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PubMedDate not supplied

[The blood circulation and microcirculation in the diagnosis of the DIC syndrome in cerebral circulatory disorders in subjects exposed to the effect of ionizing radiation].

A clinical and laboratory investigation was done in 103 patients presenting with early cerebral circulation disorders, who took part in the elimination of the effects of the Chernobyl accident. Clinical features were studied as was the state of homeostasis and of microcirculation. Employment of a complex of clinical-and-biochemical and microcirculatory techniques permits diagnosing DBC syndrome manifestable both in acute and chronic post-radiation cerebral dyscirculation. Biomicroscopy of the bulbar conjunctiva vessels and investigation into the molecular and cellular homeostasis allow the signs of syndrome development to be revealed, its further course to be prognosticated, control over the efficiency of the treatments administered to be exercised.

Acute Disease↗

PubMed2005

Nonmyeloablative stem cell transplantation and cell therapy for malignant and non-malignant diseases.

The conditioning prior to allogeneic stem cell transplantation was originally designed as a myeloablative conditioning, designed to eliminate malignant or genetically abnormal cells and then use the transplant procedure for rescue of the patients or to replace missing bone marrow products. However, allografts can induce effective graft vs. malignancy effects and can also eliminate undesirable hematopoietic stem cells in patients with genetic disorders and autoimmune diseases, thus documenting that alloreactive effects mediated by donor lymphocytes post-grafting can play a major role in eliminating hematopoietic cell of host origin, as well as provide effective immunotherapy for the treatment of disease recurrence. The efficacy of donor lymphocyte infusion (DLI) could be improved by activation with rIL-2 or by donor immunization. The cumulative experience over the years suggesting that alloreactive donor lymphocytes were most effective in eliminating tumor cells of host origin resulted in an attempt to reduce the intensity of the conditioning in preparation for the transplant procedure used for the treatment of hematological and other malignancies as well as life-threatening non-malignant disorders for which allogeneic stem cell transplantation may be indicated. Our working hypothesis proposed that the myeloablative conditioning which is hazardous and may be associated with early and late side effects, may not be required for treatment of patients with any indication for allogeneic stem cell transplantation. Instead, nonmyeloablative conditioning based on the use of reduced intensive preparatory regimen, also known as nonmyeloablative stem cell transplantation, may be sufficient for engraftment of donor stem cells while avoiding procedure-related toxicity and mortality, followed by elimination of undesirable cells of host origin by post-transplant effects mediated by alloreactive donor lymphocytes infused along with donor stem cells or administered subsequently as DLI. Improvement of the immediate outcome of stem cell transplantation using NST due to a significant decrease in transplant related mortality has broadened the spectrum of patients eligible for allogeneic stem cell transplantation, including elderly patients and other patients with less than optimal performance status. Likewise, the safer use of stem cell transplantation prompted expanding the scope of potential indications for allogeneic stem cell transplantation, such as metastatic solid tumors and autoimmune disorders, which now are slowly becoming much more acceptable. Current strategies focus on the need to improve the capacity of donor lymphocytes to eliminate undesirable malignant and non-malignant hematopoietic cells of host origin, replacing abnormal or malignant stem cells or their products with normal hematopoietic stem cells of donor origin, while minimizing procedure-related toxicity and mortality and improving the quality of life by reducing the incidence and severity of hazardous acute and chronic GVHD.

Animals↗

PubMedDate not supplied

[Interlabyrinthine asymmetry, vestibular dysfunction and space motion sickness].

The data available suggest that a disorder in the labyrinthine paired function can be regarded as a factor responsible for the initiation and development of space motion sickness. This concept is based on the assumption that in the norm the vestibular function is to a certain extent asymmetric which is made for by a compensatory center in the central nervous system. Exposure to an unusual space environment leads to a disorder of this compensation and development of a "new" vestibular asymmetry. This exposure involves: elimination of the difference in the weight of otolith membranes, disorder of the canal-otolith interaction, asymmetric blood-CSF changes, distinct interhemispheric asymmetry, general stress. Vestibular asymmetry that develops in the weightless state may become sufficient for the generalization of afferent impulsation to normal stimuli and development of a strong reaction. Adaptation to weightlessness occurs due to rearrangements of the compensatory center which are responsible for lower vestibular asymmetry. The compensatory mechanisms that have evolved in weightlessness continue to function during a certain time interval after recovery. They facilitate a re-initiation of vestibular asymmetry and motion sickness that is mainly provoked by head movements, as in the weightless state.

Ear, Inner↗

PubMed1988

Selection of controls for family studies. Biases and implications.

