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PubMed1982

Intellectual function in patients with transient ischaemic attacks (TIA) or minor stroke. Long-term improvement after carotid endarterectomy.

Psychological testing was performed in 25 patients (mean age 56 years) with transient ischaemic attacks and/or minor strokes and with angiographically verified internal carotid artery stenosis. The effects of carotid endarterectomy on intellectual functions were evaluated postoperatively at 2 weeks and 8 months respectively. Preoperatively the mean test values were below the normal level for all tests indicating a general intellectual impairment for the group as a whole. This may reflect multi-infarct dementia in statu nascendi. At the early postoperative test session some test results were statistically significantly worse than the preoperative. 8 months postoperatively the mean values for all tests had improved as compared with the preoperative values. This improvement reached a statistically significant level in 6 tests. When the side of operation was considered a pattern emerged: in the 12 patients with left-sided endarterectomies improvement was significant for tests mainly related to left-hemisphere function (Word Pairs Test, Story Recall, Trail Making B, Similarities) and in the 13 patients with right-sided endarterectomies significant improvement occurred in the functions mainly related to the right hemisphere (Visual Gestalts, Block Design, Digit Span backwards). This relationship between side of operation and improvement in lateralized functions cannot be explained by retest effects. It is concluded that TIA's and minor strokes per se may impair intellectual function, and that reversal of deterioration and even improved mental state may follow carotid endarterectomy.

Adult↗
PubMed2006

Trabecular anisotropy and collagen fibre orientation in the mandibular condyle following experimental functional appliance treatment using sheep.

In order to study the modifying effects of functional appliances on the mechanical environment of the temporomandibular joint (TMJ), we characterised the structure of the mandibular condyle subsequent to an experimental functional appliance intervention. Eight, four-month-old, castrated male Merino sheep, were randomly allocated to experimental and control groups (n = 4 in each group). Forward mandibular displacement was induced with an intraoral appliance. The study period was 15 weeks, during which time fluorochromes were administered to all of the animals. Midsagittal sections of the TMJ were selected for analysis and trabecular anisotropy was estimated using bone histomorphometry. Only the experimental group demonstrated that the trabecular bone in the central condylar region was less anisotropic when compared to the subchondral region. Also, the variation in trabecular anisotropy of the central condylar region was found to be smaller in the experimental group. The collagen fibre orientation was analysed under polarised light as the proportion of the dark or bright fibres observed in regions which existed before, and regions which formed during the experiment, as determined by the fluorochrome labels. In the experimental group, more bright collagen fibres were found in the most superior region of the mandibular condyle when compared with the controls. These results suggested that the experimental functional appliances changed the orientation and pattern of the mechanical forces acting on the mandibular condyle, and possibly increased the magnitude of the lateral functional forces applied to the most superior part of the condyle during such treatments.

Animals↗
PubMed1987

Onset of functional psychoses in later middle age. Social-psychiatric considerations.

The onset of functional psychosis occurring in later middle age (45-64 years) was studied by comparing the life situation and personal history of 74 Turku patients admitted to the mental hospital for the first time with the corresponding information obtained for randomly selected controls of the same age and of the same sex. The annual first admission rate of functional psychoses was 81 per 100,000; there was no difference between men and women. The rate was highest in unmarried individuals and lowest in married individuals (167 vs. 56 per 100,000). Measured by many different indicators, the patients' prepsychotic social development had been clearly poorer than that of the controls during the corresponding period. Almost all patients had had a precipitating life change during the last 5 years preceding the onset of psychosis. Objective losses had occurred more often in the group of affective psychoses than in the other diagnostic groups. In the case of childhood losses, on the other hand, there were no difference between patients and controls or between the diagnostic groups.

Age Factors↗
PubMed2000

Intensity and duration of suicidal crises vary as a function of previous suicide attempts and negative life events.

Borrowing from past conceptual work on the unique characteristics of multiple suicide attempters, as well on the effect of previous suicidal and depressive experience on later functioning, the authors hypothesized that negative events would be related to intensity of suicidal crises among never- and first-attempters but not among multiple attempters and that negative events would be related to duration of suicidal crises among multiple attempters but not among never- and first-attempters. Data on past suicide history, negative life events, and clinician- and self-rated suicidal symptoms were collected on 326 suicidal patients, 249 of whom were available at 1-month follow-up. Findings conformed to prediction. Previous suicidal experience alters the parameters of current suicidal crises. Implications of these findings for suicide risk and clinical assessment and management are discussed.

