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PubMed1999

Pierre Cazenave and the first detailed modern description of lupus erythematosus.

OBJECTIVES: To provide an English translation of the first detailed description of lupus erythematosus along with a reproduction of the first color illustration of the disorder, as well as an interpretive analysis. METHODS: Review of primary and secondary historical sources. RESULTS: Although lupus as we know it was first mentioned in medieval times, the first, extensive, accurate classification and description of the condition represented an evolution of Pierre Cazenave's thinking over his 60-year professional career. CONCLUSIONS: Given his complete lack of effective diagnostic tools, Dr. Cazenave demonstrated tremendous intuitive powers of deduction in shaping our understanding of the disorder.

France↗

PubMed1999

Serum proteins by capillary zone electrophoresis: approaches to the definition of reference values.

The Paragon CZE 2000 (Beckman Analytical, Milan, Italy) is an automatic dedicated capillary zone electrophoresis (CZE) system, producing a five-zone serum protein pattern with quantitative estimation of the zones. With the view of substituting this instrument for two previously used serum protein electrophoresis techniques, we planned to produce reference values for the "new" systems leading to compatible interpretation of the results. High resolution cellulose acetate electrophoresis with visual inspection and descriptive reporting (HR-CAE) and five-zone cellulose acetate electrophoresis with densitometry (CAE-D) were the previously used techniques. Serum samples (n = 167) giving "normal pattern" with HR-CAE were assayed with the CZE system, and the results were statistically assessed to yield 0.95 reference intervals. One thousand normal and pathological serum samples were then assayed with the CAE-D and the CZE techniques, and the regression equations of the CAE-D values over the CZE values for the five zones were used to transform the CAE-D reference limits into the CZE reference limits. The two sets of reference values thereby produced were in good agreement with each other and also with reference values previously reported for the CZE system. Thus, reference values for the CZE techniques permit interpretation of results coherent with the previously used techniques and reporting modes.

Blood Proteins↗

PubMed2001

Combined M-FISH and CGH analysis allows comprehensive description of genetic alterations in neuroblastoma cell lines.

Cancer cell lines are essential gene discovery tools and have often served as models in genetic and functional studies of particular tumor types. One of the future challenges is comparison and interpretation of gene expression data with the available knowledge on the genomic abnormalities in these cell lines. In this context, accurate description of these genomic abnormalities is required. Here, we show that a combination of M-FISH with banding analysis, standard FISH, and CGH allowed a detailed description of the genetic alterations in 16 neuroblastoma cell lines. In total, 14 cryptic chromosome rearrangements were detected, including a balanced t(2;4)(p24.3;q34.3) translocation in cell line NBL-S, with the 2p24 breakpoint located at about 40 kb from MYCN. The chromosomal origin of 22 marker chromosomes and 41 cytogenetically undefined translocated segments was determined. Chromosome arm 2 short arm translocations were observed in six cell lines (38%) with and five (31%) without MYCN amplification, leading to partial chromosome arm 2p gain in all but one cell line and loss of material in the various partner chromosomes, including 1p and 11q. These 2p gains were often masked in the GGH profiles due to MYCN amplification. The commonly overrepresented region was chromosome segment 2pter-2p22, which contains the MYCN gene, and five out of eleven 2p breakpoints clustered to the interface of chromosome bands 2p16 and 2p21. In neuroblastoma cell line SJNB-12, with double minutes (dmins) but no MYCN amplification, the dmins were shown to be derived from 16q22-q23 sequences. The ATBF1 gene, an AT-binding transcription factor involved in normal neurogenesis and located at 16q22.2, was shown to be present in the amplicon. This is the first report describing the possible implication of ATBF1 in neuroblastoma cells. We conclude that a combined approach of M-FISH, cytogenetics, and CGH allowed a more complete and accurate description of the genetic alterations occurring in the investigated cell lines.

Chromosome Painting↗

PubMed2000

[A video-EEG description of non-epileptic paroxysmal seizures].