The use of hospital-based controls as a means of comparison for family studies has raised a number of questions concerning the degree to which the control group represents the general population. Of primary interest is whether the control group should be completely free of disease-associated symptoms. To test the effect of the selection of psychiatric symptom-free controls, we examined the control group from our long-term follow-up and family study of major psychoses. Morbidity risks for psychiatric disorder among relatives of surgical controls were estimated, both for an unscreened proband group of 361 patients and for a screened group of 318 from which the relatives of controls with significant "psychiatric history" had been eliminated. The largest difference occurred with affective disorders, which were more frequent among the relatives of unscreened controls than among the relatives of the screened controls. Our results suggest that gathering data on both screened and unscreened control groups will yield more generalizable results than either alone.

Adult↗

PubMed1994

The empirical basis of generalized anxiety disorder.

OBJECTIVE: The authors review the empirical data on generalized anxiety disorder, a diagnostic category that has been among the more conceptually challenging in psychiatric nosology. METHOD: Published studies and recent findings that were considered by the Generalized Anxiety Disorder Subcommittee of the DSM-IV Anxiety Disorders Work Group are reviewed. Among the issues examined are diagnostic reliability, comorbidity, boundaries with other disorders, and clinical features. RESULTS: A variety of data on the reliability and validity of generalized anxiety disorder have been produced. Some authors have suggested that generalized anxiety disorder is better conceptualized as a vulnerability that should be located on axis II, and others have recommended that the category be eliminated. Although the diagnostic reliability of generalized anxiety disorder is lower than that of other anxiety disorders, the features constituting the diagnostic criteria for generalized anxiety disorder have been found to be reliable. An important development has been the determination of a set of somatic symptoms associated with generalized anxiety disorder that differs substantially from those for other anxiety disorders. These findings led to reduction in the number of items in the symptom criterion, from 18 in DSM-III-R to six in DSM-IV. Another substantial revision is greater emphasis on the uncontrollability of worry. CONCLUSIONS: Whereas the data on construct and discriminant validity, age at onset, course, familial transmission, and response to treatment generally support the DSM-IV definition of generalized anxiety disorder, the construct continues to have weaknesses and further research is needed.

Adult↗

PubMed1996

[Dental care using silver amalgam].

Dental amalgam is the most widely used filling material in dentistry. In our country there are an estimated 40 million amalgam fillings in place. The mercury present in these fillings has caused health concerns over the last 160 years that amalgam has been used in decayed teeth. The fears have always proven to be unjustified and no harmful effects have ever been demonstrated in dental patients. Mercury can be found in several forms. In dentistry, only the metallic form is used, while inorganic and organic compounds are also present in the environment. The metallic form is absorbed in the human body mostly through the lungs. Once mercury reaches toxic levels inside the body, it will interfere with cell metabolism. Most important among the target organs are the brain, the liver and the kidneys. Elimination occur through urine and feces. Mercury is universally found in blood and urine. The concentration depends on absorption by air, water, nutrition, medication (including dental fillings) and occupational hazards. There are four kinds of objectives to dental amalgam: oral galvanism, toxicity, allergenicity and ecological grievances. Disorders from oral galvanism are difficult and delicate to evaluate as the actual currents are very small. Furthermore, no significant difference can be found in current intensity between patients with and without complaints. Finally patients with complaints often present other oral disorders, the treatment of which most often eliminates all complaints that could be attributed to oral galvanism. Toxicity is dose dependent. Industrial safety rules indicate that the amount of mercury absorbed from dental amalgam fillings is far below the safety level. HgB and HgU levels in patients with amalgam fillings are situated well below the acceptable levels. Allergic disorders are observed in patients with amalgam fillings but far less than expected in view of the wide spread use of dental amalgam. The problem of mercury spilling from dental amalgam fillings into the environment will be resolved by strict legislation in the near future. In this context, it can be stated that the use of dental amalgam is safe and justified. Furthermore, it is also advisable as no other material can meet the actual dental needs as efficiently as can dental amalgam.

Corrosion↗

PubMed1998

The relationship among dysfunctional elimination syndromes, primary vesicoureteral reflux and urinary tract infections in children.