Adult↗
PubMed1987

Lateralization of visual hemifield attention across development.

Heilman and Valenstein (Clinical Neuropsychology, 1979, Oxford University Press, New York) have hypothesized a right hemispheric mechanism which mediates attention bilaterally. Shapiro and Hynd ("The development of functional lateralization in visual hemifield attention." Developmental Neuropsychology, Vol. 1, pp 67-80, 1985) examined the developmental validity of this model and their findings did not provide evidence for a lateralized mechanism for visual hemifield attention in 9, 13, and 18 year olds. However, length of foreperiod and gender effects were noted. This study attempted to compare these groups with a group of normal adults (ages 25-35) using the same reaction time paradigm. The study demonstrated support for the length of foreperiod effect found by Shapiro and Hynd. Hand effects were also found. However, these results do not lend support to either the model proposed by Heilman and Valenstein (1979) or Shapiro and Hynd's (1985) notion of developmental differences across age groups with respect to right hemisphere dominance for mediating attention.

Journal Article↗
PubMed2001

Twisting and bending: the functional role of salamander lateral hypaxial musculature during locomotion.

The function of the lateral hypaxial muscles during locomotion in tetrapods is controversial. Currently, there are two hypotheses of lateral hypaxial muscle function. The first, supported by electromyographic (EMG) data from a lizard (Iguana iguana) and a salamander (Dicamptodon ensatus), suggests that hypaxial muscles function to bend the body during swimming and to resist long-axis torsion during walking. The second, supported by EMG data from lizards during relatively high-speed locomotion, suggests that these muscles function primarily to bend the body during locomotion, not to resist torsional forces. To determine whether the results from D. ensatus hold for another salamander, we recorded lateral hypaxial muscle EMGs synchronized with body and limb kinematics in the tiger salamander Ambystoma tigrinum. In agreement with results from aquatic locomotion in D. ensatus, all four layers of lateral hypaxial musculature were found to show synchronous EMG activity during swimming in A. tigrinum. Our findings for terrestrial locomotion also agree with previous results from D. ensatus and support the torsion resistance hypothesis for terrestrial locomotion. We observed asynchronous EMG bursts of relatively high intensity in the lateral and medial pairs of hypaxial muscles during walking in tiger salamanders (we call these 'alpha-bursts'). We infer from this pattern that the more lateral two layers of oblique hypaxial musculature, Mm. obliquus externus superficialis (OES) and obliquus externus profundus (OEP), are active on the side towards which the trunk is bending, while the more medial two layers, Mm. obliquus internus (OI) and transversus abdominis (TA), are active on the opposite side. This result is consistent with the hypothesis proposed for D. ensatus that the OES and OEP generate torsional moments to counteract ground reaction forces generated by forelimb support, while the OI and TA generate torsional moments to counteract ground reaction forces from hindlimb support. However, unlike the EMG pattern reported for D. ensatus, a second, lower-intensity burst of EMG activity ('beta-burst') was sometimes recorded from the lateral hypaxial muscles in A. tigrinum. As seen in other muscle systems, these beta-bursts of hypaxial muscle coactivation may function to provide fine motor control during locomotion. The presence of asynchronous, relatively high-intensity alpha-bursts indicates that the lateral hypaxial muscles generate torsional moments during terrestrial locomotion, but it is possible that the balance of forces from both alpha- and beta-bursts may allow the lateral hypaxial muscles to contribute to lateral bending of the body as well.

Ambystoma↗
PubMed1996

Markers of failure to thrive among older hip fracture patients.