INTRODUCTION: Paroxystic disorders, especially of motor type, mean that sometimes interpretation and classification as epileptic or non-epileptic is difficult. In these cases a recording of the episodes synchronized with an EEG may help diagnosis. DEVELOPMENT: By means of digital EEG and video we have recorded various episodes similar to epileptic seizures, in which lack of correlation between the absence of paroxysms on the recording and the clinical anomalies is well seen, and therefore this investigation is more than justified. In some cases it has allowed medication to be stopped in patients who were being treated as though they were epileptics when in fact they were not. In others, such as a case of syncope with subsequent convulsions, we showed that on the EEG there was slowing followed by reduction in the amplitude representing cortical extinction, far from paroxystic hypersynchrony. Hypnagogic nocturnal episodes are differentiated from true myoclonic epilepsies. We have shown pseudo-seizures which were very similar to the automatisms of epileptic complex partial crises, without electrical changes apart from the extracerebral artefacts due to the patient's movements. CONCLUSION: In every patient in whom there is reasonable doubt as to whether the motor disorders are of cerebral origin or not, a long duration synchronized video-EEG is essential, done both whilst awake and asleep.

Child, Preschool↗

PubMed1978

The borderline patient. A comparative analysis of four sets of diagnostic criteria.

In reviewing the evidence for the validity of the diagnosis borderline, four descriptions in the literature seem to offer comprehensive criteria for the diagnosis. When the four are compared, a total of 104 criteria are enumerated encompassing the mental status, history, interpersonal relationships, defense mechansisms, and other judgments of personality functioning of the borderline patient. Half of these criteria are mentioned in only one of the four diagnostic descriptions. This apparent lack of agreement over diagnostic criteria has three possible interpretations: (1) the borderline concept is an illusion; or (2) the concept is adequately defined by those criteria held in common, the others being nonessential; or (3) apart from the concept defined by the common criteria, there are subtypes emphasized by different authors. Although we favor the third interpretation, it is suggested that further speculation await an adequate test of existing diagnostic criteria.

Diagnosis, Differential↗

PubMed1993

Personality patterns of male felons in a correctional halfway house setting: an MMPI typological analysis.

The MMPI profiles of 184 male felons who were residing in a correctional halfway house setting were cluster analyzed using S. Johnson's (1967) method to empirically identify different personality types. The samples ranged in age from 19 to 60 years and included three legal status groups: state parole, federal pre-release, and state furlough. Eight MMPI groups were derived and interpretive summaries provided. The eight types were compared across 13 demographic and descriptive variables with significant differences among groups found for age, prior felony convictions, and prior incarcerations using ANOVA. Diagnostic and treatment concerns were discussed.

Adult↗

PubMed1992

Postnatal development of the ipsilateral corticospinal component in rat spinal cord: a light and electron microscopic anterograde HRP study.

Most developmental and regeneration studies using the corticospinal tract (CST) as a model are focussed on its major contralateral component in the ventralmost part of the dorsal funiculus. However, for a correct interpretation of the data in these and future studies, a complete anatomical description of the rat CST, including its ipsilateral uncrossed component, is a prerequisite. In this study we used anterograde horseradish-peroxidase (HRP) tract-tracing at the light and electron microscopic level to describe the development of the uncrossed ipsilateral CST component. In the far caudal portions of the medulla oblongata, most of the CST fibers decussate dorsally and medially to assume positions in the ventralmost part of the dorsal funiculus. However, a small number of labeled fibers continue uncrossed in a position just lateral to the ventral median fissure. Labeled ipsilateral CST fibers caudally extend into the ventral funiculus of the third thoracic segment at postnatal day 1 (P1), into the seventh thoracic segment at P3, and into the first lumbar segment at P5 and P7. After the first postnatal week labeled ipsilateral CST fibers gradually disappear from upper lumbar, lower-, and mid-thoracic spinal cord levels, respectively. From P14 through adulthood the ipsilateral CST projection can not be visualized below upper thoracic spinal cord levels. Quantitative analysis of the amount of label along the length of the outgrowing ipsilateral CST revealed a characteristic staggered pattern of outgrowth: a small number of fibers take the lead and additional fibers are successively added. The outgrowth of labeled ipsilateral CST fibers is mainly restricted to spinal cord white matter. Occasionally a few outgrowing fibers into the adjacent cervical spinal gray can be observed, however, only between P3 and P7. Electron microscopic observations at the cervical enlargement (fifth cervical segment) demonstrate that the first labeled ipsilateral CST fibers, at P1, are characterized by the presence of growth cone-like enlargements at their distal endings. The process of myelination of labeled ipsilateral CST axons starts at about day P14. Although myelination seems to be largely completed at P28, labeled unmyelinated axons are still present in the adult ipsilateral CST component.

