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Biomedical subjects

W Huff

Publications and source records attributed to W Huff.

At least 19 recordsLinked to original sources

Cognitive function remains unchanged after endarterectomy of unilateral internal carotid artery stenosis under local anaesthesia.

OBJECTIVE: To assess changes in cognitive function and affective state following carotid endarterectomy (CEA) for high-degree unilateral internal carotid artery stenosis. METHODS: In 33 patients, a CEA was performed under local anaesthesia for a high-grade unilateral stenosis of the internal carotid artery (group A). Twenty-five patients underwent surgery for peripheral arterial occlusive disease under regional anaesthesia served as controls (group B). Patients with neurological deficits due to previous strokes or dementia were excluded. Intelligence level was assessed preoperatively. Cognitive tests were applied preoperatively and postoperatively (3-5 days after surgery) and after 4 months follow-up. Confounding factors, including anxiety and depression, were checked through questionnaires and interviews. RESULTS: No perioperative neurological complication occurred following CEA. Patients in group A showed a significant postoperative deterioration only in one sub-test. There was no significant change in anxiety and depression during follow up. The control group B had no significant changes in cognitive test performance. Anxiety improved significantly postoperatively, but increased again at the end of the study. There was no significant difference between the groups over time. CONCLUSION: Cognitive function does not change following CEA of a unilateral internal carotid stenosis.

Aged↗

[Post-stroke-depression. Algorithm for a standardized diagnostic approach in clinical routine].

Depression is a frequent and important complication after stroke. The occurrence of a post-stroke-depression (PSD) has a significant impact on the functional and cognitive deficit, on mortality and on quality of life after stroke. In contrast to the clinical importance, PSD is often ignored in routine management of stroke patients and remains often untreated if diagnosed. The diagnostic uncertainty is aggravated by the lack of appropriate diagnostic criteria for PSD in the International Classification of Diseases (ICD-10) used in Germany. For the first time, we present an algorithm, which allows for a standardized examination of stroke patients on the presence of PSD. All stroke patients should be examined initially by a short and simple screening tool and are subjected to more extensive procedures only if PSD is assumed based on the screening result. Furthermore potentials and limitations to convert the diagnosis of PSD into a diagnostic related group (DRG) that is used to calculate the hospital's reimbursement are highlighted. Finally pharmacological treatment options for PSD are discussed.

Algorithms↗

Stress-induced colibacillosis and turkey osteomyelitis complex in turkeys selected for increased body weight.

Two stress models were used to induce colibacillosis and turkey osteomyelitis complex (TOC): Escherichia coli challenge following dexamethasone injection (Dex) and E. coli challenge preceding transport stress (Transport). A total of 160 birds from 3 lines of turkeys: a slow-growing line selected for egg production (Egg), a line selected for 16-wk BW (F line), and a Commercial line (Comm), were studied in a 3 x 3 x 2 (line x treatment x sex) factorial design. At 14 wk, the Dex group was treated with 3 injections of 2 mg of Dex/kg of BW followed by airsac challenge with 100 cfu of E. coli. The Transport group was given 5,000 cfu of the same E. coli and 8 d later was transported for 3 h and held for an additional 9 h in the transport vehicle. Controls of each line were neither stressed nor challenged with E. coli. Birds were necropsied 2 wk postchallenge. All birds were sexed, scored for airsacculitis (AS) and TOC, and knee synovia were cultured for E. coli. Percent mortality was unaffected by sex, was increased by the Dex treatment, and was higher in Dex-treated male Comm-line birds and Dex-treated female F-line birds compared with their respective nonchallenged controls. Both treatments increased AS scores, and scores of Dex-treated male Comm-line birds and female F-line birds were also higher compared with their respective controls. Male Comm birds under Transport had higher AS scores as compared with nonchallenged males and challenged females. The TOC incidence was increased by Dex only. There was no TOC in Egg-line birds, whereas TOC incidence approached significance in both Comm and F lines compared with the Egg line (P = 0.06). Males had twice as much TOC as females, and this approached significance in the F line (P = 0.06). There was a low level of TOC in male Transport birds of both large-bodied lines, whereas no female Transport birds had TOC lesions. Dex-treated male birds of both the F line and Comm line had significantly higher incidence of TOC compared with their respective nonchallenged controls. The challenge strain of E. coli was isolated from more knee cultures of both large lines compared with the Egg line. Isolation was increased by Dex and was higher in male Comm-line birds and both male and female F-line birds relative to their controls. The difference in disease resistance between these lines suggests that selection for fast growth of turkeys may affect the stress response, resulting in increased chronic bacterial disease such as TOC.