OBJECTIVES: To determine whether there is a group of recent hip fracture patients who exhibit the signs of failure to thrive and to identify potential precursors to their decline in physical functioning. DESIGN: Prospective (nonintervention) study of hip fracture recovery; patients were assessed in the hospital and at 2, 6, 12, 18, and 24 months post-fracture. SETTING: Hip fracture patients admitted to one of eight Baltimore area hospitals from the community with a new fracture of the proximal femur between January 1, 1990, and June 15, 1991. PARTICIPANTS: Patients were 65 years of age and older and lived in the community before the fracture. A total of 804 patients were eligible for the study; the present study analyses were restricted to the 252 patients who survived 1 year and had a self-report assessment at 6 and 12 months post-fracture. MEASUREMENTS: A questionnaire administered during hospitalization assessed pre-fracture functional and health status and current affective and cognitive status. In-home interviews post-fracture ascertained dependence and difficulty with physical and instrumental activities of daily living. Abstraction of the medical records provided information about comorbidities, surgical procedure, and hospital length of stay. RESULTS: Patients who declined in ability to walk from 6 to 12 months post-fracture had greater use of health resources (more hospitalizations) and poorer physical functioning up to 2 years post-fracture. Impaired function in physical activities of daily living at 6 months, high glucose, calcium, and CO2 at admission, and low BUN and creatinine at admission were more prevalent among decliners than among non-decliners. CONCLUSIONS: Findings indicate that certain older hip fracture patients begin to exhibit signs and symptoms of failure to thrive. About 10% of patients who survived at least 1 year after fracture could not retain their recovery level of functioning after 6 months and began to decline further. High glucose and CO2 and low BUN and creatinine on hospital admission were associated with later functional decline among hip fracture patients, but their clinical significance is uncertain.

Activities of Daily Living↗
PubMed2007

An ERP study on self-relevant object recognition.

We performed an event-related potential study to investigate the self-relevance effect in object recognition. Three stimulus categories were prepared: SELF (participant's own objects), FAMILIAR (disposable and public objects, defined as objects with less-self-relevant familiarity), and UNFAMILIAR (others' objects). The participants' task was to watch the stimuli passively. Results showed that left-lateralized N250 activity differentiated SELF and FAMILIAR from UNFAMILIAR, but SELF and FAMILIAR were not differentiated. In the later time-course, SELF was dissociated from FAMILIAR, indicating the self-relevance effect in object recognition at this stage. This activity did not show consistent lateralization, in contrast to previous studies reporting right lateralization in self-relevant face and name recognition. We concluded that in object recognition, self-relevance was processed by higher-order cognitive functions later than 300ms after stimulus onset.

Adult↗
PubMed1999

Repetitive myocardial stunning in pigs is associated with the increased expression of inducible and constitutive nitric oxide synthases.

OBJECTIVES: Nitric oxide (NO) has complex effects on myocardial function particularly following ischaemia-reperfusion. The goal of this study was to examine the result of repetitive myocardial stunning on myocardial NO release and expression of inducible (iNOS) and constitutive (eNOS) NO synthases. METHODS AND RESULTS: Propofol anaesthetised pigs underwent ten, 2-min episodes of circumflex artery occlusion (n = 6) or acted as sham operated controls (n = 4). Measurements of segment shortening demonstrated a fall in function in the ischaemic territory to 52.5 +/- 7.3% (mean +/- S.E.M.) of baseline shortening 30 min after the stunning stimulus, recovering to 92 +/- 8.7% 5.5 h later. Function remained stable in sham controls. The change in venous-arterial [NO] between baseline and 6 h reperfusion was found to be significantly different between the two groups (0.2 +/- 0.7 in stunned vs. -4.3 +/- 1.6 microM in shams; P < 0.02). Western blotting and band optical density used to compare tissue from stunned territory (S), non-stunned territory (IC) and sham control animals (SC) demonstrated this was associated with an increase in the expression of both iNOS (S: 93 +/- 13.4, IC: 37 +/- 2.4 and SC: 25 +/- 4 [arbitrary units], P < 0.01 and P = 0.031) and eNOS (S: 104 +/- 7.4, IC; 62.5 +/- 7.4 and SC; 75.7 +/- 0.6, P < 0.03 and P < 0.01) in stunned myocardium. Immunocytochemistry localised iNOS reactivity to vascular smooth muscle cells and cardiomyocytes in stunned tissue and eNOS reactivity to endothelial cells. CONCLUSION: Recovery from repetitive myocardial stunning is associated with the increased expression of both iNOS and eNOS and would be compatible with a protective role for both these enzymes. This finding has possible relevance for both the late window of ischaemic preconditioning and myocardial hibernation.

Animals↗
PubMed1975

[Urographic and cineradiographic follow-up studies in ureteral stenoses following radical pelvic operations (author's transl)].

The results of 19 urographic follow-up studies 6-15 months following vaginal or abdominal radical pelvic operation are reported. Compared to the first follow-up studies 1-7 weeks after the operation which always showed stenosis of the pelvic ureters with various degrees of urinary retention about one half of the cases showed improvement of the stenoses and normalization of the ureteral function later on even when marked urinary retention was found earlier on. Seven cases showed marked improvement. In these seven cases the dynamics of the ureteral function was studied by cineradiography. The results of this investigation are discussed. A deterioration of the urinary retention was observed in only 2 cases. An adverse effect of preoperative or post-operative radiotherapy on the prognosis of ureteral stenosis was not observed.