Animals↗

PubMed1999

A three-dimensional model of the mouse at embryonic day 9.

This paper describes a digital, three-dimensional model of the mouse embryo at E9. The model was made by reconstruction from images of serial histological sections digitally warped to remove distortions and has a resolution of approximately 9 microns. The model can be digitally resectioned in any plane to provide images which resemble conventional histological sections. The main tissues have been identified and delineated by digital painting so that the anatomical components can be visualized and manipulated in 3-D surface- and volume-rendered views. This provides a three-dimensional definition of anatomy that will provide a useful tool for interpreting and understanding spatial data in mouse embryos. The anatomy of the model is discussed where it provides landmarks for interpretation and navigation or where it is unexpected in light of existing descriptions of the E9 mouse embryo. The complete anatomy is not presented in this paper but will be available on CD-ROM. A detailed description of the technical aspects of the construction of the model is included in an appendix. The model is the first of a series that will form the basis for an atlas/database of mouse development. This reconstruction and its associated anatomy are available in a variety of data formats with some supporting software from http:@genex.hgu.mrc.ac.uk/.

Anatomy, Cross-Sectional↗

PubMed1999

Dead time-dependent line distortions in absolute-value electron spin echo envelope modulation spectra.

It is shown that in pulse EPR experiments, absolute-value spectra can be distorted because of the instrumental dead time to an extent that the interpretation of the spectral features becomes impossible. The mathematical background for the description of the distortions is given, and the far-reaching consequences of the effect are illustrated by model calculations. A cross-term averaging procedure is proposed to get rid of these distortions in two-, three-, and four-pulse electron spin echo envelope modulation experiments. The potential of cross-term averaging is demonstrated in two- and three-pulse experiments on a single crystal and a powder sample.

Electron Spin Resonance Spectroscopy↗

PubMed1992

Expert systems and expert behavior.

Iliad 4.0 and QMR 2.03 are computer-based diagnostic knowledge bases that can play many roles in decision support and other areas of medical practice, but neither appears ready to assume the role of an expert diagnostic consultant. In contrast to human experts, these programs have problems related to recognition of their own limitations, interpretation of continuous data, recognition of dependent findings, selection of tests, and description of the impact of certain tests. Suggestions to improve these aspects of knowledge bases are offered.

Artificial Intelligence↗

PubMed1992

Implicit and explicit constraints in inverse electrocardiography.

This paper reviews the major distributed source models that have been postulated over the years to support the interpretation of observed body surface potentials: double-layer models, the source description in terms of epicardial (ie, pericardial) potentials, and its equivalent: the distributed monolayer. This includes a presentation and discussion of a source model that has been developed over the past decade: the uniform double-layer model. The properties of this model are contrasted to those of other distributed source models from the perspective of their inherent capacity for imposing the constraints that are essential for regularizing the involved inverse problem.

Electrocardiography↗

PubMed1996

Kinetic model for phototransduction and G-protein enzyme cascade: understanding quantal bumps during inhibition of CaM-KII or PP2B.

We utilize a computer model derived directly from the phototransductive enzyme cascade involving rhodopsin (R), G-proteins (G) and ultimately the membrane channels. In photoreceptors, single photons activate single rhodopsin molecules (R*), resulting in the production of quantal bumps. A CaM-KII inhibitor may inhibit whereas calcineurin (PP2B) inhibitors may augment arrestin activity. Arrestin is known to inactivate R*. We voltage-clamped and digitized quantal bumps for comparison with the kinetic model and simulations. Inhibitors of CaM-KII and PP2B produce results consistent with altering arrestin activity. In sum, we have succeeded in constructing a mathematical description of the phototransduction cascade that is biochemically derived and useful in interpreting results.

Animals↗

PubMed2006

Ecology of the free-living stages of major trichostrongylid parasites of sheep.