PURPOSE: We determine whether functional bladder and/or bowel disorders influence the natural history or treatment of children with primary vesicoureteral reflux. MATERIALS AND METHODS: We assessed 143 children with primary vesicoureteral reflux that stopped spontaneously or was surgically corrected for functional bowel and/or bladder disorders, including bladder instability, constipation and infrequent voiding, termed the dysfunctional elimination syndromes. RESULTS: Dysfunctional elimination syndromes were present in 66 of 143 children (43%) thought to have primary vesicoureteral reflux. Of these 66 patients 54 (82%) had a breakthrough urinary tract infection and underwent reimplantation compared to only 18% without the syndromes. Of 70 children who had a breakthrough urinary tract infection dysfunctional elimination syndromes were present in 54 (77%) and absent in 16 (23%). Of the remaining 73 patients who did not have a breakthrough infection dysfunctional elimination syndromes were present in 12 (16%) and absent in 61 (84%). In children with dysfunctional elimination syndromes the resolution of reflux that was 1 grade less severe required an average of 1.6 years longer. After the disappearance of reflux, urinary tract infection developed in 18 children, including 14 (78%) with dysfunctional elimination syndromes. Unsuccessful surgical outcomes involving persistent, recurrent and contralateral reflux occurred only in children with dysfunctional elimination syndromes. CONCLUSIONS: Dysfunctional elimination syndromes are common and are often unrecognized in children with primary reflux. These syndromes are associated with delayed reflux resolution and an increased rate of breakthrough urinary tract infection, which leads to reimplantation surgery. Dysfunctional elimination syndromes also adversely affect the results of reimplantation and represent a risk for recurrent urinary tract infection after reflux resolves. The evaluation and management of dysfunctional elimination syndromes should be an integral part of the treatment of every child with vesicoureteral reflux. Effective evaluation and treatment may be made cost-effective by decreasing the followup, the number of breakthrough urinary tract infections and the number of children requiring reimplantation.

Child↗

PubMed2001

Drug-induced psychotic symptoms in Parkinson's disease. Problems, management and dilemma.

Psychotic symptoms develop in 20-30% of patients with Parkinson's disease (PD) receiving chronic anti-PD medications, and visual hallucinations with or without delirium and paranoid delusions are the most frequent symptoms. Psychotic symptoms disturb ADL and QOL of PD patients and tax caregivers far more than the motor disabilities do, and good management of drug-induced psychotic symptoms is potentially important. Withdrawal of anti-PD drugs relieves the patients from psychotic side effects, but worsens the parkinsonian motor symptoms. The first step of treatment is to eliminate triggering factors other than anti-PD drugs, such as infections, metabolic disorders, subdural hematoma, and hallucinogenic drugs. The second step is to eliminate anti-PD drugs in the following order; first anticholinergics, amantadine and selegiline, second dopamine agonists, and finally levodopa/carbidopa. Anti-PD medications should be reduced to the point of improving psychotic side effects without drastically worsening parkinsonian motor symptoms. When the above adjustments fail to sufficiently alleviate psychotic side effects, the third step is consideration of antipsychotic drugs although they have potential capacity to antagonize dopamine D2 receptors and worsen parkinsonism. Atypical antipsychotics such as clozapine and olanzapine are recommended, though the former is not available in Japan.

Aged↗

PubMed1975

An analysis of lamellar x-ray diffraction from disordered membrane multilayers with application to data from retinal rod outer segments.

Oriented multilayers containing a membrane pair within the unit cell potentially possess both lattice disorder and substitution disorder. Lattice disorder occurs when there is a lack of long-range order in the lattice spacings produced by a variation in the nearest neighbor distances between unit cells. A simple form of substitution disorder can arise from a variation in the separation of the two membranes within the unit cells in the multilayer. Lattice disorder produces a monotonically increasing width for higher order lamellar "reflections" while simple substitution disorder produces an incoherent intensity underlying the coherent intensity. A generalized Patterson function analysis has been developed for treating lamellar diffraction from lattice disordered multilayers. This analysis allows the identification of the autocorrelation function of the unit cell electron density profile and its subsequent deconvolution to provide the unit cell electron density profile. A recursive procedure has been developed for separating the incoherent intensity from the coherent intensity via a Gaussian probability model of the membrane intra-pair separation. In cases studied so far both disorders can be quantitatively accounted for and eliminated from interfering with the phasing of the coherent intensity or distorting the derived electron density profile. Lamellar X-ray diffraction data from intact retinal rods, using either film or position sensitive detectors, shows severe effects of both forms of disorder which have not been taken into account in past analysis of such data. We have applied our analysis to the data on dark adapted rod outer segments in electrophysiologically intact retinas of Chabre and Cavaggioni (unpublished). An electron density profile is derived at 25 A resolution. The lattice nearest neighbor spacing has a variation of +/- 19 A out of a 295 A repeat. The intra-unit cell membrane pair center to center distance of 88 A varies +/-8 A.

Animals↗

PubMed2002

Non-myeloablative transplants for congenital diseases.