Animals↗

Use of a specific bacteriophage treatment to reduce Salmonella in poultry products.

Bacteriophages represent a group of viruses that specifically infect and replicate in bacteria and could potentially be used to reduce recovery of Salmonella from poultry carcasses. Bacteriophages were isolated from municipal wastewater in the presence of Salmonella enteritidis phage type 13A (SE). In the first 2 experiments, commercially processed broiler carcass rinse water was pooled and divided. The addition of 10(10) pfu/mL of a single bacteriophage (PHL 4) with selected concentrations of SE reduced (P < 0.05) frequency of SE recovered as compared with the control rinse water sample. In experiments 3 and 4, broiler carcasses were intentionally inoculated with SE, sprayed with selected concentrations of PHL 4, and rinsed for SE enrichment and isolation. Application of 5.5 mL of 10(8) or 10(10) pfu/mL of PHL 4 reduced (P < 0.05) the frequency of SE recovery as compared with controls. In experiments 5 and 6, commercially processed turkeys were rinsed with water containing 72 wild-type bacteriophages isolated against SE, which were amplified in SE, or the Salmonella isolated antemortem from drag swabs from the flock selected for in-plant treatment, or a combination of bacteriophages amplified by each bacterial host. All bacteriophage treatments reduced (P < 0.05) frequency of Salmonella recovery as compared with controls. Sufficient concentrations of an appropriate bacteriophage, or a bacteriophage mixture, can significantly reduce recoverable Salmonella from carcass rinses.

Animals↗

[Poststroke depression: risk factors and effects on the course of the stroke].

The incidence of poststroke depression (PSD) varies between 20% and 25% as a major variant and an additional 10% and 20% as a minor variant. Its prevalence peaks 3-6 months after stroke onset. In nearly a quarter of all PSD patients, depressive symptoms persist over at least 2 years.Several longitudinal studies have identified different factors which may increase the risk of PSD. Most probably, the severity of the neurological deficit, female gender, history of previous psychiatric disorders, and bad social living conditions increase the risk of PSD. It is uncertain whether lesion location or size modulate PSD risk. Increasing age is not associated with a higher PSD incidence. In contrast, it is obvious that PSD is associated with less favorable outcome and higher mortality. The degree of disability and quality of life are significantly reduced in PSD patients. In conclusion, PSD is presently a not predictable complication of ischemic stroke which is significantly associated with less favorable outcome.Early diagnosis and adequate therapy are still necessary in stroke rehabilitation.

Brain↗

[Post-stroke depression: diagnosis and therapy].

Depression occurs at least temporarily in up to 30 - 40 % of all patients that have experienced a stroke. In the literature the term of a "Poststroke Depression" (PSD) has already been established. However standardised criteria for this diagnoses do not exist to this day. In most cases the DSM or ICD classification system is applied. Other investigators used various psychiatric rating scales. Even though it is generally acknowledged that there is a high prevalence, the occurrence of depression in combination with a stroke fails in most cases to be diagnosed or is left untreated. The need for treatment is even more pronounced by studies showing that a combination of stroke and depression will result in a less favourable outcome, particularly pertaining to that of functional treatment (motor skills, independent participation in activities of daily life). This difference in impairment between a depressed stroke patient and a not depressed stroke patient could be proven in studies that have been conducted over years. Despite the necessity of treatment that can be concluded from such a finding, the recent literature does not offer consistent information as to the ideal point of time for intervention nor the kind and intensity necessitated. According to singular studies, that have rarely been conducted under controlled conditions, there have been positive outcomes after early treatment. Along with psychostimulants that were most predominantly applied in the USA, as well as conventional tricyclic antidepressants, the group of the "Selective Serotonin Reuptake Inhibitors, SSRIs" have resulted in particularly favourable clinical outcomes.

Animals↗

Minimally invasive treatment for localized adenocarcinoma of the prostate: review of 1048 patients treated with ultrasound-guided palladium-103 brachytherapy.