Significant developments over recent decades make it timely to review the ecology of the major gastrointestinal nematode (GIN) species of sheep. These include the relentless development and spread of anthelmintic resistance in all of the major sheep production regions of the world, and the consequent drive towards integrated parasite management (IPM) systems incorporating non-chemotherapeutic strategies such as grazing management. The success of such programs is dependent on a detailed understanding of the environmental influences on the free-living stages of the nematode lifecycle. Major reviews of the subject were conducted prior to 1980, however considerable work has been completed since, including the development of mathematical models describing the epidemiology of GIN infection. Knowledge of the temperature thresholds for free-living development has also improved, while investigations of moisture influences and interactions with temperature have allowed more effective exploitation of environmental effects for IPM. This review re-evaluates our understanding of the factors that determine the success or failure of the free-living phases of the lifecycle in light of these developments. Temperature and moisture are the dominant influences on the free-living stages of Haemonchus contortus, Teladorsagia circumcincta and Trichostrongylus colubriformis, with the effects of pasture conditions playing a significant modulating role. Early in the free-living phase, the developmental success of the three GIN species is limited by susceptibility to cold temperatures. In general, H. contortus is most susceptible, followed by T. colubriformis and then T. circumcincta. The length of the development cycle is dependent largely on temperature, with development rate increasing at warmer temperatures. However, in order for development to proceed to the infective larval stage, addition of moisture is generally required. There has been considerably less work quantifying the effects of moisture on free-living development, although it is clear that H. contortus is most susceptible to desiccation during the pre-infective stages. Once the infective stage is reached, the influences of temperature and moisture on survival are less important, resulting in considerable survival times under conditions lethal to pre-infective stages. However, hot, dry conditions can be lethal for infective larvae of all three species, while extreme cold is also lethal with significant species variation. While the existing body of knowledge is substantial, the interpretation of many studies and comparison between them is complicated by inadequate description of, or variation in, the environmental measurements used. Confounding the effects of environmental variables on development to infective stage is the migration of larvae from the faeces and subsequent survival on pasture. There is a need to build on recent efforts to explore interaction between the effects of temperature and moisture, and also the trend to more closely simulate field conditions in laboratory studies. We propose a logical framework for future ecological investigations to overcome some of these problems, facilitate the development of a more integrated dataset on the subject and improve prediction of free-living development.

Animals↗

PubMed1992

Adeno-carcinoid or amphicrine tumors of the middle ear a new entity?

The clinicopathological, ultrastructural and immunohistochemical characteristics of four primary tumors of the middle ear are reported. These neoplasms showed a striking, heterogeneous aspect ranging from solid-trabecular (Type I) to tubulo-glandular (Type II) growth patterns. Secretory activity of the tumor cells was evaluated by immunohistochemistry and electron microscopy. Based on these procedures, three cell types were found, mainly limited to tumors with a tubulo-glandular (Type II) growth pattern. Most frequent were B-cells with an abundant pale cytoplasm containing neuroendocrine granules, both cytokeratin and vimentin as well as several endocrine marker substances. Less frequent were A-cells, which are slender, darkly staining and line the glandular lumina. They showed exocrine activity only and stained strongly with a polyclonal cytokeratin antibody. Finally, least frequent were amphicrine cells, which were characterized by both lumina and neuroendocrine granules in their cytoplasm and were interpreted as the link between A and B cells. Although this morphological description closely resembles that of carcinoids and adenocarcinoids of the respiratory tract and gut, the clinical behaviour of these middle ear tumors nevertheless seems different, with no recurrence or metastasis after a follow-up of 1 to 14 years (median 78 months). Therefore, some authors suggest that these tumors should be classified as middle ear adenomas or adenomatous tumors. However, we strongly feel that these tumours represent a distinct entity and can be classified as adenocarcinoids or amphicrine tumors, i.e. demonstrating both exocrine and endocrine activities. Further work is required to evaluate the exact proportion of neuroendocrine and amphicrine tumors in the heterogeneous group of adenomas and in the rarely described group of adenocarcinomas.

Adult↗

PubMed2002

Behavioral examinations of the level of auditory processing of speech context effects.

One of the central findings of speech perception is that identical acoustic signals can be perceived as different speech sounds depending on adjacent speech context. Although these phonetic context effects are ubiquitous in speech perception, their neural mechanisms remain largely unknown. The present work presents a review of recent data suggesting that spectral content of speech mediates phonetic context effects and argues that these effects are likely to be governed by general auditory processes. A descriptive framework known as spectral contrast is presented as a means of interpreting these findings. Finally, and most centrally, four behavioral experiments that begin to delineate the level of the auditory system at which interactions among stimulus components occur are described. Two of these experiments investigate the influence of diotic versus dichotic presentation upon two phonetic context effects. Results indicate that context effects remain even when context is presented to the ear contralateral to that of the target syllable. The other two experiments examine the time course of phonetic context effects by manipulating the silent interval between context and target syllables. These studies reveal that phonetic context effects persist for hundreds of milliseconds. Results are interpreted in terms of auditory mechanism with particular attention to the putative link between auditory enhancement and phonetic context effects.