Cineradiography↗
PubMed1997

Subtalar ankle instability. A review.

The aetiology of chronic functional lateral ankle instability is fairly well understood. Pathophysiological factors such as mechanical instability, proprioceptive deficit and peroneal muscle weakness have been demonstrated. Subtalar instability has been in focus during the last years as one of the possible factors behind chronic functional instability of the foot. The exact aetiology and the true incidence of subtalar ligament injuries remain unknown. Most subtalar ligamentous injuries probably occur in combination with injuries of the talo-tibial articulation. Subtalar instability can have the characteristics of chronic lateral instability or recurrent ankle sprains. Patients with chronic subtalar instability typically complain of 'giving way' symptoms and a history of recurrent sprains. Clinical examination including increased inwards rotation and forward displacement of the calcaneus may not be sufficient for the differentiation between ankle and subtalar instability. Radiographic imaging using stress radiographs may be necessary to assess subtalar instability. Subtalar instability can be defined as chronic functional instability with increased values of talar tilt and talo-calcaneal displacement as measured with standardised stress radiographs. Few authors have addressed the treatment of subtalar instability and the condition has not been clearly defined. Subtalar instability can be treated either with a tendon transfer or tenodesis procedure, such as the Chrisman-Snook or triligamentous tenodeses, or with an anatomic ligament reconstruction using the calcaneo-fibular, lateral talo-calcaneal and cervical ligaments combined with a reinforcement of the inferior extensor retinaculum. There have been no studies comparing anatomical and non-anatomical reconstructions and the long term results after ligamentous stabilisation are unknown. The focus of this article is on subtalar instability causing chronic functional ankle instability.

Chronic Disease↗
PubMedDate not supplied

Anomalous origin of all coronary arteries from the pulmonary trunk.

The origin of both coronary arteries from the pulmonary artery is a rare cardiac malformation. We report a baby who presented with an echocardiographically diagnosed perimembranous ventricular septal defect and normal left ventricular (LV) function. Later on the boy developed failure to thrive and increasing tachypnea. At the age of 5 weeks the ECG showed that LV strain and echocardiographic LV function had worsened (FS 18%). Echocardiography and heart catheterization showed that all coronary arteries originated from the pulmonary trunk. Intraoperative inspection revealed a single ostium for the right and left coronary artery in the nonfacing sinus of the pulmonary trunk. A tube was constructed connecting the coronary artery to the ascending aorta. Coronary perfusion was sufficient and the sinus rhythm was restored. However, in the early postoperative period there was a sudden deterioration of cardiac output followed by cardiac arrest. Reanimation was not successful.

Abnormalities, Multiple↗
PubMed1993

Venous sampling: its role in localization of endocrine tumours.

Despite recent instrumentation advancement in morphologic imaging, venous sampling remains a sensitive physiological investigation for functional localization of hormonal hypersecretion. The test requires technical expertise and reliable laboratory support, and should be selectively applied to address individual clinical problems in coordination with other imaging modalities. Depending on the venous anatomy, sampling may achieve regional localization or lateralization of the endocrine tumour. Adrenal venous sampling serves to lateralize functioning tumour, and to differentiate it from hyperplasia. Inferior petrosal sinus sampling confirms pituitary Cushing's disease and lateralizes the adenoma. Systemic venous sampling identifies the site of ectopic hormonal secretion. In the localization of pancreatic islet cell tumours, the test is further enhanced by sampling after intraarterial injection of hormonal secretagogue. The experience of venous sampling in a regional referral hospital is discussed, including the patient selection, its technical details, pitfalls and effectiveness in achieving tumour localization for patient management.

Adrenal Gland Neoplasms↗
PubMed1985

Laterality of cerebral function: relations with anxiety, repression, and perception.

Based on two factor analyses of data from 67 right-handed undergraduates, a laterality quotient based on forward memory spans, spatial minus digit, divided by their sum, was devised. The hemispheric balance factor for which this quotient served as the principal marker had significant positive loadings by the laterality quotient for the Edinburgh Handedness Questionnaire and by a measure of repressive tendencies, the Marlowe-Crowne Social Desirability Scale. Scores from this factor were positively related to global as opposed to analytic perception as measured by the Navon tachistoscopic task. This factor was unrelated to the trait anxiety and working short-term memory factors which also emerged. Trait anxiety was negatively related to global perception. The results raise the possibility that greater degrees of right-handedness may be related to the release of the nondominant right hemisphere from inhibition and that working short-term memory may not be lateralized.