PURPOSE: To assess the effectiveness of palladium-103 brachytherapy in stage T1 and T2 adenocarcinoma of the prostate. PATIENTS AND METHODS: The charts of 1048 patients treated between 1991 and 1999 with transperineal realtime ultrasound-guided (103)Pd (Theraseed) implants were reviewed to assess the effects on serum prostate specific antigen (PSA) values and tissue (biopsy). Of the 1048 patients, 780 had sufficient data for this report. Preoperative total androgen blockade (leuprolide and flutamide) was used selectively in patients whose prostate size was >50 cc and those whose tumors had a Gleason score of >7. RESULTS: At 1 year, 86% of the evaluable 766 patients had stable PSA concentration <1.5 ng/mL; at 5 years, 86% of the 166 patients with data available had stable PSA values <1.5 ng/mL. Biopsies were negative in 92% of the patients studied at 2 years. Patients with pretreatment PSA values <10 ng/mL had the best outcomes, and those treated with (103)Pd plus hormone ablation achieved PSA reduction more rapidly than those treated with radioisotope monotherapy. There was one disease-related death; the principal morbidity was short-term bladder and bowel irritation without permanent sequelae. Impotence occurred in approximately 15% of patients, and incontinence occurred in 5% of those who had undergone prior transurethral resection of the prostate. CONCLUSION: The technique used in this study proved effective in reducing PSA concentrations to <1.5 ng/mL and in producing negative biopsies 1 and 2 years postoperatively. These results are comparable to those of external-beam radiation therapy and radical prostatectomy while demonstrating a significant reduction in morbidity.

Adenocarcinoma↗

Evolution of techniques for ultrasound-guided palladium 103 brachytherapy in 950 patients with prostate cancer.

PURPOSE: Brachytherapy is an effective, low-morbidity, cost-effective treatment for adenocarcinoma of the prostate. Although both iodine 125 and palladium 103 have been used extensively over the last 14 years, 103Pd (Theraseed) provides a more rapid initial dose and therefore better control of higher Gleason grade tumors. We assessed a highly refined methodology for 103Pd brachytherapy in patients with prostate cancer and compared outcomes before and after making adjustments in technique. MATERIALS AND METHODS: Standard brachytherapy techniques were modified to include combination of preplanning with real-time adjustment, placing all needles at once to minimize prostate movement, using monitored anesthesia control sedation during preoperative volume study and cystoscopy, and several other small but important changes. Charts were reviewed from 950 patients treated with 103Pd implants from 1991 through 1999. Prostate-specific antigen (PSA) and biopsy data before and after 1993 were compared for 733 patients whose data qualified for analysis. RESULTS: At 1 and 5 years after treatment, 85-88% of patients had stable PSA <1.5 ng/mL. Biopsies were negative in 90-94% at 2 years. CONCLUSION: The modification in techniques provides positive results that remain stable over time.

Adenocarcinoma↗

Outpatient ultrasound-guided palladium 103 brachytherapy for localized adenocarcinoma of the prostate: a preliminary report of 434 patients.

OBJECTIVES: To assess the effectiveness of palladium 103 (Pd-103) brachytherapy in Stage T1 and T2 adenocarcinoma of the prostate. METHODS: Charts of 474 patients treated between 1991 and 1996 with transperineal real-time ultrasound-guided Pd-103 implants were reviewed to assess post-treatment prostate-specific antigen (PSA) levels and follow-up biopsy results. Of 474 patients, 434 had sufficient data for this report. The implant technique used allows precise placement of seeds and accurate dose delivery of the entire prostate. Preoperative neoadjuvant leuprolide (Lupron) and flutamide (Eulexin) were given selectively to reduce prostate size greater than 50 cc and for Gleason grade lesions greater than 7. RESULTS: Of 434 patients, successful cancer control was demonstrated in 81% of patients by a decrease in PSA levels to less than 1.5 ng/mL at 1 year. Biopsies were negative in 88% of patients 1 year after the procedure and in 89% at 2 years. Analysis of the data suggests that patients with pretreatment PSA levels less than 10 ng/mL had the best outcomes. There were no disease-related deaths; the predominant morbidity was short-term bladder and bowel irritation without permanent sequelae. Incontinence occurred in less than 5% of patients who had undergone prior transurethral resection of the prostate. Impotence occurred in less than 15% of patients. CONCLUSIONS: The technique used in this study proved effective in reducing PSA levels to less than 1.5 ng/mL and in producing negative biopsies 1 and 2 years postoperatively. Results are comparable to external-beam radiation therapy, demonstrating a significant reduction in morbidity.