Acoustic Stimulation↗

PubMed1998

Clinical anatomy of the normal pulmonary root compared with that in isolated pulmonary valvular stenosis.

OBJECTIVES: This study aimed to clarify the clinical anatomy of the pulmonary root. BACKGROUND: Many descriptions of valvular anatomy have focused on the annulus, leading to varied interpretations of abnormal valves. METHODS: Twenty-two heart specimens with isolated pulmonary valvular stenosis were examined to analyze the gross structure of the pulmonary root. For comparison, we examined a normal series of a similar age range together with nine adult hearts. Serial histologic sections were prepared from five specimens. RESULTS: The normal pulmonary valve is enclosed in a proximal sleeve of free-standing right ventricular infundibulum supporting the fibroelastic walls of the pulmonary sinuses at the anatomic ventriculoarterial junction. The valvular leaflets are attached in semilunar fashion across this junction, delimiting the extent of the valvular sinuses. The stenotic valves were separated into dome-shaped valves, dysplastic valves and a third group of less typical cases. In the dome-shaped valves, which had a relatively circular origin of their leaflets, three raphes were tethered to the arterial wall at the sinutubular junction, producing a waistlike narrowing. The leaflets of the dysplastic valves were attached in a relatively normal semilunar fashion, but stenosis was caused by thickening of the leaflets at their free edges. Serial histologic sections through normal and abnormal valves failed to demonstrate any well defined fibrous "annulus" that could be of clinical relevance. CONCLUSIONS: Unlike the normal and the dysplastic valves, the dome-shaped valves have circular rather than semilunar lines of attachment of the valvular leaflets. Liberation of the fused zones of apposition of the leaflets within the dome is unlikely to restore such abnormal valves to normal structure, even if this procedure relieves the stenosis.

Cadaver↗

PubMed2002

The use of complementary therapies among breast and prostate cancer patients in Finland.

This study describes the use of complementary therapies (CTs) among breast (women) and prostate cancer patients (men) in Finland. The data were collected using a self-administered postal questionnaire. Responses were received from 216 women (response rate 54.9%) and 190 men (response rate 55.4%). Data analysis was based on descriptive statistics, the chi-square test and Fisher and Wilcoxon tests. Interpretation of the responses to the open-ended questions used the method of content analysis. Half the respondents (women 53%, men 50%) were interested in CTs. Women (59%) had seriously considered using CTs significantly (P = 0.006) more often than men (44%). Among the women and men who had considered the option, CT use was not started because there was not enough scientific evidence (women 56%, men 77%) or because conventional treatments had worked well enough (women 45%, men 70%). Almost one-third of all women (30%) and men (28%) either continued to use or started using CTs after they had fallen ill with cancer. They resorted to CTs in order to restore their hope in the future (women 36%, men 36%) and to do as much as they could for themselves (women 46%, men 29%). The results indicate that cancer patients are interested in CTs and use them quite frequently. This presents a major challenge to official health care: how should cancer patients be supported in the care relationship to make an informed decision about using CTs; what kind of advice should they be given; and how can patients' individual requirements be adequately met in nursing care?

Adult↗

PubMed1999

Collecting data in the operating department: issues in observational methodology.

The UK literature contains few references to nursing in the operating department and even fewer to methods for researching nursing in what is often a complex and stressful environment. Nursing staff work under intense pressure and this presents a challenge, not only for nurses who work in the operating department, but also for researchers who choose to study nursing within its bounds. This paper focuses on some of the key issues which emerged during one study of nursing in the operating department where an observational methodology was used. The author suggests that observation, as a research method, is an important feature of contextual investigation. However, like other methods of investigation, it requires careful planning and preparation. Furthermore, the author believes that sensitivity and skill are required for the enactment of the observer role when researching nursing within this specialized environment.

Data Collection↗