Adult↗
PubMed2003

Disruption of lateral efferent pathways: functional changes in auditory evoked responses.

The functional consequences of selectively lesioning the lateral olivocochlear efferent system in guinea pigs were studied. The lateral superior olive (LSO) contains the cell bodies of lateral olivocochlear neurons. Melittin, a cytotoxic chemical, was injected into the brain stem using stereotaxic coordinates and near-field evoked potentials to target the LSO. Brain stem histology revealed discrete damage to the LSO following the injections. Functional consequences of this damage were reflected in depressed amplitude of the compound action potential of the eighth nerve (CAP) following the lesion. Threshold sensitivity and N1 latencies were relatively unchanged. Onset adaptation of the cubic distortion product otoacoustic emission (DPOAE) was evident, suggesting a reasonably intact medial efferent system. The present results provide the first report of functional changes induced by isolated manipulation of the lateral efferent pathway. They also confirm the suggestion that changes in single-unit auditory nerve activity after cutting the olivocochlear bundle are probably a consequence of disrupting the more lateral of the two olivocochlear efferent pathways.

Action Potentials↗
PubMed2006

Cognitive functioning as a predictor of functional disability in later life.

OBJECTIVE: The contribution of cognitive functioning on multiple levels of functional disability and mortality over two years as well as individual activities of daily living (ADLs) and instrumental activities of daily living (IADLs) tasks, in a sample of older U.S. adults was examined. METHODS: A total of 4,077 U.S. adults (1,493 males and 2,584 females) aged > or =70 years (mean = 76.35 years) from the Second Longitudinal Study of Aging (1997/1998-1999/2000) were examined using an adapted Telephone Interview of Cognitive Status (TICS), ADLs, and IADLs. RESULTS: Multivariate logistic regression investigated cognition as a predictor of five mutually exclusive levels of functional disability. People with the lowest level of cognition had greater odds of mortality at follow-up (adjusted odds ratio [AOR] = 2.86, 95% confidence interval [CI] = 1.94-4.20), ADL and IADL disability (AOR = 1.58, 95% CI = 1.15-2.16), ADL disability (AOR = 1.83, 95% CI = 1.27-2.64), or IADL disability (AOR = 1.22, 95% CI = 0.86-1.71) than those who were disability-free. Cognitive functioning was not predictive of individual ADL tasks but was predictive of the IADL tasks of preparing meals, shopping for groceries, managing money, telephone use, light housework, and medications but not heavy housework. CONCLUSION: Persons with lower levels of cognitive functioning were more likely to die or become disabled than those with higher levels of cognition. Changes in cognitive functioning might serve as an early indicator of neurologic and medical factors.

Activities of Daily Living↗
PubMed2005

Attention to pain localization and unpleasantness discriminates the functions of the medial and lateral pain systems.

Functional imaging studies have identified a matrix of structures in the brain that respond to noxious stimuli. Within this matrix, a division of function between sensory-discriminative and affective responses has so far been demonstrated by manipulating either pain intensity or unpleasantness under hypnosis in two different normal volunteer groups studied on separate occasions. Our study used positron emission tomography (PET) to demonstrate this division of function under more natural conditions in a healthy group of volunteers, using a CO(2) laser to provide nociceptive stimuli that selectively activate A-delta and C-fibres without contamination by touch sensations. We measured the differential cerebral responses to noxious and innocuous laser stimuli during conditions of selective attention to either the unpleasantness or location of the stimuli. Attention to location increased responses in the contralateral (right) primary somatosensory and inferior parietal cortices. This result implies that these components of the lateral pain system are concerned mainly with the localization of pain. In contrast, attention to unpleasantness increased responses in bilateral perigenual cingulate and orbitofrontal cortices, contralateral (right) amygdala, ipsilateral (left) hypothalamus, posterior insula, M1 and frontal pole. These areas comprise key components of the medial pain and neuroendocrine systems and the results suggest that they have a role in the affective response to pain. Our results indicate the importance of attentional effects on the pattern of nociceptive processing in the brain. They also provide the first clear demonstration, within a single experiment, of a major division of function within the neural pain matrix.

Adult↗