Adenocarcinoma↗

Comparison of quantitative cultures to semiquantitative loop cultures of bronchoscopic protected specimen brush samples.

STUDY OBJECTIVE: To compare quantitative growth from a calibrated loop to growth from the standard serial dilution technique of culturing bronchoscopic protected specimen brush (PSB) samples and to determine the effect of refrigeration of the PSB sample on subsequent quantitative growth. DESIGN: Laboratory stock cultures were sampled with a PSB and cultured by both standard 100-fold serial dilution as well as 1:100 mL and 1:1,000 mL calibrated loops. Stock cultures were also sampled with a PSB and growth before and after refrigeration for 24 h at 4 degrees C (both serial dilution and calibrated loops) was compared. Clinical PSB samples from seven patients suspected of having lower respiratory tract infections were cultured by both techniques as well. SETTING: Clinical research laboratory and teaching hospital. PATIENTS AND INTERVENTIONS: PSB samples from inpatients and outpatients who had clinically indicated bronchoscopy. No interventions. MEASUREMENTS AND RESULTS: Quantitative growth from the 1:1,000 mL calibrated loop was within 1 log10 of growth from the serial dilution technique for 20 of 21 organisms, including 2 yeasts. Except for Haemophilus influenzae (known to be cold intolerant), there were no important differences in growth of bacteria before and after 24 h at 4 degrees C. For quantitative bacterial growth, there was a significant correlation between serial dilution and the 1:1,000 mL loop cultures (r=0.86, p < 0.0001). CONCLUSION: In this study, quantitative growth from a single 1:1,000 mL loop culture of PSB samples was comparable to growth from the standard serial dilution technique. Our results also suggest that overnight refrigeration of PSB samples may be possible in certain clinical situations.

Bacteria↗

NASA and Russian Space Agency sign agreement for additional Space Shuttle/Mir missions

On December 16, 1993 NASA Administrator Daniel S. Goldin [correction of Golden] and the Russian Space Agency (RSA) director Yuri Koptev signed a protocol agreeing to up to 10 Shuttle flights to Mir with a total of 24 months time aboard Mir for U.S. astronants, a program of scientific and technological research, and the upgrade and extension of the Mir lifetime during the period 1995-1997. This is the first of a three-phase program in human spaceflight cooperation which may culminate in the construction of an international Space Station. This agreement starts joint development of spacecraft environmental control and life support systems and potential common space suit.

Humans↗

Space program spin-offs of environmental systems underway

Several large NASA contractors are reevaluating their investments in space programs. As future NASA projects are put on hold or reduced in scope, companies are having to look to other areas in marketing their products. The companies that have invested in developing environmental systems for the space program are starting to realize they have a valuable product in non-space related projects. The environmental systems that are proving valuable were developed for space shuttle, space station and lunar/Mars stations. These are systems that handle air, waste, process water, potable water, solid waste, liquid waste and plant systems. With the development of longer space flights, environmental systems are developing which match Earth's environment. Now environmental systems developed for space are valuable on Earth.

Air Pollution↗

Spacelab Life Sciences-2: early results are in

In September the Space Shuttle Columbia mission Spacelab Life Sciences-2 (SLS-2) was the second Spacelab flight dedicated to life sciences research. Columbia's seven crew members performed a series of experiments to gain more knowledge on how the human body adapts to the weightless environment of space during the flight and after returning to Earth. The STS-58 crew performed experiments focusing on the cardiovascular, regulatory, neurovestibular and musculoskeletal systems of the body. Fourteen total experiments, with eight experiments performed on Columbia's crew and six on laboratory animals, along with data collected on the SLS-1 mission in June 1991, will provide the most detailed and interrelated physiological measurements acquired in the space environment since the Skylab program in 1973 and 1974.