The morbidity and mortality associated with postnatal HSCT, toxicity of HSCT conditioning regimens, lifelong immunosuppressive therapy, and lack of compatible donors discourages many patients and physicians from utilizing postnatal HSCT as a treatment for congenital disease. Non-myeloblative in utero HSCT is now being considered as an alternate treatment with the hope that it will be more therapeutic with less toxicity to a wider spectrum of patients with congenital disorders. Prenatal stem cell transfer may eliminate many of the risks and hazards associated with postnatal HSCT, as the fetus may be less reactive than an immunologically mature individual such that tolerance to donor cells could be developed. GVHD and rejection of postnatal therapeutic grafts may be minimized thus reducing or eliminating altogether the need for postnatal myeloablation and immunosuppression. Much work must be done both in animal studies as well as in clinical trials. By using well-designed murine models such as the beta-thalassemic mouse outlined above, we believe we can determine the optimal conditions for non-myeloablative postnatal transplants with allogeneic or haplocompatible HSC following prenatal tolerance induction with these cells. In addition, we may answer basic immunology questions regarding the development and regulation of immunity and tolerance in both mice and humans.

Animals↗

PubMed1991

[The possibilities for surgical correction of dentoalveolar adaptations within skeletal repositioning osteotomy].

In the combined surgical orthodontic treatment the essential task is to eliminate the dentoalveolar adaptations of maxillofacial disorders. Additional segmental osteotomies can be considered if these adaptations are excessive or if complications are to be expected during the orthodontic treatment. Possibilities and indications as well as complications and limits of this approach are described.

Alveolar Process↗

PubMed1988

Information transfer in biological systems: targeting of proteins to specific organelles or to the extracellular environment (secretion).

Orderliness is the salient characteristic of living systems. Cells are intolerant of disorder. They express this by rapidly eliminating or degrading out-of-place molecules. When cells are broken apart and their constituent organelles separated and analysed, the same types of macromolecules are always associated with the same subcellular structures. One finds, for example, the same proteins in mitochondria time after time, and these differ from the sets of proteins found in nuclei, secretory granules, or plasma membranes. The information necessary to target each protein to its appropriate intracellular destination is determined primarily by the gene for that protein. Encoded within the DNA structure of genes are signals that specify where each protein molecule belongs. Thus, it is the transfer of information from one macromolecule to another that maintains the integrity and orderliness of living cells.

Animals↗

PubMed2000

The relationship between clinical and kinematic responses from human subject testing in rear-end automobile collisions.

Recent experiments have produced a linked data set of clinical and kinematic responses for human subjects exposed to controlled low-speed rear-end collisions. The purpose of this paper was to examine this paired data set and determine whether the presence or absence of clinical symptoms could be predicted from the peak linear and angular kinematic response of the head and neck. The data were generated using 42 male and female human subjects seated normally in the front passenger seat of a stationary vehicle struck from behind to produce vehicle speed changes of 4 and 8 km/h. Pre- and post-test clinical examinations documented the presence, severity and duration of whiplash-associated disorders (WAD). Logistic regression and backward elimination of independent variables were used to develop the prediction model. The analysis yielded a 16 parameter model that was significantly related (odds ratio = 21.2; P = 0.0069) to the presence or absence of transient whiplash symptoms. The model correctly predicted symptom presence in 13 of 23 tests (sensitivity 57%) and symptom absence in 49 of 52 tests (specificity 94%) in a population of 75 with a symptom prevalence of 31%. The model's positive predictive value was 81% and its negative predictive value was 83%. Despite statistical significance, the model did not discriminate between the presence and absence of symptoms in all tests, and indicated that factors other than the selected peak kinematic responses influenced symptom production.

Accidents, Traffic↗

PubMed2003

Ultrasound and CT evaluation of emergent gallbladder pathology.

Ultrasound is the initial imaging modality of choice for the evaluation of suspected acute gallbladder disorders, and is often sufficient for correct diagnosis. CT also plays a vital role, however, in the evaluation of acute gallbladder pathology. CT is particularly useful in situations where ultrasound findings are equivocal. CT is also extremely valuable in the assessment of suspected complications of acute cholecystitis, particularly emphysematous cholecystitis, hemorrhagic cholecystitis, and gallbladder perforation, which are often very difficult diagnoses to establish at sonography. If CT is the initial imaging test performed in a patient with abdominal pain of uncertain etiology, recognition of the various disorders described in this article may eliminate the need for further imaging and facilitate appropriate management.

Abdomen, Acute↗

PubMed2001

Management of patients with essential thrombocythemia: current concepts and perspectives.

