catheter was then inserted into the respective vein. Instrumentation of the hepatic system required probes on the hepatic artery and portal vein, and nonocclusive catheters were placed into hepatic and portal veins. One week later, rabbits were reanesthetized and nonocclusive catheters were inserted into the cranial vena cava via the jugular vein and abdominal aorta to the level of the celiac axis. Probes and catheters were evaluated daily up to 30 days. Implants remained functional for an average of 3 weeks, permitting chronic measurement of velocity and blood variables in individual tissue beds of the conscious rabbit.

Animals↗

Delirium in terminally ill cancer patients.

Nineteen patients believed to be in the terminal stages of cancer were evaluated for signs of delirium. Six patients improved; 13 who died during hospitalization were studied until their death. Patients were interviewed three times a week using a delirium scale; medical records also were used to gather data. Eleven (85%) of the 13 patients developed delirium. In most patients, delirium was caused by multiple factors. The authors outline strategies for management of terminal cancer patients with delirium.

Attitude to Death↗

Phagocyte recognition by lectin receptors.

A "lectin-like" receptor for bacterial cell wall sugars, originally described in the membrane of mouse peritoneal macrophages, which facilitates binding of various bacteria to the macrophage surface, has now been shown to be present on most phagocytes from a variety of species. The role of such a receptor in the inflammatory response has been investigated by examining changes in its expression in response to chemoattractants. The chemoattractants, whilst enhancing or not altering expression of C3 and Fc receptors, respectively, appeared to decrease lectin receptor expression. The possibility of a relationship between I-region gene products of the major histocompatibility complex (MHC) and the bacterial binding lectin receptor was investigated. It was found that various conventional and monoclonal antibodies directed against I-region determinants inhibited binding of bacteria to mouse peritoneal macrophages. These findings suggest the need to examine the possibility that, in addition to phagocytosis and elimination of bacteria, the lectin receptor may also be involved in antigen presentation and macrophage-T-lymphocyte cooperative events leading to an immune response.

Animals↗