Adaptation, Physiological↗

Panel discussion--NASA Russia agreement/Earth applications. Summary of the panel discussion during the 1994 Life Support and Biosphere Science (LSB Science) Conference

The panel at the Life Support and Biosphere (LSB) Science conference resulted in a discussion of the current issues facing this industry today. As the LSB Science industry looks to future space missions, joint Russian missions and Earth applications several quandaries arise, such as funding future work, developing practical workable standards and applying these systems to Earth applications. The panel members addressed these quandaries with some insightful comments.

Financial Support↗

The rat rectus abdominis myocutaneous flap: a true myocutaneous flap model.

UNLABELLED: Investigations of experimental flaps in lower-order animals have concluded that the cutaneous vascular anatomy of "loose-skinned" animals is not analogous to that of humans. This is particularly relevant with respect to myocutaneous flaps. The interpretation of results of studies in lower-order animals raises questions as to the applicability of these data to the human condition. OBJECTIVES: To establish a true myocutaneous flap model in the rat, to define the microvascular anatomy and the cutaneous vascular territory of the rat rectus abdominis myocutaneous flap, and to determine its suitability for additional investigative study of myocutaneous flaps. METHODS: Forty-two Sprague-Dawley rats weighing 300 to 400 gm were divided into the following six experimental groups: Group 1 (microvascular anatomy, n = 5), microfil injection and microdissection; Group 2 (n = 5), India ink injection of an isolated superior or inferior epigastric artery pedicle; Group 3, flap control (n = 6); Group 4, superior epigastric (n = 17); Group 5, deep inferior epigastric (n = 16); and Group 6, bipedicle deep inferior epigastric (n = 3). Rectus abdominis myocutaneous flaps based on a single superior or inferior vascular pedicle, or on a double inferior vascular pedicle with an overlying cutaneous island extending from the costal margin to the pubis and anterior to the anterior axillary line, were raised and replaced. Control flap vascular pedicles were transected. Assessment of viability was performed at 7 days using two-dimensional planimetry, tetrazolium, and hematoxylin and eosin stain. RESULTS: Injection studies revealed large (0.1 mm), direct, perforating vessels from the rectus abdominis muscle to the overlying cutaneous island. The cutaneous territory was defined by isolated pedicle india ink injection extended over the vertical muscle axis to the anterior axillary line and for a variable distance across the midline. All controls flaps were nonviable at 7 days. Superiorly based single-pedicle, and double-pedicle inferiorly based, flaps had 97% (SD, 0.03) survival of the cutaneous island. Single inferior pedicle flaps had 77% (SD, 0.07) survival of the cutaneous island with necrosis of the contralateral distal skin island. All flaps had 100% muscle survival. CONCLUSION: The rat rectus abdominis muscle and overlying cutaneous island constitutes a true myocutaneous territory. This has not been described in a low-order laboratory animal. The flap can be based on single or double, superior or inferior, epigastric vessels with predictable flap survival. The superiorly based and double pedicle flap demonstrates nearly complete viability. This model should serve as a useful investigational tool in the laboratory study of myocutaneous flaps.

Animals↗

Compromised antioxidant status associated with ascites in broilers.

Tissue infiltration by white blood cells in poultry with ascites has been reported, which could alter endogenous antioxidant status from oxidant stress. Therefore, the objective of this study was to determine the effect of ascites on ascorbic acid, tocopherol, and glutathione (GSH), which are major intracellular antioxidants. Broiler chicks (1 day) were placed in environmental chambers maintained with normal ventilation (Control) or under low ventilation, which produced a cumulative mortality of 31.3% due to ascites. At 3, 5, and 7 wk, lung and liver tissues were obtained from control birds (n = 5) and from birds in the low ventilation chamber with (ASC, n = 5) or without (NASC, n = 5) overt symptoms of ascites. There were no differences in tissue ascorbate, tocopherol, and GSH between the control and NASC groups with the exception of hepatic tocopherol at 7 wk, which was higher (P < .05) in NASC birds than in ASC and control birds. In general, lung and liver concentrations of all three antioxidants were lower (P < .05) in ASC birds than in NASC and control groups. Uric acid, a product of purine metabolism, was lower (P < .05) in liver and lung in ASC birds at 3 wk compared with control birds. However, uric acid concentrations in ASC birds were higher (P < .05) in the lung and serum at 5 wk, and in the liver at 7 wk compared with NASC and control birds.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