Essential thrombocythemia must now be regarded as a heterogeneous disease. Recent availability of clonality studies have repeatedly shown that a significant number of female patients diagnosed as E.T. according the most stringent criteria had a definitely polyclonal myelopoiesis. Although the incidence of patients newly diagnosed every year is low, there is in fact a conspicuous population of E.T., followed as outpatients in every department of hematology or internal medicine, including a large number of young females. These eventualities should be integrated in further discussions of the benefit/risk ratio of cytoreduction with the presently available drugs. The combination of several evidence-based data is the basis of a widely accepted stratification of high-risk patients defined by any of the following features. Age > 60 to 65. History of thrombosis or embolic or major ischemic events. Platelet counts in excess of 1000 or 1500 x 10(9)/L. In the question of chemotherapy in E.T., growing concern comes from the potential leukemogenic risk associated with the presently available drugs and extends beyond Melphalan, Busulfan and other alkylating agents and includes non-alkylating agents like Hydroxyurea. At the same time, much attention has been paid to the introduction of very precise initial diagnostic criteria directed to elimination of other myeloproliferative or myelodysplastic disorders with an increased risk of transformation. Present treatment of E.T. is a compromise between prevention of E.T. related thrombotic and bleeding complications on one hand and long term side effects and toxicity of the presently available drugs on the other hand. The recent availability of non mutagenic drugs like Interferon and most of all Anagrelide; the recognition of the role of antiaggregating agents in the treatment of platelet related microvascular ischemic events gives the opportunity for further comparative prospective trials. The use of aspirin in the management of pregnant E.T. patients is now widely accepted but there is still controversies concerning the use of Interferon in this situation.

Adult↗

PubMed2001

Apoptosis-regulating proteins as targets for drug discovery.

Defects in the regulation of apoptosis (programmed cell death) contribute to many diseases, including pathologies associated with cell loss (e.g. stroke, heart failure, neurodegeneration and AIDS), and disorders characterized by a failure to eliminate harmful cells (e.g. cancer, autoimmunity). Apoptosis is caused by activation of intracellular proteases, known as caspases, which are responsible directly or indirectly for the morphological and biochemical events that characterize the apoptotic cell. Numerous caspase regulators have been discovered, which respond to environmental stimuli and influence the decision of cell death and survival. Knowledge of the molecular details of apoptosis regulation, and the three-dimensional structures of proteins constituting the apoptosis core machinery has revealed new strategies for identifying small-molecule drugs that could one day yield more effective treatments for a wide variety of illnesses.

Animals↗

PubMed2006

Coplanarity in the backbones of ladder-type oligo(p-phenylene) homologues and derivatives.

p-Tolyl-substituted ladder-type oligo(p-phenylene)s containing three, four, and five phenylene rings were readily synthesized. The uniform aryl substitution of these systems allowed us to determine the coplanarity of the pi-conjugated backbones crystallographically. The intramolecular annulations eliminate almost all of the conformational disorder and enhance the degree of pi-conjugation of the backbones, resulting in significant red shifts in the absorption and emission maxima and lower oxidation potentials in the higher homologues. [structure: see text]

Journal Article↗

PubMedDate not supplied

[Calcifying solitary bone cyst of the sacrum--A rare type of bone cyst and its unknown localisation, differential diagnosis and management].

AIM: The diagnostic procedures and management of calcifying bone lesions occurring in the sacrum. METHOD: A case report of a rare type of bone cyst at an unknown localisation including the differential diagnosis and management. RESULTS: Low back pain of a 41-year-old women was correlated with a calcifying bone formation of the sacrum on X-ray, demonstrating cystic, solid and exophytic components. On radionuclide bone scan, additional skeletal lesions were ruled out, the focus showed an increased uptake. An inflammatory process was excluded by lab studies. On computed tomography and magnetic resonance imaging, the calcifying bone formation was identified as surrounding the sacral canal, respecting the anatomical borders. Considering this anatomic region, a neurogenic tumor could be eliminated by the absence of neurological disorders, but the radiologic feature of this osseogenic process was not clear enough for classification. Hence, an incisional biopsy was essentially required. Describing the lesion as a bony cavity, the operating surgeon could macroscopically exclude an chordom a (known to be soft consistency). The histological work-up classified this tumor-like lesion as a calcifying solitary bone cyst (CSBC). A dorsal exostosis causing the complaint of the patient was resected. The patient became asymptomatic. CONCLUSION: For the first time, a calcifying solitary bone cyst located in the sacrum is described, By sole resection of a dorsal exostosis causing the complaint, an overtreatment of grave consequences was avoided.

Adult↗